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