Omentum

Infringement is usually accompanied by a sudden pain in the emerging field of hernia bulge, and sometimes around the abdomen. Nature, intensity and irradiation of pain vary depending on the type of infringement, the affected organ, the patient's age, etc. Sometimes, especially in older people, pain is relatively minor and easily tolerated, in other cases, especially among the young, achieve great power and can accompanied by tachycardia and decreased blood pressure. Pain may be constant, progressive or labor-- when developing acute intestinal obstruction.

Sometimes the pain subsides from necrotic ulcers. Similar to elucidate the nature of pain and the dynamics of the pain is of great diagnostic value.
The cardinal sign of prejudice-free reducible hernia is the inability to reposition hernial protrusion of the abdominal cavity.

Hernial protrusion increases in volume, becoming tense and painful. Dullness on percussion is determined (if the hernial sac contained fluid, omentum) or tympanitis (swollen bowel loop). If irreducible hernia diagnosis of infringement is made by the sudden appearance of pain, soreness and tension hernial protrusion.

An important feature of infringement is also a lack of transmission of the cough impulse toward hernial protrusion.

Hernia strangulation is often accompanied by vomiting, sometimes repeated. Initially, vomiting is a reflex, and later due to intoxication.

When infringement of a part of the intestine develop intestinal obstruction phenomenon.

On examination the abdomen is determined by: bloating, increased intestinal motility, anastaltic wave. In some patients, there is an urgent urge to defecate, may withdraw gases and feces from the portion of the colon, located distal to the place of infringement. Characteristically, the bowel is not improving, feeling sick.

The general condition of the patient the first time after hernia incarceration remains satisfactory. True, the suddenness of the pain attack, usually causes a certain anxiety patients. Appear weakness, dry mouth, thirst. Pulse and body temperature is only marginally affected. In the future, with the progression of acute intestinal obstruction, health and the patient's condition rapidly deteriorated due to the rise of intoxication and the development of peritonitis.

Isolated impairment of omentum, fallopian tube, ovary, bladder diverticulum or accompanied by pain syndrome and dysfunction of these organs. The latter circumstance is not immediately detected and not always. Phenomenon of acute intestinal obstruction are absent, due to which the clinical picture of infringement pain in the hernial protrusion is leading.

Greater danger because of the difficulty of diagnostics is membrane impairment of bowel - hernial protrusion at the same time small and hardly detectable, bowel obstruction is incomplete, after conservative measures begins feeling better, and the strangulated bowel area, meanwhile, often and pretty soon undergoes necrosis.

In the case of infringement in the primary brand viagra when a hernia patient can categorically deny the existence of a hernia in the past. Objectively, the hernial protrusion can not clearly defined. However, the totality of the symptoms of acute intestinal obstruction, local pain in the region, where usually a hernia, along with tenderness to palpation Canal Zone or the ring can make the correct diagnosis. This also applies to abuses in the inner ring.

In patients with symptoms of old age are not infringing the usual brightness and intensity. Pain in the hernial protrusion and in the stomach may be weak. These pains people are special, because prolonged use of the bandage, they often have experienced the unpleasant sensation of pain, are accustomed to them, and therefore can not give due importance to newly-found pain in the infringement. Only when patiently and persistently questioning to figure out that a sudden strengthening of abdominal pain and in the hernial protrusion yet occurred and it was accompanied by nausea or vomiting, after which the patient "was very bad." Can also find out that when trying to right a hernia were pain, "which did not exist" and that the reduction in this regard was not possible.

Ileus, occurs because of infringement of hernia in elderly patients has features that make it difficult diagnosis. Thus, the period when, after the infringement intestine observed hyperperistalsis leading her department, in older people short duration, after which there enteroplegia with abdominal distention. The abdomen was soft, distended mild symptoms of peritoneal irritation are absent or detected vague. Soreness is small, determined only at a relatively deep palpation.

In connection with necrosis of entrapment (usually colon) symptoms of poisoning and peritonitis: the deterioration of general condition, weakness, thirst, dry mouth, rapid pulse, vomiting, fever, abdominal distension, etc. The old people, all these symptoms are usually less pronounced than in young. This must be remembered and correctly assess even mild expression, "erased" clinical symptoms.

The reason for the misdiagnosis of hernia are often inflammatory processes in the inguinal lymph nodes metastases in these nodes, wandering abscesses, varicose terminal nodes in the department of superficial femoral vein.

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