Inguinal hernia Flashcards
1
Q
What is the definition of an inguinal hernia?
A
Protrusion of abdominal organ through weak muscles of the abdominal wall into the inguinal canal
2
Q
How common are inguinal hernias?
A
Most common type of hernia – 70% of all hernias
3
Q
What is the pathology of inguinal hernias (including direct and indirect)?
A
- Intestine/fatty tissue goes into the inguinal canal
- Through the transversalis fascia, internal oblique, external oblique
- Indirect: Congenital defect in abdominal wall, lateral to inferior epigastric artery. Originates at the deep ring and goes through the superficial ring like the spermatic cord
- Direct: weakness in abdominal wall over time, medial to inferior epigastric artery. Only goes through the superficial inguinal ring
4
Q
What are the risk factors/aetiology of inguinal hernias?
A
- Males – bigger inguinal canal as more passes through it
- Hernia history
- Age – older = more risk
- Caucasian
- Weak abdominal wall
- Smoking
- Chronic cough
- Constipation
- Urinary obstruction
- Heavy lifting
- Previous abdominal surgery
- Obesity
5
Q
What are the signs/symptoms of inguinal hernias?
A
- Lump in groin (medial and superior to pubic tubercle) – maybe painful
- Enlarged scrotum – maybe painful
- Lump appears when lifting something/straining/coughing/exertion
- Lump disappears when you lie down
- Nausea/vomiting – obstruction
- Constipation
- Obesity
6
Q
What diseases can inguinal hernias present similarly to?
A
- Femoral hernia
- Hydrocele
- Undescended testes
7
Q
What investigations are undertaken for suspected inguinal hernias?
A
- US
- CT – with contrast and the Valsalva manoeuvre being done is best
- MRI – when uncertain of hernia
8
Q
What are the surgical treatments for inguinal hernias?
A
- Laparoscopic inguinal hernia surgery – only done if symptomatic
- Open laparoscopic inguinal hernia surgery – only done if symptomatic
9
Q
What are the pharmacological treatments for inguinal hernias?
A
- Painkillers
* Fluids
10
Q
What are the non pharmacological treatments for inguinal hernias?
A
- High fibre and water diet – to avoid constipation
- Weight loss advice
- Smoking cessation
- Truss hernia belt
