How does an inguinal hernia manifest?

An inguinal hernia causes not only physical, but also psychological discomfort. This disease is more often diagnosed in men, and affects sexual activity and the work of the genitourinary system. Understanding what an inguinal hernia looks like externally is quite easy. In the groin there is a rounded formation, which is independently reduced at rest and with pressure.

Women can also be diagnosed with this disease, but this happens much less frequently, which is associated with the anatomical features of the inguinal canal and the musculo-ligamentous apparatus.

Signs of an inguinal hernia are visible during ultrasound, magnetic resonance imaging, CT. An experienced urologist and surgeon only needs one glance at the formation to determine the disease. But with the ease of recognizing the disease, a differential diagnosis is necessarily carried out with such pathologies as dropsy, varicocele, benign neoplasm, cancerous tumor.

You can confirm the diagnosis with the help of an ultrasound of an inguinal hernia, then the doctor has the opportunity to examine the hernial sac and surrounding tissues.

How to identify an inguinal hernia:

• in the groin area there is an oval or rounded formation;
• palpation can detect hernial orifice;
• the protrusion increases during muscle tension when coughing, sneezing, straining, while the child is screaming and crying;
• unilateral enlargement of the scrotum, which is observed with inguinal-scrotal hernia;
• reduction of the defect with light pressure, and when the patient lies on his back;
• enlargement and soreness of the labia with a hernia in newborn girls and adult women.

Types and clinic of hernias

Symptoms are largely determined by the form of the disease:

1. Inguinal-scrotal - occurs only in men, is characterized by the lowering of organs into the scrotum on one or both sides, the hernial sac is located next to the testicle (differentiate with dropsy and varicocele).
2. Cord - the hernial sac is located near the spermatic cord, not descending to the testicles.
3. Actually inguinal - a hernia is located in the inguinal canal, near its outer opening.
4. Oblique - organs descend through the groin canal, passing near the spermatic cord.
5. Direct - the contents of the hernial sac passes into the inguinal canal without affecting the opening.
6. Combined (direct and oblique) - two forms of the disease occur simultaneously, which are not related to each other, manifest a complex of symptoms typical for each disease.

A strangulated inguinal hernia is considered separately.

This is a variant of the complication in which the organs are compressed in the area of ​​​​the hernial sac or gate. This is facilitated by a sharp increase in intra-abdominal pressure, a high load on the muscles of the anterior abdominal wall, and injury.

Clinical manifestations will depend on the organs in the hernia sac. If it is the intestines, which happens most often, the patient has digestive disorders. In this case, associated problems with defecation can be identified. Often the patient is faced with constipation and bloating, and in severe cases, intestinal obstruction develops, which will be an indication for immediate surgery.

Such complications can be detected by ultrasound. A differential diagnosis with a tumor requires an additional biochemical study of the blood and tissues of the pathological focus. When there is a suspicion of varicocele or dropsy, the urologist conducts an examination, prescribing a series of laboratory tests.

A surgeon diagnoses a hernia, and a urologist, oncologist, infectious disease specialist and other specialists help to differentiate the disease, based on how the pathology manifests itself in a particular case.

Strangulated hernia

You can recognize a pinched inguinal hernia by the following symptoms:

• severe pain syndrome;
• increased pain while walking;
• increase in education, its irreducibility;
• nausea and vomiting are rarely noted;
• dyspeptic symptoms appear in the form of heartburn, belching of acidic contents, which is associated with disruption of the gastrointestinal tract, and the release of stomach contents into the esophagus;
• subsidence of symptoms after a few hours;
• pallor of the skin, dizziness and weakness due to circulatory disorders.

The intestinal loop located in the hernial sac suffers from ischemia, the tissues begin to die.

This is accompanied by an inflammatory process, infection of tissues and general intoxication of the body. There is only one treatment option for infringement - surgery. Before surgery, ultrasound diagnostics is performed and laboratory tests are prescribed.

