Abdominal hernias are called prolapse of internal organs covered with peritoneum through natural or artificial openings in the abdominal wall, pelvic floor or other areas of the abdomen. Hernias are a widespread pathology and can occur at any age. The main cause of abdominal hernias is an increase in intra-abdominal pressure associated with excessive physical exertion, loud screaming or strong coughing, and other similar conditions. In addition, the structural features of the body of some people, such as wasting or weakening of the muscles of the abdominal wall, are factors that predispose to the occurrence of abdominal hernias. In the absence of timely treatment, the contents of the hernial sac can become necrotic and cause serious complications, even death.
The structure of abdominal hernias: three essential components
A true hernia of the abdomen consists of three components: the hernial orifice, the hernial sac, and the contents of the hernial sac. Hernial orifice – this is a natural or artificially created opening in the muscular-aponeurotic layer of the abdominal wall, through which a hernial protrusion appears. The hernial sac is the part of the peritoneum that protrudes through the hernial orifice. It can be single or multi-chamber. The contents of the hernial sac – these are all the organs that are in its cavity. Basically, these are mobile organs, such as the omentum and intestinal loops. Depending on the mobility of the hernial contents, there are three types of hernias:
- reducible hernia – the hernial contents are completely reduced into the abdominal cavity;
- irreducible hernia – hernial content is reduced partially or not reduced at all;
- strangulated hernias: the hernial content is strangulated in the hernia orifice.
Inguinal hernia of the abdomen: main symptoms
Inguinal hernias account for more than 75% of all types of hernias. Moreover, almost 90% of them are found in males. There are congenital inguinal hernias, which occur mainly in children due to the pathology of the structure of the peritoneum. Acquired inguinal hernias are divided into oblique and direct. An oblique inguinal hernia passes through the external inguinal fossa, straight – through internal. Such hernias usually occur suddenly at the moment of strong physical exertion, which provokes a sharp rise in intra-abdominal pressure.
Patients complain of a protrusion, a sharp pain in the hernia and in the abdomen, a feeling of discomfort when moving. Often, the diagnosis of an inguinal hernia is not particularly difficult.
Femoral abdominal hernia: main symptoms
Femoral hernias of the abdomen occur in the region of the femoral triangle. They make up about 8% of all hernias of the abdomen, more often occur in women, due to the lower strength of the inguinal ligament in them. The most characteristic sign of a femoral hernia is a hemispherical protrusion in the upper third of the thigh, below the inguinal ligament. In most cases, femoral hernias are reducible. The clinical picture of a femoral hernia is characterized by a pain symptom, as well as a positive symptom of a cough shock. It is checked as follows: the fingertip of the subject is inserted into the alleged hernial orifice, and the patient is asked to cough. At this moment, tremors are felt with a finger when coughing – the symptom is positive.
Umbilical hernia of the abdomen: main symptoms
Umbilical hernias account for about 5% of all abdominal hernias, they are more typical for newborns, due to physiological anatomical features. In adults, umbilical hernias occur in the presence of congenital defects in the umbilical region, as well as against the background of frequent pregnancies. An umbilical hernia is characterized by the appearance of a gradually increasing protrusion in the umbilical region, as well as pain during physical exertion and severe coughing, sneezing and similar conditions. An important point is the differential diagnosis of umbilical hernias, since a protrusion in the umbilical region can be a metastasis of stomach cancer. For the purpose of differential diagnosis, an X-ray examination of the organs of the gastrointestinal tract is carried out.
Hernias of the white line of the abdomen: main symptoms
Such hernias are quite rare, their appearance is associated with atrophic changes in the abdominal wall. Hernias of the white line of the abdomen are supra-umbilical, para-umbilical and sub-umbilical. Paraumbilical hernias are most often located on the side of the navel, and they are extremely rare. In the clinical picture of hernias of the white line of the abdomen, the leading symptom is pain in the epigastric region, which intensifies after eating, and during physical exertion, provoking an increase in intra-abdominal pressure. For differential diagnosis, endoscopic and X-ray examination is carried out to detect other diseases that cause pain in the epigastrium.
Postoperative hernia of the abdomen: the main symptoms
Postoperative hernias are also very rare, they form in the area of the postoperative scar. The reasons for the formation of postoperative hernias are the divergence of the edges of the stitched aponeurosis or other defects in it, suppuration of the wound and great physical exertion in the postoperative period. Incisional hernias in the early stages may be reducible and not accompanied by pain. In later stages, symptoms appear that are characteristic of all hernias of the abdomen, in addition, symptoms of intestinal dysfunction appear, stagnation of feces and symptoms of intoxication may occur.
Methods of treatment and prevention of abdominal hernias
The only highly effective way to treat abdominal hernias is surgery. Wearing special bandages can only be a temporary measure before the operation. Only umbilical hernias in young children can heal themselves. In other cases, the hernia does not disappear, and over time, the contents of the hernial sac can become necrotic, leading to serious complications, such as acute intestinal obstruction, peritonitis, and severe intoxication of the body. The operation to eliminate a hernia is called hernioplasty, and it consists in installing a special mesh material in place of the hernia – an allograft that fuses with surrounding tissues and prevents the hernia from recurring. Remember that the best way to prevent abdominal hernia – It is the strengthening of the muscles of the abdominal wall. Research shows
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