The author - Chuklin Olga, general practitioner, internist. Work experience since 2003.
Inguinal hernia is called a diverticulum of the abdomen through the inguinal canal into the skin. Inguinal canal represented gap between the abdominal muscles. On it are the nerve fibers, the spermatic cord in males and the round ligament of the uterus in women.
Most often the disease occurs in men is due to the anatomical structure - the inguinal canal they are shorter and wider than that of women.
Causes of
Accepted provide innate and acquired inguinal hernia.
Congenital occur most often in children, in adults, they are rare.
Inguinal hernia in a child
Education congenital inguinal hernia occurs due to malformations. So when lowering the testicles into the scrotum in boys and drops of the peritoneum, which later grows. But sometimes the overgrowth does not occur and the pocket is formed, which forms the hernia sac. In this hernial sac occurs protrusion of the abdominal cavity.
This does not happen girls (descent of the testes) and, respectively, and inguinal hernias are very rare.
Acquired inguinal hernias
Acquired hernias are the most common.
the presence of the following symptoms may lead to them:
- the weakness of the connective tissue;
- factors for which there is an increase in abdominal pressure:
- chronic constipation;
- chronic cough frequent;
- pregnancy;
- weight lifting;
- obesity.
Predisposing factors include the following:
- genetic predisposition;
- frequent pregnancy and childbirth in women;
- male gender;
- elderly age;
- rapid loss of body weight.
The hernial sac bowel loops fall more often, fallopian tubes, ovaries.
Types of inguinal hernias
Due to the occurrence of hernias are divided into:
- birth;
- purchased.
At the place and nature of education inguinal hernias are divided into:
- straight - there is protrusion of internal organs is not on the spermatic cord. Due to data hernia weakness of connective tissue;
- oblique - going protrusion of internal organs through the spermatic cord, oblique, they are called as the inguinal canal has oblique stroke - from top to bottom, and from outside to inside.
On presence of infringement:
- neuschemlennye;
- disadvantaged - where there is infringement of the internal organs in the hernial sac.
The position of the hernia sac inguinal hernias are divided into:
- inguinal - hernial sac is in the inguinal canal;
- inguinal-scrotal - hernial sac is located in the scrotum;
- inguinal-scrotal, testicular - hernial sac is located in the scrotum and around the testicles.
hernias are also:
- one-sided;
- bilateral.
Most often unilateral inguinal hernias.
Symptoms of inguinal hernia
Symptoms of congenital hernia
The following symptoms are found in the presence of a newborn inguinal hernia:
- groin rounded protrusion;
- increase protrusion in the upright position;
- increase hernia coughing, sneezing;
- easily reduce a hernial protrusion;
- bloating.
Symptoms of acquired hernias
The main symptoms are:
- pain and discomfort in the groin area, which are amplified during walking and exertion;
- bulging in the crotch region lying disappearing or decreasing;
- by coughing protrusion increases in size;
- men if the hernial sac is located in the scrotum, the scrotum is increased on the side of hernias;
- constipation - when released into the hernial sack intestinal loops;
- by ingestion of large hernial sac bladder patients have voiding.
When the infringing contents of the hernia sac, in a patient having:
- severe pain in the abdomen;
- palpation there is a sharp pain;
- not reduce a hernia;
- increase in body temperature.
Strangulated inguinal hernia refers to a condition requiring emergency medical care. With the development of strangulated inguinal hernia surgery is performed.
Diagnostics
If signs of disease it is imperative to consult a surgeon.
If the patient shows signs of strangulated inguinal hernia is an urgent need to call an ambulance.
To establish a preliminary diagnosis of the surgeon can immediately after the examination of the patient. For this, he visually inspects the groin and palpates inguinal ring.
Be sure to inspect the lying and standing, straining or coughing.
If necessary, the patient is carried out:
- ultrasound of the scrotum;
- herniography - introduction into the abdominal cavity of a radiopaque material to define a hernia;
- irrigoscopy bowel investigation.
Treatment of inguinal hernias
Inguinal hernia necessarily require surgical treatment. To cure an inguinal hernia without surgery impossible. If you do not spend time to operative treatment, it can lead to complications.
As inguinal hernia is not treated by traditional methods, because it leads to an increase in symptoms and the development of complications.
Inguinal hernia surgeon involved.
In the absence of contraindications and complications, the patient is carried out planned surgery in a hospital. The operation is possible under general anesthesia or local anesthesia.
Excision carried hernial sac, the presence therein of the abdominal cavity, the surgeon reduce a back them.
After that the strengthening of the anterior abdominal wall. For this purpose carried plastic surrounding tissues sewing or mesh graft.
If the patient is currently contraindicated for surgery may conduct temporary medical treatment - wearing a bandage.
Important! The bandage helps to alleviate the condition and is not a method of healing. After eliminating contraindications performed surgery.
After the surgery the patient is a few days in the hospital for observation and treatment of joints. The sutures are removed in 7-10 days.
It is now possible transactions a laparoscopic approach, when done several small punctures on the anterior abdominal wall. The patient is discharged from the hospital a few days after treatment. Pains thus punctures in the area postoperatively minor.
Complete recovery after removal of the inguinal hernia occurs at 3-6 months. During this period, should avoid heavy physical labor. Meals must be digestible food that the patient did not arise constipation.
With the development of strangulated inguinal hernia repair performed emergency surgery.
At the beginning of the surgeon opens the hernial sac and evaluates the status of bodies contained therein. Since if the intestinal tissue in the hernial sac dead, they are dissected. And only then excised hernial sac and strengthened anterior abdominal wall.
After the modern methods of treatment of inguinal hernia recurrence is extremely rare, provided that all the recommendations in the postoperative period.
complications
With inadequate or unfair treatment of an inguinal hernia may cause serious complications:
- infringement of inguinal hernia;
- coprostasis development - stagnation of feces. Coprostasia develops when released into the hernial sac of the colon. The patient is observed constipation, abdominal pain, nausea, vomiting.
- inflammation of hernia - occurs when infected hernia sac. Manifested by fever, redness of the skin over the hernia, increase the size of the hernia.
- necrosis (necrosis) of tissue organs located in the hernial sac. It occurs when a strangulated hernia.
prevention
- Conduct of exercise to strengthen the abdominal muscles.
- Maintaining normal body weight.
- Compulsory wearing of the bandage during pregnancy.
- Undergo regular medical examinations.
- Avoidance of long and frequent strenuous exercise.
