7. Recurrent inguinal Hernia and Sliding hernia

Question 1

INCIDENCE of Recurrent inguinal Hernia

Answer 1

10%

Question 2

ETIOLOGY of Recurrent inguinal Hernia

Answer 2

• Operative Causes

* Postoperative Causes

Question 3

Operative Causes in ETIOLOGY of Recurrent inguinal Hernia

Answer 3

1. Leaving part of the original sac i.e failure to ligate the sac at its proper neck.
2. Missing a second sac at operation e.g. (pantaloon hernia)
3. Failure to do the proper repair which suits the patient’s condition
4. Use of absorbable sutures.
5. Repair under tension

Question 4

Postoperative Causes in ETIOLOGY of Recurrent inguinal Hernia

Answer 4

1. Postoperative hematoma or infection
2. Rapid return to hard work or job.
3. Persistence of the predisposing factors.

Question 5

Most important Postoperative Cause in ETIOLOGY of Recurrent inguinal Hernia

Answer 5

Postoperative hematoma or infection

Question 6

TREATMENT of Recurrent inguinal Hernia

Answer 6

1. Correction of any predisposing factors.
2. Operation : Hernioplasty.
3. Truss (el7ezam) may be used to provide support for 3 month after hernioplasty

Question 7

Sliding Hernia

Answer 7

• Definition
• The commonest sliding organs
• Incidence
• Clinical picture
• Treatment

Question 8

Definition of Sliding Hernia

Answer 8

This is a hernia where a viscous forms a part of the wall of the sac and not part of the contents.

Question 9

The commonest sliding organs of Sliding Hernia

Answer 9

The commonest sliding organs are bladder, caecum, and sigmoid colon

Question 10

Incidence of Sliding Hernia

Answer 10

Common in

1- Long standing hernia

2- Old males.

Question 11

CLINICAL PICTURE of Sliding Hernia

Answer 11

1. History of long standing hernia
2. Hernia is usually complete ( scrotal ) oblique inguinal hernia or direct inguinal hernia in an old male.
3. Incomplete reduction of the hernia ( partially reducible )

4- urinary symptoms if sliding organ is the bladder

Question 12

The reason why hernia is partially reducible in CLINICAL PICTURE of Sliding Hernia

Answer 12

as Bladder forms part of the posterior wall

Question 13

urinary symptoms in CLINICAL PICTURE of Sliding Hernia

Answer 13

• Pressing the hernia causes a desire to micturate.
• Reduction of the hernia size after micturition.
• Double micturition

Question 14

Treatment of Sliding Hernia

Answer 14

• The sac is removed just distal to the sliding organ.
• Reduce the sliding organ to abdomen.
• Followed by hernioplasty.

Question 15

Solid indications for Hernioplasty

Answer 15

1. Old age with weak muscle
2. Recurrent hernia
3. Sliding hernia