Linea alba hernia: symptoms, surgery photos

Hernia linea alba - pathological process, during which the protrusion is formed between the abdominal muscle tendon fibers slits median line (white line). In another such disease called epigastric hernia, and it is found in 10% of cases, mostly among men.

Bulging bodies occur anywhere along the median line of the abdomen at the site of the hole formation. White line acts weave tendon bundles abdominal muscles in a wide plate. Is localized on the central axis line from the xiphoid process to the pubic articulation, its thickness is about three centimeters.

What it is?

Hernia white line - a protrusion out of subcutaneous fat and internal organs through the large gap between the tangle of tendons linea alba.

As practice shows, the pathology of 3-10% more common in men under the age of 30 years. In this form of the disease part of the internal organs and fat begins to exude through the holes between the muscles. A typical place of localization - the epigastric region.

Depending on the location in relation to the umbilical depression the following types of hernias:

1. Nadpupochnye (located above the navel);
2. Umbilical (navel disposed near cavity);
3. Podpupochnye (localized depressions below the navel).

Location hernia the white line near the navel and below it is uncommon.

Modern treatment methods make it easy to get rid of the disease, however, for its detection at an early stage need to be familiar with the causes of disease and its accompanying symptoms. Hernia, like any other disease, it is easier to treat at an early stage of development.

At first glance, education does not cause significant discomfort, but the disease is still fraught with danger. The main threat is pinching bodies trapped inside the hernia sac. In some cases there is a compression of the nerves.

Causes of

Factors that trigger the development of diseases, divided into 2 categories: the reasons arising from the weakness of the white line, and the factors that caused the increase in pressure inside the peritoneum.

Reasons related to the first group, are preconditions for the emergence of a hernia. It:

1. Genetic predisposition In the presence of relatives diagnosed with the disease risk increases.
2. Overweight due to a thick layer of subcutaneous fat anterior abdominal wall becomes weak, and the white line begins to stretch.
3. Scars formed due to surgery each one is vulnerable point, wherein the bulging herniation can occur.
4. Any damage to the trauma of the abdomen makes the anterior abdominal wall weaker.
5. Pregnancy During this period weakened abdominal muscles and the abdominal wall is stretched.

Factors of the second group, are direct instigators of the disease. These include:

• strong and prolonged crying in infants;
• difficult birth, large baby;
• disease, occurring against the background of problems with urination;
• great physical exertion;
• constipation;
• diseases of the abdominal cavity, occurring against a background of severe coughing.

Symptoms of hernia linea alba, photos

Symptomatology hernia the white line of the abdomen (see. photo) in men and women is the same, the pathology is independent of sexual characteristics. In some cases, the hernia at all can manifest itself only protrusion, which is typical for early stage disease.

Over time the hernia pain begins to manifest itself, are significantly enhanced in moments of intense movements and straining. Pain in each case may have a different character. They can be harsh, blunt, pulling, persistent or paroxysmal, sharp and even a "dagger".

Also, the disease in men and women is accompanied by the following symptoms:

• nausea, vomiting, alternating with;
• the pain of a different nature - in flexion, rotation, and other movements;
• stretching midline abdominal muscles;
• pain after eating;
• belching, heartburn, hiccups.

With the progression of the disease and the symptoms of disease are amplified:

• pain intensified and become unbearable for the patient;
• vomiting constantly tormented by the patient;
• blood can be detected in the stool;
• straighten hernia becomes impossible.

In the case of pinching hernia, helping the patient to be an emergency. If any of the manifestations, should immediately contact the clinic.

stage

Normally, the white line from the sternum to the navel is 10-25 mm in width, and below it narrows to a few millimeters. In the spot, where a hernia linea alba, tendon fiber 100 may diverge and even 120 mm, forming a hernial different shapes (oval, rhomboid, circular).

