Hernias

Question 1

Define hernia

Answer 1

Prolapse of the membrane lining a cavity due to a defect in the cavity wall.

Question 2

Types of hernia

Answer 2

Sliding (contain part of an organ)
Reducible hernia
Incarcerated
Stranguated

Question 3

How to differentiate abscess and strangulated hernia

Answer 3

Hernia will have bowel obstruction, abdo distension and vomiting.
Abscess will be on a soft abdomen

Question 4

Causes of hernias

Answer 4

Congenital
Acquired (local: post surgery, ischaemia, tension, sepsis, haematoma. Systemic; smoking, malnutrition, DM, immune suppression)

Question 5

In who and where do direct hernias form

Answer 5

Older people

Hesselbach’s triangle (Deep inferior epigastric vessels, inguinal ligament and lateral border of rectus muscle)

Question 6

Narrow process from peritoneum to scrotum

Answer 6

Tunica vaginalis

Question 7

Who gets more femoral hernias

Answer 7

Old females

Question 8

How to differentiate indirect inguinal from femoral hernias

Answer 8

Inguinal -> scrutum. Femoral -> thigh
Pressure on internal ring maintains inguinal reduction but doesnt control femoral.
Inguinal above inguinal ligament whilst femoral is below.

Question 9

Wide apart rectus muscles

Answer 9

Devarication

Question 10

Mesh techniques used for hernias

Answer 10

Sublay
Inlay
Onlay