hernias Flashcards
hernia?
- Abnormal protrusion of a viscus outwith its normal body cavity
what is the most common?
inguinal
predisposing factors?
heavy lifting, coughing, constipation, prostates, pregnancy, obesity
how can you classify hernias?
reducible and non reducible
natural hernias ?
Inguinal, femoral, umbilicus, oesophageal hiatus, obturator
weakness?
Incisional, parastomal, epigastric, paraumbilical
epigastric hernia arises from congenital weakness in the
linea alba
what does epigastric usually contain?
extraperitoneal fat
how is epigastric treated?
suture or mesh
what would you do with a paediatric inguinal hernia?
operate immediatey
Femoral hernia - male or female?
female
anatomical position of femoral?
below and lateral to the pubic tubercle
how do femoral hernias present ?
50% PRESENT AS SURGICAL EMERGENCY AND 50% then require small bowel resection
inguinal hernia - male or female?
male
how do you differentiate between inguinal and femoral?
find pubic tubercle
if above and medial –> inguinal
if below and lateral –>femoral
what need to tell patient after surgery for hernia?
no driving for about a week, no heavy lifting for about a months
complications?
haematoma, urinary retention, wound infection, chronic neurogenic pain, hernia recurrence, testicular pain and atrophy
in inguinal - how can you differentiate direct and indirect?
Indirect
♣ Lateral to inf. Epigastric vessels and with the cord
♣ May reach scrotum (inguino-scrotal)
♣ Congenital hernias are indirect
♣ Controlled by digital pressure over internal ring
o Direct
♣ Posterior bulge through transversalis fascia
♣ Medial to inf. Epigastric vessels
♣ Often bilateral
♣ Poor controlled by digital pressure
♣ OLDER MEN
Indirect hernia - medial or lateral to epigastric vessels?
lateral
direct - medial or lateral to epigastric vessels
medial
