Editing Hernia (section)

==Diagnosis==

===Inguinal===
{{main article|Inguinal hernia}}

[[File:USofaninguinherniaMark.png|thumb|Ultrasound showing an inguinal hernia]]
[[File:Inquinalhernia.png|thumb|An incarcerated inguinal hernia as seen on CT]]
[[File:Colonic Herniation 08787.jpg|thumb|X-ray of colonic herniation]]
By far the most common hernias (up to 75% of all abdominal hernias) are inguinal hernias, which are further divided into the more common [[indirect inguinal hernia]] (2/3, depicted here), in which the inguinal canal is entered via a congenital weakness at its entrance (the internal inguinal ring), and the [[direct inguinal hernia]] type (1/3), where the hernia contents push through a weak spot in the back wall of the inguinal canal. An [[indirect inguinal hernia]]  and a  [[direct inguinal hernia]] can be distinguished by their positioning in relation to the inferior epigastric vessels. An indirect hernia is situated laterally to these vessels, whereas a direct hernia is positioned medially to them. Inguinal hernias are the most common type of hernia in both men and women. In some selected cases, they may require [[inguinal hernia surgery|surgery]].

There are special cases where a direct and indirect hernia appear together. A [[pantaloon hernia]] (or saddlebag hernia) is a combined direct and indirect hernia when the hernial sac protrudes on either side of the [[inferior epigastric vessels]].

Additionally, though very rare, two or more indirect hernias may appear together such as in a [[double indirect hernia]].<ref name="JPSCR13">{{cite journal| vauthors = Jones R |title=An unexpected finding during an inguinal herniorrhaphy: report of an indirect hernia with two hernia sacs|journal=Journal of Pediatric Surgery Case Reports |date=2013 |volume=1 |issue=10 |pages=331–332 |doi=10.1016/j.epsc.2013.09.002 |doi-access=free}}</ref>

===Femoral===
{{main article|Femoral hernia}}

Femoral hernias occur just below the [[inguinal ligament]], when abdominal contents pass into the weak area at the posterior wall of the [[femoral canal]]. They can be hard to distinguish from the inguinal type (especially when ascending cephalad){{clarify|date=October 2021}}: however, they generally appear more rounded, and, in contrast to inguinal hernias, there is a strong female preponderance in femoral hernias. The incidence of strangulation in femoral hernias is high. Repair techniques are similar for femoral and [[inguinal hernia]].

A ''Cooper's hernia'' is a femoral hernia with two sacs, the first being in the femoral canal, and the second passing through a defect in the superficial fascia and appearing almost immediately beneath the skin.

===Umbilical===
{{main article|Umbilical hernia}}

They involve protrusion of intra-abdominal contents through a weakness at the site of passage of the [[umbilical cord]] through the [[abdominal wall]]. 
Umbilical hernias in adults are largely acquired, and are more frequent in [[obese]] or [[pregnant]] women. Abnormal [[decussation]] of fibers at the [[Linea alba (abdomen)|linea alba]] may be a contributing factor.

===Incisional===
{{main article|Incisional hernia}}

An incisional hernia occurs when the defect is the result of an incompletely healed surgical wound. When these occur in median [[laparotomy]] incisions in the [[Linea alba (abdomen)|linea alba]], they are termed [[ventral hernia]]s. These occur in about 13% of people at 2 years following surgery.<ref>{{cite journal | vauthors = Bosanquet DC, Ansell J, Abdelrahman T, Cornish J, Harries R, Stimpson A, Davies L, Glasbey JC, Frewer KA, Frewer NC, Russell D, Russell I, Torkington J | display-authors = 6 | title = Systematic Review and Meta-Regression of Factors Affecting Midline Incisional Hernia Rates: Analysis of 14,618 Patients | journal = PLOS ONE | volume = 10 | issue = 9 | pages = e0138745 | date = 2015 | pmid = 26389785 | pmc = 4577082 | doi = 10.1371/journal.pone.0138745 | bibcode = 2015PLoSO..1038745B | doi-access = free }}</ref>

===Diaphragmatic===
{{main article|Diaphragmatic hernia}}

[[File:Hiatalhernia.gif|thumb|Diagram of a [[hiatus hernia]] ([[Anatomical position|coronal section]], viewed from the front).]]
Higher in the abdomen, an (internal) "diaphragmatic hernia" results when part of the stomach or intestine protrudes into the [[Thoracic cavity|chest cavity]] through a defect in the diaphragm.

