Home »Hernia» Why develop and how does a hernia of the abdomen manifest in adults and children
Experienced surgeons know how to perform abdominal hernia removal. This is a pathological condition in which the internal organs (most often the stomach and intestinal loops) go under the skin. Causes - weakness of the ligaments and a defect in the muscles surrounding the organ. This pathology is diagnosed mainly in adults and requires surgery.
Summary of the article
Causes of abdominal hernia
The following conditions can be a provoking factor for the appearance of a hernia of the anterior abdominal wall:
- congenital abnormalities, incomplete closure of the umbilical ring or inguinal canal,
- chronic injury of the anterior abdominal wall,
- high intrauterine pressure
- pregnancy and childbirth,
- acute abdominal injuries in violation of the integrity of soft tissues.
Depending on the cause of the appearance, the hernia of the anterior abdominal wall has specific manifestations that often appear only at the time of the complication of the disease, which makes it impossible to make a diagnosis on time.
This leads to the need for immediate surgical treatment and the installation of a supporting mesh to return the organs to their place. In this regard, the doctors are doing everything necessary for the possibility of timely diagnosis and non-surgical removal of the defect of the abdomen.
The main reason for the development of this pathology can be called with certainty the weakening of the abdominal wall due to anatomical features. Also worth noting defects associated with injury or surgery of the abdominal cavity.
Moreover, the development of hernias, as a rule, is carried out unnoticed by humans. However, there are other factors that provoke such effects. These should definitely include:
- heavy exercise
- weight problems,
- difficulty urinating,
- prolonged cough (in the presence of chronic lung disease),
- flatulence (excessive gas formation in the intestinal tract).
It is not necessary to ignore the hereditary factor, age-related changes, sudden weight loss due to starvation, as well as stretching of the walls of the abdominal cavity during pregnancy.
Reasons contributing to the weakening of the abdominal wall:
- Special body structure
- Hereditary Diseases (Flatfoot, Varicose, Myopathy, Scoliosis)
- Trauma to the abdominal wall
Causes of increasing pressure in the abdomen:
- Long constipation
- Heavy and prolonged labor
- Diseases of the respiratory system, accompanied by cough
- Work involving physical activity and weight lifting.
Ventral abdominal pathologies
A hernia of the abdomen is a protrusion of the viscera from the abdominal cavity, together with the covering sheet of peritoneum covering them through the "weak" places of the abdominal wall under the skin or into various pockets and bags of peritoneum. A distinctive feature of the abdominal hernia is the preservation of the integumentary membranes (peritoneum).
Abdominal hernia is the most common pathology requiring surgical intervention. Up to 50 people per 10,000 of the population suffer from this disease. Abdominal hernias are observed at any age, but most often in children of preschool age and in people over 50 years of age.
In men, hernia of the abdomen is formed more often than in women. The most frequently formed inguinal (75-80%), then postoperative (8-10%) and umbilical (3-8%).
Available after registration
A hernia can not suddenly appear. It is formed due to certain factors and time, nothing else. Virtually all the causes of this disease are divided into predisposing to the emergence of protrusion and accomplishment.
The abdomen after the removal of a hernia can be sagging and cause discomfort. Often there is pain.
The first category includes such factors as the weakness of tendons and muscles obtained since birth, and also the acquired changes (due to surgical interventions, weight loss, etc.), which cause the formation of weak points of the body inguinal canal, umbilical ring, etc.).
The second category includes factors that stimulate the growth of intra-abdominal pressure and the appearance of abdominal hernia in women and men in the weak point. These factors include heavy physical exertion, abdominal swelling, flatulence, urination problems, pregnancy, etc.
It is important to pay attention to the fact that for the occurrence of a hernia of the abdomen the above factors should act for a long time. There are also other factors that influence the appearance of this disease:
- Hereditary predisposition
- Flabbiness of tissues due to age.
- Weight loss due to illness or hunger.
- Long lasting cough.
To recognize the formation of the disease, you should know its signs. The following symptoms are abdominal hernia:
- The main symptom is the existence of a bulge (in size it can be like a pea or a watermelon). Almost always bulging can be noticed.
- Sometimes there are pain, but extremely rare. They appear in the presence of large formations, or when the latter have existed for a long time and there are complications.
- Pain arises around the protrusion, but can spread throughout the abdomen and even give in the back, sacrum and groin.
- In some hernias, there may be a burning sensation and chest pain.
- Sometimes there is vomiting, nausea and constipation.
- Education in the abdomen are different, but they have certain symptoms of their own.
The following symptoms are characteristic of such formations:
- In the presence of a femoral hernia, women or men have problems with urination, as well as pain in the lower abdomen, if the person fully straightens.
- In the presence of diaphragmatic hernia, the following symptoms are distinguished: the appearance of heartburn, belching, difficulty in swallowing.
- Difficult breathing, coughing and hoarseness are also possible.
- The sudden appearance of sharp pain in the abdomen, lethargy, nausea, and continued vomiting.
These are quite dangerous symptoms, with the appearance of which you need to sound the alarm, because they say that the formation is undermined. If there are such signs, it is recommended that you seek medical help as soon as possible.
