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An incisional hernia usually can be identified from bulging or weakness in the area of a surgical incision.The extent of the herniation (fascial defect and identification of hernial sac) usually can be felt by hand (palpated).In general, the mass that protrudes through the incision site can be pushed back into the abdominal cavity with a finger (reducible).If pain and tenderness continue after the hernia is manually reduced, strangulation of the hernia is a possibility.Fever or toxic appearance may be present if strangulation or perforation has occurred.

When the scar tissue thins or stretches, it weakens and may rupture when intra-abdominal pressure comes to bear upon it.

In some cases, computed tomography (CT), ultrasound, or introduction of a contrast material into the area of herniation and subsequent x-ray analysis (herniography), can visualize an incisional hernia. Closing the defect in the abdominal wall with sutures may repair small hernias.

Large incisional hernias often require more extensive treatment using one of many different open surgical repairs for incisional hernia that can be are performed (e.g., Babcock, Koontz technique), depending on the location, severity of the defect, and the surgeon's preference.

If the individual does not want surgery or is a poor risk for the procedure, manual reduction may be performed followed by use of an elastic corset to support the weakened area and control symptoms.

The outcome for open surgical treatment of incisional hernia depends primarily on the size of the hernia, the organ that has protruded through the weakened fascia, and the tension that remains on the incision line following surgery.