Hernia are bulges protruding form a weak point on belly (abdomen) through which intestine and abdominal fat comes out to lie just below the skin. It can also be found in groin, upper thigh and chest. There are several types of hernia like inguinal hernia (direct and indirect), femoral hernia, umbilical hernia, umbilical hernia, epigastria hernia and incision hernia.

Who get hernia?

Conditions that lead to increased abdominal pressure are at more risk of developing hernia  

o Persistent cough

o Being overweight or pregnant

o Lifting, carrying or pushing heavy loads

o Straining on the toilet

What are the symptoms of hernia?

o Mostly they are asymptomatic/ no symptoms.

o People just notice a swelling or bulge which gets bigger while standing or straining and disappear while lying down/sleeping.

o Some might feel a dragging/aching sensation.

o The swelling tends to get bigger with time.

o Symptoms develop when there is a complication like strangulation. This happens when the content of abdomen (intestine) come out and can not go back. There will be severe pain in the region and vomiting. Overlying skin will become red. Urgent surgery is needed in this situation otherwise the blood supply to intestine gets cut-off and the intestine in hernia might die (gangrene).

How are hernia treated?

Surgery is the only treatment for hernia. Now a days, most of the hernias are operated laparoscopically (key hole or minimally access technique)

Minimally Invasive Hernia Repair - The surgery is done with a laparoscope which has a small tiny camera, hernia mesh and small tool with it. So the patient can return back to their normal routine earlier as the incision made is smaller.

Advantages of Laparoscopy:

Laparoscopy has clear advantage over open repair in the way of less pain, less complications like wound infection, small and more cosmetic scar, shorter hospital stay, early return to work and daily activities and less chance of recurrence (repeat formation of hernia after surgery).

Before undergoing hernia surgery:

* One week before surgery it is much essential to stop taking drugs that are causing the thinning of the blood. Drugs like Clpodogrel and Acitrome or Warfarin should be stopped with the doctor s advice. 
* Stop herbal supplements and check the fitness of your cardio and diabetes. 
* Gain adequate knowledge about surgery and be prepared for post surgical care.

After hernia surgery:

* Avoid heavy weight lifting, exercises, and physical works with excessive strain a few weeks after surgery 
* Cough or laugh loud only with support to the surgical site until one week after surgery

DO s & DON T s in patients of Hernia:

DO s:

1. Increased intake of fibers in diet. ( Fruits, vegetables and grains)

2. Drink plenty of water and other fluid to prevent constipation.

3. Exercise regularly: sweat and loose excess weight and toxins.

4. Eat small meals more frequently in place of one or two large meals

DON T s:

1. Stop smoking and drinking

2. Don t reduce the amount of food you eat

3. Avoid lying down or bending after meal

4. Avoid wearing tight clothes

5. Avoid food difficult to digest

6. Avoid strenuous activities like heavy weight lifting

Types of Hernias:

Incisional hernia:

This happens at the site of previous surgery. This occurs as a result of poor wound healing at the time of previous surgery or as a result of complications like in infection. It is rare after laparoscopic or key hole surgery.

Umbilical hernia:

This occurs through or around belly button (umbilicus). It can be present at the time of birth and needs no repair as most of them resolve by the end of one year. If it persists or appears after 5 years of age then operation is required.

Inguinal hernia:

These are most common hernias and occur in groin region. They are more common in men.

All You Need To Know About Hernia!

When blood clot blocks one or more arteries in your lungs the condition is known as pulmonary embolism. It can cause a decrease in the oxygen levels in your blood, damage to your lungs due to sudden restrictions in the flow of blood along with adverse effects on other parts of your body. Life threatening blockage can cause death if left untreated and you should immediately contact your health care provider to get proper diagnosis. Pulmonary embolism requires various lab tests and generally requires short time to resolve.

Symptoms:
The symptoms of pulmonary embolism mainly depend upon many factors pertaining to your previous medical history. Pulmonary embolism varies with the size of your lungs, the size of the clots formed in your blood, and any other underlying history of the heart or lungs. That said, pulmonary embolism has symptoms which are not similar to any two persons and will vary accordingly.

The common symptoms however may include the following and you are advised to opt for a health checkup if these are persistent in your body:
1. Cough along with bloody sputum is a common symptom.
2. Shortness of breath, which will become worse as the days passes by. They will appear suddenly and cause huge discomfort in breathing.
3. Chest pain which may give you the feeling of a heart attack. The pain will intensify when you sit to eat or cough. Deep breath will cause problems too and will not go away easily with exertion.
4. Some other symptoms include fever, excess sweat, irregular heartbeat and dizziness.

