Search This Blog
It is all about surgery,surgerical equipments,diseases related to surgeries etc & many more...
posts
- Get link
- X
- Other Apps
various types of hernia
Hernias occur when a viscus or part of it protrudes from
within its normal anatomical cavity. Specific hernias are covered under their
designated titles the remainder are addressed here.
Spigelian
hernia
• Interparietal hernia occurring at the level of the arcuate
line
• Rare
• May lie beneath internal oblique muscle. Usually between
internal and external oblique
• Equal sex distribution
• Position is lateral to rectus abdominis
• Both open and laparoscopic repair are possible, the former
in cases of strangulation
Lumbar
hernia
The lumbar triangle (through which these may occur) is
bounded by:
Crest of ilium (inferiorly), External oblique (laterally),
Latissimus dorsi (medially)
Primary lumbar herniae are rare, most are incisional hernias
following renal surgery
Direct anatomical repair with or without mesh re-enforcement
is the procedure of choice
Obturator
hernia
• Herniation through the obturator canal
• Commoner in females
• Usually lies behind pectineus muscle
• Elective diagnosis is unusual most will present acutely
with obstruction
• When presenting acutely most cases with require laparotomy
or laparoscopy (and small bowel resection if
indicated)
Richters
hernia
• Condition in which part of the wall of the small bowel
(usually the anti mesenteric border) is strangulated within
a hernia (of any type)
• They do not present with typical features of intestinal
obstruction as lumenal patency is preserved
• Where vomiting is prominent it usually occurs as a result
of paralytic ileus from peritonitis (as these hernias may
perforate)
Incisional
hernia
• Occur through sites of surgical access into the abdominal
cavity
• Most common following surgical wound infection
• To minimise following midline laparotomy Jenkins Rule
should be followed and this necessitates a suture length
4x length of incision with bites taken at 1cm intervals, 1
cm from the wound edge
• Repair may be performed either at open surgery or
laparoscopically and a wide variety of techniques are
described
Bochdalek
hernia
• Typically congenital diaphragmatic hernia
• 85% cases are located in the left hemi diaphragm
• Associated with lung hypoplasia on the affected side
• More common in males
• Associated with other birth defects
• May contain stomach
• May be treated by direct anatomical apposition or
placement of mesh. In infants that have severe respiratory
compromise mechanical ventilation may be needed and
mortality rate is high
Morgagni
Hernia
• Rare type of diaphragmatic hernia (approx 2% cases)
• Herniation through foramen of Morgagni
• Usually located on the right and tend to be less
symptomatic
• More advanced cases may contain transverse colon
• As defects are small pulmonary hypoplasia is less common
• Direct anatomical repair is performed
Umbilical
hernia
• Hernia through weak umbilicus
• Usually presents in childhood
• Often symptomatic
• Equal sex incidence
• 95% will resolve by the age of 2 years
• Surgery performed after the third birthday
Paraumbilical
hernia
• Usually a condition of adulthood
• Defect is in the linea alba
• More common in females
• Multiparity and obesity are risk factors
• Traditionally repaired using Mayos technique - overlapping
repair, mesh may be used though not if small bowel
resection is required owing to acute strangulation
Comments
Post a Comment
if you have any doubt, please let me know...