[25] Other Hernias Flashcards
What is a hernia defined as?
The protrusion of part or a whole of an organ or tissue through the wall of the cavity that normally contains it
Where does an epigastric hernia occur?
In the midline through the fibres of the linea alba
How common are epigastric hernias?
Relatively common, with a prevalence of up to 10%
Who do epigastric hernias most commonly affect?
Middle-aged men
How do epigastric hernias present?
They are typically asymptomatic, but may present as a midline mass that disappears when lying on the back
What is an important differential for epigastric hernias?
Divarication of the recti
What is divarication of the recti?
A cosmetic condition where the linea alba becomes widened, resulting in a palpably increased distance between the rectus muscles and a subsequent midline buldge
Where does a paraumbilical hernia occur?
Through the linea alba around the umbilicus (not through the umbilicus itself)
What are paraumbilical hernias typically secondary too?
Chronic raised intra-abdominal pressure, such as with obesity, pregnancy, or ascites
How do paraumbilical hernias present?
As a painful lump around the umbilicus, which will worsen with an increased intra-abdominal pressure such as straining or coughing
What can umbilical hernias form as in infants?
Ventral wall abnormalities
Give two examples of ventral wall abnormalities in infants
Omphalocele
Gastroschisis
What is a spigelian hernia?
A rare form of abdominal hernia that occurs at the semilunar line around the level of the arcuate line
What is the rectus abdominis muscle enclosed by?
The rectus sheath
Where is the arcuate line?
At the lower limit of the posterior layer of the rectus sheath (about 1/3 of the distance between the umbilicus and pubic symphysis)
What is the semilunar line?
The tendinous lateral border of the rectus, where the aponeuroses fuse
How do spigelian hernias present?
As a small tender mass at the lower lateral edge of the rectus abdominus
Why should spigelian hernias be repaired?
Due to the high risk of strangulation
What % of cases of spigelian hernias in male infants have cryptorchidism also present?
75%
What is cryptochidism and spigelian hernias in male infants likely associated with?
Failure in gubernaculum development