What is an inguinal hernia?

Inguinal hernia is a common condition that consists of part of the abdominal viscera coming out of the abdominal cavity. We explain why it occurs and how it is corrected.

The inguinal hernia consists of the exit of part of the abdominal viscera outside through holes in the abdominal wall. Our abdomen has in its interior viscera covered with a thin and lubricated layer of peritoneum, which allows the intestinal movements of the digestion. Usually, the interior of the abdomen has positive pressure.

That is, its content presses the walls outwards so that the viscera or the peritoneum can use any small opening to exit through it. This can cause discomfort and, if it is allowed to progress, it can cause a lack of blood risk and a heart attack in the area.

It is a very common pathology, and its only treatment is surgery. It is the most common surgical disease globally, and approximately 20,000,000 inguinal hernias are operated on each year. Men mainly suffer it; in women, it is less frequent because their groin anatomy is different. Another type of hernia related to the thigh, the femoral hernia, is more common in their case.

It can also appear in children. 5 out of 100 children develop inguinal hernias and have to be operated on. The incidence of inguinal hernia increases in boys with cystic fibrosis or developmental disorders of the testes such as cryptorchidism (lift testicle), hydrocele, or varicocele.

Its diagnosis is very simple since a good physical examination is sufficient, and complementary tests are very rarely required. Surgery is also simple if the inguinal hernia does not have serious alterations, so much so that it can often be performed on an outpatient basis without requiring admission to the hospital. The prognosis of those affected by this problem is very good since complications after treatment are minimal.

Causes of inguinal hernia

Although it can be considered that the common denominator of this problem is a weakness of the abdominal wall at the groin level, some more specific causes of inguinal hernia can be recognized, such as:

  • Congenital: they are usually the cause of hernias in childhood due to the persistence of a peritoneum-vaginal duct, which does not properly form the muscular wall at that level at the end of fetal development.
  • Increased abdominal pressure: this situation can occur more or less abruptly, for example, with a significant effort, such as some extreme physical exercise (weightlifting, weight lifters) or any professional activity that involves loading or lifting. Lifting of heavy material. But it can also occur due to small repeated increases in pressure, as occurs in respiratory diseases that cause chronic cough ( COPD, asthma ), also in individuals with constipation, which require abdominal efforts, or patients with prostatic symptoms who need to perform a push to achieve the emptying of the bladder at each urination. In this sense, it can also include other situations that cause an increase in abdominal pressure, perhaps smaller but maintained over time, such as pregnancy, or people with ascites (abdominal fluid secondary to liver diseases), and obesity.
  • The abdominal wall’s constitutional weakness: some individuals constitutionally present lower muscle tone in the area called Hesselbach’s triangle, whose limits are formed by the anterior rectus muscle and the inguinal ligament. This is where the abdominal content can appear over time, forming the hernia.