4. Oblique (Indirect) inguinal hernia Flashcards Preview

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Flashcards in 4. Oblique (Indirect) inguinal hernia Deck (53)
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1

ETIOLOGY & TYPES of Oblique inguinal hernia

1 - Congenital hernia :

2- Infantile hernia (operative finding only)

3-Adult (acquired) oblique inguinal hernia

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Congenital hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

* Pathogenesis

* Clinical picture

* Age of presentation

3

Pathogenesis of Congenital hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

persistent patency of the whole processus vaginalis.

4

Clinical picture of Congenital hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

It reaches down the scrotum from the start.

The testis is inseparate from the hernial sac and its contents.

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Age of presentation of Congenital hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

Although congenital, it may appear in adult life

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Infantile hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

Pathogenesis

Its problem

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Pathogenesis of Infantile hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

Combined inguinal hernial sac + infantile hydrocele (2 sacs).

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problem of Infantile hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

At operation, the tunica is liable to be opened in mistake for the true sac.

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Adult (acquired) oblique inguinal hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

Pathogenesis

Types

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Pathogenesis of Adult (acquired) oblique inguinal hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

* Raised intra abdominal pressure

* Weak abdominal wall.

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Types of Adult (acquired) oblique inguinal hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

a) Bubonocele

b) Funicular

c) Complete (scrotal) hernia

12

Pathogenesis of Bubonocele Type of Adult (acquired) oblique inguinal hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

The hernial sac is limited to the inguinal canal and is seen as a bulge or swelling in the inguinal region and does not come out through the external ring.

13

Pathogenesis of Funicular Type of Adult (acquired) oblique inguinal hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

The hernia passes out through the external ring and starts to descend into the scrotum, reaching only its neck.

14

Pathogenesis of Complete (scrotal) hernia Type of Adult (acquired) oblique inguinal hernia in ETIOLOGY & TYPES of Oblique inguinal hernia

* The hernia descends to the bottom of the scrotum, as a continuation of funicular type.

* The testis is separate from the hernial sac and its contents

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Difference between Adult Scrotal hernia and Congenital hernia by

History

Examination

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History of Adult Scrotal hernia

The hernia descends to the bottom of the scrotum, as a continuation of funicular type.

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History of Congenital hernia

It reaches down the scrotum from the start.

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Examination of Adult Scrotal hernia

The testis is separate from the hernial sac and its contents

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Examination of Congenital hernia

The testis is inseparate from the hernial sac and its contents.

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PATHOLOGY of Oblique inguinal hernia

1. The defect :

2. The sac :

3. The contents :

4. The coverings :

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Pathogenesis of The defect in PATHOLOGY of Oblique inguinal hernia

Stretched deep inguinal ring.

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Pathogenesis of The sac in PATHOLOGY of Oblique inguinal hernia

Congenital sac

acquired sac

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in Pathogenesis of The sac in PATHOLOGY of Oblique inguinal hernia, Congenital sac present within

The spermatic cord contents

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in Pathogenesis of The sac in PATHOLOGY of Oblique inguinal hernia, acquired sac present within

The spermatic cord coverings antero-lateral to the vas and vessels.

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The contents in PATHOLOGY of Oblique inguinal hernia

Small intestine, omentum or both.

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The coverings in PATHOLOGY of Oblique inguinal hernia

a) In the inguinal region

b) In the scrotum

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The coverings of a hernia In the inguinal region in PATHOLOGY of Oblique inguinal hernia

Skin

superficial fascia

external oblique aponeurosis

cremasteric muscle and fascia

internal spermatic fascia

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The coverings of a hernia In the scrotum in PATHOLOGY of Oblique inguinal hernia

Skin,

Dartos muscle

Colles' fascia

The three cord coverings

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CLINICAL PICTURE of Oblique inguinal hernia

History

Examination

30

History in CLINICAL PICTURE of Oblique inguinal hernia

* Painless inguinal or inguinoscrotal swelling (unless complicated).

* Before appearance of the hernia, the patient may complain of stitching pain (Pre eruptive pain)