Hernia

Question 1

Precipitating factors

Answer 1

Chronic lung disease (causing cough)
Urinary obstruction
Colonic disorders (constipation)
Prev abdominal surgery

Question 2

Features which may suggest obstruction or strangulation

Answer 2

Discomfort is common, but severe pain may indicate obstruction or strangulation
Vomiting
Dehydration, shock, and peritonitis

Question 3

What type of hernia is the most common and occurs predominantly in males?

Answer 3

Inguinal hernias are up to 10 times more common than femoral hernias and occur predominantly in males

Question 4

Femoral hernias are several times more frequent in ________ (gender)

Answer 4

Women

Question 5

Typical presentation of hernia

Answer 5

Intermittent groin swelling, precipitated by physical exertion or increased intra-abdominal pressure and relieved by relaxation, lying supine or local pressure

Question 6

Position of femoral hernia

Answer 6

Below inguinal ligament (more lateral)

Question 7

Position of inguinal hernia

Answer 7

Above inguinal ligament (can extend downward and medially into scrotum)

Question 8

Manoeuvres to elicit hernia (if not spontaneously present while lying down)

Answer 8

Lifting head off pillow
Standing

Question 9

Is imaging needed for hernia?

Answer 9

No - clinical diagnosis

Question 10

Management if minimal symptoms

Answer 10

Inguinal - watchful waiting
Femoral - higher risk of strangulation, refer