They may be congenital, secondary to high-energy trauma such as motor vehicle collisions, or found in high-level athletes [8]. Presenting signs and symptoms may be vague and nonspecific. Clinical examination has demonstrated high sensitivity of 100%, but a poor positive predictive value (PPV) at 36% [9]. Primary lumbar hernias are protrusions of the abdominal contents through the superior or inferior lumbar triangles. The first branches of the iliolumbar vessels may pass through the superior triangle, found in 46% of patients in a series of 50 upper abdominal CTs evaluating triangle anatomy [10]. The second, third, and fourth lumbar nerve branches may traverse the inferior triangle and were found in 9%, 67%, and 8%, respectively. These anatomic channels may contribute to the development of hernias because they represent natural weak points in the abdominal wall. Umbilical hernia is a common abdominal wall defect because the healed site of traverse of the umbilical vasculature represents a congenital abdominal wall weak point. Umbilical hernias are associated with causes of increased intraabdominal pressure. Among these causes are ascites, bland and malignant, and masses [11,12]. Ascites volume in cirrhotic patients was positively associated with development of umbilical hernias (P < . 0001, r = 0.4579). In many cases, umbilical hernias become apparent during pregnancy. An ultrasound (US) examination of the abdominal wall in a series of 302 patients referred for unrelated reasons yielded a prevalence of paraumbilical hernia in 24.9% of women and 23.3% of men [13]. Diastasis recti, weakened linea alba without disruption, may have a similar presentation. If possible, width should be measured and reported. Clinically, incisional hernia is defined as a detectable abdominal wall defect following surgical intervention with protrusion of abdominal contents or preperitoneal fat beyond the aponeurosis. Incidence is variable and related to patient characteristics and procedure.
Hernia. They may be congenital, secondary to high-energy trauma such as motor vehicle collisions, or found in high-level athletes [8]. Presenting signs and symptoms may be vague and nonspecific. Clinical examination has demonstrated high sensitivity of 100%, but a poor positive predictive value (PPV) at 36% [9]. Primary lumbar hernias are protrusions of the abdominal contents through the superior or inferior lumbar triangles. The first branches of the iliolumbar vessels may pass through the superior triangle, found in 46% of patients in a series of 50 upper abdominal CTs evaluating triangle anatomy [10]. The second, third, and fourth lumbar nerve branches may traverse the inferior triangle and were found in 9%, 67%, and 8%, respectively. These anatomic channels may contribute to the development of hernias because they represent natural weak points in the abdominal wall. Umbilical hernia is a common abdominal wall defect because the healed site of traverse of the umbilical vasculature represents a congenital abdominal wall weak point. Umbilical hernias are associated with causes of increased intraabdominal pressure. Among these causes are ascites, bland and malignant, and masses [11,12]. Ascites volume in cirrhotic patients was positively associated with development of umbilical hernias (P < . 0001, r = 0.4579). In many cases, umbilical hernias become apparent during pregnancy. An ultrasound (US) examination of the abdominal wall in a series of 302 patients referred for unrelated reasons yielded a prevalence of paraumbilical hernia in 24.9% of women and 23.3% of men [13]. Diastasis recti, weakened linea alba without disruption, may have a similar presentation. If possible, width should be measured and reported. Clinically, incisional hernia is defined as a detectable abdominal wall defect following surgical intervention with protrusion of abdominal contents or preperitoneal fat beyond the aponeurosis. Incidence is variable and related to patient characteristics and procedure.