Pulmonary embolism can be diagnosed by the following methods:
1. Electrocardiography (also known popularly as ECG) to measure your heart's electrical activity and functioning.
2. CT plumonary angiography is gold standard for diagnosing pulmonary embolism.
3. Chest x ray, which is a common and non invasive test to check your heart and lungs as well as the problems with any bones surrounding them.
4. ECHO can detect secondary changes in heart due to pulmonary embolism.

Treatment of pulmonary embolism can be done with medicines if it is detected at an early stage or also if the clot is small. However, if the size of your clot is problematic and blocks the blood flow to your lungs or heart then surgery may be necessary. Open surgery and clot removal surgery are common in the treatment of pulmonary embolism and will require good regular follow up check ups. Regular leg exercises will also reduce the chances of any underlying disease and you should hence consult your doctor.

What Is Pulmonary Embolism?

Following are some common Gall Bladder and Biliary Disorders. Read on to know in brief about them. 

1. Gall stones: Gall stones also known as cholelitiasis is a condition in which gall bladder contains stones or calculi. Usually, these stones are asymptomatic and do not cause any trouble to the patients. Few patients experience recurrent right upper abdominal pain. This condition is known as biliary colic and if it persists, the patiet is adviced gall bladder removal surgery. Sometimes the patient presents with severe right upper abdominal pain with fever and deranged Liver function tests. This condition is known as acute cholecystitis. The surgery is minimally invasive and is called Laproscopic cholecystectomy. If there are dense adhesions, the surgeon may plan to convert the surgery to open cholecystectomy. The patient is usually discharged by day 3 of surgery.

2. Common bile duct stone or choledocholithiasis: Occasionally stone from the gall bladder slips into the common bile duct (CBD stone).This causes obstruction of the bile duct causing Fever, abdominal pain and Jaundice. This is called Cholangitis and is a medical emergency. The patient requires urgent hospitalisation and decompression of the bile duct by inserting a plastic stent in the CBD with the help of ERCP. Severe untreated cholangitis can be life threatenig.CBD Stones which are detected because of dull aching abdominal pain, deranged liver function tests or by ultrasonography also need removal. The CBD stone is removed by an endoscopic modality called ERCP, which is minimally invasive and needs no surgery.

3. Bile duct cancer or cholangiocarcinoma: Cancer of bile duct usually occurs in the elderly patients who present with gradually progressive jaundice. Because of the obstruction to the flow of bile, produced in the liver, the patient develops jaundice. Gastroenterologists examine the patient and CT scan abdomen with MRCP is required to fully evaluate the stage and extent of the tumour. The treatment is multimodality and requires the expertise of Radiologists, Surgeons, Oncologists and gastroenterologists. The Gastroenterologists can help in decreasing Jaundice by inserting plastic or a metal stent (SEMS self-expanding metal stent ) in the common bile duct. These are very aggressive tumours and very few patients are fit for surgery. Survival is very low for these tumours.

4. Gall bladder cancer: Gall bladder cancers are very aggressive and lethal cancers. The patients present with obstructive Jaundice and Itching all over the body. Definitive treatment is surgery but very patients present in the early stage. Advanced stage cancers are treated with palliative intent by metal stenting (SEMS for cancer of gall bladder) to reduce jaundice.

Learn More About Gall Bladder And Biliary Disorders!

The body receives its source of energy and nutrition through the blood, which is the transport medium. The blood runs through a highly complex network of blood vessels, with the aorta being the largest one. It originates in the heart, the left ventricle precisely and supplies oxygenated blood to all parts of the body. Coarctation is a condition where there is a narrowing of the aorta. The heart, therefore, has to exert extra pressure to push out blood so that blood supply to the target organs is not affected.

The exact cause of aortic coarctation is not known, though it often develops at birth and so is known as a congenital disorder. Depending on the severity of the narrowing, symptoms develop at various times in life. While some infants demonstrate symptoms, some may not show any symptoms well into adulthood. Infants with severe narrowing may manifest the below symptoms quite early in life.

Difficulty in breathing may gasp
Difficulty in feeding
Be extremely irritable
Profuse sweating
Pale skin
When these symptoms are not noticed and treated in time, the child may have heart failure or even die. If the symptoms do not manifest early in life, the infant can grow into childhood quite normally. Symptoms may then manifest which would be different, as below.

Increased blood pressure
Headaches (frequent)
Weakness in the muscles
Nosebleeds
Chest pain
Frequent fainting spells
These are generic symptoms and it is difficult to suspect coarctation of the aorta. Therefore, further imaging would be required to rule out coarctation of the aorta. There are some risk factors, most related to the heart, which puts one at increased risk of developing aortic coarctation.

