Hernias Flashcards
What are the 3 complications of hernias?
Incarceration
Obstruction
Strangulation
What is incaraceration?
Where the hernia cannot be reduced back into its proper position. The bowel is therefore trapped in the herniated position.
This can lead to obstruction and strangulation.
What is obstruction?
Where the hernia causes a blockage of the passage of faeces through the bowel.
What is strangulation?
When a hernia is non-reducible and the base of the hernia becomes so tight that it cuts off the blood supply causing ischaemia.
What is a Richter’s hernia?
Partial herniation of the bowel in which the anti-mesenteric border herniates through the defect.
What is a Maydl’s hernia?
When two loops of adjacent bowel are contained within the hernia
What are the features of an inguinal hernia?
Groin lump that is SUPEROMEDIAL to the pubic tubercle. Lump disappears with pressure or when lying down
Some discomfort, worse with activity
What is the management of an inguinal hernia?
Hernia truss for those not fir to undergo surgery
Mesh repair is associated with lowest recurrence rate
- unilateral done open
- bilateral is laprascopic
What are the features of a femoral hernia?
Mildly painful lump in groin
Inferolateral to pubic tubercle
Usually non-reducible
Cough impulse often absent
What is the management of a femoral hernia?
Surgical repair as risk of strangulation is high
What does this show?
An umbilical hernia - a symmetrical bulge under the umbilicus
Describe a para-umbilical hernia?
An asymmetrical bulge - half the sac is covered by the skin of the abdomen directly above or below the umbilicus
What does this image show?
An epigastric hernia - lump in the midline between umbilicus and xiphisternum
What are the risk factors for an epigastric hernia?
Extensive physical training
Coughing (e.g. from lung disease)
Obesity
What is a spigelian hernia?
Also called a lateral ventral hernia
A hernia through the spigelian fascia, the aponeurotic layer between the rectus abdominis muscle medially and the semilunar line laterally
Rare and seen in older patients
What is an obturator hernia?
Hernia passing through the obturator foramen
More common in females
Typically presents with bowel obstruction
What are the types of hiatus hernia?
I - Sliding
II - Rolling
III - combination of sliding and rolling
IV - large opening with abdominal organs entering the thorax
