Inguinal hernia

January 8, 2012

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Inguinal hernia   - Is a frequent disease in which there is a marked protrusion of peritoneum cavity inguinal canal . This disease is most common in men: among the total number of patients with inguinal hernias the stronger sex account for 90 to 97 percent. Such frequent manifestation of the disease in men due to anatomical features characteristic groin.

The first mention of this illness came from the ancient times: a hernia wrote Hippocrates, Galen and Celsus in the first century AD has defined as a protrusion of a hernia viscera congenital and acquired through the gates.

Types of inguinal hernia

Inguinal hernias in men are recorded more often than other types of abdominal hernias. Women hernias occur much less frequently, as the inguinal canal they are much better fortified tendons and muscles, moreover, it is narrower and longer than men.

By origin among the hernia sac   oblique inguinal hernias   release congenital   and purchased   hernia. Congenital inguinal hernias appear as a result of incomplete healing of the vaginal part of the peritoneum. In such a case, this part of the cavity communicates with the peritoneal cavity. The formation of congenital inguinal hernia, with the hernia sac becomes processus vaginalis . In most cases, congenital inguinal hernias are diagnosed in childhood, but often their symptoms in adults. In congenital inguinal hernia patients often manifest hydrocele   and spermatic cord .

Among the acquired forms of the disease with an anatomical point of view, to distinguish between two kinds of hernias: slanting   and direct . Also found combined   types of hernias. In this case, a person on the one hand there are several hernial sac, which are not aligned with each other and are straight, oblique hernia or combinations thereof. Today is isolated as a special kind of hernia - difficult forms of inguinal hernias . It large hernias . Moving . it is difficult to reduce a   and subject to relapses .

Bias   inguinal hernia passes through external inguinal fossa . In the same time, straight   hernia goes through already medial inguinal fossa . In the early stages of oblique inguinal hernia people may not notice protrusions. However, if the patient is severely straining or coughing, then it denotes swelling, which has an oval shape. Once a person is relaxed, the swelling disappears. Oblique hernia is only the first stage has an oblique direction. Hernia is increasing, and there is a medial extension of the internal opening of the inguinal canal.

Distinguish channel   form oblique inguinal hernia (in this case the bottom of the hernia sac can reach up to the hole on the outside of the inguinal canal); the cord   form of hernia (bottom, passing through the outer hole in the inguinal canal, located at different heights of the spermatic cord); inguino-scrotal   shape (bottom falls into the scrotum, it in turn increased).

There are also vpravimye   hernia (in this case the patient can reduce a their own) and nevpravimye   hernia (hernia reduction is not possible due to the presence of adhesions hernia sac with dropped out internal organs).

Symptoms of inguinal hernia

In patients with uncomplicated inguinal hernia manifest typical symptoms. First of all, one finds a protrusion in the groin area that resembles the tumor. Pain at the same time can be of varying intensity. They clearly manifest themselves during physical stress. Typically, these symptoms are specific to an inguinal hernia.

If the size of an inguinal hernia is small, it may be a long time does not cause human discomfort and pain. But if the hernia there a long time, and at the same time is large, the patient may feel constant pain. In pain patients also complain of recurrent form of the disease with.

Location of the pain - lower abdomen, groin pain gives to the sacrum and lower back. With a large hernia protrusion can significantly impair quality of life and ability to work. Often accompanying symptom of an inguinal hernia becoming constipation   chronic nature. If the hernial slips cecum, then the person is manifested abdominal distention . pain . constipation .

If the hernia becomes inflamed appendix, the symptoms of this condition are severe pain, vomiting, nausea, constipation, increased heart rate, fever. If inguinal hernia appears in women in the hernial may involve internal genital organs, causing abdominal pain, radiating into the lower back.

Diagnosis of inguinal hernia

Difficulties with diagnosis of inguinal hernia in men may be a relatively small protrusion, which occurs when the channel or hernia in the early stages of the disease. Sometimes it is difficult to determine the presence of disease in the case of atypical location protrusions (in the case of interwalled hernia). With such features, it is important to diagnose a patient study of history, palpation of the groin area and thorough inspection.

