Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

	Hernia Landing page
Patient Information
Classification Inguinal hernia Femoral hernia Umbilical hernia Diaphragmatic hernia Incisional hernia Others
Differential Diagnosis
CNS Hernia Brain Hernia Lumbar Disc Hernia
Diaphragmatic Hernia Bochdalek Hernia Morgagni Hernia
Hiatal Hernia Sliding Hernia Paraesophageal Hernias
Lumbar Hernia Petit's Hernia Grynfeltt's Hernia
Abdominal Hernia Umbilical Hernia Epigastric Hernia Spigelian Hernia Incisional Hernia Amyand's Hernia Richter's Hernia Parastomal Hernia
Pelvic Hernia Inguinal Hernia Obturator Hernia Perineal Hernia Incisional Hernia Femoral Hernia Sciatic Hernia

A hernia is “the protrusion of an organ, organic part, or other bodily structure through the wall that usually contains it.”^[1] Hernias may be congenital or acquired. Based on the protruded body structure and the location of the protrusion, the hernia may be classified into inguinal, femoral, umbilical, diaphragmatic, incisional, and other hernias. Different kinds of hernias, such as central nervous system (CNS), diaphragmatic, lumbar, abdominal, and pelvic hernias have to be differentiated on the basis of clinical manifestations.

Classification

Major classification of hernias in human body.

Hernia

CNS

Hiatal

Diaphragmatic

Lumbar

Abdominal

Pelvic

Paraesophageal hernia

Differential Diagnosis

Different kinds of hernias, such as central nervous system (CNS), diaphragmatic, lumbar, abdominal, and pelvic hernias have to be differentiated upon various history, symptoms, and physical examination findings.

Location	Diseases	History and Symptoms						Physical Examination				Laboratory Findings			Definition
		Neurological		GI				Neurological		GI		Laboratory Findings
		Confusion	Paresthesia	Dysphagia	Heartburn	Nausea	Bowel habits	Loss of Consciousness	Straight leg raise (SLR)	Mass protrusion	Tenderness/Rebound tenderness	Leukocytosis	CRP	ESR
CNS	Brain hernia^[2]	+	+	+	-	+	-	+	-	-	-	-	-	-	Brain tissue herniation through foramen magnum
CNS	Lumbar disc hernia^[3]	-	+	-	-	-	-	-	+	-	-	-	-	-	Nucleus pulposus herniation through annulus fibrosus
Hiatal^[4]	Sliding hernia	-	-	+	+	+	-	-	-	-	-	-	+	-	Stomach herniation through diaphragm
Hiatal^[4]	Paraesophageal hernia	-	-	+	+	+	-	-	-	-	-	-	-	-	Esophagus herniation through diaphragm
Diaphragmatic^[5]	Morgagni hernia	-	-	+	-	+	-	-	-	-	-	-	-	-	Congenital herniation of stomach through left side of diaphragm
Diaphragmatic^[5]	Bochdalek hernia	-	-	+	-	+	-	-	-	-	-	-	-	-	Congenital herniation of stomach through right anterior side of diaphragm
Abdominal	Umbilical hernia^[6]	-	-	-	-	+	+	-	-	+	+	+	+	-	Bowels herniation through umbilicus
	Epigastric hernia^[7]	-	-	-	+	+	+	-	-	+	+	+	+	-	Bowels herniation through epigastric abdominal wall
	Spigelian hernia^[8]	-	-	-	-	+	+	-	-	+	+	+	+	-	Bowels herniation through lateral abdominal wall
	Amyand's hernia^[9]	-	-	-	-	+	+	-	-	+	+	+	+	-	Appendix vermiformis herniation through abdominal wall
	Littre's hernia^[10]	-	-	-	-	+	+	-	-	+	+	+	+	-	Meckel's diverticulum herniation through abdominal wall
	Richter's hernia^[11]	-	-	-	-	+	+	-	-	+	+	+	+	+	Bowels herniation and strangulation through abdominal wall
	Parastomal hernia^[12]	-	-	-	-	+	+	-	-	+	+	+	+	+	Bowels herniation through stoma in the abdominal wall
Pelvic	Inguinal hernia^[13]	-	-	-	-	-	+	-	-	+	+	-	-	-	Bowels herniation through inguinal ring
	Obturator hernia^[14]	-	+	-	-	-	+	-	-	-	+	-	-	-	Viscera herniation through obturator canal
	Perineal hernia^[15]	-	-	-	-	-	+	-	-	+	+	+	-	-	Viscera herniation through pelvic floor
	Femoral hernia^[16]	-	+	-	-	-	+	-	-	+	+	-	-	-	Bowels herniation through femoral ring
	Sciatic hernia^[17]	-	+	-	-	-	+	-	+	-	+	+	-	+	Viscera herniation through sciatic canal

