About hernias in general

Types and methods of treatment of strangulated hernia

Hernia in medicine denotes a condition when the organs of the body or tissue protrude outward or move from their usual place. This happens through the weakness of the abdominal wall and connective tissues of the human body.

It manifests itself noticeable bulge at the point of the protrusion. The surgeon may notice it during the examination, and the average person will notice the appearance of a strange bump on his body.

Often, such a bowing out of the viscera can be painful and cause discomfort. Especially when touching or interacting with clothes. Not to mention the moral pressure due to the shameful appearance of a painful defect on the body.

Pinching a hernia in the white line of the abdomen is quite rare. According to statistics, this infringement does not occur often due to its anatomical features. And classical infringement in a situation with hernia of the white line of the abdomen is not always reliable.

Very often in medical practice, the suspicion of pinching a hernia in the zone of the white line of the abdomen is confused with the pinching of the preperitoneal fat layer. This is not a dangerous clinical picture, compared with the present complication of the disease.

The human abdomen is a muscular bag in which the organs of the digestive, reproductive, urinary, hematopoietic systems are laid. The anterior abdominal wall consists of three layers of multidirectional muscle fibers.

In a healthy adult, they are very powerful and firmly hold the frame of the body, are involved in maintaining posture, walking and exercise. However, in the abdominal wall there are areas where muscle fibers are held together by connective tissue.

It is elastic and stretchable, and with a large load it can even tear.

The weak points of the abdominal wall include:

  • umbilical ring,
  • white line of the abdomen (line in the middle of the body, which can be drawn from the junction of the ribs to the pubis),
  • right and left inguinal canals - formations above the inguinal folds, where men have spermatic cords, and women have round ligaments of the uterus,
  • right and left femoral canals - formations under the inguinal fold with vessels and nerves passing through them,
  • spigelian lines on both sides - arcuate boundaries between the transverse muscle of the abdomen and its tendon,
  • all postoperative scars on the abdomen.

With an increase in intra-abdominal pressure, the load on the walls of the abdominal cavity from the inside increases sharply. Muscle tissues withstand this onslaught, but connective - not. It stretches or breaks, and a hole appears in a strong muscular sheet, which can get internal organs or their parts.

Intra-abdominal pressure rises in the following cases:

  • pregnancy - while the growing uterus increases the belly in volume, and the hormonal background makes all the connective tissues of the body more pliable and elastic for readiness for childbirth,
  • childbirth, especially difficult and long,
  • overweight,
  • chronic constipation
  • prolonged cough
  • weight lifting
  • screaming or crying at a child
  • playing wind instruments
  • wearing too tight belts and belts.

Each time the intra-abdominal pressure rises, the hernial ring opens slightly and the abdominal organs fall out. Then the period of tension passes, the intra-abdominal pressure returns to its normal level, and, in most cases, the contents of the hernial sac return to the site, and the gate closes.

A pinching occurs when, with a particularly large long-term force, there are more organs in the hernial sac, and the size of the hernial ring remains the same.

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Symptoms of pathology

Pathology recognition is carried out using visual inspection and the use of instrumental examination methods. On visual examination, the doctor assesses the general well-being of the patient, the size of the protrusion, the intensity of the pain syndrome.

Accurate data on the state of internal organs can be obtained using such methods:

  • Ultrasound procedure.
  • Survey radiography of the abdominal cavity.

After the diagnosis, the doctors' tactics change. The decision is made on the extent of surgical intervention and the method of anesthesia.

Preparation for surgery

This condition is the most severe complication of the hernia and is very dangerous for the patient. Abdominal hernia trauma mainly occurs with the so-called external hernia of the anterior abdominal wall (inguinal, femoral, umbilical, postoperative).

The infringement occurs in the area of ​​the hernial ring, therefore, much more often large hernias that come out of relatively small defects of the anterior abdominal wall are subjected to infringement.

Elastic infringement occurs at the moment of a sudden increase in intra-abdominal pressure during exercise, coughing, straining. At the same time, overstretching of the hernial ring occurs, with the result that more than usual internal organs enter the hernial sac.

The return of the hernial ring to its former state leads to the restriction of the contents of the hernia. With symptoms of elastic infringement of abdominal hernia, the compression of organs released into the hernial sac occurs outside.

Any attempts to reposition without hernia operation during its infringement are unacceptable, as it is extremely often complicated by trauma of the strangulated intestine until its rupture.

Patients who have a strangulated hernia posed on their own should also be hospitalized due to the risk of peritonitis. Antispasmodics are not shown.

The diagnosis of abdominal hernia is confirmed during surgery. When dissecting the tissue under the inguinal ligament, a strangulated hernia or enlarged, inflamed lymph nodes are found.

Stages of treatment of abdominal hernia infringement

At infringement the emergency operation is necessary. It is carried out so that, without dissecting the infringing ring, to open the hernial bag, to prevent slipping of the strangulated organs into the abdominal cavity.

The operation is carried out in several stages.

The first stage of treatment is a layered dissection of tissues before aponeurosis and exposure of the hernia sac.

The second stage of therapy is the opening of the hernial sac, the removal of the hernial water. To prevent slipping into the abdominal cavity of the strangled organs, the surgeon's assistant holds them with a gauze cloth. The dissection of the infringing ring before the opening of the hernial sac is unacceptable.

The third stage of treatment is dissection of the pinching ring under visual control, in order not to damage the organs soldered to it from the inside.

The fourth stage of treatment is the determination of the viability of the strangulated organs. This is the most crucial phase of the operation.

The main criteria for the vitality of the small intestine are the restoration of the normal color of the intestine, the preservation of the pulsation of the vessels of the mesentery, the absence of strangulation grooves and subserous hematomas, the restoration of peristaltic contractions of the intestine.

Indisputable signs of intestinal non-viability are dark coloration, dim serous membrane, flabby wall, lack of pulsation of the mesentery vessels and intestinal motility.

The fifth stage of the treatment of abdominal hernia infringement is resection of the non-viable loop of the intestine. From the border of necrosis visible from the serous cover, at least 30–40 cm of the adductor segment of the intestine and 10 cm of the abductor segment are resected.

Resection of the intestine is carried out when a strangulation sulcus, subserous hematomas, edema, infiltration and hematoma of the intestinal mesentery are detected in its wall.

When a sliding hernia is injured, it is necessary to determine the viability of the part of the organ not covered by the peritoneum. If necrosis of the cecum is detected, a resection of the right half of the large intestine is performed, with ileotransverse anastomosis being applied.

In case of necrosis of the bladder wall, resection of the modified part of the bladder with the application of an epicystostomy is necessary.

