What to Know About Epigastric Hernia. An epigastric hernia happens when a weakness in the abdominal muscle allows the tissues of the abdomen to protrude through the muscle. It is usually present at birth and is similar to an umbilical hernia, except the umbilical hernia forms around the belly button and the epigastric hernia is usually between the belly button and the chest. An epigastric hernia is typically small enough that only the peritoneum, or the lining of the abdominal cavity, pushes through the muscle wall. In minor cases, the issue may be diagnosed during a CT scan or other testing for an entirely different issue, and may never cause symptoms.
In fact, many epigastric hernias are diagnosed in adults, rather than in children. In severe cases, portions of an organ may move through the hole in the muscle. Who's at Risk. Epigastric hernias are typically present at birth and may seem to appear and disappear, which is referred to as a "reducible" hernia.
The hernia may not be noticeable unless the patient is crying, pushing to have a bowel movement, or another activity that creates abdominal pressure. The visibility of a hernia makes it easily diagnosable, often requiring no testing outside of a physical examination by a physician. Treatment in Children. An epigastric hernia will not heal by itself and does require surgery to be repaired. However, unless the hernia threatens to become an emergency, surgery can be postponed until the child is older. Toddlers tend to tolerate surgery better than newborns, so it may be beneficial to wait before surgery is performed. Treatment in Adults.
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It is not uncommon for an adult to be diagnosed with an epigastric hernia that they were unaware of earlier in life. It is also possible for a hernia that was known to be present for many years to become an issue as the individual ages. For many, a hernia does not cause symptoms until later in life due to obesity, muscle weakness, or strain on the muscular wall of the abdomen. In these cases, surgical repair may be necessary if the hernia is causing pain or threatens to become strangulated. When It's an Emergency. A hernia that gets stuck in the “out” position is referred to as an incarcerated hernia. While an incarcerated hernia is not an emergency, it should be addressed, and medical care should be sought.
An incarcerated hernia is an emergency when it becomes a “strangulated hernia,” where the tissue that bulges outside of the muscle is being starved of its blood supply. This can cause the death of the tissue that is bulging through the hernia. A strangulated hernia can be identified by the deep red or purple color of the bulging tissue. It may be accompanied by severe pain, but is not always painful.
Nausea, vomiting, diarrhea, and abdominal swelling may also be present. Surgery. Epigastric hernia surgery is typically performed using general anesthesia and can be done on an inpatient or outpatient basis. If the patient is a child, special care should be taken to adequately prepare children for the surgery. This surgery is performed by a general surgeon or a colon- rectal specialist, if the patient is a child a surgeon who specializes in pediatrics is typically performing the procedure.
Once anesthesia is given, surgery begins with an incision on either side of the hernia. Aspergers Female Adults Symptoms there. A laparoscope is inserted into one incision, and the other incision is used for additional surgical instruments. The surgeon then isolates the portion of the abdominal lining that is pushing through the muscle.
This tissue is called the “hernia sac.” The surgeon returns the hernia sac to its proper position, then begins to repair the muscle defect. If the defect in the muscle is small, it may be sutured closed.
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The sutures will remain in place permanently, preventing the hernia from returning. For large defects, the surgeon may feel that suturing is not adequate. In this case, a mesh graft will be used to cover the hole. The mesh is permanent and prevents the hernia from returning, even though the defect remains open.
If the suture method is used with larger muscle defects (approximately the size of a quarter or larger), the chance of reoccurrence is increased. The use of mesh in larger hernias is the standard of treatment, but it may not be appropriate if the patient has a history of rejecting surgical implants or a condition that prevents the use of mesh. Once the mesh is in place or the muscle has been sewn, the laparoscope is removed and the incision can be closed. The incision can be closed in one of several ways.
It can be closed with sutures that are removed at a follow- up visit with the surgeon, a special form of glue that is used to hold the incision closed without sutures, or small sticky bandages called steri- strips. Recovery. Most hernia patients are able to return to their normal activity within two to four weeks. Elderly patients make take longer. The belly will be tender, especially for the first week.
Inguinal Hernia – Indirect, Direct, Pantaloon, Sliding Hernias. What is an inguinal hernia? Inguinal hernias are those which are seen in the groin region and account for about 7. With an inguinal hernia, the contents of the abdominal cavity protrude through the inguinal canal. It is more prevalent in men.
