Cap.13 Pared abdominal y hernias Flashcards
What kind of hernia occurs between the rectus muscle medially and the semilunar line laterally?
Spigelian hernia
What ligament is formed by the periosteum and fascia along the superior pubic ramus?
Cooper ligament
What kind of femoral hernias need to be repaired?
All femoral hernias need to be repaired (high incidence of strangulation)
Type of hernia with an indirect and direct hernia component:
Pantaloon hernia
Most common malignant retroperitoneal tumor:
Lymphoma
Treatment for retroperitoneal sarcoma:
Complete en bloc resection of the tumor with any involved adjacent organs (primary treatment); if invading inferior vena cava (IVC), the IVC can be excised and bypassed in the absence of sufficient collaterals. There used to be no role for radiation secondary to visceral toxicity, but with the advent of better radiation some institutions are giving radiation either pre- or postoperatively. If inoperable, symptomatic disease can consider chemotherapy with radiation.
What is a Bochdalek hernia?
A posterior diaphragmatic hernia usually occurring on the left (Bochdalek = back and to the left)
Name the repair: a multilayer imbricated repair of the posterior wall of the inguinal canal with a continuous running suture technique by superimposing running suture lines progressing from deep to more superficial layers (initial suture line—transversus abdominis aponeurotic arch to iliopubic tract, next suture line—internal oblique and transversus abdominis muscles and aponeuroses to the inguinal ligament).
The Shouldice repair
Where do direct inguinal hernias occur with regards to Hesselbach triangle?
Direct hernias occur within Hesselbach triangle
Treatment for tuberculous peritonitis:
Antituberculous drugs (isoniazid and rifampin daily for 9 months commonly used)
What procedure do you perform to repair an inguinal hernia in infants and children?
High ligation of the hernia sac
Initial treatment for peritoneal dialysis–associated peritonitis:
Intraperitoneal administration of antibiotics (usually first-generation cephalosporin)
What kind of hernia occurs at sites where vessels and nerves perforate the linea alba?
Epigastric hernia
Name the hernia repair: a large piece of mesh is placed with an extensive fascial underlay in the retromuscular space on top of either the posterior rectus sheath or peritoneum.
Stoppa repair
Treatment for pseudomyxoma peritonei:
-Drainage of mucus and intraperitoneal fluid -Peritonectomy and omentectomy with cytoreduction of primary and secondary tumor implants -Right colectomy for appendiceal adenocarcinoma or total abdominal hysterectomy and bilateral salpingo-oophorectomy for ovarian carcinoma -Post-op intraperitoneal chemo/mucolytics
What nerves are most commonly affected during open hernia repair?
Ilioinguinal, iliohypogastric, and genital branch of the genitofemoral nerve
Most common organ found in a sliding hernia in a male patient:
Cecum/sigmoid colon
Term for a congenital hernia in which the small intestine herniates behind the mesocolon:
Mesocolic (paraduodenal) hernia
Why is visceral pain felt in the midline rather than lateralize?
Organs transmit sympathetic sensory afferents to both sides of the spinal cord.
What type of hernia are most strangulated hernias?
Indirect inguinal hernia
What are the boundaries of the inguinal canal?
Anterior—external oblique aponeurosis Posterior—transversalis fascia and the aponeurosis of transversus abdominis Superior—internal oblique and transversus abdominis musculoaponeurosis Inferior—inguinal ligament and lacunar ligament
Treatment for a mesenteric hernia:
Reduce the hernia and close the mesenteric defect
What disease entails a mucous-secreting tumor coating the peritoneum and filling the peritoneal cavity with mucus and large loculated cystic masses?
Pseudomyxoma peritonei
Where do indirect inguinal hernias occur with regards to Hesselbach triangle?
Indirect inguinal hernias occur lateral to Hesselbach triangle