In an inguinal hernia, abdominal fat or a loop of minor intestine enters the inguinal canal, a tubular passage through the lower layers of the intestinal wall.A hernia occurs when function of an internal organ (usually the pocket-sized intestine) protrudes through a weak point or tear in the peritoneum, the thin muscular wall holding the abdominal organs in place resulting in a bulge. In men, inguinal hernias typically develop in the groin area nearly the scrotum, on one or both (double hernia) sides.

Hernia repairs are common—more than one million hernia repairs are performed each year in the U.S. Approximately 800,000 are to repair inguinal hernias and the rest are for other types of hernias.Repair of Inguinal hernias is among the nigh often performed surgeries in the U.S.

Blausen 0560 Inguinalhernia

Image Credit: "Blausen 0560 InguinalHernia" by BruceBlaus

Signs and Symptoms

Symptoms of an inguinal hernia include:

  • A small-scale bulge in one or both sides of the groin that may increase in size and disappear when lying downwards; in males, it tin present every bit a swollen or enlarged scrotum
  • Discomfort or abrupt pain-peculiarly when straining, lifting, or exercising-that improves when resting
  • A feeling of weakness or pressure in the groin
  • A burning, gurgling, or aching feeling at the burl

Incidence

An inguinal hernia may arise at any time from infancy to machismo. However, information technology is far more common in males  with a lifetime risk of  27% in men and 3% in women. Some individuals are built-in with weak abdominal muscles and are more likely to develop a hernia. Others are caused by excessive strain on the abdominal wall from heavy lifting, weight gain, coughing, or difficulty with bowel movements and urination.

Types

Direct Inguinal Hernias

Direct inguinal hernias are caused by connective tissue degeneration of the intestinal muscles, which causes weakening of the muscles during the developed years. Direct inguinal hernias occur only in males. The hernia involves fat or the small intestine sliding through the weak muscles into the groin. A direct hernia develops gradually because of continuous stress on the muscles.

Any action or condition which increases pressure level in the intra-abdominal cavity may contribute to the germination of a hernia, including:

  • Obesity
  • Heavy lifting
  • Coughing
  • Straining with urination or defecation
  • Chronic obstructive pulmonary disease (COPD)
  • Ascites
  • Peritoneal dialysis
  • Ventriculoperitoneal shunt

Indirect Inguinal Hernias

Indirect inguinal hernias are built hernias and are much more common in males than females because of the style males develop in the womb. In a male fetus, the spermatic string and both testicles-starting from an intra-intestinal location-normally descend through the inguinal canal into the scrotum, the sac that holds the testicles.

Sometimes the entrance of the inguinal canal at the inguinal ring does not close equally information technology should but after birth, leaving a weakness in the abdominal wall. Fat or function of the pocket-size intestine slides through the weakness into the inguinal culvert, causing a hernia. In females, an indirect inguinal hernia is caused by the female organs or the small-scale intestine sliding into the groin through a weakness in the intestinal wall.

Indirect hernias are the most mutual type of inguinal hernia. Premature infants are especially at run a risk for indirect inguinal hernias because there is less time for the inguinal canal to close.

"Incarcerated" and "Strangulated" Inguinal Hernias

An incarcerated inguinal hernia is a hernia that becomes stuck in the groin or scrotum and cannot be massaged dorsum into the abdomen. An incarcerated hernia is caused by swelling and can pb to a strangulated hernia, in which the blood supply to the incarcerated modest intestine is jeopardized. A strangulated hernia is a serious status and requires immediate medical attending. Symptoms of a strangulated hernia include:

  • Extreme tenderness and redness in the area of the burl
  • Sudden hurting that worsens in a short period of time
  • Fever
  • Rapid heart charge per unit

Left untreated, nausea, vomiting, and severe infection can occur. If surgery is not performed right away, the condition can get life threatening, and the affected intestine may die. Then that portion of the intestine must be removed.

