I – Introduction:
A- Definition of inguinal hernia:
Inguinal hernia is a common condition characterized by the projection of an abdominal organ or tissue through a weak point in the abdominal wall, also called the “inguinal orifice”. This type of hernia is most common in men, but it can also affect women. Inguinal hernia usually occurs when the abdominal wall is weakened, allowing an internal organ, such as the intestine, to pass through. This type of hernia is often associated with intense physical activity, prolonged coughing or straining, which increases intra-abdominal pressure. Symptoms of an inguinal hernia can include pain or discomfort in the inguinal area, a lump or bulge in the affected area, and pain or pain when the area is pressed.
B- Frequency of inguinal hernia:Inguinal hernia is one of the most common conditions in the world. It is estimated that around 20-25% of the male population will be affected by an inguinal hernia in their lifetime. However, the frequency of inguinal hernia varies greatly depending on the age, sex and risk factors of each individual. In men, the frequency of inguinal hernia increases with age, reaching its peak between the ages of 50 and 70. On the other hand, in women, the frequency of inguinal hernia is much lower, reaching about 2% of the female population. However, this can vary greatly depending on each woman’s medical history and lifestyle. Risk factors for developing an inguinal hernia include prolonged cough, constipation, obesity, pregnancy, strenuous physical activities and family history of inguinal hernia. Ultimately, understanding the frequency of inguinal hernia is important to assess the risks and plan the correct treatment.
C- Objectives of the article:
The objective of this article is to provide an in-depth understanding of inguinal hernia, including its causes, symptoms, diagnosis, and treatment. This document aims to help people with an inguinal hernia understand the different treatment options available and make an informed decision together with their doctor. Additionally, the article also aims to educate those at risk about the frequency of inguinal hernia and the need to monitor symptoms to avoid potential complications. Finally, this article aims to provide advice for the prevention of inguinal hernia, including advice on lifestyle habits and exercises that can help strengthen the muscles of the abdomen and reduce the risk of developing an inguinal hernia. . In summary,
II- Causes of inguinal hernia:
A- Risk factors:
There are several risk factors that can increase the likelihood of developing an inguinal hernia. Some of these factors are beyond your control, while others can be changed or prevented. The most common risk factors include:
1- Family history: People with a family history of inguinal hernia are more likely to develop a hernia.
2- Male sex: Men are more likely than women to develop an inguinal hernia.
3- Age: The risk of developing an inguinal hernia increases with age.
4- Intense physical activity: Intense physical activities, such as weight lifting, can increase intra-abdominal pressure and increase the risk of developing an inguinal hernia.
5- Obesity: People with obesity are more likely to develop an inguinal hernia due to the extra pressure exerted on the abdominal wall.
6- Pregnancy: Pregnant women are more likely to develop an inguinal hernia due to the pressure exerted on the abdominal wall by the growing uterus.
7- Prolonged coughing or straining: Prolonged coughing or straining can increase intra-abdominal pressure and increase the risk of developing an inguinal hernia.
Ultimately, understanding risk factors can help people reduce their risk of developing an inguinal hernia and plan proper treatment if diagnosed. It is important to work with a doctor to assess personal risks and determine the most appropriate preventive measures.
B- Pathogenesis of the inguinal hernia:
The pathogenesis of inguinal hernia involves the protrusion of intestinal tissue through a weakness or tear in the abdominal wall. This weakness can occur due to several factors, such as the loss of muscle tone or the natural degeneration of supporting structures with age. Inguinal hernias can occur in both men and women, but are more common in men due to the presence of an inguinal canal, which is a natural opening in the abdominal wall that can allow intestinal tissue to pass through. protrude.
Inguinal hernia can be divided into two main types: indirect inguinal hernias and direct inguinal hernias. Indirect inguinal hernias are caused by weakness in the inguinal canal that can occur during fetal life. Direct inguinal hernias are caused by weakness in the abdominal wall that develops as a result of injury or previous surgical repair.
Finally, it is important to note that the inguinal hernia can lead to potential complications, such as incarceration or strangulation. Incarceration occurs when the herniated tissue is caught in the abdominal wall and cannot be pushed back into place. Strangulation occurs when blood flow to the herniated tissue is interrupted, which can lead to tissue necrosis and an immediate medical emergency. By understanding the causes and pathogenesis of inguinal hernia, people can better manage their condition and prevent potential complications.
