Hernia

Question 1

What are the different types of abdominal hernia?

Which is the most common?

Answer 1

1. Inguinal hernia (MOST COMMON)
2. Femoral hernia
3. Umbilical hernia
4. Incisional hernia (after an abdominal surgery)
5. Hiatal hernia

Question 2

What are the risk factors of herniation?

Answer 2

1. Smoking
2. Obesity
3. Poor nutrition
4. Lifting heavy objects
5. Constipation or diarrhoea
6. Persistent sneezing or coughing

Question 3

What are the possible complications of herniation?

Answer 3

The protruding organ may become strangulated, resulting in tissue necrosis and infection.

Question 4

What are the 2 types of surgical treatment for abdominal herniation?

Answer 4

Herniorrhaphy - repair of the hernial defect

Herniotomy - ligation and excision of the sac

Question 5

What type of hernia involves the inner groin, and which type involves the outer groin?

Answer 5

Inner groin - Inguinal hernia

Outer groin - Femoral hernia

Question 6

What are the 3 types of hiatus hernia? Describe.

Answer 6

1. Sliding hiatus hernia: when the gastro-oesophageal junction slides up into the chest.
2. Rolling hiatus hernia: when a bulge of the stomach herniates into the chest cavity, but the gastro-oesophageal junction remains in the abdomen.
3. Mixed hiatus hernia

Question 7

Which is more common - sliding hiatus hernia or rolling hiatus hernia?

Answer 7

Sliding

Question 8

What are the signs and symptoms of sliding vs rolling hiatus hernia?

Answer 8

Sliding hiatus hernia: the lower oesophageal sphincter is less competent, as it is no longer in line with the diaphragm. Hence, acid reflux is common.

Rolling hiatus hernia: the gastro-oesophageal junction remains between the diaphragm. Hence, gross acid reflux is uncommon.

Question 9

Who are the typical patients presenting with hiatus herniation?

Answer 9

Older (>50yo), obese women

Question 10

What is the best diagnostic test for hiatus herniation?

Answer 10

Barium swallow

Question 11

What is the management of hiatus hernia?

Answer 11

Lose weight. treat reflux symptoms