How are hernias of the abdomen, diaphragm and spine manifested

A hernia is a congenital or acquired disease in which an organ or part of it protrudes into an adjacent cavity or under the skin through anatomically weak areas of the ligaments and muscles. Such a violation occurs more often in the abdominal cavity, and the spine and chest also suffer from this. The first symptoms of a hernia appear at the time of a sharp increase in the load, but some defects form gradually against the background of chronic weakness and increased pressure on the organs.

Hernia is a surgical disease, has serious consequences without treatment and can occur at any age, regardless of gender and lifestyle. The protrusion is painless, but most patients complain of sharp or aching pain in the left side or right side, depending on the type of ailment.

In addition to this vivid symptom, the pathology has a number of signs that allow the doctor to determine the disease at the first glance at the diseased area.

Symptoms of a hernia of the abdominal cavity

With hernias, there are many symptoms, because the disease affects several organs at the same time with a violation of their function. A protrusion in the umbilical region is manifested by pain both in the right side and in the left, while the side will have diagnostic value.

A hernia in a child and adults can show the same symptoms as gynecological, urological and gastroenterological diseases.

The presence of a common external sign facilitates diagnosis, but there is not always swelling in the defect area, therefore clinical manifestations must be checked against the x-ray picture.

All types of the disease have common symptoms of varying severity:

• discomfort, feeling of heaviness and squeezing in the defect area;
• dysfunction of organs in the hernial sac;
• soreness that occurs at rest or during exercise;
• acute pain when straining and with complications;
• a symptom of a cough shock - during a cough, a protrusion is released;
• general malaise, weakness, fatigue, irritability, poor sleep.

The appearance of swelling in the right side, on the left, along the white line, in the groin - these are signs of the external form of the disease. There are also internal defects. The latter cannot be determined by external manifestations. The internal view of the pathology is a protrusion of organs into the adjacent cavity, and not under the skin - diaphragmatic or hiatal hernia. This is one of the few forms of the disease that does not require surgical treatment, it can be treated conservatively.

HH can go unnoticed for a long time, it can be easily confused with inflammation of the esophagus and normal heartburn after eating. The diaphragmatic shape is determined only after contrast radiography or other instrumental techniques using contrast.

A rare form would be lateral protrusion. Such a defect appears in the right or left side, the hernial sac contains a bowel loop. Infrequently, there is also a defect in the Spigelian line. This is a protrusion in the region of the outer edge of the rectus muscle.

inguinal

A common type of hernia is inguinal. It occurs more often in boys and men over 30 years of age. The main factor in the appearance is the congenital weakness of the inguinal ring. In women, the disease will be the result of a high load, which also happens during pregnancy.

Forms of inguinal hernia:

• oblique - appears only in men, there is swelling in the groin area, outwardly resembles a bump in the right side, less often on the left;
• direct - occurs in women and men, often diagnosed in newborn babies;
• mixed - a rare but dangerous form, contains several hernial sacs, is manifested by pain and discomfort in the right or left side.

General symptoms:

• unilateral or bilateral protrusion in the groin area;
• discomfort while walking;
• pain during intercourse and physical activity.

umbilical

The exit of part of the intestine and the omentum in the umbilical ring occurs no less than in the groin. This phenomenon is associated with muscle weakness, and is more common in women. The main reason is the expansion of the umbilical ring during an increase in intra-abdominal pressure.

The pathology is characterized by a symptom of a cough shock, swelling is observed in the center, discomfort worries in the left side. If the pain appears on the right, inflammation of the appendix should be ruled out. An umbilical hernia in women gives more pronounced symptoms, especially in the premenstrual period.

Manifestations of umbilical hernia:

• a bulge, a small bump in the center or near the navel;
• rumbling in the abdomen, accumulation of gases;
• the protrusion disappears in a horizontal position when the body is relaxed;
• the umbilical ring is expanded;
• nausea, less often single vomiting;
• soreness in the area of ​​the defect, as well as in the left or right side.

An umbilical hernia is the most common in children. In case of illness in infants, attempts are made to reduce the defect, conservative treatment with patches and bandages without surgery. This in most cases does not work and the hernia has to be removed surgically.

White line of the abdomen

A hernia of the white line occurs above the navel, looks like a bump and shows mild symptoms. This form of the disease is often complicated, which already gives severe symptoms with a risk of organ necrosis. A feature of such localization will be a high risk of infringement due to overeating and straining. Urgent surgery will be required in case of fecal or retrograde pinching. The remaining signs of a protrusion of the white line do not differ from an umbilical hernia.

Postoperative

Ventral or incisional hernia occurs in the area of ​​the surgical scar. This is a common occurrence, and more often such a consequence of the operation is observed after tension plasty. This method involves the tension of the natural tissues of the abdominal cavity to close the defect. When a mesh implant is used for this purpose, the risk of recurrence and ventral hernia is lower, because weakened ligaments and muscles are securely fixed.