III- Symptoms of inguinal hernia:
A- Pain and discomfort:
Pain and discomfort are common symptoms associated with inguinal hernia. People with inguinal hernias may experience pain or pressure in the inguinal area, which may worsen with physical exertion or coughing. Some people may also experience pain when standing or in an upright position, which can be relieved by lying down.
In some cases, inguinal hernia can cause significant discomfort and impair quality of life. The discomfort can be caused by the constant pressure or pain associated with the hernia, as well as fear of pain or potential complications. People with inguinal hernias may also be limited in their ability to perform certain physical activities, which can lead to reduced mobility and loss of fitness.
It is important to note that pain and discomfort can vary greatly from person to person, depending on the severity of the hernia, general health and pain tolerance. Some people may be able to manage the pain with over-the-counter pain relievers, while others may require surgery to relieve symptoms. By working with a medical professional, people can develop an effective treatment plan to manage their pain and discomfort associated with inguinal hernia.
B- Protrusion of the hernia:
Hernia protrusion refers to the protrusion of the intestine or other abdominal organs through the muscular wall of the abdomen. This protrusion may be visible under the skin, which can aid in the diagnosis of inguinal hernia. The size and shape of the protrusion can vary greatly from person to person, and can be influenced by factors such as the severity of the hernia, the amount of abdominal tissue involved, and the degree of pressure exerted on the wall muscular.
Hernia protrusion can lead to a variety of symptoms, including pain or pressure in the inguinal area, pain when coughing or exercising, discomfort in the inguinal area, and reduced mobility. If the protrusion is large, it can also lead to complications such as intestinal irregularity or obstruction, which can compromise general health and require immediate medical intervention.
It is important to carefully monitor the protrusion of the hernia, as it can get worse over time. If the protrusion becomes painful or causes significant discomfort, it is recommended that you consult a medical professional to develop an appropriate treatment plan. In some cases, surgery may be needed to correct the protrusion and relieve symptoms associated with inguinal hernia.
C- Other associated symptoms:
Besides the visible protrusion of the inguinal hernia, there are other symptoms that can be associated with this condition. Some of the more common symptoms include pain in the inguinal region, which may be constant or intermittent, as well as a feeling of pressure or discomfort in the affected area.
Vomiting, nausea, and constipation may also be symptoms associated with an inguinal hernia, especially if bowel obstruction is present. Fever, excessive sweating, and a lowered food and fluid intake can also be signs of a severe or complicated inguinal hernia.
It is important to consult a medical professional if one experiences symptoms associated with an inguinal hernia. A doctor can perform tests to assess the severity of the hernia and develop an appropriate treatment plan, which may include surgery, medication, or lifestyle changes. Ignoring the symptoms can lead to serious complications and compromise overall health.
IV- Diagnosis of the inguinal hernia:
A- Clinical examination:
Clinical examination is a key element for the diagnosis of inguinal hernia. During the exam, the doctor will examine the affected area for any abnormal protrusions or swellings, and to assess the severity of the hernia.
The doctor may also perform tests to assess the mobility and tenderness of the affected area, as well as to detect any pain or discomfort felt during coughing, physical exertion, or other movements. Lab tests may also be done to assess the function of internal organs and to check for infection or other complications.
The physical examination may be supplemented with imaging tests, such as X-rays, computed tomography (CT), or MRI, to get a more detailed view of the hernia and its effects on surrounding organs.
It is important to undergo a complete clinical examination if one has symptoms associated with an inguinal hernia, in order to ensure that the diagnosis is correct and that the appropriate treatment is developed. Ignoring the symptoms can compromise your health and make the situation worse.
Ultrasound is a noninvasive imaging test that can be used to diagnose an inguinal hernia. It uses high-frequency sound waves to create real-time images of the affected area.
Ultrasound is particularly useful in evaluating the presence of an inguinal hernia because it can clearly visualize the abnormal protrusion and determine whether it is painful or not. Additionally, ultrasound can also be used to assess the size of the hernia and to detect any bowel obstruction or other associated complications.