Surveys

Diagnosis of an inguinal hernia begins with a general examination:

• the doctor sees a typical formation in the groin area;
• with inguinal-scrotal hernia, the scrotum is enlarged;
• during coughing, the protrusion intensifies;
• in the supine position, the formation disappears;
• when pressed, a gurgling sound is heard;
• when palpating a hernia, the phenomenon of "weak groin" can be determined.

Confirmation of the diagnosis and differential diagnosis of inguinal hernias include:

1. Ultrasound examination of the scrotum and inguinal canal. By ultrasound, it is possible to determine which organs are in the bag, how voluminous the formation is, and in what condition the tissues involved in the pathological process.
2. Ultrasound of the abdominal cavity and retroperitoneal space. The doctor examines the internal organs, determines the exact localization of the pathology, and which organs suffered from it.
3. Ultrasound of the pelvis. Indicated for hernia in women. The study allows you to determine the location of the ovaries and fallopian tubes, which most often descend into the inguinal canal.
4. Herniography . This is an X-ray examination using a contrast agent. Through research, the doctor determines whether it is still possible to wait from operations, or whether the patient is in serious condition, and at any time there is a risk of complications. The contrast agent penetrates into the hernial sac, and the doctor clearly sees its borders.
5. Cystography . It is carried out with suspicion of getting into the hernial sac of the bladder. During the procedure, a contrast agent is injected into the urethra through a catheter. In the pictures, the doctor sees the entire organ and that part of it that has penetrated the hernial sac.
6. Irrigoscopy . Examination of the large intestine with the use of a contrast agent. The drug is administered through the rectum with preliminary bowel cleansing. The pictures show the intestines and tissues in the hernia sac.

Why does a hernia appear

Factors in the occurrence of inguinal hernia:

1. Prematurity and congenital anomalies of the connective tissue. An increase in the load on the muscles in the first months after the operation will provoke the development of a hernia, which is facilitated by the non-closure of the vaginal process in boys.
2. Overweight and pregnancy. These conditions increase the load on weakened muscles, which at any time can lead to their divergence.
3. Hypodynamia . The absence of a moderate load affects the state of muscle tissue, it decreases in volume and is replaced by fat.
4. Exhaustion of the body . With cachexia, muscle atrophy occurs, and a protrusion appears in the most vulnerable area.
5. Chronic diseases of the respiratory organs. They are accompanied by frequent coughing, which leads to increased pressure inside the peritoneum.

Methods of treatment

How is a hernia treated in children after 6 years and adults (operation course) :

1. An incision is made in the groin area or a puncture is made on the abdominal wall.
2. Instruments and a video camera are inserted through the hole.
3. The surgeon highlights the hernial sac.
4. The organs are back in place.
5. The bag is excised.
6. The plastic of the inguinal canal is done.
7. The wound is sutured.

Before and after the operation, patients are assigned a bandage that will protect the operated area from accidental damage.

Such a belt in the form of swimming trunks will also be a means of preventing relapse. It is prescribed for children and adult patients. There are universal models for men and women. They can be right-sided, left-sided or double-sided.

Treatment for children under 6 years of age includes the following activities:

1. Wearing an inguinal bandage.
2. Diet food.
3. Physical exercise.
4. Belly massage.

With a strangulated hernia in a child, the treatment is only surgical.

The operation is performed by open or laparoscopic hernioplasty. Each variant of hernia repair involves strengthening the inguinal canal. This is done by tension and tension-free method. In the first case, the inguinal canal is sutured with the patient's muscles. Tension-free plasty involves the installation of a mesh implant, which fuses with the patient's tissues, holding the organs in place.

Prevention of complications

Before and after the operation, the patient may face a number of complications associated with dysfunction of the internal organs, which occurs as a result of their compression.

Measures to prevent complications of inguinal hernia:

What do we have to do:

• wear a supportive and postoperative bandage;
• change your diet, add more fiber to your diet;
• exclude strong physical activity;
• wear a bandage during sports and during pregnancy;
• do therapeutic exercises.

What not to do:

• lift weights;
• ignore the problem of excess weight;
• allow chronic pathologies of the respiratory system;
• eat foods that provoke gas formation.