GI: Hernias & Lumps Flashcards
Reasons for RUQ pain/mass
- cholecystitis (very tender)
- cholangiocarcinoma
- hepatomegaly
- liver cancer (firm lumpy mass)
Reasons for epigastric pain/mass
- hepatomegaly
- pancreatitis
- pancreatic abscess or pseudocyst
- gastric carcinoma
Reasons for LUQ pain/mass
- Splenomegaly
- Gastric carcinoma
- Pancreatitis
- Pancreatic abscess or pseudocyst
- Kidney/colon disorders
- Neurofibromas (rare)
Reasons for R/L flank pain/mass
- Hydronephrosis (smooth spongy mass)
- Renal cell carcinoma (smooth, firm, non-tender mass)
Reasons for periumbilical pain/mass
- AAA
- appendicitis
Reasons for RIF pain/mass
- Crohn’s
- Appendicitis
- hernia
- ileocaecal mass caused by TB
- actinomycosis
- amoebic abscess
- intussusception
- kidney abnormality
- ovarian tumour
- tumour in intra-abdominal testicle
Reasons for suprapubic pain/mass
- distended bladder
- neuroblastoma
- endometriosis
Reasons for LIF pain/mass
- UC
- diverticulitis
- hernia
- kidney abnormality
- ovarian tumour
- colorectal cancer
- tumour in intra-abdominal testicle
How to describe a lump
- 3S
- 3C
- 3T
- 1F
Site, size, shape
Contour, colour, consistency
Tenderness, tethering, Transilluminence
Flunctuance
Common hernia sites
- epigastric
- umbilical
- inguinal (direct vs indirect)
- femoral
- at site of previous incision
What structures make up the 4 walls of the inguinal canal
ANTERIOR: aponeurosis of external oblique muscle
POSTERIOR: fascia transversalis
INFERIOR: inguinal ligament
SUPERIOR: conjoint tendon
Difference between direct and indirect inguinal hernia.
Which is more common?
Direct: goes directly through weak abdominal wall
Indirect: exists through deep inguinal ring, directs down into scrotum
INDIRECT IS MORE COMMON
What might indicate a strangulated hernia?
Pain, nausea, hernia large & tense, incarcerated
In which group of people might hernia strangulation occur without pain?
Elderly
- Most common hernia across both genders
- Is inguinal hernia more common in men or women
- Is femoral hernia more common in men or women
- Inguinal most common overall
- Inguinal more common in men
- Femoral more common in women
