Causes of intra-abdominal hernia

I believe that everyone is relatively unfamiliar with the symptoms of intra-abdominal hernia, but if we accidentally suffer from intra-abdominal hernia, we should understand what intra-abdominal hernia is and the causes of intra-abdominal hernia. We should know how to avoid the causes of intra-abdominal hernia and do a good job in the treatment and care of intra-abdominal hernia. So what exactly is the cause of intra-abdominal hernia? Let’s take a look at the introduction to the causes of intra-abdominal hernia below.

The occurrence of intra-abdominal hernia is related to many factors, which brings difficulties to our treatment of intra-abdominal hernia. We divide intra-abdominal hernia into two types, one is primary intra-abdominal hernia, and the other is secondary intra-abdominal hernia.

Due to the existence of pores in the abdominal cavity, a hernia ring can be formed, which is the basis for the formation of internal abdominal hernia. There are two types of hernial ring openings in intra-abdominal hernias: primary and secondary.

1. Primary intra-abdominal hernia

Caused by congenital intra-abdominal holes. During embryonic development, when the intestine is transposed, gaps remain between the mesentery and the posterior peritoneal wall, rotation is abnormal and the colon is poorly fixed. Congenital hiats may occur in the mesentery of free intestinal segments such as the small intestine, mobile ascending colon, transverse colon and sigmoid colon, forming a hernia ring of internal hernia. The normal retroperitoneum has several recesses, but they are generally shallow and small and will not cause internal hernia. If the peritoneal recess is too deep, the intestinal tube will not be able to reposition itself after entering, which may lead to the formation of a recessive hernia.

(1) Diaphragmatic hernia and hiatal hernia

Diaphragmatic hernia is when abdominal organs such as the stomach or transverse colon protrude into the chest cavity through a congenital defect in the diaphragm. In addition to gastrointestinal obstruction, this type of diaphragmatic hernia is often accompanied by symptoms of compression of intrathoracic organs such as the heart and lungs. Hiatal hernia is a common type of diaphragmatic hernia.

(2) Omental foramen hernia

A free loop of small intestine, occasionally the transverse colon with excessive mesentery, can sometimes pass through the omental foramen into the lesser omental sac, which is called omental foramen hernia. Because the anterior wall of the hernia sac is the hepatoduodenal ligament, strangulation will occur in most cases.

(3) Peritoneal recess hernia

If the peritoneal recess is too deep, an intestinal tube may be inserted, but it may not reposition on its own and may form a recess hernia. Such as the paraduodenal fossa, mesenteric abdominal wall fossa, inter-mesocolic fossa, ileocecal fossa, retrocecal fossa, retrosigmoid fossa, and para-bladder fossa around the duodenal jejunal flexure.

(4) Mesenteric hiatal hernia

The small intestinal mesentery sometimes has congenital defects or holes, and the transverse colon mesentery occasionally has defects, and small intestinal loops can pass through this hole and cause obstruction or incarceration.

2. Secondary intra-abdominal hernia

It refers to the intra-abdominal hernia formed after surgery or trauma. In addition to traumatic diaphragmatic hernia, the common ones are as follows:

(1) Porosity caused by subtotal gastrectomy

The presence of a post-anastomotic gap after Billroth II or gastrojejunostomy may be the cause of intra-abdominal hernia. Especially when performing anterior colon anastomosis, if the input jejunal loop is too long and the gap between the jejunal mesocolon and the transverse colon mesocolon is not sutured, internal hernia may sometimes form due to the output loop or intestinal tract passing through this gap. An excessively long input loop may form a larger post-anastomotic gap, which is an important cause of internal hernia.

(2) Porosity caused by radical surgery for rectal cancer

After abdominoperineal resection for rectal cancer, two holes may be formed in the abdominal cavity. One is that a gap may be formed between the intestinal tube dragged to the abdominal wall stoma and the left abdominal wall. If it is not sutured during the operation and abdominal distension occurs after the operation, the small intestine may herniate into the side of the stoma intestinal tube and cause internal hernia. The other hole is caused by improper suturing of the pelvic floor peritoneum, or postoperative abdominal distension causes the pelvic floor peritoneum to rupture into a gap, allowing the intestine to enter and form an internal hernia.

(3) Porosity caused by biliary surgery and biliary intestinal drainage

After T-tube drainage of the common bile duct or catheter fistula creation in the gastrointestinal tract, if the catheter is not placed properly, the intestinal loops may also drill into the gap between these drainage tubes and the lateral abdominal wall, forming an internal hernia.

In the above article, we introduced what is intra-abdominal hernia. We know that the appearance of this symptom brings serious physical harm to the patient, so we need to understand the cause of intra-abdominal hernia. There are many causes of intra-abdominal hernia. The above article analyzes in detail the causes of primary intra-abdominal hernia and secondary intra-abdominal hernia.