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Inguinal Hernia
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Inguinal hernia

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Not necessarily dangerous in themselves, inguinal hernias can be painful and lead to serious complications. But surgical repair is now easier than it once was.

They occur when soft tissue — usually part of the intestine — protrudes through a weak point in the groin, where the abdomen meets the thigh. The resulting bulge can be painful — sometimes excruciatingly so — especially when you cough or lift a heavy object.

Some people develop or acquire the abdominal weakness that leads to a hernia in adulthood. But more often the weakness occurs at birth, when the abdominal lining (peritoneum) doesn't close properly. And although far more men than women have inguinal hernias, no one is immune — including infants, pregnant women and older adults.

Although not necessarily dangerous in themselves, inguinal hernias can lead to life-threatening complications. For that reason, your doctor is likely to recommend surgical removal of a hernia that's painful or growing larger. The good news is that it's not the same hernia operation your father may have had, with a large abdominal incision, a long hospital stay and weeks of immobility. Instead, many inguinal hernias now can be successfully repaired with a technique that uses several small incisions (laparoscopy), leading to a faster, less painful recovery.

Signs and symptoms 

Some inguinal hernias don't cause any symptoms, and you may not know you have one until your doctor discovers it during a routine medical exam. Often, however, you can see and feel the bulge created by the protruding intestine. The bulge is usually more obvious when you stand upright.

Other signs and symptoms of an inguinal hernia include:

  • Pain or discomfort in your groin, especially when bending over, coughing or lifting

  • A heavy or dragging sensation in your groin

  • Occasionally, in men, pain and swelling in the scrotum around the testicles when the protruding intestine descends into the scrotum

Signs and symptoms in children
Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia may only be visible when an infant is crying, coughing or straining during a bowel movement. In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period of time.

Causes

Some hernias have no apparent cause. But many occur as a result of increased pressure within the abdomen, a pre-existing weak spot in the abdominal wall or a combination of the two.

In men, the weak spot usually occurs along the inguinal canal. This is the area where the spermatic cord, which contains the tube that carries sperm (vas deferens) as well as blood vessels and nerves, enters the scrotum.

In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone.

Men are more likely to have an inherent weakness along the inguinal canal than women are because of the way males develop in the womb. In the male fetus, the testicles form in the abdomen and then move down the inguinal canal into the scrotum. Shortly after birth, the inguinal canal closes almost completely, leaving just enough room for the spermatic cord to pass through, but not enough to allow the testicles to move back into the abdomen.

Sometimes, however, the canal doesn't close properly, leaving a weakened area. There's less chance that the inguinal canal won't close after birth in female babies. In fact, women are more likely to develop hernias in the femoral canal, an opening near the inguinal canal where the femoral artery, vein and nerve pass through.

Weaknesses can also occur in the abdominal wall later in life, especially after an injury or certain operations in the abdominal cavity.

With or without a pre-existing weakness, extra pressure in the abdomen can cause a hernia. This pressure may result from straining during bowel movements or urination, from heavy lifting and from pregnancy or excess weight. Even chronic coughing or sneezing can cause abdominal muscles to tear.

Risk factors

You're far more likely to develop an inguinal hernia if you're male. Nearly 10 times more men than women have inguinal hernias, and the vast majority of newborns and children with inguinal hernias are boys.

Other risk factors include:

  • Family history. Your risk of developing an inguinal hernia increases if you have a close relative, such as a parent or sibling, with the condition.

  • Certain medical conditions. Having cystic fibrosis, a life-threatening disorder that causes severe lung damage and often a chronic cough, makes it more likely you'll develop an inguinal hernia. A persistent cough from any condition also increases your risk.

  • Chronic constipation. This leads to straining during bowel movements — a common cause of inguinal hernias.

  • Excess weight. Being moderately to severely overweight can put extra pressure on the abdomen.

  • Pregnancy. This can both weaken the abdominal muscles and cause increased pressure within the abdomen.

  • Certain occupations. Having a job that requires standing for long periods or doing heavy physical labor increases your risk of developing an inguinal hernia.

  • Premature birth. Infants who are born sooner than normal are more likely to have inguinal hernias.

  • History of hernias. If you've had one inguinal hernia, it's much more likely that you'll eventually develop another — usually on the opposite side.

inguinal hernia > 1 > 2 > 3 > 4

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 

 



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Last Modified : 03/15/08 01:12 AM