When it comes to “hernia”, I believe that no one is unfamiliar with it, but many people only know it halfway. “The medical name is “hernia”, which refers to the entry of human tissues or organs from their normal position into the neighboring area through a weak area such as a congenital or acquired hole or defect. In layman’s terms, it is a protrusion from one’s original place to another.
I. Overview:
Hernias, most often occurring in the abdomen, include extra-abdominal and intra-abdominal hernias, which are further classified into different hernias according to their location and anatomical structure, including: inguinal hernia, straight hernia, femoral hernia, umbilical hernia, incisional hernia, white line hernia, semilunar hernia, closed hole hernia, lumbar hernia, and omental foramen hernia. The most common one is inguinal hernia, commonly known as “small intestine hernia”, which is a mass that appears in one or both inguinal areas, appears when exerting force or coughing, and disappears when resting flat.
Some people will ask what exactly causes it.
Causes include.
Decreased strength of the abdominal wall and increased intra-abdominal pressure from various causes.
Extra-abdominal hernia, that is, protrusion of abdominal contents through a weakness in the abdominal wall to the body surface.
Based on clinical features, they are classified as.
1. easily reversible hernia: that is, the hernia mass comes out easily and goes back in easily.
2. refractory hernia: the hernia mass protrudes and cannot be completely returned to the abdominal cavity.
3. incarcerated hernia: the hernia mass comes out and cannot go back, causing the contents inside (mostly small intestine and large omentum) to be incarcerated, and if it cannot be returned by manipulation in time, emergency surgery is required, because if it takes too long, it will cause ischemia and necrosis of the stuck small intestine.
4. strangulated hernia: that is to say, too long a card has caused ischemia and necrosis of the contents inside, such as small intestine and large omentum, which requires emergency surgery to remove the necrotic tissue.
Treatment principles
1. Inguinal hernia and straight hernia, i.e., a mass in the inguinal region.
(1) Non-surgical treatment: Infants within 1 year of age can be treated without surgery for the time being because as the body grows, the abdominal muscles will gradually strengthen and there is a possibility of self-healing, and the hernia mass can be prevented from protruding by binding and compressing with a cotton fabric girdle. Avoid coughing, crying, etc. Once the above mentioned impaction occurs, the hernia needs to be returned in time to seek medical attention. If it cannot be returned or strangulation occurs, emergency surgery is needed. In adult hernia, if non-surgical treatment is not effective, some places in previous years claimed that it is not open, painless and cure hernia, i.e. local injection of sclerosing agent, but the effect is mostly unsatisfactory and causes serious local adhesions increasing the difficulty and trauma of future surgery.
(2) Surgical treatment: Surgery is the most effective treatment method. Previously, there were various surgical methods, but they are prone to recurrence. Currently, it is replaced by a tension-free hernia repair, in which a biomaterial – patch – is applied to repair the defective area, just like a patch for a broken dress. This reduces postoperative pain and generally does not recur.
(3) Cost: The price of the patch varies from manufacturer to manufacturer, domestic or imported, and generally ranges from 1000-2500. At present, reversible inguinal hernia belongs to the clinical pathway, that is, there is a unified treatment standard, antibiotics are only applied once before surgery or not used, and only the appropriate amount of rehydration is given on the day of surgery, and no infusion is needed after surgery. For adult hernia, the overall cost is about 4,000-5,000 yuan in general in county hospitals, which varies according to the hospital level and development level.
2. Femoral hernia, a mass at the root of the thigh, usually located below the inguinal ligament. Femoral hernia is prone to entrapment and should be operated early once it appears, and surgery is the only effective treatment.
3. Abdominal wall incisional hernia, formed when the abdominal contents protrude from the body surface through a defect in a previous abdominal wall surgical incision.
Treatment.
Surgical treatment should be performed to avoid gradual aggravation.
4. Umbilical hernia, a hernia that occurs in the navel area. Infants can often heal themselves through development within 1-2 years and therefore do not require surgery unless there is an impaction, etc. If the mass is larger than 1.5 cm in diameter after 2 years of age, surgery can be considered, and over 5 years of age and adults should be treated surgically.
5. For other relatively rare ones such as white line hernia, lumbar hernia, closed hole hernia and semilunar hernia, the effective treatment is surgery.