Hernias Flashcards
What is a scientific definition of a hernia?
The protrusion of an organ through a retaining structure.
Where do hernias usually occur?
In the abdm cavity.
Simple overview of the patho of a hernia:
Weakened retaining str + increased intra-abdm pressure = hernia
What might contribute to the weakening of retaining strs?
- Aging
- Congenital defect
What is a hiatus?
medical definition
A gap or opening between strs
What is a hiatal hernia?
When part of the stomach protrudes into the thoracic cavity through a hiatus in the diaphragm where the esophagus passes through.
What are the 2 types of hiatal hernia?
- Axial
2. Paraesophageal
What is another name for an axial hiatal hernia?
A sliding hiatal hernia
What happens in an axial hiatal hernia?
The gastro-esophageal junction (GEJ) and the upper part of the stomach protrude.
What word is used to describe the protrusion of an axial hiatal hernia
HINT: its not “hernia” ;P
A “Bell”.
What are the sympts of an axial hiatal hernia?
- ~50% asympt
- ~50% chest pain, reflux/heartburn
Why does heartburn burn?
Because the reflux from the stomach contains hydrochloric acid, which burns the lining of the esophagus.
What causes the feeling of fullness accompanying an axial/sliding hernia?
Because the herniated part of the stomach acts as a “mini stomach” which fills up quicker and activates the stomach stretch receptors before the “real” stomach has truly been filled.
How do you Tx the reflux from a hernia?
- Lifestyle modifications
- Avoid eating a couple hours before bed
- Keep HOB elevated
- Drugs
- Antacids
- H2RA
- PPIs
What is inhibited by the PPIs?
Hydrogen
What kind of Sx is used to Tx a hernia?
Fundoplication
Describe the process of fundoplication:
The fundus is wrapped around the GEJ, this will fortify the sphincter.
(looks like the stomach is wearing a cute lil sweater)
What is an inguinal hernia?
Abdm organ protrudes through the inguinal canal
Why is the term “hernial sac” used with an inguinal hernia?
Because the hernia is enclosed by the peritoneum
What is the Tx for an inguinal hernia?
Sx
