External hernias
External abdominal hernias protrude above the body surface and consist of a hernial sac, which usually contains fatty tissue and (often) a small portion of the intestine. They include: - Inguinal hernia - observed in the groin, sometimes descend into the scrotum. Femoral hernia - observed in the upper part of the thigh. Umbilical hernia - go to the navel. Epigastric hernia - observed along the midline above the navel.
Internal hernias
Diaphragmatic hernia - the contents of the abdominal cavity leaves through the defect in the diaphragm in the chest; it can squeeze the lungs and cause asphyxia. With a hernia of the esophagus, the stomach partially protrudes through the esophageal opening of the diaphragm. Inguinal, umbilical and diaphragmatic hernias often occur as a result of birth defects in the abdominal wall. The oblique inguinal hernia arises from an abnormal preservation of the canal through which the testicles descended into the scrotum during embryonic development. The femoral hernia emerges through a place in which the femoral artery, the main artery of the thigh, passes into the hip from the abdominal cavity. Many abdominal hernias are caused by factors that increase intra-abdominal pressure, such as:
- obesity;
- coughing or straining;
- weight lifting;
- pregnancy.
Infringement is observed when the intestinal loop is pinched in the hernial gates and its blood supply is blocked. Because of this: the movement of the contents through the intestines is disturbed; hernia becomes very painful, the patient has vomiting and severe colic; without treatment, the intestinal loop within 5-6 hours changes gangrenous and can be perforated; generalized pain develops in the abdominal cavity; there comes a paralysis of the intestine and the pain subsides - this is a dangerous sign. With the exception of umbilical hernia in infancy, almost all cases of external abdominal hernias require surgical treatment. The chances for successful recovery are increasing in patients:
- overweight;
- avoiding constipation;
- quitting smoking in order to reduce the risk of coughing attacks.
Surgical technique
Over the years of practice, many varieties of joints and plastic have been created to repair abdominal wall defects. Many surgeons are now successfully using a fine mesh for this purpose. Non-acute inguinal and femoral hernias are now often operated in day surgery units, sometimes under local anesthesia. Men with hernias have often been prescribed bandages, but they were uncomfortable, unreliable and demanded very qualified treatment. So now they are rarely recommended. Most patients with hiatal hernia can be treated by controlling acid casting by the following methods: raising the head of the bed; taking antacids or other drugs that suppress the release of acid in the stomach; weight reduction. Small and medium-sized umbilical hernias in children often disappear without treatment. Babies with extensive hernias should be treated as soon as possible. Most external hernias of the abdominal wall can be successfully eliminated. In the absence of treatment, most of them will increase in size. The oblique inguinal hernia, permanently left without proper attention, can become extremely large and very strongly extend the scrotum. Straight inguinal hernia of this size does not reach. External abdominal hernias do not necessarily have to be large in order to have the risk of contraction which without fatal surgical treatment is fatal. In this case, femoral hernias are more likely to infringe than inguinal hernia.
Hernias of the esophageal aperture of the diaphragm can be completely asymptomatic. If reflux starts to cause inconvenience to the patient, usually medicamentous treatment is effective. Prolonged exposure to gastric juice can cause scarring in the lower part of the esophagus, causing difficulty swallowing. Also, precancerous changes in the mucosa of the esophagus are possible. However, all these changes with the correct treatment are reversible. At least 1 out of 100 people ever had a hernia, of which 70% are inguinal, 20% are femoral and 10% are puffy. The oblique inguinal hernia is most often found in the period from infancy to early adulthood. In about 30% of cases, it is bilateral, affecting men 20 times more often than women. 10-20% of inguinal hernias are probably due to muscle damage with physical strain or trauma (direct inguinal hernia). They are usually observed in elderly people with weakened muscles, but can also occur in younger men. Femoral hernias under the age of 15 are rare and affect women twice as often as men. The greatest risk for their development is in women giving birth. Approximately 30% of people over the age of 50 suffer from hernia of the esophageal opening of the diaphragm.