Hernia Flashcards
What is a hernia?
Weakness in the abdominal wall where things push into the outside
Causes of hernias?
Anatomical areas that have weakness as structures exit through an opening in the cavity
Inherited collagen disorders
Sites where surgical incisions are made
What are the types of abdominal hernia that always need surgery?
Para-umbilical and umbilical
Femoral
What causes epigastric hernia?
A fascial defect in the lineament alba between the typhoid process and the umbilicus causes these
Main presentation of epigastric hernia?
A midline bump as usually they don’t cause pain
What will the symptoms be of an incarcerated hernia involving the bowel?
Vomiting, constipation, abdominal distension, if the bowel dies there will also be severe pain
What are para umbilical and umbilical hernias usually due to?
Stretching of the abdominal wall, obesity, multiple pregnancies or ascites
How do para umbilical and umbilical hernia usually present?
With pain
Management of para umbilical and umbilical hernia?
They do not resolve spontaneously and there is a high risk of incarceration and strangulation so management is pretty much always surgical
What causes inguinal hernias?
The inguinal canal is an anatomical area of weakness. Many men who develop these also have a patent processes vaginalis which allows communication between the peritoneum and the scrotum.
Two types of inguinal hernia?
Direct- pushes through the superficial ring
Indirect- goes through both the superficial and deep ring
Presentation of inguinal hernia?
Groin swelling that disappears when lying down, the swelling is above and medial to the pubic tubercle, there is palpable cough impulse on examination.
Inguinal hernias can be managed….
surgically or non-surgically
Who are femoral hernias more common in?
Ladies- the risk increases with age
How are femoral hernias treated and why?
Management is always surgical as these hernias are small so there is a bigger risk of strangulation
What are predisposing factors to developing an incisional hernia?
wound complications (infection), inherited collagen abnormalities, advanced age, smoking, obesity, malignancy and bad surgical technique
Management of incisional hernias?
Can be left alone if not causing problems however many people want them fixed and this can done surgically but there is a high rate of recurrence
Are Spigelian hernia common or rare? How are they usually confirmed?
They are rare and usually confirmed by CT
Explain how spigelian hernia form?
Between the rectus abdomens and the semi lunar line there is a spigelian fascia and where there is weakness a hernia can form.
Where does lumbar hernia form? How are they fixed?
In the superior and inferior lumbar triangles
Fixed by open surgery
What are parastomal hernia caused by?
Weakness around stomas