Acquired forms of emergence of the organ in the groin area are characterized by blurred symptoms and sluggish passage. The first symptoms of abdominal hernia in men may appear unexpectedly. While the hernia is small, it does not cause pain. If it has been around for quite a long time, then the patient complains of an uncomfortable condition. Pain arises with its growth. Then the patient says that he is worried about the constant pain in the lower abdomen and groin. Discomfort can be in the area of the sacrum, lower back.
At first, such a hernia in men and women looks like a small elongated protrusion located near the groin. This hernia makes itself felt during exercise and then disappears. But as soon as the painful sensations become permanent, the protrusion is visible in any state of the body. After some time, adhesions form and they cause pain. If the bladder, uterus or ovaries (in women) get into the bag, it can lead to impaired urination, pain during menstruation. In some cases, the inguinal ring can pinch a blood vessel, causing acute pain. The condition is dangerous in that necrosis of the tissue can begin, and the infection will spread throughout the abdominal cavity.
Causes of umbilical hernia of the abdomen:
- Congenital expansion of the umbilical ring when the scar does not reach the end and there is a small hole. It may not show up in childhood, but over time, under certain conditions, a hernia can form.
- Pregnancy and childbirth. During pregnancy, the abdomen of women increases, the navel of this stretches. There are constipation, which leads to an increase in pressure inside the abdomen. Very high risk for women who gave birth repeatedly and during pregnancy did not follow the advice of a doctor. Also to the appearance of a hernia lead to difficult childbirth, a large child, multiple pregnancies.
- Inactive life. If a person does not engage in physical culture, his press is much weaker.
- Big loads. At the time of lifting the pressure inside the abdomen becomes higher.
- Diseases accompanied by high intra-abdominal pressure. These can be abnormalities in the digestive system, frequent constipation, persistent coughing and so on.
- Excess weight. Subcutaneous fat is an additional volume that leads to an umbilical hernia.
- Transferred operation. A hernia near the navel may also appear after surgery.
By femoral hernia, it is customary to imply a pathology in which the organs of the abdominal cavity (as a rule, the intestines and omentum) move beyond the permissible limits.
About the presence of femoral hernia say:
- The appearance of a dense tumor of small size between the groin and the thigh, "hiding" if the patient lays down.
- Pain in the thigh when walking, any kind of physical exertion.
Diagnosis of the disease involved the surgeon. Most often, the doctor applies the following methods:
- Irrigoscopy - X-ray analysis of the colon. The patient is administered barium sulfate. After the substance is evenly distributed throughout the body, the doctor assesses the condition of the intestines. In the last stage, the intestine is filled with air in order to examine it for the presence of various kinds of polyps, ulcers, and the like.
- Herniography - the introduction of a special composition in the abdominal cavity. A substance is administered to the patient, pre-anesthetized. After that, take a picture. The whole process takes no more than sixty minutes.
At first, the patient is only worried about tingling in the area of the hernia during exercise. It would not be superfluous to clarify that at first the sensations are almost invisible, but as they develop, they become stronger and stronger. Further, a rather dense tumor is formed, which increases in diameter under load and disappears in the absence of it. Bulging increases significantly in size and ceases to disappear.
Hernia of the white line
A white hernia of the abdomen in children and adults is considered to be a tendinous structure, which is located from the chest to the pubis, clearly located in the middle. Here tendons are combined, located on both sides of the oblique muscle of the abdomen.
Abdominal line hernia - protrusion of a small portion of the abdominal organ under the skin (near the white line). At the initial stage, the pathology is painless and does not greatly disturb the patient. But over time, the disease develops and infringement can occur - the organs of the bag are compressed with an incompressible tendon ring, where they exit. This is dangerous for humans and requires urgent surgical intervention. Indeed, this is the only way to cure pathology. Without surgery, the patient can only slightly reduce the protrusion. But this will not cure, but only reduce the tone of the tendon and allow the hole to stretch even more. The operation of the hernia of the white line of the abdomen is quite simple, and it always goes well. There are three types of hernia:
- supra-umbilical hernia,
- near the navel
- below the navel.
The latter is usually rare. Pain in trauma to the lateral and medial meniscus are different. If the cartilage is injured, an acute pain occurs.
To accurately establish the diagnosis, it is necessary to check with a gastroenterologist specializing in this area. Sometimes a doctor costs only by visual examination, however, there are cases in which a simple examination is not enough. In such moments, you have to resort to one of the following methods for diagnosing a hernia of the abdomen:
- Ultrasound. This method is familiar to everyone, but to recall its principle will not be superfluous. Gel is applied to the study area. Using the device, the doctor conducts a scan of the internal organs that are displayed on the monitor.
- Survey radiography of the abdominal cavity. It can be performed while lying and standing. For problems with the intestines and stomach, the second option is preferable. Before the procedure, you must remove all the jewelry.
- Radiography of the passage of barium. The patient drinks a barium drink. Forty-five minutes later the patient is placed on the table, the apparatus is induced on him. Having given the command "do not breathe," the doctor takes a photo.
There are several types of abdominal hernia surgery:
- Standard - hernioplasty, done with complications or scheduled according to plan.
