d) Incisional hernia:
These hernias are seen in operated sites. Due to improper suturing or sepsis the operated site becomes weak resulting in hernia.
e) Epigastric hernia:
Here the hearniation occures in the epigastrium. It is a rare type.
f) Lumbar hernia:
Here the hernia appear in the lumbar area on either side of the lumbar spine(in the lumbar triangle).This is also a rare type.
g) Obturator hernia:
This is a rare type of hernia. Here the contents pass through obturator foramen in the pelvic bone.
Complications of hernia:--
1) Strangulation:
If the hernial orifice is narrow the abdominal contents may not go back easily, and later the blood flow to the herniated tissues may be blocked due to constricition.This can cause death of protruded intestine.
2) Intestinal obstruction:
This occures when the whole portion of the intestine is protruded in to the hernial sac. The narrow hernial orifice will block the passage of bowels.
3) Infection and peritonitis:
If there is strangulation with death of a portion of intestine there will be spread of infection to the abdomen resulting in peritonitis.
Treatment of hernia:--
Initial treatment: In the initial stages of hernia the following steps may be useful
1) Use of hernia belt:
Special types of hernia belts are available for each type of heania.This will prevent the protrusion and will reduce pain.
2) Constipation,recurrent cough,urinary obstruction ect should be treated.
3) Fat reduction will increase the strength of abdominal wall.
4) Abdominal exercises to increase the muscle tone.
5) Take plenty of leafy vegetables, fruits and fibrous diet for easy bowel movements.
6) Try other systems like Homoeopathy,Herbal medicine and ect
If no relief by the above steps consult a general surgeon for surgical management.
Surgical treatment.
The following operations are done depending up on the type and nature of hernia.
1) Hertniotomy : In this operation the contents of hernial sac is pushed in to the abdomen and neck of the sac is ligated with transfixion ligature and the sac is cut off.
2) Herniorrhaphy: Here along with herniotomy the posterior wall is repaired.
3) Hernioplasty: This operation is done if herniotomy is not possible due to wide neck of the sac.Here the repair is done with the healp of non absorbable materials like tantalum gauze,polypropylene mesh or stainless steel mesh.
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