An incisional hernia occurs when tissue pushes through a scar in the abdominal wall after previous surgery. Common symptoms include:
- Palpable bulge under the scar
A soft swelling that becomes more obvious when standing, coughing, or straining and may disappear when lying down. - Aching or dragging pain
Discomfort often increases toward the end of the day, after lifting, or during prolonged standing. - Feeling of heaviness or pressure
Patients report a weight in the abdomen that is relieved by rest or gentle manual pressure on the lump. - Reducible mass
The hernia can usually be pushed back into the abdomen with gentle pressure; it re-protrudes with straining. - Signs of incarceration or strangulation
Sudden severe pain, nausea, vomiting, fever, and a firm, tender, non-reducible mass with overlying skin redness or purple discoloration indicate compromised blood supply and require emergency care. - Changes in bowel habits
Intermittent bloating, constipation, or colicky pain may occur if loops of intestine are repeatedly trapped.
Anyone with a progressively enlarging bulge at an old surgical scar or new abdominal pain associated with a lump should seek surgical evaluation and imaging (ultrasound or CT).
| Symptom | Typical Features | Alarm Signs |
|---|---|---|
| Bulge | Soft, increases with strain | Non-reducible, discoloured skin |
| Pain | Aching, worse at end of day | Sudden severe constant pain |
| Nausea/vomiting | Uncommon unless obstruction | Persistent with distension |
| Fever | Usually absent in simple hernia | Present with strangulation |
| Bowel | Occasional bloating | Absolute constipation, no flatus |