Umbilical hernia age group
Extreme ages
Herniorrhaphy
Closing the defect in the strong layer of the abdomen wall
Umbilical hernia surgery indication
If it still persist in children older than 4
Complicated hernia management
- need ergent operation
- resuscitation of the patient
- relieve the obstruction
- if not gangrenous reduce it back
- repair the defect
Elective hernia management
- pre operative Manage precipitating factors - operative treatment Herniotomy / herniorrhaphy / hernioplasty - post operative Avoid factors lead to recurrence
What are the differential diagnosis for inguinal hernia?
- encysted hydrocele of the cord
- spermatocele
- femoral hernia
- lipoma of the cord
- inguinal lymphadenopathy
- incompletely descended testicle
Which side is the most common for inguinal hernia ?
And why
Right side
Because of the later descent of the right testis
And delayed obliteration of the processus vaginalis
Hernioplasty
Synthetic material utilize in repairing the defect to add extra strength (mesh patch)
What’s the most common type of hernia
Inguinal hernia (80%)
The signs in strangulated hernia (5 point)
- absence of cough impulse
- change color of skin
- non reducible
- tense
- tender
What’s the most common groin hernia in men and women ?
Indirect inguinal hernia
What are the differential diagnosis for femoral hernia ?
- inguinal hernia
- saphena varix
- lipoma
- femoral aneurysm
- psoas abscess
- enlarged femoral lymph node
What’s the most common type of ventral hernia ?
Incisional hernia
Patient related risk factors for incisional hernia
- malnutrition / diabetes mellitus / corticosteroids
- increase intra-abdominal pressure ( ascites / chronic cough / urine obstruction)
Hernia repair complications
- hematoma
- infection
- seroma
- vascular injury
- nerve injury
- visceral injury (vas deferens/bowel/ urinary bladder)
Surgery related risk factors for incisional hernia
- wound infection
- closure of abdomen under tension
- type and location of incision (vertical midline more common)