The sixth stage - plastic hernia gate. When choosing a plastic method, one should prefer the simplest one.

Treatment of complicated abdominal herniation

In a strangulated hernia complicated by phlegmon, the operation begins with a midline laparotomy (first stage) to reduce the risk of infection of the abdominal cavity with the contents of the hernial sac.

During a laparotomy, resection of the intestine within the viable tissues is performed and an inter-intestinal anastomosis is applied.

Then hernia repair is performed (second stage) - the strangulated intestine and hernial sac are removed. Plastic hernia gate is not done, and produce surgical treatment of purulent wounds of soft tissues, which is completed its drainage.

A necessary component of the integrated treatment of hernia injury is general and local antibiotic therapy.

Forecast. Postoperative mortality increases as the time elapsed from the moment of impairment to the operation lengthens, and is in the first 6 hours 1. 1%, from 6 to 24 hours - 2. 1%, and later 24 hours - 8. 2%, after resection intestinal lethality is 16%, with hernia reflux - 24%.

Photo: hernia littre

For a strangulated hernia, four symptoms are characteristic. They are found with any form of pinching. These include:

  1. The pain of a sharp nature, manifested in the area of ​​the hernia,
  2. Protrusion can not be adjusted even in the supine state,
  3. Hernia is painful and constantly tense,
  4. Cough push is not transmitted.

Abdominal hernia (abdominal hernia), if you do not get rid of them, can cause serious complications, the most dangerous of which is a strangulated hernia.

What it is? The main impetus to this state is a sharp increase in intra-abdominal pressure as a result of simultaneous excessive physical effort.

Strong tension of the abdominal wall contributes to the expansion of the hernial ring, which fall organs. After the termination of the load, the hole in the peritoneum is reduced and compresses them.

For a doctor, such a diagnosis means a critical condition that requires immediate surgery.

Emergency measures are taken, because the hernial ring squeezes the organs in the cavity of the hernia, and the access of nutrients and oxygen to them ceases, which leads to rapid tissue death.

Necrotic substances (necrosis - necrosis) rapidly enter the general bloodstream and cause severe intoxication of the body.

Almost always the infringement of a hernia occurs suddenly:

  • a person feels an unexpected attack of unbearable pain that does not go away even after relaxation,
  • hernial protrusion is stressful and cannot be reduced,
  • general condition deteriorates sharply, blood pressure falls, pulse quickens.

Within 7–8 hours, the first symptoms occur, indicating the development of necrosis in the strangulated tissues.

A delay in contacting the surgeon and an attempt at self-treatment can be fatal.

I am glad that modern methods of surgical treatment of strangulated hernia allow intervention in a minimally invasive way. The method of laparoscopy significantly reduces the recovery period, reduces the risk of developing postoperative infection and does not leave perverse scars on the body.

Surgery to remove a secondary strangulated hernia usually takes place without complications.

The risk of infringement threatens any kind of pathological protrusion, regardless of its location, anatomical location and hernial contents. The main provoking factor is the rapid and strong contraction of the abdominal muscles, in which the pressure on the hernial ring from the inside increases sharply.

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Provoke incarceration of a hernia can

Predisposing causes that create favorable conditions for sudden infringement

When clarifying the nature of the hernia and the type of infringement, patient complaints are important.

The main symptom of any kind of strangulated hernia is pain syndrome, which differs depending on the location, type and degree of infringement. The pain can only capture the area of ​​the hernia or spread throughout the abdomen.

A patient with signs of infringement of a hernia is sent for surgery on an emergency basis. Surgical intervention has the status of "for life reasons": this means that the only contraindication is an obvious death condition of the patient.

Elastic infringement occurs at the moment of a sudden increase in intra-abdominal pressure during exercise, coughing, straining. At the same time, overstretching of the hernial ring occurs, with the result that more than usual internal organs enter the hernial sac.

The return of the hernial ring to its former state leads to the restriction of the contents of the hernia. With symptoms of elastic infringement of abdominal hernia, the compression of organs released into the hernial sac occurs outside.

The first stage of treatment is a layered dissection of tissues before aponeurosis and exposure of the hernia sac.

The third stage of treatment is dissection of the pinching ring under visual control, in order not to damage the organs soldered to it from the inside.

The fifth stage of the treatment of abdominal hernia infringement is resection of the non-viable loop of the intestine. From the border of necrosis visible from the serous cover, at least 30–40 cm of the adductor segment of the intestine and 10 cm of the abductor segment are resected.

Resection of the intestine is carried out when a strangulation sulcus, subserous hematomas, edema, infiltration and hematoma of the intestinal mesentery are detected in its wall.

In a strangulated hernia complicated by phlegmon, the operation begins with a midline laparotomy (first stage) to reduce the risk of infection of the abdominal cavity with the contents of the hernial sac.

During a laparotomy, resection of the intestine within the viable tissues is performed and an inter-intestinal anastomosis is applied.

A necessary component of the integrated treatment of hernia injury is general and local antibiotic therapy.

Forecast. Postoperative mortality increases as the time elapsed from the moment of impairment to the operation lengthens, and in the first 6 hours 1, 1%, from 6 to 24 hours - 2, 1%, later 24 hours - 8, 2%, after resection intestinal lethality is 16%, with hernia reflux - 24%.

Primary and secondary impairment

In operative practice, strangulated hernia is the fourth most common pathology. It can be primary and secondary.

It is extremely rare, but it is the most dangerous. At the same time, the formation of a pathological opening in the tissues, the extrusion of internal organs there and their infringement occurs.

The danger of primary infringement is in the wrong attitude to his condition of patients, an attempt to self-treatment, and a late request for qualified help. As a result, the course of the operation is aggravated by such complications:

  • necrosis of compressed tissue
  • peritonitis,
  • severe intoxication of the body.

Forms of infringement of hernia and their manifestations

Symptoms of retrograde impairment

More often the small bowel is retrogradely restrained when two intestinal loops are located in the hernial sac, and the intermediate (connecting) loop is located in the abdominal cavity.

The binding intestinal loop is exposed to infringement to a greater degree. Necrosis begins earlier in the intestinal loop, located in the stomach above the pinching ring.

At this time, the intestinal loops in the hernial sac may still be viable.

Symptoms of retrograde impairment

Elastic

Pathology occurs mainly on the background of strong physical exertion, when lifting weights. The result of physical overvoltages is the exit of parts of the internal organs through the hernial ring, from where they cannot return to their original position after the hole has been reduced.

What happens when infringed

By incarceration is meant a pressure in the hernial ring of an organ.This compression can be gradual or sudden. Sudden infringement occurs during physical exertion, severe coughing, straining.