- An operation that is performed with the help of our own tissue or with the use of synthetic implants in order to close the defect. It is done laparoscopically, according to the method of Liechtenstein or through hernioplasty.
- Obstructive type of surgery is used to eliminate the umbilical defects.
Previously, the removal of a hernia was limited by the need to close the defect with a nearby tissue, which is practiced now, but less active. Operational intervention is done through an incision of ten to twelve centimeters, the hernial sac is separated and removed, and the organ is returned to its original place.
After removal, the plastic is made with a tissue, by flashing the muscles into the inguinal ligament.
The operation of the hernia of the white line of the abdomen with the help of tension plastic has a number of minuses and much less advantages:
- Long recovery after surgery, you will need to eliminate physical education classes, change the diet for at least six months.
- The bulging of the place where there was a hernia after abdominal surgery may come back.
- Painful sensations, a scar may heal poorly, and inflammation may appear.
- A hernia may form after surgery in the place where the scar was.
Traditional medicine offers many options for the treatment of abdominal hernia. The most common ones are:
- In the early stages of a hernia, it is recommended to drink mummy (0.2 g) dissolved in a glass of water every morning. The treatment lasts at least two weeks.
- Gooseberry decoction has a beneficial effect in combating the problem. The leaves should be crushed, two tablespoons of the resulting mass pour boiling water, it will take about two glasses of water. After a couple of hours, when the medicine is sufficiently infused and ready, use 1/3 cup up to five times a day.
- Broth clover will be useful for strengthening the weak walls of the abdomen and muscle tissue. It will take a teaspoon of the plant in a glass of boiling water. It is applied on 1/3 glasses, to food.
- Brine from sauerkraut will help in the treatment. Cabbage sheets or compress with brine should be applied to the place of hernia formation. Perform the procedure you need to constantly.
- A solution of vinegar 4% for daily rubbing the site of a hernia. To prepare just one tablespoon of vinegar, diluted in a glass of cold water. After wiping is done, it is recommended to apply a compress with infusion of oak bark.
- The use of tincture prepared from the root of the plakun-herb (wolfberry silt) will have a positive effect. Two teaspoons of the plant pour a glass of boiling water, should insist in a thermos. After two hours the tool is ready for use.It is enough to drink 1/3 cup three times a day.
Prevention of abdominal hernia consists of several points.
1. Compliance with certain rules of nutrition:
- split meals
- complete elimination of smoked meats and sausages from the diet,
- overeating is not allowed,
- it is recommended to limit sugar intake,
- a diet enriched with vegetables and fish.
The state of the body depends on the food intake, so it is extremely important to stick to a diet.
2. Reception of necessary vitamins. In order to prevent hernia, it is also recommended to take vitamin complexes that allow you to maintain a healthy state of the body, strengthen it and restore it. Taking the following vitamins will reduce the risk of abdominal hernia:
- magnesium (buckwheat, nuts and cheeses),
- vitamin C (citrus, kiwi, greens),
- vitamin B (eggs, peas, beans),
- vitamin A (carrots, fish, cantaloupe, peaches).
3. Exercise. Regular performance of certain physical exercises will prevent the depletion of the abdominal walls, which, in turn, will reduce the likelihood of a hernia:
- pull-ups from a supine position, bending the knees,
- twisting the press, it is also necessary to take a prone position, having touched the knees with elbows, to return to the starting position,
- alternate straightening of the legs from a prone position, previously legs are bent at the knees.
To prevent abdominal hernia surgery, you must comply with the above measures and constantly monitor the state of health.
How to determine a hernia in yourself?
If you have a predisposition or suspicion of a hernia, then you can check it yourself. To do this, bare the belly and stand up straight. Put your palms on your stomach and cough, if during a cough you feel that something is bulging out of your stomach, then the probability that you have a hernia is very high. To confirm the diagnosis immediately go to the doctor for an appointment.
Epigastric hernia occurs in the so-called white line of the abdomen - this is the place where the connective tissues intersect, there are no muscles in this place, which is why the hernia is most often formed in this area.
How to determine a hernia yourself
Reasons for education
Our body is designed in such a way that the entire area of the abdomen under the skin has a certain protective layer of muscles and connective tissue, which helps to keep the organs inside. In turn, the organs act on this anatomical shield with a certain pressure, which, as a rule, is in harmony with its resistance. When this harmony is broken, the organs penetrate the protective walls, forming a hernia.
The factors that provoke the weakening of this anatomical shield are:
- genetic predisposition
- connective tissue diseases
- physical overload
- long fasting
- prolonged cough.
Scar and scars after surgeries can also cause education. In addition, the mistakes made during surgery, namely, when stitching, can also cause this disease.
Symptoms of the disease
- The main symptoms are the pain of a pulling character along with bulging on the body.
- A bursting pain that is greatly exacerbated with doing physical work, lifting weights, coughing and sneezing.
- At rest and when a person assumes a horizontal position, the pain syndrome disappears. The pain may be of a cramping character, with particular acuity and periodicity.
- Often there is nausea, accompanied by vomiting, as well as constipation.
