Internal Hernia: Causes, Symptoms, Diagnosis, and Treatment

Introduction

An internal hernia occurs when an organ or part of the intestines pushes through a natural or surgically created opening inside the abdominal cavity. Unlike external hernias, internal hernias do not present as visible bulges, making them more challenging to diagnose. They can lead to bowel obstruction, severe abdominal pain, and life-threatening complications if not treated promptly.

Recognizing the symptoms of internal hernia early is crucial for preventing severe complications. This article explores the causes, symptoms, diagnosis, and treatment options for internal hernias, along with their link to post-surgical hernia and other abdominal conditions.

What Is an Internal Hernia?

An internal hernia happens when part of the intestines or abdominal organs protrude through a hole or defect inside the abdominal cavity. These defects may be congenital (present at birth) or acquired due to surgery, trauma, or inflammatory conditions.

Unlike external hernias, which form noticeable bulges on the skin, internal hernias remain hidden inside the body. This makes them hard to detect, often leading to delayed diagnosis and serious complications like intestinal strangulation or bowel obstruction.

Symptoms of Internal Hernia

Since internal hernias occur inside the abdomen, they do not cause visible lumps like external hernias. Instead, they produce digestive symptoms and severe pain.

Common Symptoms Include:

• Abdominal pain (sharp, cramping, or persistent)
• Nausea and vomiting
• Bloating and fullness
• Intermittent or severe bowel obstruction
• Changes in bowel movements (diarrhea or constipation)
• Difficulty passing gas
• Unexplained weight loss

Severe cases may cause:

• Intestinal strangulation (cut-off blood supply to the intestines)
• Sepsis (infection spreading through the bloodstream)
• Shock and low blood pressure

If you experience persistent or worsening abdominal pain, vomiting, or signs of bowel obstruction, seek emergency medical attention immediately.

Causes of Internal Hernia

Internal hernias can occur due to congenital defects or acquired conditions that create abnormal openings inside the abdominal cavity.

Common Causes Include:

1. Congenital (Present at Birth) Defects

• Abnormal peritoneal folds (tissue covering the intestines)
• Small gaps in the abdominal cavity

2. Post-Surgical Hernia

• After gastric bypass surgery (Roux-en-Y procedure)
• After laparoscopic surgery
• After abdominal trauma or injury

3. Inflammatory Conditions

• Chronic inflammation causing adhesions (scar tissue)
• Conditions like Crohn’s disease

4. Increased Abdominal Pressure

• Heavy lifting
• Chronic coughing
• Severe constipation

Post-surgical hernia is a leading cause, particularly after weight-loss surgeries where changes in the intestine create potential spaces for herniation.

Internal Hernia Diagnosis

Diagnosing an internal hernia is often challenging because symptoms mimic other gastrointestinal conditions. Doctors use advanced imaging and physical exams to confirm the diagnosis.

Diagnostic Tests Include:

1. CT Scan with Contrast

• Most effective imaging test
• Identifies bowel obstruction and twisted intestines

1. X-ray with Barium Contrast

• Reveals abnormal bowel movement patterns

1. MRI Scan

• Detects hidden hernias and vascular issues

1. Endoscopy (Camera Examination)

• Helps rule out ulcers or tumors

In some cases, exploratory laparoscopy (minimally invasive surgery) may be necessary to identify hidden hernias that do not appear on imaging tests.

Internal Hernia Treatment

The treatment for an internal hernia depends on the severity and risk of complications.

1. Conservative Management (Mild Cases)

• Observation for intermittent symptoms
• Pain management with medications
• Dietary adjustments to prevent obstruction

2. Surgery (Severe Cases)

Most internal hernias require surgical intervention to prevent life-threatening complications.

• Laparoscopic Surgery (Minimally invasive)
• Small incisions, quick recovery
• Reduces risk of recurrence
• Open Surgery (For severe cases)
• Used when laparoscopic repair is not possible
• Required in cases of bowel obstruction or strangulation

During surgery, the surgeon will:

• Identify and release trapped intestines
• Close the abnormal defect or hole
• Remove any damaged intestinal tissue if needed

Complications of Internal Hernia

If left untreated, internal hernias can cause severe complications, including:

• Bowel Obstruction (blockage of the intestines)
• Intestinal Strangulation (loss of blood supply, leading to tissue death)
• Sepsis and Infections (life-threatening condition)
• Peritonitis (inflammation of the abdominal lining)

Preventing Internal Hernia

While some internal hernias are unavoidable, you can reduce the risk by:

• Following post-surgery guidelines after abdominal or weight-loss surgery
• Avoiding heavy lifting or activities that strain the abdomen
• Eating a high-fiber diet to prevent constipation
• Seeking medical help for persistent abdominal pain or bloating

Conclusion

An internal hernia is a serious but often overlooked condition that can lead to severe abdominal pain and bowel obstruction. Since symptoms are often vague, early diagnosis and treatment are crucial. If you have undergone abdominal surgery or experience unexplained digestive symptoms, consult a doctor to rule out an internal hernia.

By staying informed about symptoms, causes, and treatment options, you can take proactive steps to prevent complications and maintain good digestive health.