Most often, a lump in the abdomen is caused by a hernia. An abdominal hernia occurs when there is a weak spot in the abdominal wall. This allows the internal organs to bulge through the muscles of the abdomen. A hernia may appear after you strain, or lift something heavy, or after a long period of coughing.

There are several types of hernias, based on where they occur:

• Inguinal hernia appears as a bulge in the groin or scrotum. This type is more common in men than women.
• Incisional hernia can occur through a scar if you have had abdominal surgery.
• Umbilical hernia appears as a bulge around the belly button. It occurs when the muscle around the navel does not close completely.

Other causes of a lump in the abdominal wall include:

• Hematoma (collection of blood under the skin after injury)
• Lipoma (collection of fatty tissue under the skin)
• Lymph nodes
• Tumor of the skin or muscles

Contact your health care provider if you have a lump in your abdomen, especially if it becomes larger, changes color, or is painful.

If you have a hernia, contact your provider if:

• Your hernia changes in appearance.
• Your hernia is causing more pain.
• You have stopped passing gas or feel bloated.
• You have a fever.
• There is pain or tenderness around the hernia.
• You have vomiting or nausea.

The blood supply may be cut off to the organs that stick out through the hernia. This is called a strangulated hernia. This condition is very rare, but it is a medical emergency when it occurs.

Your provider will examine you and ask questions about your medical history and symptoms, such as:

• Where is the lump located?
• When did you first notice the lump in your abdomen?
• Is it always there, or does it come and go?
• Does anything make the lump bigger or smaller?
• What other symptoms do you have?

During the physical exam, you may be asked to cough or strain.

Surgery may be needed to correct hernias that do not go away or cause symptoms. The surgery may be done through a large surgical cut, or through a smaller cut into which the surgeon inserts a camera and other instruments.

Abdominal hernia; Hernia - abdominal; Abdominal wall defects; Lump in the abdominal wall; Abdominal wall mass

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Abdomen. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 18.

Privratsky AM, Barreto JC, Turnage RH. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 44.

Updated by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.