The general public does not know much about this word hernia, but if it is called “small intestine gas”, most people will know it. This is because this hernia is a common and frequent disease in our surgery. According to statistics, the overall incidence of inguinal hernia in children is nearly 4%, and in elderly people over 75 years old, the probability of the disease is more than 40%. The number of hernia surgeries performed in our department is close to a thousand every year, so hernia is a fairly common surgical disease.
What are the clinical manifestations of hernia?
Patients most often report that a pouch somehow bulges on their body, which protrudes when they stand and disappears when they relax or lie down to sleep. In fact, the word “hernia” has already explained its symptoms. Most of the small intestinal gas commonly spoken of by the common people refers to inguinal hernia, which typically manifests as a swelling protruding from the inguinal region, usually bulging out when standing and exerting oneself, initially only in the inguinal region, then gradually becoming larger and falling downward, eventually falling into the scrotum. Some decades-old hernias can be as big as a basketball, which is called a “big sand pot”.
How does a hernia develop? Although it is called “hernia” or “small intestine gas”, it has nothing to do with “gas” or “small intestine”. Definition of a hernia: A part of the body’s tissue or organ leaves its original location and enters another part of the body through a gap, defect or weakness. So essentially, there is a “hole” in the body through which the intestines or organs burst out. It’s like a hole in the pocket of a garment, and the contents fall out.
What are the types of hernias? Who can get a hernia easily?
There are actually many types of hernias, and they are all named after the location of the hole, such as umbilical hernia, inguinal hernia, femoral hernia, diaphragmatic hernia, white line hernia, semilunar hernia, etc., and incisional hernia formed after surgical incision. However, the most common one is inguinal hernia, and most of the small intestinal gas that we usually talk about is inguinal hernia. Syringomyelia and spermatic effusion in children is also a kind of hernia, but the contents are fluid, also called hydrocele.
Who will be prone to hernia?
Theoretically, hernias can occur at all stages of a person’s life. However, they are usually concentrated at the two ends of the spectrum, i.e. in children and in the elderly, and their onset is different, leading to different treatment methods. Generally speaking, there are more males and fewer females with a ratio of 15:1; more on the right side and less on the left side, about 4:1.
What are the causes of hernia?
Ventral hernia is caused by a defect in the abdominal wall (belly). As I said earlier, the pathogenesis of hernia in the elderly and in children is different. A child’s hernia is generally considered to be a congenital defect in the abdominal wall, whereas an elderly person’s hernia is an acquired degeneration of the myofascial tissue causing a break. Therefore, if we compare the human body to a piece of clothing, a child’s hernia is a piece of clothing that was already torn when it was shipped from the factory, while an elderly person’s hernia is a piece of clothing that was in good condition when it was shipped from the factory, only that it has been worn for decades and some parts of it have become old and torn.
What are the causes of a hernia?
All factors that cause an increase in abdominal pressure can trigger a hernia, what do you mean? For example, children crying a lot, coughing and sneezing with a cold, coughing a lot due to emphysema in the old age, constipation, difficulty in urination due to prostate enlargement. There are some bad habits that cause hernias, such as smoking and drinking, especially smoking, which cause accelerated aging of tissues and thus hernia. In addition, although hernia is not a hereditary disease, there is a clear tendency of family concentration, and the probability of a child having a hernia is significantly higher if the father has a hernia. It is common to see three generations of grandfathers, fathers and sons with hernia in clinical practice.
Treatment
The first thing to be clear is that hernias do not heal on their own. Specialized and standardized surgery is the only reliable way to treat hernias. In fact, you may want to go to Baidu and type in the word hernia. The first three pages of search results are basically false advertisements, which are generally summarized as follows
1. hernia belt (after wearing it, by compressing the inguinal rupture, the intestinal canal is blocked from protruding, but it does not fundamentally close the rupture, but causes blood flow disorders around the rupture and accelerates the increase of the rupture, and incorrect use can easily lead to intestinal entrapment and necrosis)
2. taking Chinese herbal medicine (generally, Chinese medicine believes that hernia is caused by Qi deficiency and sinking, so the treatment revolves around this Qi, what with “moving Qi and transforming Qi” and so on, but as said before, the principle of hernia disease is abdominal wall damage, not Qi or intestinal problems).
3, injection sclerosing agent, (both the use of medical glue (actually similar to 502 glue), by bonding the hernia sac, blocking the small intestine convexity, but it can not close the rupture at all, and cause intestinal adhesions intestinal obstruction, and even cause intestinal necrosis need to cut intestine, so this is very dangerous, the Ministry of Health has been explicitly prohibited the use of)
6. How to operate?
Just now mentioned the specialized and standardized hernia surgery. Hernia surgery used to be an entry-level surgery (all surgeons know the most basic surgical method), but with the deepening of research, it is found that it is not simple and there are many details among them, so this specialized and standardized surgery is the key to avoid recurrence and reduce complications.
Another point is minimally invasive. All of our current pediatric hernias, and the vast majority of adult hernias, are treated with minimally invasive laparoscopic surgery, which is basically scarless, less painful, and quicker to recover. The wounds do not need to be removed or changed, and the patients can resume their daily activities after discharge, without the need to avoid mouth or restrict activities.
Of course, there is a certain difference between children’s surgery and adult surgery, children do not have muscle weakness, just a simple stitch can be; while adults have muscle defects, it can not be simply sutured, it is necessary to use synthetic patches to repair the defect (just like an old clothes, you will only sew up the rotten cloth around the hole, it is easy to rot again, the best way should be to take a new piece of cloth, cover the hole, is a (patch). Of course, all this is done under general anesthesia and minimally invasive surgery, the patient sleeps and the surgery is done, completely painless.
The overall cost of inpatient surgery for hernia in children is about 6,000 yuan, with no additional costs. The cost of adult hernia treatment will also depend on the patch material used and the type of hernia, and we will individualize the choice based on the specific case of the hernia, which usually ranges from $9,000 to $15,000.
Timing of surgery? The danger of not having surgery in time?
Many people say, “This hernia is usually painless, do I have to have surgery? Or can’t we do it later? (Some parents are worried that their children are small and should wait until they are older. The biggest risk of hernia is the occurrence of intussusception (sometimes when a child coughs or an elderly person sneezes, the intestine protrudes and gets stuck and cannot be returned), which is like giving someone a choke and will break off after a long time. It is generally believed that if the intestinal tube is stuck for more than 6 hours, there is a risk of necrosis and even life threatening. Therefore, early surgery is the safest and most worry-free way, do not be delayed by some worldly concepts and wrong ideas of the treatment, and thus regret.
The summary is the following.
1. hernia (small intestine gas) is a common and frequent disease in surgery, which can affect both men and women, young and old.
2, but the people often do not treat it as a disease, something is always covered up and hidden, delaying treatment.
3, large doctors can not see, small doctors can not afford, few people dedicated to research, standardized treatment is not popular.
4, traditional treatment methods are flawed, traumatic, slow recovery, complications.
5, the proliferation of false advertising, hundreds of diseases in the surgical profession, none as many false advertising as hernia.
6. early specialized and standardized surgery is the only reliable means to treat hernia.