Bicuspid aortic valve
Aortic valve stenosis and/or regurgitation
Mitral valve stenosis and/or regurgitation
Patent ductus arteriosus
Treatment: Diagnosis is the first step in treating coarctation of the aorta. This would include a series of imaging tests including an echocardiogram, electrocardiogram, chest x-ray, CT scan, and MRI.
Surgery is often the most definitive mode of treatment, and the approach chosen depends on the severity and stage of identification. The most common approach is to open up the narrowed portion and keep it from collapsing again, so that blood flow is restored. This is known as a balloon angioplasty and stenting. Some of the other procedures used include:

Resection with end-to-end anastomosis
Bypass graft repair
Subclavian flap aortoplasty
Patch aortoplasty
In all affected individuals, after surgery, medications are prescribed to maintain blood pressure levels, which is often increased. In addition, lifestyle changes including exercise and healthy eating habits have to be developed.

Coarctation of the Aorta - Symptoms and Treatment

Cover small intestine is very significant in maintaining proper digestive health by jogging nutrients are fluids that be eat or drink. Yourself in delivering the waste products in the large intestine. This surgery which is the small bowel resection is done to remove part or the entire small bowel. This is basically done when part of our small bowel as blockage or when the diseased.

Importance of intestinal surgery or small bowel resection
There are several conditions which may affect our small bowel. Generally your doctor might advise you to remove a portion of your small bowel but in some cases a portion of your small Bible might have to be removed to confirm that a disease have been ruled out if tissue diagnosis might be required. Some situations where you may require surgery involves:

Severe ulcers that develops in the small bowel leads to bleeding and in some cases infection also
A situation where there is either a congenital blockage in the intestine or maybe from a scar tissue
Cancer is an obvious option
Some injuries to the small bowel is an obvious situation
In some cases there may be a pocket of intestines present there since birth
Several diseases which cause inflammation in the small bowel
Risks Involving Small Bowel Resection
It is very obvious that any kind of surgery has some potential risks so does the small Bowel resection, which includes which includes:

There maybe some difficulty in breathing
Infections are very common
There might be some damage in the structures surrounding it
There maybe case a of heart attack
Abnormal bleeding
Bleeding resulting in blood clots
Pneumonia
Bleeding in the stomach area
The abdomen might start collecting pass which is known as intra abdominal abscess
If the intestinal blockage is formed by a scar tissue then it requires more surgery
They might be problems while absorbing the vitamins and nutrients which is commonly known as short bowel syndrome
Due to some infections diarrhoea is always a frequent risk.
A Long-term Outlook after small bowel resection A majority of people have recovered well from the surgery. You can definitely resume your normal day to day activities even if you had ileostomy and you are required to carry a drainage bag. Diarrhoea might still be a concern for you if you had a big section of your bowel removed and you still might have problem in digesting foods. Inflammatory diseases might still require for the medication.

Intestinal Surgery - Know The Risks Involved!

The tube that carries food to your stomach from your throat is called the oesophagus. When the muscular valve (lower oesophagus sphincter) in the oesophagus fails to relax and carry the food to the stomach, the condition is termed as achalasia.

Achalasia has a variety of causes, and can be difficult for your doctor to diagnose the exact cause. Some common causes of Achalasia include:
1. Hereditary predispositions
2. Autoimmune disorders (The immune system erroneously destroys healthy cells in the body)
3. Nerve degeneration in the oesophagus
There other medical conditions that often lead to symptoms identical to achalasia, such as oesophageal cancer and Chagas  disease (an infectious disease caused by a parasite).

Other symptoms of achalasia include:

The most prominent symptom of achalasia is dysphagia, which is characterised by swallowing difficulties or sensations of food stuck in the oesophagus. Dysphagia often triggers coughing and shortness of breath or choking on food.
1. Discomfort or pain in the chest
2. Weight loss
3. Heartburn
4. Intense discomfort or pain after eating

Some of the treatments include:

Most of the methods to treat achalasia focus on the lower oesophageal sphincter (LES). The treatments used can either permanently alter the sphincter s function, or reduce symptoms.
1. Oral medications such as calcium channel blockers or nitrates are prescribed, which can relax the LES to let food pass through with more ease. Your doctor may also treat the LES with Botox.
2. For a more permanent treatment, the sphincter can be dilated or altered. In dilation, a balloon is inserted into the oesophagus and it is inflated. This will stretch out your oesophagus to improve function.
3. To alter the oesophagus, oesophagomyotomy is performed. It is a kind of surgery where minimal incisions are made to gain access to the LES, and then it is carefully altered to improve flow of food to the stomach.

Unlike dilation, which can cause complications such as tears in the oesophagus, oesophagomyotomy has a greater success rate. However, certain complications may still arise, such as:
1. Acid reflux
2. Respiratory conditions that are caused by food entering your windpipe

Achalasia - Can Autoimmune Disorders be the Cause Behind it

Don't wait any longer, manage your Robotic Surgeon online with a Lybrate doctor today

Consult for Robotic Surgeon - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES