What treatment should be adopted for small intestinal hernia?

Etiology and treatment of hernia (hernia, intestinal gas)

Etiology:

Decreased abdominal wall strength:

1, congenital: patent peritoneal sheath process, high inferior margin of internal oblique muscle, etc.

2. Acquired: a) poor healing of surgical incision or drainage port b) increased intra-abdominal pressure such as trauma, inflammation and infection.

3. Chronic cough, chronic constipation, dysuria, late pregnancy, ascites, weight lifting, frequent crying of babies and intra-abdominal tumors.

Clinical type:

Easily reducible hernia: it means that the contents of hernia can be easily and completely reintegrated into abdominal cavity. When the temporary intra-abdominal pressure suddenly rises, it will be herniated, which can be brought back to the abdominal cavity by lying down naturally or nudging with your hand.

Irreducible hernia: refers to the hernia contents can not be completely incorporated into the abdominal cavity, but it does not cause serious clinical symptoms.

Incarcerated hernia: when the hernia ring is small, the abdominal pressure suddenly increases, and the contents of the hernia forcibly expand the neck of the hernia into the hernia sac, and then the contents of the hernia are tightly clamped because of the retraction of the neck of the hernia, making it impossible to recover.

Strangulated hernia: If incarcerated hernia cannot be relieved in time, it is called strangulated hernia when the contents of incarcerated hernia have blood circulation disorder or even necrosis.

Clinical symptoms:

1, reversible mass in inguinal region, sometimes falling into scrotum.

2, occasionally local swelling and pain, generally no special discomfort. With the development of the disease, the mass can gradually increase, affecting daily life. Sliding hernia is more common on the right side, and the incidence rate is about 1: 6. The sudden enlargement of the incarcerated hernia mass is accompanied by obvious pain and tenderness, and the contents of the hernia cannot be recovered. If accompanied by blood supply disorder, the clinical symptoms of strangulated hernia will appear, and if not treated in time, there will even be complications such as intestinal necrosis and intestinal fistula, which are life-threatening.

Treatment:

1. Surgical treatment: The most effective treatment for inguinal region is surgical repair. Surgical methods can be divided into the following three types:

Traditional hernia repair: high ligation of hernia sac, hernia repair (strengthening the anterior wall and posterior wall of inguinal canal) and hernia plasty; The operation is proved to be effective and reliable in clinic. However, the surgical trauma is large, and most of them need to change the normal anatomical relationship.

Tension-free hernia repair: artificial patch hernia repair is widely used in clinic at present. It has the characteristics of little trauma, no tension and no need to change the normal anatomical relationship, and can repair oblique hernia and straight hernia triangle at one time.

Laparoscopic inguinal hernia repair (LRIH): (Recommended) The advantages are obvious. It can achieve the purpose of high ligation of hernia sac and strengthening the repair of the posterior wall of inguinal canal. The key point is to avoid damaging the physiological anatomy of inguinal canal area and achieve tension-free repair, with short operation time and rapid postoperative recovery. Generally speaking, this operation only performs high ligation on patients younger than 13 years old, and no repair is needed; /kloc-patients over 0/3 years old should be repaired at the same time of high ligation.

2. Non-surgical treatment:

/kloc-infants under 0/year old can temporarily not have surgery; Non-surgical treatment can be used for the elderly and infirm or those with serious diseases who are contraindicated for surgery.

Suggestion: It is generally necessary for a specialist to diagnose and treat, and then decide which treatment scheme to adopt according to the actual situation of the patient.