Hernia is an abnormal protrusion of internal organs through an abnormal opening in the wall of the cavity.A combination of increased pressure within the body with weakness in the wall is accountable for this condition.During this condition internal organs or elements of organs are protruded out forming a swelling that will increase the size with coughing and lifting weight,and whereas passing stool and urine.In lying down position the swelling goes inside except in strangulated and irreducible hernia.
1, Weakness within the body wall:–
a) Congenital weakness.
b) Acquired weakness due to injuries,wasting of muscles,suppurative lesions within the wall and presence of weak natural openings,obesity,lack of exercise,repeated pregnancy.
c) Operation with improper suturing or sepsis of operated site.
a pair of) Increased pressure within the body.
a) Chronic constipation.
b) Recurrent cough.
c) Weight lifting.
d) Stricture of urethra.
Common sites for hernia:–
Hernia will occure anywhere in the body.But there are some common sites for hernia.Thanks to the presence of laborious bony covering chest wall is generally not affected.Hernia within the lower back is also rare thanks to spine and back muscles and tough ligaments and sheeths.The common web site for hernia is abdominal wall.Compared to other elements the abdominal wall is weak because of the presence of some natural orifices.There are some areas whereby the abdominal muscles are weaker and skinny and every one these factors create a likelihood for herniation.The common sites for hernia are following.
a) Inguinal hernia:
Here the abdominal contents protrude through the inguinal canal (passage in the lower abdominal wall just on top of the inguinal ligament.It is seen on either side).This sort is common in males.Initially the swelling comes only whereas straining and goes back whereas lying down. Later the massive portion of intestine could return out that might not return easily.
b) Femoral hernia:
This type of hernia is more in females.Here the abdominal contents experience the femoral canal which is seen just below the junction between the thigh and lower abdominal wall(Within the femoral triangle).The contents pass downwards and comes out through saphenous gap in the thigh and forms a swelling underneath the skin.
c) Umbilical hernia:
This can be common in children.The umbilicus is the weaker half of the abdomen.The contents of the abdomen could protrude as a bulb like swelling whereas crying and defecating.
d) Incisional hernia:
These hernias are seen in operated sites. Due to improper suturing or sepsis the operated site becomes weak ensuing in hernia.
e) Epigastric hernia:
Here the hearniation occures in the epigastrium. It is a rare type.
f) Lumbar hernia:
Here the hernia appear in the lumbar area on either facet of the lumbar spine(in the lumbar triangle).This is often also a rare type.
g) Obturator hernia:
This is often a rare type of hernia. Here the contents tolerate obturator foramen within the pelvic bone.
Complications of hernia:–
If the hernial orifice is slim the abdominal contents may not go back easily, and later the blood flow to the herniated tissues could be blocked thanks to constricition.This will cause death of protruded intestine.
two) Intestinal obstruction:
This occures when the full portion of the intestine is protruded in to the hernial sac. The slim hernial orifice will block the passage of bowels.
three) Infection and peritonitis:
If there is strangulation with death of some of intestine there can be spread of infection to the abdomen ensuing in peritonitis.
Treatment of hernia:–
Initial treatment: Within the initial stages of hernia the following steps could be helpful
one) Use of hernia belt:
Special types of hernia belts are out there for each sort of heania.This will forestall the protrusion and can scale back pain.
two) Constipation,recurrent cough,urinary obstruction ect ought to be treated.
3) Fat reduction will increase the strength of abdominal wall.
four) Abdominal exercises to extend the muscle tone.
five) Take plenty of leafy vegetables, fruits and fibrous diet for simple bowel movements.
half-dozen) Strive alternative systems like Homoeopathy,Herbal medicine and ect
If no relief by the above steps consult a general surgeon for surgical management.
The subsequent operations are done relying up on the sort and nature of hernia.
1) Hertniotomy : In this operation the contents of hernial sac is pushed in to the abdomen and neck of the sac is ligated with transfixion ligature and therefore the sac is cut off.
two) Herniorrhaphy: Here together with herniotomy the posterior wall is repaired.
three) Hernioplasty: This operation is finished if herniotomy isn’t possible because of wide neck of the sac.Here the repair is done with the healp of non absorbable materials like tantalum gauze,polypropylene mesh or stainless steel mesh.
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