A hernia is the protrusion[1] of an organ or the fascia A fascia (, plural fas·ci·ae (făsh'ē-ē), adjective fascial (făsh'ē-əl); (from latin: "band")) is a layer of fibrous tissue that permeates the human body. A fascia is a connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding those structures together like plastic sandwich wraps.. It consists of an organ through the wall of the cavity that normally contains it. A hiatal hernia A hiatus hernia or hiatal hernia is the protrusion of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm occurs when the stomach protrudes into the mediastinum The mediastinum is a non-delineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thoracic cavity. It contains the heart, the great vessels of the heart, esophagus, trachea, phrenic nerve, cardiac nerve, thoracic duct, thymus, and lymph nodes of the central chest through the esophageal opening in the diaphragm In the anatomy of mammals, the thoracic diaphragm or sometime simply, the diaphragm, is a sheet of internal muscle that extends across the bottom of the rib cage. The diaphragm separates the thoracic cavity from the abdominal cavity and performs an important function in respiration. A diaphragm in anatomy can refer to other flat structures such as.
By far the most common herniae develop in the abdomen In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax (chest) and pelvis. The region enclosed by the abdomen is termed the abdominal cavity. In arthropods it is the most distal section of the body which lies behind the thorax or cephalothorax, when a weakness in the abdominal wall evolves into a localized hole, or "defect", through which adipose tissue In histology, adipose tissue or body fat or just fat is loose connective tissue composed of adipocytes. It is technically composed of roughly only 80% fat; fat in its solitary state exists in the liver and muscles. Adipose tissue is derived from lipoblasts. Its main role is to store energy in the form of fat, although it also cushions and, or abdominal organs covered with peritoneum The peritoneum is the serous membrane that forms the lining of the abdominal cavity or the coelom — it covers most of the intra-abdominal organs — in higher vertebrates and some invertebrates (annelids, for instance). It is composed of a layer of mesothelium supported by a thin layer of connective tissue. The peritoneum both supports the, may protrude. Another common hernia involves the spinal discs A spinal disc herniation , informally and misleadingly called a "slipped disc", is a medical condition affecting the spine, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc (discus intervertebralis) allows the soft, central portion (nucleus pulposus) to bulge out. Tears are almost always posterior- and causes sciatica Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, and/or various parts of the leg and foot. In.
Herniae may or may not present either with pain Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It is the feeling common to such experiences as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone" at the site, a visible or palpable lump, or in some cases by more vague symptoms resulting from pressure on an organ which has become "stuck" in the hernia, sometimes leading to organ dysfunction. Fatty tissue usually enters a hernia first, but it may be followed by or accompanied by an organ.
Most of the time, herniae develop when pressure in the compartment of the residing organ is increased, and the boundary is weak or weakened.
- Weakening of containing membranes or muscles is usually congenital (which explains part of the tendency of herniae to run in families), and increases with age (for example, degeneration of the annulus fibrosus Each intervertebral fibrocartilage is composed, at its circumference, of laminæ of fibrous tissue and fibrocartilage, forming the annulus fibrosus of the intervertebral disc Intervertebral discs lie between adjacent vertebrae in the spine. Each disc forms a cartilaginous joint to allow slight movement of the vertebrae, and acts as a ligament to hold the vertebrae together), but it may be on the basis of other illnesses, such as Ehlers-Danlos syndrome Ehlers-Danlos Syndrome (also known as "Cutis hyperelastica") is a group of inherited connective tissue disorders, caused by a defect in the synthesis of collagen (a protein in connective tissue). The collagen in connective tissue helps tissues to resist deformation (increases its elasticity). In the skin, muscles, ligaments, blood or Marfan syndrome Marfan syndrome is a genetic disorder of the connective tissue, stretching of muscles during pregnancy, losing weight in obese people, etc., or because of scars from previous surgery.
