12.1 Hernia Flashcards
Common causes of hernia
-Increase abdominal pressure
Coughing, obesity, pregnancy, straining while defecation or urination, heavy lifting
-trauma (surgery)
Type of hernia
Incisional
Inguinal
Femoral
Umbilical
Incision hernia develop at ___ ___
Risks factors
Scar area
Obese, pregnancy, multiple abdominal surgeries
Indirect inguinal hernia
Inguinal hernia in male is ___ and more ___
Exit through inguinal canal
Larger and more prominent
Femoral hernia protrude through ___
Femoral ring
Irreducible hernia
Describe
Reasons
Cannot return into abdominal cavity when try to push it
Occasionally painful
- incarcerated (ad he sions)
- obstructed
- strangulated
Possible complications of hernia
Serious:
Gangrene
Perforation
Acute intestinal obstruction
Hernia incarceration
Urinary retention
Peritonitis
Social isolation
Bowel perforation S/s
Abdominal pain
Broad-like rigidty (tenderness, muscle guarding)
AXR: free gas under diaphragm
Conservation management
Wear a truss
To prevent protrusion of abdominal contents from entering hernial sac
Why truss only apply to inguinal but not femoral hernia
Occlude femoral blood vessel
Herniorrhaphy
Removal of hernia sac
Return content into abdomen
Suture muscle and fascia
(+/-) resection of ischemia bowel, colostomy
Hernioplasty
Reinforcement of the weakened area with mesh
E.g. RIIH mesh repair
Education before operation
Be careful when coughing and avoid prolong standing (aggravate symptoms)
Education before discharge
No heavy lifting for 6-8 weeks
Avoid coughing
Avoid straining
Use truss support
type of hiatus hernia
Sliding
Paraesophageal
