The hernia is a compaction of a rounded shape, which protrudes under the skin in the abdomen area through the abdominal muscles into the cavity of the groin. This formation can be placed on the stomach or in the groin area. The cavity can fall in the intestinal shell, bladder, sections of genital organs, intestines and other internal organs.

Men of all ages suffer from hernias noticeably more often than women, making up more than 90% of the total number of patients. Causes lie in the anatomical features of the male body, the nature of the physical activity of a strong sex, the fulfillment by men of severe physical work, their lifestyle.

In men, the most frequently encountered groin. This is the name of the displacement of the organs or their parts into the groin canal - a narrow, triangular cavity in cross section that is between the muscles of the peritoneum. Women are more likely to suffer from bubble or abdominal hernia. The plot on which it appears, is called a hernial gate in a medical language.

Based on the emergence mechanism, hernias divided into congenital and acquired.

Congenital hernia begins to develop even before the birth of man, in the womb. This happens if the embryo has the development of abdominal organs reaching the final stage. The fact is that inside the groin cavity there is a process called the name of the vaginal. It happens that it does not overgrow muscle tissue. Such a phenomenon is characteristic of premature children, however, may be observed in development violations. At the 6-8 months of pregnancy, the fetus across the inguinal cavity are lowered eggs and seed codes (in boys) or a bunch of uterus (girls). If this process is broken, it creates prerequisites for the occurrence of hernia in the future. According to medical statistics, even by 1 year of life, the outflow of the inguinal channel overlays less than 50% of cases, and even in adults - in 90%.

The main cause of the acquired hernia is excessive pressure on the abdominal organs. It arises due to lifting weights, too strong physical exertion, diseases of the digestive tract with frequent constipation, very strong cough, and in women also during pregnancy.

The second reason is weak muscles. A weakened person who moves little is seriously ill, falls into the risk group and during the coating of factors can "earn" the hernia. When abdominal and inguinal muscles do not cope with the load, they are physically unable to restrain the pressure of the internal organs that begin to fall into a narrow gap of the inguinal channel. Promotes the appearance of hernia obesity (due to high weight) or severe weight loss (due to weak muscles and reduce subcutaneous adhesive layers). These problems can be exacerbated in old age when the muscular system of man flies, weakens the connecting tissues of the ligaments and the entire body lacks the forces.

"Important! The predisposition to hernia in humans is different, often she can have hereditary character "

The development of hernia is affected by pregnancy, but, for obvious reasons, for men, this risk factor is irrelevant. Perennial observations of doctors show, women are sick with hernias 40-50 times less than men.

What types of hernia are in men

Pahnaya hernia is one of the most common agents. There are oblique and direct varieties of such hernia. When obliquely form, the contents are inside the seed rope along the inkhan canal and affects the scrotum. The oblique includes, including the inhabric-scrotal hernia, in which the bodies fall through the scrotum area.

"Important! Straight hernia is purchased only throughout life. Her feature is to find the fabrics and organs directly in the cavity of the inguinal channel (and not in the seed cake). "

The hernia can be located differently relative to the organs of the peritoneum and body parts. This feature allocated:

• interphea;
• epigastric;
• spinal;
• femoral.

In addition, hernia is pinched and not quincible. If the hernia is not pinched, it is capable of coming itself. When the poses change, especially in the lying position, the protruding roundness falls into the Lono of the peritoneum, the organ returns to the place. This can occur even from a simple pinch of fingers: skin coverings and internal organs for them come to its original position. In the initial stages of the disease, the pain is far from always feeling. But in the future, the plot with hernia begins to root under the load - for example, when lifting weights. It is necessary to alert if such symptoms appear as frequent urination, gas delay and feces, other uncomfortable states in the abdomen associated with violation of the abdominal organs. It should be remembered that, although such a hernia delivers unpleasant sensations, there is no danger to life in general.

"Important! Possible pinching hernia is a very serious complication. "

With a pinched hernia, the picture of the disease and the forecast for its outcome is completely changed. The patient feels bad, he needs emergency medical care. The only possible method of its treatment, or rather, salvation is an emergency surgical operation.

Types of operational interference with groin

Healing inguinal hernia in men is possible only in one way - surgical. Folk remedies, bandage, medicines will facilitate the course of the disease, but completely eliminate the disease with these funds.

Operation in hernia is called herniography. It is carried out by two basic ways: open (removal through a section) or by laparoscopy (removal through a small hole). The second method is more sparing for the body. This is due to the fact that many people seek help to the doctor at sufficiently launched stages of the disease.

Usually the operation lasts until one and a half hours. The hernia can be completely removed, but it also applies to clean its cavity with the strengthening of the muscular wall with a special grid. The operation can take place under local or general anesthesia, this will solve the doctor depending on the selected method of interference and the patient's condition. In all cases, a preliminary examination is carried out, blood tests and urine, and when diagnosing background diseases - their correction. At the time of the planned operation, there should be no exacerbation of chronic diseases, no infections and colds.

Laparoscopy (endoscopy) is a modern minimally invasive (gentle) method of surgery. It is the embedding of hernia with a laparoscope (endoscope) through a small (diameter to 1.5 cm) hole. Endoscope - a tool with a system of special lenses connected to the camcorder. As a rule, not one puncture is made, and 3-4 - for the introduction of clamps and other necessary tools.

"Important! Laparoscopy is shown to the patient in cases where there is no complications, but sometimes the complex manipulations sometimes carry out such a method. "

The overall scheme of operation is as follows: a small puncture is made in the tissues to access the hernial bag with the introduction of carbon dioxide, the hernia is displayed and cleaned, the seams are superimposed. The recovery period in the hospital lasts 6-7 days. Scars does not remain, painful sensations are also not observed.

Laparoscopy is easier to suffer with patients, but more complex for doctors compared to open-type operation. The surgeon has to rely on the technique, which increases the image of the organs, gives them a greater review, but it can create an effect of incorrect perception of the scale. The eye of the doctor should correctly assess the distance and values \u200b\u200bthrough the camera, while with a long-term operation, organs and tissues are in direct visibility. Such an operation can last longer, but with professional conducting a number of "pluses".

The extension hernia removal operation requires a tissue cut from 5 cm. Its sizes can reach 8-12 cm. In children, the operation is carried out under general anesthesia, in adults - by testimony.

