NAME:OSMAN RAHINATU

INDEX NUMBER:41200221
COURSE TITLE:PAEDIATRICS NURSING 1
ASSIGNMENT (HERNIA)

HERNIA

A Hernia occurs when there is a weakness or hole in the peritoneum (muscular wall). The function of peritoneum
is to keep the organs in the abdominal region in place. In here if the organs or tissues are pushed out to form a
bulge, then it is said to be herniated. They are commonly found in the abdomen, upper thigh and groin region.
They are usually not life threatening but in some cases surgery is advised to avoid potentially dangerous
complications.

TYPES OF HERNIA
1. Inguinal Hernia (inner groin)

2. Incisional Hernia (resulting from an incision)

3. Femoral Hernia (outer groin)

4. Umbilical Hernia (belly button)

5. Hiatal Hernia (upper stomach)

An inguinal Hernia

These Hernias make up seventy-five percent of all abdominal wall Hernias and occurs typically in
men than women, these Hernias are divided into two different types, direct and indirect. Both
occur within the groin area where the skin of the thigh joins the body part (the inguinal crease).
Both of these Hernias will present themselves as a bulge within the inguinal area. Distinguishing
between direct and indirect Hernia, however, is an important part of the clinical diagnosis.

Indirect inguinal Hernia: An indirect Hernia follows the pathway that the testicles created
throughout fetal development, descending from the abdomen into the scrotum. This pathway
unremarkably closes before birth however might become a site for a Hernia in later life.
Sometimes the Hernia sac might protrude into the scrotum. An indirect inguinal hernia may occur
at any age.
Direct inguinal Hernia: The direct inguinal hernia happens in a distinct area where the abdominal
wall is slightly diluent. It seldom will protrude into the scrotum and might possibly cause pain
that’s hard to tell apart from testicle pain. Unlike the indirect Hernia, which might occur at any
age, the Direct Hernia tends to occur to the aged as a result of their abdominal walls weakening
as they age.
What is an incisional Hernia?
These Hernias occur at the site of a previous abdominal surgery where the intestine pushes out
against the abdominal wall. It is said to be common in overweight or elderly people who are
inactive, especially after their abdominal surgery.

Femoral Hernia

The femoral canal is the path through which the femoral artery, vein, and nerve leave the cavity
of the abdomen to enter the thigh. Although usually a stiff space, typically it becomes large
enough to permit the abdominal contents (usually intestine) to protrude into the canal. A femoral
hernia causes a bulge just below the inguinal crease roughly in the middle of the upper leg.

Femoral Hernias in women are common and are particularly at risk of becoming irreducible (not
able to be pushed back into place) and strangulated (cutting off blood supply). Not all Hernias
that are irreducible are strangulated (have their blood supply cut off), however all Hernias that
are irreducible have to be evaluated by a skilled physician.

An umbilical Hernia

These common Hernias (10%-30%) are often noted in children at birth, they are observed as a
protrusion at the belly button (the umbilicus). An Umbilical hernia is caused when an opening in
the child's abdominal wall, which normally closes before birth, doesn't close completely. If tiny
(less than half an inch), this type of Hernia usually closes gradually by age 2. Larger hernias and
those that do not close by naturally require surgery when a child is 2 to 4 years of age. Even if the
region is closed at birth, umbilical hernias can appear later in life because this spot may remain a
weaker place in the abdominal wall. Umbilical Hernias can appear later in life or in women who
are pregnant or who have given birth which is caused due to the additional stress on the area.
They usually do not cause abdominal pain.

Hiatal Hernia
This type of hernia happens if part of the abdomen pushes through the diaphragm. The
diaphragm commonly includes a little gap for the esophagus. This gap will become herniated
when part of the abdomen pushes through. Small Hiatal Hernias may cause no major symptoms,
however, larger ones can cause pain and heartburn.

OTHER RARE TYPES OF HERNIAS

Diaphragmatic Hernia : This is usually a birth defect causing an opening in the diaphragm,
which allows abdominal contents to push through into the chest cavity.
Spigelian Hernia : This rare hernia happens on the sting of the rectus abdominal muscle through
the Spigelian connective tissue, which is several inches lateral to the middle of the abdomen.
Obturator Hernia : This very rare abdominal hernia develops principally in women. This hernia
protrudes from the cavum through a gap within the girdle bone. This will not show any bulge but
can act like a bowel obstruction which causes nausea and vomiting. Because of the shortage of
visible bulging, this Hernia is very difficult to diagnose.
Epigastric Hernia : Occurring between the navel and therefore the lower part of the skeletal
structure within the sheet of the abdomen, epigastric hernias are composed usually of fatty tissue
and rarely contain intestine. Formed in a locality of the relative weakness of the wall of the
abdomen wall, these hernias are often painless and unable to be pushed back into the abdomen
when first discovered.

