Abdominal wall hernia

　　1. Abdominal wall hernia is caused by the protrusion of abdominal organs along with the peritoneum through a weak spot or opening in the abdominal wall. Abdominal wall hernia can occur at any age. Inguinal hernia (the junction of the thigh and abdomen) is the most common. Other types include inguinal hernia, umbilical hernia, linea alba hernia, incisional hernia, etc. Normal people have some weak areas on the abdominal wall, such as inguinal canal, femoral ring. In addition, some people have a developmental defect in a certain part of the abdominal wall, such as incomplete umbilical ring closure, abdominal linea alba defect, etc. There are also surgical incisions, abdominal wall injuries caused by trauma, and muscle atrophy in the elderly causing weak abdominal wall muscles, which are the prerequisite conditions for the occurrence of abdominal wall hernia.

　　2. Increased intraperitoneal pressure, such as chronic cough, constipation, difficulty in urination, frequent crying in infants, weightlifting, vomiting, etc., increases intraperitoneal pressure, which will push abdominal organs out through the weak spot in the abdominal wall into a small pouch-like hernia sac. Most organs can return to the abdominal cavity, known as reducible hernia, and some need to be gently pushed back. Some abdominal wall defects are small, and the abdominal organs that are squeezed out cannot return, known as incarcerated hernia; some compress the blood vessels, and only the protruding organs are ischemic, known as strangulated hernia. Strangulated hernia can cause necrosis of the protruding organs. If the protruding object is an intestinal tract, it can cause intestinal obstruction, intestinal necrosis, perforation, peritonitis, etc. It can also break through the abdominal wall to form a fecal fistula. After the hernia is formed, as the organs repeatedly protrude, the hernia sac gradually expands.

　　It mainly manifests as the protrusion of a hernia at the incision site when standing, which is more obvious when coughing or exerting force. Usually, the hernia ring is large, and the hernia mass recedes and disappears spontaneously after lying flat. If the hernia mass is large and many organs and tissues protrude, there may be abdominal dull pain, dragging descent, and other discomforts. Due to the wide hernia ring, incarceration or strangulation is rarely occurred. Instruct the patient to lie flat, insert a finger into the abdominal wall defect, and then ask the patient to hold their breath to clearly palpate the hernia ring edge, understand the size of the defect and the strength of the edge tissue. When only the skin covers the abdominal wall defect, intestinal peristalsis can be seen.

　　1. First, a mass protrusion is found on the abdominal wall, some of which can descend into the scrotum to enlarge it. It appears when standing, exerting force, or coughing and disappears when lying flat. When the mass protrudes, gently pushing it upwards feels slight resistance and then quickly disappears. Sometimes a gurgling sound can be heard at the same time.

　　2. When the mass protrudes, the patient has a sensation of descent, accompanied by distension or pulling-type abdominal pain.

　　3. If there is an incarcerated or strangulated hernia, abdominal pain and distension, and symptoms and signs of intestinal obstruction may occur.

　　1. Take active treatment for various diseases that cause increased intraperitoneal pressure, such as chronic cough constipation, benign prostatic hyperplasia, etc.

　　2. People engaged in heavy physical labor and weightlifters should be protected.

　　3. Pay attention to prevent colds, coughing, and vomiting after various abdominal surgeries.

　　4. Take active physical exercise to enhance the protective power of the abdominal muscles.

　　5. After the surgical repair of abdominal wall hernia, it is especially important to prevent and treat various factors that increase intraperitoneal pressure, and necessary to reduce gastrointestinal pressure for 2 to 3 days if needed. The time for removing the surgical incision suture should be appropriately extended to 8 to 10 days, and get out of bed to move around after the suture is removed.

　　1. X-ray examination:X-ray透视 or abdominal X-ray film shows signs of intestinal obstruction.

　　2, Ultrasound indicates:There is an abnormal echo of intestinal fluid and gas near the lower abdominal ring.

　　3, physical examination:A hernia mass protrudes at the incision site when standing, and it is more obvious when coughing or exerting force. Usually, the hernial ring is large, and the hernia mass will be spontaneously retracted and disappear when lying flat. If the hernia mass is large and there are many organs and tissues protruding, there may be abdominal dull pain, dragging, and other discomforts. Due to the wide hernial ring, incarceration or strangulation rarely occurs. Instruct the patient to lie flat, insert a finger into the abdominal wall defect, and then ask the patient to hold their breath to clearly palpate the edge of the hernial ring, understand the size of the defect, and the strength of the edge tissue. When only the skin covers the abdominal wall defect, intestinal peristalsis can be seen.

　　Dietary recipes after incisional hernia surgery:

　　1, Jilin shen 4 grams, American ginseng 3 grams, stewed with lean meat.

　　2, winter mushrooms 4-5 pieces, stewed with lean meat or chicken breast (drink the soup).

　　3, bei qi 15 grams, dangshen 21 grams, huai shan 30 grams, lian zi 15 grams, stewed with lean meat.

　　4, tu fu ling 30 grams, sheng yi ren 30 grams, yuan rou 3 pieces, stewed with grass carp or water turtle.

　　5, dangshen 17 grams, shi shi 21 grams, ji zi 10 grams, yi ren 15 grams, stewed with lean meat or chicken.

　　6, Tianqi 3 grams, ginseng (or red ginseng) 3 grams, stewed with lean meat or chicken.

　　Hernias cannot heal themselves, although they will not deteriorate in the short term. In the early stage or when there are mild symptoms, patients may feel pain, lower abdominal坠胀, indigestion, diarrhea, and other symptoms. As the condition develops, due to the mass falling into the scrotum, it may cause inconvenience in movement and walking. Severe cases may develop incarceration, and if not treated in time, it may cause intestinal necrosis and even threaten life. Therefore, timely treatment measures should be taken, choosing surgery or drug treatment according to the patient's own condition. Generally, infants and the elderly are not suitable for surgical treatment and can take conservative drug treatment; middle-aged and young people can take surgical treatment.

　　Surgical treatment for incisional hernia: Incisional hernia has a high probability of incarceration and strangulation, so once the disease is diagnosed, if the patient has no surgical contraindications, surgical treatment should be given. Generally, a transverse incision is made, separated according to the direction of the aponeurosis of the external oblique muscle, and the hernial sac is identified after separation, incised, and ligated. The defect of the transversalis fascia is usually sutured with silk thread in a transverse overlapping mattress suture.