Inguinal and Abdominal Hernia
Inguinal and Abdominal Hernia
Hernia is a protrusion of an abdominal organ or its part through the wall of the abdominal cavity. The content remains covered by peritoneum and other layers of the abdominal wall. On the contrary, in prolapse the protruded organs are covered by nothing.
Development of Inguinal and Abdominal Hernia
The abdominal wall in formed mainly by muscles that protect the abdominal cavity and maintain its shape. The abdominal wall is naturally weakened in several places and in these places a hernia can develop. As described in the article about Hernia, hernias can be divided into groups from several aspects. Given the subject of this article, the classification into internal and external hernias is important.
- In internal hernias, a portion of the abdominal organs gets into a fold within the abdominal cavity. Internal hernias are not visible from the outside.
- External hernias, on the other hand, are a common disease that can easily be observed from the outside because the contents of the hernia are usually visible under the skin, at rest or when the muscles are clenched.
Hernial contents may be supporting apparatus of the intestine, called the omentum, or even loops of the small and large intestine, the urinary bladder, stomach, less frequently other organs of the abdominal cavity. Hernia may also be without contents. Both inguinal and abdominal hernias are external hernias.
Inguinal hernia is a condition in which part of the abdominal organs penetrates the inguinal canal. This is the canal through which during fetal development testis descended in case of a man, or uterine ligament in case of a women. By the passage the abdominal wall is congenitally weakened, in other words it is the ideal place for hernia development. Since every person has this weakened place and only some develop hernia, there must be also other factors that help hernia development. Above all it is increased intraabdominal pressure by obesity, pregnancy, lifting of heavy objects, muscle overloading. When the intraabdominal pressure is increased, from whatever reason, the abdominal organs and intestine loops are pressed hardly against the abdominal wall.
Hernias in the abdomen are generally called abdominal hernias. In all these hernias the development is almost the same. Each hernia consists of three components - hernial gate, hernial sac and hernial content (for more information see the article Hernia). Among abdominal hernias, we distinguish hernias umbilical and incisional.
- Umbilical hernia occurs in the region of the navel, since it is another congenitally weakened spot in the abdominal wall. During fetal development, the umbilical cord passes through this place into the body of the fetus.
- Incisional hernia occurs after surgeries in the abdominal cavity. Scar is formed by connective tissue that in time looses its elasticity and when stretched, may widen. Every scar, both after surgery and trauma, is acquired weakened place of the abdominal wall.
- Another common region for hernias is also the line connecting the lower tip of the breastbone and pubic symphysis.
Symptoms of Inguinal and Abdominal Hernia
Symptoms of inguinal and abdominal hernias are virtually the same; the only difference is the area where they appear. The patient feels tension in the place, soft painful lumps may appear. At the beginning of the hernia development these lumps can easily be pushed back into the abdominal cavity. Later on, this becomes impossible. Some hernial lumps are visible only when the surrounding muscles are clenched.
Diagnosis of Inguinal and Abdominal Hernia
Inguinal and abdominal hernias can be easily diagnosed by inspection and manual palpation by a physician, including a try to push the hernia back into the abdominal cavity. To verify the diagnosis, abdominal sonography is used. Ultrasound is a painless method using ultrasonic beams to image the organs under examination.
Risk Factors for Inguinal and Abdominal Hernia
Risk factors for inguinal and abdominal hernias are the same as for other hernias. Most are risk factors that cannot be influenced, for example natural weakenings of the abdominal wall. Some risk factors may be influenced, though. These risk factors comprise above all obesity and excessive overloading of the abdominal wall muscles by lifting heavy objects.
Treatment of Inguinal and Abdominal Hernia
Treatment of inguinal and abdominal hernias can be conservative or surgical.
Conservative treatment of hernias consists of trying to push the hernia back into the abdominal cavity, limiting the overloading, using hernia support belts. Such treatment, however, will never solve the underlying problem and is therefore only suitable for small hernias.
Surgery is the only consistent treatment. It consists of a tiny section in the place of the hernia, pushing the hernial sac back into the abdominal cavity and careful suture of the abdominal wall. After the surgery, the patient should follow certain regime limitations - the patient should not lift heavy objects, he or she must reduce the intraabdominal pressure at the area by pressing hands against it when coughing, sneezing, or during defecation. Otherwise there is a risk of hernia reoccurrence.
Complications of Inguinal and Abdominal Hernia
A serious complication of every hernia is its incarceration. In case of incarceration, the content of the hernial sac is undersupplied with blood and the tissue dies very quickly. This is obviously a very serious condition that can be even life-threatening to the patient. The main symptom of hernia incarceration is sudden and severe pain in the hernia.
Prevention of Inguinal and Abdominal Hernia
The only prevention against hernias in general is to maintain normal body weight, to strengthen abdominal muscles and avoid heavy objects lifting. Likewise, it is necessary to avoid sudden weight loss as the loss of weight produces loss of proteins that can contribute to weakening of the muscles.