Varieties of abdominal hernia

Abdominal hernia is a pathological condition in which the abdominal organs protrude together with the outer serous membrane through the anterior walls of the abdomen. In some cases, bowel loops and organs may move into the mesentery or diaphragm. A hernia of the abdomen can form at the weakest point of the peritoneum. The risk group includes children and people over 45 years of age, the disease is detected mainly in men. Hernias consist of a hernial orifice, a hernial sac and its contents.

This is a common male surgical pathology, which is not eliminated on its own. In the absence of complications, the disease is not manifested by the development of any symptoms, except for an external visible protrusion. Depending on how much the hernial formation is enlarged, the opportunity to set it on its own disappears. There is a symptom in the form of a feeling of soreness, which can be aggravated by physical activity. In the course of treatment, preference is given to surgical intervention. Bandages can be used only in cases where there are contraindications to radical therapy.

Classification

Classification of abdominal hernias is carried out as follows:

According to their localization: external and internal .
Guided and non-driven . The formed hernia can be set in the abdominal cavity only by a qualified specialist. In the event that there is no timely medical care and the supervision of a doctor, the pathology is transformed into an unmanageable one.
Volumetric hernias can be complete or incomplete .
Pathologies can be congenital , sliding , as well as Littre's .

If we take into account the degree of exit of organs, the hernia can be:

Complete - in this case, the organs go into the subcutaneous region or other cavities.
Incomplete - there is an exit of organs from the peritoneum, while it is localized in other anatomical formations and may not appear outwardly.

In order to determine the type, volume and localization of the disease, an internal examination of the doctor is required.

Internal abdominal hernias form after the abdominal organs enter the abdominal pocket and fold. Such a hernia of the abdomen is localized in the place on the abdomen where one section of the gastrointestinal tract passes into another. Internal abdominal hernias are classified into:

Intersigmoid - occurs in that part of the stomach where there are defects in the mesentery of the sigmoid colon.
Median hernia - is formed if there are gaps in the mesentery or gastrointestinal ligaments.
Treitz hernia - there are left- and right-sided, they are diagnosed in more than 35% of cases among all internal hernias.

Depending on the type of abdominal hernia and the symptoms that appear, the doctor selects the appropriate treatment strategy.

Causes

Abdominal hernia occurs under the influence of predisposing and producing factors. Among the producing factors, the impact is distinguished:

Accumulation of fluid in the peritoneum.
Overweight.
Cough accompanying chronic lung disease.
Hard physical labor.
Difficulties in defecation and urination, development of flatulence.

It is important to know under the influence of what predisposing factors such a violation may occur:

Trauma and postoperative wounds. Suppuration and postoperative wounds in the lower abdomen increase the risk of a violation.
Extensions of the umbilical region, femoral and inguinal rings.
Birth defects affecting the peritoneum.
Thinning and loss of tissue elasticity.

Symptoms

The main symptoms of a hernia of the abdomen are due to the appearance of a visible external volumetric formation: round, dough-like, which may or may not be reduced into the peritoneum . After the hernia is set, it is possible to identify defects that resemble a gap or a circle in appearance, the so-called hernial orifice.

Other signs will appear depending on their location: postoperative scars, umbilical region, groin, femoral canals, white lines of the abdomen.

In the event that the disease is localized in the lower abdomen, complaints arise that are similar to manifestations of acute cystitis.
Diaphragmatic hernias are not accompanied by the occurrence of protrusion, because. organs can go into the chest cavity. The patient complains of belching, heartburn, impaired breathing and swallowing, a cough occurs, and the voice becomes hoarse.
There may be complaints about a feeling of pain in the abdomen, the development of constipation, vomiting, nausea, and belching.

In most cases, the hernia does not hurt, is eliminated if the patient is in a horizontal position, protrudes during physical exertion. Uncomplicated pathologies in most cases do not manifest themselves.

In the event that an infringement occurs (a condition that threatens the life of the patient), the following symptoms develop:

The patient complains that the hernia hurts a lot: the pain is sudden, acute. Occurs after exposure to physical exertion, bowel movements, lifting heavy objects.
The hernia cannot be reduced into the abdominal cavity; on palpation, there are complaints of a feeling of soreness, the protrusion itself is tense.

If an infringement is detected, it is necessary to call an ambulance as soon as possible and hospitalize the patient.