Diagnosis

To diagnose inguinal hernia, the doc takes a thorough medical history and conducts a physical examination. The person may be asked to stand and coughing so the medico can experience the hernia every bit it moves into the groin or scrotum. The doctor checks to come across if the hernia tin be gently massaged dorsum into its proper position in the abdomen.

Treatment

In adults, inguinal hernias that enlarge, crusade symptoms, or become incarcerated are treated surgically. In infants and children, inguinal hernias are ever operated on to foreclose incarceration from occurring. Surgery is usually washed on an outpatient basis. Recovery time varies depending on the size of the hernia, the technique used, and the historic period and health of the patient. The two main types of surgery for hernias are as follows:

Open Hernia Repair

In open hernia repair, likewise chosen herniorrhaphy, a person is given local anesthesia in the abdomen or spine to numb the area, full general anesthesia to sedate or assist the person sleep, or a combination of the two. Then the surgeon makes an incision in the groin, moves the hernia back into the belly, and reinforces the muscle wall with stitches. Unremarkably the surface area of muscle weakness is reinforced with a synthetic mesh or screen to provide additional support-an performance called hernioplasty.

Laparoscopic Inguinal Hernia Repair

Laparoscopic surgery is performed using general anesthesia. The surgeon makes several small incisions in the lower abdomen and inserts a laparoscope-a thin tube with a tiny video photographic camera fastened to one finish. The camera sends a magnified paradigm from inside the torso to a monitor, giving the surgeon a close-up view of the hernia and surrounding tissue. While viewing the monitor, the surgeon uses instruments to carefully repair the hernia using constructed mesh.

People who undergo laparoscopic surgery generally feel a somewhat shorter recovery time. However, the doctor may determine laparoscopic surgery is not the best option if the hernia is very big or the person has had pelvic surgery.

Most adults feel discomfort after surgery and require pain medication. Vigorous activity and heavy lifting are restricted for several weeks. The physician will discuss when a person may safely return to work. Infants and children likewise experience some discomfort but usually resume normal activities after several days.

Potential Complications

Surgery to repair an inguinal hernia is by and large prophylactic and complications are uncommon. Knowing possible risks allows patients to report postoperative symptoms to their medico as presently as they occur.

  • Risk of general anesthesia. Before surgery, the anesthesiologist-a doc who administers anesthesia-reviews the risks of anesthesia with the patient and asks nigh medical history and allergies to medications. Complications almost likely occur in older people and those with other medical weather. Mutual complications include nausea, vomiting, urinary retention, sore pharynx, and headache. More than serious problems include eye attack, stroke, pneumonia, and blood clots in the legs.

    Getting out of bed afterwards surgery and moving as soon as the doctor allows will help reduce the risk of complications such equally pneumonia and blood clots.

  • Hernia recurrence. A hernia can recur upward to several years after repair. Recurrence is the most common complication of inguinal hernia repair, causing patients to undergo a second functioning.

  • Haemorrhage. Bleeding inside the incision is another complication of inguinal hernia repair. Information technology tin can cause severe swelling and blueish discoloration of the skin around the incision. Surgery may be necessary to open the incision and stop the bleeding. Bleeding is unusual and occurs in less than 2 per centum of patients.

  • Wound infection. The risk of wound infection is pocket-sized-less than 2 percent-and is more likely to occur in older adults and people who undergo more complex hernia repair.ii The person may experience a fever, discharge from the incision, and redness, swelling, or tenderness around the incision. Postoperative infection requires antibiotics and, occasionally, some other process requiring local anesthesia to make a small opening in the incision and bleed the infection.

  • Painful scar. Sometimes people feel abrupt, tingling pain in a specific area near the incision after it has healed. The pain normally resolves with time. Medicine may exist injected in the area if the pain continues.

  • Injury to internal organs. Although extremely rare, injury to the intestine, bladder, kidneys, fretfulness and blood vessels leading to the legs, internal female organs, and vas deferens-the tube that carries sperm-can occur during hernia surgery and may lead to more operations.

For More Data

Inguinal and Femoral Hernia Repair (American College of Surgeons)

Inguinal and Femoral Hernia Repair (American College of Surgeons) español