Hernia white discientific research institute of a stomach

Description:

Epigastrocele (it is a preperitoneal lipoma) – a state at which in tendinous fibers between muscles on the average line of a stomach cracks through which there is at first a fat, and then and abdominal organs are formed.

The epigastrocele is shown by painful protrusion in any place on the average line of a stomach.

Symptoms of Hernia white discientific research institute of a stomach:

    * painful protrusion of the average line of a stomach, a thicket in upper parts;
    * pain in upper parts of a stomach, especially at a natuzhivaniye and the sharp movements;
    * discrepancy of muscles (diastases) on the average line of a stomach;
    * nausea, sometimes vomiting.

Depending on an arrangement otnosilelno of a navel distinguish the following epigastroceles:

  1. nadpupochny - located above a navel;
  2. paraumbilical - being near an umbilical ring;
  3. infraumbilical - located below a navel.

In some cases epigastroceles show nothing themselves and are found accidentally.

Allocate three stages of hernia: a preperitoneal lipoma, the initial and created hernia.

At a lipoma stage through slit-like defects of the white line of a stomach preperitoneal fat is stuck out. Then the hernial bag is formed - it is already initial stage. At emergence of discrepancy of muscles (diastase) and progressing of process a part of an epiploon or the site of a wall of a small bowel gets to a hernial bag. Hernia was created: in the field of the white line of a stomach there is a dense painful education, hernial gate (through which there are abdominal organs) usually oval or rounded shape, their diameter fluctuates from 1 to 12 cm. Quite often there are multiple epigastroceles which are located one over another.

The pain syndrome is expressed even at early stages of an epigastrocele that is connected with infringement of nerves of preperitoneal cellulose.

Reasons of Hernia white discientific research institute of a stomach:

The white line of a stomach is a narrow tendinous plate between direct muscles of a stomach between a pubis and a xiphoidal shoot of a breast. At a direct muscle of a stomach, the creating this area, is from 3 — 6 tendinous crossing points. The inborn or acquired weakness of connecting fabric of the white line of a stomach is the reason of a gryzheobrazovaniye in this zone. Sometimes it is led to its thinning and expansion, emergence of openings in the white line and to education by a diastase of direct muscles of a stomach (divarication of recti). Width of the white line normal makes 1 — 3 cm, and at its change more can reach 10 cm, depending on degree a diastase.

Hernia of the white line arises at men 20 — 30 summer age more often. The typical place of localization is the epigastric part of the white line.

Carry to the contributing factors weakening connecting fabric of the white line of a stomach:

    * hereditary weakness of connecting fabric;
    * obesity;
    * postoperative hems.

The risk factors connected with increase in intra belly pressure:

    * physical overstrain;
    * locks;
    * pregnancy;
    * ascites;
    * long cough.

Treatment of Hernia white discientific research institute of a stomach:

It is possible to get rid of hernia only surgically in the conditions of a hospital. Types of operations (hernioplasty):

1) Plastics local fabrics - sewing up of defect of the white line of a stomach with elimination possible a diastase of direct muscles. However Izz of weakness of connecting fabric and considerable load of seams after operation in 20-40% of cases there is recurrence (repeated herniations).

2) Plastics using synthetic prostheses - installation of a grid for closing of defect of an aponeurosis after elimination a diastase of direct muscles at an epigastrocele. The probability of a recurrence is very small. Operation is carried out under anesthetic.

Feature of surgical treatment of epigastroceles is that elimination only of one hernia insufficiently. Elimination a diastase of direct muscles of a stomach is necessary.