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Introduction

Hernia is an abnormal protrusion of internal organs through an abnormal opening in the wall of the cavity.A mix of increased pressure within the body with weakness in the wall is accountable for this condition.In this condition internal organs or elements of organs are protruded out forming a swelling that will increase the dimensions with coughing and lifting weight,and while passing stool and urine.In lying down position the swelling goes inside except in strangulated and irreducible hernia.

Causes:-

1, Weakness in the body wall:–

a) Congenital weakness.

b) Acquired weakness due to injuries,wasting of muscles,suppurative lesions in the wall and presence of weak natural openings,obesity,lack of exercise,repeated pregnancy.

c) Surgery with improper suturing or sepsis of operated site.

two) Increased pressure within the body.

a) Chronic constipation.

b) Recurrent cough.

c) Weight lifting.

d) Stricture of urethra.

Common sites for hernia:–

Hernia can occure anywhere in the body.However there are some common sites for hernia.Thanks to the presence of arduous bony covering chest wall is often not affected.Hernia within the lower back is additionally rare because of spine and back muscles and tough ligaments and sheeths.The common site for hernia is abdominal wall.Compared to alternative parts the abdominal wall is weak because of the presence of some natural orifices.There are some areas whereby the abdominal muscles are weaker and thin and every one these factors create a likelihood for herniation.The common sites for hernia are following.

a) Inguinal hernia:

Here the abdominal contents protrude through the inguinal canal (passage within the lower abdominal wall simply higher than the inguinal ligament.It is seen on either aspect).This type is common in males.Initially the swelling comes only while straining and goes back while lying down. Later the big portion of intestine may come out which might not go back easily.

b) Femoral hernia:

This sort of hernia is more in females.Here the abdominal contents go through the femoral canal which is seen simply below the junction between the thigh and lower abdominal wall(Inside the femoral triangle).The contents pass downwards and comes out through saphenous opening in the thigh and forms a swelling under the skin.

c) Umbilical hernia:

This is often common in children.The umbilicus is that the weaker half of the abdomen.The contents of the abdomen may protrude as a bulb like swelling whereas crying and defecating.

d) Incisional hernia:

These hernias are seen in operated sites. Thanks to improper suturing or sepsis the operated site becomes weak ensuing in hernia.

e) Epigastric hernia:

Here the hearniation occures within the epigastrium. It’s a rare type.

f) Lumbar hernia:

Here the hernia seem within the lumbar space on either side of the lumbar spine(in the lumbar triangle).This is conjointly a rare type.

g) Obturator hernia:

This is often a rare type of hernia. Here the contents withstand obturator foramen within the pelvic bone.

Complications of hernia:–

one) Strangulation:

If the hernial orifice is slender the abdominal contents may not return simply, and later the blood flow to the herniated tissues may be blocked due to constricition.This may cause death of protruded intestine.

2) Intestinal obstruction:

This occures when the whole portion of the intestine is protruded in to the hernial sac. The slender hernial orifice will block the passage of bowels.

3) Infection and peritonitis:

If there’s strangulation with death of a little of intestine there can be unfold of infection to the abdomen resulting in peritonitis.

Treatment of hernia:–

Initial treatment: In the initial stages of hernia the following steps might be useful

one) Use of hernia belt:

Special varieties of hernia belts are on the market for every sort of heania.This can prevent the protrusion and will scale back pain.

two) Constipation,recurrent cough,urinary obstruction ect ought to be treated.

three) Fat reduction can increase the strength of abdominal wall.

4) Abdominal exercises to extend the muscle tone.

five) Take plenty of leafy vegetables, fruits and fibrous diet for simple bowel movements.

half-dozen) Strive alternative systems like Homoeopathy,Herbal medicine and ect

If no relief by the higher than steps consult a general surgeon for surgical management.

Surgical treatment.

The subsequent operations are done relying up on the type and nature of hernia.

1) Hertniotomy : In this operation the contents of hernial sac is pushed in to the abdomen and neck of the sac is ligated with transfixion ligature and therefore the sac is cut off.

two) Herniorrhaphy: Here along with herniotomy the posterior wall is repaired.

3) Hernioplasty: This operation is done if herniotomy isn’t possible because of wide neck of the sac.Here the repair is completed with the healp of non absorbable materials like tantalum gauze,polypropylene mesh or stainless steel mesh.

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