3. General Principles of hernia Flashcards
Definition of hernia
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.
ETIOLOGY of hernia
1- Congenital (Preformed sac) :
2- Acquired:
Congenital ETIOLOGY of hernia
a. Unobliterated processus vaginalis )> oblique inguinal hernias.
b. Unobliterated physiological umbilical hernia of fetus (exomphalos).
Acquired ETIOLOGY of hernia
a. Raised intra-abdominal pressure due to any cause.
b. Weak anterior abdominal wall (old age, repeated pregnancy).
COMPONENTS of hernia
1- Sac
2- Contents
3- Coverings :
Sac in COMPONENTS of hernia
This is the peritoneal pouch which bulges out through the abdominal wall defect.
It has a neck, body, and fundus.
Contents in COMPONENTS of hernia
Accepted contents
Most common contents
Special contents
Accepted contents of hernia
Any abdominal viscus except the pancreas,
Most common contents of hernia
Intestine, omentum or both.
difference between intestine and omentum by
Consistency
Gurgling on reduction
Ease of reduction
Percussion
Consistency of intestine
Soft
Consistency of omentum
Doughy
Gurgling on reduction of intestine
occurs
Gurgling on reduction of omentum
NO
Ease of reduction of intestine
First part more difficult
Ease of reduction of omentum
Last part more difficult
Percussion of intestine
May be Resonant
Percussion of omentum
Dull
Special contents in COMPONENTS of hernia
a) Richter’s hernia :
b) Littre’s hernia :
c) Maydl’s hernia :
Richter’s hernia in Special contents in COMPONENTS of hernia
* The content is part of the circumference of an intestinal loop (common in femoral hernia).
- due to very narrow neck
Littre’s hernia in Special contents in COMPONENTS of hernia
The content is Mickle’s diverticulum
Maydl’s hernia in Special contents in COMPONENTS of hernia
It contains 2 loops of intestine while an intermediate in the abdominal cavity ( hernia in W shaped )
hernia in W shaped
Maydl’s hernia
hernia contains 2 loops of intestine while an intermediate in the abdominal cavity
Maydl’s hernia
hernia contains Mickle’s diverticulum
Littre’s hernia
hernia contains part of the circumference of an
intestinal loop
Richter’s hernia
a hernia with a special content common in femoral hernia
Richter’s hernia
Coverings in COMPONENTS of hernia
Structures stretched over the sac.
