Examination of Hernia

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Presentation transcript:

Examination of Hernia

Hernia – protrusion of a viscous or part of viscous through an abnormal opening in the walls of its containing activity. What is hernia? WHY HERNIA OCCUR? PREDISPOSING FACTORS ??? Straining Coughing Obesity Smoking Abdominal distension Causes

Anatomical weaknessAcquired weakness Structures passing through the abdominal wall Muscle fail to develop Scar tissue Trauma High intra-abdominal pressure Coughing Straining Abdominal distension Causes of abdominal Herniae

Various types of Herniae?(common) Other rare herniae InguinalUmblicalIncisional FemoralEpigastric SpigelianObturator LumbarGluteal

Relation to the surrounding structures 1.Anterior wall Medially-external obliqueaponeurosis Lateral- internal oblique muscle 2.Posterior wall Medially – strong conjoint tendon Lateral- fascia transversalis 3.Floor Medial- Lacunar ligament Lateral- inguinal ligament 4.Roof Arching of fibers of into oblique and transverse muscles.

Indirect inguinal herniaDirect inguinal hernia Any age but common in youngElderly Via deep inguinal ring and long the inguinal canal Via transversalis fascia (hasselbach’s triangle) Patent or reopen processes vaginalisWeak abdominal wall/muscle Unilateral in 2/3 case (right side more common) Bilateral in > ½ case Enter scrotum (complete)Does not enter scrotum (incomplete) Reduced by patient/doctor (manually)Reduced on lying down (automatically) Narrow neck- more liable to strangulateBroad neck Zieman technique- impulse on index fingerImpulse on middle finger Deep ring occlusion test- controlBulge out Little finger invagination test- impulse on finger tip Impulse on pulp Differences between direct and indirect inguinal hernia

Dr. Sanjay Kolte MBBS - OCTOBER 1995-BHARATI VIDYAPEETH'S MEDICAL COLLEGE, PUNE, INDIA FCPS (General Surgery) - SEPTEMBER 2000, MUMBAI, INDIA (FELLOW OF COLLEGE OF PHYSICIANS AND SURGEONS) DNB (General Surgery) - MAY 2001-KING EDWARD MEMORIAL HOSPITAL, PUNE, INDIA (DIPLOMATE OF NATIONAL BOARD, NEW DELHI) MNAMS - MEMBER OF NATIONAL ACADEMY OF MEDICAL SCIENCES, NEW DELHI Contact Details: Laparoscopic Surgery Clinic, Parihar Chowk, Aundh, Pune, M maharashtra Mobile :