Most often, the intestinal areas that fall into the hernial ring are impaired. As a result, the blood circulation is disturbed both in the constricted part and in the whole organ. This is exactly what causes the problems associated with the formation of pathology.

Nuances of abdominal white line herniation

Hernia of the white line of the abdomen is not uncommon. It occurs on the front wall of the abdomen, where the so-called white line passes, which stretches from the lower part of the sternum to the pubic bone.

Anatomically, it consists of muscles and connective tissue, between which there are small slit-like spaces. Through these gaps pass the blood vessels and nerves, linking the subcutaneous tissue with fat.

The presence of these gaps, on the one hand, provides the body with normal blood flow throughout the abdominal wall, but, on the other hand, they are a weak part of the peritoneum through which organs can pass during a hernial disease.

It should be noted that most often hernia of the white line of the abdomen occurs in the upper part of the abdominal wall. This is called epigastric hernia. Loosenings in the navel (paraumbilical formations) and under the womb appear to a much lesser extent.

Pinching hernia white line of the abdomen

Pinching a hernia in the white line of the abdomen is quite rare. According to statistics, this infringement does not occur often due to its anatomical features. And classical infringement in a situation with hernia of the white line of the abdomen is not always reliable.

Very often in medical practice, the suspicion of pinching a hernia in the zone of the white line of the abdomen is confused with the pinching of the preperitoneal fat layer. This is not a dangerous clinical picture, compared with the present complication of the disease.

The true development of the disease of the white line of the abdomen leads to the pinching of not only part of the omentum, but also part of the intestinal loop. Very often the development of a hernia on the type of Richter, because the condition for its occurrence is the presence of a narrow hernia gate. With Richter's hernia, not much of the intestinal loop, but only its wall, is pinched.

This form of development of the disease to be very dangerous, and in case of late treatment even prove to be fatal for the patient. In the best cases, a strangulated hernia of the white line of the abdomen will turn out to be extremely painful, but under surgical influence it will have almost no consequences. This means that they need urgent professional attention.

Abdominal hernia: symptoms, treatment, surgery

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One of the most common surgical diseases - abdominal hernia, which is formed on the front wall of the abdomen.

Hernia is a protrusion of a portion of an internal organ from a closed space, for example, from the abdominal cavity. The abdominal form of this formation usually includes a segment of the small or large intestine. It may contain an omentum - it is a fat apron that departs from the horizontal section of the large intestine and hangs down, covering the inside of the abdominal wall. The abdominal wall includes the peritoneum, several muscle layers and skin. It can form weakened areas through which the abdominal organs protrude.

  • Kinds
  • Forms
  • Signs of
  • Diagnostics
  • Treatment of abdominal hernia
  • Prevention
  • Abdominal hernia surgery
  • After operation

The abdominal wall consists of muscles located mirror on both sides of the midline. These are direct abdominal muscles, as well as transverse, internal and external obliques. They connect in the middle of the tendon formation - a membrane, or white line, the weakening of which leads to diastasis (divergence) of muscle groups and the formation of a hernia. In this tendon formation there are holes in the form of slits through which the nerve and vascular bundles penetrate. It is here that hernial formations occur more often, usually in the upper third, less often near the navel or in the lower abdomen.

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The location of the hernial bag distinguish such hernial formations:

  • epigastric,
  • umbilical,
  • incision,
  • Spiegel's hernia.

Epigastric hernia is most often formed in infants with weakening of the upper midline. In this place, both straight muscles connect with the lower part of the sternum - the xiphoid process. Sometimes this hernial formation develops in adulthood and is manifested by protrusion in the upper part of the abdominal wall.

The navel is the point of exit of the umbilical cord connecting the fetus and the maternal organism in the period of prenatal development. After the birth of the child, the umbilical cord disappears, but in this place there remains the possibility of a hernia sac. Hernia of this area is accompanied by protrusion of the navel. It is often found in babies and often does not require treatment. The need for surgery occurs only when the appearance of adverse symptoms. In the future, surgical treatment is carried out with an increase in the size of the hernia.

There are several types of umbilical hernia:

  • embryonic,
  • originated in a child
  • first formed in an adult.

The embryonic form is referred to as developmental abnormalities that occur when the abdominal cavity of the embryo is disrupted. Its outer wall includes the umbilical cord amniotic membrane and the underdeveloped leaf of the peritoneum.

In children, an umbilical hernia occurs as a result of abnormal development of the abdominal muscles. It is more often formed in infants during the first months of life, mainly in girls. Under the action of increased intra-abdominal pressure (constant crying, constipation, flatulence), the ring around the navel expands, part of the intestine protrudes. Such hernias are usually small.

In adulthood, such formations amount to 5% of hernias. They appear in people older than 50 years, significantly more often in women, after numerous births and against the background of obesity. Often at the same time there is sagging of the abdomen due to the weakness of the abdominal muscles.

An incisional or postoperative hernia occurs as a result of a surgical procedure on the abdominal organs, if the doctor has not sufficiently connected the tissues after the incision. However, even with good tissue closure, the incision site becomes weaker than the nearest muscles and potentially has the potential to become an opening for hernial contents. After laparotomy, a hernial formation appears in a third of patients. Their causes can be inflammation of a postoperative wound, drainage of the abdominal cavity and long-term use of tamponade.

Spiegel's hernia is a rare formation that occurs at the edge of the anterior abdominal muscle.

In accordance with the time of occurrence, the hernia of the abdomen is congenital and acquired. Congenital form is observed immediately after the birth of the child, acquired acquired appears over time in a weakened part of the abdominal wall. The cause of this disease is high pressure inside the abdominal cavity.

High intra-abdominal pressure occurs in such cases:

  • persistent cough, for example, in lung diseases,
  • the formation of excess fluid in the abdomen (ascites) as a result of a tumor, cardiac, hepatic or renal failure,
  • peritoneal dialysis procedure, which is used for the treatment of renal failure and tumors of internal organs,
  • quick weight loss
  • chronic constipation or constant difficulty urinating,
  • abdominal trauma,
  • pregnancy,
  • obesity.

All of these conditions increase the risk of acquired abdominal hernia. There is a genetic predisposition to this disease.

Forms of abdominal hernia:

  • adjustable: looks like a "bump" on the skin, painless when pressed, increases in a vertical position, can be set in the abdominal cavity,
  • unmanaged: it is not possible to put the contents of the protrusion inwards, or this is accompanied by pain.

Complicated hernia - strangulated. It is accompanied by the penetration of part of the intestine beyond the abdominal wall and the compression of the blood vessels of the intestine. As a result, tissues die off and are destroyed, which leads to pain, intoxication, intestinal obstruction and peritonitis. Infringement complicates the course of the disease in 20% of patients.

