The disease has unpleasant symptoms, and with prolonged duration accompanied by the development of dangerous for life and health complications, so it should be promptly diagnosed and treated.
Abdominal hernia is the surgical disease, in which there is prolapse of the abdominal organs through the holes formed in the muscles.
Abdominal hernias occur for several reasons, which are divided into:
- congenital (affecting the human organism in utero);
- acquired (contribute to hernias in older children, adult men and women.
Abdominal hernias in newborns occur under the influence of the following factors:
- genetic pathology that contribute incorrect formation of muscle and connective tissue fibers;
- defects of the abdominal muscles occurring during fetal development;
- the weakness of the tissues of the abdominal region, which is characteristic for premature babies;
- the presence of harmful habits in women during pregnancy.
Development of protrusion of this type contribute to the following reasons:
- reduction of skin tone, thinning and stretching of muscles in elderly and senile age;
- dystrophic changes in tissues arising on the background of exhaustion of the body;
- the carrying a child, contributing to the stretching of the natural openings of the abdominal wall;
- the diastasis of the muscles, which is a common complication of multiple pregnancy;
- damage to the tissues of the abdominal wall (contributes to the development of traumatic hernias);
- postoperative complications (recurrent protrusions are formed after surgical treatment of hernias, it is connected with the accession of bacterial infections, improper stitching of the tissue, rupture of fibers;
- changes in intra-abdominal pressure that occurs when weight lifting;
- chronic disease causing long bouts of coughing;
- benign and malignant tumors of internal organs;
- accumulation in the peritoneum of the liquid, displacing the organs in the direction of the hernial ring;
- problems with the emptying of the bladder and intestines;
- the presence of excess weight, increase the load on the abdominal muscles.
Abdominal hernia is characterized by the following signs:
- 1the Appearance of a bulge in the navel area, the right or left of him. Education has different sizes, rounded and supple texture. The size of the hernia in uncomplicated it change when the patient coughs, bends over or takes the supine position.
- 2a Feeling of heaviness in the abdomen, extending to the anus, perineum and lower limbs.
- 3Pain in the epigastrium and Central abdomen. When upraveny hernias is aching or pulling in nature. With the development of the inflammatory process, the pain becomes cutting or throbbing in nature. The patient tries is in a position to facilitate the state – to lay down sideways, tucking in his legs to his stomach.
- 4Itching and burning of the skin, placed over the swelling.
- 5Signs of disorders of the digestive system. Typical for giant hernias, accompanied by a loss of the greater part of the internal organs. The patient complains of nausea, vomiting, and diarrhea.
- 6urinary retention. Wandering occurs when the hernia containing the bladder.
- 7Symptoms of intestinal obstruction. Blockage of the prolapsed intestinal loop is accompanied by nausea, vomiting, appearance of blood in the stool, stop the discharge of gases.
A survey plan of the person in the hernias of anterior abdominal wall include:
- 1Inspection. The doctor palpated the tumor, estimating its size, localization and consistency. After reposition of the organs in the abdominal cavity clearly be felt gryzenia gate. At this stage, assessment of symptom cough shock. On palpation the patient is asked to cough. If the hernial contents during the operation, we are talking about pravima protrusion.
- 2ultrasound of the hernial contents. Used to determine the amount of fallen bodies, signs of inflammation and necrosis.
- 3x-ray examination of the abdominal region. Is assigned in case of signs of violation of the bowel and bladder.
- 4Peritonealcarcinose. X-rays using contrast substance used for the assessment of retroperitoneal space with giant hernias. This is a very effective method for detecting lateral hernias.
- 5computed tomography. Is to determine the condition of the abdominal organs. The results are useful when planning surgical treatment and calculation of the probability of occurrence of postoperative complications.
- 6General analysis of blood. Is used in complicated hernias, helps to detect signs of inflammatory and infectious processes.
- 7Laparoscopy. Operation is used in both diagnostic and therapeutic purposes. The introduction of endoscopic tools, helps to view the hernial contents and return the organs to the correct position.
On the basis of the hernia are divided into:
- inguinal (located in the perineum, the scrotum in men and labia majora in women);
- hernia Spigelia line (bodies fall in the distance, formed between the abdominal muscles);
- umbilical (protrusions are formed by extension of the umbilical ring);
- diaphragmatic (part of the stomach and esophagus falls into the hole formed in the dome of the diaphragm);
- pelvic (hernias are in the lower part of the abdomen).
According to the degree of the release of the bodies
According to the degree of the release of the bodies, neoplasms are divided into:
- full (hernial contents together with the shell completely removed through a defect in the muscle wall);
- incomplete (in the soft tissues are channels, however the authorities do not fall through Gruziya gate).
The clinical signs are
On the basis of symptoms distinguish the following types gruzevich entities:
- 1Upravene. The prolapsed bowel loops, the bladder or the stomach easily return to the correct position. The patient rarely feels pain, so the operation in this form of disease are carried out routinely.
