Hernia

Subject: Medical and Surgical Nursing I (Theory)

Overview

When an organ pulls through a tear in the muscle or tissue holding it in place, a hernia results. For instance, a weak spot in the abdominal wall may be breached by the intestines. Hernias can occur everywhere in the body, however they are most frequently found in the abdomen, upper thighs, belly button, and groin. There are many different kinds, including inguinal hernias, haital hernias, incisional hernias, etc. Its causes include aging, persistent coughing, and congenital defects that prevent the stomach wall from correctly closing in the womb.The lower abdomen is typically affected, and symptoms include pain or discomfort there, especially when bending over, coughing, or lifting; weakness; pressure; or a feeling of heaviness in the abdomen; and a burning, gurgling, or aching sensation where the bulge is. Its surgical remedy is herniorrhaphy, often known as LEP (laparoscopic extra-peritoneal herniorrhaphy). Its complications include inflammation, irreducibility, etc.

When an organ pulls through a tear in the muscle or tissue holding it in place, a hernia results. For instance, a weak spot in the abdominal wall may be breached by the intestines. Hernias can occur everywhere in the body, however they are most frequently found in the abdomen, upper thighs, belly button, and groin. The majority of hernias do not immediately pose a threat to life, but because they do not go away on their own, surgery may be necessary to avoid potentially serious complications.

 Types

  • Inguinal Hernia
    The most frequent sort of hernias are inguinal hernias. Approximately 70% of all hernias are caused by them, according to the British Hernia Centre (BHC). These hernias develop when a weak patch or rip in the lower abdominal wall, frequently in the inguinal canal, allows the intestines to pass through. Your groin contains the inguinal canal. It is the region in men where the spermatic cord connects the scrotum to the abdomen. The testicles are supported by this cord. A ligament that helps hold the uterus in place in females can be found in the inguinal canal. Men are more likely than women to have this kind of hernia. This is due to the fact that a man's testicles should almost completely close the inguinal canal after they pass through it shortly after birth. Sometimes the canal does not completely close, leaving a weak spot vulnerable to hernias.
  • Hiatal Hernia
    When a portion of your stomach pushes through the diaphragm and into your chest, it is called a hiatal hernia. The diaphragm is a muscular sheet that contracts to bring air into the lungs, aiding in breathing. It divides the organs in your chest from those in your abdomen. Patients over 50 are most likely to experience this sort of hernia. The disorder is often brought on by a congenital (birth) defect in children. Gastroesophageal reflux, in which stomach contents seep backward into the esophagus and generate a burning feeling, is usually always brought on by hiatal hernias.
  • Umbilical Hernia
    Children and infants younger than six months of age can develop umbilical hernias. This occurs when their intestines protrude through the area just below the belly button of their abdominal wall. If your child is weeping, you might see a bulge in or close to their belly button. Only an umbilical hernia frequently goes away by itself, usually by the time the infant is 1 year old. By this time, surgery may be used to treat a hernia if it still exists.
  •  Incisional Hernia
    You may develop incisional hernias after undergoing abdominal surgery. The surrounding, weakened tissue or the incision scar may be penetrated by your intestines.

Causes

  • A congenital defect is when the abdominal wall does not properly close inside the womb.
  • Age
  • Chronic coughing
  • Damage from injury or surgery

Risk factors

  • A hernia history, either personal or familial.
  • Being obese or overweight
  • A persistent cough
  • Persistent constipation
  • Smoking, which may cause a persistent cough.

Symptoms

  • Discomfort or pain in the afflicted area (usually the lower abdomen).
  • Particularly when stooping, coughing, or lifting.
  • A sense of weakness, pressure, or heaviness in the abdomen.
  • A hurting, burning, or gurgling sensation where the bulge is located.
  • When stomach acid flows backward into the esophagus, it causes acid reflux, which causes a burning feeling.
  • Chest pain
  • Difficulty swallowing

Diagnosis

  • A sequence of X-ray images of your digestive tract are taken during a barium X-ray. After you've completed consuming a liquid solution containing barium, which is visible on X-ray imaging, the images are taken.
  • A small camera on a tube is threaded down your throat, into your esophagus, and into your stomach during an endoscopy.

Medical management:

  • In a hernia, a truss or hard pad is kept..

Surgical management:

  • Herniorrhaphy
  • LEP(laparoscopic extra- peritoneal herniorrhaphy)

 Nursing management

  • Because urine retention is typical after hernia surgery, make sure the patient voids.
  • As soon as the client can handle meals, put him back on a regular diet.
  • After surgery, the patient should be advised not to lift anything heavy for 4-6 weeks.
  • After repair, the incisional area is typically treated with an ice pack to reduce pain and swelling.
  • Male patients should have their scrotum thoroughly examined for swelling.
  • Encourage the client to wear a scrotal support when out of bed to reduce swelling.

