Flashcards in 7. Recurrent inguinal Hernia and Sliding hernia Deck (15)
INCIDENCE of Recurrent inguinal Hernia
ETIOLOGY of Recurrent inguinal Hernia
* Operative Causes
* Postoperative Causes
Operative Causes in ETIOLOGY of Recurrent inguinal Hernia
1. Leaving part of the original sac i.e failure to ligate the sac at its proper neck.
2. Missing a second sac at operation e.g. (pantaloon hernia)
3. Failure to do the proper repair which suits the patient's condition
4. Use of absorbable sutures.
5. Repair under tension
Postoperative Causes in ETIOLOGY of Recurrent inguinal Hernia
1. Postoperative hematoma or infection
2. Rapid return to hard work or job.
3. Persistence of the predisposing factors.
Most important Postoperative Cause in ETIOLOGY of Recurrent inguinal Hernia
Postoperative hematoma or infection
TREATMENT of Recurrent inguinal Hernia
1. Correction of any predisposing factors.
2. Operation : Hernioplasty.
3. Truss (el7ezam) may be used to provide support for 3 month after hernioplasty
* The commonest sliding organs
* Clinical picture
Definition of Sliding Hernia
This is a hernia where a viscous forms a part of the wall of the sac and not part of the contents.
The commonest sliding organs of Sliding Hernia
The commonest sliding organs are bladder, caecum, and sigmoid colon
Incidence of Sliding Hernia
1- Long standing hernia
2- Old males.
CLINICAL PICTURE of Sliding Hernia
1. History of long standing hernia
2. Hernia is usually complete ( scrotal ) oblique inguinal hernia or direct inguinal hernia in an old male.
3. Incomplete reduction of the hernia ( partially reducible )
4- urinary symptoms if sliding organ is the bladder
The reason why hernia is partially reducible in CLINICAL PICTURE of Sliding Hernia
as Bladder forms part of the posterior wall
urinary symptoms in CLINICAL PICTURE of Sliding Hernia
* Pressing the hernia causes a desire to micturate.
* Reduction of the hernia size after micturition.
* Double micturition
Treatment of Sliding Hernia
*The sac is removed just distal to the sliding organ.
* Reduce the sliding organ to abdomen.
* Followed by hernioplasty.