Other complications of the disease:

  • inflammation,
  • delayed feces - coprostasis,
  • damage (injury)
  • malignant neoplasm of the intestine.

The first manifestation of a hernia is a rounded protrusion under the skin of the abdominal wall. It is soft, painless and at first easily repositioned when pressed with the palm of your hand. Sometimes there is a feeling of fullness, discomfort in the area of ​​the base of the hernia. When lifting weights sometimes there is a short sharp pain. With a temporary increase in pressure in the abdomen, for example, when you have a bowel movement or cough, the formation increases. Soreness becomes stronger after eating or exercise, and constipation often occurs.

If it gets into the hernial protrusion of the intestinal section or omentum, there may be signs of complications. The organ is restrained at the site of the hernia. The blood vessels that feed it are compressed. This is possible with a sharp increase in pressure in the abdominal cavity. There is severe pain in the area of ​​the hernia, the patient has nausea, and often vomiting - signs of intoxication. Intestinal obstruction develops. It is accompanied by abdominal distention, lack of stools and gas. The body temperature rises.

If a patient is not operated on in time with such a complication, the hernial contents are necrotized, and peritonitis will develop - a serious condition that is life-threatening.

In some patients, only part of the intestinal wall is affected. There are no phenomena of intestinal obstruction, the protrusion on the abdomen does not increase, but the person is worried about the growing pains and signs of intoxication.

The peculiarity of the umbilical hernia is a narrow gate with a diameter of not more than 10 cm. However, the size of the formation itself can be very large. The risk of infringement, stagnation of fecal masses, chronic intestinal obstruction increases.

In the initial stages of the hernia of the white line, when only the fatty tissue penetrates through its cracks, the first symptom of the disease is a sudden sharp pain in the upper abdomen, resembling an attack of cholecystitis or peptic ulcer.

What happens when a hernia is pinched?

As already mentioned, the main problem of the hernia (not only the white line of the abdomen) is the weakness of the abdominal muscles. This allows part of the preperitoneal tissue and the intestine to get into the hernial ring, protruding through the gaps of the aponeurosis.

The process of the formation of a hernia until pinching takes place, as a rule, in three stages.

At the first stage, a preperitoneal lipoma appears at the level of the white line of the abdomen. This is a hit of fiber. When squeezed at this stage, the patient may experience severe pain that will resemble the symptoms of pancreatitis, peptic ulcer or cholecystitis.

At the second stage, a classic understanding of the hernia is formed. After the fatty tissue, the internal organs located along the white line of the abdomen, such as the omentum, loops of the small intestine, and part of the wall of the large intestine, begin to fall out and manifest themselves.

At the third stage, the hernia develops, as a result of which it can grow in size and become pinched under certain conditions.

In the event of infringement, the viscera that is stuck in the gate is squeezed. This action is sufficient to limit the work of the blood vessels inside the intestine. In the end, the restriction of blood in the free access and other beneficial substances to the clamped organs leads to a fairly rapid tissue death.

The dead parts begin to reproduce toxins and poisons that are released into the body and the blood stream. In turn, this process causes sepsis or infection of the blood and, ultimately, if not to begin treatment - to death.

Diagnostics

Recognition of a hernia of the anterior abdominal wall is usually not difficult. It is noticeable in the external examination and palpation of the abdomen.

A strangulated hernia is life threatening, so urgent surgeon consultation is required. For the diagnosis of intestinal obstruction using a survey radiography of the abdomen or computed tomography.

Symptoms of abuse

There is a small probability that intestinal obstruction will occur if a hernia is pinched in the place of the white line of the abdomen.

Symptoms of intestinal obstruction, as a rule, develop rapidly, manifesting itself:

  • intense pain
  • a feeling of bloating
  • nausea
  • vomiting.

Another possible complication of pinching a hernia of the white line of the abdomen is the result of the process of decomposition of the dead flesh, which is stuck in the hernial ring.

Symptoms of a strangulated hernia include intense pain, which gradually increases, nausea, vomiting, swelling, pain when touching, red skin around the hernia, blood in the stool.

The most common indicators of pinching are:

Treatment of abdominal hernia

The protrusion that appeared on the front wall of the abdomen is a reason to appeal to the surgeon. The part of the intestine that lies in the hernial sac may suddenly be stranded, and this will require a complicated emergency operation. Urgent need to see a doctor in cases of pain, with a sudden increase in protrusion, the inability to reduce, fever, nausea and vomiting.

Abdominal hernias are surgically removed. At the same time, the integrity of the abdominal muscles is restored. Often used for this synthetic materials, securely closing the defect. The purpose of such treatment is to prevent the incision of a hernia and the development of dangerous complications.

If the hernia is small, surgical treatment is not required. In addition, the operation is not performed with a high risk of its complications in debilitated and elderly patients, as well as in patients with severe concomitant diseases - severe rhythm disturbances, severe heart or respiratory failure, malignant hypertension, or decompensated diabetes. Contraindications are also malignant tumors, acute infectious diseases, exacerbation of inflammatory processes (pyelonephritis, bronchitis, tonsillitis, etc.), pustular skin diseases.

The relative contraindications for which the operation is still possible include:

  • pregnancy,
  • concomitant diseases in the stage of compensation and subcompensation (for example, stable angina, hypertension with a moderate increase in pressure, diabetes mellitus with a normal level of sugar and glycated hemoglobin),
  • BPH.

Such patients are offered conservative methods of treatment: bandages and corsets. They are considered only a temporary way to prevent complications and can potentially cause skin infections due to constant friction. Bandage can only be used with reducible hernia. Its constant use weakens the abdominal muscles and leads to the progression of the disease.

In 99% of children with umbilical hernia, it does not exceed 1.5 cm in diameter and disappears as the child grows. An operation for an umbilical hernia in children is carried out in 3-4 years, if by that time the defect has not disappeared. With a large hernia, surgery is performed starting from the first year of the child's life. With a small amount of education possible self-healing at the age of 3 - 6 years. However, the operation or finally abandon it is necessary before the child enters school.After that, the elasticity of the tissues begins to decrease, the hernia will not disappear on its own, and the size of the umbilical ring will continue to increase.

Prevention

Congenital hernia cannot be prevented. However, you should follow some rules to prevent their infringement. These measures also apply to healthy people for the prevention of acquired disease:

  • maintaining a normal weight
  • healthy eating and regular exercise to prevent constipation,
  • the ability to lift heavy objects without excessive tension of the abdominal muscles, not bending down, but crouching behind them,
  • to give up smoking,
  • timely treatment to the doctor and elective surgery.