- Many conditions chronically increase intra-abdominal pressure, (pregnancy, ascites Mild ascites is hard to notice, but severe ascites leads to abdominal distension. Patients with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm, COPD Chronic obstructive pulmonary disease refers to chronic bronchitis and emphysema, a pair of two commonly co-existing diseases of the lungs in which the airways become narrowed. This leads to a limitation of the flow of air to and from the lungs causing shortness of breath. In contrast to asthma, the limitation of airflow is poorly reversible and, dyschezia, benign prostatic hypertrophy Benign prostatic hyperplasia also known as benign prostatic hypertrophy (technically a misnomer), benign enlargement of the prostate (BEP), and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate in middle-aged and elderly men. To be accurate, the process is one of hyperplasia rather than hypertrophy, but the) and hence abdominal hernias are very frequent. Increased intracranial pressure can cause parts of the brain to herniate through narrowed portions of the cranial cavity or through the foramen magnum In anatomy, in the occipital bone, the foramen magnum is one of the several oval or circular apertures in the base of the skull (the foramina), through which the medulla oblongata (an extension of the spinal cord) enters and exits the skull vault. Increased pressure on the intervertebral discs, as produced by heavy lifting or lifting with improper technique, increases the risk of herniation.
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Classification
A sportman's hernia is a syndrome In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms (reported by the patient), phenomena or characteristics that often occur together, so that the presence of one feature alerts the physician to the presence of the others. In recent decades, the term has been used outside medicine characterized by chronic groin In human anatomy, the groin areas are the two creases at the junction of the torso with the legs, on either side of the pubic area. A pulled groin muscle usually refers to a painful injury sustained by straining the hip adduction muscles' pain Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It is the feeling common to such experiences as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone" in athletes A sportsperson or athlete is a person trained to compete in a sport involving physical strength, speed or endurance. Sportspeople may be professional or amateur and a dilated superficial ring of the inguinal canal, although a true hernia is not present.
Inguinal
Main article: inguinal hernia An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. They are very common (lifetime risk 27% for men, 3% for women), and their repair is one of the most frequently performed surgical operations Diagram of an indirect An indirect inguinal hernia is an inguinal hernia that results from the failure of embryonic closure of the internal inguinal ring after the testicle has passed through it. Like other inguinal hernias, it protrudes through the inguinal ring. It is the most common cause of groin hernia, scrotal inguinal hernia An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. They are very common (lifetime risk 27% for men, 3% for women), and their repair is one of the most frequently performed surgical operations (median Standard anatomical terms of location are employed in science which deal with the anatomy of animals to avoid ambiguities which might otherwise arise. They are not language-specific, and thus require no translation. They are universal terms that may be readily understood by zoologists who speak any language view from the left). repair of inguinal herniaBy far the most common hernias (up to 75% of all abdominal hernias) are the so-called inguinal hernias. Much insight is needed in the anatomy of the inguinal canal The inguinal canal is a passage in the anterior abdominal wall which in men conveys the spermatic cord and in women the round ligament. The inguinal canal is larger and more prominent in men. Inguinal hernias are further divided into the more common indirect inguinal hernia An indirect inguinal hernia is an inguinal hernia that results from the failure of embryonic closure of the internal inguinal ring after the testicle has passed through it. Like other inguinal hernias, it protrudes through the inguinal ring. It is the most common cause of groin hernia (2/3, depicted here), in which the inguinal canal is entered via a congenital weakness at its entrance (the internal inguinal ring), and the direct inguinal hernia The direct inguinal hernia, a type of inguinal hernia, enters through a weak point in the fascia of the abdominal wall, and its sac is noted to be medial to the inferior epigastric vessels. Direct inguinal hernias are the same in men and women type (1/3), where the hernia contents push through a weak spot in the back wall of the inguinal canal. Inguinal hernias are the most common type of hernia in both men and women. Femoral hernias occur more often in women than men, but women still get more inguinal hernias than femoral hernias.
Femoral
Main article: femoral hernia A hernia is caused by the protrusion of a viscus through a weakness in the containing wall. This weakness may be inherent, as in the case of inguinal, femoral and umbilical hernias. On the other hand, the weakness may be caused by surgical incision through the muscles of the abdominal/thoracic wall. Hernias occurring through these are calledFemoral hernias occur just below the inguinal ligament The inguinal ligament is a band running from the pubic tubercle to the anterior superior iliac spine. Its anatomy is very important for operating on hernia patients, when abdominal contents pass into the weak area at the posterior wall of the femoral canal The femoral sheath has three compartments. The lateral compartment contains the femoral artery, the intermediate compartment contains the femoral vein, and the medial and smallest compartment is called the femoral canal. The femoral canal contains efferent lymphatic vessels and a lymph node embedded in a small amount of areolar tissue. It is. They can be hard to distinguish from the inguinal type (especially when ascending cephalad): however, they generally appear more rounded, and, in contrast to inguinal hernias, there is a strong female preponderance in femoral hernias. The incidence of strangulation in femoral hernias is high. Repair techniques are similar for femoral and inguinal hernia An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. They are very common (lifetime risk 27% for men, 3% for women), and their repair is one of the most frequently performed surgical operations.