With this form, the inguinal channel is opened, internal and outer abdominal muscles peel apart from each other. Caution is separated by a seed rope, the hernia is opened, and the organ in it is inhibited in place - in the abdominal cavity. The doctor will decide how it is better to hold the binder and plastic fabrics. If the risk of recurrence of the disease is estimated as high, the grid is laid in places where the muscles can again "seek".

The restoration of the body after a long-term operation occurs longer than after laparoscopy. Rebuilding and processing of seams are necessary. The first hours after the cessation of anesthesia at the scene can be felt pain. For several days, the patient is shown a diet. Restoration in the postoperative period lasts at least 10 days.

One of the varieties of a strip operation is laparotomy. This method is applied with a pinched hernia, in the event of a bowel necrosis detection.

In practice, a combined surgical method is also found, combining elements and open access, and laparoscopy.

There is an intermediate method of operational treatment of groin hernia - obtuctive plastic.It is that through a cut (in 3-4 centimeters) of hernia, it is proof in the abdominal cavity, after which the muscular walls are strengthened with a grid. With this method, the rehabilitation of the body passes much faster. The operation is carried out under local anesthesia.

On the eve of the surgical intervention of the patient prepare for surgery, in the evening excluding food consumption and liquids.

Packing hernia in men: treatment without surgery

At the initial stages of the disease, as well as for the purpose of prevention, it is recommended to wear a groin bandage. Its purpose is to support muscles that do not cope (or may not cope) with a load. For the same reason, the bandage is necessary for men in case of laws of sports or severe physical work with weight lifting. The bandage itself does not heal from hernia, but will prevent complications, including such a dangerous as its pinching.

Conservative treatment includes the reception of some drugs, including non-steroidal anti-inflammatory drugs, and therapeutic physical culture. Patients with hernia useful exercises, strengthening abdominal walls: "bike", "scissors", compressing the ball. Also apply compresses from oak bark, sauerkraut. As for the diet, the doctor will recommend to eat more food rich in fiber, porridge, fruit and vegetable juices. But sweets, sharp, oily, salty food, strong tea and coffee, alcoholic beverages need to be limited.

Why are we talking about conservative treatment if the most effective method is considered surgical? Does the operation depends on the degree of development of the disease. But the main thing is due to the specifics of the body's condition, the operational intervention is not shown to everyone. The operation is not conducted by weakened patients: with the overall exhaustion of the body, severe concomitant diseases, very elderly people. For such people, restoration in the postoperative period may be more risky than life with hernia.

Improved hernia: What is the danger?

With the indispensable hernia, the plots of internal organs that fell into the sliding cavity cannot be guided by returning to their place. They are pushed, often compressed, leading to necrosis (leaning the tissues), the suppuration and intoxication of the body. Therefore, a person with disadvantaged hernia is obviously, in whole or in part, signs of inflammatory process or poisoning. He pale, his shiny, sick. There are vomiting, violation of intestinal passability. In the affected area, the skin blushes or blue, in this place there is severe pain.

"Important! If you do not take urgent measures to save the patient, this condition threatens peritonitis - inflammation of the walls of the peritoneum, in which death is possible. "

Rehabilitation and restrictions after surgery

For recovery in the postoperative period, bedding is shown (at a minimum, for 2 days), a strict diet, excluding gas-forming products (yogurts, sweets, fruits, carbonated drinks). After 10 days, the seams usually remove, and the dressing is carried out.

It is important to take the fact that in the near future, and in the future a person will have to exclude physical exertion. Ship Furniture, for example, a man after the operation to remove hernia is contraindicated, as well as other classes requiring muscle stresses under strong pressure. It happens that the surgical treatment method is erroneously chosen. But still, a negligence attitude to the recommendations of doctors after surgery and excessive physical activity become an equally important reason for the "return" of hernia. And this is observed in 5-10% of those who seem to have already recovered. Agree, better you will not be a rod than the recurrence of the disease will occur.

The groin hernia is to protrude from the abdominal cavity of the internal organs or their parts together with the parietal peritoneal covering of them (fine translucent shell, linked from the inside of the abdominal wall) under the skin through the groin canal. The groin canal is located in the groin area on both sides and is a gap between the wide muscles of the abdomen, through which the men in the norm goes through the seed rope and accompanying his nerves, and in women - a round bunch of uterus. This channel has an oblique direction: from top to bottom, outside inside and rearhead. In men, it has a length of 4-5 cm, and there are somewhat longer in women, but already than in men. The channel has an outer hole (superficial inguinal ring), located on the lane bone, and the inner hole (deep inguinal ring), which is a hole in the transverse fascia, covering the front abdominal wall from the inside, at the site of passing through this wall of the seed cord (round bundles of the uterus among women).

Like any hernia of the belly, the groin hernia has a hernia (they are a groin canal), a hernia bag (it is formed by a feet of peritoneum) and the contents of a hernia bag (they can be a large gland, a small intestine, blind, sigmoid gut, a worm-shaped process, urinary Bubble, female genitals). The hernia bag, in turn, has a mouth, neck, body and bottom.

Schematic representation of the main elements of the hernia: 1 exchanging; 2 - Parietal peritone; 3 - front abdominal wall; 4 - Herry Gate; 5 - hernia bag; 6- shells of a junk bag; 7- Hergeful Content - Loop

Inguinal hernias are observed most often among all the outdoor hernias of the abdomen and make up 75% of their total number.

Causes of groaning hernia

There are congenital and acquired inguinal hernias. Congenital inguinal hernias constitute the bulk of hernia in children (up to 90%), but may also occur in adults (about 10-12%). They are due to a congenital anatomical feature consisting in the unguardment of the so-called vaginal abdominum process, which is formed during the lowering of the egg from the abdominal cavity in the scrotum, while the cavity of the peritoneum directly communicates with the cavity of the scrotum, which creates the conditions for the occurrence of congenital hernia.

Acquired inguinal hernias are formed during the life and amount to 85% of the total number of inguinal hernia. Depending on the anatomical features of its structure, they are divided into direct and oblique.

The emergence of the acquired groin may be due to the causes of the local and general nature. Common reasons are divided into predisposing and producing.

Pre-providing reasons are:

1) heredity (genetically determined predisposition to the appearance of hernia);
2) age (with age, the likelihood of hernia increases by developing muscle weakening and reduce the elasticity of the anterior abdominal wall);
3) gender (big weakness of the groin area in men);
4) the features of the physique;
5) the degree of fatness (rapid weight loss contributes to the occurrence of hernia);
6) frequent genera in women;
7) Paralysis of nerves, innervating abdominal muscles.