Complications

  • Inflammation
  • Irreducibility
  • Obstruction of any lumen, such as intestinal hernias' bowel obstruction
  • Strangulation
  • Hydrocele of the hernial sac
  • Haemorrhage
  • Autoimmune problems
  • It cannot be lowered or pulled back into place in incarceration, at least not without a lot of external effort. This significantly raises the risk of bowel blockage and strangling in intestinal hernias as well.

References

  • A Textbook of Adult Health Nursing (2nd ed.). Mandal, G. (August 2013).  Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
  • desimd.com › Health Education › General Surgery
  • herniaclinik.com/what_is_hernia.html
  • issuu.com/colorectalsurgeons/docs/ppt
  • nairaland.com/3038514/what-hernia
  • quizlet.com/143707937/anatomy-abdomen-flash-cards/
  • vk.com/pages?oid=-130873576&p=Adult_stomach_hernia
Things to remember
  • When an organ pulls through a tear in the muscle or tissue holding it in place, a hernia results.
  • Discomfort or pain, typically in the lower abdomen, especially when stooping, coughing, or lifting
  • The most frequent sort of hernias are inguinal hernias.
  • You may develop incisional hernias after undergoing abdominal surgery.
  • Because urine retention is typical after hernia surgery, make sure the patient voids.
  • Encourage the client to use a scrotal support when out of bed to reduce edema.
Questions and Answers

Hernia

When an organ pulls through a tear in the muscle or tissue holding it in place, a hernia results. For instance, a weak spot in the abdominal wall may be breached by the intestines. Hernias can occur anywhere in the body, but they are most frequently found in the abdomen, upper thighs, belly button, and groin. The majority of hernias do not immediately pose a threat to life, but because they do not go away on their own, surgery may be necessary to avoid potentially dangerous complications.

Types

  • Inguinal Hernia
    The most frequent sort of hernias are inguinal hernias. Approximately 70% of all hernias are caused by them, according to the British Hernia Centre (BHC). These hernias develop when a weak patch or rip in the lower abdominal wall, frequently in the inguinal canal, allows the intestines to pass through. Your groin contains the inguinal canal. It is the region in men where the spermatic cord connects the scrotum to the abdomen. The testicles are supported by this cord. A ligament that helps hold the uterus in place in females can be found in the inguinal canal. Men are more likely than women to have this kind of hernia. This is due to the fact that a man's testicles should almost completely close the inguinal canal after they pass through it shortly after birth. Sometimes the canal does not completely close, leaving a weak spot vulnerable to hernias.
  • Hiatal Hernia
    When a portion of your stomach pushes through the diaphragm and into your chest, it is called a hiatal hernia. The diaphragm is a muscular sheet that contracts to bring air into the lungs, aiding in breathing. It divides the organs in your chest from those in your abdomen. Patients over 50 are most likely to experience this sort of hernia. The condition is typically brought on by a congenital (birth) defect in children. Gastroesophageal reflux, in which stomach contents leak backward into the esophagus and cause a burning sensation, is almost always brought on by hiatal hernias.
  • Umbilical Hernia
    Children and infants younger than six months of age can develop umbilical hernias. This occurs when their intestines protrude through the area just below the belly button of their abdominal wall. If your child is crying, you might see a bulge in or close to their belly button. Only an umbilical hernia frequently goes away by itself, usually by the time the child is 1 year old. By this time, surgery may be used to treat a hernia if it still exists.
  • Incisional Hernia
    You may develop incisional hernias after undergoing abdominal surgery. The surrounding, weakened tissue or the incision scar may be penetrated by your intestines.

 

Symptoms

  • Discomfort or pain in the afflicted area (usually the lower abdomen),
  • Particularly when stooping, coughing, or lifting
  • A sense of weakness, pressure, or heaviness in the abdomen
  • A burning, gurgling, or painful feeling where the bulge is located
  • When stomach acid flows backward into the esophagus, it causes a burning feeling known as acid reflux.
  • A chest ache
  • Having trouble swallowing

 

Medical management:

  • A hernia is kept in with a truss or a firm pad.

Surgical management:

  • Herniorrhaphy
  • LEP(laparoscopic extra- peritoneal herniorrhaphy)

Nursing management

  • Because urine retention is typical after hernia surgery, make sure the patient voids.
  • As soon as the client can handle meals, put him back on a regular diet.
  • After surgery, the patient should be advised not to lift anything heavy for 4-6 weeks.
  • After repair, the incisional area is typically treated with an ice pack to reduce pain and swelling.
  • Male patients should have their scrotum thoroughly examined for swelling.
  • Encourage the client to wear a scrotal support when out of bed to reduce swelling.

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