Hernia Flashcards
What is a hernia?
A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.
What are the risk factors for hernias?
- Obesity
- Ascites
- Increasing age
- Surgical wounds
What are common symptoms and signs of a hernia?
- Pain
- Palpable lump
- Cough impulse
- Complications: obstruction, strangulation
What are the types of abdominal wall hernias?
- Inguinal - most common (75%)
- Femoral
- Umbilical
- Para-umbilical
- Epigastric
- Incisional
What is a femoral hernia?
A section of the abdominal viscera passes into the femoral canal via the femoral ring.
Where is a femoral hernia located?
Located inferolateral to the pubic tubercle.
What is the epidemiology of femoral hernias?
Less common (5%) and more prevalent in women.
What are the symptoms of a femoral hernia?
- Lump within the groin
- Mildly painful (severe if strangulated)
- Usually non-reducible
- Cough impulse often absent
What is the management for a femoral hernia?
Surgical repair is necessary due to the risk of strangulation.
What complications can arise from a femoral hernia?
- Incarceration
- Strangulation
- Bowel obstruction
- Bowel ischemia
What differentiates a direct inguinal hernia from an indirect inguinal hernia?
- Direct: medial to inferior epigastric vessels
- Indirect: lateral to inferior epigastric vessels
What is the prevalence of inguinal hernias?
Most common type, accounting for 75% of hernias.
What are the symptoms of an inguinal hernia?
- Lump within the groin
- Discomfort and ache, worse on activity
What is the management approach for inguinal hernias?
Surgery is recommended for all medically fit patients. Mesh repair is often most effective.
What are the potential complications of inguinal hernias?
- Bruising
- Wound infection
- Chronic pain
- Recurrence
Which type of hernia is most commonly stragulated?
Femoral
What characterizes a strangulated hernia?
Blood supply to the hernia is compromised, leading to ischemia or necrosis.
What are the symptoms of strangulation in a hernia?
- Irreducible hernia
- Pain
- Fever
- Increased size of hernia/erythema
- Peritonitic features
What imaging studies are used in the management of strangulated hernias?
- Erect CXR
- Abdominal XR/CT
What should not be done in cases of strangulated hernias?
DO NOT manually reduce strangulated hernias as it can cause generalised peritonitis.
