1. HERNIA DR.AHMED KENSARAH

2. HERNIAS Definition Classification Etiology Composition of a hernia

3. 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

4. Composition of a hernia A hernia consist of three parts The sac The covering of the sac The contents of the sac

5. The sac of the hernia Is a diverticulum of peritoneum consist of: Neck Body Fundus

6. Covering of the sac Are derived from the layers of the abdominal wall through which the sac passes

7. 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

8. 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

9. Classificaions Congenital OR Aquired External OR Internal According to the anatomical site Irrespective of the site

10. According to the anatomical site Inguinal Femoral Umbilical Epigastric Rare :Interparietal, Spigelian, Lumbar, Perineal, Obturator, Gluteal and sciatic Hernias

11. Irrespective of site 1. Reducible 2. Irreducible 3. Obstructed 4. Strangulated 5. Inflamed

12. Inguinal Hernia Types Indirect [Oblique] Inguinal Hernia Direct Inguinal Hernia

13. Complications of the hernias Acute Chronic

14. Acute complications Obstruction Strangulation

15. Chronic complication Incarceration

16. Diagnosis History Increase intra-abdominal pressure Clinical Examination

17. Diffrential diagnosis Between inguinal – femoral Anurysm Lipoma Saphena varix

18. Investigations The causes

19. Treatment Medical – Indication Surgical - Indication