Abdominal Hernias Flashcards
Components of hernia
Sac - Covering - Contents
Abdominal hernia in which there is only a portion of the bowel wall herniated
Richter’s hernia
Congenital Out pouching or bulge of the lower part of the small intestine (leftover of the umbilical cord)
Meckel’s diverticulum
Which of the facial is not a cause or a risk factor of abdominal-hernias?
- Smoking.
- Obesity.
- Peritoneal dialysis.
- Alcohol consumption.
D
Inguinal ring boundaries
Roof: E.oblique aponeurosis + Part of internal oblique.
Floor: Fascia transversals + Part of I.oblique.
Superiorly: conjoint tendon.
Inferiorly: inguinal ligament.
Hesselbach’s triangle boundaries
Medially: Rectus abdominus.
SuperoLaterally: Inferior epigastric vessels.
Inferiorly: Inguinal ligament.
If the sac of the hernia is medial to the epigastric vessels this is?
- Direct inguinal.
- Indirect inguinal.
- Femoral.
- Non of the above.
A
Contents of the inguinal canal
Iliofemoral nerve + Genitofemoral nerve + spermatic cord or round ligament
Most common in elderly + Acquired
Direct inguinal hernia
Most common in young + when baby crying + Congenital
Indirect inguinal hernia
Wide nick
Rarely strangulate
Has narrow neck + Prevesical fat + elderly
Funicular direct inguinal hernia
2 sacs medial and lateral to the epigastric vessels
Dual (pantaloon) direct inguinal hernia
Which inguinal hernia is more common to cause strangulations?
Indirect
…… hernias should always be repaired
Femoral hernias
Richter’s hernia is more common to occur in?
- Inguinal hernia.
- Femoral hernia.
- Epigastric hernia.
- Incisional hernia.
B
The femoral hernia walls
FLII
Laterally: the femoral vein.
Medially: Lacunar ligament.
Anteriorly: Inguinal ligament.
Posteriorly: Pelvic bone covered by ileopectineal ligament.
Which type of hernias is more common in females?
- Inguinal.
- Femoral.
- Epigastric.
- Incisional.
Femoral
Below + lateral + lies in the upper leg
Femoral hernia
Dixtic clue is seen in ?
Femoral hernia (remain palpable even if it is empty
Strangulation or obstruction in the congenital umbilical hernia is uncommon before the age ……?
3 years
Common in infants + most resolve spontaneously + rarely strangulate
Umbilical hernia in children
Causes of umbilical hernia in adults
Any cause of linea alba stretching or thinning ( pregnancy - obesity - liver cirrhosis)
Risk of strangulation is increased if the umbilical hernia in?
- Adults.
- Children.
Adults
Crescent shaped + narrow neck
Paraumbilical hernia
Women , obese , multiparous
Paraumbilical hernia
If the paraumbilical hernia is firm and dull it contains?
- Omentum.
- Bowel.
Omentum (soft + Resonant= bowel)
Mayo’s operation is done in ?
- Umbilical hernia.
- Para umbilical hernia.
- Femoral hernia.
- Epigastric hernia.
Paraumbilical hernia
Common in athletes
Epigastric hernia
Between the xiphoid process to the umbilicus (complain of epigastric pain)
Epigastric hernia (irreducible + no cough impulse)
If the bowel forms one side of the sac this is called?
- Sliding hernia.
- Maydl’s hernia.
- Incarceration.
- Non of the above.
A
If the sac is full of bowel + irreducible but it is not causing strangulation this is ?
- Sliding hernia.
- Maydl’s hernia.
- Incarceration.
- Non of the above.
C (only adhesions of contents to the inner walls of the sac)
When two adjacent loops of bowel are in the sac this is called?
- Sliding hernia.
- Maydl’s hernia.
- Incarceration.
- Non of the above.
B
Basini’s repair
Herniorhaphy
Lichenstein’s mesh repair
Hernioplasty
Most common hernia in both sexes
Indirect inguinal hernia
Most common hernia to strangulate
Femoral hernia
