Direct and oblique inguinal hernia are formations located in the abdominal cavity, which differ in the exit point. Most often, this disease occurs in men. All symptoms of a direct inguinal hernia can be divided into two groups, which directly depend on the degree of development of the pathology.
When coughing, sneezing, movements of protrusion of the inguinal hernia (according to ICD-10 has the code K40) does not occur, it does not go beyond the border of the hernial ring. The hernia has an oval-oblong shape, it can be viewed above the inguinal ligament. There is a slight burning sensation and discomfort in the groin. When moving, there are pains of a pulling nature. For most people, an oblique inguinal hernia does not appear for a long time, so many are unaware of its presence.
Reasons
Inguinal hernia, according to ICD 10 code K40, is a pathological protrusion of the abdominal organs from the anatomical space they occupy into the inguinal canal. This disease most often occurs in men, the formation itself is a dense rounded bump. It is also worth noting that oblique hernias most often occur in young people, and direct hernias appear due to age-related changes.
The appearance of a hernia is accompanied by a sharp pain in the lower abdomen. Causes of oblique and direct inguinal hernia:
- Genetic predisposition.
- Intrauterine underdevelopment of the internal genital organs.
- Weakness of abdominal muscle fibers.
- Overweight.
- Chronic infectious and viral diseases.
- Diseases of the gastrointestinal tract.
- Permanent physical overload.
- Inadequate defecation.
- Premature onset of labor.
- Cryptorchism.
Indirect inguinal hernia in men increases with the appearance of a strong cough or heavy lifting. The elimination of this disease is carried out mainly by surgery.
Symptoms of oblique hernia in men
It is necessary to recognize the symptoms of inguinal hernia in men in a timely manner. In this case, the doctor will be able to prescribe the most effective treatment. The disease shows the following symptoms:
- Tumor-like protrusions in the groin area, accompanied by pain. Severe pain may occur during physical exertion.
- Unusual thickening of the spermatic cord.
- Constipation and pain in the lower abdomen that radiates to the sacrum.
Symptoms of oblique hernia in women
Female symptoms are:
- In the lower abdomen, pain is felt after lifting weights, after a while (after rest) the pain disappears.
- During the menstrual cycle or for a coupledays before, the pain may increase.
Symptoms of direct hernia in men
Symptoms of direct inguinal hernia for men:
- Protracted pain and burning in the groin.
- Bloating in the groin area, which can vary depending on the position of the body.
- Feeling uncomfortable when urinating and walking.
Symptoms of direct hernia in women
For the treatment of inguinal hernia in women, the symptoms are the first thing to be distinguished in this case:
- Protrusion in the form of a tumor that increases with a straight stance, physical exertion, during sneezing or coughing.
- The pain is sharp and intense, which radiates down the abdominal cavity, lower back and sacrum.
- flatulence, frequent urination, constipation.
- Severe pain when urinating.
Symptoms of strangulated hernia
When an oblique and direct inguinal hernia is infringed, the following symptoms are observed:
- Sharp and severe pain in the area of the hernia;
- General weakness, vomiting and nausea;
- The hernia cannot be reduced in any position of the body.
Differences between direct and oblique inguinal hernia
The anatomical difference between hernias is that the straight line can exit the abdominal cavity into the median inguinal cavity, which is located inside. You need to know this during surgery, when differential diagnosis of direct and oblique inguinal hernia is carried out.
Of the five folds that are located on the back surfaces of the frontabdominal walls, only one is considered an active artery, and the others are an overgrown formation. During surgery, when the hernial sac is opened, the doctor has a chance to stick a finger into the abdominal cavity and feel the back surfaces. If the finger has identified a pulsation, then this may indicate that there is a direct inguinal hernia. If the pulsation is felt inside, where the neck of the hernial sac is located, then the place where the hernia comes out is the inguinal cavities or deep openings of the inguinal canals, that is, oblique inguinal hernias.
Direct inguinal hernias always lie medial to the spermatic cords, which are isolated from the hernia sacs and only adjacent to them. The layers of direct inguinal hernias are considered to be the skin, subcutaneous tissue, superficial fascia, aponeuroses of the external oblique muscles of the abdomen.
Diagnosis
Diagnosing an inguinal hernia is quite simple, as it can be seen on physical examination. When collecting an anamnesis, the patient specifies the exact time of the appearance of the protrusion, the presence of cough, constipation. And also the factors that could provoke the development of inflammation are being clarified. For example, heavy physical activity.
The doctor examines how difficult the protrusion is to reduce and checks for infringements. Next, palpation is performed, the consistency, content and density of the hernia are assessed. Of great importance is the color of the skin in the focus of inflammation and soreness when pressed. Direct and oblique inguinal hernias are detected on ultrasound of the pelvic organs. This technique is used to study the internal contenteducation. In order to get an accurate diagnosis faster, the patient undergoes a series of tests, including:
- CBC;
- Urine analysis;
- ultrasound;
- ECG;
- Blood clotting test.
Instrumental diagnostics includes diaphanoscopy (translucence of the scrotum). It is done to look for fluid or inflammation. All these activities are necessary in order to confirm the presence of a hernia, since the symptoms of inflammation are similar to other pathologies.
Operation
The symptoms and treatment of inguinal hernia differ for men and women, but the operation is the same.
