Laparoscopic surgery generally has less pain following the procedure.In 2015 inguinal, femoral and abdominal hernias affected about 18.5 million people. About 27% of males and 3% of females develop a groin hernia at some time in their life. Groin hernias occur most often before the age of one and after the age of fifty. Globally, inguinal, femoral and abdominal hernias resulted in 60,000 deaths in 2015 and 55,000 in 1990. Signs and symptoms
Hernias usually present as bulges in the groin area that can become more prominent when coughing, straining, or standing up. The bulge commonly disappears on lying down. Mild discomfort can develop over time. The inability to "reduce", or place the bulge back into the abdomen usually means the hernia is incarcerated which requires emergency surgery. As the hernia progresses, contents of the abdominal cavity, such as the intestines, can descend into the hernia and run the risk of being pinched within the hernia, causing an intestinal obstruction. Significant pain at the hernia site is suggestive of a more severe course, such as incarceration (the hernia cannot be reduced back into the abdomen) and subsequent ischemia and strangulation (when the hernia becomes deprived of blood supply). If the blood supply of the portion of the intestine caught in the hernia is compromised, the hernia is deemed "strangulated" and gut ischemia and gangrene can result, with potentially fatal consequences. The timing of complications is not predictable.
Eosinophilic bronchitis has also been linked to other conditions such as COPD, atopic cough, and allergic rhinitis. Pathophysiology
The number of eosinophils in the sputum samples of non-asthmatic eosinophilic bronchitis patients are similar to those of patients with asthma. In the sputum samples of those with NAEB, histamine and prostaglandin D2 is increased. This suggests that the superficial airways have significant mast cell activation and this may lead to the differing symptom presentation compared to asthma. Inflammation caused by eosinophils is associated with an increased cough reflex. In another study, however, some follow-up patients who were asymptomatic also had increased eosinophils in their sputum, indicating that the inflammation is not always associated with an increased cough reflex.The cause of the inflammation can be associated with environmental triggers or common allergens such as dust, chloramine, latex, or welding fumes. Diagnosis
Diagnosis of eosinophilic bronchitis is not common as it requires the examination of the patients sputum for a definitive diagnosis, which can be difficult in those who present with a dry cough. In order to induce the sputum, the patient has to inhale increasing concentrations of hypertonic saline solution. If this is unavailable, a bronchoalveolar lavage can be done, and the bronchial wash fluid can be examined for eosinophils. The diagnosis is usually considered later by ruling out other life-threatening conditions or more common diagnoses such as asthma and GERD, and by seeing an improvement in symptoms with inhaled corticosteroid treatment. Chest X-rays and lung function tests are usually normal. CT scans may show some diffuse airway wall thickening.