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Inguinal Hernia

What is Inguinal hernia?

The inguinal region refers to the groin.This is the region where the lower abdomen joins the thigh.The abdominal wall is a strong muscular shell within which the internal organs are safely encased.When the muscular wall develops weakness it can thin out and allow the internal organs to protrude out of it.This is just like a cycle inner tube bulging through a weak spot in the tyre.This is called ‘hernia’.The groin is a common site for occurrence of hernia.

Why is the groin a common site for hernia?

Before birth, the testes (male sex organs) develop inside the baby’s abdomen. A few weeks before delivery these testes descend down and out of the abdomen through a gap in the muscle of the groin called the ‘inguinal canal’. When they do so they also drag their blood vessels and nerve supply along with them. So the groin musculature always has a natural ‘weak spot’ or gap to allow for the testicular blood vessels to pass through. This gap is usually a snug one and does not allow any other internal organs to slip out through it. But when the muscle becomes weak due to various reasons like old age, excess strain etc, this gap widens and the internal organs like the intestines start to slip out of the abdomen into the groin causing a bulge called hernia.

What are the symptoms of Inguinal Hernia?

Hernia usually causes a bulge in the groin.This can be painless initially and noticed on sanding up or coughing or lifting some weights.As the gap widens, more and more of the internal contents slip out and the bulge becomes very prominent.It can cause a dragging pain because of the pull of the intestines hanging out. When a hernia develops complications it can become very painful.

What are the complications of hernia?

The internal organs like the intestines are safe as long as they are encased inside the abdomen.Once they slip out through a hernia they can get twisted or kinked. This causes a block in the flow of food through the intestine and causes severe pain and vomiting. This is called an ‘obstructed hernia’.Sometimes because of the twisting of the loop of intestine the blood supply to the intestine can get decreased causing the intestine to undergo gangrene. This is a life-threatening emergency and unless operated on immediately can be fatal.

Do all hernias need treatment?

Yes. In the light of the potential complications which can be life-threatening sometimes all hernias need to be treated at the earliest.

What are the treatment options for hernia?
A hernia is a physical gap through which organs slide out.There is no medical treatment for this. Measures to keep the hernia inside by applying pressure devices on the skin like a ‘truss’ are dangerous, as they can cause gangrene.
The simplest solution for a hernia is surgery.In this, the contents which have escaped out are returned back into the abdominal cavity and the hernia or the defect is closed with stitches. A prosthetic mesh is placed over the defect and fixed to reinforce the repair and prevent future recurrence.

What are the surgical options for the treatment of hernia?

There are two major types of hernia repair viz.open hernioplasty and the laparoscopic repair.Nowadays most inguinal hernia s are treated by laparoscopy.This is done by placing three small holes in the abdomen and the hernia is repaired from inside and a mesh placed and fixed.
The recovery time after a laparoscopic repair is fast and patient goes home the next morning of the surgery.He or She is fit to resume the normal activities and attend office 3 to 4 days after the operation.The pain is also minimal in this approach.These advantages have made laparoscopic hernia repair very popular and when done by experts the results are excellent.

 

Authored By Dr G Parthasarathy - Surgical Gastroenterologist, Hyderabad