Abdominal: Femoral and Inguinal hernia

Question 1

what is an inguinal hernia?

Answer 1

art of the intestine, protrudes through a weak spot in the abdominal muscles

Question 2

which is a more common type of hernia, inguinal or femoral?

Answer 2

inguinal in general

femoral in women

Question 3

which is a more common type of hernia in women, inguinal or femoral?

Answer 3

femoral

Question 4

what is a direct hernia?

Answer 4

protrusion occurs directly through a weakness in the abdominal wall

Question 5

what is a indirect hernia?

Answer 5

when there is a protrusion through the deep inguinal ring

Question 6

what are risk factors of hernias?

Answer 6

• male
• older age
• white ethnicity
• family history
• chronic cough (e.g. smoking)
• previous abdo surgery
• chronic constipation
• pregnancy
• premature birth/low birth weight
• previous inguinal hernia or hernia repair

Question 7

what are clinical features of a hernia?

Answer 7

• a bulge that becomes more obvious when upright, or if coughing/straining
• burning or aching at site of bulge
• pain or discomfort esp when bending over, coughing or lifting

Question 8

what is a strangulated hernia?

Answer 8

a hernia that has become trapped and lost blood flow as a result (life-threatening)

Question 9

what is a incarcerated hernia?

Answer 9

If you cannot push the hernia in, the contents of the hernia may be trapped (incarcerated) in the abdominal wall.

incarcerated hernias can become strangulated.

Question 10

what are signs and symptoms of a strangulated hernia.

Answer 10

Nausea, vomiting or both.
Fever.
Sudden pain that quickly intensifies.
A hernia bulge that turns red, purple or dark.
Inability to move your bowels or pass gas.

(tender, tense lump associated with signs of bowel obstruction).

Question 11

what are some differential diagnoses of a hernia?

Answer 11

• diff type of hernia
• lipoma
• femoral raised lymph node
• saphena varies
• femoral artery aneurysm,
• athletic pubalgia

Question 12

how would you conduct a physical examination of a hernia?

Answer 12

• identify the ASIS and the pubic tubercle, the superficial inguinal ring and the deep inguinal ring.
• ask patient to cough or strain
• assess if lump is tender
• gently see if you can reduce hernia

Question 13

if you can reduce a hernia, is it likely to be a direct or indirect hernia?

Answer 13

indirect

Question 14

if you can not reduce a hernia, is it likely to be a direct or indirect hernia?

Answer 14

direct

Question 15

if the diagnosis of a hernia isn’t obvious, what investigations might you conduct?

Answer 15

imaging (Abdo ultrasound, CT, MRI)

Question 16

what is the treatment of a hernia?

Answer 16

• if it doesn’t bother patient leave it

- enlarging/painful hernias: open hernia repair or laparoscopy

Question 17

what does a open hernia repair consist of?

Answer 17

the surgeon makes an incision in the groin and pushes the protruding tissue back into the abdomen

Question 18

what is a hernioplasty?

Answer 18

The surgeon repairs a hernia and then sews the weakened area, often reinforcing it with a synthetic mesh (hernioplasty).

Question 19

is an open hernia repair performed under local or general anaesthetic?

Answer 19

either

Question 20

is an laparoscopic hernia repair performed under local or general anaesthetic?

Answer 20

GA

Question 21

why might a laparoscopic hernia repair be preferred over a open hernia repair?

Answer 21

• return to normal activities quicker
• avoid scar tissue from earlier hernia repair
• one surgery for people with bilateral hernias

Question 22

why might a open hernia repair be preferred over a laparoscopic hernia repair?

Answer 22

• hernia recurrence more likely with laparoscopic

Question 23

will hernia recurrence be more likely with laparoscopic or open hernia repair?

Answer 23

laparoscopic

Question 24

what are complications of an untreated inguinal hernia?

Answer 24

• pressure on surrounding tissues
• incarcerated hernia
• strangulation
• obstruction