Epigastric hernias arise above umbilicus and below xiphoid process
Hypogastric hernias arise below umbilicus
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Incisional hernias develop at prior abdominal wall incision
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CT: Most accurate test for detection of ventral hernias
Defect in musculofascial layers of abdominal wall through which omentum ± bowel protrude anteriorly
PATHOLOGY
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Depending on hernia type, ventral hernias may be due to either acquired or congenital factors
Incisional hernias: Acquired hernias at the site of prior surgery, incision, or abdominal wall injury
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May be related to previous abdominal surgery, laparoscopy, peritoneal dialysis, or stab wound
Epigastric and hypogastric hernias: Possible congenital predisposition due to weakness of linea alba
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Acquired risk factors include obesity, increased intraabdominal pressures, and abdominal wall strains
CLINICAL ISSUES
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Incisional hernias usually occur during first 4 months after surgery, but can develop many years later
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Ventral hernias do not close spontaneously and almost always enlarge over time
Related
Diagnostic Imaging_ Gastrointes - Michael P Federle
