This PPT is useful for GNM-II Year & B.Sc.N. Sem.-3,4. Post Basic B.Sc.N. 1 year.

1. Prepared By - Ahmed Sodha
By, Ahmed Sodha
M.Sc.(N). – M.S.N.
HERNIA

2.  HERNIA (હેર્નિયા)
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3.  TYPES OF HERNIA
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4.  Definition:-
•It’s Defined As A Bulging Of An Organ Or Tissue Through An
Abnormal Opening / Through The Wall Of The Cavity / A
Weak Spot In A Surrounding Muscle.
•A Hernia Usually Happens In Your Abdomen Or Groin,
When One Of Your Body Organs Pushes Through The
Muscle Or Tissue That Contains It.
•It May Look Like An Odd Bulge That Comes And Goes
During Different Activities Or In Different Positions.
•It May Or May Not Cause Symptoms, Such As Discomfort Or
Pain.
•Most Hernias Eventually Will Need Surgical Repair.
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5.  Etiology / Risk Factors:-
•A Hernia Occurs When A Weakness Or A Preexisting
Opening In Your Muscle Or Connective Tissue Allows An
Organ Or Other Tissue To Push Through The Barrier.
•Sometimes The Weakness Or Opening Is Present At Birth,
But Usually, It Develops During Your Lifetime.
•A Traumatic Injury Or Surgery
•Any Activity That Raises The Pressure Inside The Belly
•Heavy Lifting
•Chronic Cough Or Chronic Sneezing
•History Of Abdominal Or Pelvic Surgery.
•Pregnancy, Especially Repeat Pregnancies
•Obesity
•Fluid In The Abdomen (Ascites)
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6.  Types:-
•Inguinal Hernia:- Inguinal Hernias Are The Most Common
Type. It is more common in men. This Happen When Part
Of Your Bowel (Intestine) Protrudes Into Your Inguinal
Canal. It may go all the way down into the scrotum.
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7.  Types:-
•Femoral Hernia:- This usually occurs when fatty tissue or a
part of your bowel pokes through femoral canal. Type Is
More Common In Women Than Men.
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8.  Types:-
•Hiatal Hernia:- A Hiatal Hernia Is Another Common Type Of
Hernia That You Acquire During Your Lifetime.
•It Happens When The Opening In Your Diaphragm — Where
Your Esophagus Passes Through — Widens, And The Top Of
Your Stomach Pushes Up Through The Opening Into Your
Chest.
•Incisional Hernia:- An Incisional Hernia Occurs When Tissue
Protrudes At The Site Of A Previous Surgical Incision In Your
Abdominal Wall That Weakened Over Time.
•It’s A Common Side Effect Of Abdominal Surgery.
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9. •Umbilical Hernia:- An Umbilical Hernia Occurs When Part
Of Your Intestine Pokes Through An Opening In Your
Abdominal Wall Near Your Belly Button. Most Umbilical
Hernias Are Congenital (Present From Birth).
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10. •Congenital Diaphragmatic Hernia:- It Is A Serious Birth
Defect In Which The Diaphragm Doesn’t Close During Fetal
Development. It Can Cause Abdominal Organs To Slip Up
Into The Chest Cavity.
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11. •Ventral Hernia:-
•A Ventral (Abdominal) Hernia Refers To Any Protrusion Of
Intestine Or Other Tissue Through A Weakness Or Gap In
The Abdominal Wall. Umbilical And Incisional Hernias Are
Specific Types Of Ventral Hernias.
•Perineal Hernia:-
•It Is A Hernia Involving The Perineum (Pelvic Floor). The
Hernia May Contain Fluid, Fat, Any Part Of The Intestine,
The Rectum, Or The Bladder.
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12.  Clinical Manifestations:-
•Symptoms Include A Bulge, Swelling, Or Pain.
•In Some Cases, There Are No Symptoms.
•If The Bowel Is Obstructed, Then Nausea, Vomiting, And
Constipation May Occur.
•You’re More Likely To Feel Your Hernia Through Touch
When You’re Standing Up, Bending Down, Or Coughing.
•Discomfort Or Pain In The Area Around The Lump May Also
Be Present.
•Some Types Of Hernia, Such As Hiatal Hernias, Can Have
More Specific Symptoms. These Can Include Heartburn,
Trouble Swallowing, And Chest Pain.
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13.  Diagnostic Evaluation:-
• History Collection & Physical Examination
• Abdomen USG
•X-Ray
•CT-Scan & MRI
•Endoscopy
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14.  Treatment:-
• Surgery Is The Only Treatment That Can Permanently Fix A
Hernia.
•Hernia Repair Surgery Is Common And Generally A Minor
Procedure Unless There Are Complications. Your Surgeon
Will Push The Herniated Tissue Back Into Place And
Reinforce The Barrier It Pushed Through With Stitches Or
With Surgical Mesh. Surgeons Can Often Use Minimally-
invasive Methods For A Routine Hernia Repair, Which
Means Smaller Incisions, Less Postoperative Pain And A
Faster Recovery.
•Laparoscopic Surgery Uses A Laparoscope — A Long, Thin
Tube With A Lighted Camera On The End — To Look Inside
The Surgical Site. The Laparoscope Goes In One Small Hole
And Long, Thin Surgical Tools Go Through Another.
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 Hernia Repair with Mesh