- With an increase in the opening through which the organ protrudes, the painful sensations increase, the hernia itself increases along with the likelihood of pinching and the development of complications. That is why it is very important to start treatment immediately after diagnosis.
Complications of the disease
The most serious complication that may occur is infringement. Its essence lies in the fact that in the process of entering the intestinal loop into the hernial cavity, the abdominal muscle tissue is reduced. If blood circulation is impaired, intestinal necrosis may result. Also at infringement can be:
- chronic constipation
- disruption of the normal functioning of the liver and kidneys,
- inflammatory processes in the abdomen,
- intoxication of the body.
It should be noted that conservative treatment methods are used extremely rarely. Usually the most effective way to get rid of this disease is surgery. In any case, regardless of the method of treatment, the patient is recommended to switch to proper nutrition, adjust lifestyle, as well as preventive actions to strengthen the muscle tissue of the abdomen. Surgical intervention may consist of open operations as well as laparoscopy, implant placement to close the hernia ring.
When treating by surgical actions, it should be noted that there are certain categories of patients for whom such manipulations are contraindicated. These include patients with diabetes, chronic infectious diseases, pregnant women, children in the first year of life.
Causes of disease
The main reason for the development of hernia of the white line of the abdomen is the weakness of connective tissue fibers. This provokes its further thinning and expansion. Over time, there are slit-like holes, the size of which increases under the pressure of internal organs located in the abdominal cavity.
Muscle weakness is both acquired and congenital abnormalities. That is why, hernia on the white line is found even among children. But such a phenomenon can certainly be called extremely rare.
To provoke the appearance of a hernia of the white line of the abdomen can overweight, serious injuries and even scars formed in this area after the previous surgical intervention. A sharp increase in the level of intra-abdominal pressure is also a common cause. This process may be associated with excessive physical effort, difficult labor or regular constipation.
In some cases, muscle discrepancies occur during long bouts of severe coughing. But even hysterical crying can provoke a disease in very young children.
Based on these reasons, it becomes obvious that the prevention of the appearance of a hernia of the white line of the abdomen is associated with timely treatment of a number of diseases and constant monitoring of the level of physical activity.
Course of the disease, complications
The development of a hernia of the white line of the abdomen takes place in 3 stages:
- preperitoneal lipoma - adipose tissue passes through the formed lumens,
- initial stage of hernia formation - a hernial sac is formed,
- formed hernia - the omentum, small intestine, oval or ball-like formation is accompanied by pain through the hernial ring.
Sometimes several protrusions appear simultaneously along the midline - a multiple hernia develops. Serious complications include the infringement of organs exiting through the hernial ring from the abdominal cavity, herniation is not preventable, blood in the stool is detected, stool retention, vomiting and nausea.
With the right approach and timely treatment, the prognosis is favorable. But treatment can only be surgical. The operation is the same as in the case umbilical or inguinal hernia - methods of tension and non-tensioned hernioplasty. But with a hernia of the midline of the abdomen, the removal of a hernia is not enough. The surgeon must conduct the removal of diastasis (divergence) of the rectus abdominis muscles.
Stretch hernioplasty is performed only for young patients with small-sized hernias. The rest shows the use of mesh implants, which provides a minimum percentage of relapses in the future.
The operation is performed by an open method or laparoscopic. The second is more gentle. Through punctures in the abdominal wall, video equipment and instruments are introduced into the patient for the operation. This minimally invasive method allows to reduce the period of rehabilitation of the patient and is more aesthetic. Postoperative scars are almost invisible.
After surgery on the second day the patient can be discharged. During the month he is recommended to wear a bandage, and after 3 months all restrictions on physical activity are completely removed. A person can lead a normal life.
As a preventive measure against this disease, doctors advise you to wear a special support bandage during pregnancy, eat right, watch your weight, prevent flabbiness and atrophy of the abdominal muscles, keep them in good shape, do not lift weights and protect yourself from excessive physical exertion.
Surgery is the only effective way to cope with the disease. Depending on the condition and age of the patient, the operation can occur using one of three existing methods that provide direct access to the hernia:
- open access,
- laparoscopic access,
- preperitoneal access.
In the first case, a skin incision is made, the length of which fully corresponds to the size of the hernial protrusion vertically. Among the disadvantages of this technique should be the presence of one scar, which can be quite large. However, it should be understood that the possibilities of modern plastic surgery make it easy to cope with this problem. In addition, patients operated on in this way face relatively strong pain during the recovery period.
However, there are positive aspects of open access. Among them is the maximum security for the internal organ, which is located in the hernial sac. This is due to the excellent visualization in the process of surgical intervention.
This method allows you to install the used mesh implant as reliably as possible, and this helps to almost completely avoid relapses.
The operation can occur with local anesthesia.
Preperitoneal access is quite similar to laparoscopic. In this case, all manipulations are carried out through small punctures, special video equipment and appropriate tools are used. However, it is possible to avoid penetration directly into the abdominal cavity, since the peritoneum is exfoliated using a special balloon. The method has many positive aspects, but it is associated with the lack of reliable fixation of the implant used. And this may cause its subsequent twisting and even displacement. In addition, the operation takes a lot of time and is associated with an impressive risk of damage to parts of internal organs that have fallen into the hernial bag. Performing such an operation should be trusted only to highly qualified and experienced professionals.
