A giant abdominal wall hernia is a very large hernia of the abdominal wall that most often results from long standing ventral hernia and in many cases, failed multiple repair attempts.

This hernia is usually very difficult to repair because of large defect of the abdominal wall. To be repaired successfully, a technique of component separation can be used to allow the muscle and fascia (layer of fibrous tissue) to be sutured to each other in the midline to close the gap.

In the component separation technique the muscles are separated from each other to allow the tissue to be closed without tension. Most often this is reinforced with mesh, which is a medical material used to reinforce poly tissues.

Patients with giant ventral hernia who have had multiple failed repairs should not be discouraged from seeking a second opinion as they may be a candidate for component separation.

Gallstones are small rocks that form in the gallbladder that vary in size. There can be anywhere from a single large stone to multiple gravel-like stones. Many people with gallstones may never experience any symptoms. Symptoms vary from mild upper abdominal discomfort and bloating to severe pain due to life-threatening acute pancreatitis.

The presence of gallstones in a diseased gallbladder can be responsible for the mild symptoms of upper abdominal discomfort, bloating, and nausea; these symptoms can be confused with symptoms of other conditions, such as acid reflux or peptic ulcer disease. When one of the stones blocks the gallbladder the patient will experience severe upper abdominal pain which is “crampy”, the condition is called biliary colic.
If the blockage is not relieved biliary colic can progress into acute cholecystitis, which is an emergency.

When the gallstones are responsible for the symptoms of pain, nausea, or vomiting patients should seek a surgical consultation to consider the option of laparoscopic cholecystectomy (gallbladder removal surgery) as soon as possible to avoid serious complications of the gallstones.