Inguinal hernia is the most common variant of abdominal hernia. According to statistics, of all abdominal hernia, inguinal up to 80%. And they are mostly men. This is due to the features of their anatomy. In men, the shorter and wide inguinal canal and its walls are less reinforced by the tendon and muscle layers. In addition, men more often than women experience heavy physical exertion.
An inguinal hernia is a protrusion of the peritoneum into the lumen of the inguinal canal or through a channel under the skin in the inguinal and inguinal-scrotal area. More rarely, other internal organs (intestinal loops, bladder wall) act as hernia contents.
Fig. 1 - The manifestation of an inguinal hernia in men.
There are several varieties of inguinal hernias: congenital and acquired, straight and oblique, sliding and combined. But they all have common symptoms.
Symptoms of an inguinal hernia
Not always the bulging of the peritoneum can be determined visually. The beginning hernia does not reveal itself in any way: there are no external signs of the disease, the patient is not disturbed by anything. To detect the weakening of the walls of the inguinal ring can only a surgeon, conducting a targeted examination of the patient.
When an inguinal hernia is formed , the first symptoms begin to bother the patients: during physical exertion, attempts at defecation, coughing or sneezing, formations appear in the inguinal-scrotal area. After the cessation of the provoking action, the protrusion disappears.
When the peritoneum exits through the inguinal canal under the skin of the inguinal-scrotal area, characteristic symptoms are noted:
- Bulky formations appear in the place of hernial protrusion. Its sizes can be different - from walnut to chicken egg. Hernial protrusion may occur periodically and is easy to settle inside - spontaneously or by the patient (reducible hernia), and may be constantly present (unreducible hernia).
- The patient begins to complain of recurrent pains in the area of the hernia, which are aggravated by exertion and can be given to the scrotum, sacrum, lower back, lower abdomen. Over time, the pain becomes chronic and quite strong.
- Feeling of discomfort when walking.
There may be other problems: disorders of stool, abdominal pain, nausea, abdominal distension, cramps during urination, loss of appetite.
All these symptoms are observed with unresolved inguinal hernia.
Injured inguinal hernia
In the case of the development of infringement, when the peritoneum seems to be “clamped” in the walls of the inguinal canal, a picture of “acute abdomen” appears:
- suddenly there is severe pain in the area of the hernia and in the lower abdomen;
- pain accompanied by indomitable and unrelieved vomiting;
- previously disposable hernias become unreducible;
- stool retention and bloating due to gas buildup are often noted;
- may increase body temperature.
Peritonitis develops, and the patient's condition rapidly deteriorates. The pain becomes unbearable and painful, accompanied by repeated vomiting, a drop in blood pressure and loss of consciousness.
Diagnosis of an inguinal hernia is carried out on the basis of complaints during the examination of the patient. In addition, studies are being conducted to exclude other diseases of the inguinal-scrotal area: testicular drops, femoral hernia, lymphadenitis, abscess, tumor.
The beginning hernia is much more difficult to diagnose. Patients do not show any complaints, and with a superficial examination of the changes in the inguinal-scrotal region is not detected. In this case, palpation is performed: the doctor probes the external inguinal ring with his finger, while the patient strains the abdominal pressure. In this case, the surgeon feels the jerky protrusion of the hernia. The weakening of the walls of the inguinal ring revealed in this way is the main symptom of the beginning inguinal hernia.
To clarify the nature of the hernial content requires an ultrasound.
What is dangerous inguinal hernia?
An inguinal hernia is a dangerous complication. The most formidable of them is infringement - an acute condition that can lead to the death of the patient. In addition, with inguinal hernia, inflammation of the hernial contents and adjacent organs is possible, as well as the development of coprostasis (acute stool retention). And irreducible and large hernias, even without complications, cause discomfort to patients: they limit their activity and are accompanied by unpleasant symptoms.