Examining the patient, the surgeon pays particular attention to the magnitude and shape of protrusions, watching him in the vertical and horizontal position of the patient. If a patient in the presence of an oblique hernia, the protrusion will have a long form. It is located along the inguinal canal, often later descends into the scrotum. In patients with direct hernia protrusion has a rounded shape and is located near the medial part of the inguinal ligament. Depending on the location and size of protrusions specialist determines the shape of an inguinal hernia.

Often groin inspection includes thorough palpation herniation that allows you to define what can it be right. It is also important to determine if there is in stock phlebeurysm   spermatic cord. In the process of diagnosis, it is important to differentiate direct, oblique and femoral hernia.

Women have particular diagnosis. The most informative method of research - inspection and palpation of the protrusion. In direct hernia is the protrusion of women over the inguinal ligament, and at oblique hernia occurs in lowering its external genital lip.

If a specialist requires a patient sliding hernia, it may use other methods of inspection: cystography, barium enema, cystoscopy, and others.

Treatment of inguinal hernia

The most common surgery in patients with a free inguinal hernia is performed using local anesthesia. General anesthesia for children in the first years of life, patients who can not tolerate novocaine And the wishes of the patient regarding the general anesthesia.

When conducting operations in the inguinal hernia specialist initially necessary to make access to the inguinal canal. After that, the hernial sac is removed and sutured inguinal hole if it is destroyed or expansion. The final step is considered plastic surgery of the inguinal canal.

To prevent further manifestation of disease recurrence, a specialist during the operation necessarily draws attention to the particular topography of the inguinal canal, the view held by the patient's hernia, age, size of hernial ring.

Even recurrent hernia occurs in a sufficiently large number of cases .  This is because with conventional methods to strengthen the front wall of the inguinal canal in every case it is possible to eliminate the weakness of the rear wall .  Consequently, hernia may occur again .  Therefore, especially paying attention to the surgeon is to strengthen the reliability of the posterior wall of the inguinal canal .  The latter is especially true for patients with complex forms of hernia (direct-channel skew, combined, moving, recurrent) .  Sometimes large inguinal hernias, as well as in the case of multiple recurrences of the disease there is a need to create a new inguinal canal .  To this end, a autoplastic reconstruction of the channel walls or apply additional plastics .  After the main stages of such an operation is carried plastic inguinal canal .  Today, experts use a lot of methods for plastics .

If such an operation is considered to be the main purpose of the preservation of the physiological role and the anatomical position of the inguinal canal. Performing all phases of the operation with great care and thoroughness ensures a high level of overall quality of life for the patient in the future.

In some rather rare cases, the elderly performed the inguinal canal. Before a person is completely removed testicle   and funiculus And hernial sutured.

Prevention of inguinal hernia

To prevent an inguinal hernia in the first place, it is important to strengthen the abdominal wall. To do this, you must maintain a valid and active lifestyle, constantly carry out physical exercises to improve the overall condition of the body, as well as on training of the abdominal muscles. It is also in the process of disease prevention is important tempering . Avoid too strong muscle stress that it is important to monitor not to lift heavy weights rapidly, try to avoid injuries. Particular attention should be paid to proper diet, give up smoking completely. The last point is important in terms of prevention of cough, which is typical for heavy smokers. After all, it is often during a strong cough are formed and developed a hernia, causing complications in the future.

Women in period pregnancy   should monitor their own weight, eat healthy foods to avoid constipation. It is also advisable to wear a special bandage to prevent weakness of the abdominal muscles, and after giving birth to engage in specially selected exercises.

Good results bring constantly busy swimming, fitness. Sharp obesity   or Weight Loss   It is also a factor provoking the emergence of hernias. Therefore, in the process of losing weight should approach this issue thoughtfully, after consultation with a specialist.

Another important point in the issue of prevention of inguinal hernia - prompt treatment of those diseases which result in increased intra-abdominal pressure. This lung disease and colds, which are accompanied by a cough, constipation, urinary diseases, leading to voiding.