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18. •Herniotomy (Removal Of The Hernial Sac Only).
•Herniorrhaphy (Herniotomy Plus Repair Of The Posterior
Wall Of The Inguinal Canal).
•Hernioplasty (Herniotomy Plus Reinforcement Of The
Posterior Wall Of The Inguinal Canal With A Synthetic
Mesh).
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21.  Hiatal Hernia (હયાટલ હનીયા):-
Prepared By - Ahmed Sodha

22.  Hiatal Hernia:-
•A Hiatal Hernia Happens When The Top Of Your Stomach
Bulges Through An Opening In Your Diaphragm.
•Your Diaphragm Has A Small Opening Called Hiatus Through
Which Esophagus Passes & Connecting To Stomach.
•In A Hiatal Hernia, The Stomach Pushes Up Through This
Hiatus Opening Into Your Chest.
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23.  Etiology / Risk Factors:-
•A Hiatal Hernia Occurs When Weakened Muscle Tissue
Allows Your Stomach To Bulge Up Through Your Diaphragm.
•Age Related Changes In Your Diaphragm
•Injury To Diaphragm
•Being Born With An Unusually Large Hiatus
•Persistent And Intense Pressure On The Surrounding
Muscles, Such As While Coughing, Vomiting, Exercising Or
Lifting Heavy Objects
•Obesity
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24.  Types:-
•There Are Two Main Types: Sliding Hiatal Hernias And
Paraesophageal Hiatal Hernias.
•Sliding Hiatal Hernia / Type-1:- In This The Part Of Your
Esophagus That Connects To Your Stomach Slides Up
Through The Widened Hiatus At Times And Then Slides
Back Down.
•Paraesophageal Hernia / Type-2:- Paraesophageal Means
Beside The Esophagus. The Upper Part Of Your Stomach
Pushes Up Through The Hiatus Alongside Your Esophagus,
Forming A Bulge Next To It.
•This Is Also Called A “Rolling Hiatal Hernia.”
•Type-3:- It Is Mix Of The First Two Types.
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25.  Clinical Manifestations:-
•Most Small Hiatal Hernias Cause No Signs Or Symptoms.
But Larger Hiatal Hernias Can.
•Heartburn
•Regurgitation Of Food Or Liquids Into The Mouth
•Backflow Of Stomach Acid Into The Esophagus (Acid Reflux)
•Difficulty Swallowing (Dysphagia)
•Chest Or Abdominal Pain
•Feeling Full Soon After You Eat
•Shortness Of Breath
•Nausea & Vomiting
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26.  Diagnostic Evaluation:-
• History Collection & Physical Examination
• X-Ray, CT-Scan, MRI
•Endoscopy
•Esophageal Manometry Test
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27.  Treatment:-
•If You Experience Signs And Symptoms, Such As Recurrent
Heartburn And Acid Reflux, You May Need Medication Or
Surgery.
•Proton Pump Inhibitors (Omeprazole, Esomeprazole,
Pantoprazole, Rabeprazole)
•Histamine H2-Antagonist (Famotidine, Cimetidine,
Nizatidine, & Ranitidine)
•Antacids (Aluminium Hydroxide, Magnesium Carbonate,
Magnesium Trisilicate, Magnesium Hydroxide, Calcium
Carbonate, Sodium Bicarbonate)
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28. •Surgical Treatment:- Sometimes A Hiatal Hernia Requires
Surgery.
•Fundoplication:-
•Pulling Your Stomach And Lower Esophagus Back Under
Your Diaphragm. Closing The Hole In Your Diaphragm
Where The Hernia Came Through. Tightening The Junction
Between Your Stomach And Your Esophagus.
•Endoluminal Fundoplication
•Endoluminal Fundoplication Is A Newer Procedure, And It’s
The Least Invasive Option. No Incisions Will Be Made.
•Surgeon Will Insert An Endoscope, Into The Esophagus.
Then They’ll Place Small Clips At The Point Where The
Stomach Meets The Esophagus.
•These Clips Can Help Prevent Stomach Acid And Food From
Backing Up Into The Esophagus.
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