Hernia Flashcards
Most common cause of Small bowel obstruction […]
Hernia
[…] is the most common cause of SBO of history if surgical procedure exist
Adhesions
“Months to Years post-op”
[…] cause of post-op SBO features a silent sluggish bowel without mechanical blockage
Paralytic ileus
“Few days post-op”
If you are suspecting paralytic ileus you need to check […] & do […]
Check Electrolytes & do ECG
If you are suspecting adhesions
Best diagnostic test is […]
CT scan
Your initial management in SBO is:
Conservative
NGT, NPO “bowel rest”, Analgesics
[…] is contraindicated in SBO
Nitrous Oxide
Inguinal hernia
Asymptomatic or minimal ,
Reducible ,
Co-morbid elderly
🔹Management
Conservative
Inguinal hernia
Irreducible
🔹Management:
Urgent repair (hernioplasty)
Femoral hernia
🔹Management:
Open repair with mesh
Always need repair regardless
Which is preferred open hernia repair or laparoscopic?
Open hernioplasty
If the previous repair was open go for lap and visa versa
Indications for laparoscopic hernia repair:
- Bilateral
- Recurrent
- Obese
Para-umbilical hernia
🔹Management:
<2cm: suturing
>2cm: Mesh repair
Umbilical hernia in pediatrics
🔹Management:
Observe until 5 years old then go for herniotomy
Inguinal hernia in pediatrics
🔹Management:
Always Herniotomy
complications of unrepaired hernia:
🪤 Incarcerated
🪨 Obstructed
🥵 Stragulated
ALL indicate URGENT surgical exploration
Irreducible hernia
Incarcerated hernia
Hernia with SBO symptoms and air-fluid level
Obstructed hernia
Irriducible hernia with SBO
Ischemia & necrosis with skin changes, erythema and tenderness
Strangulated hernia
Post hernia repair
Pus oozing […]
Reaches the mesh […]
Pus: Open the wound to let it drain
Mesh: Drainage & Remove the mesh
Post hernia repair
Swelling (seroma): […]
Regular wound dressing
After hernia repair
When can patient get pregnant?
After 1 year
Post hernia surgery
Minimal time before lifting heavy weights:
Minimal time: 6 months
Ideal time: 1 year
After inguinal hernia repair patient present with shrunken testicle. Most likely cause:
Thrombosis of pampiniform plexus
Post hernia repair pain with numbness & paresthesia management:
NSAIDs -» Nerve block
Hernia mimics
~ post trauma, no cough impulse
Hematoma
Hernia mimics
~ bluish, cough impulse, percussion tap (+)
Saphena varix
What type of mesh is used in ventral hernia repair?
A. Sublay
B. Infralay
C. Onlay
D. Inlay
Sublay
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