A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it.
- Inguinal Hernia: This is a weakness where the spermatic cord in men and the round ligament in women passes through the abdominal wall in the groin area, more common men
- Femoral Hernia: This Protrusion of the intestines through the femoral ring, common in women.
- Umbilical Hernia: This occurs most often in children when umbilical opening fails to close adequately but can occur in adults in an area where the rectus muscle is weak.
- Incision Hernia: This occurs due to weakness in the abdominal wall as result of previous incision.
- Reducible Hernia: These are hernias that can be replaced into the abdominal cavity by manual Manipulation..
- Incarcerated Hernia: These are the types of hernia that cannot be manually replaced back into the abdominal cavity.
- Strangulated Hernia: In these types, blood supply and intestinal flow in the herniated area are obstructed, this can easily lead to intestinal obstruction.
- Weakness of the abdominal wall
- Increase intra abdominal wall pressure
- Over weight (Obesity)
- Chronic ulcers
- Heavy lifting
- Tumor Especially in the abdominal cavity
- Swelling in the affected area
- Intestinal Obstruction
- Clinical manifestation
- Radiological examination
- Abdominal X-ray reveals high levels the bowl
- Elevated white blood cell if incarcerated.
in reducible hernia, a truss which is an appliance with a pad and belt is held over a hernia to prevent abdominal contends from entering the hernia sac. a truss provides external compression over the defect and should be removed at night and re-applied in the morning before the patient arises.
Surgery: This is recommended to correct hernia before strangulation occurs. Some surgical procedures are;
Herniorrhaphy: this is removal of hernia sac. The contents are replaced into the abdomen and layers of the
Herniorrhapy: This is the removal of hernia sac. The contents are replaced into the abdomen and layers of the muscles and facial sutured.
Hernioplasty: This involves re-enforcement of suturing for extensive hernia repair.
Strangulated hernia requires resection of ischemia bowel in addition to repair of hernia.
- Place patient in c comfortable position to reduce pressure on hernia.
- Encourage bed rest, intermittent ice parks, and scrotal elevation to reduce scrotal edema or swelling after repair.
- Advice patient that difficultly in urinating is common after surgery, promote elimination to avoid discomfort and catheterize if necessary.
- Check dressing for drainage and incision for redness and swelling.
- Insert NG tube, if ordered, to relieve intra abdominal pressure.
- Give stool softeners as directed.
- Encourage ambulation as soon as permitted.
- Monitor for signs and symptoms of infection such as fever, chills, malaise and diaphoresis.
- Administer antibiotics if appropriate.
- Advice patient to take medication as prescribed to relieve discomfort and inform patient to avoid heavy lifting.
- Pain related to bulging hernia, evidence by patients complain.
- Acute pain related to surgical incision evidence by patients verbalization.
- Risk of infection related to strangulated or incarcerated hernia.
- Intestinal obstruction.