Minggu, 11 September 2016

Hernia



 A hernia occurs when the items in a body cavity bulge from the area where they're normally contained. These contents, usually servings of intestine or abdominal fat, are enclosed within the thin membrane that naturally lines within the cavity. Hernias on their own may be asymptomatic (produce no symptoms) or cause slight to severe pain. Almost all have a potential risk of having their circulation cut off (becoming strangulated). Once the content of the hernia bulges out, the outlet it bulges out through can use enough pressure that arteries in the hernia are constricted and then the blood supply is stop. If the blood supply is stop at the hernia opening within the abdominal wall, it might be a medical and surgical emergency because the tissue needs oxygen that is transported by the circulation.

Calssification of hernia

A hernia can happen anywhere in your abdomen (negligence your body between the chest and also the hips). There are several kinds of hernia:
Inguinal hernia occurs when part of your bowel (a part of your digestive system) pokes using your lower abdomen to your groin (the area in front of the body where your thighs meet your abdomen).

Femoral hernia is the place fatty tissue or a a part of your bowel pokes through to your groin, at the top of your inner thigh.
Incisional hernia is the place tissue pokes via a surgical wound inside your abdomen that has not fully healed.
Hiatus hernia is the place part of your stomach pushes up to your chest by squeezing with an opening in the diaphragm (a sizable, thin sheet of muscle that separates your chest out of your abdomen).
Spigelian hernia occurs when a part of your bowel pokes using your abdomen at the side of your stomach muscle, through your navel.
Muscle hernia is the place part of your muscle pokes using your abdomen and can also exist in the muscles inside your leg, often as the effect of a sports injury.
Spigelian hernia is the place part of your bowel pokes using your abdomen at the side of your stomach muscle, through your navel.
types of abdominal-wall hernia
Indirect inguinal hernia: An indirect hernia follows the pathway the testicles made during fetal development, descending in the abdomen into the scrotum. This pathway normally closes before birth but may remain a potential site for a hernia in later life. Sometimes the hernia sac may protrude in to the scrotum. An indirect inguinal hernia may occur at all ages.
Direct inguinal hernia: The direct inguinal hernia occurs slightly towards the inside of the site from the indirect hernia, in an area in which the abdominal wall is of course slightly thinner. It rarely will protrude in to the scrotum. Unlike the indirect hernia, which could occur at all ages, the direct hernia has a tendency to occur in the middle-aged and elderly as their abdominal walls weaken as time passes.
Umbilical hernia: These common hernias (10%-30%) in many cases are noted at birth like a protrusion at the bellybutton (the umbilicus). This really is caused when a dent in the abdominal wall, which normally closes before birth, doesn't close completely. If small (fewer than half an inch), this kind of hernia usually closes gradually by age 2. Larger hernias and people who do not close by themselves usually require surgery at 2-4 years. Even if the area is closed at birth, umbilical hernias can be displayed later in life because this spot may remain a weaker devote the abdominal wall. Umbilical hernias can be displayed later in life or in ladies who are pregnant or who've given birth (because of the added stress on the region).
Incisional hernia: Abdominal surgery leads to a flaw in the abdominal wall. This flaw can make an area of weakness where a hernia may develop. This happens after 2%-10% of all abdominal surgeries, even though some people are more in danger. Even after surgical repair, incisional hernias may return.
Obturator hernia: This extremely rare abdominal hernia develops mostly in females. This hernia protrudes in the pelvic cavity through an opening within the pelvic bone (obturator foramen). This will not show any bulge but could act like a bowel obstruction and cause vomiting and nausea. Because of the lack of visible bulging, this hernia is extremely difficult to diagnose.
Epigastric hernia: Occurring between your navel and the lower area of the rib cage in the midline from the abdomen, epigastric hernias are composed usually of fat and rarely contain intestine. Formed within an area of relative weakness from the abdominal wall, these hernias in many cases are painless and not able to be pushed into the abdomen when first discovered.

Causes

Although abdominal hernias could be present at birth, others develop later. Some involve pathways formed during fetal development, existing openings within the abdominal cavity, or regions of abdominal-wall weakness.
Any condition that boosts the pressure of the abdominal cavity may bring about the formation or worsening of the hernia. Examples include
obesity,
heavy-lifting,
coughing,
straining throughout a bowel movement or urination,
chronic lung disease, and
fluid within the abdominal cavity.
A household history of hernias can make you more prone to develop a hernia.

Symptoms and Signs

The twelve signs and symptoms of a hernia ranges from noticing a painless lump towards the severely painful, tender, swollen protrusion of tissue that you're unable to push back in to the abdomen (an incarcerated strangulated hernia).
Reducible hernia
It might appear as a new lump within the groin or other abdominal area.
It might ache but is not tender when touched.
Sometimes pain precedes the invention of the lump.
The lump increases in dimensions when standing or when abdominal pressure is increased (for example coughing).
It may be reduced (pushed into the abdomen) unless large.
Irreducible hernia
It may be an occasionally painful enlargement of the previously reducible hernia that cannot be returned in to the abdominal cavity by itself or when you push it.
Some might be chronic (occur on the long term) without pain.
An irreducible hernia can also be known as an incarcerated hernia.
It can result in strangulation (blood supply being stop to tissue within the hernia).
Signs and symptoms of bowel obstruction may occur, for example nausea and vomiting.
Strangulated hernia
This is an irreducible hernia where the entrapped intestine has its circulation cut off.
Pain is definitely present, followed quickly by tenderness and often symptoms of bowel obstruction (vomiting and nausea).
The affected person can happen ill with or without fever.
This problem is a surgical emergency.

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