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1

Definition of hernia

A hernia is a protrusion of a viscous or part of a viscous usually within a peritoneal sac through a defect in the abdominal wall.

2

ETIOLOGY of hernia

1- Congenital (Preformed sac) :

2- Acquired:

3

Congenital ETIOLOGY of hernia

a. Unobliterated processus vaginalis )> oblique inguinal hernias.

b. Unobliterated physiological umbilical hernia of fetus (exomphalos).

4

Acquired ETIOLOGY of hernia

a. Raised intra-abdominal pressure due to any cause.

b. Weak anterior abdominal wall (old age, repeated pregnancy).

5

COMPONENTS of hernia

1- Sac

2- Contents

3- Coverings :

6

Sac in COMPONENTS of hernia

This is the peritoneal pouch which bulges out through the abdominal wall defect.

It has a neck, body, and fundus.

7

Contents in COMPONENTS of hernia

Accepted contents

Most common contents

Special contents

8

Accepted contents of hernia

Any abdominal viscus except the pancreas,

9

Most common contents of hernia

Intestine, omentum or both.

10

difference between intestine and omentum by

Consistency

Gurgling on reduction

Ease of reduction

Percussion

11

Consistency of intestine

Soft

12

Consistency of omentum

Doughy

13

Gurgling on reduction of intestine

occurs

14

Gurgling on reduction of omentum

NO

15

Ease of reduction of intestine

First part more difficult

16

Ease of reduction of omentum

Last part more difficult

17

Percussion of intestine

May be Resonant

18

Percussion of omentum

Dull

19

Special contents in COMPONENTS of hernia

a) Richter's hernia :

b) Littre's hernia :

c) Maydl's hernia :

20

Richter's hernia in Special contents in COMPONENTS of hernia

* The content is part of the circumference of an
intestinal loop (common in femoral hernia).

* due to very narrow neck

21

Littre's hernia in Special contents in COMPONENTS of hernia

The content is Mickle's diverticulum

22

Maydl's hernia in Special contents in COMPONENTS of hernia

It contains 2 loops of intestine while an intermediate in the abdominal cavity ( hernia in W shaped )

23

hernia in W shaped

Maydl's hernia

24

hernia contains 2 loops of intestine while an intermediate in the abdominal cavity

Maydl's hernia

25

hernia contains Mickle's diverticulum

Littre's hernia

26

hernia contains part of the circumference of an
intestinal loop

Richter's hernia

27

a hernia with a special content common in femoral hernia

Richter's hernia

28

Coverings in COMPONENTS of hernia

Structures stretched over the sac.