Hernias Flashcards
Define a hernia
Protrusion of a viscus or part of a viscus through the walls of its containing cavity into an abnormal position
Define a reducible hernia
Sac can return to the abdominal cavity either spontaneously or ̄c manipulation
Define an irreducible hernia
Sac cannot be reduced despite pressure or manipulation
Define a strangulated hernia
Blood supply of contents is compromised due to pressure at the neck of the hernia
Define a Maydl’s hernia
Herniating double loop of bowel. Strangulated portion may reside as a single loop inside the abdomen
Define a Littre’s hernia
Hernial sac containing strangulated Meckel’s diverticulum
Define an Amyand’s hernia
Inguinal hernia containing strangulated Appendix
Define a Richter’s hernia
Only part of circumference of bowel is within sac Most commonly seen with femoral hernias.
Can strangulate w/o obstructing
Define a pantaloon hernia
Simultaneous direct and indirect hernia
What percentage of people need to have an inguinal hernia repaired (hernioplasty)?
3%
What percentage of male neonates have an inguinal hernia?
4%
What is the ratio of males to females for inguinal hernias?
M9:1F
What side are inguinal hernias most commonly on?
Right
What procedure can cause inguinal hernias?
Appendectomy can damage ilioinguinal nerve = muscle weakness + susceptibility to hernias
What percentage of inguinal hernias present as an emergency with strangulation/obstruction?
10%
What is the name of the congenital complication that leads to indirect inguinal hernias?
Patent processus vaginalis
What is the main cause of acquired inguinal hernias?
Increased abdominal pressure
Chronic cough prostatism constipation heavy lifting previous incision ascites/obesity appendectomy
What is the ratio of indirect to direct inguinal hernias?
4:1
Which type of inguinal hernia is most likely to strangulate?
indirect
What type of inguinal hernia is more common in the young?
indirect
direct more common in elderly
Which ring does an indirect inguinal hernia appear from
deep ring
From where do direct inguinal hernias emerge?
Hesselbach’s triangle
If an inguinal hernia is covered by the same three coverings as the spermatic cord, which type is it?
Indirect
Which type of inguinal hernia is most likely to descend into the scrotum
Indirect
Which type of inguinal hernia is most commonly acquired
Direct
What are the three non-surgical options for inguinal hernias?
Treat RF’s (cough, constipation)
Lose weight
Truss
At which point along the inguinl ligament is the deep ring?
Midway
What is the mesh repair technique for inguinal hernias called
Lichtenstein repair
Which type of hernia is more common in females?
Femoral
Femoral canal larger due to larger female pelvis and changes during childbirth
Is a femoral hernia most commonly acquired or congenital?
acquired
Are femoral hernias often reducible?
no
commonly present with strangulation
What is the name of elective femoral hernia surgery
Lockwood approach
What is the name of emergency femoral hernia surgery
McEvedy approach
What percentage of surgical incisions lead to incisional hernias?
6%
