Abdominal wall hernia: groin, umbilical and incisional

What is a hernia?

A hernia is a bulge from the abdominal cavity through a weak spot or an opening in the abdominal wall. It usually shows up as a lump that becomes clearer when you stand, cough or strain. Some people feel burning or pressure before the lump is visible.

Hernias appear most often in the groin, around the navel and in old surgical scars. 1

The three common types

Type	Location	Read more
Groin hernia	In the groin, sometimes towards the thigh or scrotum	Groin hernia
Umbilical hernia	In or just above the navel	Umbilical hernia
Incisional hernia	In a scar from earlier abdominal surgery	Incisional hernia

Hernias can also occur in the flank and other places, but that is less common. 1

Typical symptoms

• A lump that appears on exertion and can often be pushed back in.
• Pressure, burning or a feeling of heaviness.
• Discomfort when lifting, coughing, straining or standing for long periods.
• Cosmetic concerns, which for some matter more than the discomfort.

Many hernias cause few or no symptoms. 1

Examination

The diagnosis is usually made by a clinical examination, where the doctor looks at and feels the area while you stand and cough. Imaging is rarely needed for an obvious hernia. With unclear findings, large abdominal wall hernias or when surgery has to be planned, CT or ultrasound may be relevant. 2

Does every hernia need surgery?

No. A hernia does not disappear on its own, but a small hernia without symptoms can often simply be watched. Whether surgery is the right route depends on symptoms, the type and size of the hernia, your general health and how much it affects daily life. Women with a groin hernia should always be assessed by a surgeon, because femoral hernias somewhat more often become trapped. 1

Contact the clinic to clarify whether your referral belongs here.

Urgent signs: incarceration

Seek help immediately if:

• the lump suddenly becomes hard, very tender and cannot be pushed back
• the pain increases quickly
• you vomit or cannot pass gas or stool
• you develop a fever or feel generally unwell.

This may mean bowel is trapped, and it needs urgent assessment. Call 112 if you are severely affected. Otherwise call 1813 in the Capital Region or your local out-of-hours doctor the same day. Email is not an emergency channel. 1

What you can do yourself

• Avoid constipation and hard straining. See constipation.
• Lift sensibly, especially heavy and repeated lifting.
• Stopping smoking and losing weight improve healing if you later have abdominal wall surgery.
• Keep an eye on whether the hernia grows or causes more symptoms.

Sources

• Hernia, Patienthåndbogen at sundhed.dk
• Ventral hernia, Lægehåndbogen at sundhed.dk