11. Epigastric Hernia Flashcards Preview

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Flashcards in 11. Epigastric Hernia Deck (15)
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1

PATHOLOGY and TYPES of Epigastric Hernia

1. Fatty hernia of the linea alba

2. True Epigastric hernia

2

Pathogenesis of Fatty hernia of the linea alba in PATHOLOGY and TYPES of Epigastric Hernia

The hernia starts as a protrusion of the extraperitoneal fat through a defect in the supraumbilical part of the linea alba

3

Pathogenesis of True Epigastric hernia in PATHOLOGY and TYPES of Epigastric Hernia

As the protrusion enlarges, the extraperitoneal fat pulls a small peritoneal sac through the defect which may contain intestine or omentum.

4

The defect in the linea in Pathogenesis of True Epigastric hernia in PATHOLOGY and TYPES of Epigastric Hernia

* Alternative name

* Structures Passing through

5

Alternative name for The defect in the linea in Pathogenesis of True Epigastric hernia in PATHOLOGY and TYPES of Epigastric Hernia

Foramen of Egres

6

Structures Passing through The defect in the linea in Pathogenesis of True Epigastric hernia in PATHOLOGY and TYPES of Epigastric Hernia

Paramedian vessels and nerves

7

Difference between True epigastric hernia and fatty hernia of linea alba

No expansile impulse with cough with fatty hernia of linea alba

8

Difference between fatty hernia of linea alba and Lipoma

Can not be differentiated from lipoma except intraoperative

9

CLINICAL PICTURE of Epigastric Hernia

* Associated symptoms

* Examination

10

Associated symptoms in CLINICAL PICTURE of Epigastric Hernia

Dyspepsia and epigastric pain

11

Pathogenesis of Dyspepsia and epigastric pain

may be due to traction on the lesser omentum or the stomach

12

Examination in CLINICAL PICTURE of Epigastric Hernia

* Soft epigastric swelling

* Frequently irreducible

* Gives expansile impulse on cough.

13

TREATMENT of Epigastric Hernia

* Exclusion of similar diseases first

* Repair

14

Exclusion of similar diseases first in TREATMENT of Epigastric Hernia

* Exclude first peptic ulcer or gallbladder disease by endoscopy or abdominal U.S

* if there is continuous dyspepsia & epigastric pain

15

Repair in TREATMENT of Epigastric Hernia

1) Hernioplasty.

2) Anatomical repair.

3) Mayo's repair (vertical)