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Injury of the hernia: symptoms, diagnosis, first aid

911821 Hernia is a condition in which abdominal wall defects( anterior abdominal wall, diaphragm, inguinal canal) protrude various abdominal organs, provoking a variety of symptoms.The most frequent and dangerous of its consequences is the strangulated hernia.

Table of contents: What is a hernia? Components of a hernia? Causes of hernia stinging? Symptomatology of strangulated hernia? Complications of strangulated hernia. Treatment . Recommended:

. What is a hernia

? In musculo-aponeurotic( aponeurosis - part of the abdominal wall, consisting of connective tissue)There are a number of weak areas in the abdominal cavity, where the thickness of the barrier is less than in the rest.For a number of reasons, they gradually create a hole that grows in size over time, so that the organs of the abdominal cavity begin to "fall through".Most often, the contents of the hernia are the loops of the small intestine, the sigmoid colon and the large gland - a kind of apron, located between the internal organs and the anterior abdominal wall.

Hernia components

Each hernia, regardless of its location, size and shape, has three components: 01e0beea496850dc3cdca4b918d3079f

  • hernial gates are the weakest point, the abdominal wall defect through which the organs are protruded;
  • hernial sac is a parietal peritoneal site( the lining that lining the inside of the abdomen), which under the influence of increased intra-abdominal pressure is stretched, becoming a kind of bag, sometimes quite large;
  • hernia contents - those organs that penetrate from the abdominal cavity into the cavity of the hernial sac.

Only the presence of all these three components allows us to talk about a true hernia.

Reasons for infringement of hernia

There are three types of infringement of a hernia depending on the mechanism of development of this process:

  1. Elastic.It arises because of suddenly increased vnutrubryushnogo pressure due to coughing, straining, a sharp physical strain.In this hernia gates are stretched more than usual, they contain more content.After the normalization of the abdominal pressure, the hernial gates return to the usual dimensions, as by pulling down the organs that penetrated through them.
  2. Fancy.It is noted mainly among the elderly.Due to the deterioration of intestinal motility in the leading loop of the intestine( the one that enters the hernial sac, in contrast to the outflow, which leaves it) a large number of feces accumulate.As a result of this, the pressure on the outflow gut becomes higher and gradually it is impaired by the elastic type.
  3. Mixed.In fact, this is the final stage of fecal infringement, when as the enlarging loop of the intestine increases, the hernial gates stretch, squeezing and withdrawing, and leading the loop.

Symptomatology of strangulated hernia

The clinic of an injured hernia depends on which organ is in the hernial sac, on the type of infringement and on the time that has passed since its onset.In any case, the first and the initial phase of the disease's sole symptoms are pain and irreparable hernia, previously self-controlled or manually.The intensity of pain can vary significantly from moderate to extremely high, chocolate.

Local signs of infringement are considered sharp abdominal tenderness at palpation in the appropriate place, the hernial protrusion is compacted, strongly strained.The symptom of a cough shock, positive for an uncompensated hernia, becomes negative.

In the future, when medical assistance is not provided, complications develop, each of which manifests itself in its own symptomatology and inevitably leads to the development of peritonitis with very illusive chances of recovery.

Complications of strangulated hernia

When you get into the hernial sac of the intestine, there is a classic picture of strangulation intestinal obstruction.At the same time, the disappearance of gases and feces ceases, there is multiple severe vomiting, eventually acquires a fecal odor( "vomiting"), pains in the abdomen increase, the patient's condition progressively worsens, becoming critical at some point.


Peritonitis is another formidable complication of the disease.He can develop for any type of infringement, regardless of which organ was in the hernial sac.At the same time, the patient's condition gradually becomes critical, and violations of the functions of all organs increase( polyorganic insufficiency).Very often peritonitis ends with the death of the patient, regardless of any efforts of doctors.

The third complication, which sharply worsens the prognosis for a patient's life, is the phlegmon of the hernial sac.It develops 3-5 days after infringement due to bowel necrosis, which is thinned and loses its ability to retain the microorganisms living in it.Gradually, the microbes penetrate farther, first infecting the hernial sac, and then the rest of the abdominal wall tissue up to the skin.

Treatment of

The first thing to say is - never try to correct the hernia yourself.Sometimes, with such attempts, the elastic ring of the hernial ganglenium detaches.The hernia goes into the stomach, but the infringement does not go away anywhere.This is called "imaginary direction" and this situation is extremely dangerous because of the inevitable development of peritonitis.

Treat injured hernia only in an operative way.The surgeon dissects the hernial sac( carefully, so as not to damage its contents), seizes the intestine or the large omentum with a gauze napkin, and then dissects the hernial gates( that most restraining ring).After that, the doctor determines the viability of the contents of the hernia and, depending on this, makes a decision whether to remove the necrotic parts of the organs or proceed immediately to the plastic of the hernial gates-restoring the integrity of the abdominal wall.

Infringement is without a doubt the most serious and deadly complication of the hernia.You can avoid it only in one way - a timely operation.No other method, including folk, will restore the structure of the abdominal wall and not close the aperture that has already arisen.Therefore, if the doctor offers surgery - do not refuse.You can not avoid it anyway, but intervention on emergency indications is much more dangerous than planned when your body is prepared for it.

More information about the hernia and infringement of the hernia you will get by viewing this video:

Volkov Gennadiy Gennadievich, medical columnist, ambulance doctor.

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