Flashcards in Hernias Deck (59)
What is a hernia.
The protrusion of a viscus or part of a viscus through a defect of the wall of its containing cavity into an abnormal position.
What is an irreducible hernia.
Hernias involving the bowel are said to be irreducible if they cannot be pushed back into their right place.
What is an incarcerated hernia.
It implies that the contents of the hernial sac are stuck inside by adhesions.
What is an obstructed hernia.
GI hernias are obstructed if bowel contents cannot pass through them.
What set of signs and symptoms do you see with an obstructed GI hernia.
The classical features of intestinal obstruction.
What is a strangulated hernia.
A hernia is strangulated if the blood supply is cut off and ischaemia occurs.
What is the best course of action when presented with a strangulated hernia.
What are the typical hernias that can occur. (14)
What is the typical presentation of a femoral hernia. (2)
Bowel enters the femoral canal, presenting as a mass in the upper medial thigh or above the inguinal ligament (it points down the leg).
Who do femoral hernias occur most in. (2)
Especially middle aged and elderly.
What complication can occur with a femoral hernia. (2)
They can become strangulated.
They tend to be irreducible due to the rigidity of the canal borders.
What is the anatomy of a femoral hernia. (5)
The neck: it is felt inferior and lateral to the pubic tubercle.
The boundaries of the femoral canal are-
Anteriorly: the inguinal ligament.
Medially: the lacunar ligament (and pubic bone).
Laterally: femoral vein (and iliopsoas).
Posteriorly: the pectineal ligament and pectineus.
What is contained within the femoral canal. (2)
What is the differential diagnosis for a femoral hernia. (6)
Enlarged Cloquet's node.
Where do paraumbilical hernias occur.
Just above or below the umbilicus.
What are some risk factors for paraumbilical hernias. (2)
What is within a paraumbilical hernia. (2)
Omentum or bowel.
Where do epigastric hernias occur.
They pass through the lineal alba above the umbilicus.
Where do incisional hernias occur.
They follow breakdown of muscle closure after surgery (11-20%).
What complicates an incisional hernia repair.
What is associated with mesh repair of incisional hernias. (2)
Lower recurrence rate.
Increased infection rate over sutures.
Where do spigelian hernias occur.
They occur through the linea semilunaris at the lateral edge of the rectus sheath, below and lateral to the umbilicus.
Where do lumbar hernias occur.
They occur through the inferior or superior lumbar triangles in the posterior abdominal wall.
What is the characteristic of Richter's hernias.
They involve bowel wall only, not the whole lumen.
What do Maydl's hernias involve. (2)
They involve herniating 'double loop' of bowel.
The strangulated portion may reside as a single loop INSIDE the abdominal cavity.
What are Littre's hernias.
They are hernial sacs containing strangulated Meckel's diverticulum.
Where do obturator hernias occur.
They occur through the obturator canal.
What is a typical symptom of an obturator hernia in a thin woman.
Pain along the medial side of the thigh.
What is a sciatic hernia.
They pass through the lesser sciatic foramen.