Direct and oblique inguinal hernia are formations located in the abdominal cavity, which differ in the place of exit. Most often, this ailment occurs in men. All symptoms of a direct inguinal hernia can be divided into two groups, which directly depend on the degree of development of the pathology.
When coughing, sneezing, movements of protrusion of an inguinal hernia (according to ICD-10 has the code K40) does not occur, it does not go beyond the boundary of the hernial ring. The hernia has an oval-oblong shape, it can be viewed above the inguinal ligament. There is a slight burning sensation and discomfort in the groin. When moving, there are pulling pains. For most people, oblique inguinal hernia does not appear for a long time, so many are unaware of its presence.
Causes
An inguinal hernia, according to ICD 10 whose code is K40, is a pathological protrusion of the abdominal organs from the anatomical space they occupy into the inguinal canal. This disease most often occurs in men, the formation itself is a dense rounded bump. It is also worth noting that oblique hernias most often occur in young people, and straight ones appear due to age-related changes.
The appearance of a hernia is accompanied by sharp pain in the lower abdomen. Causes of oblique and direct inguinal hernia:
- Genetic predisposition.
- Intrauterine underdevelopment of internal genital organs.
- Weakness of muscle fibers of the abdominal cavity.
- Overweight.
- Chronic infectious and viral diseases.
- Diseases of the gastrointestinal tract.
- Permanent physical overload.
- Inadequate bowel movements.
- Premature onset of labor.
- Cryptorchidism.
Oblique inguinal hernia in men increases with the appearance of a strong cough or a lifting of their weight. The elimination of this disease is carried out mainly by a surgical method.
Symptoms of oblique hernia in men
It is necessary to recognize the symptoms of inguinal hernia in men in a timely manner. Treatment in this case, the doctor will be able to prescribe the most effective. The disease shows such signs:
- Tumor-like protrusions in the groin area, accompanied by pain. Severe pain can occur with physical exertion.
- Unusual thickening of the spermatic cord.
- Constipation and pain in the lower abdomen, which radiates to the sacrum.
Symptoms of oblique hernia in women
For women, the following symptoms are characteristic:
- In the lower abdomen, pain is felt after lifting weights, after some time (after rest) the pain goes away.
- During the menstrual cycle or a couple of days before it, the pain may intensify.
Symptoms of a direct hernia in men
Symptoms of a direct inguinal hernia for men:
- Lingering pain and burning in the groin.
- Bloating in the groin, which may vary depending on the position of the body.
- Discomfort during urination and walking.
Symptoms of a direct hernia in women
To prescribe treatment for inguinal hernia in women, symptoms are the first thing that needs to be distinguished in this case:
- A protrusion in the form of a tumor, which increases with direct stance, physical activity, during sneezing or coughing.
- The pain is sharp and intense, which gives down the abdominal cavity, lower back and sacrum.
- Flatulence, frequent urination, constipation.
- Severe pain during urination.
Symptoms of infringement of a hernia
When infringement of an oblique and direct inguinal hernia, the following symptoms are observed:
- Sharp and severe pain in the hernia;
- General weakness, vomiting, and nausea;
- In any position of the body, the hernia does not adjust.
Differences between a direct and oblique inguinal hernia
The anatomical difference between the hernias is that the straight line can exit from the abdominal cavity into the middle inguinal cavity, which is located inside. This must be known during surgery, when differential diagnosis of a direct and oblique inguinal hernia is performed.
Of the five folds that are located on the posterior surfaces of the anterior abdominal walls, only one is considered an active artery, and the other is an overgrown formation. During surgery, when the hernia sac is opened , the doctor has a chance to stick a finger into the abdominal cavity and feel the back surfaces. If the finger has detected a pulsation, then this may indicate that there is a direct inguinal hernia. If the pulsation is felt inside where the neck of the hernial sac is located, then the place where the hernia comes out is the inguinal cavities or deep holes of the inguinal canals, i.e. oblique inguinal hernias.
Direct inguinal hernias always lie more medially than the spermatic cords, which are isolated from the bags of hernias and only adjoin to them. Layers of direct inguinal hernias are considered to be the skin, subcutaneous tissue, superficial fascia, aponeurosis of the external oblique muscles of the abdomen.
Diagnostics
Diagnosing an inguinal hernia is quite simple, as it can be seen during a physical examination. When collecting the patient’s history, the exact time of the appearance of protrusion, the presence of cough, constipation is specified. And also factors that could provoke the development of inflammation are being clarified. For example, heavy physical exertion.
The doctor examines how difficult the protrusion is and adjusts for infringements. Next, palpation is performed, the consistency, content and density of the hernia is assessed. Of great importance is the color of the skin in the focus of inflammation and soreness when pressed. Inguinal hernias are revealed direct and oblique on ultrasound of the pelvic organs. This technique is used to study the internal content of education. To quickly get an accurate diagnosis, the patient passes a series of tests, including:
- General blood analysis;
- General urine analysis;
- Ultrasound
- ECG;
- Blood coagulation test.
Instrumental diagnostics includes diaphanoscopy (scrotal scans). It is performed to detect fluid or inflammation. All these measures are necessary in order to confirm the presence of a hernia, since the symptoms of inflammation are similar to other pathologies.
Operation
In men and women, the symptoms and treatment of inguinal hernia vary, but the operation is the same.