A [[hiatus hernia]] is a particular variant of this type, in which the normal passageway through which the esophagus meets the stomach ([[Diaphragm (anatomy)|esophageal hiatus]]) serves as a functional "defect", allowing part of the [[stomach]] to (periodically) "herniate" into the chest. Hiatus hernias may be either "''sliding''", in which the [[Esophagus|gastroesophageal junction]] itself slides through the defect into the [[chest]], or non-sliding (also known as ''para-esophageal''), in which case the junction remains fixed while another portion of the stomach moves up through the defect. Non-sliding or para-esophageal hernias can be dangerous as they may allow the stomach to rotate and obstruct. Repair is usually advised.

A [[congenital diaphragmatic hernia]] is a distinct problem, occurring in up to 1 in 2000 births, and requiring [[pediatric surgery]]. Intestinal organs may herniate through several parts of the [[diaphragm (anatomy)|diaphragm]], posterolateral (in [[Bochdalek's triangle]] (lumbocostal triangle), resulting in a [[Bochdalek hernia]]), or anteromedial-retrosternal (in the cleft of [[foramina of Morgagni]] (sternocostal triangle), resulting in a [[Morgagni's hernia]]).<ref name="pmid19527083">{{cite journal | vauthors = Arráez-Aybar LA, González-Gómez CC, Torres-García AJ | title = Morgagni-Larrey parasternal diaphragmatic hernia in the adult | journal = Revista Espanola de Enfermedades Digestivas /| volume = 101 | issue = 5 | pages = 357–66 | date = May 2009 | pmid = 19527083 | url = http://www.grupoaran.com/mrmUpdate/lecturaPDFfromXML.asp?IdArt=461435&TO=RVN&Eng=1 }}</ref>

