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GI > 3- hernia > Flashcards

3- hernia Flashcards

1
Q

what is hernia?

A

= rupture, protruded viscus →abnormal exit of tissue or organ through wall of cavity in which normally residues

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2
Q

what are classifications of hernia?

A

hiatal hernia = herniating into thoracic cavity

internal hernia (within abdomen) = rare, not visible and common in weight loss surgery

external hernia = common

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3
Q

what are risk factors for hernia?

A
  • obesity (causes pressure)
  • chronically increased intra-abdominal pressure →cough, constipation, straining
  • abdominal surgery
  • pregnancy
  • smoking
  • peritoneal dialysis
  • collagen disorders
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4
Q

what hernia’s are in diaphragm?

A
  • Hiatal hernia
  • Congenital
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5
Q

what hernia’s are in abdominal wall?

A
  • Incisional (hernia at the site of scar)
  • Ventral (midline, general term)
  • Umbilical (specifically located)
  • Spigelian (specifically located)
  • Parastomal
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6
Q

what hernia’s are in groin?

A
  • Inguinal (direct, indirect, pantaloon, sliding)
  • Femoral
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7
Q

what is treatment for hiatal hernia?

A

treat with omeprazole (reduces symptoms) = large symptoms you consider surgery (often re-occur)

  • also manage lifestyle factors as treatment
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8
Q

what are direct and indirect inguinal hernias?

A

direct inguinal hernia = abdominal contents directly pushes through weakness posterior wall of the inguinal canal/anterior abdominal wall (directly pops out)

indirect inguinal hernia = enter the deep ring (the start) of the inguinal canal →using inguinal canal as area of weakness to push through

  • both types exit throughsuperficial ring of inguinal canal (and sometimesenter scrotum = more common forindirectto do this as path through both anatomical inguinal rings offers less resistance)
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9
Q

does femoral or inguinal hernia have a higher risk of strangulation?

A

femoral (Strangulation of a hernia is a serious complication that occurs when the blood supply to the herniated tissue becomes compromised)

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10
Q

what are midline hernia’s?

A
  1. Epigastric
  2. Divarication of recti (not hernia)
  3. Supraumbilical
  4. Umbilical
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11
Q

what is divarication of recti?

A
  • not true hernia
  • Thinning of linea alba →happens in pregnancy = can sometimes see bulge or gap
  • Rarely treated unless during repair for a neighboring hernia
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12
Q

what is a spigelian hernia?

A

rare abdominal wall hernia
- Linea semilunaris line
- At lateral border of rectus sheath as it meets the oblique muscles
- usually operate

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13
Q

what is incisional hernia?

A
  • failure of fascia to restore strength in surgical wound
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14
Q

what are risk factors for incisional hernia?

A

obesity, smoking, post op wound infection, post op resp failure, early return to heavy lifting

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15
Q

what is parastomal hernia?

A
  • specific type of incisional hernia
  • common with stomas
  • difficult to repair without reversing stoma
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16
Q

what is obturator hernia?

A

= a rare external abdominal hernia formed by protrusion of the abdominal visceral organs or extraperitoneal fat through the obturator foramen of the hip bone (may extend to femoral triangle)
- usually presents as obstruction

17
Q

what are signs & symptoms of hernia?

A
  • 1/3 asymptomatic
  • if no pain - might not do surgery
  • might have pain particularly when straining
18
Q

what are complications of hernias?

A
  • Irreducible (a.k.a. ’incarcerated’) = The hernia content cannot be manipulated back into the abdominal cavity
  • Obstructed = Bowel loop gets trapped in hernia and becomes non-functioning but no compromise to blood supply
  • Strangulation = Bowel loop gets trappped in hernia & Blood supply to bowel is compromised leading to ischaemia, perforation and peritonitis
19
Q

what are treatment options for hernia?

A
  • do nothing - just watch
  • conservative = hernia belt, avoid straining
  • surgical repair = open surgery, laparoscopic conventional, laparoscopic robotic
20
Q

what are surgical complications of hernias?

A
  • hole in bowel = most feared
  • most common = seroma (fluid under wound- settles with time)
  • can get necrosis of fat
  • hematoma →often leave drains in
  • mesh infection - rare (not good when happens)
  • chronic pain (have to be willing to risk)
  • big pressure problems - cause breathing problems etc
21
Q

what factors does treatment of hernias depend on?

A
  • Symptoms
  • Emergency or not
  • Site and size
  • Previous surgery
  • Comorbidity
22
Q

what is femoral triangle?

A

a space in the groin region, bordered by the inguinal ligament superiorly, the sartorius muscle laterally, and the adductor longus muscle medially

GI (56 decks)

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