Hernia

A hernia is caused when part of an internal organ or body part juts out through an opening into another location where it normally should not be situated. There are various types of hernias, a portion of the intestine protrudes through a weak area in the muscular wall of the abdomen is the most common. This promotes an abnormal bulge under the skin of the abdomen, generally near the groin or the navel.

Hernias can crop up in various locations. Some hernias are present during birth, while others grow during adulthood. The enlargement of hernias may be due to augmented pressure inside the abdomen, possibly during straining, lifting, coughing or pregnancy.

Different types of abdominal-wall hernias include the following:

Inguinal hernia
This type of hernia is predominant among men. Most of the time this occurs before birth. In Inguinal hernia the groin region the testes come down into the scrotum through the narrow passage of inguinal canal. Due to this downward movement of the hernial contents into the scrotum it enhances and becomes tough to differentiate from the swelling of the testes or scrotum.

Indirect inguinal hernia: An indirect inguinal hernia may occur at any age. An indirect hernia follows the track that the testicles made at the time of fetal growth, descending from the abdomen into the scrotum. This pathway normally blocks prior to birth but may remain a probable site for a hernia in later life. Occasionally the hernia sac may project into the scrotum.

Direct inguinal hernia: The direct inguinal hernia takes place little inside the site of the indirect hernia, in an area where the abdominal wall becomes naturally little thinner. Seldom it will jut out into the scrotum. Unlike the indirect hernia, which can occur at any age, the direct hernia inclines to crop up in the middle-aged and elderly because their abdominal walls weaken as they age.

Femoral hernia

This sort of hernia is usually common in women. In Femoral hernia the abdominal grow into the front of the thigh through an opening which leads to the femoral artery into the leg. This artery caters the blood to the leg.

Umbilical hernia

These common hernias (10%-30%) are frequently noticed at birth as a projection at the bellybutton (the umbilicus).This take place before birth when an opening in the abdominal wall doesn\’t close completely. Normally it is closed naturally. If it is small (less than half an inch), then this type of hernia closes gradually by age 2.Larger hernias and those that do not close by themselves usually need surgery at age 2-4 years. Even if the area is closed at birth, umbilical hernias can appear later in life because this spot may remain a weaker place in the abdominal wall. Umbilical hernias can appear later in life or in women who are pregnant or who have given birth (due to the added stress on the area).

Incisional hernia

Abdominal surgery creates a defect in the abdominal wall. This flaw can produce an area of weakness in which a hernia may expand. This occurs after 2%-10% of all abdominal surgeries, although some people are more at risk. Even after surgical restore, incisional hernias can come back.

Spigelian hernia

This unusual hernia crops up next to the edge of the rectus abdominus muscle, which are quite a few inches to the side of the middle of the abdomen.

Obturator hernia

This unique abdominal hernia is typically common in women. This hernia protrudes from the pelvic cavity through an opening in the pelvic bone (obturator foramen). This will not focus on any bulge but can work like bowel hindrance and cause nausea and vomiting. Because of the absence of noticeable bulging, this hernia is very tough to identify.

Epigastric hernia

This kind of hernia used to take placed between the navel and the lower part of the rib cage in the midline of the abdomen and is comprised usually of fatty tissue and rarely contain intestine. In the comparatively defective locale of the abdominal wall, these hernias are often exposed. They are painless and unable to be pushed back into the abdomen.

Hiatal hernia

This hernia takes on the stomach rather than the intestine. The stomach slips upward through the normal opening in the diaphragm and passes into the chest. It is frequently related with acid reflux, or \”gastroesophageal reflux disease\” (GERD), which causes heartburn.

Causes

Although abdominal hernias can be present at birth, others grow later in life. Some involve pathways formed during fetal development, existing openings in the abdominal cavity, or areas of abdominal-wall weakness.