Inguinal hernias are either of a direct type or indirect type but the distinction is not critical as both are managed with similar surgical procedures. Read more about the part, types, causes and risk factors of a hernia under What is a Hernia. Indirect Inguinal Hernia. The indirect inguinal hernia is the most common of all type of inguinal hernias. Indirect inguinal hernias are more common in males and more frequently seen on the right side. It is common in children and young adults and may be due to congenital causes. The hernial sac is believed to be the remains of an outpouching of part of peritoneum in fetal life (the processus vaginalis) that is responsible for the formation of inguinal canal.
Ask a Doctor Online Now! The hernial sac of an indirect inguinal hernia passes from the deep (internal) inguinal ring towards the external (superficial) inguinal ring through the inguinal canal. The sac then extends into the scrotum in men or labia major in women. The neck of the hernial sac in indirect inguinal hernia will be at the deep inguinal ring, at the outer (lateral) side of the inferior epigastric blood vessels. The body of the hernial sac will be in the inguinal canal, extending into the scrotum or labia.
Excluding a few large direct hernias, most hernias reaching scrotum are indirect inguinal hernias. Picture from Wikimedia Commons. Direct Inguinal Hernia. Direct inguinal hernia accounts for about 2. Direct hernias are rare in women. The hernial sac of a direct inguinal hernia passes directly through the wall of inguinal canal along the inner (medial) side of the deep inguinal ring and inferior epigastric vessels. The direct inguinal hernia usually appears like a generalized bulge and the hernial sac has a wide neck.
Most direct inguinal hernias are seen in old men with weak abdominal muscles and are often found on both sides. Pantaloon- Type Hernia. A co- existing direct and indirect inguinal hernia is called a pantaloon- type hernia. They two hernias bulge through the either sides of the inferior epigastric blood vessels appearing like a pantaloon. Sliding Inguinal Hernia. A sliding hernia is one in which a portion of the wall of the hernia comprises of an internal organ. Sliding inguinal hernias commonly involve the colon or urinary bladder.
Most sliding inguinal hernias are indirect inguinal hernias, but occasionally direct sliding hernias can also develop. Failure to identify the visceral part of the sliding hernia correctly can result in the injury of the bladder or bowel during surgery.
Age spots (liver spots) - Symptoms and causes. Overview. Age spots — also called liver spots and solar lentigines — are small dark areas on your skin. They vary in size and usually appear on the face, hands, shoulders and arms — areas most exposed to the sun.
Age spots are very common in adults older than 5. But younger people can get them too, especially if they spend a lot of time in the sun. Age spots can look like cancerous growths. But true age spots are harmless and don't need treatment. For cosmetic reasons, age spots can be lightened with skin- bleaching products or removed. You can help prevent age spots by regularly using sunscreen and avoiding the sun. Symptoms. Age spots may affect people of all skin types, but they're more common in people with light skin.
Age spots: Are flat, oval areas of increased pigmentation. Are usually tan, brown or black. Occur on skin that has had the most sun exposure over the years, such as the backs of hands, tops of feet, face, shoulders and upper back. Age spots range from freckle size to about a 1/2 inch (1. When to see a doctor.
Age spots are usually harmless and don't require medical care. Have your doctor look at spots that are dark or have changed in appearance. These changes can be signs of melanoma, a serious form of skin cancer. It's best to have any new skin changes evaluated by a doctor, especially if a spot: Is darkly pigmented.
Is rapidly increasing in size. Has an irregular border. Has an unusual combination of colors. Is accompanied by itching, redness, tenderness or bleeding. Causes. Age spots are caused by overactive pigment cells.
Ultraviolet (UV) light accelerates the production of melanin. On the areas of skin that have had years of frequent and prolonged sun exposure, age spots appear when melanin becomes "clumped" or is produced in high concentrations. The use of commercial tanning lamps and tanning beds can also contribute to the development of age spots. Risk factors. Anyone can develop age spots, but you may be more likely to develop the condition if you: Have red hair and light skin. Have a history of frequent or intense sun exposure or sunburn. Prevention. To help avoid age spots and new spots after treatment, follow these tips for limiting your sun exposure: Avoid the sun between 1. Because the sun's rays are most intense during this time, try to schedule outdoor activities for other times of the day.
Use sunscreen. Fifteen to 3. UVA and UVB light. Use a sunscreen with a sun protection factor (SPF) of at least 3.
Apply sunscreen generously, and reapply every two hours — or more often if you're swimming or perspiring. Cover up. For protection from the sun, wear tightly woven clothing that covers your arms and legs and a broad- brimmed hat, which provides more protection than does a baseball cap or golf visor. Consider wearing clothing designed to provide sun protection. Look for clothes labeled with an ultraviolet protection factor (UPF) of 4.