FK Unswagati semester IV

What is Hernia ?
Kind of Hernia :
Sites
Characters : Reponible, Irreponible, Incarcerated,
strangulated


Anatomy
Sign and Symptom
Causes
Examination
Predisposition
Differential Diagnosis
Treatment

Indirect inguinal hernia is associated with a
peritoneal sac that protrudes through the
internal ring into the inguinal canal and lies
anteromedial to the spermatic cord or round
ligament.
Direct inguinal hernias, protrusions through
Hesselbachs triangle as a result of weakness of
the posterior wall of the inguinal canal.
Femoral hernias occur when a segment of the
peritoneum protrudes through the femoral
ring.
Bulge at inguinal are or scrotal
Obvious when you stand upright, especially if
you cough or strain.
Disapear when lie down
Reponible
Irreponible
Incarcerated
Strangulated


Indirect and Direct inguinal hernia, the
primary abnormality is weakness of the
posterior wall of the inguinal canal, leading to
a bulge through Hesselbachs triangle.
Femoral hernia : also widening of the femoral
ring.

Increased Abdominal Pressure
The construction worker who attempts to lift a heavy
object
Chronic cough,
Constipation
Straining to urinate as a result of prostatic
hypertrophy.
Pregnancy
Supine and standing position
With or without Valsava manuver
Finding bulging : I,P,A
Finger tip into scrotal sac up into inguinal canal
: Tip or side

Reponible and Irreponible : Elective Surgery
Incarcerated and Strangulated : Emergency
Surgery

ER:
Fasting, decompression with NGT
Rehidration with urinary catheter
Laboratory and X ray Finding
Prepare for surgery
Most inguinal hernias in children are indirect,
Related to a persistent patent processes
vaginalis.
Rightsided hernias are twice as common as left
Silk glove sign
DD/: hydrocele, undescended testicle,
varicocele or even a testicular tumor
Treatment : herniotomi or high ligation