Introduction

Hernia is an abnormal protrusion of internal organs through an abnormal gap within the wall of the cavity.A combination of increased pressure within the body with weakness within the wall is responsible for this condition.During this condition internal organs or parts of organs are protruded out forming a swelling which can increase the scale 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 within the body wall:–

a) Congenital weakness.

b) Acquired weakness because of 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.

2) 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.But there are some common sites for hernia.Because of the presence of exhausting bony covering chest wall is normally not affected.Hernia within the lower back is also rare because of spine and back muscles and tough ligaments and sheeths.The common site for hernia is abdominal wall.Compared to other elements the abdominal wall is weak due to the presence of some natural orifices.There are some areas whereby the abdominal muscles are weaker and skinny and all these factors make a likelihood for herniation.The common sites for hernia are following.

a) Inguinal hernia:

Here the abdominal contents protrude through the inguinal canal (passage in the lower abdominal wall simply above the inguinal ligament.It is seen on either side).This sort is common in males.Initially the swelling comes solely whereas straining and goes back while lying down. Later the large portion of intestine may come back out that could not return easily.

b) Femoral hernia:

This type of hernia is a lot of in females.Here the abdominal contents suffer the femoral canal that 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 gap in the thigh and forms a swelling underneath 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 could protrude as a bulb like swelling whereas crying and defecating.

d) Incisional hernia:

These hernias are seen in operated sites. Because of improper suturing or sepsis the operated website becomes weak ensuing in hernia.

e) Epigastric hernia:

Here the hearniation occures within the epigastrium. It is a rare type.

f) Lumbar hernia:

Here the hernia appear within the lumbar space on either facet of the lumbar spine(within 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 might not go back easily, and later the blood flow to the herniated tissues may be blocked because of constricition.This may cause death of protruded intestine.

two) Intestinal obstruction:

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

3) Infection and peritonitis:

If there is strangulation with death of a portion of intestine there can be unfold of infection to the abdomen resulting in peritonitis.

Treatment of hernia:–

Initial treatment: Within the initial stages of hernia the subsequent steps could be helpful

1) Use of hernia belt:

Special varieties of hernia belts are obtainable for each type of heania.This can forestall the protrusion and will scale back pain.

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

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

4) Abdominal exercises to increase the muscle tone.

five) Take masses of leafy vegetables, fruits and fibrous diet for straightforward bowel movements.

half dozen) Attempt other systems like Homoeopathy,Herbal drugs and ect

If no relief by the on top of steps consult a general surgeon for surgical management.

Surgical treatment.

The following operations are done relying up on the sort and nature of hernia.

one) 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 the sac is cut off.

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

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

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