A hernia is defined as a protruding organ or organ part through the wall of the cavity that normally contains it. An acquired hernia arises anytime after birth, and usually results from excessive strain on the muscular wall.

Acquired hernias frequently occur following penetrating injuries, operations, or compression of an area.

In general, hernias interfere with the normal function of a given area because they affect the muscle wall. Signs and symptoms depend on the area being affected by the hernia, for example, if a diaphramatic herniation occurs, respiratory distress or strangulation and gangrene of the fundus of the stomach may occur. However, the patient may exhibit no symptoms for several years before respiratory or abdominal symptoms occur. Inguinal hernias which account for about 80% of all hernias, manifest with pain, and the spermatic cord is not palpable above the mass.

The diagnostic tests performed depend on the location of the suspected hernia. Ultrasonography may be performed to confirm diagnosis, as well as computed tomography (CT) scan, and x-rays. To determine damage to the muscle, evaluations of motor strength and muscle atrophy may be done. In addition, to determine the movements of the diaphragm, a diaphragmatic excursion measurement may be done. Arterial blood gases (ABG), with or without pulse oximetry, are usually done to evaluate adequacy of oxygenation. In cases of inguinal hernias, patients are usually examined both lying down and standing up since inguinal hernias tend to reduce when the patient lies down.

Treatment for hernias will most likely be surgical. The surgery is termed herniorrhaphy. The procedures are done on inguinal and other abdominal hernias. Hernioplasty repairs done on extensive hernias may require reinforcement of the damaged areas with wires, plastic, etc. Once the herniation is repaired and the patient has recovered, physical therapy is one of the major treatments to restore and maintain muscle function. In addition, transcutaneous electrical nerve stimulation (TENS), and ultrasound may be helpful. In addition, for extensive diaphragmatic hernias, patients may require supplemental oxygen or artificial ventilation to maintain oxygen levels until the condition improves.

Recovery is usually quick and uneventful for elective hernia surgery. The patient may return home the same day and resume normal activities in four to six weeks. However, emergency surgery may require a hospital stay of a week or more. Physical capabilities require certain functioning muscles to perform activities of daily living (ADL). The extent of muscle injury from the hernia and recovery will determine the outcome for independent living. Hernias that require surgery may result in scars (see Diagnostic Code: 7804 Scars, superficial, painful on examination). In addition, hernias in the diaphramatic area may result in inadequate oxygenation and acid-base imbalance resulting in a need for supplemental oxygen until normal functioning returns.

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