The question of the operation to remove an inguinal hernia still does not have a final solution and requires further development and improvement. Recurrence rates after surgery are still high and there is no big downward trend. It is noted that recurrence with direct inguinal hernia is significantly higher than the number of recurrence with oblique. Therefore, the desire of doctors for the subsequent study of the anatomical-topographic relationship with different types of inguinal hernia is obvious, so that the data of surgical anatomy are used clearly and purely personally. Not every time there is a consideration of the difference between oblique and direct inguinal hernia in terms of etiology, anatomy of tissue ratio.
Unreasonable choices of methods of surgical intervention are observed, or “favorite” methods are used in everyday practices, which cannot affect the immediate and long-term results.
Surgical anatomy of hernias (oblique, straight, sliding and others) has its own characteristics, therefore, the choice of method and the implementation of a separate part of the surgical intervention must be done taking into account the differences. In connection with the various options for oblique inguinal hernia (diverticulum of the sac, closed cavity, encysted hernia, and others), complications of excessive injuries of the spermatic cord appear.
The treatment of the neck of the hernial sac is of exceptional importance, and only a large selection of the neck gives a chance to remove the abdominal funnels, whose role in creating relapses is indispensable.
The fundamental setting for surgical intervention of any type of inguinal hernia is the mandatory dissection of the aponeuroses of the external oblique muscles, in connection with this, surgical intervention according to the Roux method and its variants is considered unreasonable. It is a mistake to refuse to use a muscle for plastic surgery of the inguinal canals.
After inguinal hernia surgery, a rehabilitation period begins, which includes diet, lifestyle changes and reduced exercise levels.
Drug treatment of oblique and direct inguinal hernia
There is a fairly extensive list of methods for eliminating inguinal hernia. The most popular and effective ways to deal with this pathology are provided in the following list:
- Surgical intervention.
- Drug therapy.
- Recipes of traditional medicine.
- Wearing a bandage.
Definitely the right decisionthere will be an operation, however, during pregnancy or inflammatory processes in the body, radical measures are contraindicated. In this case, you have to resort to the second option - the use of medicines.
As a rule, in the presence of a direct or oblique inguinal hernia, the patient uses the following drugs:
- Painkiller No-shpa.
- Laxative "Duphalac".
"No-shpa" belongs to the category of painkillers. Its use is justified by the fact that with an inguinal hernia, the patient experiences severe pain, sometimes intolerable, and this medicine will help reduce pain. The cost of the drug varies from forty to four hundred and seventy-five rubles. It should be borne in mind that an overdose of the drug is dangerous. Overuse of painkillers can be fatal. The normal dose per day is one hundred and twenty grams, that is, three tablets.
As you know, constipation is characteristic of an inguinal hernia, which is fraught with a number of unpleasant consequences: intoxication, dysbacteriosis. Therefore, to prevent such incidents, a laxative should be taken. "Duphalac" can be purchased by paying from three hundred to nine hundred rubles. As in the case of the first drug, "Duphalac" should not be consumed in large quantities. There will be no lethal outcome, but it will be replaced by vomiting or diarrhea, severe stomach pain and bloating.
Folk Therapy
To heal a hernia that is not complicated by strangulation,folk remedies are used as an additional factor. It is recommended to use folk remedies to eliminate the inflammatory process, relieve pain, restrain the growth of a hernia, strengthen the body, and so on.
Usually, inguinal hernia in men, the symptoms and treatment of which are discussed in this article, is treated with a hernia. One of the easiest methods that can help relieve the inflammatory process is the use of a compress with this herb. To prepare a compress, you need to wash a handful of freshly picked herbs and put in a steamer. Then you need to keep it over hot water for ten minutes, then grind it and apply it to the place where the hernia has formed. Fix the bandage and adhesive plaster upstairs so that the compress cannot move. Apply this method once a day for two weeks. The compress is kept for forty minutes.
Gryzhnik is used to make a compress for inguinal hernias. It also relieves pain and swelling of the compress, where nettle is added. Ten medium-sized leaves of fresh nettle should be washed and chopped. Mix the resulting contents with three tablespoons of warm fat sour cream. Then smear the sore spot with this consistency and cover with a cabbage leaf on top. Fix with a clean cotton towel so that the compress does not move, leave overnight. Repeat session for four weeks.
A compress with a white cabbage leaf will also help. Pass two or three large leaves of cabbage through a meat grinder or chop with a blender, sofor the juice to come out. Then apply the resulting mass to the sore spot and fix with a bandage.
Prevention
The most common type of hernia is inguinal. To prevent this pathology, you need to perform a set of physical exercises daily. Get a consultation beforehand to determine the strength of the load appropriate for age and he alth.
Emphasis on the anterior abdominal muscles:
- Take a horizontal position, lift your legs together at a right angle 10 times.
- In the same position, stretch your arms along the body. Raise your legs in turn at a right angle, slowly lowering down. Do the exercise 10 times.
- Bend your legs, lifting your torso, wrap your arms around your knees. Do the exercise 10 times.
- In the same position, we perform movements that imitate cycling. Every 3-4 movements we lower our legs to the floor. Do the exercise 10 times.
- Pull your knees up to your chest 10 times.
Benefits in the prevention of pathology will bring long walks on foot in the fresh air, within 1 hour. Maintain sleep time, if you cannot do it yourself, consult a doctor for the appointment of special medications that respond to the restoration of the body's biorhythms.
The meaning here is the strict implementation of the diet. Sit down at the table every 3 hours, 5 times a day. Remove spicy and fatty foods, alcohol, sweet and flour products from the menu. Give preference to vegetables, fish, meat.
Consequences of direct and obliqueinguinal hernia is not felt at all (subject to successful surgical intervention). If no measures were taken, then this pathology threatens the he alth and life of the patient.