Factors for the appearance of ventral protrusion after surgery:

• insufficient diagnosis before choosing a removal technique;
• surgeon's mistake during the operation - tissue injury, inaccurate fixation of the mesh;
• earlier return to physical work after surgery;
• congenital features of the muscular-ligamentous apparatus;
• damage to the ligaments in the left or right side, trauma;
• obesity, frequent overeating, gastrointestinal diseases with frequent constipation.

Symptoms of HH

Hiatus hernia can be attributed to the most "harmless" in relation to protrusions in the abdominal cavity and spine. They can be treated without surgery, which is done in 99% of cases. HH is the exit of the abdominal part of the esophagus and the cardia of the stomach into the chest cavity. The disease is of a sliding type and fixed. In the first case, organs move from one cavity to another. When there is a fixed hernia, the risk of strangulation is higher and the symptoms are more pronounced.

Diaphragmatic hernia in men and women is more often asymptomatic. It turns out to be detected by chance, during an examination of the chest or abdominal cavity. There are some specific manifestations, but they are so blurred and infrequent that many patients do not even think about being examined.

Common signs of a hernia of the esophageal opening of the diaphragm:

• discomfort behind the sternum after eating;
• frequent hiccups, heartburn, rarely belching;
• sour taste in the mouth, increased sensitivity of the enamel;
• bloating;
• labored breathing;
• discomfort in the esophagus when bending forward.

HH is rarely complicated, but there is a risk of bleeding and inflammation of the esophagus. Diaphragmatic hernia is often accompanied by reflux esophagitis. This disorder is characterized by inflammation of the esophageal mucosa due to its constant irritation by the acidic contents of the stomach.

Treatment of such patients is aimed at eliminating reflux and the inflammatory process. You can remove the symptoms with antacids, prokinetics and folk remedies.

This type of pathology will be dangerous if the stomach and esophagus are infringed. This is manifested by a strong patient behind the sternum, vomiting with blood, general intoxication of the body. Such manifestations can lead to the doctor for the first time, then the disease will be determined, but with severe complications.

Signs of hernia of the spine

The most common form of spinal hernia is a bulging disc in the lumbar region. This disease, like HH, is treated conservatively, the operation will be the last measure when there is a threat of disability.

All spinal hernias have the following common manifestations:

• pain in the area of ​​the damaged intervertebral disc;
• numbness and tingling of the skin;
• pain on one side of the body (in the right or left side, arm and leg);
• headaches, drops in blood pressure.

With a cervical hernia, neurological symptoms are manifested: dizziness, memory impairment, apathy, irritability. Damage to the disc in the chest gives signs similar to angina pectoris, disturbing aching pain between the shoulder blades. With a hernia in the lumbar region, the organs of the genitourinary system and intestines suffer.

Congenital hernia in children

In newborns, all types of hernias can be diagnosed, and the most dangerous for a child are diaphragmatic, vertebral and inguinal. In the first case, the risk lies in the development of respiratory failure, which occurs with a large defect. With a hernia of the spine in a newborn, the prognosis is unfavorable, the disease requires only surgical treatment, but even it does not guarantee recovery.

An inguinal hernia does not threaten the baby's life, but there is a risk of infertility when testicular necrosis occurs in boys and the uterus in a girl due to infringement. Damage to the reproductive organs can also occur during the operation.

Symptoms of diaphragmatic hernia in newborns:

• shortness of breath, blue skin;
• vomiting, foaming at the mouth, increased salivation;
• sunken abdomen, chest bulging.

Manifestations of inguinal hernia in children:

• in boys, the scrotum is enlarged on one or both sides;
• girls have enlarged labia;
• restless behavior, poor sleep;
• stool disorder, colic;
• urinary retention.

In boys, a hernia in the groin is often combined with an undescended testicle, and the operation in this case will be aimed at eliminating two problems at once.

Causes and risk factors

Hernias of the abdominal cavity appear when the muscles of the abdominal wall are weak, which are stretched with an increase in intra-abdominal pressure. The combination of this factor with high physical activity with a probability of 99% will lead to the appearance of a hernia, if you do not reconsider activities and habits.

Diseases of the spine are also associated with the load, but other conditions are needed for the occurrence of a hernia. Damage to the intervertebral disc begins with malnutrition, which occurs with osteochondrosis. The cause can be a curvature of the spine, weakness of the back muscles, surgery, physical inactivity.

HH occurs with a regular increase in intra-abdominal pressure, which is not always, but combined with congenital weakness of the diaphragm ligament. This can be facilitated by overeating, having a difficult birth, and being overweight.

Methods of treatment

Abdominal hernias are treated exclusively surgically. Only an umbilical hernia in children under one year old can self-reset, but this rarely happens. The protrusion of the intervertebral disc is treated conservatively, drugs, physiotherapy, bandage are prescribed. With HH, drug treatment with a change in nutrition is indicated.

Any violation of the anatomical position of the organs is a signal that the body lacks an adequate load or there is too much of it. When there is a predisposition to the disease, it is recommended to be examined by a doctor every year or even more often when alarming symptoms appear.