A hernial sac is a part of the parietal or visceral peritoneum that has fallen out through the hernial orifice under the skin of the abdomen or groin. In turn, a hernial orifice is a hole in the peritoneum of various shapes, sizes and origins. That is, the hernial sac is the hernia. It is soft and easily reduced (without complications). A hernia complicated by incarceration or inflammation is impossible and dangerous to correct.
The hernial sac has no other treatment than surgery. In rare cases, if the operation is temporarily contraindicated and the hernia has no complications, the hernial orifice is held with a bandage.
Types of hernia
Hernia is a fairly common occurrence. Most often, a hernial sac is formed in children under 5 years of age and in adults after 45 years of age. Moreover, in men, a hernia falls out 3 times more often than in women. The cause of prolapse of part of the intestine or serosa is the appearance of a gap in the peritoneum or in the groin. Therefore, hernias are divided into several types:
- Inguinal - most often fixed in men and boys. In addition, this is the most common hernia - it occurs in 8 cases out of 10 recorded.
- Postoperative - in this case, the intestine falls out through an incision in the peritoneum.
- Umbilical - appears around the navel.
- White rare hernia - femoral. Occurs in only 3% of patients.
- The rarest type of pathology is diaphragmatic hernia. The occurrence of such a phenomenon is recorded in only 1% of all cases.
Causes of pathology
A multi-chamber hernia sac or an ordinary solitary hernia does not occur for any one reason. For this, several key factors must coincide.
First of all, the person's muscular corset must weaken. This can happen as a result of an injury, surgery, advanced or, conversely, too young a person.
Secondly, the pressure inside the abdominal cavity should rise sharply. This is caused by strong physical exertion, for example, when lifting heavy things, or if the child screams for a long time and strongly.
Tension in the abdomen can create prolonged coughing, swelling, gas, constipation, pregnancy, urinary problems, and more.
It is important to understand that the coincidence of tension inside the abdomen and the weak walls of the peritoneum must be long-term. You can not get a pathology, having had a cold with a cough. But a long-term disruption of the gastrointestinal tract will lead to this with a high degree of probability.
Danger of pathology
The contents of the hernial sac is usually the small intestine. One or more loops fall out through the hernial orifice under the skin of a person, but at the same time retain their functions. If there is a compression of the hernial ring after the intestine has passed through them, complications begin. Blood and oxygen stop flowing to the tissues of the intestine. As a result, tissue necrosis begins and then general blood poisoning.
The bowel may not be completely clamped, but only by the edge of the bowel, but this still leads to necrosis. There is a dangerous congenital hernia. In this case, the child is born with some organ outside the peritoneum: the bladder, the caecum, and so on. In this case, the operation is carried out immediately.
Symptomatic manifestations
The symptom of the pathology is quite simple - a leathery bag soft to the touch appears on the surface of the skin. But there is an inguinal hernia. In this case, palpation of the hernial orifice shows that it has opened into the scrotum and the intestines have descended directly to the testicles. One in five men over 50 suffers from this type of hernia.
Umbilical hernia is characterized by a pouch on the umbilical ring. If the hernia is not infringed, then in the supine position it disappears, that is, the intestinal loop goes into place. Pain, nausea, fever, constipation occur only after the hernia is incarcerated. In this case, the patient must be assisted urgently (urgently).
Diagnostic measures
A hernia is diagnosed by visual inspection. But in order to work out an operation plan, the doctor may prescribe an examination of the contents of the hernial sac using ultrasound.or a barium solution passed through the intestines. In the latter case, the abdominal cavity is examined using x-ray equipment. How to treat a hernia in each case, the gastroenterologist or endoscopist surgeon decides.
Principles of treatment
To date, there is no effective method of hernia treatment with a conservative method. The hernial ring is sutured and strengthened only by surgery. During the operation, the intestines or mesentery are removed into the abdominal cavity, and a special retaining net is fixed on the hernial ring. This helps to avoid future relapses.
If the patient's condition is critical, that is, a hernia is pinched, the operation is performed on an emergency basis. Part of the bowel affected by necrosis is removed.
Usually the operation is performed under general anesthesia, but if the patient has contraindications to this type of anesthesia, then it is not performed. In this case, the surgical field is anesthetized with topical preparations.
If the patient is pregnant or elderly, the operation is generally not performed, but the person will need to wear a special restraint at all times.
The decision on how to treat a hernia should be made by a doctor. It is impossible to correct the intestines on your own, it is very dangerous.
Prevention measures
The prognosis of most hernia surgeries is good. Even if she was restrained and complicated by necrosis. It makes sense to pay attention to the prevention of this phenomenon. ForTo do this, you need to regularly engage in strengthening the muscle corset. That is, do gymnastics with an emphasis on the abdominal muscles.
It is also important to eat right so that the intestines do not create excess pressure in the abdominal cavity with chronic constipation and flatulence. To do this, it is necessary to exclude fatty, spicy foods, fried foods from the diet, include beans in large quantities. You need to eat more fiber and vitamins - these are cereals and fresh fruits. Bad habits - smoking, alcohol, drugs - should also be abandoned, because they adversely affect the entire body as a whole.
