HERNIA
DR.AHMED KENSARAH
HERNIAS
Definition Classification
Etiology Composition of a hernia
Definition of a hernia
• A hernia is the protrusion of a viscus or part of a viscus through an abnormal opening in the walls of its containing cavity
Composition of a hernia
• A hernia consist of three parts The sac The covering of the sac The contents of the sac
The sac of the hernia
• Is a diverticulum of peritoneum consist of: Neck Body Fundus
Covering of the sac
• Are derived from the layers of the abdominal wall through which the sac passes
Contents of a hernia
• 1 Omentum 2 Intestine 3 A Portion of the circumference of the intestine 4 A portion of the bladder 5 Ovary 6 A Meckel”s diverticulum 7 Fluid
Aetiology
• Congenital eg:the remain of the processus vaginalis Aquird :any condition which raises intra-abdominal pressure eg: Whooping cough in childhood Chronic cough Straining on micturation Chronic constipation Intra-abdominal malignancy Stretching of the abdominal musculature
Classificaions
• Congenital OR Aquired External OR Internal According to the anatomical site Irrespective of the site
According to the anatomical site• Inguinal
Femoral Umbilical Epigastric Rare :Interparietal, Spigelian, Lumbar, Perineal, Obturator, Gluteal and sciatic Hernias
Irrespective of site
• 1. Reducible 2. Irreducible 3. Obstructed 4. Strangulated 5. Inflamed
Inguinal Hernia
• Types Indirect [Oblique] Inguinal Hernia Direct Inguinal Hernia
Complications of the hernias
• Acute Chronic
Acute complications
• Obstruction Strangulation
Chronic complication
• Incarceration
Diagnosis
• History Increase intra-abdominal pressure Clinical Examination
Diffrential diagnosis
• Between inguinal – femoral Anurysm Lipoma Saphena varix
Investigations
• The causes
Treatment
• Medical – Indication Surgical - Indication
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