Any condition that increases the pressure of the abdominal cavity may contribute to the formation or worsening of a hernia. Examples include:

Obesity,
Heavy lifting,
Coughing,
Straining during a bowel movement or urination,
Chronic lung disease, and
Fluid in the abdominal cavity.

A f

amily history of hernias can make you more likely to develop a hernia.

Symptoms

Symptoms may be or may not be obvious in some of inguinal hernias. Symptoms and signs depend on the nature of hernia. In the case of reducible hernias, you can frequently observe and sense a bulge in the groin or in another abdominal area. When you are standing, such bulge becomes more obvious. Apart from the bulge, other symptoms include pain in the groin. You may also feel a deep or dragging sensation. In men, there is also from time to time pain and swelling in the scrotum around the testicles region.

Irreducible hernias or incarcerated hernias may be painful, but their most relevant symptom is that they cannot return to the abdominal cavity when pushed in. They may be chronic, although painless, and can cause strangulation. Nausea, vomiting, or fever can give more troubles in these cases due to bowel obstruction. In this case the bulge in hernia also may become red, purple or dark.

Strangulated hernias are always painful and pain comes after the tenderness. Here also due to bowel obstruction nausea and vomiting are present. The patient may also experience fever.

Diagnosis

In the diagnosis of abdominal hernias, imaging is the most useful means of detecting internal diaphragmatic and other nonpalpable or unsuspected hernias. Multidetector CT (MDCT) can detect with precision the anatomic site of the hernia sac, the contents of the sac, and any complications. MDCT also presents clear detail of the abdominal wall allowing wall hernias to be identified accurately. However, most people can determine their own hernias by feeling a bulge. At the time of routine check up your doctor may discover a small hernia in your body.

Treatment

It is normally advisable to treat hernias promptly in order to prevent complications like organ dysfunction, gangrene, multiple organ dysfunction syndrome, and death. Nearly all abdominal hernias can be surgically cured, and recovery hardly ever calls for long-term modifications in lifestyle. Uncomplicated hernias are mostly repaired by pushing back, or \”reducing\”, the herniated tissue, and then restoring the weakness in muscle tissue (an operation called herniorrhaphy). If complications have taken place, the surgeon will verify the possibility of the herniated organ, and resects if it is compulsory.

There are various alternatives, including standard surgery, surgery using mesh plugs or patches, and surgery done using a telescope through a small incision (laparoscopic surgery). In case repairing of your hernia, you and your surgeon will talk about which technique is most suitable for you. Type, size and location are the deciding factors of selecting which type of method is perfect for you.

Umbilical hernias in infants generally are not treated surgically unless the hernia persists on the child\’s third or fourth birthday, becomes larger, causes symptoms or strangulates. If the opening through which the hernia passes is greater than 2 centimeters in diameter Umbilical hernias probably require surgical treatment

Hiatal hernias that are not promoting indications of acid reflux do not need to be treated. When symptoms crop up, medicine may be recommended to reduce acid reflux. Surgery possibly will be prescribed for large hiatal hernias that have long-lasting symptoms or for hernias that develop into stuck within the chest.

Complications

Complications may arise post-operation. The rejection of the mesh that is adopted to repair the hernia is the main trouble. In the occasion of a mesh rejection, the mesh will be required to be removed. Mesh rejection can be identified by clear, sometimes localized swelling and pain around the mesh area. Continuous discharge from the scar can happen for a while following elimination of the mesh.

An untreated hernia can be complicated by:

Inflammation

Irreducibility
Obstruction
Strangulation
Hydrocele of the hernial sac
Haemorrhage
Autoimmune problems

Prevention

To prevent hernias combined with increased abdominal pressure, avoid activities that are the roots of the abdominal strain, like lifting heavy weights. If you are with hernia as well as overweight losing weight is helpful for you. If you often need to strain when you move your bowels, talk to your doctor. Your doctor may prescribe stool-softening medications or recommend you to adjust your diet comprising more high-fiber foods.