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1

Complications of Hernia

* Common

* Rare

2

Common Complications of Hernia

1. Irreducibility

2- Obstruction

3. Strangulation

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Rare Complications of Hernia

1. Inflammation

2. Rupture

3. 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

or

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

1. Reduction of strangulated loop to the abdomen.

2. Reduction en bisac

3. 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

1. Vomiting.

2. Abdominal distension.

3. Abdominal colics.

4. 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

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CBC in Investigations of Obstruction in Common Complications of Hernia

Normal

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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.

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ABGs in Investigations of Obstruction in Common Complications of Hernia

Hypokalemic, hypochloremic metabolic alkalosis

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

due to severe emesis and loss of HCl

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

Multiple fluid levels & distended loops.