IN SAFE HANDS

A hernia is the abnormal exit of tissue of the abdominal cavity (with organs or without them) through inborn or aquired weak spot on the abdominal wall (navel cavity, groin). Hernias of the abdominal wall represent one of the most common pathological conditions amongst humans. It is estimated that one in ten persons in the world would have a hernia throughout their life. Hernias are one of the most frequent illnesses, which can only be treated by surgical interventions. Today, this is one a routine surgery in the field of general surgery.

Hernias can be inborn and they appear in children when some openings (navel cavity, groin) on the abdominal wall are not completely closed. They are most evident postpartum. These hernias usually withdraw when the child begins walking and strenghtens abdominal musles. Hernias can be acquired. They appear in grown ups when abdominal cavities expand and form a defect in the musculo-aponeurotic and fascial structures through which tissue abnormaly exits. Third major group of hernias are postoperative hernias which appear when operative wounds in the abdominal area do not heal completely.

What are hernias and how do they appear?

Hernia types

Depending on the location on the abdominal wall there exist:

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Groin hernia (hernia inguinalis)

appears as a bulge in the groin. It accounts for 75% of all abdominal hernias and it appears in 15% of male population. It is more common in males than in females (12:1), and its frequency hightens as the age of the patient progresses: 5-8% for people aged 25-40; 23% for people aged 60-71; and >30% for people over the age of 80. Hernias most typically apear between the ages of 55 and 85 in the right groin area. The exit of the abdominal tissue through the weakend area on the groin froms a hernia sac. The abdominal organs (most commonly the colon) can enter the sac whcih causes swelling in the groin. If the hernia is left untreated for a long period of time it can drop to the testicals when it becomes inguinal-scrotal (hernia inguinoscrotalis). The inguinal hernia surgery is a routine surgery in the filed of general surgery.

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Femoral, femoral or femoral hernia

appears as a bulge in the upper inner part of the tigh beneath the inguinal ligament. The hernia appears in the passage where femoral artery, vein, and nerve are also locaded when exiting the abdominal cavity and enter the upper leg. Usually this space is narrow, however at tiems it can be wide to the extent that orgains of the abdominal cavity exit through it. Contrary to the groin hernia, this type most frequently occurs in women (7:1), and there is a higher risk of complications (clamping).

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Navel hernia (hernia umbillicalis)

appears as a bulge in the navel area. Most commonly it develops in children due to the natural weakness of the frontal abdominal wall; and in most cases it spontaneously disappears when children begin waliking. A navel hernia may appear in later stges of life because the abdominal musles weaken. It is somewhat more frequent in women (2:1). This is linked to the pregnancies, and the increased pressure in this area.

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Epigastric hernia
(hernia epigastrica)

appears as a small bulge in the mid-abdominal line (linea alba); between the navel cavity and the lower rib arch. Ths herina contains fat tissue, and very rarely contains the colon. It develops in zone of the white line, the aponeurosis that connects the two right abdominal muscles (rectus abdominis). This hernia is often painful because of the hernia opening.

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Semilunar line hernia or
Spiegel's hernia

is a rare and herdly deteced type. It passes through the aponeurotic layer located between the rectus and oblique muscles laterally below the navel level.It can develop on both sides of the abdominal wall as a small swelling laterally along the lateral edge of the right abdominal muscle.

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Postoperative or incisional hernia (hernia incisionalis)

develops in the area around the scarring from prior surgical interventions which include opening the abdominal wall and cavity. They can dvelop even after minimally invasive procedures. This type of hernias develops in about 20% cases after the surgical procedure.