Ventral Hernia

Published on 06/08/2015 by admin

Filed under Radiology

Last modified 06/08/2015

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 Epigastric hernias arise above umbilicus and below xiphoid process

image Hypogastric hernias arise below umbilicus
• Incisional hernias develop at prior abdominal wall incision
• CT: Most accurate test for detection of ventral hernias

image Defect in musculofascial layers of abdominal wall through which omentum ± bowel protrude anteriorly

PATHOLOGY

• Depending on hernia type, ventral hernias may be due to either acquired or congenital factors

image Incisional hernias: Acquired hernias at the site of prior surgery, incision, or abdominal wall injury

– May be related to previous abdominal surgery, laparoscopy, peritoneal dialysis, or stab wound
image Epigastric and hypogastric hernias: Possible congenital predisposition due to weakness of linea alba

– Acquired risk factors include obesity, increased intraabdominal pressures, and abdominal wall strains

CLINICAL ISSUES

• Incisional hernias usually occur during first 4 months after surgery, but can develop many years later
• Ventral hernias do not close spontaneously and almost always enlarge over time
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