Peresented by amirhosein kalantar hernia Peresented by amirhosein kalantar

Definition Reducible Non-reducible ( incarcerated) Strangulated Internal External Interparietal

Location Umbilicus Lumbar triangles Linea alba (epigastric) Surgical incisions Semi-lunar line Diaphragm Pelvis

Umbilical Hernia Women> men(3/1) Incidence:10% more common in African American children Risk factors Obesity Pregnancy abdominal distension ascites

Richter’s hernia incarceration of a portion of the wall of the small bowel in a hernia.

Lumbar Hernia Congenital, spontaneous or traumatic Grynfeltt’s triangle 12th rib, internal oblique and sacrospinalis muscle Covered by latissimus dorsi Petit’s triangle Latissimus dorsi, external oblique and iliac crest Covered by superficial fascia

Lumbar Hernia Develops at Petit’s Triangle Between abdominal and back muscles Fascia in this region is thin

Littre’s hernia hernia containing a Meckel’s diverticulum.

Epigastric hernia In midline Between xiphoid and umbilicus Incidence 3-5% Men> women(3/1) 12% multiple Etiology: multiple factors: congenitally weakened linea alba from a lack of decussating midline fibers increase in intra-abdominal pressure surrounding muscle weakness chronic abdominal wall strain

Spigelian Hernia occurs along the semilunar line Rare Ultrasound examination&ct scan operative repair is mandatory once the hernia is confirmed on diagnosis

Pelvic Hernia Obturator hernia Sciatic hernia Perineal hernia Most commonly in women Howship-Romberg sign Sciatic hernia Perineal hernia

Obteratour hernia …… Very rare Seen in elderly, emaciated patients Develops in obturator fossa Not visible or palpable on outside Can strangulate, cause bowel obstruction ……

Incisional Hernia Risk factors Laparoscopic . open repair Gold standard

Parastomal Hernia Variant of incisional hernia Paracolostomy > paraileostomy Low rate if through rectus muscle Laparoscopic repair

Hiatal hernia

Thank you Refrence: schwartzs principles of surgery Uptodate:Overview of abdominal wall hernias(Author:david C brooks, MD) Clinical Correlation: Abdominal Wall Hernias(Richard E. Burney, MD,Professor of Surgery) Thank you