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