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Pathology and therapy of umbilical hernia

Umbilical hernia ring out is called the umbilical hernia. Cord is central located in the abdominal wall, in the process of embryonic development, the late closure of the abdominal wall parts. Meanwhile, navel lacks fat tissue, so that the outer layer of the abdominal wall skin, fascia and peritoneum are directly linked together, all the weakest part of the abdominal wall, abdominal contents this site is easy to highlight the formation of umbilical hernia. In the human fetus through the umbilical ring site has two arteries and one vein, umbilical and vitelline duct duct connected with the mother to obtain nutrition. Before and after the birth, the structure gradually closed umbilical ring lock forming the umbilical depression. If the insufficiency or extension block occurred just after birth deformities and form.
navel rings protruding hernia umbilical hernia. Clinical infant Umbilical hernias and umbilical hernia in adults divided into two. The former is far more common than the latter. Etiology:
1. Infant umbilical hernia. Is congenital. Hypoplasia of the etiology of umbilical, umbilical ring is not fully locked; or the umbilical scar tissue is weak, not strong enough. In intraabdominal pressure increases. (Often crying, constipation, such as phimosis) cases, internal organs can be formed protruding from the umbilicus. Are covered only for scar tissue, subcutaneous and skin.
2. Adult umbilical hernia: rare. May be associated with weaker umbilical ring of scar tissue. Causes are pregnancy, ascites and chronic cough. Hernia initially within the greater omentum, and then there is the small intestine, colon, and so on. Due to extensive adhesions with the hernia SAC wall form a gap.
symptoms:
1. Infant umbilical hernia: common multiple is a highly complex hernias, incarcerated rare. When you cry, when standing and hard, cord swollen lumps, usually 1~2 cm in diameter, with no other symptoms, often in the shower, dressing accidentally discovered.
2. Umbilical hernia in adults: more common in middle-aged obese women. Main symptom is hemispherical hernia umbilical blocks, can be satisfied, often accompanied by indigestion, abdominal discomfort and pain. Due to a tough scar tissue around the ring are usually small and therefore more prone to incidents of incarceration and strangulation. Huge umbilical hernia is hung.
disease:
1. Infant umbilical hernia, most through umbilical fascia ring gradually shrinking and within a year of healing. So before the age of 2 unless the incarcerated, could wait. Non surgical therapy to promote healing or if they have reached the age of 2, umbilical hernia diameter of more than 1. 5 cm who should be with surgery treatment, along umbilical mouth 1 cm at, along umbilical for semicircle incision points high skin and subcutaneous tissue, significantly abdominal straight muscle Qian sheath, hernia ring and the hernia SAC, middle cut abdominal since line, free hernia SAC, back na hernia content real, in hernia ring at resection part hernia SAC Hou, give sewing tied then will sides abdominal straight muscle sheath margin (that abdominal since line) continuous suture, last suture skin.
2. Early surgical operation treatment of adult umbilical hernia, block immediately to emergency surgery. Around the transverse oval the umbilical incision, separation of hernia SAC until the neck, careful separation of adhesions in the hernia SAC and neck cut, hernias will work closely with the adhesive it is difficult to separate the greater omentum and excess skin to be removed. So, as much as free ring around the transversalis fascia and peritoneum. Transverse suture and free around the upper and lower rectus abdominis muscle and its fascia and, if necessary, can be used for overlapped stitching.
medication principles:
1. selective umbilical hernia surgery generally does not use antibiotics. 2. when incarcerated, strangulated hernias occur, or hernia incarcerated, strangulated, but merged have breathe, infections of the urinary system, which required medication including medication box limit "a" and "b". 3. after operation of strangulated hernia complications or physical persons, were used except for "a", "b", the application could be considered new drugs and support for symptomatic treatment.
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