Diseases

Hernia

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Carola Felchner

Carola Felchner is a freelance author at lifelikeinc.com and a certified exercise and nutritionist. She worked at various trade magazines and online portals before becoming self-employed in 2015 as a journalist. Before her traineeship, she studied translating and interpreting in Kempten and Munich.

More about the lifelikeinc.com experts hernia (Inguinal hernia, inguinal hernia) arises when layers of the abdominal wall break through the inguinal canal. A typical symptom is a palpable swelling, similar to a bump that can often be pushed inwards. Also pain can occur, which increase under stress. In most cases, the patients are male. A hernia in women or girls is less common. The therapy usually consists of surgery. Read more here: What is a hernia exactly? How can one recognize a hernia? How is he diagnosed and treated?

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. K40ArtikelübersichtLeistenbruch

  • symptoms
  • Causes and risk factors
  • Examination and diagnosis
  • General information on inguinal hernia treatment
  • Hernia surgery
  • Course and prognosis

Inguinal hernia: short overview

  • Important symptoms: visible and palpable swelling in the groin, pulling and possibly pain, which become stronger under stress
  • Reason: Weakness in the abdominal wall (innate or acquired)
  • Risk factors: severe pressure load (sneezing, coughing, pressing with defecation, lifting of heavy loads etc.), tissue weakness, diabetes mellitus, asthma, COPD, cystic fibrosis (cystic fibrosis)
  • complications: entrapment
  • Treatment: usually surgery. In men with a hernia that shows no symptoms and does not increase, it is also possible to wait and see the hernia.
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Inguinal hernia: symptoms

Even if the term suggests otherwise: In a hernia (inguinal hernia) no bone is broken, but it is pierced tissue in the groin - the so-called inguinal canal. This tubular connection between the abdominal cavity and the outer pubic region draws obliquely from back to front. In this channel run blood and lymph vessels and the spermatic cord in the man and one of the mother tapes in the woman.

If this inguinal canal is punctured by a hernia, this can be recognized by a visible and / or palpable swelling in the grointhat can often be pushed inwards. Sometimes the genital region is also affected by inguinal hernia: In the case of a woman, the swelling can then occur in the area of ​​the labia, in the man on the scrotum.

In most cases, the inguinal hernia symptoms (woman & man) are on the right side.

Inguinal hernia: pain

In many cases, the inguinal hernia causes no pain. Those affected report more of an indefinite feeling of pressure or a pulling, sometimes of abdominal pain or a foreign body sensation in the groin.

If inguinal hernias occur, they can drag into the testicles or labia. Increases the abdominal pressure, for example, when coughing or lifting loads, the complaints increase. At rest and while lying on the inguinal hernia symptoms. So if someone is more in pain lying down / at night, it is usually not a hernia. Instead, for example, a hip joint or muscle disease behind it.

Both pain and swelling increase during exercise. In the case of particularly intense inguinal hernia signs, tissue may already be trapped. Then you should immediately go to the doctor!

Inguinal hernia symptoms in children

Recognizing a hernia in children is not always easy. Often, parents accidentally discover visible swelling in the groin or genital area as they bathe, dress or undress their child. When pushing on the child reacts sensitively. Other signs of a hernia in children may be:

  • Tearfulness or seemingly groundless crying (especially by baby and toddler)
  • Refusal to eat
  • great restlessness

Pinched hernia: warning symptoms!

In rare cases, inguinal hernias (such as bowel loops) are trapped in a hernia. These are then no longer sufficiently supplied with blood and can die off. The symptoms of a hernia with entrapment are much more intense, for example:

  • strong pain
  • Redness of the site
  • Nausea and vomiting

If someone shows such symptoms, one must immediately alert a doctor. It threatens a bowel obstruction and a life-threatening peritonitis!

Severe pain in a hernia is a symptom of there are (dangerous) complications. Go to the doctor immediately!

  • "Not every hernia has to be operated on immediately"

    Three questions

    Dr. med. Joachim Conze,
    Specialist in surgery and visceral surgery
  • 1

    Why do men in particular get a hernia?

    Dr. med. Joachim Conze

    This is due to the testicle development. The gonads develop in the body and migrate through the groin into the scrotum - this is then the weak point. Overall, it is believed that every fifth man can develop a hernia. Striking is a familial accumulation, that is, if the father or grandfather had a hernia, their own chance is higher.

  • 2

    Must always be operated on?