The ultrasound examination is quick, painless and can be done in a clinic or hospital. It requires no special preparation and poses no health risk.
Ultrasound is often used in conjunction with other imaging tests to fully assess the severity of inguinal hernia and to determine the most appropriate treatment. If you have symptoms associated with an inguinal hernia, it is important to see a doctor for a full examination, including an ultrasound if necessary.
C- Computed tomography (CT):
Computed tomography (CT) is an imaging test used to diagnose an inguinal hernia. This exam uses x-rays and a computer to create very detailed layered images of the affected area.
CT is particularly useful for assessing the severity of inguinal hernia because it can show the abnormal protrusion as well as surrounding organs, such as the intestines and blood vessels. Additionally, CT can also be used to detect any bowel obstruction or other related complications.
The CT scan is usually done in a clinic or hospital, and takes about 15 minutes. It usually does not require any special preparation, but it is important to be examined by a qualified doctor who can interpret the results of the examination.
Although CT is considered safe for most people, it is important to consider the potential risks of X-rays. If you are pregnant or think you may be pregnant, you should tell your doctor before having a scan. CT.
If you have symptoms associated with an inguinal hernia, it is important to see a doctor for a full examination, including a CT scan if necessary. This will help in making a correct diagnosis and developing appropriate treatment to manage your condition.
MRI (magnetic resonance imaging) is another imaging test used to diagnose an inguinal hernia. Unlike computed tomography (CT), which uses X-rays, MRI uses magnetic fields and radio waves to create detailed images of internal body structures.
MRI is particularly useful for evaluating inguinal hernias because it can produce very detailed layered images of the affected area, which helps doctors better understand the position of the hernia and its surrounding structures, such as the intestines and Blood vessels.
The MRI scan is usually done in a clinic or hospital and takes about 30 to 60 minutes. It does not require any special preparation, but it is important to inform your doctor if you are wearing any metallic device, such as prostheses or vascular clips, as this may affect the results of the examination.
Although MRI is considered safe for most people, it can be difficult for some people, such as those with phobias or anxiety, to stay still during the exam. It is also important to consider the potential risks associated with using a strong magnetic field, such as effects on pacemakers and other electronic devices.
If you have symptoms associated with an inguinal hernia, it is important to see a doctor for a full examination, including an MRI if necessary. This will help in making a correct diagnosis and developing appropriate treatment to manage your condition.
V- Treatment of inguinal hernia:
A- Conservative treatment:
Conservative treatment for an inguinal hernia involves using non-surgical measures to relieve symptoms and prevent progression of the hernia. This type of treatment is often recommended for benign inguinal hernias or for people who do not wish to undergo surgery.
One of the most common ways to manage an inguinal hernia is by wearing a support device, such as a gym bag or support belt. This device helps hold the tissues of the inguinal area in place and can relieve the pain and discomfort associated with a hernia.
It is also important to adopt a healthy lifestyle to help prevent the hernia from worsening, including a balanced diet and regular exercise to strengthen the abdominal muscles. If you are obese or overweight, losing weight can also help reduce pressure on tissues in the inguinal region.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be prescribed to relieve pain and reduce inflammation. Other medications, such as pain relievers and antispasmodics, may also be used to treat pain associated with an inguinal hernia.
It is important to note that conservative treatment is not always effective for everyone with an inguinal hernia, and surgery may be needed to correct the hernia. Therefore, it is important to consult a doctor to determine the most appropriate treatment for your condition.
B- Inguinal hernia surgery:
Surgery is often recommended for painful inguinal hernias or those that don’t respond to conservative treatments. There are several surgical techniques for treating an inguinal hernia, and the choice depends on the type and size of the hernia, as well as the general health of the patient.
One of the most common techniques is inguinal ligament hernia repair, also known as thread repair. This procedure involves strengthening the abdominal muscle wall using a nylon mesh to hold the intestines in place.
Endoscopic traction band repair, also called laparoscopic repair, can be performed under general anesthesia and involves the use of a laparoscope to view and correct the hernia.
There are also more traditional surgical techniques, such as open repair, which involves an incision through the skin to access and repair the hernia.
