ROJoson PEP Talk: Abdominal Hernias - Overview

1. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL
HERNIAS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management of
ABDOMINAL
HERNIAS
June 4, 2022
1400H - 1500H
Via Zoom

2. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL
HERNIAS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management of
ABDOMINAL
HERNIAS
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

3. There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

4. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.

5. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL
HERNIAS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management of
ABDOMINAL
HERNIAS
My PEP TALK today
is entitled:
Fundamentals and
Generalities in
Medical
Management of
ABDOMINAL
HERNIAS. This is
part of the Health
Disorder Course.

6. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
Contents of PEP TALK on ABDOMINAL HERNIAS
• What are ABDOMINAL HERNIAS?
• What are the different types of ABDOMINAL HERNIAS?
• What are the causes of ABDOMINAL HERNIAS?
• Are there preventive measures against ABDOMINAL
HERNIAS?
• How common are the ABDOMINAL HERNIAS?
• Clinical diagnosis of ABDOMINAL HERNIAS
• Paraclinical diagnostic procedures for ABDOMINAL
HERNIAS
• Basic treatment modalities for ABDOMINAL HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
• Myths and facts on INGUINAL HERNIAS

7. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
Definition of Terms in Title AND Delimitation of
Coverage of Talk:
Fundamentals – simplest and essential facts and
theories which can serve as a basis or foundation
and support for advanced information
Generalities – general statements of info, not
covering specifics and details
Medical Management – diagnosis and treatment
by physicians

8. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are ABDOMINAL HERNIAS?

9. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are ABDOMINAL HERNIAS?
Abdominal hernias consist of a defect, a hole or
weakness in the abdominal wall or a peritoneal or
mesenteric aperture or opening inside the
abdominal cavity that allows abdominal tissues or
organs like the small intestines to bulge through
or be trapped inside the aperture.

10. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?

11. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?
There are two general ways of classifying types of
abdominal hernias based on location.
1.External and internal abdominal hernias
2.Hernias indicated by specific location

12. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?
There are also two general ways of classifying
types of abdominal hernias based on cause.
1. Congenital and acquired hernias
2. Incisional and non-incisional hernias

13. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?
External and internal abdominal hernias

14. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?
External abdominal hernias are those in which
abdominal organs or tissues leave their normal
anatomic site and protrude towards the skin of
abdomen because of a congenital or acquired
defect, hole or weakness in the abdominal wall.

15. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?
Internal abdominal hernias are those in which
abdominal organs or tissues protrude through a
peritoneal or mesenteric opening inside the
abdominal cavity or through a defect in the inner
wall of the abdominal cavity such as in the
diaphragm and pelvic wall.

16. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?
Hernias indicated by specific location
Inguinal
hernias
Femoral
hernias
Umbilical
hernias
Epigastric
hernias
Spigelian
hernias
Incisional
hernias
Diaphragmatic
hernias
Hiatal hernias
Obturator
hernias
Mesenteric
hernias
Adhesion-
associated
hernias

17. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?
Congenital and acquired hernias
Congenital hernias are those hernias present at
birth. The defect, hole, or defect causing the
hernia is present at birth.
Acquired hernias are those hernias developing
after birth and whose weakness in the wall or
presence other defects causing the hernias are
due to causative factors occurring after birth.

18. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the different types of ABDOMINAL
HERNIAS?
Incisional and non-incisional hernias
An incisional hernia is a protrusion of tissue that
forms at the site of a healing or healed surgical
scar. It is due to a weakened abdominal wall
associated with the surgical incision. An incisional
hernia implies that a prior operation was done.
In non-incisional hernias, there is no history of
operation done in the areas of the hernias.

19. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the causes of ABDOMINAL HERNIAS?

20. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the causes of ABDOMINAL HERNIAS?
There is a defect, a hole or weakness that allows
internal organs or tissues to protrude or be
inserted into causing a hernia.
The defect, the hole or weakness can be present
at birth (congenital) or developing after birth
(acquired).

21. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• What are the causes of ABDOMINAL HERNIAS?
Among the acquired hernias, prior operation
producing weakness of the abdominal wall and
adhesion-associated hernia is a cause.
Other causes include aging, repeated straining,
weight lifting and some rare medical diseases that
cause weakness of the abdominal wall due to
abnormal systemic collagen synthesis (such as
Marfans Syndrome and Ehlers-Danlos).

22. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Are there preventive measures against
abdominal hernias?

23. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Are there preventive measures against
abdominal hernias?
For the congenital hernias, there are currently NO
preventive measures.
For the acquired hernias, except for age and
medical diseases that cause abdominal weakness,
there are preventive measures.
• Proper operative technique of operative
wound closure can prevent incisional hernias.
• Avoiding repeated straining and strenuous
weight lifting can also prevent hernias to a
certain degree.

24. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• How common are the ABDOMINAL HERNIAS?

25. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• How common are the ABDOMINAL HERNIAS?
Some are common; some are rare.
Inguinal hernias are most common among the
non-incisional hernias.

26. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Clinical diagnosis of ABDOMINAL HERNIAS

27. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Clinical diagnosis of ABDOMINAL HERNIAS
For external abdominal hernias,
1st cue - an unusual bulge on the abdominal wall.
2nd cue -bulge becomes more prominent on
increased intra-abdominal pressure like standing
up; straining; and coughing and becomes less
prominent to the point of reducible when the
intra-abdominal pressure has decreased.
3rd cue -bulge can be reduced back into the
abdominal cavity.

28. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Clinical diagnosis of ABDOMINAL HERNIAS
For internal abdominal hernias, these will be not
evident on inspection and palpation of the
abdomen. They are often diagnosed through an
imaging procedure such ultrasound, CT-can, and
MRI or during an exploratory laparotomy
(opening of the abdomen) done because of
intestinal obstruction (the internal abdominal
hernias are subsequently discovered).

29. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Paraclinical diagnostic procedures for
ABDOMINAL HERNIAS

30. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Paraclinical diagnostic procedures for
ABDOMINAL HERNIAS
Common paraclinical diagnostic procedures are
the imaging procedures such as ultrasound, CT
scan and MRI.
These are done only when indicated.
Usually, for external abdominal hernias, there is
no need for paraclinical diagnostic procedures. If
unsure of diagnosis of hernia, then one is done.

31. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Basic treatment modalities for ABDOMINAL
HERNIAS

32. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Basic treatment modalities for ABDOMINAL
HERNIAS
The basic treatment modality is OPERATION or
SURGERY.
• To repair the hole, defect, or weakness causing
the hernia.
• To reduce the incarcerated organs.
• To resect any strangulated bowels.

33. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS

34. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS

35. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
Inguinal hernias are hernias at the groin.
These are the commonest types of abdominal
hernias.
They are more common in the males than in
females.

36. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
There are 2 types inguinal hernias: indirect and
direct hernias. There can be a combination of the
two.

37. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
The inguinal hernias are commonly congenital,
particularly the indirect ones.
The direct hernias are usually acquired, in older
people because of weakness due to age.

38. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
The inguinal hernias are recognized through a
bulge in the groin area and the bulge is reducible.
In those with complications such as incarceration
and strangulation, the bulge may not be reducible
and there will be skin discoloration (dark blue and
even black) if there is already strangulation of the
incarcerated small intestines.

39. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
Usually, inguinal hernias are diagnosed clinically
without need for paraclinical diagnostic
procedures.

40. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
Treatment is surgical with repair of the defect,
hole or weakness preventing an occurrence of a
hernia.
Reduction is done when there is incarceration.
Resection of strangulated small intestines is done
when there is already strangulation.

41. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
Dangers of INGUINAL HERNIAS when not treated
(operated on time):
Incarceration, obstruction and strangulation

42. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Myths and facts on INGUINAL HERNIAS

43. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Myths and facts on INGUINAL HERNIAS
Can an inguinal hernia be cured by a supporter?
No.
A hernia truss or belt is a supportive
undergarment for men designed to keep the
protruding tissue in place and relieve discomfort.
A hernia truss can help a patient with inguinal
hernia feel more comfortable temporarily, but it
doesn't treat the hernia.

44. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Myths and facts on INGUINAL HERNIAS
Can a groin hernia heal itself? Will it disappear
spontaneously?
No.
A groin hernia or any abdominal hernia cannot
heal on its own. If left untreated, the defect or
hole of the hernia usually gets bigger with time.
The presence of the defect or hole in a hernia is a
constant risk for incarceration and strangulation
of small intestines. A strangulated herniated
intestine is one in which the blood supply to the
intestines is cut-off as it is strangulated by the
hernia.

45. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
• Myths and facts on INGUINAL HERNIAS
Surgery is the only way to fix an inguinal hernia.
The surgeon will push the bulging tissue back
inside; close the hole or defect; and strengthen
the abdominal wall with stitches and perhaps
mesh.

46. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
Contents of PEP TALK on ABDOMINAL HERNIAS
• What are ABDOMINAL HERNIAS?
• What are the different types of ABDOMINAL HERNIAS?
• What are the causes of ABDOMINAL HERNIAS?
• Are there preventive measures against ABDOMINAL
HERNIAS?
• How common are the ABDOMINAL HERNIAS?
• Clinical diagnosis of ABDOMINAL HERNIAS
• Paraclinical diagnostic procedures for ABDOMINAL
HERNIAS
• Basic treatment modalities for ABDOMINAL HERNIAS
• Overview – GROIN or INGUINAL HERNIAS
• Myths and facts on INGUINAL HERNIAS
Summary
Take Away

47. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
HERNIAS
Take Away in
relation to
Patient
Empowerment
Be always in touch with reliable medical
information on fundamentals and
generalities in medical management of
ABDOMINAL HERNIAS.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of ABDOMINAL
HERNIAS.

48. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL
HERNIAS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management of
ABDOMINAL
HERNIAS