    Dr. med. Joachim Conze

    It used to be thought that way. In the meantime, it is known that the risk of entrapment in men with a non-painful (asymptomatic or less symptomatic) hernia is less than one percent. If there is only a small protrusion and there are no other complaints, it is also an active waiting, the "Watchful Waiting" possible. That is, every six to nine months is controlled, of course, immediately with complaints.

  • 3

    Must always be operated on?

    Dr. med. Joachim Conze

    It used to be thought that way. In the meantime, it is known that the risk of entrapment in men with a non-painful (asymptomatic or less symptomatic) hernia is less than one percent. So today is a therapeutic option for men who have only a small protrusion and otherwise no complaints, also an active waiting, the so-called "Watchful Waiting". However, patients should be checked regularly, every six to nine months, in case of complaints, of course, immediately.

  • Dr. med. Joachim Conze,
    Specialist in surgery and visceral surgery

    Dr. med. Joachim Conze leads the hernia center Conze in Munich. He is a founding member of the German Hernia Society (DHG) and was a member of the EHS Board for many years.

To the table of contents

Inguinal hernia: causes and risk factors

The abdomen is largely closed and lined with a fine skin, the peritoneum. It houses organs such as the stomach, liver and intestine. Gravity pulls the organs down. The abdominal wall holds her in position. But especially in the lower abdominal area there is still a certain pressure.

This pressure is also felt by the inguinal canal. Especially when lifting heavy loads, sneezing, coughing or pressing (such as when defecating), the abdominal organs press on the inguinal canal. Normally, he can withstand the strain - thanks to the powerful muscles, ligaments and tight connective tissue surrounding him.

But if the pressure becomes too great, a gap in the inguinal tissue (hernial): The peritoneum bulges at this point baggy outward. That is why one speaks of one sac, Sometimes also entrails occur (usually parts of the intestine) - enclosed by the fracture sac- through the gap and out of the abdomen (breaking content).

This happens at the herniaIn a hernia, the pressure of the abdominal organs (for example, when coughing, sneezing or lifting heavy loads) on the inguinal tissue is too large and the inguinal canal breaks. The peritoneum then bulges outwards and it can happen that parts of the intestine escape through the gap in the inguinal canal.

Indirect and direct inguinal hernia

Most patients have one indirect inguinal hernia: Here, the hernia sac occurs laterally through the inguinal canal and can penetrate to the scrotum or labia.

The indirect inguinal hernia is innate in most cases: it is then based on an incompletely closed inguinal canal. Normally, the inguinal canal is lined by the peritoneum until it returns to birth and usually closes completely until the end of the first year of life. If this does not happen, often a congenital indirect inguinal hernia arises. Babies, children and young people are the most affected, boys more often than girls.

Rarely, an indirect hernia develops later in life (acquired indirect inguinal hernia).

In contrast, the direct inguinal hernia always purchased. It arises from a weak spot in the wall of the inguinal canal. The fractured bag pushes directly through the abdominal wall, so it does not reach the genital region. Various factors can favor this wall weakness and thus the direct inguinal hernia (such as surgery or various diseases: see below). Mostly, adults develop this form of inguinal hernia. Women are relatively rarely affected. As a rule, the patients are older men.

risk factors

There are several factors that favor inguinal hernia, such as tissue weakness (such as Marfan syndrome) or abdominal pressure (such as constipation or constant coughing in heavy smokers or COPD). These risk factors for inguinal hernia include:

  • Diverticulosis (protuberance of the intestinal wall)
  • Varicose veins
  • Marfan syndrome (genetic connective tissue disease)
  • Diabetes (diabetes mellitus)
  • asthma
  • COPD
  • cystic fibrosis (cystic fibrosis)
  • overweight
  • Smoke
  • Malformations of the urinary tract and genitals

In children it can be through umbilical hernia (Omphalocele) or one prolapse (Gastroschisis) come to an increased pressure in the abdomen. The possible consequence of this is a hernia. In the pregnancy weight bearing in the groin can cause a hernia. Children who as premature birth were also more susceptible to inguinal hernia.

In addition, the hernia occurs frequently in some families. This suggests that the Gene to play a role.

To the table of contents

Inguinal hernia: examinations and diagnosis

If a hernia is suspected, go quickly to the doctor. The first point of contact can be the family doctor or pediatrician. However, a inguinal hernia is usually treated by specialized surgeons.

First, the doctor will raise the medical history in the so-called anamnesis interview. For example, he can ask the following questions:

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