Features of implants used
Previously, the hernia of the white line of the abdomen was eliminated solely by the use of a tension technique. But the damaged tissues joined during surgery are extremely weakened. This is what causes the re-development of the disease, the subsequent treatment of which causes certain difficulties.
The appearance of mesh implants has become a real coup. They are made of materials that are perfectly perceived by any human body.
The absence of allergic reactions makes the method associated with the use of these elements truly universal and optimal.
In addition, the presence of implants allows you to avoid unwanted relapses, which is an indisputable advantage of their use. And the absence of contraindications guarantees its high efficiency and complete safety regardless of the patient's age, the size of the eliminated hernial sac, and the condition of the tissues.
Existing types of pathology
The most common types of pathology are considered postoperative, inguinal, umbilical, femoral and hernia of the esophageal opening of the diaphragm. In the case of the formation of an inguinal hernia in the area of the inguinal canal or abdominal wall, a protrusion of the bladder or intestines is observed. Statistics show that the most common are inguinal hernias of the abdomen. Most often, this pathology is observed among men, which is explained by the weak muscular wall of the inguinal canal. Symptoms of this type of abdominal hernia usually appear gradually. In addition to the rounded protrusion, the patient may suffer pain in the lower abdomen.
With the formation of postoperative hernia, a protrusion of the abdominal organs in the scar area occurs. The reason is that after surgery, the abdominal wall is in a weakened state. This type of abdominal hernia can be observed in both men and women. In most cases, this pathology is found among people in old age, those who have problems with obesity, as well as people whose lifestyle can be called inactive (which is often associated with the surgery).
In the case of a femoral hernia, a portion of the intestine bulges into the femoral canal region with the femoral artery passing through it. In most cases, the pathology of this type is observed among women. Especially often this pathology occurs during pregnancy and if the woman is overweight.
The umbilical hernia of the abdomen is especially marked by protrusion of the greater part of the omentum or intestine, which can be observed in the navel. Newborns, women with many children and those who have problems with overweight are especially susceptible to this pathology.
With the formation of a hernia of the esophageal orifice of the diaphragm, a protrusion of a part of the stomach occurs. It is quite difficult to recognize the signs of this type of disease, in some cases, the patient may be tormented by heartburn, pain in the chest, hiccups, and indigestion.
Common signs of abdominal hernia
With abdominal hernia obvious symptoms may not be present, so the pathology often remain unattended for a long time. In the case of external abdominal hernia, the symptoms go unnoticed very rarely, because the patient notices an abnormal protrusion of the abdominal wall. A person can be tormented by painful sensations. The pain can be given to the lumbar and epigastric region.
The main symptoms of external abdominal hernia is a protrusion that can occur during exercise, if the pathology is associated with the bladder, a symptom of dysuria is possible. With an umbilical hernia of the abdomen, which has a large size, and in case of suspicion of the presence of a sliding hernia in order to determine the nature of the contents of the pathological formation of the patient is sent for X-ray examination. Particular attention is paid to the bladder and digestive tract.
What can cause abdominal hernia?
A hernia of the abdomen is formed for two main reasons - it is a weakened muscle and pressure on one of the organs. The pressure leads to the ejection of an organ or part of its tissue through the opening formed.
Very often, pathology is formed due to hereditary predisposition, but a number of factors may contribute to the weakening of the muscular wall, among which are:
- bad habits,
- unlimited physical exertion on the body.
It is worth adding that the disease, among other things, may be the result of a strong cough, constipation, diarrhea, overweight, etc.
A bit about diagnostics
As already mentioned, in most cases, a hernia of the abdomen is accompanied by characteristic clinical manifestations, the diagnosis is often made on clearly pronounced symptoms.
There are cases when the installation of the diagnosis causes difficulties, mainly due to the small size of the hernia, less often the cause is overweight (obesity) of the patient, etc. It does not do without ultrasound or X-ray examination of the bladder and digestive tract. Computed tomography is often used to establish the diagnosis.
What treatment can be used?
With a hernia of the abdomen without surgery, it is very rarely managed. The treatment is aimed at restoring the muscle wall defect. At the first suspicion of a hernia, you should consult a doctor.
It is very important to fear the infringement of a hernia, in which the patient, as a rule, feels rapidly increasing pain.
If the hernia of the esophageal opening of the diaphragm is not accompanied by severe heartburn, chest pain, or inflammation of the esophagus, surgery may not be necessary. Antacid medication may be prescribed to the patient. It is recommended to exclude from the diet products that can cause irritation of the gastric mucosa. Meal should be in small portions.
For inguinal hernia, serious physical exertion should be avoided. Weight lifting provokes tension in the abdominal muscles, which causes pressure in the abdominal cavity. If you still have to lift heavy objects - your legs should be bent at the same time, make sure that your back is straight. Thus, the main burden will fall on the muscles of the legs.
