Hernia bounces up when the patient coughs!! 🗣
This is an Incisional hernia, one that occurs through a previously made incision in the abdominal wall, i.e they can occur near or along a scar left from a previous surgical operation.
They can occur months or years after an abdominal operation and appear as a small lump or swelling near the site of the original scar, especially when coughing.
See, most surgical wounds heal well, leaving the abdominal wall just as strong as it was before the operation. But if the cut that was made in the abdominal wall doesn’t grow back together tightly enough, the abdominal wall may be weakened in that area. If the scarred area can then no longer withstand the pressure in the abdomen, tissue or parts of organs might push through the gap that arises and bulge out.
The likelihood of postoperative wound failure and resultant hernia is greatly increased with factors such as poor surgical technique, postoperative wound infection, age, obesity, pulmonary complications that stress the repair as a result of vigorous coughing, defects in collagen, and placement of drains and stomas though the primary operative fascial defect.
Small incisional hernias should be treated by early repair since they may cause bowel obstruction. If the patient is unwilling to undergo surgery or is a poor surgical risk, symptoms may be controlled by an elastic binder.
Defects too large to close easily may be left without surgical repair if they are asymptomatic, since they are less likely to incarcerate bowel than smaller defects.
The very smallest incisional hernias (< 2 cm in diameter) can be managed by a direct fascia-to-fascia repair, by an interrupted or continuous closure using nonabsorbable sutures.