Bloating

As with the previous symptom, abdominal distention will manifest, due to intestinal obstruction. At the same time gases cannot pass through obstacles to the outside.

Patients with strangulated hernia, as a rule, have a fever. It is also associated with the inflammatory process caused by the death of the strangulated tissue. Fever may indicate a possible infection of the tissues of the white line of the abdomen that were involved in this process.

State of shock

This refers to the disruption of the functioning of the circulatory system due to systemic infection from the death of the strangulated tissue. Patients have low blood pressure, very rapid heartbeat. The mental state is changing. This is a very dangerous condition that often borders on a critical situation.

Classification

Types of strangulated bulging differ depending on the anatomical areas. First, it is customary to isolate external and internal hernias. Internal are less common.

In case of internal pathology, a compression of the stomach or a small omentum occurs. External hernia is the exit of part of the abdominal organs through the abdominal wall. Depending on where it happens, it can be detected:

  • inguinal
  • umbilical,
  • ventral.

Inguinal hernia

A strangulated inguinal hernia most often manifests itself suddenly during physical exertion. The main symptom is pain, and it can be felt not only in the area of ​​the neoplasm, but also throughout the abdomen. The site of intestines is compressed by the hernial ring. It can be of different sizes, the degree of manifestation of symptoms depends on this. At the very beginning, there is often liquid stool, and later there is no stool. The manifestation of complications is vomiting, which can be invincible with prolonged compression of the intestinal section. Symptoms can also occur from other organs. For example, with a large hernial ring, a portion of the bladder may get into them, and the dislocated intestine may also exert pressure on it. Crushing of the bladder can be painful and too frequent urination.

Umbilical hernia

A strangulated umbilical hernia can be of any size, but more often this complication occurs with large hernias. The first sign is pain and inability to correct the protrusion. In case of umbilical pathology, the omentum or the intestinal loop may be injured. Symptoms in both cases will be different.

Symptoms of bowel obstruction:

  • Cramping severe pain
  • Periodic enhanced intestinal motility,
  • Gas retention
  • Vomiting.

Symptoms of infringement of an epiploon:

  • Moderate pain syndrome
  • Vomiting (usually single).

The disease looks like a dense protrusion in the navel. When straining it does not increase in size. In the first few hours, the skin in this area does not change the appearance, but it gradually turns red and becomes painful. If you do not seek help for two to three days, necrosis of the strangulated part of the intestine develops, inflammation and suppuration spreads to the tissues of the hernial sac and skin with the corresponding symptoms:

  • tissue infiltration,
  • hyperemia,
  • sharp pain,
  • increase in local and general temperature.

Ventral hernia

Ventral or cicatricial is called postoperative hernia. The output of the abdominal cavity behind the abdominal wall occurs in the postoperative scar. Symptoms of infringement are the same as in the previous case, because the intestines or the greater omentum are also affected.

A strangulated ventral hernia requires a differential diagnosis, because acute pain may be due to adhesive disease, rather than infringement.

However, with the development of intestinal obstruction, the diagnosis is not fundamental, since in both cases an urgent operation is necessary. It is impossible to wait and postpone hospitalization, since it threatens with the development of peritonitis and the threat of death.

First aid for a strangulated hernia or for suspicion is that a person should be hospitalized in a surgical hospital as soon as possible. Usually they call an ambulance.

While waiting for the arrival of doctors, you can not give a person painkillers and antispasmodic drugs. Unacceptable any heat on the area of ​​pathology. Never try to correct the bulge.

The consequences of self-reduction:

  • Displacement of compressed organs
  • Separation of the hernia sac from surrounding tissues,
  • The separation of the neck of the hernial bag from the body,
  • Ruptured stranded area.

As a result of rectification actions, clinical symptoms may disappear, which makes diagnosis very difficult and can significantly aggravate the situation.

The only method of treatment is surgery, and, urgently. There are usually no contraindications to it, as it is a patient’s life. Surgical intervention implies that it is necessary to eliminate the infringement and to make a thorough audit of the organs that have been infringed. The defect of the abdominal wall is sutured, or artificial closure of the hernial ring is carried out. The decision is made depending on the size of the infringement, the hernial ring and the state of the surrounding tissues.

During the operation, carefully open the hernial sac, fix the organ and then dissect the infringing ring. Gut carefully inspected. The viability of the affected area is determined by the following features:

  • quick restoration of normal pink color
  • the serous membrane is shiny,
  • peristalsis and pulsation of vessels is felt.

In this state, the section of the intestine can be reset in place. If there are doubts about the viability, then hold special events. In the case of tissue death, resection of the intestine is performed.

Indications for resection

  • Dark color guts,
  • Sluggish wall
  • Dull serous membrane
  • Lack of peristaltic pulsation of blood vessels.

Remove not only the directly stranded area, but also a significant portion of unchanged tissue (from 15-20 to 30-40 centimeters).

The operation ends with hernioplasty. The most modern method of surgical problem solving is a non-tensioned hernioplasty technique using a mesh implant that closes the hernial orifice, supports tissues and prevents re-infringement.

Abdominal hernia surgery

Surgical treatment of abdominal hernia is carried out under general anesthesia, with a small amount of protrusion spinal anesthesia can be used. Special training is needed in the case of other chronic diseases and includes the normalization of pressure, blood sugar levels, and so on. It is also necessary to consult a specialist specialist and the conclusion about the safety of surgical intervention.

Preoperative preparation is also required for large education. During the operation, moving the contents of the hernia into the abdominal cavity can lead to a sudden increase in intra-abdominal pressure, leading to impaired breathing and blood circulation. Therefore, before intervention, techniques are used to gradually increase the pressure in the abdominal cavity, for example, bandaging or bandage.

  • sequential dissection of tissues over the formation,
  • the selection of the hernial sac formed by the wall of the peritoneum,
  • movement of the intestine and omentum into the abdominal cavity,
  • ligation of the hernial formation in the neck and its removal,
  • closure of the defect (hernioplasty).

Plastic defect conduct their own tissues or synthetic material. The duration of the intervention is about an hour.

The main methods of surgical treatment:

  • according to Lekser: it is used at small education at children. The hole formed after removal of the hernia is sutured with a purse-string suture, in other words, it is tightened,
  • Sapezhko: make a longitudinal incision, remove the hernia, and then the edges of the tendon aponeurosis and muscles overlap each other, creating a double layer (duplication) and sew,
  • Mayo: a horizontal incision is made and the navel is removed along with the hernia (the patient must be warned about this in advance), the edges are overlapped and stitched.

