Hernia pg 2251 Flashcards
most common locations of hernias
inguinal (most common) , femoral, hiatal, umbilical. less common obturator, lumbar
two main types of inguinal hernias?
direct (through hasselbachs triangle) and indirect (inguinal canal)
indirect inguinal hernias are caused by patent what?
processus vaginalis
which type of hernia (direct or indirect) rarely incarcerate or strangulate?
direct inguinal hernias
all hernias have the ability to present like what condition?
small bowel obstruction
how would you differentiate upon visual inspection the difference between incarcerated hernias and non incarcerated?
bruising and overlying redness
with incarcerated hernias, the patient will present with which signs?
possible fever, extreme pain with palpation of the defect
if strangulation occurs, a patient may be toxic and if left unrelieved, it could result in what?
perforation
abscess formation
peritonitis
septic shock
labs for hernias
CBC (increased WBC’s with strangulation and incarceration)
Complete Metabolic Panel
UA
Rads for hernias
x rays are not diagnostic, but can evaluate for perforation.
possible CT and ultrasound prior to referral to surger.
if there is a reliable history, the hernia may be reduced in what timeframe?
24 hrs
what should you give if strangulation is suspected or shock is present? (hernias)
etrapenem 1g
what is the closed passive reduction technique
trendelenburg position. (head below feet)
morphine.1-.15 mg for analgesia and diazepam 5mg for muscle relaxation over a 30-40 min timeframe
what is the closed active reduction technique
place one hand over the neck of the hernia sack to guide its contents into the peritoneal cavity, use the other hand to provide gentle and steady distal to proximal compression over the hernia
