ABSTRACT
Neonatal/infantile hernias are congenital and result from failure of closure of the umbilical cicatrix. The hernial sac protrudes through this defect into the subcutaneous tissues. Adult hernias are acquired and are a consequence of increased intra-abdominal pressure upon the umbilical cicatrix, which stretches and bulges outwards. Poor surgical technique, placing drains or stomas through wounds, age, diabetes, jaundice, renal failure, obesity, malignancy, gross abdominal distension. Acquired weakness in the abdominal wall as a result of a surgical or accidental wound. The hernial sac protrudes through the scar. Incisional hernias represent a partial wound dehiscence where the deep layers of the abdominal wall separate, but the skin remains intact. The constricting agent is usually the neck of the sac which is often fibrosed and rigid where it traverses the defect in the abdominal wall. If the hernia contains bowel, the lumen may become obstructed by the neck of the hernial sac.