- 2Irreducible. The tumor doesn’t change size with pressure and the change of body position. Nepravilnosti develops on the background of the formation of adhesions that prevent the movement of the organs. The disease is characterized by the presence of pronounced pain syndrome.
- 3Infringed. Drop-down the bodies are compressed with a sharp narrowing of the hernial orifice that helps stop blood supply to the tissues, causing tissue necrosis.
If untreated develop the following complications:
- 1Bacterial infection. Pathogenic microorganisms penetrate into the hernial SAC through injuries in the skin and through the blood of chronic inflammatory lesions. When perforation intestinal wall contents on grievou poured into the abdominal cavity, contributing to the appearance of symptoms of peritonitis. Acute inflammatory processes lead to poisoning of the body, changing the condition of the surrounding tissues.
- 2Nepravilnosti. Consequence occurs with prolonged lack of treatment. Can develop on the background of inflammation. It can be complete or partial, and is accompanied by obstruction of the affected portion of the intestine.
- 3Koprostaz. A pathological condition occurs on the background of abdominal hernias in the elderly people. A slower development is accompanied by acute pain, delayed stool and gas, loss of appetite, intoxication of the organism. Palpation found a solid fecal stones.
- 4Infringement. Promotes rapid tissue death, members of the hernial contents. A strangulated hernia is a dangerous high risk of death of patient, so eliminate it urgently.
The only effective method to eliminate abdominal hernia is surgery. Conservative techniques are used for the temporary relief of the human condition before surgery.
To reduce the signs and symptoms of a hernia are:
- 1anti-inflammatories (Diclofenac, Ibuprofen). Eliminate the signs of inflammation, relieve pain syndrome.
- 2Antibiotics (Cefazolin, Amoxiclav). Assigned in preparation for operations to prevent bacterial infections.
- 3Prokinetics (Metoclopramide). Normalize the motility of the digestive organs, relieving the patient from the nausea.
- 4Spasmolytics (Drotaverine, Papaverine). Used to eliminate the severe pain associated with spasm of the hernial orifice.
Physiotherapy treatments are used to prevent complications and eliminate discomfort. These include:
- 1Ultraviolet irradiation. Destroys pathogenic microorganisms, preventing their spread in the body.
- 2Paraffin baths. Relieve the patient’s pain, improve the General condition of the body. Do not apply in complicated hernia.
- 3diadynamic therapy, laser treatment. Used to eliminate adhesions preventing reduction of the hernia content.
Physical exercises are performed to strengthen the muscles of the abdominal region and hold organs in proper position.
With regular sessions therapeutic exercise helps to get rid of protrusions of small sizes.
Before training, the patient wears a brace that helps to avoid the expansion of defects in the muscles. A set of exercises is tailored to the size of the hernia, presence of comorbidities, General condition of the body.
For hernia repair in home conditions use:
- 1Cabbage brine. Liquid-impregnated gauze, which is applied to the protrusion for 30-60 minutes. The procedure is carried out 2 times a day – morning and evening.
- 2Vinegar. 2 tbsp 3% vinegar mixed with 200 ml of cold water. Hernia wash the resulting solution, after which apply a compress with infusion of oak bark. 50 g of bark pour 100 ml of red wine, insist 3 weeks.
- 3Infusion of cornflower. 3 tsp. flowers pour 0.5 liters of boiling water, leave for an hour, cooled and filtered. Ready infusion drink 0.5 glass before each meal.
The choice of the type of surgery depends on the size of the protrusion and presence of complications.
Plan of operations in complicated and large hernias includes the following steps:
- the statement of General or epidural anesthesia;
- the production of long incision in the abdominal wall;
- dissection of the hernia SAC;
- examination of the internal organs for signs of necrosis and inflammation;
- the removal of the affected tissues;
- the return of the organs in the correct position;
- closure of the hernia orifice by suturing the tissue or the implantation of the mesh implant;
- sutures and sterile bandages.
The procedure of laparoscopic hernioplasty include:
- pain relief;
- the production of several punctures in muscle tissues;
- the introduction of endoscopic instruments;
- filling the retroperitoneal space with a sterile gas;
- inspection and return of the organs in the abdominal region;
- the installation of the implant.
Endoscopic procedures have a short recovery period, low risk of complications. The indication for surgery is a small uncomplicated hernia of the abdominal cavity.
Prognosis and prevention
Prevention of hernias is based on the introduction in the daily routine of moderate physical activity, refusal from carrying heavy loads, timely treatment of chronic diseases. To avoid the formation of the external abdominal protrusions in women helps wearing the brace during pregnancy. Monitor the functioning of the intestines, avoiding constipation.
In most cases, hernias have a favorable prognosis. With timely treatment the patient fully recovers.
Relapse occurs in 5% of people undergoing surgery. Infringement of hernia makes the prognosis unfavorable. If untreated, kills more than 90% of patients.