Incisional Hernia

What is an incisional hernia?

An incisional hernia is one that happens through a previous incision or scar in your abdominal wall from a previous abdominal operation you had undergone. It is rather common of between 12 to 15 per cent of abdominal operations leading to incisional hernia.

The incision had been made by a surgeon to reach an internal organ in your body such as an appendix or a caesarian section. After the operation, the surgeon would have had stitched together the layers of your abdominal wall. In cases where the stitches fail to heal properly or comes apart with time, this results in an incisional hernia. A partial segment of your organ, muscle or tissue may protrude through the open and weakened surgical opening and place pressure under your surgical scar. This causes pain, swelling or fever and is known as an incisional hernia.

While an incisional hernia can can develop or get larger a few months or years after surgery, most cases happen within three to six months post-surgery, where your incision is the weakest.

What causes it?

An incisional hernia may be caused by an infection, poor wound care, improper surgical techniques and other factors that interfere with the healing of your surgical wound or a past surgical wound.

You would be at a higher risk if you

  • Have had a wound infection after surgery or more than one surgery through the same incision
  • Are overweight or obese
  • Have gained a significant amount of weight after surgery
  • Are older
  • Are pregnant
  • Participate in strenuous exercise such as heavy lifting
  • Have frequent cough or sneezing which places internal pressure on your organs
  • Overstrain during bowel movement

What are the symptoms of an incisional hernia?

Common signs and symptoms of an incisional hernia include:

  • Fever and aching
  • Pain and swelling
  • Infection which may be indicated by redness
  • Bulging (lump on surgical scar)
  • Visible protrusion (internal segment coming out of surgical wound)
  • In emergency medical conditions:
  • Severe and persistent abdominal discomfort and pain
  • Difficulty in passing gas or bowel movement (strangulation of intestines)

How is it diagnosed?

During a consultation session, your doctor will be able to diagnose an incisional hernia during a physical examination. Hernia becomes noticeable only when you perform activities that place extra pressure on your abdomen. You may be asked to cough or strain so that your doctor can observe if the hernia bulges out.

Should you need further tests to screen for complications, you may be scheduled for an X-ray, abdominal ultrasound or blood tests.

Why surgery to treat an incisional hernia?

In rare cases where the incisional is small enough, surgery is an option. However, if you leave an incisional hernia as it is, it will almost certainly grow larger. It will likely become increasingly unsightly and cause greater discomfort. Thus surgery is highly recommended.

As with other types of hernias, severe cases may cause the hernia contents (the intestines) to get trapped and interfere with blood supply. This is known as strangulation and poses a serious health threat as blood flow to organs, muscle and tissue is restricted which may cause permanent damage to these components.

Surgery is used as the primary mode of treatment to repair your incisional hernia.

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