A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained.

These contents, usually portions of intestine or abdominal fatty tissue, are enclosed in the thin membrane that naturally lines the inside of the cavity.

Hernias by themselves may be asymptomatic, but have a potential risk of having their blood supply cut off (becoming strangulated).

If the blood supply is cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency as the tissue needs oxygen which is transported by the blood supply.

Types

1.Inguinal (groin) hernia:

Making up 75% of all abdominal-wall hernias and occurring up to 25 times more often in men than women,
These hernias are divided into two different types, direct and indirect.

Both occur in the groin area, but they have slightly different origins.

Both of these types of hernias can similarly appear as a bulge in the inguinal area.

Distinguishing between the direct and indirect hernia, however, is important as a clinical diagnosis.

a.Indirect inguinal hernia:

An indirect hernia follows the pathway of testicles which descend from the abdomen into the scrotum during the fetal life.

This pathway normally closes before birth but may remain a possible site for a hernia in later life.

Sometimes the hernia sac may protrude into the scrotum.

An indirect inguinal hernia may occur at any age.

b.Direct inguinal hernia:

The direct inguinal hernia occurs slightly to the inside of the site of the indirect hernia, in an area where the abdominal wall is naturally slightly thinner.

It rarely will protrude into the scrotum.

Unlike the indirect hernia, which can occur at any age, the direct hernia tends to occur in the middle-aged and elderly because their abdominal walls weaken as they age.

2.Femoral hernia:

The femoral canal is the path through which the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh.

Although normally a tight space, sometimes it becomes large enough to allow abdominal contents (usually intestine) to protrude into the canal.

3.Umbilical hernia:

These common hernias (10%-30%) are often noted at birth as a protrusion at the bellybutton (the umbilicus).

This is caused when an opening in the abdominal wall, which normally closes before birth, doesn’t close completely.

If small (less than half an inch), this type of hernia usually closes gradually by age 2.

Larger hernias and those that do not close by themselves usually require surgery at age 2-4 years.

4.Incisional hernia:

Abdominal surgery causes a flaw in the abdominal wall.

This flaw can create an area of weakness in which a hernia may develop.

5.Epigastric hernia:

Occurring between the navel and the lower part of the rib cage in the midline of the abdomen, epigastric hernias are composed usually of fatty tissue and rarely contain intestine.

Causes

1.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.

2.A family history of hernias can make you more likely to develop a hernia.

Symptoms:

Reducible hernia

Def: Can be returned to normal position by manipulation.

It may appear as a new lump in the groin or other abdominal area.

It may ache but is not tender when touched.

Sometimes pain precedes the lump.

The lump increases in size when standing or when abdominal pressure is increased (such as coughing).

It may be reduced (pushed back into the abdomen) unless very large.

Irreducible hernia or Incarcerated hernia

Def: A hernia that cannot be reduced without surgery.

It may be an occasionally painful enlargement of a previously reducible hernia that cannot be returned into the abdominal cavity on its own or when you push it.

Some may be chronic (occur over a long term) without pain.

It can lead to strangulation.

Signs and symptoms of bowel obstruction may occur, such as nausea and vomiting.

Strangulated hernia

This is an irreducible hernia in which the entrapped intestine has its blood supply cut off.

Pain is always present, followed quickly by tenderness and sometimes symptoms of bowel obstruction.

This condition is a surgical emergency.

Diagnosis

If the symptoms of a hernia like dull ache in groin or other body area with lifting or straining may be indication.

Other tests are not required.

Treatment

Reducible hernia

In general, all hernias should be repaired to avoid the possibility of future intestinal strangulation.

If preexisting medical conditions exist that would make surgery unsafe

Irreducible hernia

All acutely irreducible hernias need emergency treatment because of the risk of strangulation.

An attempt to reduce (push back) the hernia will generally be made, often with medicine for pain and muscle relaxation.

If unsuccessful, emergency surgery is needed.

Author Bio: Dr Guptha Faculty in medical billing training

Category: Wellness, Fitness and Diet
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