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YASHWANT KUMAR DILLI
BABU
GROUP-8
3 RD YEAR
A hernia is a protrusion of
a viscus (Plural - viscera) or
part of a viscus through an
abnormal opening in the
walls of its containing
cavity.

an abnormal weakness or
hole in an anatomical
structure which allows
something inside to
protrude through.
Hernias by themselves usually are harmless, but
nearly all have a potential risk of having their
blood supply cut off (becoming strangulated).


If the blood supply is cut off at the hernia
opening in the abdominal wall, it becomes a
medical and surgical emergency.
Any condition that increases the pressure of the
abdominal cavity may contribute to the formation
or worsening of a hernia.
   Obesity
   Heavy lifting
   Coughing
   Straining during a bowel movement or urination
   Chronic lung disease
   Fluid in the abdominal cavity
   Poor nutrition
   Ehlers-danlos and Marfan syndrome
   Congenital
A hernia consists of 3 parts
   The sac
     Mouth
     Neck
     Body and Fundus
   The covering of the sac
   Contents of the sac
     Omentum – omentocele
     Intestine – enterocele
     Fluid – ascites
     Sometimes part of bladder or ovary
Reducible – contents can be returned to
abdomen
Irreducible – contents cannot be returned but
there are no other complications
Obstructed – bowel in the hernia has good
blood supply but bowel is obstructed
Strangulated – blood supply of bowel is
obstructed
Inflamed – contents of sac have become
inflamed
Most common (75 %)
   Inguinal
   Femoral
   Umbilical
Incisional
Others (Rare – 1.5 %)
   Spigelian
   Hiatus (Diaphragmatic)
   Obturator
   Epigastric, Etc..
More common in men than women.
Two types of inguinal hernias: indirect inguinal
hernia and direct inguinal hernia.
   Indirect inguinal hernia
     In congenital form hernia follows pathway (processus
     vaginalis) that testicles made during prebirth development.
     This pathway normally closes before birth but remains a
     possible place for a hernia.
     Sometimes the hernial sac may protrude into the
     scrotum.
     Can occur at any age mainly at old age.
Direct inguinal hernia
  This occurs slightly to the inside
  of the sight of the indirect
  hernia, in a place where the
  abdominal wall is naturally
  slightly thinner.
  It rarely will protrude into the
  scrotum.
  The direct hernia almost always
  occurs in the middle-aged and
  elderly because their abdominal
  walls weaken as they age.
The femoral canal is the way that
the femoral artery, vein, and
nerve leave the abdominal cavity
to enter the thigh.
Although normally a tight space,
sometimes it becomes large
enough to allow abdominal
contents (usually intestine) into
the canal.
This hernia causes a bulge below
the inguinal crease in roughly the
middle of the thigh.
Has risk of becoming irreducible
and strangulated.
A hernia is present at the site of 
 the umbilicus (commonly called 
 a navel, or belly button) in the 
 newborn
 Although sometimes quite large, 
 these hernias tend to resolve 
 without any treatment by 
 around the age of 2-3 years 
 Obstruction and strangulation of the hernia is rare
  because the underlying defect in the abdominal
  wall is larger than in inguinal hernia
 They most often appear later in elderly people
  and middle-aged women who have had
  children.
Abdominal surgery 
 causes a flaw in the 
 abdominal wall that 
 must heal on its own. 
 This flaw can create an 
 area of weakness where 
 a hernia may develop.

 This occurs after 2-10% of all abdominal surgeries,
  although some people are more at risk.
 After surgical repair, these hernias have a high rate
  of returning (20-45%).
A hiatus hernia occurs when 
  the upper part of the stomach, 
  which is joined to the 
  oesophagus (gullet), moves up 
  into the chest through the 
  hiatus in the diaphragm.
 It is common and occurs in about 10
  per cent of people.
 It is most common in overweight
  middle-aged women and elderly
  people and can also occur during
  pregnancy.
Epigastric hernia
    Occurring between the navel and the 
    lower part of the rib cage in the 
    midline of the abdomen, these 
    hernias are composed usually of fatty 
    tissue and rarely contain intestine.
Richter's hernia: 
    Hernia involving only one sidewall of 
    the bowel, which can result in bowel 
    strangulation leading to perforation 
    through ischemia without 
    causing bowel obstruction or any of 
    its warning signs.
Spigelian hernia
    Occurs along the edge of the rectus
    abdominus muscle, which is several
    inches to the side of the middle of
    the abdomen.
Obturator hernia
    Rare; happens mostly in women.
    This hernia protrudes from the pelvic
    cavity through an opening in your
    pelvic bone (obturator foramen).
    wont show any bulge but can act like
    a bowel obstruction and cause
    nausea and vomiting
In irreducible hernia - advisable to
repair, in order to prevent
complications as organ
dysfunction, gangrene and multipl
e organ dysfunction syndrome.
Laparoscopy is preferred
Uncomplicated hernias are
principally repaired by pushing
back, or "reducing", the herniated
tissue, and then mending the
weakness in muscle tissue (an
operation called herniorrhaphy).
Hernia  yashwant kumar.

