Hernia

Hernia

An organ or portion of an organ that protrudes through an irregular hole in the cavity that typically houses it is referred to as a hernia.

When an organ pulls through a tear in the muscle or tissue holding it in place, a hernia results. For instance, a weak spot in the abdominal wall may be breached by the intestines.

Hernias can occur everywhere in the body, however they are most frequently found in the abdomen, upper thighs, belly button, and groin. The majority of hernias do not pose a life-threatening threat right away, but because they do not go away on their own, surgery may be necessary to avoid any potentially dangerous complications.

Causes:

Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or over a long period of time.

Common Causes of Muscle Weakness Include:

• failure of the abdominal wall to close properly in the womb, which is a congenital defect.
• age.
• chronic coughing.
• damage from injury or surgery.

Factors that Strain Your Body and May Cause a Hernia, Especially if Your Muscles are Weak Include:

• being pregnant, which causes your abdomen to swell.
• being constipated, which makes it difficult to go to the bathroom.
• intense weightlifting.
• Ascites is a term for abdominal fluid.
• rapidly putting on weight.
• persistent sniffling or coughing.

Risk Factors

The factors that increase your risk of developing a hernia include:

• Hernias are a personal or familial history.
• being fat or overweight.
• a persistent cough.
• persistent constipation.
• Smoking, which can cause a persistent cough.

Types

• Inguinal hernia
• Femoral hernia
• A diaphragmatic hernia or a hiatal hernia
• Umbilical hernia
• Ventral hernia
• Pelvic hernia
• Intracranial hernia

A Common Hernia in Children are:

• An Inguinal Hernia:

  It is the condition in which the abdominal contents such as large and small intestine, omentum, peritoneum or bladder protrudes into the inguinal canal. It is most common of all childhood hernias and occurs more frequently in boys. Right sided an inguinal hernia is more common but may be bilateral also.

Clinical Presentation

• Unless the abdomen contents are pushed into the patient sac, the infant won't exhibit any symptoms.
• The existence of different-sized, painless inguinal swellings.
• Swelling goes away when you rest or apply gentle pressure, but it comes back when you cry, cough, or stand still for a long time.
• On palpitation, the chord in the groin thickens.
• The loop of intestine can occasionally become partially obstructed, leading to a variety of symptoms like anxiety, irritability, tenderness, anorexia, and abdominal distension.
• A looping issue that affects defecation becomes irreducible and results in total intestinal obstruction.

Diagnosis

• Medical history + clinical presentation + physical examination findings.
• Ultrasonography to visualize a hernia and confirmed the mass is due to a hernia.
• Chest x-ray and electrocardiogram to make sure that the heart and lungs are functioning well.
• Blood and urine test standard preoperative test.

Treatment

Treatment of an inguinal hernia is surgery: Repairment of a hernia i.e. Herniorrhaphy. Other treatment includes: maintain intravenous fluid, medications, avoid heavy lifting for six to eight weeks after surgery.

Nursing Management

Preoperative Care

• Educate parents and obtain their informed permission.
• Baby should be admitted the day of the operation and watched.
• Look for common preoperative tests and research.
• If the patient is taking medication, such as aspirin before surgery, stop taking it.
• Keep the intravenous line open and the intake output steady.
• Child kept in nil per oral.
• Psychological assistance for the parents and child.

Postoperative Care

• Keep repair site clean and dry.
• Check for any sign of infection such as red swollen.
• Manage pain by giving painkiller.
• Change diaper as soon as become damp.
• Advice parents to give the child sponge baths for 2-5days and change a diaper as per need, no restriction of activity in case of infant and toddler but limit the activities for older children.
• Provide discharge teaching on a follow-up visit, a diet like high fiber diet, low salt and avoid constipation etc.
• An umbilical hernia: Umbilical hernias can occur in children and babies under 6 months old. This happens when their intestines bulge through their abdominal wall near their belly button. You may notice a bulge in or near your child’s belly button, especially when they’re crying.
  • An umbilical hernia is the only kind that often goes away on its own, typically by the time the child is 1-year-old. If a hernia has not gone away by this point, surgery may be used to correct it.

Nursing Consideration

• Reassuring the parents that the illness is often not dangerous.
• The pre- and post-operative treatment for children with umbilical hernias is the same as for other small gastrointestinal surgeries. There is no need to admit the child to the hospital.
• A pressure dressing needs to be kept on for about 40 hours after surgery.
• Observe and instruct others to watch for complications from general anesthesia, such as hematomas or respiratory problems.
• Food and drink are typically tolerated postoperatively.
• Instruct the child and parents to avoid strenuous activity or play for 2-3 weeks.