{"id":4171,"date":"2023-04-05T07:58:20","date_gmt":"2023-04-05T05:58:20","guid":{"rendered":"http:\/\/berlin-boehm.de\/Kanty\/?p=4171"},"modified":"2023-04-05T07:58:21","modified_gmt":"2023-04-05T05:58:21","slug":"nabelhernie","status":"publish","type":"post","link":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4171","title":{"rendered":"Nabelhernie"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_full-7acc1372e522d1472d3487e02738ae1c\">\n.flex_column.av-av_one_full-7acc1372e522d1472d3487e02738ae1c{\nbackground-color:#22689e;\n}\n<\/style>\n<div  class='flex_column av-av_one_full-7acc1372e522d1472d3487e02738ae1c av_one_full  avia-builder-el-0  el_before_av_hr  avia-builder-el-first  first flex_column_div  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lg3a29zm-6859c3683e97b7426bc5f2d0eaf364b4\">\n#top .av-special-heading.av-lg3a29zm-6859c3683e97b7426bc5f2d0eaf364b4{\nmargin:20px 20px 20px 20px;\npadding-bottom:0;\ncolor:#ffffff;\n}\nbody .av-special-heading.av-lg3a29zm-6859c3683e97b7426bc5f2d0eaf364b4 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-lg3a29zm-6859c3683e97b7426bc5f2d0eaf364b4 .av-special-heading-tag{\npadding:5px 5px 5px 5px;\n}\n.av-special-heading.av-lg3a29zm-6859c3683e97b7426bc5f2d0eaf364b4 .special-heading-inner-border{\nborder-color:#ffffff;\n}\n.av-special-heading.av-lg3a29zm-6859c3683e97b7426bc5f2d0eaf364b4 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-lg3a29zm-6859c3683e97b7426bc5f2d0eaf364b4 av-special-heading-h3 custom-color-heading blockquote classic-quote  avia-builder-el-1  avia-builder-el-no-sibling '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Nabelhernie<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><\/div><div  class='hr av-av_hr-91d7ccd583a503147498e120fee2ff9b hr-default  avia-builder-el-2  el_after_av_one_full  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><\/p>\n<section  class='av_textblock_section av-lg3a2xwy-d47767c163fb6772f6f775af64c679c3 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Bei der Nabelhernie st\u00fclpt sich das Peritoneum durch den Anulus umbilicalis, so dass eine palpable Vorw\u00f6lbung und Bruchpforte nachweisbar sind. Der Nabelbruch ist bei Neugeborenen physiologisch und \u201everschlie\u00dft\u201c sich innerhalb von einem Jahr.<\/p>\n<h4 id=\"heading_id_40\">Klinik<\/h4>\n<p>Die meisten Hernien sind asymptomatisch und gut reponibel. Mit zunehmendem Alter, nach Schwangerschaften oder bei zunehmender Adipositas k\u00f6nnen sie gr\u00f6\u00dfer werden. Die Patienten stellen sich in der Regel bei einer Gr\u00f6\u00dfenzunahme oder bei rezidivierenden Beschwerden vor.<\/p>\n<h4>Operationsindikation<\/h4>\n<p>Symptomatische oder gr\u00f6\u00dfer werdende Nabelhernien sollten operiert werden. Kontraindikationen bestehen lediglich bei einer Peritonealkarzinose.<\/p>\n<h4 id=\"heading_id_41\">Leberzirrhose<\/h4>\n<p>Manchmal werden Patienten mit massivem Aszites vorstellig, bei denen durch den erh\u00f6hten intraabdominellen Druck der Nabelbruch auff\u00e4llig wird. Er vergr\u00f6\u00dfert sich rasch und die d\u00fcnne Haut zeigt eine livide Verf\u00e4rbung mit trophischen St\u00f6rungen bis zur Nekrose. Meistens liegt eine fortgeschrittene Leberzirrhose mit zus\u00e4tzlichen Gerinnungsst\u00f6rungen vor. Die Operationsindikation sollte bei diesen Patienten nur bei ausgepr\u00e4gter Symptomatik, drohender Nekrose oder Inkarzeration gestellt werden, weil die postoperative Komplikationsrate sehr hoch ist. Auf eine Korrektur der meist vorhandenen Thrombozytopenie und Gerinnungsst\u00f6rung ist zu achten.<\/p>\n<h4>Operation nach Spitzy<\/h4>\n<p>Ein Nabelbruch wird \u00fcblicherweise nach Spitzy operiert. Der Nabel wird kaudal halbkreisf\u00f6rmig umschnitten und vom verklebten Bruchsack gel\u00f6st. Er wird reponiert und die Bruchpforte quer verschlossen.<\/p>\n<div class=\"ir\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone  wp-image-3826\" src=\"http:\/\/berlin-boehm.de\/wp-content\/uploads\/2023\/04\/Spitzy-300x290.jpg\" alt=\"\" width=\"348\" height=\"336\" srcset=\"http:\/\/berlin-boehm.de\/wp-content\/uploads\/2023\/04\/Spitzy-300x290.jpg 300w, http:\/\/berlin-boehm.de\/wp-content\/uploads\/2023\/04\/Spitzy-36x36.jpg 36w, http:\/\/berlin-boehm.de\/wp-content\/uploads\/2023\/04\/Spitzy.jpg 600w\" sizes=\"auto, (max-width: 348px) 100vw, 348px\" \/><\/p>\n<p class=\"caption\"><b><i>Reparation kleiner Nabelhernien durch Naht<\/i><\/b><\/p>\n<\/div>\n<h4 id=\"heading_id_50\">Netzimplantation<\/h4>\n<p>Bei gro\u00dfen Nabelbr\u00fcchen wird die vordere Rektusscheide quer eingekerbt und die Rektusmuskulatur nach lateral weggehalten. Die hintere Rektusscheide wird freigelegt, so dass ein 10 x 10 cm gro\u00dfes Netz in Sublay-Technik eingelegt werden kann. Wie bei den Narbenhernien beschrieben, wird die hintere Rektusscheide gen\u00e4ht, das Netz eingebracht, und danach die vordere Rektusscheide quer mit einer fortlaufenden Naht verschlossen. Es gibt auch besonders zugeschnittene Netzimplantate aus verschiedenen Materialien (z.B. PTFE), die die Bruchl\u00fccke mit einem einfachen Mechanismus gut verschlie\u00dfen.<\/p>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"categories":[34],"tags":[],"class_list":["post-4171","post","type-post","status-publish","format-standard","hentry","category-chirurgie"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Nabelhernie - Berliner Gelassenheit<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/berlin-boehm.de\/Kanty\/archive\/4171\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Nabelhernie - 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