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Hernia yashwant kumar.

  • 2. A hernia is a protrusion of a viscus (Plural - viscera) or part of a viscus through an abnormal opening in the walls of its containing cavity. an abnormal weakness or hole in an anatomical structure which allows something inside to protrude through.
  • 3. Hernias by themselves usually are harmless, but nearly all have a potential risk of having their blood supply cut off (becoming strangulated). If the blood supply is cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency.
  • 4. Any condition that increases the pressure of the abdominal cavity may contribute to the formation or worsening of a hernia. Obesity Heavy lifting Coughing Straining during a bowel movement or urination Chronic lung disease Fluid in the abdominal cavity Poor nutrition Ehlers-danlos and Marfan syndrome Congenital
  • 5. A hernia consists of 3 parts The sac Mouth Neck Body and Fundus The covering of the sac Contents of the sac Omentum – omentocele Intestine – enterocele Fluid – ascites Sometimes part of bladder or ovary
  • 6. Reducible – contents can be returned to abdomen Irreducible – contents cannot be returned but there are no other complications Obstructed – bowel in the hernia has good blood supply but bowel is obstructed Strangulated – blood supply of bowel is obstructed Inflamed – contents of sac have become inflamed
  • 7. Most common (75 %) Inguinal Femoral Umbilical Incisional Others (Rare – 1.5 %) Spigelian Hiatus (Diaphragmatic) Obturator Epigastric, Etc..
  • 8. More common in men than women. Two types of inguinal hernias: indirect inguinal hernia and direct inguinal hernia. Indirect inguinal hernia In congenital form hernia follows pathway (processus vaginalis) that testicles made during prebirth development. This pathway normally closes before birth but remains a possible place for a hernia. Sometimes the hernial sac may protrude into the scrotum. Can occur at any age mainly at old age.
  • 9. Direct inguinal hernia This occurs slightly to the inside of the sight of the indirect hernia, in a place where the abdominal wall is naturally slightly thinner. It rarely will protrude into the scrotum. The direct hernia almost always occurs in the middle-aged and elderly because their abdominal walls weaken as they age.
  • 10. The femoral canal is the way that the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh. Although normally a tight space, sometimes it becomes large enough to allow abdominal contents (usually intestine) into the canal. This hernia causes a bulge below the inguinal crease in roughly the middle of the thigh. Has risk of becoming irreducible and strangulated.
  • 11.
  • 12. A hernia is present at the site of  the umbilicus (commonly called  a navel, or belly button) in the  newborn Although sometimes quite large,  these hernias tend to resolve  without any treatment by  around the age of 2-3 years   Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in inguinal hernia  They most often appear later in elderly people and middle-aged women who have had children.
  • 13. Abdominal surgery  causes a flaw in the  abdominal wall that  must heal on its own.  This flaw can create an  area of weakness where  a hernia may develop.  This occurs after 2-10% of all abdominal surgeries, although some people are more at risk.  After surgical repair, these hernias have a high rate of returning (20-45%).
  • 14. A hiatus hernia occurs when  the upper part of the stomach,  which is joined to the  oesophagus (gullet), moves up  into the chest through the  hiatus in the diaphragm.  It is common and occurs in about 10 per cent of people.  It is most common in overweight middle-aged women and elderly people and can also occur during pregnancy.
  • 15. Epigastric hernia Occurring between the navel and the  lower part of the rib cage in the  midline of the abdomen, these  hernias are composed usually of fatty  tissue and rarely contain intestine. Richter's hernia:  Hernia involving only one sidewall of  the bowel, which can result in bowel  strangulation leading to perforation  through ischemia without  causing bowel obstruction or any of  its warning signs.
  • 16. Spigelian hernia Occurs along the edge of the rectus abdominus muscle, which is several inches to the side of the middle of the abdomen. Obturator hernia Rare; happens mostly in women. This hernia protrudes from the pelvic cavity through an opening in your pelvic bone (obturator foramen). wont show any bulge but can act like a bowel obstruction and cause nausea and vomiting
  • 17. In irreducible hernia - advisable to repair, in order to prevent complications as organ dysfunction, gangrene and multipl e organ dysfunction syndrome. Laparoscopy is preferred Uncomplicated hernias are principally repaired by pushing back, or "reducing", the herniated tissue, and then mending the weakness in muscle tissue (an operation called herniorrhaphy).