Obstructed/ strangulated hernia Flashcards
What are abdominal hernias?
the protrusion of intra-abdominal contents through congenital/acquired areas of weakness in the abdominal wall
What are the 4 categories of anatomically classified abdominal hernias?
- Ventral hernias (e.g. epigastric, umbilical, incisional hernias)
- Groin hernias (inguinal and femoral hernias)
- Pelvic hernias (obturatory, sciatic and perineal hernias)
- Flank/lumbar hernias
What are the 3 most common types of hernias?
- Inguinal
- Incisioal
- Umbilical
What key factor increases the risk of abdominal hernias?
persistently raised intra-abdominal pressure (e.g. due to ascites, pregnancy, intra-abdominal tumours, chronic cough)
What are 4 features of uncomplicated hernias?
- Asymptomatic
- Non-tender
- Completely reducible
- Expansile cough impulse
What are 3 forms of complicated hernias?
- Incarcerated
- Obstructed
- Strangulated
What are 4 features of complicated hernias?
- Tenderness
- Irreducibility
- Features of bowel obstruction
- Absent cough impulse
What is a diagnosis of abdominal hernias often based on?
clinical examination
When is imaging used to help diagnose abdominal hernias?
to confirm the diagnosis and evaluated the contents of the hernia
What 2 types of imaging may be useful to aid the diagnosis of abdominal hernias?
Ultrasound, CT
What is the management of complicated hernias or those with a narrow neck?
surgical repair: primary repair/ mesh repair
What are 3 examples of hernias with a narrow neck (therefore needing surgical repair)?
- Femoral hernia
- Obturator hernia
- Paraumbilical hernia
What is usually the typical course of congenital umbilical hernias?
typically close spontaneously bt 5 years of age
have a wide so low risk of complications, surgical intervention rarely necessary
What are 4 examples of ventral hernias?
- Epigastric hernia
- Umbilical hernia
- Incisional hernia
- Spigelian hernia
- Parstomal hernia
What is an epigastric hernia?
herniation through the linea alba, between the xiphoid process and the umbilicus
What is a Spigelian hernia?
hernia that can occur anywhere along the semilunar line, most commonly below the arcuate line (i.e. below the umbilicus)
What are 2 examples of groin hernias?
- Inguinal hernia (direct/ indirect)
- Femoral hernia