Hernias

Question 1

can be?

Answer 1

• reducible
• incarcerated
• strangulated

Question 2

classification?

Answer 2

• primary
  
  • from increased intra-abdominal pressure
• incisional
  
  • occurring at site of incision from previous surgery, most commonly midline
  • due to poor wound healing
  • high recurrence rate

Question 3

general presentation?

Answer 3

• soft lump, that may protrude on coughing or standing
• discomfort / dragging sensation
• may be able to reduce it

Question 4

main 3 complications?

Answer 4

• incarceration
  
  • hernia cannot be reduced back
  • bowel is stuck in herniated position
• obstruction
• strangulation
  
  • presents w significant pain & tenderness at hernia site
  • surgical emergency

Question 5

Mx options?

Answer 5

• Conservative
  
  • pts w low risk of complications who aren’t fit for surgery
• Tension repair
  
  • Muscle & tissue either side of defect are sutured back together
  • high recurrence rates
• Tension-free repair
  
  • mesh sutured to muscle & tissue either side of defect
  • low recurrence rates