hernias

Question 1

most common abdominal wall hernia

Answer 1

inguinal hernia

Question 2

presentation of inguinal hernia

Answer 2

groin lump
- superior and medial to the pubic tubercle
- disappears on pressure or when patient lies down
discomfort and ache
strangulation is rare

Question 3

management of inguinal hernias

Answer 3

treat fit patients even if asymptomatic
- mesh repair (open if unilateral, laparoscopic if bilateral or recurrent)
hernia truss if patient not suitable for surgery

Question 4

indication that hernia is at risk of strangulation

Answer 4

episodes of pain in the hernia that was previously asymptomatic
irreducible hernias

Question 5

symptoms of strangulated hernias

Answer 5

pain
fever
increase in the size or erythema of overlying skin
peritonitic features: guarding
bowel obstruction
bowel ischaemia

Question 6

blood results for patients with strangulated hernia

Answer 6

leukocytosis
raised lactate

Question 7

Risk factors for abdominal wall hernias

Answer 7

obesity
ascites
increasing age
surgical wounds

Question 8

location of femoral hernia

Answer 8

Below and lateral to the pubic tubercle

Question 9

location of umbilical hernia

Answer 9

Symmetrical bulge under the umbilicus