Hernia overview Flashcards
(14 cards)
Define a hernia
Define an abdominal wall hernia
“An abnormal protrusion of a viscus or part of a viscus through a defect either:
In the containing wall of that viscus, or
W/in the cavity in which the viscus is normally contained
An abdominal hernia = The ‘wall’ refers to the anterior and posterior muscle layers of the abdomen, the diaphragm, and the walls of the pelvis.
What are the components of a hernia?
Can be a good way of summarising the principles
Sac (neck, body, fundus) – Peritoneum.
Hernial contents
Hernial defect/ orifice (fascial)
List three ways of classifying hernias
Congenital vs Acquired
Primary vs Secondary (trauma or surgery)
Location - Internal vs External Congenital vs Acquired
List seven types of internal hernias
Paraduodenal fossae
Paracaecal fossae
Epiploic foramen (into lesser sac)
Beneath congenital band adhesions
Defects in small bowel mesentery
B/w lateral abdominal wall muscles and stoma
Defects in the diaphragm (Bochdalek and Morgagni)
What is a Ricters hernia? What is the clinical risk with this type of hernia?
Only part of the circumference of the bowel (usu anti-mesenteric border) is trapped within the hernia sac ®
Significance is obstruction may not occur with incarceration.
Define a Maydls hernia
Hernial sac contains 2 x loops of intestine ® loop within the abdominal cavity becomes obstructed and strangulated
What is a sliding hernia?
Contents (which are retroperitoneal organs, e.g. colon/ bladder) form part of the wall of the sac and are susceptible to injury at operation
Define a Littre’s hernia
A hernia where a meckel’s diverticulum protrudes through the abdominal wall
What is an amyand’s hernia
Where the appendix is incarcerated in an inguinal hernia
What is a de garengeot hernia?
A femoral hernia containing the appendix
What is a femoral hernia containing the appendix called? What is an inguinal hernia containing the appendix called?
Femoral - de Garengeot
Inguinal - amyand
What two factors contribute to the development of hernias?
A weakness in the abdominal wall
Increased intraabdominal pressure
List three types of weakness in the abdominal wall, and give examples of each
Congenital – Incl. Patent processus vaginalis, parasternal diaphragmatic defect, patent umbilical ring in children.
Where a normal anatomical structure passes through the abdominal cavity – Incl. Oesophageal hiatus, umbilical ligament, obturator foramen, sciatic foramen
Acquired – Incl. incision site, stoma site, and muscle wasting with aging.
