INGUINAL HERNIA

The inguinal hernia is the protrusion of a tract of the intestine or another abdominal organ through an opening of the abdominal wall in the groin.
The patient arrives at the observation sent by the MMG or for a swelling in the groin and/or scrotum. The surgical examination allows identification of hernia, however sometimes is useful a targeted ultrasound.

Other types of hernias (such as umbilical hernias and femoral hernias) are formed in other locations.

The main symptoms

A not painful swelling in the groin or scrotum (in the case of inguinal hernia). The swelling can get bigger when the man stands and shrink when he is lying down because the intestine or fat slides back and forth due to gravity. In some cases a part of the intestine is trapped in the scrotum causing a fearsome complication of the inguinal hernia (incarceration). The entrapment of the intestine may involve the risk of blood circulation interruption (strangulation). The throttled intestine may be affected by ischemia (become gangrenous) within a few hours.

Diagnoses

Diagnosis of inguinal hernia based on the objective examination. Usually the patient is in an upright position, the groin is examined and the patient is asked to cough increasing the abdominal pressure. If the patient has an inguinal hernia, this one leaks forward, facilitating the doctor’s valuation.

Therapy

The therapy is mainly surgical, proceeding to the repair of the hernia and the placement of a prosthesis. For strangled and incarcerated hernias, urgent surgery is required to push the intestine out of the inguinal canal.

GALLBLADDER STONES

Gallstones are generally composed of cholesterol, which precipitates in the form of crystals in the bile. They form in the gallbladder. They can leave the gallbladder and get stuck in the cystic duct, coledocum or Vater’s ampoule in the gallbladder.

The causes are multiple: diet, previous surgeries, risk factors. Gallbladder stones can cause pain. In biliary colic the pain is felt in the upper abdomen, usually in the right side below the ribs. Occasionally, the exact location of pain is difficult to locate, especially in diabetics and in the elderly. Pain usually increases in intensity within 15-60 minutes and remains constant for 12 hours. Pain is generally severe enough to require transport to the emergency room to relieve it. Then, the pain resolves in the arc of 30-90 minutes, leaving a dull ache.The subject may sometimes feel nausea and vomiting. Eating a heavy meal can trigger biliary colic regardless of whether the food is fat or not.

Complications

Among the main complications of cholelithiasis we have: acute cholecystitis, jaundice, sepsis, pancreatitis.

Diagnoses

A surgical examination is performed, assisted by instrumental examinations (mainly an abdomen ultrasound).

Therapy

If gallstones cause recurrent and disabling pain attacks, your doctor may advise surgical removal of the gallbladder (cholecystectomy). The removal of the gallbladder avoids the episodes of biliary colic, while not compromising digestion. No specific food restrictions are required after ithis surgical ntervention. During cholecystectomy, the doctor may look for the presence of gallstones in the bile ducts.

Laparoscopic cholecystectomy surgery

In the laparoscopic surgery, the surgeon practices 3-4 small diameter holes (less than 1 cm) in which he introduces an optical instrument (laparoscope) and other surgical instruments. The procedure is performed under general anesthesia. The patient does not feel any pain during the execution.

Discharge after laparoscopy occurs within 2-3 days. In the following 10 days the patient should avoid physical exertion. After a few days the patient can return to work and daily activities, except for the heavier ones.