Hernias - PowerPoint PPT Presentation

Loading...

PPT – Hernias PowerPoint presentation | free to download - id: 40a545-NTE3M



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Hernias

Description:

Inguinal hernia True incidence of ... post operative venteral hernia Spigelian hernia Hiatal hernia Lumbar hernias Perineal hernias ... – PowerPoint PPT presentation

Number of Views:686
Avg rating:3.0/5.0
Slides: 56
Provided by: ruthiego
Learn more at: http://www.niv-zmora.com
Category:
Tags: hernia | hernias | hiatal

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Hernias


1
Hernias
  • Dr. Gold-Deutch Ruthie

2
  • H e r n i a -
  • Protrusion of abdominal viscera outside the
    abdominal cavity through a
  • natural or acquired defect (not include
    internal hernias).

3
(No Transcript)
4
(No Transcript)
5
(No Transcript)
6
(No Transcript)
7
(No Transcript)
8
(No Transcript)
9
(No Transcript)
10
  • Inguinal hernia
  • True incidence of inguinal hernia is not
    known.
  • overall incidence in adults 10-15
  • male / female ratio 12
    1
  • 25 40 years old 5
    8
  • over 75 years old gt 45
  • Children
    10- 20 per 1000 live births
  • High incidence in premature infants
  • male / female ratio 4 1
  • Almost all are indirect hernias
  • Direct hernias lt 1

11
  • Etiology
  • Presence of a preformed sac -
  • Patent processus vaginalis prime cause of
  • indirect hernia in infants and children
  • Repeated elevations in intra-abdominal
    pressure -
  • COPD- coughs
  • BPH
  • Constipation / colonic obstruction
  • Strains
  • Pregnancy
  • Ascites
  • Peritoneal dialysis
  • Ventriculo-peritoneal shunt

12
  • Etiology (cont)
  • High intra-abdominal pressure? Weak areas
    -Ttransversalis fascia

  • Internal
    inguinal ring


  • ?

  • Direct
    hernia
  • Weakening of the body muscles and the tissues
    with time -
  • lack of physical exercise, adiposity,
    multiple pregnancies,
  • loss of weight as may occur after illness
    or operation.
  • Multifactorial
  • Abnormalities in the structure of collagen
    - (recurrent
  • hernias, familial tendency)

13
  • Clinical manifestations
  • Present at birth or appear afterward
  • In adults more insidious
  • (rapid onset acute
    indirect hernia following an unusual
  • exertion)
  • Discomfort in the groin, small bulge crease
    when intra-peritoneal
  • pressure raises - reduces when patient lies
    down - Reducible hernia
  • Patient learns to reduce it manually
  • Early stages pain
  • Later - unaesthetic bulge of the groin and
    scrotum interferes daily
  • activities and causes a heavy dragging
    sensation
  • Adhesions between the sac and content -
    Irreducible hernia
  • Incarcerated hernia
  • Strangulated hernia

14
(No Transcript)
15
(No Transcript)
16
  • Examination
  • Bulge that increases in size with coughing
    and can be reduced in supine
  • position (gurgling sound)
  • Small hernias when the patient stands, a
    cough impulse can be felt at
  • the tip of the finger, introducing it into
    the inguinal canal through the
  • external ring by invaginating the scrotum.
  • Differentiation between indirect and direct
    hernias is of academic interest only
  • The true nature of the hernia is revealed at
    operation and is handled
  • accordingly.
  • Incarcerated / strangulated - tense, swollen,
    tender, red, edematous, inflamed

17
  • Indications for operation
  • Risk of hernia operation is negligible,
    recurrence rate is small that there is hardly any
    reason not to operate all hernias as soon as they
    are diagnosed.
  • Elderly patient should be operated on
    electively because of the associated medical
    problems, rather than citing these problems as
    causes for not operating.
  • Bassini repair
  • Shouldice repair
  • Lichtensteins (tension free) repair
    polypropylene mesh
  • Mcvay (coopers ligament) repair
  • Laparoscopic repair TEPA - Totally
    Extra-Peritoneal Approach
  • TAPP
    - Trans-Abdominal Pre-Peritoneal repair

18
(No Transcript)
19
(No Transcript)
20
(No Transcript)
21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
  • Complications - Systemic complications urinary
    retention
  • Local
    complications wound - hematoma, seroma,
    infection

  • scrotum and cord swelling,
    hematoma


  • Ischemic orchitis


  • Testicular atrophy


  • cut vas deferens


  • Ilioinguinal neuritis


  • Open
    herniorrhaphy - Ilioinguinal n.
    Iliohypogastric n.
  • Laparoscopic
    repair - Lateral femoral cutaneus n.
  • (Meralgia
    Paresthetica - pain and paresthesias in
    anterolateral
  • thigh)
    genitofemoral n.
  • Recurrence
    indirect hernia - 1 - 7

  • direct hernia - 4 - 10

  • recurrent hernia - 5 35

29
Kinds of hernias Inguinal
hernia Femoral hernia Umbilical
hernia Epigastric Supraumbilical hernia
POVH post operative venteral hernia
Spigelian hernia Hiatal hernia
Lumbar hernias Perineal hernias
Obturator hernia Paracolostomy para
stomal hernia Littres hernia
Maydles hernia Internal hernia
Richters hernia Sliding hernia
30
(No Transcript)
31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
(No Transcript)
36
(No Transcript)
37
(No Transcript)
38
(No Transcript)
39
(No Transcript)
40
(No Transcript)
41
(No Transcript)
42
Sliding Hernia
  • Sliding Hernia is defined as one in which a
    viscus makes up part of the wall of the hernial
    sac.

43
(No Transcript)
44
(No Transcript)
45
(No Transcript)
46
(No Transcript)
47
(No Transcript)
48
(No Transcript)
49
(No Transcript)
50
(No Transcript)
51
(No Transcript)
52
(No Transcript)
53
(No Transcript)
54
(No Transcript)
55
(No Transcript)
About PowerShow.com