Hernia

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Hernia
Typical Hernia
Recurrent Hernia

Hernia is a protrusion of an organ through a defect in a particular organism cavity wall. We are going to talk about external hernias. Most common are abdominal, inguinal, femoral, umbilical and post surgical hernias.

Though hernias look differently, their causes, symptoms, complications and treatment are similar.

Causes

All hernias are classified into congenital and acquired. Congenital causes include anatomical peculiarity as well as defects of the connective tissue. Acquired causes include traumas, surgeries, obesity, fluid in abdominal cavity and etc. If there are any of the causes mentioned above, even coughing, sneezing, hard defecation and overexertion might provoke hernia.

Signs and Symptoms

The main symptom of hernia is a bulge in the inguinal area or lower, near the umbilicus, or in the area where surgery was performed as well as the abdomen. If there are no complications, the bulge might be the only symptom. In some cases the bulge can be painful, especially in cases of physical tension. It is characteristic for the bulge to shrink when the patient is lying and to grow when he/she is standing, while coughing and sneezing. The bulge is elastic, but sensitive when touched. One can bring this kind of hernia back to the abdominal cavity (reposition).

Other symptoms might occur when the hernia gets stuck. In that case the organs in the sack of the hernia become compressed and bloodflow to these organs becomes limited. This condition is called irreducible hernia (hernia incarcerata). All kinds of hernias can get stuck. The main symptom of that kind of hernia is acute pain in its location. If the hernia becomes irreducible it usually shrinks neither when the patient lies down, neither when trying to repose it with hand. It becomes hard (not elastic) when touched.  This condition might be accompanied by worsening of the patient’s general condition: hypotension, tachycardia and intestinal obstruction as well signs of infection might occur. Do not try to bring the hernia back by force! Dead tissues in the hernia could cause severe complications when reposed.

Diagnosis

Uncomplicated hernia is diagnosed by observation and palpation. Sometimes echoscopy and rentgenography are used. Complicated hernia has to be checked using echoscope. If the diagnosis is still unclear laporoscopic surgery might be performed.

Treatment

The main method of treatment is surgery. Scheduled surgery is used in cases of uncomplicated hernias. The surgical procedure is usually short and not complex. Emergency surgery is performed in cases of complicated hernias. Dead tissues are removed from the organs. When surgery cannot be performed on an uncomplicated hernia, special elastic corset-bandage is used.

Prognosis

10 % of hernias are irreducible.  The prognosis is bad if a complicated hernia is not treated immediately. Otherwise the outcome of hernias is good.

   

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