Przepukliny brzuszne – co lekarz rodzinny wiedzieć powinien

*Wojciech Szczęsny, Adrian Reśliński, Stanisław Dąbrowiecki, Jakub Szmytkowski

Summary
The authors present the problem of abdominal hernias with respect to their pathogenesis, epidemiology and contemporary treatment options. As many as 70 thousand hernia repairs are performed in Poland annually, and the number of people who do not undergo treatment is likely even greater. Hernia is so common that every family practitioner will encounter the problem of primary or recurrent hernia in their practice. They are often required to advise the patient about treatment options as well as the ways to prevent complications of an existing hernia. The patients also want to know how they should behave after hernia surgery. There have been many misconceptions as to the cause of this condition, compensation claims and hernia as an occupational hazard. The development of a hernia is unrelated to physical labor; it is, rather, a result of generalized alterations within the structure of the connective tissue, including both the synthesis and breakdown of the extracellular matrix. Therefore, hernia cannot be considered an occupational hazard and its discovery during work is not grounds for personal injury compensation. The diagnosis of a hernia, though obvious in most cases, may sometimes prove difficult, especially in differentiation with other pathologies. Surgery remains the only treatment option. Non-surgical methods (such as hernia belts) offer only a temporary protection against the development of complications. An untreated hernia may result in potentially life-threatening complications. Contemporary surgical techniques, using synthetic materials, have brought recurrence rates down to approximately 1%. The primary problems of modern herniology are chronic pain and infections. Currently, the most widespread technique of hernia repair is the Lichtenstein tension – free method, in which a flat mesh implant is used. Laparoscopic surgery, allowing for a shorter disability period, have been gaining in popularity. The above – listed problems have been discussed based on current publications and the authors' own experience.

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