inguinal sliding hernia
Introduction
Brief introduction of groin sliding Scarpa (1821) first proposed the concept of sliding sputum. The sliding inguinal hernia refers to the posterior organ of the abdominal cavity together with the covered part of the peritoneum from the inguinal canal, forming part of the sac wall. The most common organs that slide out of the inguinal hernia are sigmoid colon, cecum, bladder, uterus and attachments. This type of sputum often has no characteristic manifestations. It is often difficult to diagnose before surgery, and it is often diagnosed during surgery. basic knowledge Sickness ratio: 0.5% Susceptible people: no special people Mode of infection: non-infectious Complications: inguinal hernia
Cause
Inguinal hernia
Parachase type (pulling type) (65%):
This type is more common, the organ that is removed is the colon and constitutes the posterior wall of the sac, and the sac of the peritoneum is located in front of the tumor.
Intracapsular type (30%):
This type is no different from general sputum, but should pay attention to the extraperitoneal organs during surgery.
Capsule (5%):
This type is rare, the organs that come out constitute most of the sputum, and the part of the peritoneum is relatively high. If you look for the sac in surgery, you can easily damage the organs that are easily removed.
Classified by the contents of the organs that are taken out
(1) Bladder slippery.
(2) Intestinal tube slippery.
(3) Mixing slipper.
Prevention
Inguinal hernia prevention
1. Early diagnosis and early treatment.
2. Change bad habits and cultivate a healthy lifestyle
3. Active prevention and treatment of diseases that promote increased intra-abdominal pressure, such as chronic bronchitis, emphysema, and enlarged prostate.
Complication
Inguinal hernia Complications inguinal hernia
Due to repeated friction during the sliding process, the abdominal organ is prone to adhesion between the organ and the sac, which forms a difficult sputum.
Symptom
Inguinal hernia symptoms common symptoms lower abdominal pain persistent lower abdominal pain abdominal mass
Inguinal hernias are almost all oblique, and even straight tendons are pulled out from the Hesselbach triangle. The symptoms are similar to those of the general oblique hernia. In some cases, special clinical manifestations may occur, which may contribute to the diagnosis of the slippery.
1. When the content of the bowel movement after the reduction is the descending colon or sigmoid colon, the patient has no defecation, and can only defecate after the reduction of the hernia.
2. The phenomenon of "two urines" means that the sputum is painful when urinating. After the first urination, the sputum shrinks, and soon there is urine, forming a urine discharge twice. This phenomenon is more common in the bladder. The bigger one.
3. Pulling the testicle phenomenon is to reduce the sliding sputum of the elderly.
Examine
Examination of the inguinal sliding hernia
Clinically, the above conditions or signs are available, and the organs are damaged during the anti-surgical exploration. Colonography, cystoscopy or cystography can be performed before surgery.
1. Digestive tract angiography or barium enema can be found in the inguinal region.
2. Intravenous angiography or cystography to observe whether sputum affects the genitourinary system and determine the relationship between sputum and bladder.
Diagnosis
Diagnosis and differential diagnosis of inguinal hernia
1. Medical history for middle-aged and elderly patients with long course of disease, especially body fat, huge complete paralysis, and difficult to re-entertain, but rarely incarcerated, should consider the possibility of sliding.
2. The clinical manifestation is like a squat, and it can appear quickly when it is erected; there is a phenomenon of "two urinary tracts", and the testicle sputum appears, etc., and the possibility of sliding sputum should be considered.
3. Auxiliary inspection.
4. During the intraoperative exploration, it is not easy to find the hernia sac, or there are more adipose tissue around it. It should be suspected to be a sliding sputum. During the operation, the sac is also retracted when it is removed. It is also a manifestation of sliding sputum.
