Hernias

Question 1

What are clinical features of inguinal hernias?

Answer 1

Groin lump
Pain or discomfort
Lump increases on standing or coughing- may reduce when lying down
Examination
- lump superomedial to pubic tubercle
- cough impulse present
- may descent into scrotum
- normally reducible

Question 2

How can you differentiate between direct and indirect inguinal hernia?

Answer 2

Reduce hernia and apply pressure to deep ring
- no reappearance= indirection
- reappearance= direct

Question 3

What are complications to inguinal hernias?

Answer 3

Incarceration
Strangulation- bowel iscehamia
Bowel obstruction

Question 4

What is the investigation and management of inguinal hernia?

Answer 4

Clinical diagnosis
US if uncertain

Offer surgical repair for symptomatic hernias

Question 5

What are risk factors for femoral hernias?

Answer 5

Female
Older age
Lower BMI

Question 6

What are clinical features of femoral hernias?

Answer 6

Small lump in upper medial thigh
Lump inferolateral to pubic tubercle
Often presents with complications such as strangulation

Question 7

What are hte investigations and management for femoral hernia?

Answer 7

Clinical diagnosis
US if uncertain

Urgent surgical mesh repair is recommended due to risk of complications