References

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↑ Webster's new college dictionary. Boston: Houghton Mifflin Harcourt. 2008. p. 531. ISBN 9780618396016.
↑ Fisher CM (1995). "Brain herniation: a revision of classical concepts". Can J Neurol Sci. 22 (2): 83–91. PMID 7627921.
↑ Schoenfeld AJ, Weiner BK (2010). "Treatment of lumbar disc herniation: Evidence-based practice". Int J Gen Med. 3: 209–14. PMC 2915533. PMID 20689695.
↑ Hyun JJ, Bak YT (2011). "Clinical significance of hiatal hernia". Gut Liver. 5 (3): 267–77. doi:10.5009/gnl.2011.5.3.267. PMC 3166665. PMID 21927653.
↑ "Congenital Diaphragmatic Hernia Overview - GeneReviews® - NCBI Bookshelf".
↑ Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003). "Laparoscopic versus open umbilical hernia repair". JSLS. 7 (4): 323–8. PMC 3021337. PMID 14626398.
↑ Muschaweck U (2003). "Umbilical and epigastric hernia repair". Surg. Clin. North Am. 83 (5): 1207–21. doi:10.1016/S0039-6109(03)00119-1. PMID 14533911.
↑ Mittal T, Kumar V, Khullar R, Sharma A, Soni V, Baijal M; et al. (2008). "[Not Available]". J Minim Access Surg. 4 (4): 95–8. PMC 2699222. PMID 19547696.
↑ Singal R, Gupta S (2011). ""Amyand's Hernia" - Pathophysiology, Role of Investigations and Treatment". Maedica (Buchar). 6 (4): 321–7. PMC 3391951. PMID 22879848.
↑ Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P (2006). "Littre hernia: surgical anatomy, embryology, and technique of repair". Am Surg. 72 (3): 238–43. PMID 16553126.
↑ Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P (2006). "Richter hernia: surgical anatomy and technique of repair". Am Surg. 72 (2): 180–4. PMID 16536253.
↑ Gillern S, Bleier JI (2014). "Parastomal hernia repair and reinforcement: the role of biologic and synthetic materials". Clin Colon Rectal Surg. 27 (4): 162–71. doi:10.1055/s-0034-1394090. PMC 4226750. PMID 25435825.
↑ Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.
↑ Nakayama T, Kobayashi S, Shiraishi K, Nishiumi T, Mori S, Isobe K, Furuta Y (2002). "Diagnosis and treatment of obturator hernia". Keio J Med. 51 (3): 129–32. PMID 12371643.
↑ Levic K, Rosen KV, Bulut O, Bisgaard T (2017). "Low incidence of perineal hernia repair after abdominoperineal resection for rectal cancer". Dan Med J. 64 (7). PMID 28673377.
↑ LUDINGTON LG (1958). "Femoral hernia and its management, with particular reference to its occurrence following inguinal herniorrhaphy". Ann Surg. 148 (5): 823–6. PMC 1450902. PMID 13595543.
↑ Kandpal H, Madhusudhan KS (2010). "Sciatic hernia causing sciatica: MRI and MR neurography showing entrapment of sciatic nerve". Br J Radiol. 83 (987): e65–6. doi:10.1259/bjr/47866965. PMC 3473559. PMID 20197431.

