Symptoms and causes

What is it?

An incisional hernia or a hernia cicatricalis is a bulge of the peritoneum in a weak spot in a scar from a previous abdominal operation.

Even though an incision from an abdominal surgery may be closed correctly, a significant number of patients develop a hernia in the incision over time. There are many determining risk factors, such as obesity, smoking behaviour, inflammation and infection of the wound. But an incisional hernia can occur also without risk factors. Even at the site of the small incision for a keyhole surgery, scar fractures (trocar hernia) can occur.

Does every scar rupture need to be treated?

Absolutely not! Many incisional herniae cause little or no symptoms. Many people have a small incisional hernia but are unaware of this. On the other hand, some people with a painful and growing incisional hernia do not get help because they are afraid of surgery. Consequently, certain people do report to us who have very large incisional herniae.

An incisional hernia that is very painful, swollen and cannot be pushed away is a matter of urgency. After all, this so-called ‘strangulated incisional herniea’ may contain intestinal structures that can die off because the blood supply is interrupted. These patients must proceed to the A&E immediately. And, if the umbilical hernia cannot be pushed back there either, urgent surgery will be required. An incisional hernia, however, is rather rare and more than 90% of patients are operated on in non-urgent conditions.

Treatment

Read more about the different treatments: Incisional hernia repair

Treatment centres and specialisations

Hernia Centre

Latest publication date: 21/01/2021