If the hernia is accompanied by diastasis (divergence) of the rectus muscles, for example, in obese women, Napalkov is performed: after removal of the tendon margin, the tendons are sutured, then the edges of the rectus muscles are divided, and their aponeuroses are joined over the white line, which strengthens the abdominal wall and causes to reduce its volume.

In modern hospitals, laparoscopic surgery is used. In this case, all manipulations are carried out using miniature instruments inserted into the abdominal cavity of the patient through small incisions. Advantages of the laparoscopic method:

  • minor trauma,
  • practical absence of postoperative complications,
  • no seams, scars and scars
  • quick recovery after surgery
  • painless in the postoperative period,
  • A return to normal life is possible within 5 to 7 days after the intervention.

The best effect of the operation is achieved when using a grid of polypropylene, less often - from other synthetic materials. Apply lightweight composite mesh, through the pores of which germinate collagen portage, creating a strong, but elastic fabric, comparable to the natural aponeurosis. However, doctors consider the use of nets a necessary measure. This technique requires the surgeon to have knowledge of the features of these materials and a good mastery of the technique of operation.

The question of how to close a defect in the abdominal wall is solved in each case individually, depending on the size of the hernia and the characteristics of the organism.

Postoperative complications occur in 7% of patients:

  • disease recurrence (the most frequent complication),
  • urine retention
  • postoperative wound infection.

In modern clinics, treatment of hernia is common in a “one-day hospital”. The operation is performed under local anesthesia, and then the patient is discharged home, subject to regular medical supervision.

After operation

Full restoration of the body after hernia repair occurs only several months after the operation. At this time, it is important to go through successive stages of rehabilitation to avoid complications and recurrence of the disease.

Immediately after the intervention, the patient should use a bandage. A wipe of sterile gauze should be placed on the postoperative wound area to prevent friction and infection of the skin. You can get up and walk slowly a day after the operation. Antibiotics and painkillers are prescribed.

The patient is discharged home after a few days, when the doctor is satisfied with the normal healing process. At home, it is necessary to do dressings 2 times a week. Used wipes made of sterile gauze, which are attached to the skin with adhesive tape. The edges of the wound can be treated with a solution of brilliant green.

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If the seams were made with absorbable sutures, they do not need to be removed. If the threads are normal, the removal of sutures takes place on the 10th day in the clinic. If the wound has healed well, you can take a shower 2 weeks after the intervention. At this time, prescribed physiotherapy procedures, accelerating the recovery process.

For at least 2 months it is impossible to lift objects weighing more than 2 kg and to make sharp movements, including straining the abdominal muscles. Exercise and sports should not be within 3 months after the hernia repair. Within 2 months you need to wear a postoperative bandage, placing a gauze cloth over the seam area.

Nutrition of the patient after the removal of the hernia should be gentle to avoid constipation:

  • light soups, oatmeal, millet, buckwheat porridge,
  • meat, fish, eggs,
  • dairy products,
  • fruits and vegetables, juices, jelly,
  • seafood.

It is necessary to refuse spicy, salty, canned food, alcohol, fresh pastries. There is a need 5 times a day. Cooking should be done using olive oil, baked or boiled. Fry food is impossible.

In most patients, the surgery is very effective. Hernia recurrence develops in 10% of the operated. Risk factors for relapse:

  • elderly age,
  • large size of the abdominal wall defect,
  • festering wounds after surgery
  • subsequent significant loads and other causes of increased intra-abdominal pressure.

With the development of infringement, the prognosis depends on the volume of the necrotic colon and the severity of intoxication. In this case, part of the intestine is removed, which further leads to indigestion. Therefore, it is preferable to do a planned operation with a low risk of postoperative complications.

A hernia of the abdomen develops with protrusion of the abdominal organs beyond its limits through defects in its wall. It is epigastric, umbilical or postoperative. Symptoms of the disease include a bulging on the abdominal wall, a feeling of fullness and soreness. When infringing, symptoms of "acute abdomen" occur. Surgical treatment of the disease. For the plastic of the defect of muscles and tendons, the body's own tissues or synthetic mesh implants are used. When observing the technique of surgical intervention and the recovery period, the prognosis of the disease is favorable.

Symptoms and signs of intervertebral hernia of the lumbar spine

Not everyone knows that the spine can withstand a vertical load of 400 kg. It increases 20 times when lifting weights on outstretched arms. A larger percentage of this weight load falls on the lumbar region, because it is the center of balance of the body and the most mobile part of the spine. These distinctive features make the lumbar region more vulnerable and lead to early wear of the intervertebral discs, which play the role of a shock absorber. Their structure is special - a dense fibrous ring keeps the jelly-like core in the center.

In the initial stage of an intervertebral hernia, microcracks form in the disc, but at some point the fibrous ring is broken and the contents are shed, squeezing the stem of the spinal cord or its roots. This forms a hernia (protrusion) of the intervertebral disc.

At first, bulging is insignificant and does not cause much trouble. Symptoms of an intervertebral hernia of the lumbar spine increase with its size and serve as a diagnostic criterion for the stage of the disease. They are diverse and grouped into three large characteristic groups.

  1. Pain symptom
  2. Spinal syndrome
  3. Radicular syndrome

Consider the dynamics of their appearance.

The first, main and permanent symptom. The pain will change its strength, place, character, will be independent or in combination with other symptoms, but accompanies the disease at all its stages.

In the early stages of the disease, when the size of the hernia is insignificant, pain in the lumbar region, at the site of projection of the damaged disc, is troubling. Dull, aching pain increases with sudden movements, lifting weights and prolonged sitting position. Completely disappears in a prone position.

Such a course of the disease, with aggravations and remission, can last for several years. It is at this stage that it is very easy to stop the disease by changing only the way of life. Not many people apply for qualified help. Most are treated on their own. The disease is progressing!

As the size of the hernia increases, compression of the membranes or roots of the spinal cord occurs. The pain in the lumbar region increases when the head is tilted, when the straightened leg is raised on the side of compression of the spine, while pressing on the interspinal gaps. Tapping on the spinous processes of vertebrae with a damaged disc causes a sharp pain in the leg.

The nature of the pains is changing. Now she is aching and shooting. Depending on which spinal segments of the spine are damaged, pains in the area of ​​the buttock, thigh, lower leg, heel, thumb, or back of the foot join. They are aggravated by movements, coughing, sneezing, and driving on uneven roads. They calm down when lying on a healthy side with a sore leg bent at the joints.

Spinal syndrome

The muscles of the lumbar region and back, due to constant pain, are in a spastic condition. This further intensifies the pain. Movement in this area is limited. It becomes impossible to complete extension of the back. Appears slouch, humpback and distortion of the body in a healthy way. Posture is disturbed, unsure gait, stability is lost during movement.

