Hernias

Question 1

Define a hernia

Answer 1

Protrusion of a viscus or part of a viscus through the walls of its containing cavity into an abnormal position

Question 2

Define a reducible hernia

Answer 2

Sac can return to the abdominal cavity either spontaneously or ̄c manipulation

Question 3

Define an irreducible hernia

Answer 3

Sac cannot be reduced despite pressure or manipulation

Question 4

Define a strangulated hernia

Answer 4

Blood supply of contents is compromised due to pressure at the neck of the hernia

Question 5

Define a Maydl’s hernia

Answer 5

Herniating double loop of bowel. Strangulated portion may reside as a single loop inside the abdomen

Question 6

Define a Littre’s hernia

Answer 6

Hernial sac containing strangulated Meckel’s diverticulum

Question 7

Define an Amyand’s hernia

Answer 7

Inguinal hernia containing strangulated Appendix

Question 8

Define a Richter’s hernia

Answer 8

Only part of circumference of bowel is within sac Most commonly seen with femoral hernias.
Can strangulate w/o obstructing

Question 9

Define a pantaloon hernia

Answer 9

Simultaneous direct and indirect hernia

Question 10

What percentage of people need to have an inguinal hernia repaired (hernioplasty)?

Answer 10

3%

Question 11

What percentage of male neonates have an inguinal hernia?

Answer 11

4%

Question 12

What is the ratio of males to females for inguinal hernias?

Answer 12

M9:1F

Question 13

What side are inguinal hernias most commonly on?

Answer 13

Right

Question 14

What procedure can cause inguinal hernias?

Answer 14

Appendectomy can damage ilioinguinal nerve = muscle weakness + susceptibility to hernias

Question 15

What percentage of inguinal hernias present as an emergency with strangulation/obstruction?

Answer 15

10%

Question 16

What is the name of the congenital complication that leads to indirect inguinal hernias?

Answer 16

Patent processus vaginalis

Question 17

What is the main cause of acquired inguinal hernias?

Answer 17

Increased abdominal pressure

Chronic cough
prostatism
constipation
heavy lifting
previous incision
ascites/obesity
appendectomy

Question 18

What is the ratio of indirect to direct inguinal hernias?

Answer 18

4:1

Question 19

Which type of inguinal hernia is most likely to strangulate?

Answer 19

indirect

Question 20

What type of inguinal hernia is more common in the young?

Answer 20

indirect

direct more common in elderly

Question 21

Which ring does an indirect inguinal hernia appear from

Answer 21

deep ring

Question 22

From where do direct inguinal hernias emerge?

Answer 22

Hesselbach’s triangle

Question 23

If an inguinal hernia is covered by the same three coverings as the spermatic cord, which type is it?

Answer 23

Indirect

Question 24

Which type of inguinal hernia is most likely to descend into the scrotum

Answer 24

Indirect

Question 25

Which type of inguinal hernia is most commonly acquired

Answer 25

Direct

Question 26

What are the three non-surgical options for inguinal hernias?

Answer 26

Treat RF’s (cough, constipation)
Lose weight
Truss

Question 27

At which point along the inguinl ligament is the deep ring?

Answer 27

Midway

Question 28

What is the mesh repair technique for inguinal hernias called

Answer 28

Lichtenstein repair

Question 29

Which type of hernia is more common in females?

Answer 29

Femoral

Femoral canal larger due to larger female pelvis and changes during childbirth

Question 30

Is a femoral hernia most commonly acquired or congenital?

Answer 30

acquired

Question 31

Are femoral hernias often reducible?

Answer 31

no

commonly present with strangulation

Question 32

What is the name of elective femoral hernia surgery

Answer 32

Lockwood approach

Question 33

What is the name of emergency femoral hernia surgery

Answer 33

McEvedy approach

Question 34

What percentage of surgical incisions lead to incisional hernias?

Answer 34

6%