inguinal hernia

Inguinal hernia




It is a pathological protrusion of the peritoneum through the inguinal canal (obliquely through the abdominal wall above inguinal ligament). The inguinal canal has two mouth (inside - deep inguinal ring, external - superficial inguinal ring) and four constraints (front - aponeurosis of the external oblique muscle; back - peritoneum and transverse fascia; lower - the inguinal ligament; upper - the internal oblique muscle and transverse abdominal , these muscles fascia.


Types



a) oblique inguinal hernia - congenital or acquired. Passes through the inguinal canal penetrating through the deep inguinal ring and finding mouth through the superficial inguinal ring. Further developments were reflected in the distribution of incomplete hernias (does not go beyond the superficial inguinal ring), complete (those that left superficial inguinal ring), scrotal (find an mouth in the scrotum), labial (in the area of labia majora), slides (organ partly intraperitoneally - pulled with peritoneum to the hernia sac).

b) simple inguinal hernia – it is acquired hernia. It penetrates medial inguinal bottom, which is a hernia's gate. It is limited by lower epigastrical vessels and lateral umbilical fold. Mouth is located just under the skin, near the inguinal ligament.
Diagnostics - a physical examination can sometimes feel hernias by examination of the scrotum (putting a finger into the inguinal canal) and requiring the patient to cough. Ultrasound is also helpful.
Symptoms - they depend on the severity of the hernia. It may be asymptomatic. Some of the popular symptoms include burning, pain in the inguinal area (especially during defecation and cough) and visible protrusion.


Treatment



All of the inguinal hernia is an indication for surgery (in case of entrapment - immediately). Operations can be divided into several types:

a) classic operations with the use of their own tissues. They rely on dissection of the hernia sac, the intersection, and the escorting contents and ligation and cutting off of its residues. It is necessary to repair the posterior wall of the inguinal canal (it can be done several methods - Bassini, Halsted, Shouldice).

b) Treatment with the use of plastics - mesh reinforcing the posterior wall of the inguinal canal (Lichtenstein); cork closing hernia's gate. (Rutkow method), two meshes connected by a hyphen (Prolen hernia system).

c) laparoscopic operations - a lower frequency of relapses.

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