Hernia!!

This post is summarized for your quick reference:

A hernia is a weakness in the muscles of the abdominal wall, resulting in a hole that is only covered by the skin.

There many places on the abdominal wall where this weakness can occur, these places are:

1.         The navel area                                                     (umbilical hernia)
2.         The junction between abdomen and the legs         (Inguinal and Femoral hernia)
3.         Along the center of the abdomen                          (Epigastric hernia)
4.         Anywhere after abdomen surgery                         (Incision Hernia)
5. Along the side of the abdomen                            (Spigellian hernia)

What causes the hole?

In some people, the muscles have not developed well enough to join together by the time of birth, and therefore these hernias (hole) occur in childhood.  They are called congenital hernias and they are especially

1.      Umbilical hernias or

2.      Inguinal hernias

To other people, the muscle weakness (hernia) occurs due to increase in pressures inside the abdomen (for example: Body builders, causal laborers, those which chronic cough) or due to old age the resulting hernias are especially

1.      Umbilical hernias

2.      Inguinal hernias

3.      Epigastric hernias

4.   Spigellian hernia

Finally, some hernias occur during or after pregnancy due to stretch of the abdominal wall, or after caesarian section. These common hernias in this case are:

a.      Epigastric hernias

b.      Incision Hernias

How one can know that they have a hernia!!

Mostly hernias present with swelling (with or without pain). Hernias which present with pain are the one to worry about; since they are an emergency.

What does the pain mean!

The hole in the muscle (hernia) is not the problem; the problem occurs when the intestines within the abdomen enter through that hole and get stuck.

When the intestines are stuck inside the hole, there blood supply to the intestines is slowly cut off (they are choked) and this causes the pain. This is now called an obstructed hernia!

When the obstruction is not corrected, the part of the intestine which is stuck in the hernia dies, this will then be called a strangulated hernia.

Treatment of hernias:

Treatment is surgical; the hole has to be closed surgically. The purpose of treatment is;

1.      Prevent  obstruction or strangulation:                     Elective (planed) surgery advised

2.      Correct obstruction:                                              Emergency (Urgent) surgery

3.      Correct strangulation, and repair the intestine:        Emergency  (Urgent) surgery

Conclusion:

1. Not all hernias need treatment, but prevention of hernia complications (obstruction and strangulation) should be considered.
2. Surgery is the only mode of treatment (the aim is to close the hole to prevent intestines from herniating through it).
3. It is almost  twice expensive to treat the hernia as an emergency (obstructed/ strangulated) than as an elective in Uganda.

Have a great weekend and
Happy New year
Chao..............

1.