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HERNIA

Introduction

Hernia is an abnormal protrusion of internal organs through an abnormal opening in the wall of the cavity.A mixture of increased pressure inside the body with weakness in the wall is responsible for this condition.In this condition internal organs or elements of organs are protruded out forming a swelling which will increase the scale 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.

Causes:-

1, Weakness within the body wall:–

a) Congenital weakness.

b) Acquired weakness due to injuries,wasting of muscles,suppurative lesions in the wall and presence of weak natural openings,obesity,lack of exercise,repeated pregnancy.

c) Surgical treatment with improper suturing or sepsis of operated site.

2) Increased pressure within the body.

a) Chronic constipation.

b) Recurrent cough.

c) Weight lifting.

d) Stricture of urethra.

Common sites for hernia:–

Hernia can occure anywhere in the body.But there are some common sites for hernia.Due to the presence of arduous bony covering chest wall is normally not affected.Hernia in the lower back is also rare thanks to spine and back muscles and tough ligaments and sheeths.The common website for hernia is abdominal wall.Compared to different parts the abdominal wall is weak due to the presence of some natural orifices.There are some areas wherein the abdominal muscles are weaker and thin and all these factors create a probability 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 simply above the inguinal ligament.It is seen on either facet).This kind is common in males.Initially the swelling comes solely whereas straining and goes back whereas lying down. Later the big portion of intestine may return out that may not return easily.

b) Femoral hernia:

This sort of hernia is additional in females.Here the abdominal contents withstand the femoral canal which is seen simply below the junction between the thigh and lower abdominal wall(Inside the femoral triangle).The contents pass downwards and comes out through saphenous gap within the thigh and forms a swelling under the skin.

c) Umbilical hernia:

This is often common in children.The umbilicus is that the weaker half of the abdomen.The contents of the abdomen may protrude as a bulb like swelling whereas crying and defecating.

d) Incisional hernia:

These hernias are seen in operated sites. Because of improper suturing or sepsis the operated web 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 seem within the lumbar space on either facet of the lumbar spine(in the lumbar triangle).This is often conjointly a rare type.

g) Obturator hernia:

This can be a rare type of hernia. Here the contents have obturator foramen in the pelvic bone.

Complications of hernia:–

one) Strangulation:

If the hernial orifice is slim the abdominal contents may not go back simply, and later the blood flow to the herniated tissues may be blocked because of constricition.This could cause death of protruded intestine.

two) Intestinal obstruction:

This occures when the whole portion of the intestine is protruded in to the hernial sac. The slim hernial orifice can block the passage of bowels.

three) Infection and peritonitis:

If there’s strangulation with death of a little 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 subsequent steps might be helpful

one) Use of hernia belt:

Special types of hernia belts are out there for every sort of heania.This will forestall the protrusion and will scale back pain.

a pair of) Constipation,recurrent cough,urinary obstruction ect ought to be treated.

three) Fat reduction can increase the strength of abdominal wall.

4) Abdominal exercises to increase the muscle tone.

5) Take plenty of leafy vegetables, fruits and fibrous diet for simple bowel movements.

6) Strive alternative systems like Homoeopathy,Herbal drugs and ect

If no relief by the on top of steps consult a general surgeon for surgical management.

Surgical treatment.

The subsequent operations are done relying up on the type and nature of hernia.

1) Hertniotomy : During this operation the contents of hernial sac is pushed in to the abdomen and neck of the sac is ligated with transfixion ligature and the sac is cut off.

two) Herniorrhaphy: Here along with herniotomy the posterior wall is repaired.

three) Hernioplasty: This operation is completed if herniotomy isn’t possible thanks to wide neck of the sac.Here the repair is finished with the healp of non absorbable materials like tantalum gauze,polypropylene mesh or chrome steel mesh.

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