Common Types

1. Inguinal Hernia

• Presentation: Groin lump
• Risk factors:
  • Heavy lifting
  • Chronic cough
  • Constipation
  • Urinary incontinence
  • Previous abdominal surgery
• Types:
  • Direct: Through abdominal wall defect (elderly)
  • Indirect: 80% of cases, follow spermatic/round ligament
• Assessment:
  • Examine standing
  • Look for a bulge above the inguinal ligament
  • Check cough impulse and reducibility
• Management:
  • Small asymptomatic: Often, no treatment is needed
  • Larger/symptomatic: Consider surgical referral
  • Truss: For the elderly unfit for surgery (FP10)

2. Femoral Hernia

• Higher strangulation risk
• Presents: Painful groin lump ± bowel obstruction
• Management:
  • Urgent surgical referral
  • Emergency admission if complicated

3. Incisional Hernia

• Post-surgical muscle closure defect
• Features:
  • Visible on standing
  • Prominent with cough/straight leg raise
• Management:
  • Usually, reassurance is sufficient
  • Refer if strangulated/symptomatic

4. Umbilical/Paraumbilical Hernia

• Common in infants
• Adult presentation:
  • Periumbilical bulge
  • Due to Linea Alba’s weakness
• Management:
  • Refer adults (high strangulation risk)
  • Emergency admission if complicated

5. Epigastric Hernia

• Midline defect above the umbilicus
• Usually asymptomatic
• May present with:
  • Epigastric pain
  • Vomiting
• Management: Surgical referral if symptomatic

Hernia’s Reference