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January 11, 2012
Hernia is a process at which there is a protrusion of a certain body under integuments, in cellulose between muscles or in other internals. Hernia can be also stuck out in loops of guts or in an epiploon, at the same time integrity of skin will not be broken.
Stomach hernias – one of the most widespread hernias. At the same time umbilical hernia and at children is diagnosed for adults today especially often, taking on prevalence degree the second place among kinds of hernias of a front abdominal wall. At patients with umbilical hernia internals leave through a physiological opening which appears in a front abdominal wall. This opening is localized near a navel (the umbilical ring is an inborn weak place).
In view of the fact that symptoms and the course of this disease considerably differ at people in the different age periods, distinguish umbilical hernias at adults and umbilical hernias at children.
Umbilical hernia at children
At children's age umbilical hernia is a consequence of manifestation of defect in development of a front abdominal wall. As a rule, developing of hernia happens owing to the increased intra belly pressure which cause the most various factors. Umbilical hernias are diagnosed for babies rather often. At the same time the disease arises generally in the first months of life of the child, more often umbilical hernia is shown at girls.
To define existence of umbilical hernia at children, it is necessary to pay attention to presence of some symptoms of this disease. So, if to hold the child vertically, then at a natuzhivaniye he will show the protrusion having the oval or rounded form. At the same time if to return the kid to horizontal position, then protrusion will independently be set back into place. It easily occurs if there are wide hernial gate. At narrow hernial gate reposition of hernia can happen more difficult. The similar phenomenon is regarded sometimes as existence of partial infringement. Much less often at hernia full infringements occur at children.
Umbilical hernias at adults
At adults umbilical hernias make low interest (3-5%) of stomach hernias in general. Umbilical hernia at adults is most often diagnosed for women who already reached thirty-year age. Weakening of an umbilical ring which provokes stretching of a front abdominal wall in the course of incubation of the child and at the time of delivery is the main reason of display of this disease. If hernia very big, then a bag can have several cameras, and intestines and a stomach can become its contents.
Symptoms of umbilical hernia are shown depending on what size directly hernias what sizes of hernial gate, commissures are how expressed and whether the patient has an obesity.
Hernias at adults can be distinguished set and not set. In the latter case there is an accretion of a hernial bag to surrounding fabrics owing to commissural process.
In some cases umbilical hernias of the small size do not cause special troubles to patients. But it is possible only if width of hernial gate rather big, and at the same time hernia can be set freely. If hernia big, and gate rather narrow, then the movement of contents on intestines can be at a loss considerably. As a result, at patients locks, pain, vomiting and nausea are shown. If hernia unreducible, then the similar phenomena are more expressed.
In development of a disease of education can reach especially big sizes, to leave in all bodies located in an abdominal cavity in a hernial bag.
As a result patients feel considerable discomfort, hernia worsens quality of human life generally. In this situation not always perhaps surgical treatment of hernia, before operation planned measures for preparation for similar intervention are necessary. Rather often the condition of patients is influenced negatively by existence of excess weight.
Infringement of umbilical hernia
Umbilical hernia at adults can be restrained. Similar manifestations are characteristic of elderly people, conditions for a strangulation of a hernia are shown over time, and, the longer time exists hernia, the it is more than chances for emergence of infringement.
The strangulation of a hernia can occur at any size of education. The main symptom of infringement of umbilical hernia sharp manifestation of pain in the place of hernial protrusion, and also impossibility of reposition of hernia which was set simply earlier is considered. If intestinal loops are restrained, then at the person the symptoms characteristic of a condition of acute intestinal impassability can be shown.
Diagnosis of umbilical hernia
As a rule, it is possible to diagnose umbilical hernia rather simply, in most cases to specialists patients handle certain symptoms. So, the expressed protrusion in a navel disappearing when the person accepts horizontal position is a strong indication of umbilical hernia. Besides, in the course of poll and survey of the patient the doctor finds out whether there is pain at a stomach during strong exercise stresses and cough, whether expansion of an umbilical ring takes place.
Diagnosis of umbilical hernia is carried out by the surgeon. For receiving more detailed results radiographic research of a stomach and duodenum, ultrasonic research of hernial protrusion, and also gastroscopy is conducted. In certain cases also the gerniografiya method is applied (introduction to belly a contrast agent which allows to investigate hernia).
In the course of inspection differentiation of umbilical hernia with metastasises of a carcinoma of the stomach is especially important. Also during researches diseases which accompany umbilical hernia quite often come to light.
Treatment of umbilical hernia
Generally at treatment of umbilical hernia the surgery is not required from children. As a rule at children by three-five years an umbilical opening to become less then it is closed without foreign influence. However if to the specified age this process does not happen, then intervention of the surgeon is required.
Also conservative methods of treatment of hernia are applied. It is process of strengthening of an abdominal wall by performance of gymnastic exercises, and also by means of specially developed massage course. Massage of a stomach is actively applied to treatment of children with inborn umbilical hernia. As a result of similar procedures and in the course of growth and strengthening of an abdominal wall umbilical hernia at children generally successfully recovers.
Specialists advise especially carefully to approach sticking up of hernia an adhesive plaster. This action is fraught with irritation on skin and the subsequent distribution of an infection.
At the same time at treatment of umbilical hernia at adults the surgery is a necessary method. Conservative methods of therapy at umbilical hernia are appointed only in case of uncomplicated hernia or at serious contraindications to surgical intervention at the patient. So, operations are not made at acute diseases, and also at an exacerbation of chronic illnesses, to people with pathologies of cardiovascular and respiratory systems, serious illnesses, to women on late durations of gestation. At conservative treatment by the patient it is strongly recommended to reduce considerably exercise stresses, to lose weight, to constantly carry a special bandage.
When carrying out a surgery the doctor allocates and opens a hernial bag then contents of this bag are immersed in an abdominal cavity. Further closing and the subsequent strengthening of hernial gate according to the developed technique is carried out.
Complications of umbilical hernia
The most widespread complication of umbilical hernia is its infringement in the course of which there is a sharp squeezing contained in hernial gate. At this state acute management can be required for the patient. It is important to address urgently the specialist if at the person vomiting and nausea is shown, at Calais there is blood or defecation and passages of flatus are absent in general, hernia cannot be set in horizontal position.
Also inflammatory process in the body staying in a hernial bag can become complication. One more possible option of complication of umbilical hernia — a coprostasis (stagnation a calla in a large intestine).
Prevention of umbilical hernia
At newborn babies for prevention of emergence of umbilical hernias it is important to tie up correctly an umbilical cord and in the first days of life of the kid it is correct to look after a navel. It is necessary to monitor food of the newborn – he should not overeat and suffer from locks. Chest kids several times in days are spread on a stomach for the purpose of strengthening of muscles of a prelum abdominale. It is not necessary to swaddle the newborn child too hardly. In the first days and weeks of life you should not keep it in vertical position and to throw up to prevent display of umbilical hernia at children.
Pregnant women for prevention of stretching of an abdominal wall can carry a special bandage. It is important to pay special attention to quality of food, to lead an active and dynamic life. An important role in prevention of umbilical hernia is played by training of muscles of a stomach by means of special exercises. If the person has obesity, it is necessary to take the correct actions for normalization of weight.
Special attention to prevention of hernia should be paid to those people who already underwent earlier operations on abdominal organs. To warn problems further, follows for two months after operation constantly to carry a postoperative elastic bandage, not to lift weight at all and not to carry out exercise for a prelum abdominale.