Abdominal Wall Hernias Flashcards
What are some risk factors for developing abdominal wall hernias?
- Obesity
- Ascites
- Increasing age
- Surgical wounds
Which hernias are more likely to be obstructed?
Femoral hernias
- *75% of abdominal wall hernias**. Around 95% of patients are male; men have around a 25% lifetime risk of developing this type of hernia.
- *Above and medial to pubic tubercle**
- *Strangulation is rare**
Inguinial hernia
Below and lateral to the pubic tubercle
More common in women, particularly multiparous ones
High risk of obstruction and strangulation
Surgical repairisrequired
Femoral hernia
Symmetrical bulge under the umbilicus
Umbilical hernia
Asymmetrical bulge - half the sac is covered by skin of the abdomen directly above or below the umbilicus
Paraumbilical
Lump in the midline between umbilicus and the xiphisternum
Most common in men aged 20-30 years
Epigastric hernia
May occur in up to 10% of abdominal operations
Incisional hernia
Also known as lateral ventral hernia
Rare and seen in older patients
A hernia through the spigelian fascia (the aponeurotic layer between the rectus abdominis muscle medially and the semilunar line laterally)
Spigelian hernia
A hernia which passes through the obturator foramen. More common in females and typical presents with bowel obstruction
Obturator hernia
A rare type of hernia where only the antimesenteric border of the bowel herniates through the fascial defect
Richter hernia
Indirect type of hernia resulting from a patent processus vaginalis
Occur in around 1% of term babies. More common in premature babies and boys
60% are right sided, 10% are bilaterally
Should be surgically repaired soon after diagnosis as at risk of incarceration
Congenital inguinal hernia
Symmetrical bulge under the umbilicus
More common in premature and Afro-Caribbean babies
The vast majority resolve without intervention before the age of 4-5 years
Complications are rare
Infantile umbilical hernia