Umbilical
Main article: umbilical hernia Congenital umbilical hernia is a congenital malformation, common in infants of African descent. Among adults, it is three times more common in women than in men; among children, the ration is roughly equal. An acquired umbilical hernia directly results from increased intra-abdominal pressure and are most commonly seen in obese individualsUmbilical hernias are especially common in infants of African The African continent is home to many different ethnic groups and people of wide-ranging phenotypical traits, both indigenous and foreign to the continent. Many of these populations have diverse origins, with differing cultural, linguistic and social traits and mores. Distinctions within Africa's geography, such as the varying climates across the descent, and occur more in boys. They involve protrusion of intraabdominal contents through a weakness at the site of passage of the umbilical cord In placental mammals, the umbilical cord is the connecting cord from the developing embryo or fetus to the placenta. During prenatal development, the umbilical cord comes from the same zygote as the fetus and (in humans) normally contains two arteries (the umbilical arteries) and one vein (the umbilical vein), buried within Wharton's jelly. The through the abdominal wall There is a common set of layers covering and forming all the walls: the deepest being the extraperitoneal fat, the parietal peritoneum, and a layer of fascia, which has different names according to what it covers. These hernias often resolve spontaneously. Umbilical hernias in adults are largely acquired, and are more frequent in obese Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. Body mass index , a measurement which compares weight and height, defines people as overweight (pre-obese) when their BMI is between 25 kg/m2 and 30 or pregnant Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the womb of a female. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets. Human pregnancy is the most studied of all mammalian pregnancies. Childbirth usually occurs about 38 weeks after conception; i.e., approximately 40 weeks women. Abnormal decussation of fibers at the linea alba may contribute.
Incisional
Main article: incisional herniaAn incisional hernia occurs when the defect is the result of an incompletely healed surgical wound. When these occur in median laparotomy A laparotomy is a surgical procedure involving an incision through the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy incisions in the linea alba, they are termed ventral hernias. These can be the most frustrating and difficult to treat, as the repair utilizes already attenuated tissue.
Diaphragmatic
Main article: diaphragmatic hernia Diagram of a hiatus hernia A hiatus hernia or hiatal hernia is the protrusion of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm (coronal section Standard anatomical terms of location are employed in science which deal with the anatomy of animals to avoid ambiguities which might otherwise arise. They are not language-specific, and thus require no translation. They are universal terms that may be readily understood by zoologists who speak any language, viewed from the front).Higher in the abdomen, an (internal) "diaphragmatic hernia" results when part of the stomach or intestine protrudes into the chest cavity through a defect in the diaphragm.
A hiatus hernia A hiatus hernia or hiatal hernia is the protrusion of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm is a particular variant of this type, in which the normal passageway through which the esophagus meets the stomach (esophageal hiatus In the anatomy of mammals, the thoracic diaphragm or sometime simply, the diaphragm, is a sheet of internal muscle that extends across the bottom of the rib cage. The diaphragm separates the thoracic cavity from the abdominal cavity and performs an important function in respiration. A diaphragm in anatomy can refer to other flat structures such as) serves as a functional "defect", allowing part of the stomach In some animals, including vertebrates, echinoderms, insects and molluscs, the stomach is a muscular, hollow, dilated part of the alimentary canal which functions as the primary organ of the digestive tract. It is involved in the second phase of digestion, following mastication (chewing). The stomach is located between the esophagus and the small to (periodically) "herniate" into the chest. Hiatus hernias may be either "sliding," in which the gastroesophageal junction The esophagus or oesophagus , sometimes known as the gullet, is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. During swallowing food passes from the mouth through the pharynx into the esophagus and travels via peristalsis to the stomach. The word esophagus is derived from the itself slides through the defect into the chest The chest is a part of the anatomy of humans and various other animals. It is sometimes referred to as the thorax, or non-sliding (also known as para-esophageal), in which case the junction remains fixed while another portion of the stomach moves up through the defect. Non-sliding or para-esophageal hernias can be dangerous as they may allow the stomach to rotate and obstruct. Repair is usually advised.
