13. Complications of Hernia Flashcards by Waleed Eldahshan

Complications of Hernia

Common

* Rare

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Common Complications of Hernia

Irreducibility

2- Obstruction

Strangulation

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Rare Complications of Hernia

Inflammation
Rupture
Hydrocele of the hernial Sac

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Irreducibility in Common Complications of Hernia

DEFINITION
CAUSES
CLINICAL PICTURE
COMPLICATIONS
Treatment

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DEFINITION of Irreducibility in Common Complications of Hernia

failure to return the contents into the abdomen

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CAUSES of Irreducibility in Common Complications of Hernia

Adhesions between the contents and the sac

Adhesions between the contents themselves.

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Pathogenesis of Adhesions in CAUSES of Irreducibility in Common Complications of Hernia

Chronic irritation )> fibrous tissue )> Adhesions

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Pathogenesis of Adhesions between the contents themselves in CAUSES of Irreducibility in Common Complications of Hernia

Forms one mass larger than the defect

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CLINICAL PICTURE of Irreducibility in Common Complications of Hernia

No symptoms of intestinal obstruction

* The best person to reduce the hernia is the patient himself, failure to do so, it is considered irreducible

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COMPLICATIONS of Irreducibility in Common Complications of Hernia

Irreducibility predisposes to obstruction and strangulation

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Treatment of Irreducibility in Common Complications of Hernia

Urgent surgery.

Reduction by Taxis is contraindicated

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Reduction by Taxis is contraindicated in Treatment of Irreducibility in Common Complications of Hernia

Meaning of Reduction by Taxis

* The reason why it’s contraindicated

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Meaning of Reduction by Taxis in Reduction by Taxis is contraindicated in Treatment of Irreducibility in Common Complications of Hernia

Manual Reduction of hernia

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The reason why it’s contraindicated in Reduction by Taxis is contraindicated in Treatment of Irreducibility in Common Complications of Hernia

As it may lead to

Reduction of strangulated loop to the abdomen.
Reduction en bisac
Rupture of the hernia.

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Reduction en bisac in The reason why it’s contraindicated in Reduction by Taxis is contraindicated in Treatment of Irreducibility in Common Complications of Hernia

Reduction of the sac between the layers of the abdominal wall

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Obstruction in Common Complications of Hernia

Incidence
DEFINITION
CLINICAL PICTURE
COMPLICATIONS
Investigations
Treatment

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Incidence of Obstruction in Common Complications of Hernia

In cases of Enterocele only

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DEFINITION of Obstruction in Common Complications of Hernia

Occlusion of the intestinal lumen from without or from within
without affecting its blood supply.

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Meaning of from without in DEFINITION of Obstruction in Common Complications of Hernia

All causes of intestinal obstruction regardless the hernia such as F.B

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Meaning of from within in DEFINITION of Obstruction in Common Complications of Hernia

Obstructing adhesions

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Meaning of lncarcerated hernia

Obstructed hernia by faeces

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CLINICAL PICTURE of of Obstruction in Common Complications of Hernia

The 4 Cardinal symptoms of Intestinal Obstruction

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The 4 Cardinal symptoms of Intestinal Obstruction in CLINICAL PICTURE of Obstruction in Common Complications of Hernia

Vomiting.
Abdominal distension.
Abdominal colics.
Absolute constipation.

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COMPLICATIONS of Obstruction in Common Complications of Hernia

predisposes to strangulation

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Investigations of Obstruction in Common Complications of Hernia

1. Serum electrolytes (Na & K) 2. KFTs & LFTs 3. CBC 4. ABGs 5. Plain x-Ray abdomen erect & supine

CBC in Investigations of Obstruction in Common Complications of Hernia

Normal

Pathogenesis of Leucocytosis in CBC in Investigations of Obstruction in Common Complications of Hernia

if intestinal bacteria translocate into the bloodstream, causing the systemic inflammatory response syndrome or sepsis.

ABGs in Investigations of Obstruction in Common Complications of Hernia

Hypokalemic, hypochloremic metabolic alkalosis

Pathogenesis of Hypokalemic, hypochloremic metabolic alkalosis in Investigations of Obstruction in Common Complications of Hernia

due to severe emesis and loss of HCl

Plain x-Ray abdomen erect & supine in Investigations of Obstruction in Common Complications of Hernia

Multiple fluid levels & distended loops.

Treatment of Obstruction in Common Complications of Hernia

Urgent surgery.

