Hernia infringement
Hernia infringement is the most common of the complications of abdominal hernias. This condition requires immediate qualified surgical intervention to exclude the possibility of complications. Infringement of the hernia occurs due to compression of the hernial sac in the hernial gate.
CAUSES LEADING TO HERNIA INFRINGEMENT
The main reason for the development of hernia infringement is a regularly repeated or one-time strong increase in intra-abdominal pressure. It can increase with strong physical effort, coughing, constipation, difficulty urinating. Also, weakness of the abdominal wall muscles, abdominal injuries, surgical interventions, rapid weight loss can contribute to the development of hernia infringement. After the intra-abdominal pressure normalizes, the hernial gates contract and pinch a part of the hernial sac that is outside them. The probability of hernial infringement does not depend on the diameter of the hernial gate and the size of the hernia.
SYMPTOMS CHARACTERIZING HERNIA INFRINGEMENT
The infringement makes itself felt by local or general abdominal pain, abdominal wall tension and soreness of hernial protrusion, the inability to return the hernial sac to its place, the absence of a so-called cough push. The main factor in the development of infringement is pain, which reaches its highest point at the peak of physical effort and does not disappear at rest. Often, due to the intense intensity of pain, the patient cannot restrain moans, the patient’s behavior becomes restless, nervous. There is pallor of the skin, tachycardia and hypertension. Depending on the type of strangulated hernia, pain can be given to the hip, groin, epigastrium. The pain is pronounced for two hours, until necrosis of the organ pinched by the hernial gate begins to develop. As a result, the death of nerve endings develops and this reduces pain. With fecal infringement, pain and intoxication are not developed as much and, as a rule, intestinal necrosis develops more slowly. Also, if a hernia is pinched, a single vomiting may occur. This is a reflex reaction of the body. With the development of intestinal obstruction, vomiting becomes permanent, and becomes fecal. In the case of partial infringement, obstruction does not occur, gas retention, frequent urination, pain may occur. Long-term infringement leads to the formation of a hernial sac, it can be identified by characteristic signs on the surface of the skin, swelling and hyperthermia of tissues.
DIAGNOSIS OF HERNIA INFRINGEMENT
If the patient has indications for the development of a hernia, then diagnosis will not be difficult. During a visual examination of the patient, attention is paid to the soreness of the protrusion. The absence of a cough push is also a sign of the development of hernia infringement, sometimes it is possible to find symptoms of intestinal obstruction (noises, splashes, etc.). There is also an asymmetry of the abdomen. For accurate diagnosis and differentiation, ultrasound of the abdominal cavity is indicated.
TREATMENT OF HERNIA INFRINGEMENT
Regardless of the timing of localization, variety, infringement of a hernia requires immediate surgical intervention. Before the patient is taken to a medical institution, it is impossible to independently try to correct the hernia, inject analgesics or antispasmodics to the patient and take laxatives. Surgical intervention is aimed at freeing the organ from the hernial gate, restoring its viability, resection of the necrosis-affected area, carrying out plastic manipulations with the hernial gate. Doctors should assess the viability of the affected organ by special signs, if the organ is considered viable, then it sinks into the abdominal cavity.
