In incisional hernia – colloquially called incisional hernia – (Latin: hernia cicatrica; ICD-10-GM K43.0: incisional hernia with incarceration, without gangrene; ICD-10-GM K43.1: incisional hernia with gangrene; ICD-10-GM K43.2: incisional hernia without incarceration and without gangrene), the hernial orifice is formed by a scar that passes through all abdominal wall layers. Under stress, this diverges due to its lack of elasticity.
In all hernias, including incisional hernia, protrusions of the parietal peritoneum (outer sheet of peritoneum lining the abdominal cavity) through the weak point in the abdominal wall are called external hernia. The hernial orifice is the gap in the abdominal wall through which the hernial sac protrudes. Depending on the location of the hernia, the hernia sac contents may include almost any component of the abdomen (abdominal cavity); most commonly omentum (Latin for “net” or “abdominal net”) or small intestine.
Cicatricial hernia represents the most common late complication of previous abdominal surgery (abdominal surgery).
The incidence (frequency of new cases) of incisional hernia is 4-10%, depending on the surgical procedure.
Course and prognosis: The worst complication of an unoperated incisional hernia (scar hernia) is incarceration (entrapment of the contents of the hernia sac), which is estimated to occur in 6-15% of cases. As a result of incarceration, gangrene (tissue death (necrosis) due to reduced blood flow) of the hernia sac contents usually occurs.In emergency surgery, bowel resection (partial removal of the bowel) is required in approximately 25% of cases. Note: An incisional hernia should always be operated on.
