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Forum Name: Surgery Topics

Question: At what stage can a hernia burst?


 xmummytokaylax - Thu Jun 24, 2010 4:29 am

hi i've had a hernia for 5 months which was caused by having a c-section.. i'm still waiting for an appoitment at the hospital to discuss my options. but i'm very worried about it bursting which is causing me to have anxitety attacks which is stopping me from sleeping and being on my own as im scared incase anything happens. my partners aunt died due to a hernia bursting but she had hers since her daughter was born so she had it for 3 years. i would be grateful if u could answer my question. many thanks.
 Dr.M.Aroon kamath - Wed Jul 14, 2010 5:15 am

User avatar Hi,

Although very rare, spontaneous ruptures of incisional hernias have been reported.

Factors which are thought to contribute to the rupture of a hernia are
- thin atrophic skin,
- constant friction caused by the patient's clothing or an abdominal support(if being used),and
- lack of any adhesions between bowel and sac, allowing the bowel to act as a hammer-head upon the skin.

Progressive thinning of the overlying skin and associated capillary thrombosis may result in formation of a dystrophic ulcer at the summit of the bulge and eventually the ulcerated area may give way following any event which acutely increases the intrabdominal pressure like coughing or lifting a heavy weight.

Excessively thin overlying skin is mentioned as an indication for surgical repair.If ulceration has already occurred, it will have to be treated prior to the hernia repair.

There have been Isolated reports of spontaneous ruptures during pregnancy.

Evisceration of bowel or omentum is an indication for emergency surgery and this may or may not be combined with an attempt at definitive hernia repair. If the bowel can be reduced easily and the defect readily closed, it has been recommended that primary repair may be carried out, but if strangulation necessitates bowel resection, then primary repair will be hazardous.

If your hernia shows features of thin atrophic skin (even in some areas) or ulcerations, it is better to plan for early repair.It will be best to consult a surgeon who will be able to decide on the management based on the prevailing clinical findings.
Best wishes!

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