What is Richter Hernia: Symptoms, Treatment, Surgery and Recovery

Overall, a hernia refers to the malady in which a portion of an organ or tissue pops where it doesn’t belong. Inside our body, our organs and tissues as separated into designated compartments. As a fetus, it allows for fetal development of the organs to continue as normal and lead to a healthy birth.

What is the Richter hernia definition?

Beyond that, it separates parts of our body to where they belong. This prevents one section from impeding on the function or health of another. Sadly, this doesn’t always stick. The walls which encase these cavities sometimes become weak. When this occurs, they can wear away and break. The weakened tissue can also be a result of prior surgery or a general birth defect.

This occurrence can happen in many ways, defined by what’s protruding and what’s burst. The definition of a Richter hernia is the instance when the antimesenteric wall of the intestines breaks through the abdominal wall. This is the portion of the small intestine lying opposite of the mesenteric borders.

What’s so special about this?

This significantly separates this condition from other abdominal hernias as the intestinal casing only partially protrudes. This keeps it incompletely both sticking out of the wall and in the peritoneal cavity.

Considering it is only partly defective, some might mishear this as a bonus and beneficial attribute. In reality, it’s a rare type of hernia that’s accompanied by complications. It creates a cloud of confusion and secrecy surrounding it

Is this condition deadly?

Generally, hernias are not a life threatening illness. There’s no immediate threat and you have to just be worried about the secondary issues which manifest as a result of this deformity. These notions become extra complicated with a Richter’s hernia. It is possible for part lumen to get killed while the adjacent stays intact. Dead parts become necrotic. Necrosis refers to the death of tissue on someone remaining alive. If not removed, it can kill you pretty abruptly. The nature of this disease makes it more difficult to identify, even confusing surgeons. A confused surgeon may fail to recognize death in the protrusion and simply push it back into place instead of cutting it out. This botched repair can lead to perforation and peritonitis if not caught in time. This sinister problem disguises as postoperative symptoms or hematomas. This delay can cost you your life as havoc takes its toll before recognition of advanced issues.

What are the Richter’s hernia symptoms?

It is important you understand what it feels and looks like. More notable Richter’s hernia symptoms include swelling of the area and pain. If you are worried about complications following hernia surgery, immediate flulike symptoms (especially fever and the site being hot to the touch) are your best indications.

How is this diagnosed?

After a physical examination, there are imaging techniques that allow your physician to visualize the without becoming invasive. Something like a sonograph (ultrasounds aren’t just for pregnancy people) can be implemented. Once this is done, a surgeon will help plan out the next step with you. This will probably require surgery to alter the anatomy of the site.

What are the treatment options?

Early treatment is important so that you can avoid complications like sepsis or a ruptured hernia before diagnosis. The most common surgery would be hernia repair surgery. In this surgery, the patient is put to sleep and an incision is made to gain access to the site the hernia is located. Sometimes this is accomplished by exposing the internal organs to open air in a traditional manner or laparoscopy. In this less invasive technique, a miniature camera attached to tubing (laparoscope) is snaked into the flesh towards the affected region. Mini surgical tools are used by the experienced surgeon to perform the operation being only guided through the images received through the recording tool. In both approaches, the displaces tissue is inspected and fixed in its home cavity.

Then, the site of the protrusion is patched up (either by sewing endings of the hole or implementing a mesh to literally function as a patch). If the tissue cannot be saved, two additional methods can be attempted. The first, resectioning, refers to slicing out the infected portion and piecing it back together with healthy tissues in the body.

The second option is anastomosis. It’s when you connect healthy tissues like abridge (very similar to a resection). This is possible in tubular structures, like vessels or the loops of the intestines. Two sides being reconnected and using staples, sutures, or glue, it is called being anastomosed. Imagine taking sausages links and trying to create a Frankenstein creation. Cut out the rotten part and sew a consumable end of the sausage to another good end.

CPT Code information on Richter Hernia repair

Official medical codes are the most reliable and efficient way to obtain information on diagnoses and surgical procedures. Every single operation possible is assigned an official code. This assignment is used for systematic purposes and makes organizational things much smoother. The assigned string for Richter hernia repair varies as a function of the exact technique used or additional complications like incarceration or strangulation.



Article References:

  1. http://gsm.utmck.edu/surgery/documents/AbdominalWallandAbdominalWallHernias.pdf
  2. https://www.ncbi.nlm.nih.gov/pubmed/1052444
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421226/
  4. https://www.ncbi.nlm.nih.gov/pubmed/16536253
  5. https://medlineplus.gov/ency/article/002231.htm