What is an allergy?

An allergy or hypersensitivity is one of the most common ailments that arises due to abnormal functioning of the immune system. It is a result of exposure to a specific antigen (allergen) by a sensitized person who has already developed antibodies against the allergen in question.

The interaction of the allergen with the antibody can result in an allergic reaction in many of these sensitized individuals. However, not ever person harboring specific antibodies to certain allergens develops an allergic reaction – some are only sensitized but it does not progress to an allergic reaction.

What are the types of allergic reactions?

There are four types of allergic (hypersensitivity) reactions based on the mechanism of the reaction. The types I, II, and III allergic reactions are antibody mediated reactions, while type IV is a T-cell mediated reaction.

continue reading Allergy, Types of Allergic Reactions and Anaphylaxis

The uncommon types of abdominal hernias include :

• Spigelian hernia
• Obturator hernia
• Lumbar hernia
• Sciatic hernia
• Interparietal hernia
• Perineal hernia
• Richter’s hernia
• Internal hernia

Spigelian Hernia

What is a spigelian hernia?

It is a rare hernia that occurs through the spigelian fascia which lies just outside the outer edge of the rectus sheath, which contains the rectus abdominis (abdominal) muscles. The herniation occurs just below the level of the umbilicus (navel, belly button) and is also known as the hernia of the linea semilunaris.

Spigelian hernias usually develop in older age groups, often the 50s and 60s. The spigelian hernia has a narrow neck that predisposes the contents to adhesions and strangulation. Spigelian hernias are usually small and often start with pain in the area. The bulge of the hernia is not often seen as it lies beneath the aponeurosis of the external oblique muscle. Confirmation of the diagnosis may require ultrasound or CT-scan.

continue reading Rare Abdominal Hernias

Diagnosis of an Inguinal Hernia

The most important feature in diagnosing an inguinal hernia is identifying the bulge in the inguinal region. The bulge may be associated vague pain or discomfort in the groin region. Pain can be very severe if the hernia gets incarcerated or strangulated. Some patients may have abnormal sensations in the region due to pressure on the inguinal nerves.

Physical examination is essential to confirm the diagnosis. It is done with the patient lying and standing position. The bulge may disappear on lying down and appear on standing. The size of the bulge may also increase on standing or coughing (cough impulse). Ultrasonography (ultrasound examination) is useful in the diagnosis of the clinically undetectable inguinal hernias. In some situations, a laparoscopy may serve as the diagnostic as well as the therapeutic procedure at the same time.

continue reading Diagnosis, Treatment and Surgery of Inguinal Hernias

What is a femoral hernia?

A femoral hernia is a protrusion of the abdominal contents through the femoral canal forming a hernial sac that appears as a swelling or bulge in the upper thigh. Due to the close proximity, a femoral hernia is often mistaken for an inguinal hernia especially since the latter is more common.

How does a femoral hernia develop?

The femoral canal is present within the femoral sheath, which is a fascia that extends from abdominal wall and surrounds the femoral blood vessels for about one inch below the inguinal ligament. The femoral sheath has 3 compartments; the outermost is occupied by the femoral artery, followed by the femoral vein in the middle and the innermost (medial) compartment forms the femoral canal which contains the lymphatics.

continue reading Femoral Hernia