Most serious complication of Hernia

Strangulation

Strangulation in Common Complications of Hernia

* INCIDENCE * CAUSES * PATHOLOGY * CLINICAL PICTURE * Investigations * Treatment

INCIDENCE of Strangulation in Common Complications of Hernia

* The most common hernia liable to strangulate * The most common hernia seen strangulated * It is the most common cause of Intestinal Obstruction in developing countries. * It's the most serious complication of Hernia

The most common hernia liable to strangulate in INCIDENCE of Strangulation in Common Complications of Hernia

femoral hernia then paraumbilical hernia

The most common hernia seen strangulated in INCIDENCE of Strangulation in Common Complications of Hernia

oblique inguinal hernia as it is the commonest form | of hernia.

The most common cause of Intestinal Obstruction in developing countries

Strangulation of Hernia

CAUSES of Strangulation in Common Complications of Hernia

1. Presence of a constricting agent 2. Narrowing of the neck of the sac by adhesions. 3. It may follow other complications as irreducibility or obstruction.

Presence of a constricting agent in CAUSES of Strangulation in Common Complications of Hernia

* Examples | * Pathogenesis

Examples in Presence of a constricting agent in CAUSES of Strangulation in Common Complications of Hernia

* Deep or superficial inguinal ring in Oblique Inguinal Hernia * Sharp edge of lacunar ligament in femoral hernia.

Pathogenesis of Presence of a constricting agent in CAUSES of Strangulation in Common Complications of Hernia

* Constriction of the contents leading to interruption of their blood supply. * If the Constriction is not relieved, gangrene occurs in few hours.

Pathology of Strangulation in Common Complications of Hernia Very important

* The sequelae that The strangulated loop will suffer | * Note

The sequelae that The strangulated loop will suffer in Pathology of Strangulation in Common Complications of Hernia

1- Pressure on the veins & impeded venous congestion 2- Pressure on the arteries & impeded arterial supply 3. Gangrene occurs at the site of constriction 4- Perforation and peritonitis are the terminal events

Pathogenesis of Pressure on the veins & impeded venous congestion in The sequelae that The strangulated loop will suffer in Pathology of Strangulation in Common Complications of Hernia

* The strangulated loop becomes congested and distended with gas & fluid. * increased congestion causes haemorrhage in the wall & lumen of the affected loop

Pathogenesis of Pressure on the arteries & impeded arterial supply in The sequelae that The strangulated loop will suffer in Pathology of Strangulation in Common Complications of Hernia

* Ischemia & infarctions of the mucosa )> Ulceration * Mucosal barrier failure * Bacterial translocation occurs & predisposes to septic shock.

Mucosal barrier failure in Pathogenesis of Pressure on the arteries & impeded arterial supply in The sequelae that The strangulated loop will suffer in Pathology of Strangulation in Common Complications of Hernia

* The devitalized loop exudates its contents (fluid, blood & bacteria) into the hernial sac which now contains Sero sanguinous highly toxic fluid. * At this point the strangulated loop is still viable

Note on Pathology of Strangulation in Common Complications of Hernia

Strangulated hernia is categorized as Mixed strangulation ( obstruction of both blood supply and intestinal lumen)

CLINICAL PICTURE of Strangulation in Common Complications of Hernia

* Symptoms | * Examination

Symptoms in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

1- Acute pain in the hernia. 2- Sudden enlargement of the hernia. 3- Irreducibility. 4- Symptoms of intestinal obstruction 5- Finally perforation occurs with generalized abdominal pain of peritonitis.

Pathogenesis of Acute pain in the hernia in Symptoms in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Due to Inflammatory reaction

Symptoms of intestinal obstruction in Symptoms in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

1. Vomiting. 2. Abdominal distension. 3. Abdominal colics. 4. Absolute constipation.

Note on Absolute constipation in Symptoms of intestinal obstruction in Symptoms in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Absolute constipation is absent in cases of 1- Strangulated omentum. 2- Littre's hernia 3- Richter's hernia

Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

* General * Abdominal * Local * Clinical differentiation between obstruction and strangulation

General Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

1. Fever. | 2. Shock in neglected cases

Shock in neglected cases in General Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

* Hypovolemic Shock | * Septic shock

Pathogenesis of Hypovolemic Shock in shock in neglected cases in General Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Vomiting or intra luminal hge

Pathogenesis of Septic shock in shock in neglected cases in General Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

due to Bacterial translocation

Abdominal Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

* Inspection * Palpation * Percussion * Auscultation

Inspection in Abdominal Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Abdominal distension.

Palpation in Abdominal Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Abdominal rigidity in cases of perforation & peritonitis

Percussion in Abdominal Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Hyper-resonance

Auscultation in Abdominal Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

1st there are accentuated intestinal sounds Later there is silent abdomen.