Wide hernial not appear immediately - hernial protrusion goes through several stages of development:

1. The first stage - preperitoneal lipoma. It occurs when the appearance of one or more precipitating factors, which we discussed earlier. In this case, through the still, small holes in a diverging tendon acts under the skin fat.
2. Initial stage. peritoneum fall into the hernial ring, which begins to form a skin to the internal organs, leaving the skin. Peritoneum - a thin skin covering the internal wall surface of the abdominal cavity and internal organs.

Hernia linea alba final forming step includes all the required elements:

• hernial ring - a hole in the white line where the organs are located;
• hernial sac - peritoneum;
• the contents of the bag: the gland, intestine, stomach wall, some ligaments.

Depending on when the disease was discovered, it depends on the complexity of the operation.

strangulated hernia

Strangulated hernia the white line of the abdomen is a compression of the organs and tissues that are in the hernial sac. Depending on the mechanism of development distinguish elastic, fecal and retrograde strangulated hernia.

Elastic pinching hernia occurs when a sharp rise in intra-abdominal pressure (e.g., during defecation, coughing, sneezing, etc.), when the hernial rapidly expanding, bulging of the abdominal organ most of them cavity. Then hernial returned to its original state as tissue elasticity, and fallen bodies back into the abdominal cavity do not have time.

When fecal infringement gradual filling of loops of intestine, which happened in the hernial sac, feces and gases. As a result of intestinal loop stretches and increases in size, resulting in its pinching occurs.

If retrograde infringement compressed portion intestinal loop or other organ, was not in the hernial sac and in the abdominal cavity. In this type of infringement is rapidly developing peritonitis and bowel necrosis and the severity of clinical symptoms is growing rapidly.

Diagnostics

Primary diagnosis can be made based on visual inspection of the patient, to accurately determine the status required to perform additional tests.

1. Ultrasound examination of the state of the abdominal cavity. Checking the status of the internal organs.
2. X-ray examination of the hernia sac. Before the examination the patient is given a barium preparation for enhancing image contrast.
3. Multislice imaging. Is used in the most severe cases, can completely eliminate errors during diagnosis and assessment of the current state.

Treatment

Often the treatment of the disease make mistakes that affect the pathology negatively:

1. Treatment of pain medications or drugs relieves spasms only eliminate the pain.
2. Constant wearing of the belt. The device can not be used for a long period. Belt does not replace a full-fledged functioning of muscles. If you frequently use tools muscle fibers may lose their tone, causing them to atrophy.
3. Folk remedies (extracts from the leaves of drupes, Helichrysum, Artemisia), taken by mouth, can reduce flatulence and improve intestinal function. This will reduce the degree of protrusion of the intestine, but a defect in the tendon does not heal due to the properties of the tissue.
4. The use of drugs to enhance gastric motility. For some time, this type of treatment really brings relief but does not solve the problem. Treat pathology recommended by the operation.
5. Exercise is good for prevention of herniation, but not for treatment.

Abandonment of self, timely diagnosis of disease and its proper therapy - this is the only way to avoid complications and to return to a full life.

Preparation for surgery

Self-preparation of the patient includes the following items:

• avoiding alcohol not later than three days prior to surgery;
• avoidance of drugs that impair blood clotting and increase the risk of bleeding (you must inform the doctor of any medication taken, and he will give a list of prohibited);
• 14 days before the operation to secure a balanced diet that includes all the necessary trace elements and vitamins (which makes it easier to move the procedure and anesthesia, as well as improve rehabilitation);
• a complete refusal to eat after 20.00 on the day before surgery.

The hospital should take the necessary laboratory tests to check blood sugar, HIV exceptions, hepatitis and other sexually transmitted diseases, the exact determination of blood group and Rh factor. Also conduct an electrocardiogram to check heart function to make sure that the patient will take anesthesia.

Surgery to remove a hernia linea alba

Surgery is carried out in a planned manner. The doctor examines the patient, establishes the diagnosis, appoints examination and date of admission to hospital.

