ischial hernia
Introduction
Introduction to Ischia Abdominal organs or tissues through the large hole of the ischial bone, the small hole out, called sciatichernia. Also known as glutealhernia or ischiatichernia, sciatic ridge is extremely rare in clinical practice, especially in middle-aged women, especially in women who are born, although males occur, but more rare. There are many ways to remove the sciatic hole. basic knowledge The proportion of illness: the incidence rate is about 0.007%-0.008%, more common in obese women Susceptible people: women after middle age Mode of infection: non-infectious Complications: intestinal obstruction
Cause
Cause of sciatic ridge
(1) Causes of the disease
The pelvis is a strong bone ring composed of the posterior tibia, the coccyx and the hip bones on both sides. The pelvic sacral ligament, the sacrospinous ligament and the large ischial sac are enclosed in the greater sciatic foramen. The small ischial incision encloses the 1esser sciatic foramen. The upper boundary of the ischial hole and the front are the hip bone, the posterior iliac nodular ligament, and the lower boundary is the sacrospinous ligament. Through this hole, there is a piriformis. Above it, there are upper gluteal nerves and blood vessels passing through, under which there are sciatic nerves, subgluteal nerves, pudendal nerves and blood vessels. The ischial bones are in front of the ischial tuberosity. The upper boundary is the ischial spine and the sacrospinous ligament, followed by the sacral knot. The ligaments, through which the pudendal nerves and blood vessels, and the obturator inner tendons.
When a large hole in the ischial bone or a small area around the small hole is weakened due to paralysis or injury, the organ in the lower abdomen and the pelvic cavity can be ejected when the intra-abdominal pressure is increased.
(two) pathogenesis
1. Classification According to the way in which the contents of the sputum are removed, there are three types of sciatic ridge: the piriformis type of the large ischial bone, the subtype of the piriformis, and the subsacral type of the ischial bone through the ischial hole.
2. The path of the ischial sacral sac in the ovary fossa behind the broad ligament, the contents of the sputum can be any organ in the lower abdomen and pelvis, but the most common in the small intestine, the contents of the sputum into the sac, after the piriformis Under the upper or piriformis, or under the ischial spine, the pelvic cavity is removed, and the sciatic nerve with the least resistance enters the thigh, descending on the lower edge of the gluteus maximus or the posterior side of the thigh.
Prevention
Ischial hernia prevention
There are no effective preventive measures.
Complication
Ischial complication Complications, intestinal obstruction
The contents are incarcerated, and intestinal narrowing and necrosis can occur.
Symptom
Symptoms of ischial sacral symptoms Common symptoms Severe sciatica abdominal discomfort in the size of the ischial size
1. There is tenderness in the large hole area of the ischial bone, sometimes accompanied by gluteal, subgluteal or sciatica.
2. There is a mass in the gluteal cleft (ie, the gluteal fold at the gluteal fold), and there is a change in size depending on the position. The mass disappears when the pelvis is in a high position, and there is a local impact when the abdominal pressure is increased. A mass appeared.
3. There is a slight abdominal discomfort in normal times. When the content is incarcerated, mechanical intestinal obstruction may occur.
Examine
Ischial hernia check
When clinical complications occur, white blood cell counts and the like can be increased.
1. Abdominal X-ray plain film low inflated small intestine bowel and cup image.
2. Abnormal intestinal reflex waves can be found in the B-ultrasound.
Diagnosis
Diagnosis of ischial hernia
Diagnostic points
1. History: Middle-aged women have multiple births; reversible masses appear in the gluteal sulcus, and the size changes with body position; there is tenderness or bronchial neuralgia in the size of the ischial size.
2. Signs: There is tenderness in the large hole of the ischial bone or the small hole of the ischial bone. In some cases, the mass can be touched in the gluteal sulcus. When the abdominal pressure is increased, the local mass increases. When coughing, there is a local impact. If there is no incarceration, it can be returned. Na.
3. Auxiliary examination: Comply with the sciatic corpus callosum.
