Flashcards in HERNIA ABDOMINAL WALL SPLEEN Deck (18)
A hydrocele result of
and what is presentation
patent processus vaginalis
and leads to an accumulation of serous fluid around the testicle.
This fluid filled structure can be differentiated from an inguinal hernia in that it is generally asymptomatic and transilluminates with a light on physical exam.
Another important distinction is that an examiner is able to get his / her fingers above a hydrocele on palpation of the scrotum and cord structures.
This is not possible with an inguinal hernia as the contents are a protrusion from the abdominal cavity.
symptomatic, nonparasitic cysts Tx
may be excised with splenic preservation,
symptomatic nonparasitic cysts may be unroofed
Both of these operations may be performed laparoscopically.
tumor that most commonly spreads to the spleen.
The most common primary tumor of the spleen is
'spleen is kind of stomal muscular tissue'
A Richter’s hernia
involves only the antimesenteric border of the intestine and strangulation is likely to occur
WITHOUT the presence of obstruction.
ITP autoantibodies source
The spleen is believed to be the source of these antibodies
at risk for injury with manipulation below the iliopubic tract during lap hernia
lateral femoral cutaneous nerves
Placing staples beyond the external iliac artery in this region will most likely injure either of these structures.
This will result in sensation deficits to the upper, lateral, and anterior thigh.
Lap that aids in the workup of hereditery spherocytosis
A NEGATIVE Coombs test can aid in diagnosis.
Femoral hernias are found here
under the inguinal ligament.
lateral aspect of the pubic tubercle. I
inguinal ligament anteriorly,
pectineal ligament posteriorly,
lacunar ligament medially,
femoral vein laterally
ITP patient require no treatment as long as:
platelet counts are greater than 50,000 /mm3
first line tx of ITP
glucocorticoids (prednisone 1 mg/kg)
If a patient fails to respond or is unable to tolerate prednison:
ITP response rate to splenectomy
75% to 85% long term response rate.
utility of platelet transfusion for ITP patient undergoing splenectomy and platelet count less than 20,000
Even in the face of marked thrombocytopenia, administration is indicated only for significant bleeding events
An alternative preoperative preparation for those patients whose platelet counts are less than 20,000 /mm3 is the administration of
IV immunoglobulin (1 g/kg for 2 days).
Transfusions that are required during splenectomy are ideally held until after arterial inflow to the spleen has been ligated
This practice prevents exposure of the administered platelets to antibody opsonization and clearance by the offending organ.
Bottom Line: Administration of platelets to patients with ITP undergoing splenectomy is indicated only for significant bleeding events.
Umbilical hernias require intervention in children if:
defect is greater than 2 cm
Umbilical hernias less than 2 cm in size will often close spontaneously without intervention.
The risk of incarceration of an umbilical hernia in children is very low and treatment should be delayed until after the age of 5.
percent kids born with Umbilical hernias and what ethnic group has highest risk
Higher incidence in African Americans
Occur in up to 20% of live births
indirect inguinal hernia is primarily caused by
a patent processus vaginalis
defect is result of the passage of the testis from its abdominal origin into the scrotum through the muscular layers of the abdominal wall.
processus is obliterated during the first few months of life.
Persistence of any or all of the processus vaginalis results in a spectrum of disorders ranging from a scrotal hydrocele to an indirect inguinal hernia.
can lead to a direct inguinal hernia
A weakness of the conjoint tendon
which forms the posterior wall of the inguinal canal