Production causes are factors causing an increase in pressure in the abdominal cavity. These include:

1) severe physical work;
2) severe childbirth;
3) constipation;
4) the difficulty of urination (may be due to the adenoma prostate gland, narrowing the urethra);
5) Permanent cough (with diseases of respiratory organs: tuberculosis, chronic bronchitis).

In the case of a groin hernia, the cause of a local character is the very presence of a groove channel - the "weak" place of the abdominal wall.

Symptoms of groin grozhi

The manifestations of groin hernia depends on its size and on which organ in it is. Characteristic are pain and feeling of discomfort in the groin area, especially when walking, disorders of digestion and sometimes urination. In the groin area there appears swelling, increasing during the stance and cough.

With large inguinal hernias in men, the corresponding side of the scrotum increases, and it stretches it, while the penis is deviated in the opposite direction. With very large inguinal hernias, the penis can completely hide under the skin.

With groin hernia of large sizes, its contents ceases to go into the abdominal cavity. In case of being in the groin hernia of the bladder, urination is disturbed, which can occur in two receptions, sometimes requires the adoption of patients with the forced position of the body; As the bladder fills the urine, the sizes of hernia are increasing.

The incorporated inhabric-scrotal hernia can be confused with the water membranes of the Egg (Hydrocel), which also increases the size of the scrotum due to the accumulation of liquid in it. Varicocele varicose veins can also be accepted for the inguinal hernia - varicose veins of the seed rope can be taken: with it in a patient in a vertical body position there are blunt sawing pains in the scrotum and there is a certain increase in its size, but the extended veins are easily falling down when pressed on them and when picked up the scrotum up . In women, the cyst of a circular bundle of the uterus passing in the inkhan canal can be adopted for inguinal hernia.

Examination in suspected inguinal hernia

Laboratory examination with uncomplicated groin hernia does not have an independent diagnostic value. In case of hospitalization on a planned operational intervention about the hernia, a generally crystal laboratory survey (general blood test, general urinary analysis, biochemical blood test, blood glucose, hepatitis, HIV, syphilis study, is carried out, which makes it possible to eliminate contraindications to surgical interference.

Treatment of groin grooms

Treatment of inguinal hernia - operational. The radical surgery on the groin hernia (inguinal hernutyrophe) is to remove the hernial bag and strengthen the weak section of the front abdominal wall (inguinal channel) in the area of \u200b\u200bthe hernial gate by means of plastic by local tissues, plastic is also possible by stitching into the hernia defect of the mesh graft made from polypropylene ( Liechtenstein method). The operation is carried out under local anesthesia or general anesthesia.

Currently, laparoscopic methods of hernias are obtained. Their advantages are to reduce the traumatic operation, the early return of patients to active activity, a good cosmetic effect. However, there are also disadvantages to which include: the need to perform the operation under general anesthesia, the possibility of damage to intraperous organs and blood vessels, damage to the peritoneal cover in four places (3 points of administration of trocars and opening of the peritoneum over the hernial gate), which can lead to the development of the adhesion in Abdominal cavity.

Preoperative preparation for uncomplicated groin hernia is reduced to the appointment of a hygienic bath and a cleansing enema on the eve of the operation, shaving hair in the groin area, emptying the bladder before surgery.

The recurrences of the inguinal hernia after surgical treatment are quite common: with oblique inguinal hernias within 3-15%, with direct - at 15-35%.

Deadly outcomes in the operational treatment of uncomplicated hernia are extremely rare (up to 0.04%). The total number of postoperative complications does not exceed 4.8%, and the wound suppuration is 0.2%.

Temporary disability after herniferation is an average of 1 month. Workers of heavy physical work are transferred for up to 6 months on a lot of work. The development of recurrent hernia is contraindicated to all types of physical labor associated with significant or moderate physical tension, long walking, business trips for a long time for a long distance from medical institutions, which is associated with the threat of increasing hernia.

The only radical method of treatment of congenital groove hernia is the operational method. The development of anesthesiology currently allows the surgical operation at any age immediately after the discovery of hernia, including a newborn. However, in the case of the presence of such relative contraindications, as rickets, presence, some suffering diseases, subject to the lack of complications of the groin hernia, it is possible to transfer a planned operational intervention at a later date - up to age 6-12 months. The purpose of the operation is to remove the hernia bag, and unlike the dozing in adults, it is not necessary to strengthen the anterior abdominal wall by the child. In the development of the infringement of congenital groin hernia, an emergency operational intervention is shown, but in weak, premature children, as well as in the presence of therapeutic contraindications in the first 12 hours after the infringement it is possible to conduct conservative treatment aimed at facilitating the independent right of hernia. For this purpose, atropine and drug painkillers are introduced, use a 15-minute warm bath, the child is placed on the back with an elevated position of the pelvis. In the absence of an effect from conservative treatment within 1.5 hours, emergency operational intervention is shown.

Complications of groin grozhi

The main complications of the groin hernia are: infringement, coprostas, non-execution, inflammation and damage to hernia. More rarely encounters neoplasms and bodies of hernia.

Infringement The groin hernia is the most frequent and life-threatening its complication, which is due to the sudden compression of its contents and requires urgent surgical treatment. The abdominal cavity bodies that came out in the hernial bag are most often squeezed in the hernial gate at the neck of the hernial bag. The infringement is elastic and kalov, and their combination is also possible.

With elastic infringement greater than usual, the number of abdominal organs quickly surrounds through the hernia, which is polished at the moment of a sharp increase in intra-abdominal pressure due to significant physical exertion, coughing, outling or other factors. After stopping the increase in intra-abdominal pressure, the jewelry gate is returned to the previous state, which leads to the infringement of hernia. With groin hernia, the infringement is most often occurring in the area of \u200b\u200bthe outdoor hole in the inguinal channel. In this form of infringement, the compression of the extensions came out occurs outside.

Caluing infringement occurs more often in the elderly and is due to the weakening of the wave-like intestines aimed at promoting its contents. In this case, a large number of contents accumulates in the hernial bag, which leads to the compression of the reservoir loop of this intestine, and then to strengthen the pressure of the hernial gate to the hernial content. Thus, the caval reinforcement is aggravated by elastic, and mixed infringement develops.

