Lateral Hernias of the Abdominal Wall
What are Lateral Abdominal Wall Hernias?
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Lateral hernias of the abdominal wall are rare, occurring in less than 1% of the adult population. Depending on their location, they appear on both sides and a little below the navel or very lateral to it. They have different names such as: Spiegel's hernia, Grynfeltt's hernia, Petit's hernia or lumbar hernias.
The causes of its appearance are due to congenital, traumatic reasons, due to previous surgeries in some lateral area of ​​the abdomen, due to some type of injury to the lateral nerves of the thorax or abdomen, due to extreme obesity or weakness of the lateral muscles of the abdomen.
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Symptoms of lateral abdominal wall hernias
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The symptoms of lateral hernias of the abdominal wall are the presence of a mass or increase in volume somewhere in this part of the abdomen that is occasionally associated with mild pain that is increased by some efforts or unusual body positions.
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Diagnosis
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The diagnosis of lateral hernias of the abdominal wall is made by the hernia specialist surgeon through a detailed physical examination assisted with ultrasound, X-rays, tomography, magnetic resonance imaging or electromyography, as the case warrants.
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Treatment
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The treatment of lateral abdominal wall hernias is surgical and should be done as soon as they are identified since they always grow over time and the possibility of complications increases day by day.
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The complications of lateral abdominal wall hernias are:
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a) Progressive increase in volume, reaching large dimensions that determine notable asymmetries of the abdomen that can cause back pain or even alter the way you walk.
b) Imprisonment, when some structure or organ of the abdomen protrudes or "comes out" through the hernia orifice and is definitively established without being able to return to its place through external maneuvers. This complication can cause intestinal obstruction and / or pain if it is the intestine that has "come out" through the orifice of the hernia.
c) Strangulation, when these mentioned structures are "hanged" by the hernia orifice causing them lack of circulation and the consequent death of the trapped organ; if it is the intestine, it can be perforated and produce peritonitis.
The treatment of lateral hernias of the abdominal wall is always surgical, with open techniques being the most used with or without application of plastic meshes (prostheses), according to the criteria of the hernia specialist surgeon. Laparoscopic techniques (minimally invasive surgery or "laser surgery") can also be performed with the application of mesh in an internal position. Both techniques have very good results as they reduce postoperative pain, disability time, the use of analgesics and the possibility of a recurrence of the hernia in the future. It is widely recognized that the treatment of lateral abdominal hernias should be performed by the hernia surgeon.
The risks of these surgeries are minimal as well as the possibility of postoperative complications, although it is often necessary to install surgical drains inside the abdominal wall that will remain in place for one to five days.
Recovery from surgery for lateral abdominal hernias takes one to three days of hospital stay and 15 to 20 days of relative rest, requiring constant abdominal bandaging for up to two to three months. You can return to work after 21 days, if it is low activity.
It is up to the hernia surgeon to decide which procedure is best for each patient.
