Hernias Flashcards
what are the 1st and 2nd most common cause of bowel obstruction?
1st: adhesions
2nd: abdominal hernias
what clinical finding is enough means to diagnose a hernia?
pain/bulge with palpable mass
contents return to the abdomen spontaneously or with light manual pressure
reducible
contents are stuck and can’t be pushed back into abdomen
incarcerated (irreducible)
a patient presents with a dull ache with intermittent protrusion
reducible hernia
a patient presents with acute, crampy abdominal pain, localized tenderness, N/V, obstruction, +/- fever
incarcerated/irreducible hernia
when contents become trapped and blood supply becomes compromised leading to ischemia and necrosis
strangulated
incarcerated and strangulated hernia are considered what?
surgical emergencies
what does elevated lactic acid indicate?
strangulation
what is the treatment for an umbilical hernia in children < 2 yrs?
heal spontaneously
watchful waiting + education
what is the treatment for umbilical hernia in an adult?
surgical repair
any hernia of the abdominal wall
ventral hernia
what is the most common site of all hernias?
groin region
what are the 3 different groin hernias?
indirect inguinal hernia
direct inguinal hernia
femoral hernia
what is the most common hernia in both males and females?
indirect inguinal hernia
what type of hernia is more commonly incarcerated than inguinal hernias?
femoral hernias
protrudes at the internal inguinal rings, which is the site where the spermatic cord in males and the round ligament in females exits the abdominal cavity
indirect inguinal hernia
what kind of hernia is more often found in the scrotum?
indirect inguinal hernia
most indirect inguinal hernias are considered _____
congenital
what size hernias have a higher risk for strangulation?
narrow hernias
herniated sac protrudes through the inguinal wall, and is less likely to end up in the scrotum
direct inguinal hernia
direct inguinal hernias protrude medial to the inferior epigastric vessels within the _____ _____
hesselbach triangle
hernia located inferior to the inguinal ligament
femoral inguinal hernia
which type of hernia is more common in females? which side is more common?
femoral inguinal hernia
right side
how will an acute herniation present? (2)
sharp pain
swelling
what physical fining indicates a direct inguinal hernia?
visible/palpable mass superior to pubic tubercle
what physical fining indicates an indirect inguinal hernia?
scrotal mass/enlargement
how is an inguinal hernia exacerbated? (3)
cough
straining
valsalva maneuver
a mass touching the tip of finger indicates what type of inguinal hernia?
indirect inguinal hernia
a mass touching the side of finger indicates what type of inguinal hernia?
direct inguinal hernia
what is the imaging of choice to help differentiate hernias and identify small hernias causing pain without clinical evidence?
CT w/ contrast
which diagnostic rules out perforation and may show bowel in scrotum?
abdominal xrays
which diagnostic helps differentiate scrotal masses?
ultrasound
what is the management for an inguinal hernia? (4)
daytime truss
avoid straining
manual reduction in supine position
sx consult
what are 2 treatment options for an inguinal hernia?
herniorrhaphy OR hernioplasty
return to normal activities within 3-6 weeks
