Does anyone know what a leaky hernia is? Does it matter?

The formation of hernia [shàn], English hernia; Commonly known as hernia, the picture shows that a part of human tissue or organ leaves the original part and enters another part through a gap, defect or weak part of the human body. There are umbilical hernia, straight inguinal hernia, oblique hernia, incision hernia, recurrent hernia, white line hernia, femoral hernia and so on. Hernia is mostly caused by coughing, sneezing, overexertion, abdominal obesity, forced defecation, pregnancy of women, excessive crying of children, and deterioration of abdominal wall strength of the elderly. Clinical manifestations are divided into direct inguinal hernia, indirect inguinal hernia, femoral hernia, umbilical hernia, white line hernia, incision hernia, incarcerated hernia, strangulated hernia and so on. General symptoms: protruding when standing, disappearing after lying on your back, and returning to abdominal cavity after pressing. However, incarcerated hernia and strangulated hernia are painful and difficult to push back to abdominal cavity. Hernia, if left unchecked, is prone to adhesion and incarceration, so it should be treated as soon as possible. [Edit this paragraph] Type of hernia (according to the affected part) Inguinal hernia: This kind of hernia can occur at any age, but the peak occurs in early childhood, and 80%-90% occurs in boys, followed by the elderly. Abdominal hernia: this kind of hernia mainly occurs around the navel, mostly in women. Most of them occur between the ages of 20 and 50. Umbilical hernia: it occurs at the navel, and the inner side of the navel is ring-shaped. Umbilical hernia 10%-20% occurred in infants, followed by adult women. Vaginal hernia (scrotum bulging): Male occurs in the scrotum, which leads to scrotum bulging, and in severe cases, it is obviously swollen, making it extremely inconvenient to walk. Women occur in the ovary, which causes obvious swelling of the lower body and pain. Incisional hernia: This hernia occurs at the scar of the original surgical incision. Incisional hernia may occur months or years after surgery. [Edit this paragraph] The harm of hernia first affects the digestive system of patients, with symptoms such as abdominal bulge, abdominal distension, abdominal pain, constipation, nutrient malabsorption, fatigue and physical decline. Because the groin is adjacent to the genitourinary system, elderly patients are prone to bladder or prostate diseases such as frequent urination, urgency and nocturia. Children will affect the normal development of testicles because of the extrusion of hernia; Young and middle-aged patients are prone to sexual dysfunction. Moreover, the intestinal tube or omentum in hernia sac is easy to be squeezed or collided, causing inflammatory swelling, making it difficult for hernia to be readmitted to hospital, leading to dangerous situations such as hernia incarceration, intestinal obstruction and intestinal necrosis. [Edit this paragraph] Hernia treatment methods 1, conservative treatment Conservative treatment mainly includes drug treatment and hernia belt treatment: it can relieve symptoms such as abdominal distension, abdominal pain and constipation caused by hernia, thus relieving hernia; The disadvantage is that hernia can not be controlled. Commonly used Chinese patent medicines include Hernia Neixiao Pill, He Ju Pill, Buzhong Yiqi Pill, etc. Or grind cinnamon into vinegar and apply it to the navel with gauze. Hernia band therapy: it can quickly prevent hernia from protruding, thus effectively preventing the development of hernia and relieving symptoms such as abdominal distension, abdominal pain and constipation caused by hernia. Hernia band therapy can be cured and cured. The disadvantage is that it can only treat reversible small intestinal hernia, but not water hernia. 2. Surgical treatment There are three types of hernia repair: hernia repair, hernia repair and laparoscopic hernia repair: repair the hernia ring by suturing the tissues around the defect; Cover the defect with patch material and repair the hernia ring; Laparoscopic hernia repair: it is a method to complete hernia repair through endoscope to relieve hernia pain. The root above the thigh, medically called "groin", is the most prone part of male hernia. Oblique hernia often protrudes from the inguinal canal of the lower abdominal wall or directly enters the scrotum. This kind of hernia is characterized by occasional lumps, often standing, walking or coughing, especially when doing heavy physical labor, local swelling and discomfort often occur. At this time, you should stop working immediately, rest in bed, breathe smoothly, and the pain will slowly return to the abdominal cavity. If the tumor does not disappear after rest, you can slowly push the tumor back to the abdominal cavity by hand. For hernia that can't be recovered by the above methods, you can also try to raise your hips or lower your head and raise your feet, and then push