Related articles: Inguinal hernia
Definition
An inguinal hernia is a protrusion of part of the intestine through the abdominal wall, at the level of the groin. Usually, it develops in correspondence of a zone of weakness of the muscular and connective tissues, which does not allow the containment of the viscera in their natural cavity ( direct hernia ). The intestine can also protrude through the inguinal canal by descending into the scrotal sac in man and the large lip in the woman ( indirect hernia ).
Factors that can contribute to the development of the inguinal hernia include a constitutional or acquired weakening of the connective tissue, overweight, trauma and the type of work (eg activities involving the lifting of heavy objects).
Most common symptoms and signs *
- Ascites
- Colic
- Abdominal cramps
- Abdominal pain
- Abdominal pain on palpation
- Groin pain
- Testicular pain
- Sore legs
- Abdominal swelling
- Freckles
- Abdominal mass
- Mass or swelling in the groin
- Nausea
- Sense of testicle discomfort
- He retched
Further indications
In most cases, an inguinal hernia causes only a visible swelling, which can cause a vague discomfort or can be asymptomatic.
Over the months, this swelling evolves, becoming more and more prominent and causing local disorders: pain in the groin, burning and feeling of weight or foreign body. Painful symptoms can extend to the testicles, scrotum and leg.
The most serious complication is determined by the compression of the part of the intestine which comes out of the inguinal breccia (incarcerated or strangled hernia). In this case, the protrusion causes fixed, gradually increasing pain, typically with nausea and vomiting. In addition to causing very severe pain, impaired blood supply to the small intestine can lead to necrosis and perforation with inflammation of the entire abdominal cavity (peritonitis).
The diagnosis is clinical. The hernia is evident only with the increase in abdominal pressure, therefore the patient must be visited in the standing position and is invited to an effort or a cough. On palpation of the abdominal wall, the hernia appears as a soft swelling of variable volume. If the physical examination is doubtful, an ultrasound scan can be performed. The differential diagnosis must be made with respect to an adenopathy (infectious or malignant), an ectopic testis and a lipoma. In general, however, these masses are solid and cannot be reduced.
The conservative treatment is temporary and involves the application of a containment device (cinto erniario) that keeps the viscera in its cavity. If this approach becomes insufficient, a surgical repair through a standard or laparoscopic incision can restore the integrity of the anatomical structures. Surgical treatment of complicated hernia (clogged and choked) must be performed urgently.
