Pain or heaviness in the hernia area

Introduction The pain or bulging sensation in the reclamation area is a minor symptom of the meniscus. There is only pain or swell in the reclamation area, and it is often aggravated by an increase in intra-abdominal pressure. The semilunar sputum is a kind of abdominal wall sputum, which is rare. The age of onset is about 50 years old and the ratio is about 1:1.6. The incidence of incarceration and strangulation can reach 21%, so early surgical treatment should be performed. If the pain in the patient's crotch region and the abdominal wall mass can be confirmed, especially if the compression block can be retracted and can reach the edge of the ankle ring, and the method of increasing the intra-abdominal pressure can aggravate the pain in the crotch region, then there is almost no diagnosis. difficult.

Cause

1. Abdominal wall tissue inflammation, abscess, or local tissue degeneration after surgery to form a weak area.

2. Direct trauma.

3. Nerve damage causes the local tissue to lose nerve support and the ability to resist abdominal pressure is reduced. The anatomical structure can be divided into 3 layers. The first layer is the inward extension of the external oblique muscle, and the anterior sheath of the rectus abdominis is fused in the middle of the rectus abdominis. The second layer is the thickest of the ventral oblique muscles, which constitutes the semilunar line. The main body participates in the anterior and posterior sheath of the rectus abdominis above the semicircular line; the third layer is the aponeurosis of the transverse abdominis muscle which occludes inward to form the rectus sheath. In the anterior and posterior sheath transition zone of the rectus abdominis, the peritoneum and viscera can be dislodged to form sputum when a defect or gap is formed for some reason.

an examination

Related inspection

Abdominal shape palpation abdominal perspective abdominal CT

If the pain in the patient's crotch region and the abdominal wall mass can be confirmed, especially if the compression block can be retracted and can reach the edge of the ankle ring, and the method of increasing the intra-abdominal pressure can aggravate the pain in the crotch region, then there is almost no diagnosis. difficult. However, because the defect may be located under the sacral membrane of the complete external oblique muscle, the shape of the sacral block is mostly flat, not easy to touch or the mass is located at a certain distance from the half moon line, so the diagnosis is often difficult despite the tenderness of the simple pupil. Not enough to make a diagnosis, but can prompt the site of the prolapse (the position of the ankle ring or defect), more or less helpful for diagnosis. B-ultrasound and CT scans may help to confirm the diagnosis.

Differential diagnosis

Differential diagnosis of pain or bulging in the reclamation area:

Inguinal hernia: The intra-abdominal organs and tissues are located in the inferior groin of the Hesselbach triangle on the medial side of the inferior epigastric artery. Old and frail, abdominal muscles, diaphragm, fascia degeneration, abdominal wall strength decreased, under the effect of increased intra-abdominal pressure can occur. The huge straight sputum makes the strength of the posterior wall of the inguinal canal significantly weakened or absent.

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