Post-operative hernia appear in the anatomical regions where conducted typical operating sections provide access to the organs of the abdominal cavity: in the linea alba (after the upper or lower midline laparotomy), right iliac region (after operations on cecum, appendectomy), the navel , right upper quadrant (after cholecystectomy, resection of liver), left upper quadrant (after operations on spleen), side of the lumbar region (after operations on kidneys and ureters), suprapubic (after gynecological and urological surgery).
Symptoms of post-operative hernias
The main manifestation of a hernia is a protrusion on the appearance of lines and post-operative scar and on his sides. In the early stages of post-operative hernias are irreducable and do not deliver pain. Tenderness and increased tumor-protrusion appears at sharp movements, straining, lifting heavy weights.
Later abdominal pain becomes constant, sometimes gets cramping in nature. Among other symptoms of post-operative hernia come flatulence, constipation, belching, nausea, decreased activity. When hernias situates above the pubis, urinary disorder can be marked. In the area of herniation in the abdominal wall evolves irritation and inflammatory changes in the skin.
Post-operative hernia may be complicated by coprostasis, punching, partial or complete adhesive intestinal obstruction. When complications of post-operative hernia appear there a rapid increase in abdominal pain; appear nausea and vomiting, blood in the stool or delayed stool and gas. Herniation becomes nevpravimym in the supine position.
Conservative treatment of post-operative hernias is to appoint a support belt - bandage that should be made in special workshops. Conservative treatment should be applied in case of serious contraindications to surgery, which is the only radical method.
Surgical treatment of post-operative hernia involves the separation of the hernia sac, division of adhesions between scar-altered skin and organs fallen into hernia, dissection of tissue for the plastic closure of the defect in the abdominal wall.
Posto-perative hernia, even in the absence of complications, lead to a decrease in physical activity, cosmetic defects, deteriorations in the quality of life. Infringement of post-operative hernia often is fatal. After surgical removal of post-operative hernia, except in cases of multiple recurrences, prognosis is satisfying.
Prevention of post-operative hernias requires that surgeon chooses right physiological operative access for different types of interventions, thorough compliance with aseptic technique in all stages of operation, the use of high quality sutures, adequate preoperative preparation and management of the patient after surgery.
In the post-operative period, the patient is required a strict compliance with the recommendations on diet, wearing a brace, physical activity with its limitation, weight normalization.