Inguinal hernia Flashcards

1
Q

What is the definition of an inguinal hernia?

A

Protrusion of abdominal organ through weak muscles of the abdominal wall into the inguinal canal

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2
Q

How common are inguinal hernias?

A

Most common type of hernia – 70% of all hernias

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3
Q

What is the pathology of inguinal hernias (including direct and indirect)?

A
  • Intestine/fatty tissue goes into the inguinal canal
  • Through the transversalis fascia, internal oblique, external oblique
  • Indirect: Congenital defect in abdominal wall, lateral to inferior epigastric artery. Originates at the deep ring and goes through the superficial ring like the spermatic cord
  • Direct: weakness in abdominal wall over time, medial to inferior epigastric artery. Only goes through the superficial inguinal ring
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4
Q

What are the risk factors/aetiology of inguinal hernias?

A
  • Males – bigger inguinal canal as more passes through it
  • Hernia history
  • Age – older = more risk
  • Caucasian
  • Weak abdominal wall
  • Smoking
  • Chronic cough
  • Constipation
  • Urinary obstruction
  • Heavy lifting
  • Previous abdominal surgery
  • Obesity
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5
Q

What are the signs/symptoms of inguinal hernias?

A
  • Lump in groin (medial and superior to pubic tubercle) – maybe painful
  • Enlarged scrotum – maybe painful
  • Lump appears when lifting something/straining/coughing/exertion
  • Lump disappears when you lie down
  • Nausea/vomiting – obstruction
  • Constipation
  • Obesity
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6
Q

What diseases can inguinal hernias present similarly to?

A
  • Femoral hernia
  • Hydrocele
  • Undescended testes
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7
Q

What investigations are undertaken for suspected inguinal hernias?

A
  • US
  • CT – with contrast and the Valsalva manoeuvre being done is best
  • MRI – when uncertain of hernia
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8
Q

What are the surgical treatments for inguinal hernias?

A
  • Laparoscopic inguinal hernia surgery – only done if symptomatic
  • Open laparoscopic inguinal hernia surgery – only done if symptomatic
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9
Q

What are the pharmacological treatments for inguinal hernias?

A
  • Painkillers

* Fluids

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10
Q

What are the non pharmacological treatments for inguinal hernias?

A
  • High fibre and water diet – to avoid constipation
  • Weight loss advice
  • Smoking cessation
  • Truss hernia belt
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