Types of abdominal hernia
Depending on the weak point of the herniation, which could not withstand intra-abdominal pressure, allowed the internal organs to go beyond the abdominal wall, Inguinal:
- distinguish hernia -abnormal protrusion of the organs of the skin under the weakened muscles in the groin. all more common in medical practice. As such, the rule of the type of hernia prone men from 40 When. In a male, this can go beyond the seminal limits of the cord or intestinal loop, and in the uterus - women, ovary or bladder.
- are located - Perineal in the pelvic floor with protrusion of the skin under. Passing through muscle tissue, a hernia can bulge into the front wall of the rectum or intestine of the vagina, perineal fossa, or part of the lower outer labia. This type of hernia is most often diagnosed in women.
- white hernia line abdomen -the output of the omentum and other internal organs of the peritoneum beyond which the hole is formed in the midline of the abdomen. Pathology originates from the pubis and through the navel area to the chest passes. The disease is rarely asymptomatic.
- Femoral - occur in women from 30 years. Such a hernia is impressive in size, although it is less likely to be affected. In most cases, its contents, the epiploon protrudes or the intestinal loop. Excessive physical loads, pregnancy and chronic constipation are provoking the occurrence of femoral hernia factors.
- Umbilical - when internal organs exit from the abdominal limits beyond the cavity of the umbilical ring. The reason for this is the pathology of the decrease in the tone of the abdominal muscles. Umbilical hernia is quite rare and mostly in more women, in women who have given birth.
- Lateral - may appear in the vagina area, and in case of injury - in any place. their occurrence is caused by obesity, a violation of the innervation of inflammatory, muscle processes. Penetrating into the openings of blood vessels contributes to their expansion of fat, which allows you to create perfect conditions for the development of hernial formation.
- are - Spinal congenital anomaly. In this case, the vertebrae are not able to close at the location of the spinous, forming processes, thus, the gap. The spinal cord with its shells penetrates into it. If the vertebrae are too large, the disease will be serious.
Signs of hernia Clinic
abdominal hernia abdominal nonspecific, but quite the most. recognizable a clear sign of the disease is pain syndrome, which is accompanied by a bursting sensation. There may also be cramping pains, differing in their severity and periodicity.
Soreness may appear with only physical exertion, after which it subsides for a bit. Constipation, vomiting and nausea are often uncomfortable. The appeared hernia is clearly visible at first and the patient may disappear when the horizontal body assumes a position.
The most obvious symptoms and signs of illness are pain of a pulling nature and therefore. bulging question of how to identify a hernia is not a stomach of particular complexity. Often patients themselves set this diagnosis on their own.
Pathological early on swelling stages bulges stronger when coughing, straining, sneezing, and at rest may later. to disappear, when the hernial ring is still expanded more, the hernia is significantly increased in size, the risk of its infringement and the development of various complications. therefore, hernia is considered dangerous and requires Diagnosis.
What is dangerous abdominal hernia?
A hernia is a kind of hole in the tissues through which internal organs can fall out. The biggest threat is that at this moment a serious pinching of vital organs can occur, it can be dangerous to human health and even life.
During the pinching of the internal organs, a violation of the blood circulation and, as a result, the death of tissues can occur, which means that the internal organs will not be able to function properly.
Unfortunately, abdominal hernia cannot be cured with the help of special exercises, diets or folk remedies. The only and reliable way to cure a hernia is surgical. So from going to the doctor does not get out.
What can not do a person with a hernia?
The main thing that cannot be done is to lift weights, since at this moment there is a strong internal abdominal pressure, as a result of which the hernial ring can stretch and the internal organs fall out.
Also during the lifting weights the abdominal muscles are strained, which can lead to strangulation.
If you needed to lift something heavy, but there was no one nearby who could be asked to lift this object, then do it carefully, without sudden movements, and not bending down, but squatting.
What can not do a person with a hernia
Many believe that a special bandage will be able to solve this problem, but it is not. Hernia Bandage is a temporary solution. If you wear it for a long time, it will weaken the abdominal wall and increase the hernia opening. The bandage can only prevent the prolapse of the internal organs.
Concept and classification
By origin, congenital or acquired peritoneal hernias are isolated. Depending on the place of emergence of the protrusion are external and internal. Hernias are also divided, depending on the location of the lesion. Most commonly diagnosed are umbilical congenital hernia in children, inguinal hernia in men and protrusion of the structures of the abdomen during pregnancy.
Due to the peculiarities of the structure of the male body, an inguinal hernia is more often diagnosed in young boys and men, and an umbilical hernia in women.
The aggravation of the disease occurs at the time of contraction of the muscles of the abdominal wall and reduction of the protrusion opening.
A dangerous complicated hernia can lead to the following serious conditions:
- acute or chronic intestinal obstruction,
- intoxication organism, sepsis,
- internal bleeding
- kidney or liver failure
Bulging of the peritoneum can be fatal if not treated immediately, by surgery to remove dead tissue and repair organs.
There are several types of hernia. It is necessary to consider in more detail what hernias are and what are their features. Classification is carried out according to the place of pathology development, therefore there are hernias:
- inguinal, femoral, umbilical,
- abdomen white line,
What are hernias? No less rare are the following types of pathology:
- Hernia of the white line of the abdomen. In this case, damage occurs along the midline of the abdominal wall on any floor. Symptoms will be in the form of a characteristic protrusion, which most often occurs in the upper part, nausea appears, which often ends in vomiting, severe pain, muscles disperse along the midline of the abdomen.
