Inguinal sliding hernia
Introduction
Brief introduction of groin snoring Inguinal sacral hernia refers to the sac of the sac that protrudes from the inguinal canal and/or its mesentery. The sac is usually the cecum on the right side and the sigmoid on the left side. The serosa layer of the cecum or sigmoid colon constitutes the posterior wall of the hernia sac and folds back to the sides to form the sides and anterior wall of the hernia sac. Sometimes the organ that slides out is the bladder. basic knowledge The proportion of illness: 0.0002% Susceptible people: no special people Mode of infection: non-infectious Complications: constipation, abdominal pain
Cause
Inguinal hernia
Congenital factors (75%)
Under normal circumstances, part of the ascending colon, descending colon, bladder and fallopian tubes are covered by the peritoneum, while the other part is not covered with peritoneum. Due to congenital dysplasia or acquired factors, such as old ligament relaxation, weight loss, visceral drooping and other reasons, the organ's mobility is increased, and the above factors of sputum formation are added to cause disease.
Pathogenesis
There are two main methods for pathological classification of abdominal hernia sliding:
1. Classification of the position of the sac and the organ
(1) sac-type (pulling type): 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.
(2) internal capsule type: This type is the same as general sputum, but should pay attention to the extraperitoneal organs during surgery.
(3) Pushing type: This type is rare. The organs that come out form most of the sputum. The part of the peritoneum is located at a high position. If you look for the sac in the operation, you can easily damage the detached organs.
2. Sort by the contents of the organs that are taken out
(1) Bladder slippery.
(2) Intestinal tube slippery.
(3) Mixing slipper.
Prevention
Inguinal sacral spasm prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Inguinal sacral hernia complications Complications constipation abdominal pain
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. The inguinal hernias are almost all oblique, and even the straight sacs are pulled out from the Hesselbach triangle, and the symptoms are similar to those of the general oblique.
Symptom
Inguinal sacral sputum symptoms Common symptoms Pain or bulge in constipation area with constipation and severe abdominal pain in the inguinal area
Sliding sputum is rare, and there is no characteristic clinical manifestation. It is not easy to make a diagnosis before surgery. However, based on the characteristics of the sliding sputum structure, it is not easy to fully return, so it often appears to be difficult to relapse, all old, obese, In patients with a long history, the sputum is not easy to return, or can only be partially returned, and the possibility of sliding sputum should be considered.
Examine
Examination of inguinal sacral 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: Intestinal shadows in the groin area can be found.
2. Venous angiography or cystography: observe whether sputum affects the genitourinary system and determine the relationship between the genital warts and the bladder. It looks like a slanting scorpion, and it can appear quickly when it is erected. There is a phenomenon of "two urinations", and the testicle sputum appears, etc., and the possibility of sliding sputum should be considered.
Diagnosis
Diagnosis and differential diagnosis of inguinal hernia
1. Defecation after sputum reduction: The patient has no defecation when the content is descending colon or sigmoid colon, and can only defecate after sputum reduction.
2. The phenomenon of "two urines": that is, the pain of the ankle when urinating, the sputum shrinks after the first urination, and soon there is urine, forming a phenomenon that the urine is discharged twice. This phenomenon is more common in the bladder and larger.
3. Pulling the testicle phenomenon: that is, there is no need to increase the abdominal pressure after the reduction, as long as the testicle is pulled down, the block can appear. This is the slippery organ that forms adhesion to the spermatic cord, and is more common in the sliding sputum of the elderly.
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