In the disadvantaged authority, circulatory disorders and lymph circulation develop. The liquid from the vessels is heganate into the intestinal lumen and in the shelf's cavity (hernia water), which further enhances the infringement. Development of the intestine, starting with its mucous membrane. Gangrene the walls of the intestine often leads to its spout, the exit of the intestinal masses with the microbes contained in them in the hernia and the development of peritonitis. Because of the development of circulatory disorders, pathological changes occur not only in the most disadvantaged intestine, but also in leading the intestinal deposits.

Koprostaz (stagnant mass) develops in cases where the contents of the hernial bag are the thick intestine, as a result of the disorder of the intestinal motor function. Promotes the development of coprostase, the nepherupability of hernia, abundant food and a low-wear lifestyle. More often occurs in senior patients with increased body weight. It is manifested by difficult abscessive constipation, abdominal pain and nausea, less often vomiting. Koprostaz may lead to a fenced root of hernia.

Neepruppiness of the hernia It occurs as a result of development in the hernial bag of the battles of internal organs among themselves and with a hernial bag, which is due to the injuryization of hernia content. The incorrect may be partial (when part of the hernia content can be edited into the abdominal cavity, and the other part is not) or full (all the contents of the hernia do not go into the abdominal cavity).
The inflammation of the hernia is developing when infected with a hernia bag, which is possible in acute inflammation of a worm-like process (appendicitis) or a meckylene diverticulus, which fell into the hernia bag, with peritoneum tuberculosis. At the same time, the general condition of patients suffers, the body temperature increases, chills arises, and vomiting appears, the latency of the chair and the difficulty of fatting gases. The size of the hernia is increasing, kaja bloom over it.

Damage to hernia They can lead to a rupture of the intestine in the junk bag and are found with a sharp increase in intra-abdominal pressure, with a direct injury of hernia or due to the abdominal wall injury away from hernia.

Novoku formation of hernia Very rare, can occur from the contents of hernia, a hernial bag or surrounding tissues and organs. Most often there are lipoms (wen) of a hernial bag.

Foreign bodies in the hernial bag can perform objects, worms, bladder stones.

Prevention of groin grozhi

In terms of prevention of the occurrence of hernia, regular physical culture activities are important as a means of strengthening the muscles of the anterior abdominal wall and the body at all. It is also important to combat obesity and, important, with severe weight loss after it, since these pathological conditions create favorable conditions for the formation of hernia. As organizational activities in production, the correct selection of workers in difficult physical labor in accordance with their physical abilities and health status is necessary.

To prevent the development of complications of the inguinal hernia, the early detection of people suffering from hernias is of great importance and the direction of them on the planned operational intervention before complications have time to develop. For this purpose, the organization of preventive inspections of the population, in particular, among people of school and retirement ages is important.

Doctor surgeon cells M.E.

Video about the reasons, symptoms and treatment of groin hernia:

The groove hernia is the process of bringing into the groin canal of the abdominal cavity courtyards covered with an on-line (parity) leaflet of peritoneum. This loss occurs through a congenital or acquired breach of the abdominal wall. The men of hernia goes to the scrotum, and in women - in the subcutaneous space around the big sex lips.

The most often groin hernia is observed in children. Most of all the boys suffer. Usually it is protruding on the one hand. This happens 3 times more often than the left. After 10 years, the disease is rarely developed. The main surgical complication of the "acute abdomen" is precisely infringed inguinal hernia.

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About the structure of the inguinal canal

The inner cavity of the belly is lined with a trousers - a thin connective tissue film. She "wraps" walls, and almost all in the stomach organs.

In the appearance of hernia, a specific role is played by a specific anatomical education - a groin canal that takes into the hernial content. This is a small slot (about 4.5 cm), which is in groin between the muscles, connecting fascia and bundles. Its beginning lies in the abdominal cavity, then heads forward, down, inside. And the outer hole is located outside in the groin, surrounded by a strengthening group of muscles. Women in the area of \u200b\u200bthis channel hits a round uterine bunch, in men - elements of seed rope, including vessels, nervous tissue, seed-eyed ducts.

The mechanism of development of congenital groove hernia

Eggs in male embryos are developing in the abdomen. The familiar location during the first three months of pregnancy is behind the peritoneum. Closer to the fifth month, the forming tests begin to descend and approach the entrance to the groin canal, enter it and up to the seventh month are slowly moving along it, forming the so-called "vaginal process". With normal development on the ninth month, the testicles of the boy completely enter the scrotum together with a stretched peritoneal "pocket", preserving a message with the cavity of the abdomen.

At the birth of a child, he "closes", then overgrown. But sometimes it fails, and the passage from the belly to the scrotum remains open. This anatomical defect is the first "bell" that signals the possibility of the development of groin hernia. With an increase in intra-abdominal pressure in this process, the intestinal loops and even some organs can "fail."

The formation of gentle hernia in girls is similar to the above-described hernia formation process in boys. In developing female female, the uterus is above ordinary place. In the process of development, it descends on "his" place together with the fold of the peritoneum, forming the same "vaginal process", the non-unforgettable it subsequently provokes hernia.

Congenital groin hernia - a malfunction of the developing fetus. It is formed from birth.

How does the acquired grozha occur

Acquired inguinal hernias appear due to heavy loads and in connection with the pathology of the abdominal press, its weakening.

The factors that contribute to the occurrence and development of hernia include:

• premature pregnancy, as a result of which the vaginal process with the rest of the authorities has not yet completed its development cycle and remained "open";
• heredity, the presence of hernia in family members and close relatives;
• the presence of anatomical weakness of the muscles of the abdominal wall;
• overweight, causing an increased load on the abdominal organs;
• injuries in the area of \u200b\u200bgroin provoking the weakening of the ligament
• strong alliance. The absence of fatty interleavers in the channel leads to the formation of empty volumes in which the outer layer of the peritoneum can be formed;
• pregnancy, as a result of which increased intra-abdominal and mechanical pressure on the organs, the intestines, which contributes to the formation of hernia;
• hypodynamia in which the flabbing and atrophied muscles are not able to perform their functions, resulting in the peritoneum, without encountering muscle resistance, can "join" into the canal;
• physical overloads that create a constant high pressure in the abdominal cavity;
• chronic, strong cough, providing additional load on the "weak" venues of peritoneum;
• intestinal diseases, accompanied by constant constipation, which also cause an increase in pressure.