Diagnostics

Often patients wonder how to identify the disease. This requires a comprehensive survey.

Taking anamnesis allows you to find out what concomitant diseases the patient has. If there are concomitant pathologies from the gastrointestinal tract, the doctor may recommend an additional study.
Oral questioning of the patient allows you to understand what type of disorder develops in the patient, how it hurts and how long ago the disease arose.

In order to recognize the exact localization of the pathological process and the degree of its spread, the doctor recommends an ultrasound examination and herniography (an X-ray technique that requires the introduction of a contrast agent).

Treatment

Treatment of abdominal hernia requires surgical intervention , since conservative therapy does not contribute to the proper therapeutic effect and can be used as an auxiliary element. The absolute indication for surgical intervention is the incarceration of the hernia. Having received information about what a hernia is, in no case should you try to correct it yourself. In the event that the doctor reveals an uncomplicated form of the disease - this is an indication for a planned hernia excision, infringements require emergency surgical intervention.

The elimination of an external hernia is carried out with the use of local anesthetics and endoscopic techniques;
If a decision is made to initiate an emergency operation in case of hernia strangulation, then an extended laparotomy is recommended.

After the operation, the patient must follow the diet recommended by the doctor and use a bandage.

Carrying out hernioplasty

In modern surgery, doctors prefer the procedure - hernioplasty , during which the doctor uses his own tissue or mesh endoprostheses. This type of treatment helps to eliminate a hernia of the white line of the abdomen, diaphragmatic, inguinal, postoperative, umbilical, femoral hernia.

In the event that the doctor has decided to use hernioplasty "with tension", the abdominal walls are dissected above the hernias. After that, the organs are repositioned and the abdominal walls are sutured using their own tissues, which are tightened until they are in tight contact.
In the event that they decide to use the “tension-free” procedure in the form of patches, the doctor uses a special endoprosthesis. Materials for endoprostheses are sterile, non-toxic, high strength, so the likelihood of inflammatory and allergic reactions during the recovery period is minimized. 30 days after the procedure, muscle tissue grows into the endoprosthesis, which contributes to the formation of a framework capable of holding the hernial orifice.

After hernioplasty, adverse reactions may occur in the form of a violation of sensitivity, edema, which are eliminated after 7-14 days. The doctor recommends to refrain from physical activity for several months after the operation.

For a month, the patient is recommended to use a special supporting bandage.

Conservative therapy

Conservative treatment involves the use of:

Special bandages.
Massage.
Diet therapy.
Gymnastics.
Patients are advised to refrain from using certain groups of drugs : laxatives, antispasmodics.
Factors that contribute to an increase in intra-abdominal pressure should be eliminated: constipation, sudden physical exertion.

Conservative therapy is used only during the treatment of patients who are contraindicated in surgical intervention: people of older age groups, severe dysfunction of the cardiovascular system, exacerbation of a chronic disease, pregnancy.

What complications can occur?

It should be taken into account what are the complications of external abdominal hernias:

The development of intestinal obstruction is a condition in which the passage of food may be difficult or completely absent.
With marginal infringement, accompanied by the development of perforation, fecal peritonitis may occur - a serious condition in which the inflammatory process affects all organs localized in the abdomen.
The development of suppuration.
Infringements, accompanied by necrosis of the tissues of the peritoneal organs, followed by the development of peritonitis.
In some cases, a "small belly syndrome" develops - the hernia ceases to fit into the abdominal cavity.

Important! In the event that a patient has an infringement, this is a dangerous, life-threatening condition for the patient, which requires immediate surgical intervention.

Preventive actions

Prevention of abdominal hernia involves the following simple recommendations:

Empty the bowels in a timely manner;
Give preference to a balanced, healthy diet. Recommended fresh fruits and vegetables, foods that contain fiber. Patients are advised to exclude excessively spicy, salty, fatty, fried foods from the daily diet. You should refrain from overeating;
It is necessary to give preference to moderate physical activity, which tone the muscles of the anterior abdominal walls. Excessive physical overvoltage is unacceptable. In the event that the patient has undergone surgery, it is necessary to follow all the doctor's recommendations regarding any physical activity.

In the event that a patient develops a hernia of the abdomen, it is necessary to seek advice from a qualified, experienced surgeon as soon as possible . The condition itself can cause multiple inconveniences and cause the development of a dangerous complication - infringement, so you should not hesitate to visit doctors and self-medicate.