===Other hernias===
Since many organs or parts of organs can herniate through many orifices, it is very difficult to give an exhaustive list of hernias, with all synonyms and [[eponyms]]. The above article deals mostly with "visceral hernias", where the herniating tissue arises within the abdominal cavity. Other hernia types and unusual types of visceral hernias are listed below, in alphabetical order:
*[[Abdominal wall]] hernias:
**[[Umbilical hernia]]
**[[Epigastric hernia]]: a hernia through the [[Linea alba (abdomen)|linea alba]] above the [[Navel|umbilicus]].
**[[Spigelian hernia]], also known as spontaneous lateral ventral hernia
*[[Amyand's hernia]]: containing the appendix vermiformis within the hernia sac
*[[Brain herniation]], sometimes referred to as brain hernia, is a potentially deadly side effect of very high [[intracranial pressure]] that occurs when a part of the [[human brain|brain]] is squeezed across structures within the [[human skull|skull]].
*[[Broad ligament hernia]], of the uterus.<ref>{{cite journal | vauthors = Ozben V, Aliyeva Z, Barbur E, Guler I, Karahasanoglu T, Baca B | title = Laparoscopic management of incarcerated broad ligament hernia in a patient with bilateral parametrium defects - a video vignette | journal = Colorectal Disease | volume = 22 | issue = 9 | pages = 1197–1198 | date = September 2020 | pmid = 32180330 | doi = 10.1111/codi.15039 | s2cid = 212739555 }}</ref><ref>{{cite journal | vauthors = Hiraiwa K, Morozumi K, Miyazaki H, Sotome K, Furukawa A, Nakamaru M | title = Strangulated hernia through a defect of the broad ligament and mobile cecum: a case report | journal = World Journal of Gastroenterology | volume = 12 | issue = 9 | pages = 1479–80 | date = March 2006 | pmid = 16552826 | pmc = 4124335 | doi = 10.3748/wjg.v12.i9.1479 | doi-access = free }}</ref>
*[[Double indirect hernia]]: an indirect inguinal hernia with two hernia sacs, without a concomitant direct hernia component (as seen in a pantaloon hernia).<ref name="JPSCR13" />
*[[Hiatus hernia]]: a hernia due to "short oesophagus" — insufficient elongation — stomach is displaced into the thorax
*[[Littre Hernia|Littre's hernia]]: a hernia involving a [[Meckel's diverticulum]]. It is named after the French anatomist [[Alexis Littré]] (1658–1726).
*[[Lumbar]] hernia: a hernia in the lumbar region (not to be confused with a [[Spinal disc herniation|lumbar disc hernia]]), contains the following entities:
**[[Petit's hernia]]: a hernia through Petit's triangle (inferior lumbar triangle). It is named after French surgeon  [[Jean Louis Petit]] (1674–1750).
**[[Grynfeltt's hernia]]: a hernia through Grynfeltt-Lesshaft triangle (superior lumbar triangle). It is named after physician Joseph Grynfeltt (1840–1913).
*[[Maydl's hernia]]: two adjacent loops of small intestine are within a hernial sac with a tight neck. The intervening portion of bowel within the abdomen is deprived of its blood supply and eventually becomes necrotic.
*[[Obturator hernia]]: hernia through [[obturator canal]]
[[File:Colostomy and parastomal hernia.JPG|thumb|Patient with a [[colostomy]] complicated by a large parastomal hernia.]]
*Parastomal hernias, which is when tissue protrudes adjacent to a [[stoma (medicine)|stoma]] tract.
*[[Paraumbilical hernia]]: a type of umbilical hernia occurring in adults
*[[Perineal hernia]]: a perineal hernia protrudes through the muscles and fascia of the perineal floor. It may be primary but usually is acquired following perineal prostatectomy, abdominoperineal resection of the rectum, or pelvic exenteration.
*Properitoneal hernia: rare hernia located directly above the [[peritoneum]], for example, when part of inguinal hernia projects from the [[deep inguinal ring]] to the preperitoneal space.
*[[Retrocolic hernia]]: entrapment of portions of the small intestine behind the [[mesocolon]].
*[[Richter's hernia]]: a hernia involving only one sidewall of the bowel, which can result in bowel strangulation leading to perforation through ischaemia without causing [[bowel obstruction]] or any of its warning signs. It is named after German surgeon [[August Gottlieb Richter]] (1742–1812).
*[[Sliding hernia]]: occurs when an organ drags along part of the peritoneum, or, in other words, the organ is part of the hernia sac. The [[Colon (anatomy)|colon]] and the [[urinary bladder]] are often involved. The term also frequently refers to [[sliding hernias of the stomach]].
*Sciatic hernia: this hernia in the [[greater sciatic foramen]] most commonly presents as an uncomfortable mass in the gluteal area. Bowel obstruction may also occur. This type of hernia is only a rare cause of [[sciatic]] neuralgia.
*[[Sports hernia]]: a hernia characterized by chronic groin pain in athletes and a dilated [[superficial inguinal ring]].
*[[Tibialis anterior hernia]]: can present as a bulge in the shins. Pain on rest, walking, or during exercise may occur. The bulge can typically not be present unless pressure or flexing of the leg occurs.<ref>{{cite journal | vauthors = Nguyen JT, Nguyen JL, Wheatley MJ, Nguyen TA | title = Muscle hernias of the leg: A case report and comprehensive review of the literature | journal = The Canadian Journal of Plastic Surgery | volume = 21 | issue = 4 | pages = 243–7 | date = 2013 | pmid = 24497767 | pmc = 3910527 | doi = 10.1177/229255031302100408 }}</ref><ref>{{cite journal | vauthors = Masoumi A, Ramogida G | title = Tibialis anterior herniation - a rare clinical entity: a case report and review of the literature | journal = The Journal of the Canadian Chiropractic Association | volume = 64 | issue = 1 | pages = 88–91 | date = April 2020 | pmid = 32476672 | pmc = 7250514 }}</ref><ref>{{cite journal | vauthors = Sharma N, Kumar N, Verma R, Jhobta A | title = Tibialis Anterior Muscle Hernia: A Case of Chronic, Dull Pain and Swelling in Leg Diagnosed by Dynamic Ultrasonography | journal = Polish Journal of Radiology | volume = 82 | pages = 293–295 | date = 2017-05-31 | pmid = 28638493 | pmc = 5462483 | doi = 10.12659/PJR.900846 }}</ref>
*[[Velpeau hernia]]: a hernia in the groin in front of the femoral blood vessels