Varieties of inguinal gryzh

The disease is classified at the location of the junk bag.

Types of pathology:

Symptoms of groin hernia, how externally it looks like

The main features include:

• The appearance in the region of the emphasis, increasing when coughing, sneezing, any physical voltage, as well as when in a vertical position.
• Available swelling in most cases when pressed on her fingers returns to the cavity of the peritoneum. At the same time, a characteristic rumbling is heard.
• There are usually no pain. Sometimes she can appear in groin and irradiate (give) to the lumbar region.
• When falling out uterine pipes or ovaries, diseases are developing during menstruation.
• With a moving form of inguinal hernias, breathtaking bladder - symptoms of dysuric disorders (pain at the bottom of the abdomen, frequent and (or) painful urination).
• When inserting a blind intestine in the hernial bag - flatulence, cutting, constipation
• In the formation of the groan-scrotal shape of hernia - an increase in the scrotum by education.

In the lying hernia position, it is hiding and externally becomes invisible.

What is the infringement of groin hernia

This is one of the unpleasant and frequent. The intestinal plot (or the uterine tube and the ovary - in girls and women, the seed rope - in boys and men) are thrown in the groin canal, it is disturbed by trophic and blood circulation, which will subsequently provoke necrosis (motion) tissues.

The causes of this situation can be the problem in the work of the intestine, flatulence, sharp overvoltage with an increase in pressure in intraperitoneal space.

The patient appears complaints about:

• intensive pain in groin;
• tensions and density of hernia;
• the impossibility of filing a protrusion;
• symptoms of intoxication: pallor, nausea, urge on vomiting, stool delay.

In this case, after an examination of the doctor, immediate hospitalization and operational intervention is required.

Diagnosis and examination with grozhe

Any suspicion of the hernia that appeared is a reason for turning to the surgeon.

The doctor in the patient's position standing inspects hernia protrusion, conducts his feeling (palpation), makes a sample with a fitting, then a cough sample. Assesses the symptom of the shock. Finger study finds the outer hole of the channel. Sometimes this hole can be determined without a hernia bag, this symptom is called "weak grooves" in surgery.

The ultrasound of scrotum, channels, abdominal cavities and pelvic organs are additionally carried out, under which the hernia bag is determined with all the anatomical formations and hernia contents, the size, position and state of the inguinal channel are estimated.

Very important information can be obtained with a radiographic study with the introduction of a contrast agent. Also, an irrigoscopy is carried out in the hernia of the intestine (a large intestinal examination) and cystoscopy (urinary bubble radigenvalization).

Treatment of groin grooms

Self-deflection of groin hernia without surgery does not happen. The surgical method is the only way to get rid of this pathology.

Operational treatment is not carried out:

• weakened patients in old age;
• with strong types of exhaustion (cachexia);
• in case of severe diseases;
• during pregnancy;
• for the prevention of the return of hernia after removal.

Treatment and prophylaxis of groin hernia wearing a bandage

In the case of existing contraindications to the operation, wearing a bandage. Also, this type of treatment is shown with the prophylactic goal of people, by the nature of the activities colliding with physical overloads.

Bandage for groin hernia and its size picks up the doctor individually to each patient. These devices can be double-sided or left right-handed.

Note: The use of the bandage does not cure inguinal hernia, and serves as a means of preventing the intestinal loss and organs in the hernia and prevents infringement.

After selection of the bandage, the rules of its wearing should be followed:

• dress it only in a position lying on the back;
• keep track of finding inserts. They must correspond to the place of hernia prick.

Important: The use of the bandage is contraindicated with the infringement of hernia and in diseases of the skin sinking with it.

Surgical treatment of groin hernia

As mentioned above, alternative to the surgical treatment of inguinal hernia does not exist. In the presence of infringement, the operation is made in an emergency order. In other cases, planned operational intervention has been shown after preparing the patient.

The process of preparation includes the examination of the patient, the appointment of clinical analysis of blood and urine. Before the operation, the patient is not allowed to eat and drink. It is also necessary to treatable chronic diseases to minimize the risk of complications (for example, prostatitis,).

On the question of exciting many patients, the question is: "Is it worth doing an operation with groin hernia?" Responded to D.M. Short I.V.:

Surgical methods:

• laparoscopy - embedding hernia by an endoscope through the puncture of the abdominal wall with the help of minicimers, microendoscopic tools and with the mesh installation;
• operational hernuty. Various techniques of operational treatment of groin hernia (Bassini, Matrynova, Ruji, etc.) are used.

General steps to remove the groin hernia:

• release of the hernia bag and separating it from tissues;
• cut bag with content management;
• cutting off the bag and plastic restoration of the wall integrity,
• sunning the gate and operating room.

Surgical treatment of groaning hernia in children

In children, the removal of groin hernia is carried out necessarily under general anesthesia (anesthesia). Most often operational access is about 1.5 cm long. The hernial bag is separated from the seed rope, then stitched and excised. At the same time, the bag is conducted for the presence of the contents of the abdominal cavity in it. The outer opening of the channel in the child is not strengthened.

About the reasons for the formation of inguinal hernia in children, the symptoms of infringement of hernia in children and methods of treatment tells a children's surgeon:

Emergency Removal Operation of the Disadvantaged hernia

The danger of this complication is that in the disadvantaged intestine or other organ, death (necrosis) may come, due to circulatory disorder in the tissues. This leads to a life-threatening state, and sometimes - and to the death of the patient.

In the treatment of groin hernia, complicated by the infringement, the surgeon has to carefully examine the infringered body after the dissection of the hernial bag. In the case of the samples of death, the affected area is removed, the ring in which the infringement is dissected. Next, the operation continues in a planned manner. After such an operation, the patient necessarily prescribe antibiotics for several days.

What is a recurrence of groin hernia

In some patients, inguinal hernias appear again. Recurrements happen in 5-10% of cases.

The reasons for the new hernia can be:

• operation errors and incorrectly selected type of plastic;
• failure to comply with recommendations in the postoperative period: intensive physical overloads, weight lifting, etc.;
• coughing;
• diseases accompanied by constipation;
• void processes in the postoperative seam area;

In men, the recurrence of gentle hernia happens because of the adenoma unbearable in front of the planned operation.

