Hernia

Hernia

A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place.

Definition

Hernia is a localized bulge in the abdomen that occurs when there is a weakness in the muscular wall.

Causes

•               Congenital - failure of the abdominal wall to close.

•               Age – after 60 years

•               Chronic cough

•               Pregnancy - which puts pressure on the abdomen

•               Constipation

•               Lifting heavy weight

•               Fluid in the abdomen, or ascites

•               Abdominal surgery

•               Obesity

Types

Inguinal hernia: Intestines push through the inguinal canal.

Incisional hernia: Resulting from an operated site.incision

Hiatal hernia: Part of the stomach protrudes up through the diaphragm into the chest cavity.

Umbilical hernia: A part of the bowel protrude through the belly button (umbilicus).

Congenital diaphragmatic hernias is a birth defect in which there is an abnormal opening in the diaphragm.

Sports hernia is a tear or strain of any tissue in the lower abdomen or groin due to gym activity.

Signs and Symptoms

•               Swelling in the abdomen or in the groin which disappears when lying down.

•               Pain on palpation

•               Vomiting

•               Feeling of weight in the abdomen.

•               Constipation

•               Discomfort in the abdomen or groin when coughing, lifting a weight or bending over.

•               Fever

•               Upper abdominal pain

•               Chest pain

Diagnosis

•               History collection

•               Physical examination

•               Abdominal X-rays

•               Complete blood count, electrolytes.

•               Ultrasonography of the abdomen

•               CT abdomen

Management

Non Medical: Abdominal binder

Surgical management:

•               Herniorrhaphy

•               Hernioplasty

Nursing management

•               Provide trendelenburg’s position

•               Administer stool softners

Prevention

•               Stop smoking

•               Avoid developing a persistent cough

•               Maintain appropriate body weight for the age.

•               Avoid straining during bowel movements

•               Lift objects with knee flexion and not with hip flexion.

•               Heavy lifting should be avoided for 4 to 6 weeks after treatment.

Complication

•               Strangulation: reduced blood supply to a herniated organ.

•               Obstruction: the bowel contents may no longer be able to pass through the herniated area, leading to cramps, the absence of defecation and vomiting.

•               Recurrence hernia