After surgery, it is important to get enough rest and follow the doctor’s instructions for a quick and effective recovery. Recovery varies depending on the type of surgery and the general health of the patient, but most people can return to their daily activities within a few weeks.
It is important to note that surgery can lead to complications, such as bleeding, infection, and postoperative pain. Therefore, it is important to discuss the benefits and risks of surgery with a doctor to determine if this option is the most appropriate for your condition.
C- Choice between open surgery and laparoscopic surgery:
The choice between open surgery and laparoscopic surgery depends on several factors, such as the size and type of hernia, the patient’s general health, as well as personal preferences and medical history.
Open surgery is a more traditional procedure that involves a larger incision through the skin to access the hernia. This technique is generally recommended for larger hernias or for people with complex health conditions.
On the other hand, laparoscopic surgery is a more modern technique that involves small incisions and special equipment to access the hernia. This technique is generally considered less invasive and may result in faster and less painful recovery than open surgery.
The benefits of laparoscopic surgery include reduced postoperative pain, faster recovery, and lower risk of complications. However, this technique is not always possible for all hernias or all patients.
Ultimately, the choice between open surgery and laparoscopic surgery should be based on a thorough discussion with a physician, who considers each patient’s individual factors and recommends the best option for their condition.
VI- Complications of inguinal hernia:
A- Incarcerated hernia:
An incarcerated hernia occurs when tissue that has slipped through the abdominal wall becomes stuck and cannot be returned to its normal position. This can cause acute pain and can lead to ischemia, i.e. deprivation of blood supply to the trapped tissue, which can lead to necrosis (cell death) if not treated quickly.
An incarcerated hernia can occur in any hernia, but is more common in inguinal hernias and obturator hernias. Symptoms may include sudden sharp pain in the hernia area, painful swelling, fever, nausea, and vomiting.
In most cases, an incarcerated hernia requires immediate surgery. Treatment may include surgical decompression to allow the trapped tissue to break free and return to its normal position, as well as surgical repair to prevent the hernia from returning.
It is important not to ignore the symptoms of an incarcerated hernia and seek immediate medical attention if you experience unusual pain or symptoms. Prompt management can help prevent potentially serious complications and ensure a quick and complete recovery.
B- Strangulated hernia:
A strangulated hernia is a potentially serious complication of inguinal hernia, where the contents of the abdominal cavity become stuck in the hernia and cannot be repositioned. This can lead to intestinal obstruction, ischemia (lack of blood supply) and necrosis (cell death). Symptoms include sharp pain, swelling, redness, fever and vomiting. Treatment requires immediate surgery to avoid permanent damage to the gut. Patients with a strangulated hernia should see a doctor right away to assess the situation and determine the appropriate treatment. It is important to note that strangulated hernias can occur at any time, even after surgical treatment of the inguinal hernia.
C- Postoperative complications:
Postoperative complications of inguinal hernia surgery may include pain, swelling and hematoma at the incision site, infection, recurrence of the hernia, temporary nerve paralysis, vascular injury, bowel injury and dysphagia (difficulty swallowing).
Although most complications are minor and temporary, some may be more serious and require additional treatment. For example, a recurrence of the hernia may require further surgery to correct the problem, while an infection may lead to potentially serious complications such as sepsis.
It is important to monitor symptoms and report any changes or problems to your doctor immediately. Patients may also be asked for regular follow-up exams to make sure healing is on track and to monitor for any complications.
In general, most patients make a full recovery after inguinal hernia surgery and can return to their usual activities within a few weeks. However, preventing postoperative complications can help ensure a quick and complete recovery.
VII- Prevention of inguinal hernia:
A- Modification of lifestyle habits:
Lifestyle changes can play an important role in the prevention and treatment of inguinal hernia. Weight loss may be recommended if you are overweight or obese, as this can reduce pressure on the inguinal area and prevent new hernias from forming.
It’s also important to maintain correct posture when performing activities that can put pressure on the inguinal region, such as lifting weights or driving a vehicle. It may be helpful to wear abdominal support to relieve pressure on the inguinal area.
In addition, it is important to adopt a healthy and balanced diet to strengthen the abdominal muscles and prevent the formation of hernias. Foods high in fiber, protein, and vitamins can help build muscle and reduce pressure on the inguinal region.