Preventive measures to prevent the development and progression of inguinal hernia

To prevent the possibility of the appearance and development of purchased inguinal hernia, it is necessary:

• lead an active lifestyle with normal physical exertion;
• feed products with sufficient content of plant fiber;
• during the hard work and classes related to weight lifting wearing a bandage;

The groin hernia is a defect of the anterior abdominal wall, in which due to its weakness there is a partial yield of some internal organs (as a rule, of large glands, intestines, ovary) from the abdominal cavity in the groin canal.

The groin canal is a 4-6 cm long slot in the lower part of the groin area, which originates in the abdominal cavity, heads forward and down and reaches the surface inguinal ring. Women through the groin canal passes a round uterine bundle with a loose connective tissue, and in men - seed rope. The protrusion of internal organs and peritoneum during groin hernia can occur through a congenital or acquired defect in the inguinal channel (a hernia).

In men, the groin hernia is found 9 times more often than women, most often in children under 10 years old.

Packing hernia - Pathological protrusion of peritoneum in the cavity of the inguinal canal

Causes and risk factors

Inguinal hernias, as a rule, are formed when a combination of congenital and acquired risk factors.

An innate defect caused by the emergence of congenital groin hernia, or its development at an early age, is the incoming of the vaginal abnormal process. By the one-year-old, the vaginal process will overgrow in 41%, and 10% of people it does not overgrow even in adulthood, creating prerequisites for the occurrence of groin.

The most frequent and dangerous complication of hernia is its infringement when the contents of the hernia bag suddenly squeezed with a hernial gate.

Acquired inguinal hernias arise due to the weakness of the abdominal muscles due to heavy physical exertion, muscle atrophy due to a sharp weight loss or by the age reasons.

The risk factors for the development of groin hernia include:

• anatomical weakness of the muscles of the pitch wall;
• tight swearing of infants;
• loud long crying of infants;
• numerous childbirth;
• premature pregnancy;
• overweight, obesity;
• injuries of the groin area;
• strong chronic cough;
• game on wind instruments;
• diseases of the gastrointestinal tract, which are accompanied by constant disorders of the defecation process;
• urination disorders for prostate diseases;
• insufficient mobility; etc.

Forms of the disease

Inguinal hernias may be congenital and acquired.

On the localization of a hernia bag:

• pakhovaya - hernia is protruding into the cavity of the inguinal canal, but does not go beyond the level of the outdoor hole in the inguinal channel;
• the rod - the contents of the herniated bag falls into the scrotum to the seed rope;
• patch-scrotal - hernial content reaches an egg, stretching the scrotum;
• kosy - Content passes through the entire groin canal. This form is most common, it can be both congenital and acquired. Acquired has an oblique direction only at the initial stages of pathology, with increasing hernia, the inner opening of the inguinal channel is expanding inside. In most cases, slanting hernia is one-sided;
• straight - There is a passage of the contents of hernia to the groove channel through the wall of the peritoneum, while the inner opening of the inguinal channel is not affected. As a rule, this form arises as a result of overvoltage and is bilateral;
• interstitial straight (subcutaneous) - the dozening of hernia occurs in the subcutaneous transshipment of the aponeurosis by the outer oblique abdominal muscle;
• sliding - there is an additional protrusion of the inner shell of the abdominal cavity. In this case, not only the delicious intestines can be out of the abdominal cavity, but also the walls of the bladder, the uterus, the uterine pipes, the ovary, etc. is the most dangerous form of groin hernia, since it is more and more capable of infringement.

With the combined form of groin hernia, two and more hernia bags are determined on one side. At the same time, hernias are not communicated to each other, each of them has its own hernias. Pathology meets relatively rarely.

By the ability of the contents of the hernial bag, return to its original position (improve) hernias are:

• unrequited;
• published.

Symptoms of groin grozhi

The main symptom of groin hernia is the rounded protrusion in the groin area, which is accompanied by pulling and painful sensations of varying degrees of intensity. The pain often irrades into the lumbar region. Plowing with groin increases with exercise, cough, sneezing, at the same time in a lying position, as a rule, disappears.

In addition, the clinical picture of the groin depends on which of the internal organs became the contents of the hernial bag.

In engaging in the pathological process of the bladder, patients make complaints on rapid and / or painful urination, pain in the lower abdomen. In patients of old age, urine delay can be observed. If the hernia's contents are uterine pipes and / or ovaries, women have painful menstruation. The loss in the hernial bag of a blind intestine is accompanied by constipation, meteorism, bloating, thumbs in the abdomen.

Inguinal hernias of small sizes may not bring the patient inconvenience and be completely painless. With large sizes of groaning hernia

he is discomfort when walking, as well as a constant feeling of gravity in the stomach.

Diagnostics

To detect groin hernia, a patient is inspected in vertical and horizontal positions, a sample with a fitting and a cough sample is carried out.

To clarify the localization of pathology and the state of the inguinal channel, an ultrasound study of the abdominal cavity, pelvic organs, scrotics are made. Ultrasound allows you to find out which of the internal organs are involved in the pathological process. For the same purpose, irrigoscopy is carried out (the possible intestinal involvement is determined) and cystoscopy with a contrasting amplification (the involvement of the bladder).

In men, the groin hernia is found 9 times more often than women, most often in children under 10 years old.

If the ultrasound examination of the hernia was not detected, x-ray examination with a contrasting substance is carried out to clarify the diagnosis.

Differential diagnosis of groin hernia with water membranes of eggs (hydrocel), varicose veins of seed canopa (varicocele), lymphadenitis, lipoma seed rope, femoral hernias are necessary. The inhabric-scrotal shape of the disease in children should be differentiated with the unexpecified egg in the scrotum (cryptorchism).

Treatment of groin grooms

The treatment of groin hernia is carried out by the operational method under a surgical hospital. Operational intervention is not shown in the presence of severe concomitant diseases, with strong depletion of the patient, as well as weakened patients of senile age and pregnant women. Such a patient is recommended to wear a bandage for groin hernia that prevents the loss of internal organs from the abdominal cavity.

Operation in gentle hernia

Operation in the groin hernia is carried out in a preliminary preparation plan, which lies in a detailed laboratory and instrumental study, and if necessary, in the correction of violations identified. One of the requirements for the operation to remove the groin hernia in children is the absence of any infectious diseases within two weeks before surgical treatment. Operational intervention is carried out under general anesthesia, endoscopic or open.

