2. A hernia is a protrusion of
a viscus (Plural - viscera) or
part of a viscus through an
abnormal opening in the
walls of its containing
cavity.
an abnormal weakness or
hole in an anatomical
structure which allows
something inside to
protrude through.
3. Hernias by themselves usually are harmless, but
nearly all have a potential risk of having their
blood supply cut off (becoming strangulated).
If the blood supply is cut off at the hernia
opening in the abdominal wall, it becomes a
medical and surgical emergency.
4. Any condition that increases the pressure of the
abdominal cavity may contribute to the formation
or worsening of a hernia.
Obesity
Heavy lifting
Coughing
Straining during a bowel movement or urination
Chronic lung disease
Fluid in the abdominal cavity
Poor nutrition
Ehlers-danlos and Marfan syndrome
Congenital
5. A hernia consists of 3 parts
The sac
Mouth
Neck
Body and Fundus
The covering of the sac
Contents of the sac
Omentum – omentocele
Intestine – enterocele
Fluid – ascites
Sometimes part of bladder or ovary
6. Reducible – contents can be returned to
abdomen
Irreducible – contents cannot be returned but
there are no other complications
Obstructed – bowel in the hernia has good
blood supply but bowel is obstructed
Strangulated – blood supply of bowel is
obstructed
Inflamed – contents of sac have become
inflamed
7. Most common (75 %)
Inguinal
Femoral
Umbilical
Incisional
Others (Rare – 1.5 %)
Spigelian
Hiatus (Diaphragmatic)
Obturator
Epigastric, Etc..
8. More common in men than women.
Two types of inguinal hernias: indirect inguinal
hernia and direct inguinal hernia.
Indirect inguinal hernia
In congenital form hernia follows pathway (processus
vaginalis) that testicles made during prebirth development.
This pathway normally closes before birth but remains a
possible place for a hernia.
Sometimes the hernial sac may protrude into the
scrotum.
Can occur at any age mainly at old age.
9. Direct inguinal hernia
This occurs slightly to the inside
of the sight of the indirect
hernia, in a place where the
abdominal wall is naturally
slightly thinner.
It rarely will protrude into the
scrotum.
The direct hernia almost always
occurs in the middle-aged and
elderly because their abdominal
walls weaken as they age.
10. The femoral canal is the way that
the femoral artery, vein, and
nerve leave the abdominal cavity
to enter the thigh.
Although normally a tight space,
sometimes it becomes large
enough to allow abdominal
contents (usually intestine) into
the canal.
This hernia causes a bulge below
the inguinal crease in roughly the
middle of the thigh.
Has risk of becoming irreducible
and strangulated.
11.
12. A hernia is present at the site of
the umbilicus (commonly called
a navel, or belly button) in the
newborn
Although sometimes quite large,
these hernias tend to resolve
without any treatment by
around the age of 2-3 years
Obstruction and strangulation of the hernia is rare
because the underlying defect in the abdominal
wall is larger than in inguinal hernia
They most often appear later in elderly people
and middle-aged women who have had
children.
13. Abdominal surgery
causes a flaw in the
abdominal wall that
must heal on its own.
This flaw can create an
area of weakness where
a hernia may develop.
This occurs after 2-10% of all abdominal surgeries,
although some people are more at risk.
After surgical repair, these hernias have a high rate
of returning (20-45%).
14. A hiatus hernia occurs when
the upper part of the stomach,
which is joined to the
oesophagus (gullet), moves up
into the chest through the
hiatus in the diaphragm.
It is common and occurs in about 10
per cent of people.
It is most common in overweight
middle-aged women and elderly
people and can also occur during
pregnancy.
15. Epigastric hernia
Occurring between the navel and the
lower part of the rib cage in the
midline of the abdomen, these
hernias are composed usually of fatty
tissue and rarely contain intestine.
Richter's hernia:
Hernia involving only one sidewall of
the bowel, which can result in bowel
strangulation leading to perforation
through ischemia without
causing bowel obstruction or any of
its warning signs.
16. Spigelian hernia
Occurs along the edge of the rectus
abdominus muscle, which is several
inches to the side of the middle of
the abdomen.
Obturator hernia
Rare; happens mostly in women.
This hernia protrudes from the pelvic
cavity through an opening in your
pelvic bone (obturator foramen).
wont show any bulge but can act like
a bowel obstruction and cause
nausea and vomiting
17. In irreducible hernia - advisable to
repair, in order to prevent
complications as organ
dysfunction, gangrene and multipl
e organ dysfunction syndrome.
Laparoscopy is preferred
Uncomplicated hernias are
principally repaired by pushing
back, or "reducing", the herniated
tissue, and then mending the
weakness in muscle tissue (an
operation called herniorrhaphy).