the hernia block slowly and continuously to the abdominal cavity with your hands, gently to prevent intestinal rupture. For patients with hernia after reduction, especially those with hernia for a long time, we must pay attention to the abdominal situation. If abdominal pain is aggravated, and there is tenderness and rebound pain locally, you should go to the hospital immediately, and surgery may be needed. Another kind of hernia that cannot be reinjected is called incarcerated hernia. At this time, the pain will be aggravated and the lump will become tense and hard. If incarceration lasts for a long time, don't blindly push the lump back into the abdominal cavity. Because the incarcerated intestine may have ischemic necrosis, if it is forcibly pushed back into the abdominal cavity, there may be a risk of intestinal necrosis and perforation. For such patients, they should go to the hospital for treatment immediately, and there should be no luck, so as not to delay treatment. For patients with recurrent hernia, it is necessary to choose the right time and achieve the goal of radical cure through surgical repair. [Edit this paragraph] Comparison between three surgical treatments and traditional hernia repair: there are 1 large incision (about 6 ~ 8cm)； long); Need to be hospitalized for about 7 ~ 10 days; Routine anti-infection; Postoperative pain and other discomfort are common; The recurrence rate is about 20%; The complete recovery time of common hernia is about 3 months, and that of extra-large hernia is 6 ~ 12 months. Tension-free repair of hernia patch: medium incision 1 piece (about 4 ~ 6cm)； long); Need to be hospitalized for about 3 ~ 7 days; Routine anti-infection; The recurrence rate is about 65438 0%. The complete recovery time of common hernia is about 1 month, and that of extra-large hernia is 3 ~ 6 months. Laparoscopic hernia repair: there are 3 small incisions (about1cm); Need to be hospitalized for about 4 ~ 7 days; Routine anti-infection; General anesthesia is needed, and there may be complications such as puncture and injury caused by pneumoperitoneum; The recurrence rate is about 10%. The complete recovery time of common hernia is about 1 month, and that of extra-large hernia is 3 ~ 6 months. [Edit this paragraph] How to choose the correct treatment method after suffering from hernia disease can choose the treatment scheme according to the following procedures: 1. Infants with reversible hernia should consider hernia band treatment. If the illness is not too serious, about 95% of babies can be cured by this method. 2. Most patients should consider surgical treatment, but it is also beneficial to use hernia belt in time before receiving surgical treatment. First, it can prevent the further development of the disease, and second, it can effectively prevent the occurrence of emergency complications such as hernia incarceration and intestinal obstruction. The surgical treatment of hernia in children is difficult, because the organs and tissues in various parts of children are delicate, and the vas deferens and spermatic arteries are easily damaged. Hernia surgery may affect the future fertility of patients and lead to infertility. Because the child does not cooperate with the treatment, crying after the operation is easy to cause complications, with high recurrence rate and great danger. 2. Surgical treatment of hernia in children often requires general anesthesia, which is easy to damage brain cells and cause mental retardation. 3. Therefore, children with hernia should avoid surgical treatment as much as possible, and choose to use drugs from professional institutions and specialized hospitals for professional guidance and treatment as much as possible. [Edit this paragraph] Description of hernia in TCM Medical Source Database: hernia, disease name. Refers to diseases such as visceral protrusion or pain caused by the invasion of cold pathogens. Su Wen's theory of intestinal explanation: "The disease is in the lower abdomen, and abdominal pain can't defecate. This disease is called hernia. If you are cold, you will stab between your abdomen and your leg ... "Fifty-two Diseases has a lot to say about the treatment of hernia, with the title" Hump ". Also known as hernia, bladder intestinal gas, thief wind entering the abdomen, intestinal gas, bladder gas, running dolphin gas, flatulence, kidney yin swelling, fat (hernia), fox fork (hernia), fat (hernia), thigh carbuncle and so on. Because the concept of hernia has not been unified in past dynasties, the understanding of doctors is very different, so it is very chaotic and lacks standardization. Su Wen's Theory of Atmosphere: "The kidney pulse is big and steep, and the liver pulse is big and steep, all of which are hernias. The heart pulse is slippery and urgent, which is a heart hernia; Pulmonary vein stagnation is pulmonary hernia; Sanyang is in a hurry and Yin San is in a hurry. " The theory in Volume 20 of Etiology points out: "Seven hernias are syncope, symptomatic