Operation in gentle hernia (herniasthesty, genephia, hernioplasty) has the following steps:

1. Formation of access to the inguinal canal.
2. Removal of a junk bag.
3. Sunning a deep inguinal rings to normal size.
4. Plastic in the inguinal canal.

The choice of the method of the inguinal channel plastic is carried out depending on the shape of the disease and the magnitude of the hernia:

• the method of Bobrov - Girard - allows to strengthen the front wall of the inguinal channel, ensures the adheated of homogeneous tissues due to the simultaneous bearing of the aponeurosis of the outer oblique muscle with the transverse and inner oblique muscles;
• method of Spakokukotsky - Modification of the method of Bobrov - Girard. During the operation, the aponeurosis and the muscles are captured and laid at the same time as a groove with further duplicate of the aponeurosis. Allows you to prevent gloomy ligament, which may occur because of the frequent seam imposition;
• the method of imposing seams in Kimbarovsky - contributes to a good fit of the same tissues to the groin bond. At the same time, the edge of the upper brace of the aponeurosis of the outer oblique muscle envelops the edges of the transverse and internal braid abdominal muscles;
• the bassini method is based on the imposition of deep seams, which helps to strengthen the rear wall of the inguinal channel;
• the Shaldays method is a modification of the bassini method. During the surgical intervention, after removal of the groin, a duplication of transverse fascia is formed using a continuous seam, the lower edge of the transverse and inner braid abdominal muscles is laid in the same thread. The seed rope is placed in place, on top of it in the form of a duplication, sew the edges of the dissected aponeurosis outer oblique muscle;
• poshpsky method - complete elimination of the inguinal channel, inguinal gap and the formation of a groin canal with a new direction;
• the Kukuchanov method is shown in the straight form of groin hernia, as well as in complex cases of the disease, consists in drying the aponeurotic fibers of the internal oblique and transverse muscles and the vagina of the abdominal muscle to the medial section of the iliac and grooves;
• martynov method - applied in oblique inguinal hernias and is to form a duplication of duplicate from the disseminated aponeurosis;
• the Liechtenstein method is to cross the fabrics without tension. At the same time, special hypoallergenic grids use as an allogenic transplant;
• the method of ru - Opel is used with small innate and acquired inguinal hernias. After the contents of the hernial bag in the abdominal cavity, the hernial bag is supplied to the neck, the groin hernia is removed, after which the outer opening of the inguinal canal.

The recurrences of groin hernia are observed in 5-10% of patients due to the incorrectly selected surgical method, the patient's failure to fulfill the doctor's prescriptions in the postoperative period, excessive physical exertion, etc.

Removal of groin hernia Laparoscopic method

Endoscopic (laparoscopic) henioplasty is widely used in surgical practice. The advantages of the method refers to the possibility of closing the inner opening of the inguinal and femoral channels at the same time. In the course of the operation, small sections of the groin area are produced, through which a laparoscope is injected containing a surgical manipulator, a fiber optic chamber, displaying the image of the operating field to the monitor in the operating room and the source of cold light, which ensures a good overview of the operating field. With operations for groin hernia, laparoscopes are used to allow the side inspection of the operating field. Unlike traditional long-distance operations, the laparoscopy method makes it possible to carry out surgical interference with the minimum possible amount of operational injury, reduce the rehabilitation period to several days, as well as reduce the likelihood of relapses and complications.

The laparoscopic operation is not recommended for inguinal hernias of large sizes and in the presence of adhesions.

Possible complications and consequences

The most frequent and dangerous complication of hernia is its infringement when the contents of the hernia bag suddenly squeezed with a hernial gate. There is a violation of blood circulation and innervation of organs dropped out of the abdominal cavity and in the junk bag, up to their necrosis, followed by the development of peritonitis, which is a life-degrading state. The infringement can be elastic, cavalous and combined. Elastic infringement is observed when lagging into a hernial bag of internal organs than usual. Caluing pinching occurs with the stitching masses in the intestinal section, which fell into the hernial bag. In the case of the development of infringement of hernia, the patient needs emergency surgical treatment.

To other complications of groin hernia include:

• inflammation of groin hernia;
• ischemic (i.e., due to insufficient blood flow) orchit;
• koprostaz - stagnation of feet;
• neepie hernia.

The incorrect hernia may arise due to the injury to the contents of the hernial bag and its walls, which, in turn, can determine the development of the adhesive process. Depending on the spread of the pathological process, the incorrect hernia can be partial and complete.

Forecast

Forecast with an uncomplicated hernia under the condition of its timely diagnosis and properly selected treatment is favorable. With the development of complications, it worsens, some of the complications carry a direct threat to life.

The recurrences of groin hernia are observed in 5-10% of patients due to the incorrectly selected surgical method, the patient's failure to fulfill the doctor's prescriptions in the postoperative period, excessive physical exertion, etc.

Prevention

1. The prevention of a long cry in infants, the rejection of their tight swarenia.
2. Body mass control.
3. Training of abdominal muscles.
4. Avoiding excessive physical activity, refusal to raise weights.
5. Smooth correction of overweight.
6. Wearing a bandage during pregnancy.

The prevention of the development of life-threatening states is to immediately appeal for medical care when the following features appear: harsh soreness, nausea, vomiting, blood in the carte masses or the absence of defecation, the impossibility of entering the hernia in a lying position.

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When the groin hernia occurs in men, treatment without surgery is possible? This issue will be discussed below. Pahnaya hernia is a tumor-like protrusion, overlooking the groin canal and beyond its limits. The most frequent dislocation of hernia is the area of \u200b\u200bpassage of the seed rope. Pathology more often amazes men than women, and is able to develop at any age. The etiology of the disease is associated with weakened connecting tissues, ligaments and muscles that lose the ability to retain organs in their places. A predisposing factor in the appearance of hernia is a specific anatomical formation - a slot of about 4 cm, located in the groove zone between the connecting fascia and ligaments. It is in this gap that drops hernia content.

The reasons for the development of pathology:

• weak muscles of the abdominal wall;
• obesity - excess weight puts pressure on the abdominal organs;
• injuries in the groin zone, weakening the binder;
• long-term physical tension;
• pathology of digestive bodies accompanied by frequent constipation.