Types of operations for hernia the white line of the abdomen:

1. Open surgery with nenatyazhnoy plastic. To strengthen the white line of the abdomen, the surgeon uses a special prosthetic mesh. This method is now applied more often, because after him the least likely to relapse.
2. Open surgery with tension plastic. After removal of the hernia surgeon tightens the abdominal sutures white line, thereby strengthening it - hence the word "tension" in the title. This type of operation is straightforward, but it has drawbacks: it is necessary to do quite a long incision (scar remains high), high risk of relapse.
3. Paraperitonealnoe surgery. Also make three punctures but, unlike laparoscopic surgery, instruments are not introduced into the stomach, do not pierce the peritoneum. Between it and the surrounding tissue was placed a special balloon is inflated and it - a space is formed, from which one can gain access to the hernial sac and perform a surgery. The advantages of such an operation the same as that of laparoscopic. However, its implementation is technically more difficult, it is impossible to securely fasten the mesh prosthesis.
4. Laparoscopic surgery. With the advent of modern high-tech equipment in hospitals this type of surgery for hernia the white line of the abdomen began to gain popularity all the more. Instead, the surgeon makes an incision three holes through which the hernia removes and installs mesh prosthesis. Laparoscopic surgery provides a low risk of recurrence and reduces the rehabilitation period to 10 days - after that the patient can again be engaged in the usual chores. But this operation can not be carried out at diseases of lungs and heart. it is also not possible if the clinic is not the appropriate equipment and specialists.

When strangulated hernia the white line of the abdomen surgery should be carried out urgently. The surgeon opens the hernial sac and looks that are therein of the intestine. If she died - it must be removed. Sometimes it turns out that had omertvet large intestine site - have to increase the cut and remove all the dead tissue.

rehabilitation period

After elective surgery, that is when the hernia has not been infringed, recovery is fast enough. In a hospital patient hold no more than three days. During this period, the nurse makes regular dressings, and the doctor monitors the state of the joints and the patient's state of health, to exclude the possibility of infection. To the same effect is assigned a prophylactic course of antibiotics.

aftertreatment requires compliance with certain rules:

• smoking raise above 5 kg weight (the restriction is not less than 3 months after the operation);
• forbidden inclinations forward, sudden movements and too intensive training;
• It shows moderate physical activity, especially walking;
• must take doctor prescribed laxatives (constipation may trigger divergence sutures);
• should reconsider your diet and go on a balanced diet.

People whose profession is associated with heavy physical work, translated into an easy job for a period of up to 6 months.

Diet

Sometimes there are situations when immediate surgery to perform for various reasons it is impossible, it is necessary to set aside a certain time. Compliance with the diet can alleviate the disease and minimize the risk of abuses.

• It is recommended to be administered in the diet of more than rice porridge, fish, eggs and dairy products. Be sure to drink a liquid physiological norm. All products must be digested quickly with a minimal amount of gas.
• It is not recommended to use the products that cause bloating: beans, fried and smoked food, chocolate, nuts, butter, pickled vegetables.

If there are initial problems with digestion, it is necessary to eliminate them by any means, of medicinal products to the folk methods. The condition of choosing the right diet is the final diagnosis made by the medical establishment.

prevention

Warning hernia the white line includes the following activities:

• identifying the causes of extra kilos and the normalization of body weight;
• timely cure of diseases accompanied by cough;
• avoiding heavy lifting;
• adherence to the principles of a balanced healthy diet that would help regular bowel movement;
• avoidance of injuries of the anterior abdominal wall;
• regular physical exercise to strengthen the abdominal muscles (morning exercises, training in the gym);
• dosing of physical activity, in which the involved abdominal muscles, in proportion to their own physical fitness;
• implementation of all the recommendations of doctors (including the wearing of abdominal bandage) during pregnancy and in the postoperative period.

Remember that the band does not cure the hernia. With long-term wear on the contrary it can assist its emergence as begins to perform the function abdominal muscles that are weakened as a result of inactivity, diverge even more, which contributes to hernia.