- Umbilical hernia. If an umbilical hernia develops, the symptoms will manifest as a protrusion in the corresponding area of the abdomen. When a person is in a horizontal position, education disappears. In men, this pathology is much more common. In addition, there may be pain, vomiting and expansion of the umbilical ring. The treatment is carried out only by surgery, using the methods of non-tension plastics (both conventional and laparoscopic).
- Lateral hernias are characterized by protrusion through the defect of the abdominal cavity, which was formed on the lateral surface of the abdomen.
- Hernia of the spigelian line is located along the outer edge of the rectus abdominis muscle.
- Hernia of the esophageal opening of the diaphragm (POD). Hernia POD - what is it? This question can be heard from many. In this case, the aperture of the diaphragm expands, which leads to the raising of the entire stomach or its part into the chest cavity. As a result, gastric juice from the stomach and duodenum enters the esophagus, which leads to the development of gastroesophageal reflux disease. In such cases, the person suffers from heartburn, after eating a pain in the chest appears.
Symptoms and signs of hernia
If a person knows what the first signs of abdominal hernia are, then he will be able to consult a doctor in time and take the necessary measures with him for the treatment of this pathology. Despite the fact that there are different types of this disease, its symptoms will be almost the same in all cases.
In some situations, signs of the development of the disease can occur immediately, and sometimes they develop gradually.
Symptoms of abdominal hernia
The specific symptoms of abdominal hernias are similar and appear at the moment of increased load. In the abdominal area, the pineal bulge appears, which disappears at the moment of relaxation or pressure. Symptoms of pain in most cases are absent, due to the continuation of the normal functioning of the prolapsed organs.
At the initial stage of the disease, the only true symptoms are protrusion and slight discomfort in the abdomen.
In case of a complication of a hernia, the following symptoms join:
- dyspeptic disorders: nausea, vomiting, diarrhea, bloating,
- dull or occasional sharp pain in the area of protrusion,
- anorexia, belching, heartburn,
- deterioration of general well-being.
When a hernia is strangled (compression of the hernia gate), the patient's condition worsens greatly, symptoms of intoxication appear: nausea, headache, fever, sharp pain in the abdomen, pale skin, cold sweat and clouding of consciousness.
When the internal structures become pinched, all the symptoms intensify and the bulging does not take its place. The danger is to stop the normal blood circulation of the pinched tissue, followed by necrosis.
In this condition, immediate surgical treatment with the restoration of organ function or partial resection (removal of the affected part of the organ) is necessary.
The main symptom of abdominal hernia is the presence of protrusion. The shape of these hernias is round, with a long origin sometimes irregular or pear-shaped, the surface is smooth.
Rumbling, nausea, vomiting, general deterioration, constipation and pain appear less frequently.
The pains are usually mild, dull, aching in nature. Often the pain is reflected and felt sick in the epigastric region, lower back, in the scrotum, etc. Sometimes the pain is absent, and the patient does not even suspect the existence of a hernia.
One of the most common surgical diseases - abdominal hernia, which is formed on the front wall of the abdomen.
Methods for the diagnosis of abdominal hernia
Hernia of the abdominal wall, detected in the early stages of development, can be eliminated without surgical intervention. If a patient is suspected of this disease, they are referred to a series of examinations, including an x-ray examination of the bladder, gastrointestinal tract, liver, and chest.
The main symptom, which indicates the presence of a problem, is a noticeable displacement of the small intestine. Normally, it is located in the entire lower abdomen. At the same time, the jejunum is located on the left, and the ileum is on the right.
In this case, differential diagnostics can also be performed. The study is conducted in different positions of the body. Do not pass diagnosis without ultrasound.
If a hernia tumor appears on the usual places for hernia (inguinal, femoral, umbilical region), then it is easy to recognize the hernia. The appearance of such a tumor in the perineum, in the sciatic region or in the region of the obturator orifice, first of all, makes one think about its possibilities.
The second characteristic symptom of a hernia is a “cough push”. If you put your hand on the tumor and make the patient cough, then the hand clearly feels the push. Tapping, palpation of the hernial tumor, as well as a digital examination of the hernial ring establish a diagnosis.
Treatment of protrusion of the organs of the peritoneum cavity is to prevent complications and return structures to the anatomical site. For defects of the anterior abdominal wall, preference is given to surgical methods: a hernia is removed by returning the organs and fixing them.
The protrusions of the abdomen do not have the opposite development, because treatment should be carried out radically, followed by a conservative recovery.
Successful surgery ensures complete elimination of the disease with minimal risk of recurrence. The patient after treatment should limit physical exertion for some time, follow a diet.
After the seams have healed, gymnastics is shown to strengthen the muscles of the peritoneum, pool, meditation. There are hernias that can occur without surgery with the use of gymnastics and supporting bandage alone.
The umbilical hernia in children often disappears on their own, if you wear an anti-hernia bandage on the abdominal wall and engage in physical therapy with the child.
How does the protrusion surgery go?
