12. Femoral and inguinal hernias Flashcards
1
Q
How common is it?
A
Inguinal = common Femoral = uncommon
2
Q
Who does it affect?
A
Risk triples >45 y/o, but indirect inguinal is mostly congenital
F = women, older
I = men
3
Q
What causes it?
A
F = abdominal viscera passes through the femoral ring and into potential space of femoral canal I = bowel enters inguinal canal either directly through weakness in Hesselbach's triangle (d) or via the deep inguinal ring (id)
4
Q
What risk factors are there?
A
Obesity, caucasians, FH, pregnancy
Previous hernia
Chronic cough
Chronic constipation
5
Q
How does it present?
A
Usually asymptomatic until strangulation
N+V, severe abdo pain
6
Q
What signs may the patient have on examination?
A
Small lump in the groin
F = infero-lateral to pubic tubercle, medial to femoral pulse
I = supero-medial to pubic tubercle
7
Q
What treatments are there?
A
Urgent surgical reduction
Reduces hernia and narrows femoral ring
Low approach or high approach
8
Q
What complications are there?
A
Irreducible hernia (contents cannot return to original cavity) Obstruction (bowel) Strangulation (ischaemic bowel)
