A hernial sac is a part of the parietal or visceral peritoneum that has fallen through the hernial portal under the skin of the abdomen or groin. In turn, a hernia gate is a hole in the peritoneum of various shapes, sizes and origin. That is, a hernial sac - this is a hernia. It is soft and easy to adjust (without complications). A hernia complicated by pinching or inflammation cannot be fixed and dangerous.
The hernial sac has no other treatment than surgical. In rare cases, if the operation is temporarily contraindicated and the hernia has no complications, the hernia gate is held by a bandage.
Types of hernia
Hernia is a fairly common occurrence. Most often, a hernial sac is formed in children under 5 years of age and in adults after 45 years of age. Moreover, in men, the hernia falls 3 times more often than in women. The cause of loss of part of the intestine or serous membrane is the appearance of a gap in the peritoneum or groin. Therefore, hernias are divided into several types:
- Inguinal - most often fixed in men and boys. In addition, this is the most common hernia - it occurs in 8 cases out of 10 recorded.
- Postoperative - in this case, the intestine falls out through an incision in the peritoneum.
- Umbilical - appears around the navel.
- A whiter hernia is femoral. It occurs in only 3% of patients.
- The rarest type of pathology is diaphragmatic hernia. The occurrence of such a phenomenon is recorded in only 1% of all cases.
Reasons for the formation of pathology
A multi-chamber hernia sac or a conventional single hernia does not occur for any one reason. To do this, several key factors must coincide.
First, a person’s muscle corset should weaken. This can happen as a result of trauma, surgery, advanced or, conversely, too young a person.
Secondly, while the pressure inside the abdominal cavity should increase dramatically. This results in strong physical stress, for example, when lifting weights, or if the child screams for a long time.
Stress in the abdominal cavity can create a long cough, swelling, gas congestion, constipation, pregnancy, disruption of the urination system and several other factors.
It is important to understand that the coincidence of tension within the abdomen and the weak walls of the peritoneum should be long-term. You can not get a pathology by having a cold with a cough. But a long-term violation of the gastrointestinal tract will lead to this with a high degree of probability.
Danger of pathology
The contents of the hernial sac are usually the small intestine. One or more loops fall through the hernia gate under the skin of a person, but at the same time retain their functions. If squeezing of the hernia gate occurs after the intestine has passed through them, complications begin. To the intestinal tissues, blood and oxygen cease to flow. As a result, tissue necrosis begins and then general infection of the blood.
The intestine may not be clamped completely, but only by the edge of the intestine, but this still leads to necrosis. There is a dangerous congenital hernia. In this case, the child is born with some kind of organ located outside the peritoneum: the bladder, the cecum, and so on. In this case, the operation is carried out immediately.
Symptomatic manifestations
The symptom of the pathology is quite simple - a leathery bag that is soft to the touch appears on the surface of the skin. But there is an inguinal hernia. In this case, palpation of the hernial gate shows that they opened into the scrotum, and the intestines descended directly to the testicles. This type of hernia affects every fifth man older than 50 years.
An umbilical hernia is characterized by a sac on the umbilical ring. If the hernia is not restrained, then in the supine position it disappears, that is, the intestinal loop goes into place. Pain, nausea, fever, constipation occur only after infringement of the hernia. In this case, help to the patient must be provided urgently (urgently).
Diagnostic measures
A hernia is diagnosed by visual inspection. But in order to work out a plan of operation, the doctor can prescribe a study of the contents of the hernial sac using an ultrasound or barium solution passed through the intestines. In the latter case, the abdominal cavity is examined using x-ray equipment. How to treat a hernia in each case, the surgeon decides gastroenterologist or endoscopist surgeon.
Treatment principles
To date, there is no effective method of treating hernia with a conservative method. The hernia gate is sutured and strengthened only by surgery. During the operation, the intestines or mesentery are removed into the abdominal cavity, and a special retention network is fixed to the hernial gate. This avoids relapses in the future.
If the patient's condition is critical, that is, a hernia is pinched, the operation is performed on an emergency basis. Part of the intestine affected by necrosis is removed.
Usually the operation is performed under general anesthesia, but if the patient has contraindications for this type of anesthesia, then it is not performed. In this case, the surgical field is anesthetized with local drugs.
If the patient is a pregnant woman or is of advanced age, the operation is not carried out in principle, but the person will have to wear a special restraining bandage all the time.
The decision on how to treat a hernia should be made by a doctor. It is impossible to straighten the intestines yourself, it is very dangerous.
Preventive actions
The prognosis of most hernia surgery is positive. Even if it was impaired and complicated by necrosis. It makes sense to pay attention to the prevention of this phenomenon. To do this, you need to regularly engage in strengthening the muscle corset. That is, doing gymnastics with emphasis on the muscles of the press.
It is also important to eat properly so that the intestines do not create excessive pressure in the abdominal cavity with chronic constipation and flatulence. For this, it is necessary to exclude fatty, spicy foods, fried foods from the diet, include beans in large quantities. You need to eat more fiber and vitamins - these are cereals and fresh fruits. Bad habits - smoking, alcohol, drugs - should also be abandoned, because they adversely affect the whole body as a whole.