Hernias

Hernias: causes, symptoms and treatment

A hernia is the exit of organs beyond the anatomical cavity under the general integument of the body or into an adjacent cavity. The cause of the development of hernias can be both general factors, such as gender, age and degree of fatness, and local factors, including congenital or acquired weakness of the wall of the anatomical cavity.

One of the producing moments in the development of hernias is an increase in pressure in the corresponding cavity. There are two main types of hernias: internal and external.

Internal hernias include intra-abdominal and diaphragmatic hernias. Intra-abdominal hernias form when internal organs become trapped in various pockets of the peritoneum. Such hernias usually appear only during the period of complications, when strangulation occurs, which can lead to partial or complete intestinal obstruction. Treatment for intra-abdominal hernia usually involves surgery.

Diaphragmatic hernias are divided into traumatic and non-traumatic. They can be false when the abdominal organs are not covered by the peritoneum and are displaced into the chest cavity through congenital defects of the diaphragm, and true when the abdominal organs or preperitoneal fatty tissue extend into the mediastinum or pleural cavity. The diagnosis of diaphragmatic hernia is clarified by x-ray examination of the chest cavity, which reveals an increase in the mediastinal shadow. Treatment of diaphragmatic hernias usually involves surgical suturing of the diaphragm defect.

Hiatal hernias can be congenital or acquired, and sliding and paraesophageal hernias are also distinguished. With a sliding hernia, the cardiac part of the stomach moves freely into the posterior mediastinum through the dilated esophageal opening of the diaphragm, without causing strangulation. With paraesophageal hernias, which are much less common, the cardiac part of the stomach is fixed, and its vault or antrum, and sometimes other abdominal organs, are displaced to the posterior mediastinum. In this case, infringement of the displaced organ may occur, which is manifested by sharp pain in the chest, reminiscent of angina pectoris, sudden dysphagia or vomiting mixed with blood.

Treatment of hiatal hernia depends on its type and severity. In the case of a sliding hernia, surgery is usually not required unless there is strangulation. In the case of paraesophageal hernias, surgery may be required to prevent strangulation and return the organs to their place.

External hernias include inguinal, umbilical, femoral, and linea alba hernias. The reasons for the development of external hernias may be weakness of the wall of the corresponding anatomical cavity, as well as increased intra-abdominal pressure during physical activity or coughing.

Symptoms of external hernias may include protrusion of soft tissue in the hernia area, pain with exercise or coughing, and rarely, organ strangulation. Treatment of external hernias depends on their type and severity. Surgery may be required if organs are strangulated or if there is severe pain.

In general, the treatment of hernias consists of surgical intervention, which consists of eliminating the defect in the wall of the anatomical cavity and returning the protruding organs to their places. In some cases, for example, if there are significant comorbidities or the patient does not want surgery, conservative treatment with support bandages may be recommended.