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Flashcards in Hernias Deck (21):
1

Hernia definition

protrusion of a viscus or part of a viscus through a defect of the walls of its containing cavity into an abnormal position

2

Irreducible

if a bowel hernia can't be pushed back into the right space

3

Incarcertaion

contents of the hernia sac are stuck inside by adhesions

4

Obstructed

if bowel contents cannot pass through them

5

strangulated

if ischamia occurs

6

whats the most common type of hernia?

inguinal

7

indirect inguinal hernias

pass through the internal (deep) inguinal ring, and, if large, out through the external (superficial) ring

8

direct inguinal hernias

push their way directly forward through the posterior wall of the inguinal canal, into a defect in the abd wall

9

predisposing conditions to an inguinal hernia

male, chronic cough, constipation, urinary obstruction, heavy lifting, ascites, past abd surgery

10

relations of the inguinal canal

floor: inguinal ligament
roof: fibres of transversalis, internal oblique
anterior: external oblique aponeurosis + internal oblique
posterior: laterally, transversals fascia. medially, conjoint tendon

11

gold standard for determining the type of inguinal hernia?

at surgery:
- (80%) direct hernias arise lateral to inferior epigastric vessels
- indirect hernias are medial

12

which hernias frequently strangulate and are frequently irreducible

femoral

13

femoral hernia

bowel enters the femoral canal, presenting as a mass in the upper medial thigh or above the inguinal ligament where it points down the leg

likely to be irreducible and to strangulate

14

RF for femoral hernia

female, elderly

15

boundaries of the femoral canal

anteriorly: inguinal ligament
medially: lacunar ligament (and pubic bone)
laterally: femoral vein
posteriorly: pectineal ligament + pectineus

16

treatment for femoral hernia

surgical repair

herniotomy - ligation + excision of the sac
herniorrhaphy - repair of hernial defect

17

incisional hernia

follow breakdown of muscle closure after surgery

repair isn't easy if obese

18

hiatus hernia

part of the stomach herniates through the oesophageal hiatus of the diaphram

19

whats a sliding hiatus hernia?
symptoms?

accounts for more than 95% of cases
GO junction slides through hiatus + lies above diaphragm

no symptoms unless associated reflux

20

other type of hiatus hernia aside from sliding?

**para-oesophageal hernia** dangerous!!

gastric funds rolls up through the hiatus alongside oesophagus, GO junction remaining below the diaphragm

21

hernia repair

mesh techniques
advise to diet and stop smoking pre-op