A congenital diaphragmatic hernia is a distinct problem, occurring in up to 1 in 2000 births, and requiring pediatric surgery Pediatric surgery or paediatric surgery (BE) is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults. Many pediatric surgeons practice at children's hospitals. Intestinal organs may herniate through several parts of the diaphragm In the anatomy of mammals, the thoracic diaphragm or sometime simply, the diaphragm, is a sheet of internal muscle that extends across the bottom of the rib cage. The diaphragm separates the thoracic cavity from the abdominal cavity and performs an important function in respiration. A diaphragm in anatomy can refer to other flat structures such as, posterolateral (in Bochdalek's triangle, resulting in Bochdalek's hernia), or anteromedial-retrosternal (in the cleft of Larrey Dominique Jean Larrey was a French surgeon in Napoleon's army and an important innovator in battlefield medicine/Morgagni's foramen, resulting in Morgagni-Larrey hernia, or Morgagni's hernia).
Other hernias
Since many organs or parts of organs can herniate through many orifices, it is very difficult to give an exhaustive list of hernias, with all synonyms and eponyms. The above article deals mostly with "visceral hernias", where the herniating tissue arises within the abdominal cavity. Other hernia types and unusual types of visceral hernias are listed below, in alphabetical order:
- Cooper's hernia: a femoral hernia with two sacs, the first being in the femoral canal, and the second passing through a defect in the superficial fascia and appearing almost immediately beneath the skin.
- Epigastric hernia: a hernia through the linea alba above the umbilicus.
- Hiatal hernia: a hernia due to "short oesophagus" - insufficient elongation - stomach is displaced into the thorax
- Littre's hernia: a hernia involving a Meckel's diverticulum. It is named after the French anatomist Alexis Littre (1658–1726).
- Lumbar hernia (Bleichner's Hernia): a hernia in the lumbar region (not to be confused with a lumbar disc hernia), contains the following entities:
- Petit's hernia: a hernia through Petit's triangle (inferior lumbar triangle). It is named after French surgeon Jean Louis Petit (1674–1750).
- Grynfeltt's hernia: a hernia through Grynfeltt-Lesshaft triangle (superior lumbar triangle). It is named after physician Joseph Grynfeltt (1840–1913).
- Maydl hernia: two adjacent loops of small intestine are within a hernial sac with a tight neck. The intervening portion of bowel WITHIN the abdomen is deprived of its blood supply and eventually becomes necrotic.
- Obturator hernia: hernia through obturator canal
- Pantaloon hernia: a combined direct and indirect hernia, when the hernial sac protrudes on either side of the inferior epigastric vessels
- Paraesophageal hernia
- Paraumbilical hernia: a type of umbilical hernia occurring in adults
- Perineal hernia: a perineal hernia protrudes through the muscles and fascia of the perineal floor. It may be primary but usually, is acquired following perineal prostatectomy, abdominoperineal resection of the rectum, or pelvic exenteration.
- Properitoneal hernia: rare hernia located directly above the peritoneum, for example, when part of an inguinal hernia projects from the deep inguinal ring to the preperitoneal space.
- Richter's hernia: a hernia involving only one sidewall of the bowel, which can result in bowel strangulation leading to perforation through ischaemia without causing bowel obstruction or any of its warning signs. It is named after German surgeon August Gottlieb Richter (1742–1812).
- Sliding hernia: occurs when an organ drags along part of the peritoneum, or, in other words, the organ is part of the hernia sac. The colon and the urinary bladder are often involved. The term also frequently refers to sliding hernias of the stomach.
- Sciatic hernia: this hernia in the greater sciatic foramen most commonly presents as an uncomfortable mass in the gluteal area. Bowel obstruction may also occur. This type of hernia is only a rare cause of sciatic neuralgia.
- Spigelian hernia, also known as spontaneous lateral ventral hernia
- Sports hernia: a hernia characterized by chronic groin pain in athletes and a dilated superficial ring of the inguinal canal.
- Velpeau hernia: a hernia in the groin in front of the femoral blood vessels
- Amyand's Hernia: containing the appendix vermiformis within the hernia sac
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Tue, 22 Jun 2010 05:19:49 GMT+00:00
Florida Today Now, as the foot heals, Schafer will undergo surgery to repair the hernia , which is caused when tissue pushes through a weak spot in the groin muscle. ...
Prongs
Fri, 16 Apr 2010 22:51:19 GM
I cant believe I laughed so hard about the stork/. hernia. joke . *still grabbing my sides and panting*. 24 Katrina 04.17.10 at 6:15 am. The world is a better place with another baby giraffe! 25 Fegli 04.17.10 at 6:42 am ...