Pachwasted hernia has several varieties. A straight groin hernia can only be purchased, characterized by pathological protrusion in the inguinal channel, while the seed rope is not affected. With oblique hernia, the protrusion is localized next to the inguinal canal and falls out of the abdominal cavity. This type of hernia is congenital or formed under the influence of external reasons. Combined hernia is less common, consists of several hernial bags.

The groin hernia needs compulsory treatment, as self-esteem is impossible. The most effective treatment method is a surgical operation. Cured herriation is difficult to cure a loose method. With groin hernia, men have treatment without surgery provides for the right of hernia. Conservative treatment is appointed by a doctor in the following cases:

• if there are medical contraindications to surgical intervention;
• infectious diseases of the genitourinary system;
• if the disease has revealed at an early stage of development;
• broken blood coagulation;
• serious violations of cardiac activity;
• renal failure.

Treatment of groin hernia in men without surgery should be carried out under the supervision of the attending physician. Independent treatment of groin hernia is not categorically recommended, as it can complicate the state and cause infringement.

How to treat inguinal hernia? There are basic methods to combat this pathology:

1. The use of a special bandage is an elastic belt with a clamping foot by a retainer. There is also underwear having special tight inserts. With the help of a correctly fixed design, the missing strength of connecting ligaments is replenished. Wearing a bandage belt is necessary during exercise. Do not wear a bandage constantly, this will lead to the weakening of the muscles of the abdominal press and back. The constant wearing of such a belt is recommended to people of old age. Design is recommended to use at an early stage of pathology.
2. Moderate sports. It is recommended to engage in swimming, easy run or walking, classes should be carried out with an instructor. Especially useful are swimming, in which the abdominal muscles are strengthened without much effort.
3. Physiotherapy. Treat inguinal hernia without surgery can be healing exercises. There is a special complex of gymnastic exercises aimed at strengthening the muscle group of the lower abdomen. Exercises are selected by a specialist individually depending on the physical training of a person. During sports, you need to wear a bandage belt.

How to treat inguinal herriation by folk remedies

Fitotherapy may serve as an addition to the main treatment and should be coordinated with the attending physician. Main methods are reduced to the use of compresses, lotions and ointments.

1. Rye bread and infusion wormwood. Rye bread is soaked in a concentrated nasty wormwood. The mixture in the form of a compress is applied to the hernia area. The method slows down the progressive process and prevents complications.
2. Vinegar. Wipe daily hernial protrusion with 4% vinegar solution.
3. Brine sauerkraut. Gauze, moistened in the cabbage brine, applied to hernia. Compress well soothes pain. The method is contraindicated with a disadvantaged hernia.
4. Oak bark. The crushed boring is brewed with boiling water in the ratio: 1 tsp. on a glass of boiling water. Insist 20 minutes. Gauze impregnate the decoction and impose on the inguinal hernia. The compress can be fixed with the plaster so that it does not slip.
5. Field Horsetail 3 tbsp. Dry grass is brewed with a glass of boiling water. The decoction insists 30 minutes and use for compress.
6. Ointment. The chicken egg is mixed with 100 ml of vinegar, 0.5 liters of melted pork fat and removes in a dark, cool place for 5 days. Then, it is necessary to add 2 quail eggs to the mixture and 10 g of plaque fat. Ointment is thoroughly mixed, impose daily to the inguinal hernia for 2 hours, the course of treatment is 1 month. On top of the ointment impose a napkin and fix the bandage.
7. Larkspur. 25 g of dry grass is poured with a glass of water, boil 10 minutes, consumed inside 1 tsp. before meals.
8. Sagebrush. 1 tsp. Herbs, flooded with a glass of water, boiled 5 minutes, the decoction is used for compresses.
9. Flowers cornflower. 30 g of herbs brew 0.5 liters of water. Drink half a cup before meal.
10. Nettle. The leaves of the plant are crushed into the cleaner and impose on the inguinal hernia.
11. The oak and acorns are insist on red wine for 3 weeks, infusion is used for compresses.
12. Spiraea. 3 tbsp. The herbs brew 0.5 liters of hot water, insist for 20 minutes and drink 3 times a day before meals.
13. Leaves of the gooseberry or tolody. 1 tsp. Dry herbs need to be brewed in a glass of boiling water, consumed three times a day before meals.

Exercises for groaning hernia

1. Take the position lying on the back, the legs bend in the knees, hands to sick into the castle on the back of the head. Alternately elbow the right hand touching the left knee, then the left elbow to reach the right knee. Exercise to perform 20-30 times in each direction.
2. Exercise "Bike" for 2-3 minutes.
3. Exercise "Scissors" is performed lying on the back for 2-3 minutes.
4. Lying on the side, perform mahi legs up with my left foot, then right.
5. Alternately perform the slopes to the right and left leg, one hand concerns the foot, the other hand is given behind the back.
6. Lying on the back, clasp the ball, lift legs with the ball, linger for a couple of seconds and lower the legs.

Exercises must be performed in a bandage belt. Depending on the state, the load can be increased or decreased. The main thing is that the therapeutic gymnastics is performed regularly. Therapeutic gymnastics, wearing bandage and phytotherapy may not bring the desired results. With a deterioration of the state, immediately apply to the doctor.

Preventive actions

It is well known that the disease is always easier to prevent than to treat. The occurrence of groin hernia is often due to the weak muscles and the absence of the abdominal press. To prevent hernia's formation, your physical form should be maintained. It has been proven that in most cases the groove-scrotal hernia is found in men with a safer belly and the flabby muscles of the abdominal press. It is 20-30 minutes a day to perform simple exercises aimed at strengthening oblique and transverse abdominal muscles, or several times a week to visit the gym, swim in the pool, and then the risk of groin hernia will be minimized. Refuse the elevator, more walk on foot, it stabilizes the vertical position of the body in space, which, in turn, forms the normal location of the internal organs and supports the abdominal muscles in the tone.

It is also necessary to regulate exercise, especially people whose professional activities are related to lifting weights. Remember that one of the causes of groin hernia is excessive physical stress.

It is necessary to monitor the right nutrition, not allowing frequent constipation. With a disturbed intestinal function, intra-abdominal pressure increases, which provokes the extrusion of internal organs into the inguinal ring. So that the intestines worked properly, in a large volume you need to use plant food and drink a sufficient amount of fluid.

In preventive measures, it is recommended to undergo a medical examination at least once a year. Pahnaya hernia is a pathology that develops gradually for several years. Early diagnosis can successfully help cope with the ailment, not allowing the development of pathology.