What is an Epigastric Hernia?

The abdominal organs leave the original position and enter another part through the weak point or defect of the human body and the gap. Morphologically, the hernia of the abdomen can protrude outside the abdomen, and it can also manifest as a hernia of organ tissues such as intestines into a certain space in the abdominal cavity.

The abdominal organs leave the original position and enter another part through the weak point or defect of the human body and the gap. Morphologically, the hernia of the abdomen can protrude outside the abdomen, and it can also manifest as a hernia of organ tissues such as intestines into a certain space in the abdominal cavity.

Chinese name

Abdominal hernia

Foreign name

celiocele

Classification

External and internal abdominal hernias

Abdominal hernia I. Classification:

Abdominal hernia can be divided into extra-abdominal hernia and intra-abdominal hernia. Intra-abdominal hernia is rare, and extra-abdominal hernia is more common. A clinically common inguinal hernia is a type of extra-abdominal hernia, accounting for about 90% of the total number of extra-abdominal hernias. According to relevant data, there are about 20 million cases of inguinal hernia in the world each year.

Abdominal hernia Second, differential diagnosis:

History of chronic cough, frequent vomiting, constipation, prolapse of the anus, urethral stricture, phimosis, bladder stones, laborious urination, abdominal surgery, trauma and other previous medical history of hernia incarceration. Pay attention to abnormal swelling or depression in the abdomen, ascites, enlarged liver and spleen, and prominent bumps when standing. The elderly should be checked for enlarged prostate. Respiratory motion is limited on one side of the chest, breathing sounds are weakened, intercostal fullness, and signs of diaphragmatic hernia such as bowel sounds or water tremors can be heard on the chest. Inguinal hernia should pay attention to the shape of the hernia and the size of the hernia ring. When standing or coughing, the contents are lowered into the scrotum and reset.

Abdominal hernia

1. Medical history: Ask about the time of onset, whether there is a history of chronic cough, frequent vomiting, constipation, anal prolapse, urethral stricture, phimosis, bladder stones, laborious urination, abdominal surgery, trauma and other history of hernia incarcerated.

2. Physical examination: Note whether there is abnormal swelling or depression in the abdomen, ascites, enlarged liver and spleen, and prominent lump when standing. The elderly should be checked for prostate hypertrophy. Does the chest have restricted breathing on one side, reduced breathing sounds, full intercostal space, and whether you can hear bowel sounds or water bouncing signs in the chest? Inguinal hernia should pay attention to the shape of the hernia and the size of the hernia ring, whether the content drops into the scrotum and can be reset when standing or coughing. It is important to know if there is stenosis or incarceration and to determine the type of hernia. It should be distinguished from other diseases in the scrotum. Those with suspected scrotal fluid should be tested for light transmission.

3. Auxiliary examination: see through the chest for lung disease. Those with suspected diaphragmatic hernia should take a positive and lateral chest radiograph, and check for barium meal and barium enema to confirm the diagnosis.

Abdominal hernia IV. Principles of treatment:

1. Find and treat the cause of the disease.

2. Inguinal hernias in children over 2 years of age who do not have a tendency to heal should be surgically ligated with hernia sacs. Infant umbilical hernias can be self-healed after long-term pressure reduction with bandages.

3. Small inguinal hernias in children and adolescents. After the hernia sac is ligated high, the spermatic cord need not be displaced during repair. In young adults, the spermatic cord should be shifted to the external oblique fascia. In old age and huge oblique inguinal hernias, the repair of the posterior wall of the inguinal canal must be strengthened, and the spermatic cord must be displaced subcutaneously.

4, the femoral hernia can be made above or below the inguinal ligament, do not damage the contents of the hernia, after the hernia sac resection and suture, the inguinal ligament, pit ligament and cooper ligament (Cooper ligament) suture under the inguinal ligament Together to close the loop. When a hernia is suspected, an incision above the inguinal ligament is appropriate.

5. If the white line hernia is painful, repair the white line hole.

6. Diaphragmatic hernias can be repaired from the thoracic cavity or abdominal cavity by repairing the abdominal muscles after the contents of the abdominal cavity have been received.

7, incarcerated or strangulated hernia, surgery should be performed immediately, but if self-reset after preoperative medication or anesthesia, should be closely observed for 24 hours, according to the condition of the operation time. Except in children under 2 years old who can be reset manually within 4 hours of onset, it should not be forcibly reset.