Other hernias

Question 1

Apart from Inguinal and femoral hernias, what other abdominal hernias are present?

*think 9

Answer 1

• Hiatus
• Incisional
• Epigastric
• Paraumbilical
• Sphigelian
• Obturator
• Littre’s
• Lumbar
• Richter’s

Question 2

Where do epigastric hernias occur?

Answer 2

• @ upper midline through the fibres of the linea alba

Question 3

What causes EH?

Answer 3

• Pregancy
• Obesity
• Ascites

Question 4

What is an important differential for EH?

Answer 4

• Rectus Divarication
  
  • difference is that in divarification the linea alba is stretched and weakened but is intact

Question 5

What is Paraumbilical hernia?

Answer 5

• herniation occurring through the linea alba around the umbilical region

Question 6

What causes PH?

Answer 6

• Obesity
• Pregnancy

Question 7

What are the congenital differentiation for PH?

Answer 7

• omphalocele
• gastroschisis

Question 8

Do PH commonly strangulate?

Answer 8

• no

Question 9

What is Sphigelian hernia?

Answer 9

• hernia that occurs at the semilunar line, around the level of the arcuate line
• Rare

Question 11

Are SH high risk of strangulation?

Answer 11

• yes. Surgical emergency

Question 12

What is Obturator Hernia?

Answer 12

• hernia of the pelvic floor, occurring through the obturator foramen, into the obturator canal

Question 13

What are the RF for OH?

?

Answer 13

• F
• Elderly
• Undergone rapid weight loss

*anything with wider pelvis

Question 14

What are the clinicl features of OH?

Answer 14

• Mass in upper medial thigh
• Bowel obstruction
• positive Howship-Romberg sign
  
  • (hip and knee pain exacerbated by thigh extension, medial rotation, and abduction).

Question 15

What is Littre’s Hernia?

Answer 15

• herniation of a Meckel’s diverticulum
• commonly occurs in the inguinal canal
• Common to strangulate
• uncommon hernia

Question 16

What is Lumbar hernia?

Answer 16

• posterior hernias, that typically occur spontaneously or iatrogenically following surgery (classically following open renal surgery)
• uncommon
• CF: Posterior mass + back pain

Question 17

What is Richter’s hernia?

Answer 17

• occur at any of the above sites and is a partial herniation of bowel, whereby the anti-mesenteric border becomes strangulated, therefore only part of the lumen of the bowel is within the hernial sac

Question 18

What are the CF of RH?

Answer 18

• tender irreducible mass
• varying levels of obstruction
• surgical emergencies