An internal hernia occurs when some of your internal organs protrude through weakened tissues in your abdominal wall. Though internal hernias are rare, they are a serious life-threatening issue—especially given how they often involve intestinal loops and can lead to bowel obstruction.
Internal hernias may be effectively treated using surgery. Here’s more about common causes and treatments for an internal hernia and how to contact Advanced Laparoscopic Associates if you are experiencing symptoms.
What Is an Internal Hernia?
There are several types of internal hernias. The most common types involve the intestines and occur when organs protrude through part of the intestine or when intestines bulge through and become entangled with other parts of the intestine.
Types of internal hernias include:
- Paraduodenal hernia. This hernia represents an estimated 53% of all internal hernias. It is a congenital disorder that causes herniation near the duodenum (the first part of the small intestine).
- Foramen of Winslow hernia. This type occurs when the intestines move into the passage that divides two parts of the abdomen (the omental bursa and the general peritoneal space).
- Pericecal hernia. This hernia is an abnormality in tissue that is attached to the large intestine.
- Sigmoid-mesocolon hernia. This is a hernia that bulges through tissue that is attached to the last part of the large intestine.
- Transmesenteric hernia. This hernia is a congenital disorder that affects the mesentery (tissues that attach the intestine to the abdominal wall).
- Transomental hernia. This type affects the tissues that cover your abdominal organs.
- Supravesical and pelvic hernias. These hernias usually affect the tissues that connect the uterus and pelvis.
What Causes an Internal Hernia?
Internal hernias occur when a tissue wall is weakened to the point it allows other tissues or organs to protrude and push through the lining to create a bulge.
The most common causes of an internal hernia are congenital defects (disorders present at birth), inflammation, trauma, and previous surgery—such as liver transplantation and gastric bypass surgeries. Pregnancy, chronic cough, straining during bowel movements and heavy lifting may also cause an internal hernia.
The symptoms of an internal hernia will vary from one person to the next based on the location, cause, and severity of the hernia. For instance, abdominal pain is the most common symptom associated with internal hernias that occur after Roux-en-Y gastric bypass surgery and also the most common reason for rehospitalization following this procedure. However, it is possible to have an internal hernia and not experience any symptoms at all.
Potential internal hernia symptoms include:
- Abdominal discomfort
- Abdominal tenderness
- Nausea
- Vomiting
- Constipation
How Is an Internal Hernia Treated?
An internal hernia may not require treatment if it is mild and is not causing any symptoms or discomfort. Surgery may be required if your hernia is severe to the point it is causing pain or bowel obstruction. Bowel obstruction, or intestinal obstruction, is when food or stool cannot move through your intestines.
If your hernia is small or producing mild symptoms, your provider may suggest drinking more fluids and eating smaller portions to help the hernia resolve on its own. In more severe cases, internal hernia surgery may be required to repair the hernia and resolve any blockages in the intestine.
Internal hernia surgery is usually required when your hernia is causing bowel obstruction. Any hernia that affects the intestines can cause the intestinal loops to become “kinked” or entangled. This can lead to complete obstruction, which is considered a medical emergency.
The following symptoms of bowel obstruction may indicate you need internal hernia surgery:
- Severe pain or cramping in the abdomen
- Nausea and vomiting
- Abdominal swelling
- Abdominal bloating
- Loud sounds coming from the bowels
- Constipation
- Inability to pass gas
Contact your provider right away if you think you may be experiencing bowel obstruction, as this is often a severe and life-threatening emergency.
How Is Surgery Performed?
Surgery for internal hernia repair may be performed as an open surgery or laparoscopic surgery. Laparoscopic surgery is far less invasive than open surgery, producing less downtime and a shorter recovery.
During open surgery, your surgeon makes one large incision in your abdominal area or groin near the site of the hernia. The hernia is gently pushed back into its appropriate place, and the weakened part of the abdominal wall is strengthened using stitches or synthetic mesh material.
During laparoscopic surgery, your surgeon makes a few tiny incisions near the site of the hernia instead of one large incision. Your abdominal cavity is inflated with carbon dioxide so your surgeon can easily view your internal organs and perform the surgery without having to make a larger cut to reveal your insides. A series of small surgical tools are inserted into these incisions to perform the surgery, including a thin wand with a camera at the end called a laparoscope.
Recovery after laparoscopic surgery usually lasts several days, compared with the several weeks of recovery required with open surgery. Your provider can discuss whether you are an ideal candidate for internal hernia surgery based on your symptoms and condition.
