HERNIA

Introduction

Hernia is associate abnormal protrusion of internal organs through associate abnormal gap within the wall of the cavity.A combination of augmented pressure within the body with weakness within the wall is to blame for this condition.In this condition internal organs or elements of organs area unit protruded out forming a swelling which is able to increase the scale with coughing and lifting weight,and whereas passing stool and piddle.In lying down position the swelling goes within except in strangulated and irreducible herniation.

Causes:-

1, Weakness within the body wall:--

a) inherent weakness.

b) nonheritable weakness attributable to injuries,wasting of muscles,suppurative lesions within the wall and presence of weak natural openings,obesity,lack of exercise,repeated physiological state.

c) operation with improper stitching or infection of operated web site.


2) augmented pressure within the body.
 
a) Chronic constipation.

b) repeated cough.

c) Weight lifting.

d) Stricture of channel.

Common sites for hernia:--

Hernia will occure anyplace within the body.However there area unit some common sites for herniation.Due to the presence of exhausting bony covering chest wall is often not affected.Hernia within the lower back is additionally rare attributable to spine and back muscles and hard ligaments and sheeths.The common web site for herniation is wall.Compared to alternative elements the wall is weak attributable to the presence of some natural orifices.There area unit some area unitas whereby the abdominal muscles are weaker and skinny and every one these factors build an opportunity for hernia.The common sites for herniation area unit following.

a) region hernia:

Here the abdominal contents protrude through the {inguinal canal|canalis regionis|duct|epithelial duct|canal|channel} (passage within the lower wall simply on top of the inguinal ligament.It is seen on either side).This type is common in males.Initially the swelling comes solely whereas straining and goes back whereas lying down. Later the massive portion of gut could pop out which can not return simply.
   
b) leg bone hernia:

This type of herniation is a lot of in females.Here the abdominal contents submit to the leg bone canal that is seen slightly below the junction between the thigh and lower abdominal wall(Inside the leg bone triangle).The contents pass downwardly and comes out through saphenous gap within the thigh and forms a swelling underneath the skin.

c) point hernia:

This is common in youngsters.The bellybutton is that the weaker a part of the abdomen.The contents of the abdomen could protrude as a bulb like swelling whereas crying and defecating.

d) Incisional hernia:

These hernias area unit seen in operated sites. attributable to improper stitching or infection the operated web site becomes weak leading to herniation.
   
e) Epigastric hernia:

Here the hearniation occures within the region. it's a rare kind.

f) body part hernia:

Here the herniation seem within the body part space on either aspect of the body part spine(in the body part triangle).This is conjointly a rare kind.

g) prosthetic device hernia:

This is a rare kind of herniation. Here the contents submit to prosthetic device opening within the girdle bone.


Complications of hernia:--

1) Strangulation:

If the hernial opening is slender the abdominal contents might not return simply, and later the blood flow to the herniated tissues could also be blocked attributable to constricition.This can cause death of protruded gut.

2) enteric obstruction:

This occures once the entire portion of the gut is protruded in to the hernial sac. The slender hernial opening can block the passage of bowels.

3) Infection and peritonitis:

If there's strangulation with death of some of gut there'll be unfold of infection to the abdomen leading to rubor.

Treatment of hernia:--

Initial treatment: within the initial stages of herniation the subsequent steps could also be helpful

1) Use of herniation belt:

Special varieties of herniation belts area unit accessible for every kind of heania.This will forestall the protrusion and can scale back pain.

2) Constipation,recurrent cough,urinary obstruction ECT ought to be treated.

3) Fat reduction can increase the strength of wall.

4) Abdominal exercises to extend the tone.

5) Take lots of leafed vegetables, fruits and fibrous diet for simple viscus movements.

6) strive alternative systems like homeopathy,Herbal drugs and ECT

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

Surgical treatment.

The following operations area unit done relying au courant the kind and nature of herniation.

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 therefore the sac is stop.

2) Herniorrhaphy: Here at the side of herniotomy the posterior wall is repaired.

3) Hernioplasty: This operation is finished if herniotomy isn't potential attributable to wide neck of the sac.Here the repair is finished with the healp of non absorbed materials like Ta gauze,polypropylene mesh or stainless-steel mesh.