Other symptoms accompany pain, which depend on the size of the hernia, concomitant diseases of the musculoskeletal system and the direction of the protrusion. In the lateral - the roots of the spinal cord are compressed and there are changes in the organs for which the damaged segment of the spine is responsible. With posterior hernia protrusion, symptoms associated with compression of the spinal cord stem appear.

Hernia of the lumbar spine in 90% of cases occurs in the lower sections. Discs between L4 - L5 and L5 - S1 are damaged (where L is the designation of the lumbar vertebrae. S is the vertebrae of the sacral spine). Each segment is responsible for the work of a certain part of the body. This is due to the appearance of symptoms of a herniated lumbar spine in strictly defined places.

Damage to the roots in the L5 segment leads to the detection of symptoms on the outer surface of the thigh, the anterior surface of the lower leg, the back of the foot, and in the area of ​​the big toe. At infringement of the roots, S1 symptoms are felt in the lumbosacral, gluteal region, along the back of the thigh and lower leg, in the heel and little finger. If there are several hernias of intervertebral discs, the manifestation of symptoms will not be strictly delineated.

Radicular syndrome

The compression of the roots of the spinal cord, and later its death, leads to a deterioration of nutrition in the tissues and the appearance of several characteristic symptoms.

  • The weakness of the muscles of the thigh, leg and foot. The patient can not squat, climb the high steps, stand on their toes, jump. This is one of the earliest symptoms of spinal cord squeezing.
  • The tone of this muscle group decreases.
  • Their atrophy becomes noticeable. The leg becomes thinner, weaker, does not perform the necessary movements. The gluteal fold is smoothed. Appearance asymmetry appears.
  • Sensitivity of the skin is disturbed, tingling, feeling of "crawling goosebumps", numbness of fingers and their chilliness occur.
  • Appears dry or excessive sweating of the skin in the zone of action of the damaged root.
  • Paralysis is possible. Movement becomes difficult. The patient is socially limited. Life concentrates on the four walls. Often the disease leads to complete disability.

Protrusion of the hernia back causes compression of the spinal cord. Sharp movements or weight lifting can lead to a complete compression of the spinal cord, leading to severe paralysis or to conditions incompatible with life. The main symptoms of such hernias are:

  • dysfunction of the pelvic organs. Patients complain of incontinence of urine and feces, which alternates with their delay,
  • violation of the sensitivity of this area,
  • reduced potency in men. Frigidity and gynecological problems in women,
  • symptoms of intermittent claudication are possible - due to pain in the legs, the patient is forced to stop and continue to move only after resting.

If complications of an intervertebral hernia occur, other symptoms also join. Lumbodynia - shot in the lumbar region. The pain is sharp, sharply aggravated with slight movement. This condition may persist for several weeks. Possible dysfunction of the hip and knee joints. This complication drastically reduces the ability to move independently and leads to disability early.

If the intervertebral hernia is combined with other diseases of the musculoskeletal system, the symptoms overlap, become more pronounced. The disease progresses much faster.

Intervertebral hernia of the lumbar spine occurs more often at the age of 30 - 50 years. A low-grade, unstable pain syndrome is the first sign of a serious disease of the spine, and can occur at a younger age. Knowledge of the main symptoms that occur as the progression of the disease, will encourage the patient to consult a specialist, without waiting for the terrible complications.

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The exit of an organ from the cavity it occupies is called a hernia. Intervertebral hernia is a rupture of the intervertebral disc (a shift of the nucleus with connective substances and a breakthrough of the fibrous ring). Hernia is the most common manifestation of osteochondrosis of the lumbar region or to be a consequence of injury.

The maximum possible load on the human spine is 400 kg. The lumbar region, as the most mobile part, has the greatest pressure. The 5 vertebrae of this region are interconnected by the discs, which evenly distribute the weight. The breakthrough of the annulus causes the nucleus to enter the spinal canal. There is a pinching of the nerve endings.

Causes

  • age-related changes occur due to a decrease in the activity of the spine.
    The fibrous ring can wear out for a long time and break at any moment from the usual action.
  • vertebral injury may occur with sudden sudden pressure or severe shock. Increased disk pressure can cause constant, identical movements.
  • hereditary factor: hormonal disorders, metabolic disorders.
  • latent course in existing diseases (osteochondrosis, scoliosis, curvature, etc.)
  • stenosis of the vertebral canals, both congenital and acquired (chronic narrowing of the central canal, intervertebral foramen or lateral pocket)

Symptoms of the disease

  1. Pain and tightness in the lower back
  2. Sudden pain, shooting
  3. Soreness when bending and turning
  4. Pain in one leg or buttock
  5. Radicular syndrome (lamp pains in the leg)
  6. Burning, tingling, numbness
  7. Muscle weakness
  8. Incontinence or retention of urine, constipation or diarrhea, erection problems (urinary system)

Conservative drug treatment without surgery

The goal of treatment is the elimination of symptoms, the elimination of causes, and remission.
Nonsteroidal anti-inflammatory drugs successfully relieve pain and inflammation, are prescribed for diseases of the joints. The action is based on the fact that substances that stimulate the sensation of pain are produced much less. A prominent representative of drugs is ibuprofen.

Muscle relaxants eliminate muscle tension. Muscle relaxants relieve tone, reduce motor activity, relax muscle tissue, eliminating pain. Drugs act from the bottom up, stopping the flow of nerve impulses and stopping the contraction of muscles. The main representatives are carysoprodolidiazepam. Side effects are dry mucous membranes, fatigue and urinary retention.

Corticosteroids are derived from the hormone cortisol and have anti-inflammatory properties, relieve tissue edema around the nerve and strangulated root. They are not painkillers, but removing inflammation, facilitate the patient's condition. Used when nonsteroidal drugs and muscle relaxants cease to function, or when the disease is severe. Representatives: dexamethasone and prednisone. Do not use for a long time.

Opioids are narcotic drugs that have an analgesic effect. Strong opioids (morphine, methadone, fentatin) are used for severe acute pain, weak ones (codeine and tramadol) are prescribed to relieve sharp, sharp pains. Narcotic drugs are characterized by a strong analgesic effect and pronounced side effects, addictive in case of failure.

Hypnotics are prescribed to facilitate the onset of sleep, with violations of night sleep. The combined use of certain drugs adversely affects the psychological state of the patient, causes insomnia, restless states. Sleep aids help to remedy the situation. Hypnotics have a number of side effects that vary depending on the drug being taken.