hernia, cold hernia, gas hernia, intervertebral disc hernia, accessory hernia and Wolff hernia." He also said: "Five hernias, one is called stone hernia, the other is called blood hernia, the third is called vaginal hernia, the fourth is called hernia, and the fifth is called air hernia, also called five hernia". Since then, "Confucian Family" and "The Complete Book of Choosing Doctors" and so on. Everyone has his own seven theories of hernia, which are the same, similar or different, with different names and different diseases and syndromes. As far as diseases are concerned, they can be roughly divided into two categories. In other words, the internal organs of the body cavity protrude outward, and there may be symptoms of swelling and pain, or there may be severe abdominal pain with two blocked stools. In addition, diseases of genitalia, testis and scrotum are described, such as swelling and pain of male and female external genitalia, purulent secretion of urethral orifice, swelling and pain of scrotum and testis, or abdominal traction pain; Or just take "pulse hernia" as the diagnosis basis. Based on the clinic, it can be roughly summarized as follows: ① indirect inguinal hernia: as in Confucianism: "fox hernia ... lies in the lower abdomen, but protrudes from the lower abdomen and enters the sac"; "The Complete Book of Choosing Doctors": "People with blood hernia, such as cucumbers, lie on both sides of the lower abdomen." ② refers to the external genitalia of men and women, including diseases such as testis, epididymis and spermatic cord. For example, "On the Cause of Disease": "Hernia causes pain". "The General Record of Shengji" records: "Hernia is painful, and pathogenic factors gather in the yin, causing vulva swelling and pain." Introduction to Medicine: "Hernia has testicular pain and less abdominal pain." "The Complete Book of Choosing Doctors": "People with cold hernia suffer from contracture of tendons and eggs ... as hard as stone, and the penis does not lift, or control testicular pain." ③ Scrotal diseases, including scrotal elephantiasis and hydrocele of testis. Authentic surgery: "There is also a kind of water hernia, with bright skin color, neither hot nor red, swelling and pain, and sometimes water accumulation." "Confucianism is close to people": "hernia, its pubic cyst is swollen, if it rises like a bucket, it will not hurt." ④ refers to diseases of urogenital system, such as cystitis and prostatitis. For example, Confucianism is close to each other: "Tendon hernia ... or pain in the stem, itching when it is extremely painful, or not stopping, or something white is as fine as fine, and it goes down." ⑤ refers to abdominal tumor or diseases of uterus and bladder. For example, various pathogenic theories: "there is accumulation under the navel of the abdomen, which is called visceral hernia" and so on. ⑥ refers to intestinal spasm and partial intestinal obstruction caused by intestinal dysfunction. Such as "Etiology": "The abdomen is full of gas, the heart is full of pain, and the gas accumulation is like an arm, which is called hernia; Abdominal pain next to the navel is called intervertebral disc herniation. "The lower abdomen yin causes pain and difficulty in defecation, which is called wolf hernia." See related articles for treatment based on syndrome differentiation. Radical treatment of hernia: radical stroke: 5 external stroke: 3 total stroke: 8 quadrangle number: 00 17 [Edit this paragraph] Physical examination of hernia [Diagnosis of symptoms of hernia] The symptoms of hernia are different, which are related to factors such as the type of hernia, contents of hernia, incarceration and strangulation. There are only slight local symptoms in the early stage of abdominal external hernia, such as local swelling and pain, reducible mass and so on. , does not affect visceral function, no systemic symptoms. With the increase of hernia contents, local swelling and pain are aggravated, accompanied by a sense of falling. Incarceration of hernia contents leads to corresponding systemic symptoms. If the contents of hernia are small intestine and colon, there may be symptoms of intestinal obstruction such as paroxysmal abdominal pain, abdominal distension, nausea, vomiting, stopping defecation and anal exhaust. If the contents of hernia are bladder and kidney, there may be obvious urinary symptoms, such as frequent urination, urgency, dysuria, hematuria, lumbago and so on. If the contents of hernia are fallopian tubes, ovaries or omentum, there may be non-specific gastrointestinal symptoms such as abdominal pain, lumbosacral pain, loss of appetite, indigestion and flatulence. When the hernia contents are strangulated, there will be different degrees of systemic poisoning symptoms, such as fever, leukocytosis, water, electrolyte and acid-base balance disorder, and even shock. The incidence of intra-abdominal hernia is more acute, only showing digestive tract obstruction. Preoperative diagnosis of congenital intra-abdominal hernia