GI Section 1: Luminal (Hernias)

Question 1

Answer 1

Spigelian Hernia - lateral border of teh rectus

Also referred to as a
“lateral ventral hernia”
for the purpose of fucking with you.

Question 2

SPigelian hernia location

Answer 2

Along the Semilunar line (“s” for “s”)

lateral border of the rectus muscles

but most commonly they are at or slightly above the arcuate line (horizontal dotted line with the black arrows).

Question 3

Above and Below the arcuate line difference

Answer 3

Question 4

Two types of lumbar hernia

Answer 4

Superior

and

Inferior

Question 5

Grynfeltt-Lesshaft

Answer 5

Superior Lumbar

Question 6

Petit

Answer 6

Inferior Lumbar

Question 7

Superior Lumbar Hernia

Answer 7

Question 8

Inferior lumbar

Answer 8

Question 9

Hernia with a Meckel Diverticulum in it.

Answer 9

Littre Hernia

Question 10

Hernia with the Appendix in it.

Answer 10

Amyand Hernia

Question 11

Contains only one wall of bowel and therefore does not obstruct.

Answer 11

Richter Hernia

Question 12

Richter Hernia have higher risk of this condition

Answer 12

These are actually at higher risk for strangulation.

Question 13

Old lady + Ascites, COPD - chronic cough, pregnancy)

Answer 13

Obturator Hernia:

Question 14

Bowel herniating between the obturator and the pectineus muscles

Answer 14

Obturator Hernia

Question 15

Obturator hernia can cause paresthesia along the innder thigh, due to?

Answer 15

Compression of the obtrurator nerve

Question 16

“Howship-Romberg Sign ”

Answer 16

Obturator Hernia

Compression of the obturator nerve

Question 17

most common manifestation of internal Hernia

Answer 17

Closed loop obstruction (often with stranguation)

Question 18

This is a herniation of viscera through the peritoneum or mesentery.

Answer 18

Internal hernia

Question 19

Where does internal hernia take place?

Answer 19

through a known anatomic foramina or recess - created post op

Question 20

The most common type of internal hernias

Answer 20

Paraduodenal hernias

Question 21

Paraduodenal hernias occur through these congenital defects

Answer 21

Lanzer and Waldeyer

Lanzer - more common

Question 22

post prandial abdominal pain + gets better after belly rub

Answer 22

Paraduodenal hernias

Question 23

Answer 23

a sac-like cluster of dilated small bowel loops (arrow) in the left anterior pararenal space, behind the IMV and the ascending left colic artery.

Lanzert paraduodenal hernia

“L”eft sided (75%)
through fossa of Lanzert in the descending colon mesentery / LUQ

Question 24

Answer 24

sac of abnormal dilated small bowel loops (black arrow) on the right, below the part of the duodenum, and behind the SMA (white arrow) which gets displaced anteriorly.

Right sided (25%)

Fossa of Waldeyer in the ASCENDING colon/RLQ

Question 25

Paraduodenal hernia associated with malrotation + normally rotated large bowel

Answer 25

Waldeyer (Right)

Question 26

There are a bunch of other locations internal hernias can occur, but in gfeneral they have the same pattern -

Answer 26

sac- like cluster of dilated bowel loops with twisted mesenteric vessels in an abnormal location in a patient with symptoms of bowel obstruction.

seen in:
lesser sac /foramen of winslow, pericecal, sigmoid mesocolon, small bowel mesentery, post-gastric bypass surgery