It is also important to avoid smoking, as nicotine can damage blood vessels and affect blood circulation in the inguinal area, which can increase the risk of hernia. Finally, regular moderate physical activity is recommended to strengthen abdominal muscles and maintain good posture.
B- Exercises to strengthen the muscles of the abdomen:
Exercises to strengthen the muscles of the abdomen can help prevent the formation of inguinal hernias and improve their stability. It is important not to start intensive exercises without medical advice, especially if you already have a hernia.
Simple exercises, such as planks, can strengthen abdominal muscles and help maintain good posture. Abdominal crunches, sit-ups, and core twists can also help strengthen the muscles in the abdomen.
It is also important to incorporate exercises to strengthen the pelvic floor muscles, which can help prevent the formation of inguinal hernias and maintain their stability. Activities such as yoga, dancing, or calisthenics can also help strengthen abdominal muscles.
It is important not to overload the muscles of the abdomen by performing intensive exercises without sufficient rest. It is recommended to start with simple exercises and gradually increase them in intensity and duration. It is also important to respect the limits of your body and not to continue the exercises if you feel pain or discomfort.
C- Use of a support for the inguinal hernia:
Using an inguinal hernia support can help relieve the pain and discomfort associated with this condition. Inguinal hernia supports can be used to compress the herniated area and support the muscles in the abdomen.
There are several types of inguinal hernia supports, such as inguinal hernia belts, corsets, and bands. Inguinal hernia belts are often made of soft, comfortable materials and can be adjusted to fit the shape of the body.
It is important to choose an inguinal hernia support that fits well and is comfortable to wear. It is also important to consult a doctor before using an inguinal hernia support, to ensure that it is suitable for your condition.
It’s also important not to wear an inguinal hernia brace all the time, as it can interfere with blood flow and breathing. Supports should be worn temporarily to help relieve pain and discomfort, and it is important to remove them regularly to allow the herniated area to relax and rest.
A- Summary of key information:
The following paragraph summarizes key information about inguinal hernia:
Inguinal hernia is a common condition that occurs when the bowels push through a weakness in the muscles of the abdomen. Risk factors include advanced age, constipation, smoking, chronic cough, obesity, pregnancy, and a family history of inguinal hernia. Symptoms include pain or discomfort in the inguinal area, a visible bulge, and additional symptoms such as nausea and vomiting. Diagnosis can be made using clinical examination, ultrasound, CT, or MRI. Treatment may include lifestyle changes, exercises to strengthen the muscles in the abdomen, use of an inguinal hernia support, and surgery. The surgery can be performed open or laparoscopically and the choice depends on medical history, personal preference and the severity of the hernia. It is important to watch for postoperative complications such as pain, infection, and hernia recurrence. In summary, inguinal hernia is a common condition that can be effectively managed with the right treatment.
B- Importance of early treatment of inguinal hernia:
Early treatment of inguinal hernia is essential to avoid potentially serious complications. Indeed, the longer the hernia is left untreated, the more difficult it becomes to treat and the greater the risk of complications. For example, if the hernia is incarcerated, it can lead to intestinal obstruction, which can be very painful and can even lead to irreversible damage. Also, the larger the hernia, the more pain and discomfort it can cause, which can significantly affect quality of life. This is why it is important to seek early treatment for the symptoms of inguinal hernia. Treatment options include surgery and supportive measures, such as muscle strengthening exercises and the use of an inguinal hernia support. By choosing early treatment, patients can minimize the risk of complications and improve their quality of life.
C- Advice for people suffering from an inguinal hernia:
People with an inguinal hernia should take the necessary steps to avoid any potential complications. It is important to carefully monitor symptoms, such as pain, discomfort, and protrusion, and to seek medical attention if these symptoms worsen. It is also important to change lifestyle habits by adopting a healthier lifestyle, eating a balanced diet and exercising regularly to strengthen the muscles of the abdomen. It is recommended to use an inguinal hernia support to relieve pressure on the affected muscles and prevent worsening of symptoms. Finally, it is essential not to delay to consult a doctor if the inguinal hernia is suspected.