Types of abdominal hernia inguinal hernia femoral hernia umbilical hernia incisional hernia epigastric hernia hiatus hernia causes,symptoms,diagnosis and treatement.

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Jabir Ibn Hayyan Medicine College
Medical University Second Stage
Dr. Hyder Al-Kefaey

2.  Hernia means : rupture in Latin
 It is medical condition in which an organ
protrudes through an opening in its
surrounding walls, especially in the abdominal
region.
 It consist of three parts: hernia sac, covering of
the sac, content of the sac
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3.  Hernial sac : it is a pouch of peritoneum emerges throw
hernia orifice and has the loop of bowel . hernia sac has
neck and body.
 Hernial contents: it consist of any structure found
within the abdominal cavity and emerges throw the sac,
for example
• Greater omentum
• Small or large intestine
• Urinary bladder
• Ovaries malignant nodules
 Hernial coverings : they are derived from the
layers of abdominal wall through which
the sac passes and surround the sac.
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4. Types of herniaTypes of hernia
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5.  Femoral hernia occur just below the inguinal ligament, when
abdominal contents pass through a natural weakness in the
abdominal wall called the femoral canal.
 femoral hernias can occur in both males and females, almost all
develop in women due to the increased width of the female pelvis
 Femoral hernias are more common in adults than in children. 70%
of children’s femoral hernia occur under the age of one yeare
 Femoral hernias are a relatively uncommon type, accounting for
only 3% of all hernias.
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femoral herniafemoral hernia

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7.  inguinal hernia are the most common of the abdominal hernias
(73%).
 The inguinal canal is a canal which in males convey the spermatic
cords and in females the round ligament of uterus. The inguinal
canals are larger and more prominent in males. The spermatic cord
and testicle to descend from the abdomen into the scrotum.
 After the testicle descends, the opening is supposed to close tightly,
but sometimes the muscles leave a weakened area. the weakened
tissues can allow a portion of lesser omentum to slide through that
opening, causing pain and producing a bulge.
 It is two types direct and indirect hernia
inguinal herniainguinal hernia
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8. Direct and in direct herniaDirect and in direct hernia
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9.  Direct inguinal hernia (20%) – intestine enters the inguinal
canal “in the posterior wall of the canal, the direct inguinal
hernia occur medial to inferior epigastric vessels
 Most common in adult males and rare in children.
 Indirect inguinal hernia (80%) – intestine enters the inguinal
canal via the deep inguinal ring
 Indirect inguinal hernia located lateral to the inferior
epigastric artery
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Types of inguinal herniaTypes of inguinal hernia

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• Umbilical hernias cause abnormal bulging in the belly button.
• this bulge consisting of abdominal fat from the greater omentum or
occasionally parts of the small intestine. The bulge can often be
pressed back through the hole in the abdominal wall, and are very
common in newborns and often do not need treatment unless
complications occur.
• these hernias tend to resolve without any treatment by around the age
of 2–3 years. Some umbilical hernias enlarge and may require repair
later in life
umbilical herniasumbilical hernias

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13.  Incisional hernias occur as a complication of abdominal
surgery, where the abdominal muscles are cut to allow the
surgeon to enter the abdominal cavity to operate.
 Although the muscle is usually repaired, it becomes a relative
area of weakness, potentially allowing abdominal organs to
herniate through the incision.
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IncIsIonal hernIasIncIsIonal hernIas

14. Incisional herniasIncisional hernias
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15.  Epigastric hernias are lumps or bulges that occur in the upper
part of the abdominal wall - in an area known as the
epigastrium, which is above the umbilicus and just below the
breastbone.
 An epigastric hernia can occur when the tissues in the
abdominal wall don’t close completely during development.
 They may vary in size, and it is possible to have more than one
epigastric hernia at a time.
 Typically, an epigastric hernia is small. Larger hernias,
however, may cause fatty tissue or part of the stomach to push
through.
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epIgastrIc hernIaepIgastrIc hernIa

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17.  The hiatus is an opening in the diaphragm .Normally, the esophagus goes
through the hiatus and attaches to the stomach. In a hiatus hernia the
stomach bulges up into the chest through that opening.
 There are two main types of hiatal hernias: sliding and Paraesophageal
(next to the esophagus).
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hIatus hernIahIatus hernIa

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 In a sliding hiatal hernia, the stomach and the section of the esophagus
that joins the stomach slide up into the chest through the hiatus. This is
the more common type of hernia.
 The paraesophageal hernia is less common, but is more cause for
concern. The esophagus and stomach stay in their normal locations, but
part of the stomach squeezes through the hiatus, landing it next to the
esophagus.
slIdIng and para esophagealslIdIng and para esophageal

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CausesCauses
Increased intra-abdominal pressure may lead to weakening of a
portion of the abdominal wall.Some risk factors include the
following:

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SymptomsSymptoms

21. At the outset, your doctor will ask for your medical history and
then perform a physical examination to touch or feel a hernia.
You may be asked to cough, bend, push, or lift
In infants or children though, the hernia may not be easily seen,
except when the child is crying or coughing.
The doctor may ask you to undergo Ultrasound or CT scans to
look for a hernia.
If you may have a blockage in your bowel, you will be asked to
take an x-ray of the abdomen.
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22.  1. Open hernia repair: procedure, which might be done with local
anesthesia and sedation or general anesthesia, the surgeon makes an
incision in your groin and pushes the protruding tissue back into your
abdomen.
 After the surgery, you'll be encouraged to move about as soon as
possible, but it might be several weeks before you're able to resume
normal activities
 laparoscopic repair than with open surgery
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TreatmentTreatment
There are two general type of hernia operation
1. Open hernia repair
2. laparoscopy repair

23.  2. laparoscopy repair :
 this minimally invasive procedure, which requires general anesthesia,.
Gas is used to inflate your abdomen to make the internal organs easier to
see.
 A small tube equipped with a tiny camera (laparoscope) is inserted into
one incision
 People who have laparoscopic repair might have less discomfort and
scarring after surgery and a quicker return to normal activities
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