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    Ghisa Anindya - Hernia Abdominalis

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    1. Abdominal wall hernias occur when part of the intestine or surrounding tissue pushes through a weakness in the abdominal wall. 2. Hernias are commonly detected during physical exams but may also present with complications like pain, nausea or vomiting. 3. The most common hernias are inguinal hernias, followed by umbilical and incisional hernias. Hernias can become incarcerated or strangulated if the protruding tissue becomes trapped.

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    Ghisa Anindya - Hernia Abdominalis

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    1. Abdominal wall hernias occur when part of the intestine or surrounding tissue pushes through a weakness in the abdominal wall. 2. Hernias are commonly detected during physical exams but may also present with complications like pain, nausea or vomiting. 3. The most common hernias are inguinal hernias, followed by umbilical and incisional hernias. Hernias can become incarcerated or strangulated if the protruding tissue becomes trapped.

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    types of hernia abdominalis

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    1. Abdominal wall hernias occur when part of the intestine or surrounding tissue pushes through a weakness in the abdominal wall. 2. Hernias are commonly detected during physical exams but may also present with complications like pain, nausea or vomiting. 3. The most common hernias are inguinal hernias, followed by umbilical and incisional hernias. Hernias can become incarcerated or strangulated if the protruding tissue becomes trapped.

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    Download as pptx, pdf, or txt
    116 views19 pages

    Ghisa Anindya - Hernia Abdominalis

    Uploaded by

    Ghisa Anindya
    1. Abdominal wall hernias occur when part of the intestine or surrounding tissue pushes through a weakness in the abdominal wall. 2. Hernias are commonly detected during physical exams but may also present with complications like pain, nausea or vomiting. 3. The most common hernias are inguinal hernias, followed by umbilical and incisional hernias. Hernias can become incarcerated or strangulated if the protruding tissue becomes trapped.

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    Abdominal Wall Hernia

    Ghisa Anindya Widyatami


    20194010103
    Introduction
    Abdominal wall hernias are among the most common of all
    1. surgical problems.

    Hernias occur when part of the intestine or peritoneum pushes


    2.
    through a gap in the abdominal wall.

    The protruding pouch, called the hernia sac may contain part of
    3.
    the peritoneum, intestine or stomach, as well as belly fat.

    Hernias may be detected on routine physical examination, or


    4. patients with hernias may present because of a complication
    associated with the hernia.
    Symptoms
    Seen as bulges, pain, burning, pulling sensation, nausea and
    vomitting

    Causes and Risk Factors


    - Weak abdominal muscles and weak connective tissue
    - Being very overweight
    - Pregnant woman
    - Lifting heavy objects, coughing

    Prevalence
    The most common is inguinal hernias. The second most common
    types is umbilical and incisional hernia. The less common are
    Epigastric hernias, femoral hernias and diaphragmatic hernias
    Classification
    Based on Place
    Based on Clinical Manifestation

    • Reponible
    • Irreponible

    Based on causes

    • Congenital
    • Aquisita Based on Complication

    • Incarserated
    • Strangulated
    Hernia Femoralis
    • Common in females (ratio 2:1), common
    in multipara. Rare occurs before puberty,
    more common in right side.
    • Presents as a swelling in the groin below
    and lateral to the pubic tubercle
    • obstruction and strangulation occurs
    which is more common, presents with
    features of intestinal obstruction—
    painful, tender, inflamed, irreducible
    swelling without any impulse
    A femoral hernia follows the tract below the inguinal ligament through the
    femoral canal. Because femoral hernias protrude through such a small defined
    space, they frequently become incarcerated or strangulated
    Hernia Umbilicalis

    • Develops due to absence of umbilical


    fascia or incomplete closure of umbilical
    defect
    • It can be congenital or acquired
    • Congenital  few months after birth
    which presents as a swelling in the
    umbilical region which increase during
    crying
    • Treatment: Initially conservative (< 2cm)
    and indication for surgery after two years
    of age and >2 cm
    Hernia Paraumbilicalis (Supra / Infra – umbilicalis)

    • It occurs commonly in adults. It is a


    protrusion or herniation through linea
    alba, just above or below the umbilicus
    • The contents are usually omentum,
    small bowel, sometimes large bowel.
    • It has got tendency to go for adhesion,
    irreducibility and obstruction
    • Surgery is the treatment of choice
    Hernia Incisional
    Definition
    It is herniation through a weak abdominal scar of
    previous surgery
    Predisposing Factors
    • Vertical scar, midline scar, lower abdominal scar
    may injure the nerves of the abdominal muscles
    • Scar of emergency surgeries (peritonitis, acute
    abdomen)
    • Faulty technique of closure
    • Poor nutritional status of the patient
    • Presence of cough , hypoproteinaemia,
    malignancy, immunosuppression
    Hernia Epigastric
    (Fatty hernia of line alba)
    • Occurs through the linea alba
    anywhere between the xiphoid
    process and the umbilicus
    • Its usually as a protrusion of
    extraperitoneal fat.
    • The patients are often manual
    workers between 30 and 45 years
    of age.
    Hernia Inguinalis (Anatomical classification)

    1. Indirect Hernia

    It comes out through internal ring


    along with the cord lateral to the
    inferior epigastric artery
    2. Direct Hernia
    It occurs through the posterior wall
    of the inguinal canal through
    ‘Hesselbach’s triangle medial to the
    inferior epigastric artery
    Zieman’s test
    • The examiner places his index finger on the
    deep inguinal ring and middle finger on the
    superficial inguinal ring, ring finger over
    saphenous
    • Patient is asked to cough or to hold the nose
    and blow If the impulse is felt on
     index finger it is indirect hernia,
     middle finger its direct hernia,
     Ring finger femoral hernia
    Finger Test
    • Using the 2nd or 5th of finger
    • The examiner’s finger entering the
    inguinal canal, ask the patient to cough:
    • - hernia bulges can be felt in the side of
    finger: Hernia Inguinalis Direct
    • - hernia bulges can be felt on the tip of
    finger: Hernia Inguinalis Indirect
    Thumb Test
    - Pressing the anulus
    internus with thumb’s
    examiner
    - Ask the patient to cough:
    bulges can be feel on
    hernia inguinalis
    medialis
    Hernia Complication
    1. Irreponible (Irreducible)
    If contents cannot be returned but there is no other complication
    2. Incarcerated
    An irreducible hernia which the intestinal flow is completely
    obstructed
    3. Strangulated
    An irreducible hernia which the blood and intestinal flow are
    completely obstructed. Occurs when the loop of intestine in the
    sac becomes twisted and constriction (ischemia)  emergency
    surgery
    Strangulata-ischemia

    Inkarserata
    Sources
    Goethal, Andrea, Curtis Adams. 2018. Femoral Hernia.
    Available from:
    https://www.ncbi.nlm.nih.gov/books/NBK535449/
    Institute for Quality and Efficiency in Health Care. 2016.
    Hernia: Overview. Available from:
    https://www.ncbi.nlm.nih.gov/books/NBK395554/
    Pearson, Robert. 2018. Hernia Explained. Available from:
    https://geekymedics.com/hernias-explained/
    Rather, Assa, et cal. 2019. Abdominal Hernias. Available
    from: https://emedicine.medscape.com/article/189563-
    overview#a4
    Thank You

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