Tricyclic antidepressants increase mood and regulate pain. In small doses, they are used to treat and reduce chronic pain syndromes, solve problems of poor sleep and fatigue. The disadvantage of such drugs is a variety of side effects:

  • constipation, urination problems
  • dry mucous membranes
  • blurred vision, exacerbation of glaucoma
  • fatigue, decrease in pressure, drowsiness
  • increased appetite and weight gain
  • decreased libido
  • limb tremor
  • sweating

Conservative non-drug treatment. (without operation)

Drug treatment is recommended to combine with non-drug. The patient is at rest for several days and complies with bed rest. Next, the restriction of motor activity is introduced. Then the patient is prescribed physiotherapy procedures that accelerate recovery and rehabilitation.
Physical therapy has a complex effect on the body: it relieves muscle tension, restores damaged tissues, raises the tone.

Basic physiotherapy for hernia:

  1. Electromyostimulation (effect of alternating current on the muscles)
    The result is a deep reduction, strengthening of muscles and improvement of their tone.
  2. Electrophoresis (introduction of drugs into the body using current)
    Drugs immediately go to the right place, displayed about three weeks.
  3. Phonophoresis (administration of drugs using ultrasound)
    Waves with medicine penetrate inward by 6 cm, accumulate and slowly spread through the body through the blood.
  4. UHF-therapy (ultrasonic pulses of a high-frequency electric field)
    Under their action, heat arises in the body, which accelerates blood circulation, anesthetizes and regenerates tissues.
  5. Paraffin therapy (paraffin heat effect on the body)
    Paraffin applications reduce pain, relieve muscle spasm, improve blood circulation and conduct nerve endings.
  6. Detenzor therapy (stretching and unloading of the spine)
    The patient’s spinal cord is pulled out by its own weight.
  7. UHT (shock wave therapy)
    A sound wave is transmitted to the affected area, up to 7 cm deep.
  8. Laser therapy (exposure to polarized light)
    The treatment is made by infrared and red radiation.
  9. Magnetotherapy (magnetic field exposure)
    It creates a field frequency close to the frequency of human biorhythms.

Treatment of folk remedies
  • Infusions of lime, rosehip and chamomile inside
  • Broth cooked from bran
  • Spinal warming
  • Lubricate the spine with camphor oil, then put a towel soaked in hot milk for 2 hours
  • Altai mummy with honey and boiling water outwardly
  • Various compresses on the sore spot

Massage and physical therapy

Recovery from an acute course of the disease is easier with simultaneous treatment with massage and therapeutic exercises (exercise therapy).
Methods have a beneficial effect on the body, restore blood circulation, increase elasticity, stretch and relax muscles. Massage techniques are varied, only a doctor can prescribe the one that suits the patient (point, classical, Thai, canned, segmental-reflex).

Features of massage for vertebral hernia of the lumbar spine:

  • average course up to 20 sessions
  • sparing impact without sudden and rough movements
  • use of soothing oils

Therapeutic exercise is one of the best treatments.

is a light exercise type "flexion - extension", stretching exercises and stretching of the spine. Training takes place at a quiet pace. Exercises improve the nutrition of the joints, warm up and increase the elasticity of the muscles.

Manual therapy and acupuncture are unconventional hernia treatments. Can be used in postoperative recovery.
Acupuncture is the effect on the patient's body with needles, which are inserted at certain points, while the pain syndrome disappears, swelling and inflammatory processes are reduced. With innovative acupuncture, a small electrical discharge passes through the needles, which is hardly felt by the patient.
Manual therapy treats the spine, rules the vertebrae and intervertebral discs. The specialist owns a system of manual methods aimed at correcting changes in the spine.

Surgery to remove a lumbar spine hernia

Acute pain, in which relief does not come (or comes in a short period of time), conservative treatment from two weeks to three months, an increase in neurological symptoms (numbness, pinched) - all this is an indication for surgery. After surgery, relief comes immediately.

The consequences of the operation to remove a hernia. Risks:

  • high probability of relapse
  • spinal cord injured during surgery
  • frequent postoperative complications

Methods of operation develop in the direction of reducing injuries, so endoscopic methods have become preferable to classical laminectomy.

Rehabilitation after hernia removal

Conducted in three stages

  1. Neurological symptoms and pain are eliminated.
  2. Eliminates domestic constraints and restores the patient’s stable condition.
  3. The strength of the muscular corset, the spine is restored, and relapse prevention is carried out.

The postoperative period lasts a lifetime. The speed of recovery depends on the course of the disease.

Full disposal of intervertebral hernia, possibly within 2-3 months subject to bed rest and rest. After the diagnosis, you should immediately begin treatment.

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Effective ointments for osteochondrosis. http://zdorovya-spine.ru/bolezni/osteohondroz/shejnyj/mazi.html. What are the types and how to choose from them?

Stories of people who were able to get rid of back pain:

They could mean and you can. The disease can and must be defeated. The main thing is not to despair. All in your hands!

Inna She gave birth at the age of 24. A couple of weeks had to carry firewood and sand. The next day, my leg became seriously ill, the foot did not rise. The surgeon said that I have osteochondrosis. An MRI was done at the Military Medical Academy, it showed as many as two hernias - 4mm and 7mm. Prescribed injections and tablets course 10 days. The pain began to pass, the foot rose and I rushed to the reception, confident that the disease was receding. Not here it was - an operation. I have a little six-month old baby, and after the operation there is a long recovery. Decided not to do. Rummaged through the forums - an osteopath advises. I went off already two times, like the pain recedes.

Helena. For two years now I have been suffering with exacerbations of lumbar hernia (S1 L5). For three months I went to manual therapy - now relief, now pain again. A year later, a wild exacerbation happened - again treatment and again terrible pains. At the forum I read about the research center for neuro-orthopedics of restorative medicine near Sochi - treatment without surgery. Signed up and went. The course of treatment lasts 14 days. At first I did not feel any difference, but gradually the pain disappeared. I'm much better now, pains do not bother me. In September, I want to go there again for prevention. In the autumn I will go again for prevention. Long could not find a center or sanatorium for non-surgical treatment.

Pauline. Painful five years gave me this hernia. I tried all known methods of treatment. Center Dikul, Bob, Center for Manual Therapy Sittel, which only did not try. The longest and best results for the duration of action turned out in the center of manual therapy. I was lucky to get on treatment to Shubin (he leads “Live healthy” on the first channel with Malysheva). Once, when she could not walk on her own, she decided to have an operation. Microdiscectomy under epidural anesthesia was done, two years have passed. The pains passed both in the back and in the legs. Shovchik is small, not noticeable - only 3 or 4 cm.

Watch the video: Saving Lives With Gus: Incarcerated Hernia (September 2019).