Hernias Flashcards
Ability to externally push the contacts back into the abdominal cavity
Reducible hernia
Contents become “trapped” and will not reduce
Incarcerated hernia
Contents are trapped and now have compromised blood supply
This is a surgical emergency
Strangulated hernia
Protrusion of the stomach through the diaphragm, usually around the
hiatus
Hiatal Hernia
What are the two types of hiatal hernias?
Sliding
Paraesophageal
What are the signs/symptoms of a hiatal hernia?
Many people have no symptoms (incidental finding)
Some have chest pain
Can present like GERD - Will see some reflux with a hiatal
hernia (Responsible for many cases of GERD)
What are the treatment options for hiatal hernias?
Symptomatic: treat GERD, small meals
Surgery if severely symptomatic - Nissen Fundoplication
Protrusion of bowel or abdominal fat through the inguinal canal
More common in males
Caused by testis movement during development
Inguinal Hernia
What are the two types of inguinal hernias?
Direct
Indirect
What is the most common type of inguinal hernias?
Indirect
Which type of inguinal hernia does not happen in infants?
Direct
Which type of inguinal hernia is described below?
Medial to inferior epigastric vessels
Contents “spill” through a weak point along the abdominal wall in the area of Hesselbach’s triangle bordered by inguinal ligament, inferior epigastric vessels, and rectus abdominis
Can occur later in life as obesity develops
Do not occur in infants
Direct
Which type of inguinal hernia is described below?
Most common type
Lateral to inferior epigastric vessels
Contents pass lateral to inferiorepigastric vessels through the inguinal ring and can pass into the scrotum (patent processus vaginalis)
Females have a superficial ring
Common occurrence and often found in infancy
Indirect
Which type of inguinal hernia is described below?
Bulge in the area of Hesselbach’s triangle
Pain and sepsis if incarcerated
Direct
Which type of inguinal hernia is described below?
Bulge in the scrotum
Indirect
Which type of inguinal hernia has a higher risk of strangulation?
Indirect
Which type of inguinal hernia has a high post-op recurrence?
Direct
Occur through the femoral canal below the inguinal ligament
Often presents as a bump in the leg
More common in women
Rare/very uncommon
Femoral Hernia
Defect in the anterior abdominal wall which can be either spontaneous or acquired
Identified by anatomic location:
Epigastric
Umbilical
Incisional
hypogastric
Ventral Hernia
What are some causes of a direct inguinal hernia?
Increased abdominal pressure
Weakening of tissue due to age or smoking
Occur between umbilicus and xiphoid process
Low risk for incarceration
Epigastric Hernia
Due to imperfect closure or weakness of the umbilical ring
Congenital defect at site of umbilicus allowing abdominal contents to protrude
Umbilical Hernia
Umbilical hernias in infant patients typically resolve spontaneously by what age?
Typically resolves spontaneously by age 4 (most by 1 year)
Occurs post-operatively when the incision fails to heal, or is opened before the healing is complete
Abdominal surgeries can produce a ventral hernia
Incisional Hernia
Hernia through the spigelian fascia
High risk of strangulation – needs to be fixed with surgery
Spigelian Hernia
