Hernias Flashcards
How do abdominal wall hernias present?
Soft lump protruding
Reducible
Protrudes on coughing or standing
Aching, pulling or dragging sensation
What are complications?
Incarceration
Obstruction
Strangulation
What is incarceration
Hernia can’t be reduced back into the proper position so becomes trapped in the herniated position which can lead to obstruction and strangulation
What is Richters Hernia
only part of the bowel wall and lumen herniate through the defect, with the other side of that section of the bowel remaining within the peritoneal cavity. They can become strangulated, where the blood supply to that portion of the bowel wall is constricted and cut off.
What is Maydls hernia
Where two different loops of bowel are contained in the hernia
What are the different surgical options
Tension free repair - mesh
Tension repair
How do you differentiate between an indirect and direct inguinal hernia?
When an indirect hernia is reduced and pressure is applied (with two fingertips) to the deep inguinal ring (at the mid-way point from the ASIS to the pubic tubercle), the hernia will remain reduced.
Direct hernia - pressure over the deep inguinal hernia will not stop the herniation
What is a spigelian hernia?
Hernia occurring at the lateral border of the rectus abdominis muscle and liner semilunaris
Why may spigelian hernias need to be corrected?
Narrower base so increases risk of incarceration
What is diastasis recti?
Widening of lines alba
Technically not a hernia
becomes most prominent when the patient lies on their back and lifts their head.
What are causes of diastasis recti?
Congenital in newborns
Weakness in connective tissues e.g. pregnancy or obesity
What is an obturator hernia?
abdo or pelvic contents herniate through the obturator foramen at the bottom of the pelvis
How do obturator hernias present
Often asymptomatic
Pain in the groin or medial thigh due to irritation of the obturator nerve
What is Howship-Romberg sign
Pain extending from the inner thigh to the knee when the hip is internally rotated due to compression of the obturator nerve
