Gallbladder Surgery

Hernia - Introduction To Hernias Together With Your Alternatives

A hernia is an abnormal protrusion of internal organs through an abnormal opening in the wall of the cavity. A combination of increased pressure inside the body with weakness in the wall is responsible for this condition.

In this condition internal organs or parts of organs are protruded out developing a swelling and this will increase the size with hacking and coughing and lifting weight,and when passing stool and urine.In a lying down position the lump goes on the inside other than in strangulated and irreducible hernia.

WHAT CAUSES HERNIAS?

1. Weakness in the body wall, caused by...

a) Congenital weakness.

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

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


2. Increased pressure inside the body, caused by...

a) Long-term constipation.

b) Recurrent cough.

c) Weight lifting.

d) Stricture of urethra.


COMMON SITES FOR HERNIAS

A hernia might occur anywhere in the body. Even so there are a number of typical locations for hernia. Because of the presence of a hard bony covering, the chest wall is normally not affected. Hernia in the lower back is also uncommon due to spine and back muscles and tough ligaments and sheaths.

The most wide-spread site for hernia is the abdominal wall. When compared with other parts, the abdominal wall is weak due to the presence of some natural orifices. There are some areas where the abdominal muscles are weaker and thin and all these factors create a chance for herniation. The common locations for hernia are following.

a) Inguinal hernia:

Here the abdominal contents thrust outward through the inguinal canal (passage in the lower abdominal wall just above the inguinal ligament. It is seen on either side).This type is common in males. Initially the swelling comes only while straining and goes back while lying down. Later the large portion of intestine may come out which may not go back easily.

b) Femoral hernia:

This type of hernia is more in females. Here the abdominal contents pass through the femoral canal which is seen just below the junction between the thigh and lower abdominal wall (inside the femoral triangle). The contents pass downwards and comes out through the saphenous opening in the thigh and forms a bulge underneath the skin.

c) Umbilical hernia:

This is frequent in children. The umbilicus is the weaker part of the abdomen. The contents of the abdomen may protrude as a bulb-like swelling while crying and defecating.

d) Incisional hernia:

These hernias are seen in operated sites. Due to improper suturing or sepsis the operated site becomes weak resulting in hernia.

e) Epigastric hernia:

Here the herniation occurs in the epigastrium. It is a unusual type.

f) Lumbar hernia:

Here the hernia appears in the lumbar area on either side of the lumbar spine (in the lumbar triangle). This is also a unusual type.

g) Obturator hernia:

This is another rare type of hernia. Here the contents pass through obturator foramen in the pelvic bone.

 
COMPLICATIONS THAT ARISE FROM A HERNIA

1) Strangulation:

If the hernial orifice is narrow the abdominal contents may not go back easily, and later the blood flow to the herniated tissues may be obstructed due to constriction.This can cause the death of the protruded intestine.

2) Intestinal obstruction:

This appears when the whole portion of the intestine is protruded in to the hernial sac. The narrow hernial orifice will block the passage of bowels.

3) Infection and peritonitis:

If there is strangulation with death of a portion of intestine, there will be a spread of infection to the abdomen creating peritonitis.


TREATMENT OF HERNIA -- INITIAL TREATMENT OPTIONS

In the first stages of hernia the following steps may be useful.

1) Use of hernia belt. Special types of hernia belts are for sale for each type of hernia. This will minimize the protrusion and will diminish pain.

2) Constipation, recurrent cough, urinary obstruction etc. should be treated.

3) Fat reduction will increase the strength of abdominal wall.

4) Abdominal exercises to strengthen the muscle tone.

5) Take loads of leafy vegetables, fruit and fibrous diet for easy bowel movements.

6) Try various other systems like homoeopathy, herbal medicine, etc.

If there is no relief from implementing the above steps, consult a general surgeon for surgical management.

TREATMENT OF HERNIA -- SURGICAL OPTIONS

The following operations are done depending up on the type and nature of hernia.

1) Herniotomy: In this procedure the contents of hernial sac are pushed into the abdomen and the neck of the sac is ligated with transfixion ligature and the sac is cut off.

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

3) Hernioplasty: This procedure is done if herniotomy is not possible due to a wide neck of the sac. In this procedure, the repair is done with the help of non absorbable materials like tantalum gauze, polypropylene mesh or stainless steel mesh.