CAUSES OF HERNIA

 Straining on the toilet

 Persistent cough
 Enlarged prostate
 Cystic fibrosis
 Straining to urinate
 Obesity
 Abdominal fluid
 Lifting heavy items
 Peritoneal dialysis
 Poor nutrition
 Smoking
 Physical exertion
 Undescended testicles

SYMPTOMS OF HERNIA

1. Reducible Hernia

 It may appear as a new lump in the groin or abdominal region

 It may ache but not tender when touched
 The pain precedes in the lump region
 The lump may increase in size while standing or when abdominal pressure is increased due to coughing
or sneezing continuously
 It may be pushed back unless very large

2. Irreducible Hernia

 Occasionally painful
 Enlargement of the previously reducible Hernia will not be able to return to its original shape when you
push it
 It may be chronic without pain
 It is also known as incarcerated Hernia
 Leads to strangulation Hernia
 Bowel obstruction symptoms may occur such as nausea and vomiting
3. Strangulated Hernia

 The blood supply of the entrapped intestine is cut off

 Pain followed by tenderness
 Nausea and vomiting
 The person may appear ill with or without fever

RISK FACTORS REGARDING HERNIA

Incisional Hernia

This Hernia is caused after the surgery mostly around 3-6 months after the procedure. This happens usually when
the person involved is:

 Involved in strenuous activity

 Gains extra weight
 Becomes pregnant.

These activities put extra stress on the healing tissue which mostly causes a Hernia in women.

Inguinal Hernia

These Hernias are usually common in:

 Older adults
 Hereditary
 Males
 Smokers
 Chronic constipation
 Premature birth
 Pregnancy
 Low birth weight

Umbilical Hernia

These Hernias occur in cases of:

Babies

 With a low birth weight

 Who are born prematurely

Adults

 Who are overweight

 Women who bear multiple pregnancies
Hiatal Hernia

These Hernias occur in:

 Individuals aged over 50 years

 Individuals who are overweight

TREATMENT FOR HERNIA

The need for Hernia treatment depends upon the size and the severity of the symptoms. Hernia treatment includes
three options:

1.Lifestyle changes

2.Medication

3.Surgery

1.Lifestyle changes

Dietary changes can often treat the symptoms of a Hiatal Hernia but it won’t make the hernia go away. The
affected person is asked to avoid large or heavy meals and not to bend over after the meal or to lie down. The
person must keep the body weight in a healthy range.

Certain exercises for Hernia may help strengthen the muscles around the Hernia site which helps reduce the
symptoms. But if the exercise is done improperly, it increases the pressure in that area and causes the Hernia to
bulge. And so it is essential to follow the Hernia doctor or physical therapist's order properly.

The symptoms of a Hernia can be treated by avoiding foods such as spicy foods which may cause acid reflux or
heartburn. Additionally, you can avoid acid reflux by weight loss and quitting cigarettes.

Hernia Medication

Hernia medicines such as antacids, H-2 receptor blockers and proton pump inhibitors. can reduce stomach acid
which can relieve the discomfort and improves symptoms.

Hernia Surgery

Hernias are often repaired with either open or laparoscopic surgery. Laparoscopic surgery for Hernia uses a tint
camera and miniaturized surgical equipment to repair the Hernia using few incisions. They are said to be less
damaging to the surrounding tissues.

COMPLICATIONS ARISING IF A HERNIA IS LEFT UNTREATED

If the Hernia is left untreated, it may grow and become more painful. A portion of the intestine could become
trapped in the abdominal wall. This can obstruct the bowel and cause severe pain, nausea, or constipation. An
untreated hernia also can place an excessive amount of pressure on nearby close tissues. This can cause swelling
and pain within the surrounding space.

If the trapped section of the intestines doesn’t get enough blood flow, strangulation Hernia occurs. This can cause
the tissue of intestine to become infected or die. A strangulated hernia is critical and needs immediate medical aid.

Untreated Hernia complications

It is important to recognize the early signs of a Hernia. An untreated Hernia may not disappear on its own.
However, with proper medical care or lifestyle changes, the effects of Hernia can be minimized which can avoid
life-threatening complications like strangulation Hernia.

PREVENTION OF HERNIA

The muscle weakness which causes the Hernia cannot be prevented. However, the amount of strain one puts on
their body can be reduced. This helps in avoiding Hernia or keeping an existing Hernia from getting worse.

Few tips that may help in preventing Hernia are as follows:

 No smoking
 Seeing the doctor when you are sick to avoid developing a persistent cough
 Maintaining a healthy body weight
 Avoiding straining during bowel movements or urination
 Lifting objects together with your knees and not your back
 Avoid lifting weights that are too heavy