Among 2,597 patients with intra-abdominal aneurysms, 32.23% presented with at least one hernia, with 'a high coexistence of abdominal and hiatal hernias observed among patients with intra-abdominal aneurysms.'
Key Findings
Results
Nearly one-third of patients with intra-abdominal aneurysms had at least one hernia identified on computed tomography angiography.
2,597 patients with intra-abdominal aneurysms were analyzed from CT angiography reports collected between January 2005 and July 2021 at a private quaternary hospital in São Paulo, Brazil.
837 patients (32.23%) presented with at least one hernia.
416 patients (16.03%) had abdominal wall hernias and 421 patients (16.20%) had hiatal hernias.
Data were collected retrospectively via CT angiography report review.
Results
Patients with hernias were significantly older than patients without hernias.
Patients with hernias had a mean age of 72.2 ± 12.0 years compared to 68.2 ± 14.0 years in those without hernias.
The age difference was statistically significant (p < 0.001).
There were no significant age differences between sexes among hernia patients (p = 0.714).
Statistical analysis used Student's t-test and chi-square test.
Results
Hiatal hernias had a high prevalence among patients with both aortic and visceral aneurysms, particularly those involving the hepatic artery and celiac trunk.
Hiatal hernia prevalence was 50.3% among patients with both aortic and visceral aneurysms.
Hepatic artery aneurysms were associated with hiatal hernia in 42.91% of cases.
Celiac trunk aneurysms were associated with hiatal hernia in 41.82% of cases.
These associations were identified through descriptive and inferential statistical analysis of CT angiography reports.
Discussion
The study found a statistical association between intra-abdominal aneurysms and hernia coexistence, but the authors explicitly state this should not be interpreted as causal.
The authors note the findings 'highlight a statistical association and should not be interpreted as indicating a causal relationship.'
The authors caution against using these findings 'as a risk-stratification tool in the absence of prospective, controlled studies.'
The study design was cross-sectional, relying on retrospective CT angiography report analysis.
Variables analyzed included sex, age, number of vessels with aneurysms, and number of hernias identified.
What This Means
This research suggests that among patients already known to have aneurysms (abnormal bulging) of major abdominal blood vessels, a substantial proportion — nearly one in three — also have hernias detectable on CT imaging. Hernias are weaknesses or gaps in the abdominal wall or diaphragm that allow internal tissues to protrude. The study, which reviewed CT scan reports from over 2,500 patients at a Brazilian hospital over 16 years, found that roughly 16% had abdominal wall hernias and another 16% had hiatal hernias (where part of the stomach pushes up through the diaphragm). Patients who had hernias tended to be older on average than those without hernias.
The co-occurrence was especially notable among patients with aneurysms affecting both the aorta and smaller visceral arteries, and was particularly high in those with aneurysms of the hepatic artery and celiac trunk. This pattern may point to shared underlying factors — such as connective tissue or collagen abnormalities — that could predispose people to both conditions, though the study does not establish a cause-and-effect relationship.
This research suggests that when physicians are evaluating patients with abdominal aneurysms using CT imaging, they may want to pay attention to the possible presence of hernias as well, since both conditions appear to coexist frequently. However, the authors caution that this is an observational, retrospective study, and prospective controlled studies would be needed before these findings could be used for clinical risk stratification or management decisions.
Oliveira N, Portugal M, Nora M, Chadud P, Benetti L, Corrêa C, et al.. (2026). Abdominal wall hernias in abdominal aneurysm cases: a cross-sectional imaging study.. Einstein (Sao Paulo, Brazil). https://doi.org/10.31744/einstein_journal/2026AO2405