3. General Principles of hernia

Question 1

Definition of hernia

Answer 1

A hernia is a protrusion of a viscous or part of a viscous usually within a peritoneal sac through a defect in the abdominal wall.

Question 2

ETIOLOGY of hernia

Answer 2

1- Congenital (Preformed sac) :

2- Acquired:

Question 3

Congenital ETIOLOGY of hernia

Answer 3

a. Unobliterated processus vaginalis )> oblique inguinal hernias.
b. Unobliterated physiological umbilical hernia of fetus (exomphalos).

Question 4

Acquired ETIOLOGY of hernia

Answer 4

a. Raised intra-abdominal pressure due to any cause.

b. Weak anterior abdominal wall (old age, repeated pregnancy).

Question 5

COMPONENTS of hernia

Answer 5

1- Sac

2- Contents

3- Coverings :

Question 6

Sac in COMPONENTS of hernia

Answer 6

This is the peritoneal pouch which bulges out through the abdominal wall defect.

It has a neck, body, and fundus.

Question 7

Contents in COMPONENTS of hernia

Answer 7

Accepted contents

Most common contents

Special contents

Question 8

Accepted contents of hernia

Answer 8

Any abdominal viscus except the pancreas,

Question 9

Most common contents of hernia

Answer 9

Intestine, omentum or both.

Question 10

difference between intestine and omentum by

Answer 10

Consistency

Gurgling on reduction

Ease of reduction

Percussion

Question 11

Consistency of intestine

Answer 11

Soft

Question 12

Consistency of omentum

Answer 12

Doughy

Question 13

Gurgling on reduction of intestine

Answer 13

occurs

Question 14

Gurgling on reduction of omentum

Answer 14

NO

Question 15

Ease of reduction of intestine

Answer 15

First part more difficult

Question 16

Ease of reduction of omentum

Answer 16

Last part more difficult

Question 17

Percussion of intestine

Answer 17

May be Resonant

Question 18

Percussion of omentum

Answer 18

Dull

Question 19

Special contents in COMPONENTS of hernia

Answer 19

a) Richter’s hernia :
b) Littre’s hernia :
c) Maydl’s hernia :

Question 20

Richter’s hernia in Special contents in COMPONENTS of hernia

Answer 20

* The content is part of the circumference of an
intestinal loop (common in femoral hernia).

• due to very narrow neck

Question 21

Littre’s hernia in Special contents in COMPONENTS of hernia

Answer 21

The content is Mickle’s diverticulum

Question 22

Maydl’s hernia in Special contents in COMPONENTS of hernia

Answer 22

It contains 2 loops of intestine while an intermediate in the abdominal cavity ( hernia in W shaped )

Question 23

hernia in W shaped

Answer 23

Maydl’s hernia

Question 24

hernia contains 2 loops of intestine while an intermediate in the abdominal cavity

Answer 24

Maydl’s hernia

Question 25

hernia contains Mickle’s diverticulum

Answer 25

Littre’s hernia

Question 26

hernia contains part of the circumference of an

intestinal loop

Answer 26

Richter’s hernia

Question 27

a hernia with a special content common in femoral hernia

Answer 27

Richter’s hernia

Question 28

Coverings in COMPONENTS of hernia

Answer 28

Structures stretched over the sac.