Hernia

Question 1

Most common cause of Small bowel obstruction […]

Answer 1

Hernia

Question 2

[…] is the most common cause of SBO of history if surgical procedure exist

Answer 2

Adhesions
“Months to Years post-op”

Question 3

[…] cause of post-op SBO features a silent sluggish bowel without mechanical blockage

Answer 3

Paralytic ileus
“Few days post-op”

Question 4

If you are suspecting paralytic ileus you need to check […] & do […]

Answer 4

Check Electrolytes & do ECG

Question 5

If you are suspecting adhesions
Best diagnostic test is […]

Answer 5

CT scan

Question 6

Your initial management in SBO is:

Answer 6

Conservative
NGT, NPO “bowel rest”, Analgesics

Question 7

[…] is contraindicated in SBO

Answer 7

Nitrous Oxide

Question 8

Inguinal hernia
Asymptomatic or minimal ,
Reducible ,
Co-morbid elderly
🔹Management

Answer 8

Conservative

Question 9

Inguinal hernia
Irreducible
🔹Management:

Answer 9

Urgent repair (hernioplasty)

Question 10

Femoral hernia
🔹Management:

Answer 10

Open repair with mesh
Always need repair regardless

Question 11

Which is preferred open hernia repair or laparoscopic?

Answer 11

Open hernioplasty

If the previous repair was open go for lap and visa versa

Question 12

Indications for laparoscopic hernia repair:

Answer 12

1. Bilateral
2. Recurrent
3. Obese

Question 13

Para-umbilical hernia
🔹Management:

Answer 13

<2cm: suturing
>2cm: Mesh repair

Question 14

Umbilical hernia in pediatrics
🔹Management:

Answer 14

Observe until 5 years old then go for herniotomy

Question 15

Inguinal hernia in pediatrics
🔹Management:

Answer 15

Always Herniotomy

Question 16

complications of unrepaired hernia:

Answer 16

🪤 Incarcerated
🪨 Obstructed
🥵 Stragulated

ALL indicate URGENT surgical exploration

Question 17

Irreducible hernia

Answer 17

Incarcerated hernia

Question 18

Hernia with SBO symptoms and air-fluid level

Answer 18

Obstructed hernia

Question 19

Irriducible hernia with SBO
Ischemia & necrosis with skin changes, erythema and tenderness

Answer 19

Strangulated hernia

Question 20

Post hernia repair
Pus oozing […]
Reaches the mesh […]

Answer 20

Pus: Open the wound to let it drain
Mesh: Drainage & Remove the mesh

Question 21

Post hernia repair
Swelling (seroma): […]

Answer 21

Regular wound dressing

Question 22

After hernia repair
When can patient get pregnant?

Answer 22

After 1 year

Question 23

Post hernia surgery
Minimal time before lifting heavy weights:

Answer 23

Minimal time: 6 months
Ideal time: 1 year

Question 24

After inguinal hernia repair patient present with shrunken testicle. Most likely cause:

Answer 24

Thrombosis of pampiniform plexus

Question 25

Post hernia repair pain with numbness & paresthesia management:

Answer 25

NSAIDs -» Nerve block

Question 26

Hernia mimics
~ post trauma, no cough impulse

Answer 26

Hematoma

Question 27

Hernia mimics
~ bluish, cough impulse, percussion tap (+)

Answer 27

Saphena varix

Question 28

What type of mesh is used in ventral hernia repair?
A. Sublay
B. Infralay
C. Onlay
D. Inlay

Answer 28

Sublay
🚉🦦