is extremely difficult, and most of them are diagnosed as mechanical intestinal obstruction, which can only be diagnosed after exploratory laparotomy. The diagnosis of postoperative abdominal hernia should be prompted by the history of operation, but it may be misdiagnosed as adhesive intestinal obstruction. Traumatic diaphragmatic hernia has serious symptoms and is often accompanied by respiratory or/and circulatory dysfunction. Combined with the history of trauma, it is easy to get a diagnosis. Congenital diaphragmatic hernia has atypical symptoms and is easy to be misdiagnosed. Esophageal hiatal hernia is often misdiagnosed as chronic gastritis, peptic ulcer, reflux esophagitis and carditis. In a word, the symptomatology of hernia is rich, and the diagnosis of external abdominal hernia can often be made through the development and evolution of symptoms, especially early symptoms, local symptoms and symptoms. So it is very important to ask the medical history in detail. For early hernia without mass, small hernia with incarceration, serious systemic symptoms and concealed local symptoms, the correct diagnosis of hernia should be based on symptoms, combined with physical examination and auxiliary examination. At the same time, in the diagnosis of intestinal obstruction, the possibility of hernia should be considered in the etiology analysis, and it must not be satisfied with the diagnosis of intestinal obstruction, and missed diagnosis of incarcerated hernia will lead to strangulation and necrosis of hernia contents. 【 Examination of hernia signs 】 1. Local signs, local signs of abdominal external hernia appeared earlier and more obvious. Typical signs are local uplift, recoverable or unrecoverable mass. The location, size, shape, tension and tenderness of the mass vary with the type and content of hernia. The mass of indirect inguinal hernia is mostly round or pear-shaped, passing through the inner ring of inguinal canal, passing through the inguinal canal, leaving the outer ring mouth and entering the scrotum. Its outer ring mouth is wider, and the inguinal canal is slack. After the hernia contents were admitted to the hospital again, when the finger pressed the inner ring orifice (2cm above the midpoint of inguinal ligament), the lump stopped protruding. The mass of direct inguinal hernia is mostly semicircular, protruding forward from the hessel-Bach triangle and not entering the inguinal canal and scrotal inner ring. Femoral hernia mass is located under inguinal ligament, which is small and difficult to be readmitted. The masses of white line hernia and umbilical hernia are hemispherical and mostly asymptomatic. Lumbar hernia mass is deep and difficult to touch, and there may be tenderness locally. Masses of obturator hernia and perineal hernia should be palpated by rectal finger. Abdominal hernia can't palpate the mass. If palpable and tender, it usually indicates that the hernia contents are incarcerated and strangulated. The reducible hernia mass is soft and has little tenderness, which often appears when the abdominal pressure increases such as standing, coughing and defecation, and the mass can disappear when lying down or pressing the surface of the mass. If the contents of hernia are mixed with bowel sounds, the bowel sounds can be heard by auscultation on the mass, and there is a "purring" sound when the mass is pressurized and refluxed. 2. General signs (1) Signs of digestive system: Obstruction of digestive tract is the main sign, such as abdominal distension, intestinal type, tenderness of abdomen in different degrees and ranges, etc. When abdominal hernia is strangulated, there are symptoms of peritoneal irritation such as rebound pain and abdominal muscle tension. Abdominal auscultation can hear the sound of hyperactivity of bowel sounds and the passage of underwater gas. (2) Signs of urinary system; When the hernia content is bladder, there may be mild suprapubic tenderness. If there is obstruction of ureter or its opening, tenderness and percussion pain in renal area may occur, and occasionally renal swelling may be involved. (3) Respiratory system signs: Mainly seen in diaphragmatic hernia, a large number of hernia contents enter the chest cavity, which can affect the expansion of the affected alveoli, leading to gas exchange disorder and hypoxemia. The main signs are accelerated breathing, blue lips, shortness of breath, cough and so on. Patients with chronic diseases may have clubbed fingers and barrel chest. (4) signs of circulatory system; It is more common in diaphragmatic hernia, especially pericardial hernia, elderly patients and patients with original cardiac insufficiency. Diaphragmatic hernia will displace the mediastinum, squeeze the heart and reduce the cardiac output. Pericardial hernia can cause acute pericardial tamponade, which is common in clinic, such as rapid heartbeat, decreased blood pressure, and even acute signs of heart failure such as cyanosis, edema, hepatomegaly and jugular vein dilatation.