[1] Webster's new college dictionary. Boston: Houghton Mifflin Harcourt. 2008. p. 531. ISBN 9780618396016.

[pmid7627921-2] Fisher CM (1995). "Brain herniation: a revision of classical concepts". Can J Neurol Sci. 22 (2): 83–91. PMID 7627921.

[pmid20689695-3] Schoenfeld AJ, Weiner BK (2010). "Treatment of lumbar disc herniation: Evidence-based practice". Int J Gen Med. 3: 209–14. PMC 2915533. PMID 20689695.

[pmid21927653-4] Hyun JJ, Bak YT (2011). "Clinical significance of hiatal hernia". Gut Liver. 5 (3): 267–77. doi:10.5009/gnl.2011.5.3.267. PMC 3166665. PMID 21927653.

[urlCongenital_Diaphragmatic_Hernia_Overview_-_GeneReviews®_-_NCBI_Bookshelf-5] "Congenital Diaphragmatic Hernia Overview - GeneReviews® - NCBI Bookshelf".

[pmid14626398-6] Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003). "Laparoscopic versus open umbilical hernia repair". JSLS. 7 (4): 323–8. PMC 3021337. PMID 14626398.

[pmid14533911-7] Muschaweck U (2003). "Umbilical and epigastric hernia repair". Surg. Clin. North Am. 83 (5): 1207–21. doi:10.1016/S0039-6109(03)00119-1. PMID 14533911.

[pmid19547696-8] Mittal T, Kumar V, Khullar R, Sharma A, Soni V, Baijal M; et al. (2008). "[Not Available]". J Minim Access Surg. 4 (4): 95–8. PMC 2699222. PMID 19547696.

[pmid22879848-9] Singal R, Gupta S (2011). ""Amyand's Hernia" - Pathophysiology, Role of Investigations and Treatment". Maedica (Buchar). 6 (4): 321–7. PMC 3391951. PMID 22879848.

[pmid16553126-10] Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P (2006). "Littre hernia: surgical anatomy, embryology, and technique of repair". Am Surg. 72 (3): 238–43. PMID 16553126.

[pmid16536253-11] Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P (2006). "Richter hernia: surgical anatomy and technique of repair". Am Surg. 72 (2): 180–4. PMID 16536253.

[pmid25435825-12] Gillern S, Bleier JI (2014). "Parastomal hernia repair and reinforcement: the role of biologic and synthetic materials". Clin Colon Rectal Surg. 27 (4): 162–71. doi:10.1055/s-0034-1394090. PMC 4226750. PMID 25435825.

[pmid18244999-13] Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.

[pmid12371643-14] Nakayama T, Kobayashi S, Shiraishi K, Nishiumi T, Mori S, Isobe K, Furuta Y (2002). "Diagnosis and treatment of obturator hernia". Keio J Med. 51 (3): 129–32. PMID 12371643.

[pmid28673377-15] Levic K, Rosen KV, Bulut O, Bisgaard T (2017). "Low incidence of perineal hernia repair after abdominoperineal resection for rectal cancer". Dan Med J. 64 (7). PMID 28673377.

[pmid13595543-16] LUDINGTON LG (1958). "Femoral hernia and its management, with particular reference to its occurrence following inguinal herniorrhaphy". Ann Surg. 148 (5): 823–6. PMC 1450902. PMID 13595543.

[pmid20197431-17] Kandpal H, Madhusudhan KS (2010). "Sciatic hernia causing sciatica: MRI and MR neurography showing entrapment of sciatic nerve". Br J Radiol. 83 (987): e65–6. doi:10.1259/bjr/47866965. PMC 3473559. PMID 20197431.

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Hernia

Overview

Classification

Major classification of hernias in human body.

Differential Diagnosis

References

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