A hernia is an abnormal protrusion of internal organs via an abnormal hole in the wall of a bodily cavity. It arises owing to a combination of increased internal pressure and a weakening in the body wall. This disorder causCausesernal organs or sections of organs to bulge out, causing a swelling that grows in size during actions such as coughing, lifting heavy things, or when passing feces and urine. In a laying posture, the swelling normally recedes, especially in situations of strangulated or irreducible hernia.
Causes
1) Weakness in the body wall
a) Congenital weakness
Some people are born with a genetically weaker muscular wall, rendering them more prone to hernias.
- b) Acquired weakness
- Injuries
- Muscle wasting
- Suppurative infections in the wall
- Presence of inherently weak openings
- Obesity
- Lack of exercise
- Repeated pregnancies
- d) Surgical factors
- Improper suturing after surgery
- Infection at the surgical site, leading to weakening tissue
2) Increased internal pressure
- a) Chronic constipation
- b) Recurrent coughing
- b) Heavy weight lifting
- d) Urethral stricture (narrowing of the urethra)
Common Sites of Hernia
Hernias may occur anywhere in the body; however, certain places are more prone to this problem. The chest wall is normally protected by a robust bone structure, making hernias in this location uncommon. Similarly, lower back hernias are rare owing to the presence of the spine, back muscles, and tight ligaments. The most prevalent place for hernias is the abdominal wall, which is inherently weaker owing to existing anatomical holes. Some parts of the abdominal muscles are thinner and more sensitive to herniation. The most prevalent forms of hernias include:
- a) Inguinal Hernia
- Occurs when abdominal contents protrude through the inguinal canal (a channel in the lower abdominal wall, directly before the inguinal ligament).
- More prevalent among guys.
- Initially, the swelling emerges solely while straining and recedes when resting down.
- In advanced situations, a bigger piece of the intestine may protrude and not return quickly.
- a) Femoral Hernia
- More prevalent among females.
- Abdominal contents travel via the femoral canal, positioned right below the connection between the thigh and the lower abdomen.
- The contents may descend and protrude through the saphenous hole in the leg, causing a bulge beneath the skin.
- d) Umbilical Hernia
- Common in children.
- The umbilicus is a naturally weak part of the abdomen.
- Abdominal contents may protrude, generating a bulging mass, particularly when sobbing or feces.
- d) Incisional Hernia
- Develops at past surgery locations.
- Caused by poor suturing or post-operative infection, resulting to weakening in the abdominal wall.
- f) Epigastric Hernia
- Occurs in the epigastric area (upper abdomen).
- A uncommon kind of hernia.
- f) Lumbar Hernia
- Appears in the lumbar area on each side of the spine (in the lumbar triangle).
- Uncommon occurrence.
- g) Obturator Hernia
- A uncommon kind of hernia.
- Occurs when stomach contents flow through the obturator foramen in the pelvic bone.
Complications of Hernia
- Strangulation
- If the hernial opening is limited, the abdominal contents may get stuck, preventing them from returning to their usual place.
- This may lead to limited blood supply, causing tissue death in the protruded part of the gut.
- Intestinal Obstruction
- When a considerable piece of the intestine is stuck inside the hernial sac, it may block bowel motions.
- The small hernial aperture may restrict the flow of intestinal contents.
- Infection and Peritonitis
- If strangulation leads to intestinal tissue death, it may cause severe infection and inflammation of the abdominal cavity (peritonitis), which is a life-threatening illness.
Treatment of Hernia
Initial Management
In the early stages of hernia, the following methods may help control symptoms:
- Use of a Hernia Belt
- Specialized hernia belts are offered for various kinds of hernias.
- These belts assist minimize protrusion and give support, decreasing pain.
- Address Underlying Conditions
- Treat constipation, persistent cough, and urinary blockage to avoid additional strain.
- Weight Management
- Reducing extra weight strengthens the abdominal wall, minimizing the chance of hernia advancement.
- Abdominal Exercises
- Strengthening the abdominal muscles may assist increase muscular tone and offer greater support.
- Dietary Adjustments
- Consuming green vegetables, fruits, and fiber-rich diets improves smooth bowel motions, lowering strain.
- Alternative Treatments
- Some people seek alternative treatments such as homeopathy and herbal therapy.
If these conservative methods do not offer relief, a visit with a general surgeon is indicated for surgical surgery.
Surgical Treatment
Depending on the kind and severity of the hernia, numerous surgical techniques may be performed:
- Hernioplasty
- Performed when the hernia sac has a broad neck, making traditional repair problematic.
- Reinforcement is done utilizing non-absorbable materials such as tantalum gauze, polypropylene mesh, or stainless steel mesh.
- Herniorrhaphy
- Combines hHerniotomywith posterior wall repair for greater reinforcement.
- Herniotomy
- The herniated contents are forced back into the abdominal cavity.
- The neck of the hernia sac is tied off using a transfixion ligature, and the sac is removed.
A hernia is a frequent ailment that may affect numerous regions of the body, mainly the abdominal wall. Early identification and therapy are critical to avoid complications such as strangling and intestinal blockage. While conservative methods may give temporary relief, surgery remains the ultimate therapy for most instances. If symptoms continue or worsen, early surgical intervention is critical to avert life-threatening consequences.