- Creating access to the hernial sac, by multiple punctures in the abdomen,
- Introduction of tools and camera through punctures,
- Assessment of the internal organs,
- Installation on the site of a hernia special mesh, which grows together with the tissues and holds the internal organs,
After surgery, the patient is at rest for several hours, after which he can move around and is discharged the next day. Postoperative recovery lasts about a month, after which the person returns to the usual life, but avoids stress and monitors nutrition.
If a hernia is suspected, a very detailed diagnosis is important, which can only be achieved with a comprehensive examination of the body. In a situation such an X-ray examination of the bladder of the urinary, chest, gastrointestinal liver and tract will be mandatory. The procedure is carried out with the use of barium, which allows you to see the location on the picture If.
hernia occurred displacement of the small intestine, then this sign indicates the development of a hernia. Additionally, differential diagnosis or irrigoscopy may be prescribed.
also ultrasound is an effective method of examination. With the help of it, it is possible to distinguish unreducible protrusions from lymph nodes and benign ones in the inguinal region. Ultrasound allows the anatomy to study the cavity in which the hernia is found, and suitable to plan the method of its removal.
Computed tomography makes it possible to recognize the nature and size of the defect with a high accuracy.
Possible complications of hernia
danger The main danger of abdominal hernia, infringement is. Such a condition may come in contact with a bowel loop in the hernial bag. pinching The process is associated with contraction of the abdominal muscles, which contributes to the reduction of the hernial ring. Ultimately, a result is a deterioration in blood circulation, against which a bowel necrosis can form - the death of tissues. infringement With a hernia the following complications are possible:
- serious body toxicity,
- intestinal obstruction
- peritonitis - the process of inflammatory abdominal cavity,
- disruption of the liver and kidneys.
How to treat a hernia
In rare cases, the hernia is amenable to conservative correction and treatment with physiotherapy and massage. she often requires surgery. And if a vital operation is already infringed upon an important internal organ, then an emergency takes place.
The choice of surgical methods for removing hernia today is quite addictive. In wide from the type of hernia and technical complexity, the doctor of the operation may recommend open or laparoscopic hernioplasty, by the method of tension or implantation of the net implant to close the hernia gate.
categories There are patients for whom surgery is contraindicated or is contraindicated only in emergency cases, when the risk associated with hernia complications significantly exceeds the risk of surgery. Such patients include children under the age of 1 year, pregnant women suffering from, people with chronic or infectious diseases associated with metabolic disorders, for example, diabetes mellitus.
Often, if the development of a hernia is connected to the abdomen with a general weakened condition of the connective muscle or tissue, the operation does not guarantee, then after a time, a hernia will reappear, but in another area. Therefore, preventive measures to strengthen the abdominal press, the adjustment of nutrition and lifestyle is recommended to all patients.
No matter what the hernia situation seemed easy, the only way to deal with such a problem is to have an operation. pathologies Such do not disappear on their own. Over time, only the amount of protrusion increases and creates a danger to human life and health.
Moreover, if there is a hernia in the body for too long, the adjacent tissue deformation occurs. And this, in turn, can have a direct impact on the result even after the operation. Even a special bandage and reposition can not solve the problems with hernia. Wearing a supportive bandage will not reduce the likelihood of infringement.
There is the only type of hernia that can disappear on its own - a umbilical hernia in a child under five years of age. In the remaining cases without surgical intervention is indispensable.
A specialist should be contacted immediately at the first suspicions of what. a hernia before the patient is operated on, the greater the chance of an easy recovery without How. complications will only be confirmed by the diagnosis, the patient will have to undergo an additional examination, delivery including tests. These measures are necessary in order to assess a person’s overall health. A detailed analysis of all indicators of the presence and patient of concomitant diseases allows the surgeon suitable to determine the treatment option, adapted to the body features of a particular person.
Preoperative examination analysis:
- includes blood (biochemical and clinical),
- blood on RW,
- HIV for analysis,
- analysis for the detection of hepatitis,
- group analysis,
- blood urine
- chest x-ray,
- ECG gynecologist or andrologist,
- conclusion Modern.
the therapist the possibilities of medicine are simply amazing. Removal by operation Hernia today is conducted low-impact through the method of laparoscopy. At the appropriate part of the body, the surgeon makes small incisions, into which laparoscopy is inserted together with the necessary instruments. This device allows the doctor to monitor every action for the presence, and the monitor of the miniature surgical instruments allows hernia to be removed without injury to nearby tissues.
In the operation of the process of hernia have a kind of patch, which is made of mesh material. Subsequently, it will grow into tissue, which will further prevent the hernia from occurring. The percentage of repeated hernias in this case is minimal.
The operation is performed under local general or anesthesia. It all depends on the severity of the disease and on the condition of the patient. But surgeons accept intravenous pain relief, because in this case, all the patient's muscles are relaxed. This makes it easier for the doctor to carry out the necessary manipulations. Under local anesthesia, the patient is under stress, which only aggravates the surgical process, and this may adversely affect the outcome of the operation.
The duration of the surgery - 1.5-2 And. an hour after the operation, the patient does not lose the ability to move independently, and in a day he can go home.