Local Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

The hernia is : 1- Irreducible. 2- Tender 3- Tense 4- Giving no expansile impulse on cough. 5. Showing signs of acute inflammation.

Sure sign of strangulated hernia in Local Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

1. Tense | 2. Giving no expansile impulse on cough , if no. one is not found in the choices of MCQ

Pathogenesis of Giving no expansile impulse on cough in Local Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

As defect of hernia became very narrow And hernia is tense

Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

* It's difficult Thus it is safer to consider any obstructed hernia as strangulated hernia until proved otherwise * Difference between obstructed and strangulated Hernia

Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

* General Examination * Local Examination * Ryle insertion * Investigations

General Examination in obstructed Hernia in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Not toxic

General Examination in strangulated Hernia in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Toxic " Feverish "

Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Expansile impulse Consistency Overlying signs of inflammation Percussion of intestine in the sac Auscultation of intestine in the sac

Expansile impulse in obstructed Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Present but difficult to be elicited

Expansile impulse in strangulated Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Absent

Consistency in obstructed Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Not tense

Consistency in strangulated Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Tense

Overlying signs of inflammation in obstructed Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Absent

Overlying signs of inflammation in strangulated Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Present

Percussion of intestine in the sac in obstructed Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Resonant

Percussion of intestine in the sac in strangulated Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Dull

Auscultation of intestine in the sac in obstructed Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Accentuated intestinal sounds

Auscultation of intestine in the sac in strangulated Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Silent

Pathogenesis of Silent intestinal sounds in Auscultation of intestine in the sac in strangulated Hernia in Local Examination in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Due to dec blood supply )> paralytic ileus

Ryle insertion in obstructed Hernia in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Relives pain as Suction of fluids relieves colics

Ryle insertion in strangulated Hernia in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Doesn't Relive pain as As the pain is ischemic not colic

Investigations in obstructed Hernia in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Normal CBC

investigations in strangulated Hernia in Difference between obstructed and strangulated Hernia in Clinical differentiation between obstruction and strangulation in Examination in CLINICAL PICTURE of Strangulation in Common Complications of Hernia

Leucocytosis

Investigation of Strangulation in Common Complications of Hernia

1. Serum electrolytes (Na & K), 2. KFTs & LFTs 3. CBC : 4. ABGs 5. Plain x-Ray abdomen erect & supine

CBC in Investigation of Strangulation in Common Complications of Hernia

Leucocytosis

ABGs in Investigation of Strangulation in Common Complications of Hernia

Metabolic acidosis.

Plain x-Ray abdomen erect & supine in Investigation of Strangulation in Common Complications of Hernia

Multiple fluid levels & distended loops.

TREATMENT of Strangulation in Common Complications of Hernia

* Urgent surgery after resuscitation * Preoperative preparation "resuscitation" * Operative management

Preoperative preparation "resuscitation" in TREATMENT of Strangulation in Common Complications of Hernia

1. NPO & nasogastric tube suction 2. I.V fluids & correction of any electrolytes disturbance. 3. I.V antibiotics 4. I.V. H2 blockers 5. Fluid chart.

Benefits of NPO & nasogastric tube suction in Preoperative preparation "resuscitation" in TREATMENT of Strangulation in Common Complications of Hernia

decreases distension and vomiting.

I.V antibiotics in Preoperative preparation "resuscitation" in TREATMENT of Strangulation in Common Complications of Hernia

3rd generation cephalosporins & metronidazole.

I.V. H2 blockers in Preoperative preparation "resuscitation" in TREATMENT of Strangulation in Common Complications of Hernia

to avoid stress peptic ulcer.

Operative management in TREATMENT of Strangulation in Common Complications of Hernia

1. The incision must explore the neck & the fundus of the sac. 2. Dissection & opening the sac, at the fundus 3. Evacuation of the toxic fluid. 4. Holding the contents & division of the constriction ring on your finger or hernia director. 5. Delivering the loop outside 6. Dealing with the contents according to viability. 7. Finally herniorrhaphy using prolene sutures but mesh is contraindicated.

The reason of Dissection & opening of the sac, at the fundus in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

To avoid escape of the toxic fluid to the peritoneal cavity.

The reason of Delivering the loop outside in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

to avoid strangulated inner loop in cases of Maydle's hernia.

Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

a. Dealing with Omentum | b. Dealing with Intestinal loop

Dealing with Omentum in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Must be resected as viability can't be guaranteed.

Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

* Difference between Viable and non-viable loop * Management of Viable loop * Management of Doubtful loop * Management of Gangrenous loop

Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

* Luster * Color * Mesenteric arteries * Response to pricking or pinching

Luster of Viable loop in Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Normal luster

Luster of non-viable loop in Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Lusterless

Color of Viable loop in Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Pink

Color of non-viable loop in Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Grey or black

Mesenteric arteries of Viable loop in Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Pulsating mesenteric arteries

Mesenteric arteries of non-viable loop in Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Not pulsating ,thrombosed

Response to pricking or pinching of Viable loop in Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Contracts if pricked or pinched

Response to pricking or pinching of non-viable loop in Difference between Viable and non-viable loop in Dealing with Intestinal loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

No response

Management of Viable loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Return the viable loop to abdomen

Management of Doubtful loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

1. Hot packs are applied for maximum 10-15 minutes 2. ask the anesthesiologist to increase pure oxygen inhalation for few minutes 3. see if it is viable or not.

Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

* Management of Small intestine Gangrenous loop * Management of Gangrenous Right colon and caecum * Management of Gangrenous Left colon

Management of Small intestine Gangrenous loop in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Resection and 1ry anastomosis

The reason why 1ry anastomosis can be done in Management of Small intestine Gangrenous loop in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

1. Good blood supply of the small intestine. 2. Small intestine is less contaminated. 3. Has complete serosa & musculosa

Management of Gangrenous Right colon and caecum in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

* The reason why they are managed as one unit | * Principle

The reason why they are managed as one unit in Management of Gangrenous Right colon and caecum in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

both having the Same blood supply

Principle of Management of Gangrenous Right colon and caecum in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Right hemicolectomy and ileo transverse anastomosis

Management of Gangrenous Left colon in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

1. Exteriorization resection 2. Wait for 3 months ( till improvement of general condition) 3. Colonic preparation and secondary anastomosis

Principle of Exteriorization resection in Management of Gangrenous Left colon in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

1. The gangrenous part is excised. 2. The proximal segment is exteriorized as colostomy. 3. The distal segment is closed (Hartman's pouch) or sutured to the skin (mucus fistula).

Colonic preparation in Management of Gangrenous Left colon in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

2 days Preparation : to dec bacterial load and stools by 1. Castor oil to induce diarrhea 2. Enema

the reason why it's secondary anastomosis in Management of Gangrenous Left colon in Management of Gangrenous loop in Dealing with the contents according to viability in Operative management in TREATMENT of Strangulation in Common Complications of Hernia

Secondary anastomosis as it's after a month has passed

Rare Complications of Hernia

1. Inflammation 2. Rupture 3. Hydrocele of the hernial Sac

Inflammation in Rare Complications of Hernia

Contents as inflamed appendix or Meckel's diverticulum.

Rupture in Rare Complications of Hernia

Common in patients with CLD & ascitis.

Hydrocele of the hernial Sac in Rare Complications of Hernia

1. Predisposing factor 2. ETIOLOGY 3. CLINICAL PICTURE 4. TREATMENT

Predisposing factor of Hydrocele of the hernial Sac in Rare Complications of Hernia

Use of Truss

ETIOLOGY of Hydrocele of the hernial Sac in Rare Complications of Hernia

Due to fluid accumulation in an empty hernial sac which has been shut off from the peritoneal cavity by omentum or by adhesions

CLINICAL PICTURE of Hydrocele of the hernial Sac in Rare Complications of Hernia

1. Symptoms | 2. Examination

Symptoms in CLINICAL PICTURE of Hydrocele of the hernial Sac in Rare Complications of Hernia

1. There is history of a hernia. | 2. Later, there is an irreducible pyriform swelling in the upper part of the cord.

Examination in CLINICAL PICTURE of Hydrocele of the hernial Sac in Rare Complications of Hernia

Swelling with the following characters 1. Consistency 2. Special characters

Consistency of swelling in Examination in CLINICAL PICTURE of Hydrocele of the hernial Sac in Rare Complications of Hernia

The swelling is cystic

Special characters of the swelling in Examination in CLINICAL PICTURE of Hydrocele of the hernial Sac in Rare Complications of Hernia

1. Translucency | 2. Mobility

Translucency of swelling in Special characters of the swelling in Examination in CLINICAL PICTURE of Hydrocele of the hernial Sac in Rare Complications of Hernia

The swelling is translucent

Mobility of swelling in Special characters of the swelling in Examination in CLINICAL PICTURE of Hydrocele of the hernial Sac in Rare Complications of Hernia

1. The swelling is mobile from side to side but not from above downwards. 2. Gentle traction on the testis does not alter the mobility of the swelling.

Treatment of Hydrocele of the hernial Sac in Rare Complications of Hernia

Like that of the hernia

13. Complications of Hernia Flashcards

(135 cards)