Hernia - Ulas Flashcards
When is incarceration and strangulation are most COMMON?
Indirect inguinal hernia
When is incarceration and strangulation are at highest risk?
In femoral hernia
…..: It is the presence of a part of the intestine on the side wall of the pouch in the sac.
Richter Hernia (Pincement lateral)
…..: It is the presence of Meckel’s diverticulum in the
hernial sac.
Littre hernia
……..:It is the formation of the wall of the hernial sac not entirely by the peritoneum, but by the retroperitoneal organs such as the colon or bladder that accompany the hernia sac by partially slipping.
Sliding (hiatal)hernia
…….: Formation of a hernia from the site of m. transversus abdominis aponeurosis on the side edge of the rectus muscle sheath
Speigel hernia
Most common hernia
Indirect inguinal hernia
Which hernia Exits laterally to the inferior epigastric vessels passing through inguinal canal?
Indirect hernia
Which hernia Exits the medially to the inferior epigastric vessels nd passes through abdominal wall
?
Direct hernia
Umbilical hernia occurs mainly in ?
Women(due to pregnancy ) or obese men
Which is the deadliest hernia?
Obturator hernia
Rarest hernia?
Sciatic hernia
Hernia most commmon in women?
Umbilical hernia** and femoral hernia
Tx for hernia?
Golden standart: The most commonly used surgical technique with the lowest recurrence
rate is Lichtenstein herniorphy.
What is the tx of hernia?
Decide the type of hernia then do SURGERY
Why is laparoscopic surgery preffered?
Recovery time is short
Cosmetic
Back to business faster
Disadvantages of laparoscopy?
Cost
Must be experienced surgeon
High complications
Conventional hernia surgery (open)?
Cheap
Everyone knows how to do it
What are the layers of the abdominal wall?
They are of mesoderm origin:
1-skin
2-subcutaneous tissue
3-superficial fascia/scarpa fascia
4-external abdominal oblique muscle(makes inguinal lig)
5-internal abd oblique m.
6-transversus abdominus m.
7-transversalis fascia
8-peritoneum
What are the borders of the inguinal canal?
(Indirect hernia exits through this canal)
^Anteriorly: aponeurosis of the external oblique m.
Inferiorly: inguinal lig.
Superiorly:conjoint tendon
^Posteriorly: transversalis fascia
What may induce hernias ?
Coughing and physical activity& increased intra-abdominal pressure
What is the most common recurrent hernia?
Direct inguinal hernia
Which hernia is characterized as having nutritional disorder such as ischemia and necrosis and is considered an emergency?
Strangulated hernia (bcz it’s strangled)
**Which type of herniation has symptoms of GERD and heart burn?
Type 1 sliding
Which type of hernia is associated with symptoms of hematemesis(vomiting of blood) and severe pain and melena?
Type 2 paraesophageal
How do you treat sliding type herniation?
Treat like reflux disease/GERD
Which type of hernias are treated with surgery?
Types 2 3 4
What is the clinical approach for hernias?
1-Decide the type of hernia; and if it is GERD related to herniation or not
2-decide if it needs surgery or not
(Type 1 sliding doesnt need)
