Hernias

Question 1

Inguinal Hernia

Classification, signs and symptoms

Answer 1

Indirect 60% direct 35%

Symptoms- groin lump or swelling, inability to reduce it, increase in size/ pain

Signs- lump in groin which may be irreducible if incarcerated
Medial to public tubercle
Cough impulse
Controllable with pressure to Inguinal ring

Question 2

Inguinal hernia

Investigations and treatment

Answer 2

Investigations: fbc, Crp, u&e’s, ABG, erect chest x-ray and abdominal x-Ray

Management: mesh repair, laparoscopic mesh repair, emergency surgery with bowel resection

Question 3

Inguinal Hernias

Complications

Answer 3

Incarceration- hernia stuck in weak part of abdominal wall causing obstruction in part of bowl, leading to nausea, vomiting and difficulty passing wind

Strangulation-cutting off blood supply to testes

Pressure on surrounding tissues

Question 4

Inguinal Hernia

Definition and Causes

Answer 4

Definition: abnormal protrusion of peritoneal sac through a weakness in abdominal wall in Inguinal region

Causes: congenital- contents pass through abdominal wall from persistent processus vagunalis

Acquired: increased intra abdominal pressure with weak transversus abdominalis