Internal Hernia · What Is It, Rupture, Causes, Symptoms, Diagnosis, Treatment, and More

An internal hernia refers to the protrusion of internal organs through a weak abdominal tissue wall. Internal hernias most commonly involve the intestinal bowel loops and cannot be visualized externally. External hernias, in contrast, can be seen on the outside of the body, often as a bulge under the skin.

There are eight main types of internal hernias, categorized depending on where the hernia occurs. These include paraduodenal hernias: a congenital disorder resulting in herniation near the first part of the small intestine (e.g. duodenum); foramen of Winslow hernia: the movement of the intestines into a channel that divides two parts of the abdomen; pericecal hernia: a defect in a tissue attached to the large intestine; sigmoid-mesocolon hernia: herniation through tissue attached to the last portion of the large intestine; transmesenteric hernia: a hernia impacting layers of tissue in the abdomen; transomental hernia: a hernia affecting the tissue covering abdominal organs; and supravesical and pelvic hernias: hernias that most commonly involve the tissue that attaches the uterus to the pelvis.

Internal hernias can occur when there is a weakness in a tissue wall that allows internal contents to push up against it and create a bulge in the lining. This weakness can occasionally be due to birth defects that impact the abdominal wall, causing an individual to be more prone to developing an internal hernia. Additionally, internal hernias can be acquired after trauma, inflammation, or surgery to the abdomen. Surgeries that may result in an internal hernia include liver transplants and gastric bypass surgery (a weight loss procedure that creates a small pouch within the stomach).

In addition, raised intra-abdominal pressure can increase the risk of developing an internal hernia. Circumstances that raise the pressure inside of the abdominal cavity include pregnancy, chronic cough, fluid buildup, heavy lifting, and straining while defecating.

In order to diagnose an internal hernia a thorough medical history and physical examination will likely be performed. Since internal hernias are not visible externally, they may require imaging studies in order to be visualized. Computerized tomography (CT) scans are frequently used to diagnose an internal hernia, but an X-ray can also be used when a CT scan is unavailable. In some cases, a laparoscopy, which is a minimally invasive surgical procedure, may be required to determine the severity of the hernia.