The issue of an operation to remove an inguinal hernia still does not have a final solution and requires further development and improvement. The percentage of relapse after surgery is still high, and there is no big downward trend. It is noted that relapse in direct inguinal hernia is significantly higher than the number of relapse in oblique. Therefore, the desire of doctors to the subsequent study of the anatomical and topographic relationship for different types of inguinal hernia is obvious, so that the data of surgical anatomy are used clearly and purely personally. Not every time the differences in oblique and direct inguinal hernias are accounted for in the etiology and anatomy of the tissue ratio.
Unjustified choices of surgical intervention methods are observed, or “favorite” methods are used in everyday practice, which cannot affect the immediate and long-term result.
Surgical anatomy of hernias (oblique, straight, sliding, etc.) has its own characteristics; therefore, the choice of method and the conduct of a separate part of the surgical intervention must be done taking into account the existing difference. In connection with a variety of options oblique inguinal hernia (diverticulum of the bag, a closed cavity, a herniated hernia, and others), complications of excessive injuries of spermatic cord appear.
Processing the neck of the hernial sac is of exceptional importance, and only a large allocation of the neck gives a chance to remove the abdominal funnels, whose role in creating relapses is indispensable.
The principal installation during surgery of any type of inguinal hernia is the mandatory dissection of aponeurosis of the external oblique muscles, in this regard, surgery according to the method of Ru and its variants is considered unreasonable. It is a mistake to refuse to use muscle for plastic inguinal canals.
After an operation to remove an inguinal hernia, a rehabilitation period begins, which includes a diet, lifestyle changes and a decrease in physical activity.
Medication for oblique and direct inguinal hernia
There is a fairly extensive list of methods for eliminating inguinal hernia. The most popular and effective ways to combat this pathology are provided in the following list:
- Surgical intervention.
- Drug therapy.
- Recipes of traditional medicine.
- Wearing a bandage.
Of course, the operation will be the right solution, however, during pregnancy or inflammatory processes in the body, radical measures are contraindicated. In this case, you have to resort to the second option - the use of medicines.
As a rule, in the presence of a direct or oblique inguinal hernia, the patient uses the following drugs:
- Anesthetic "No-spa".
- Laxative "Dufalac".
"No-spa" refers to the category of pain medication. Its use is justified by the fact that with an inguinal hernia, the patient has severe pain, sometimes intolerable, and this medicine will help reduce pain. The cost of the drug varies from forty to four hundred seventy-five rubles. It is worth considering that an overdose of the drug is dangerous. Excessive use of painkillers can be fatal. The normal dose per day is one hundred twenty grams, that is, three tablets.
As you know, inguinal hernia is characterized by constipation, which is fraught with a number of unpleasant consequences: intoxication, dysbiosis. Therefore, to prevent such incidents, a laxative should be taken. Dufalac can be purchased by paying from three hundred to nine hundred rubles. As in the case of the first drug, Dufalac should not be consumed in large quantities. There will be no fatal outcome, but vomiting or diarrhea, severe stomach pain and bloating will replace it.
Alternative methods of therapy
To cure a hernia, which is not complicated by infringement, folk remedies are used as an additional factor. It is recommended to use folk remedies to eliminate the inflammatory process, relieve pain, restrain hernia growth, strengthen the body and so on.
Usually, inguinal hernia in men, the symptoms and treatment of which are discussed in this article, is treated with a hernia. One of the easiest methods that can help relieve the inflammatory process is the use of a compress with this herb. To prepare a compress, you need to wash a handful of freshly picked herbs and put in a steamer. Then you need to keep over hot water for ten minutes, then grind and attach to the place where the hernia formed. Fix the bandage and adhesive plaster up so that the compress cannot move. Apply this method once a day for two weeks. Compress hold for forty minutes.
A hernia is used to make a compress for inguinal hernias. Also relieves pain and swelling of the compress, where nettle is added. Ten medium-sized leaves of fresh nettle need to be washed and chopped. Mix the resulting contents with three tablespoons of warm fat sour cream. Then coat the sore spot with this consistency and cover on top with a leaf of cabbage. Fix with a clean cotton towel so that the compress does not move, leave overnight. Repeat the session for four weeks.
A compress with a leaf of white cabbage will also help. Pass two or three large leaves of cabbage through a meat grinder or grind with a blender so that the juice appears. Then attach the resulting mass to a sore spot and fix it with a bandage.
Prevention
The most common type of hernia is inguinal. To prevent this pathology, you need to perform a set of physical exercises daily. Preliminarily get a consultation to determine the strength of the load, corresponding to age and state of health.
Emphasis should be placed on the anterior abdominal muscles:
- Take a horizontal position, lift your legs together at a right angle 10 times.
- In the same position, extend your arms along the body. Raise your legs in turn at a right angle, slowly lowering them down. Perform the exercise 10 times.
- Bend your legs, lifting your torso, hug your knees with your hands. Perform the exercise 10 times.
- In the same position, we perform movements that simulate cycling. Every 3-4 movements lower your legs to the floor. Perform the exercise 10 times.
- Pull the legs bent at the knees 10 times to the chest.
Benefits in the prevention of pathology will bring long walks in the fresh air, within 1 hour. Withstand sleep time, if you can’t do it yourself, consult a doctor for the appointment of special medications that respond to the restoration of body biorhythms.
The importance here is the strict implementation of the diet. Sit at the table every 3 hours, 5 times a day. Remove spicy and fatty foods, alcohol, sweets and flour products from the menu. Give preference to vegetables, fish, meat.
The consequences of a direct and oblique inguinal hernia are not felt at all (subject to successful surgical intervention). If measures were not taken, then this pathology threatens the health and life of the patient.