Hernia is defined as the protrusion of an organ or tissue through an abnormal opening. Common causes include congenital defects, injury, straining, or obesity. There are several types of hernias including inguinal, hiatal, femoral, and umbilical. Symptoms vary depending on type but may include lumps, pain, or difficulty swallowing. Diagnosis involves physical exam, imaging, and patient history. Treatment is generally surgical repair to return organs to normal position and reinforce weak areas. Post-operative care focuses on pain management, preventing infection, and education on wound healing.

1. HERNIA
JUSTIN V SEBASTIAN

2. DEFINITION
Hernia is the protrusion or projection of an organ or part of
an organ through the abnormal opening in the wall of the
cavity that normally contains it.
Hernias of abdominal organ are more common.

3. CAUSES
Hernia may result due to-
a. Failure of certain normal opening to close during
development.
b. Weakness due to debilitating illness and injury.
c. Prolonged distension due to tumors or obesity
d. Increased intra abdominal pressure due to
straining and coughing.
e. Improper heavy weight lifting
f. Sharp blows to the abdomen
g. Ascitis

4. Classification
Reducible; can be placed back in to the
abdominal cavity.
Irreducible; can not be placed back in
to the abdominal cavity.

5. TYPES OF HERNIAS
1. Inguinal Hernia-
2. Congenital Diaphragmatic Hernia
3. Hiatal Hernia
4. Epigastric Hernia
5. Femoral Hernia
6. Umbilical hernia
7. Incisional hernia

6. INGUINAL HERNIA
An inguinal hernia showing the small intestine
descending through the inguinal canal

7. The two types of inguinal hernia have different causes.
1.Indirect inguinal hernia.
● Indirect inguinal hernias are congenital hernias and
are much more common in males than females
because of the way males develop in the womb.
● Indirect hernias are the most common type of inguinal
hernia. Premature infants are especially at risk for
indirect inguinal hernias because there is less time for
the inguinal canal to close.

8. 2. Direct inguinal hernia
❑One or more of the following factors can cause pressure
on the abdominal muscles and may worsen the hernia:
sudden twists, pulls, or muscle strains
lifting heavy objects
straining on the toilet because of constipation
weight gain
chronic coughing

9. Symptoms of inguinal hernia include
enlarged scrotum
discomfort or sharp pain
a feeling of weakness or pressure in the groin
a burning, gurgling, or aching feeling at the bulge

10. CONGENITAL DIAPHRAGMATIC HERNIA-
Two types of diaphragmatic hernia
1. Bochdalek hernia
2. Morgagni hernia

11. Causes a diaphragmatic hernia
In a Bochdalek (a space between the costal and
lumbar parts of the diaphragm) hernia, the diaphragm
may not develop properly, or the intestine may
become trapped in the chest cavity as the diaphragm
is forming. At times, the tendon that should develop
in the middle of the diaphragm does not develop
properly. In both cases, normal development of the
diaphragm and the digestive tract does not occur.

12. Causes a diaphragmatic hernia
Morgagni hernias are one of the congenital
diaphragmatic hernias (CDH), and is characterised
by herniation through the foramen of Morgagni
(incomplete fusion of the septum transversum and
sternum with the anterior ribs)

13. Diaphragmatic hernia is a multifactorial
condition, which means that "many factors,"
both genetic and environmental, are involved. It
is thought that multiple genes from both
parents, as well as a number of environmental
factors that scientists do not yet fully
understand, contribute to diaphragmatic
hernia.

14. Symptoms Of A Diaphragmatic Hernia
difficulty breathing
fast breathing
fast heart rate
cyanosis (blue color of the skin)
abnormal chest development, with one side being larger
than the other
Abdomen that appears caved in (concave).

15. HIATAL HERNIA
A Hiatal hernia is when part of the stomach moves
upward and bulges through the wall of the
esophagus and diaphragm.
It is caused because of a weakness in the muscle
where the esophagus passes through to the stomach.
Although Hiatal hernias normally occur in adults,
they can occur in children as well.

17. Symptoms
Patient with a Hiatal hernia may feel like there is
something burning in the chest and throat, especially after
eating. Because of the strain from the hernia, stomach acid
is pushed up into the esophagus causing a burning
sensation.
Some patient with a Hiatal hernia suffer from reflux
disease.
Symptoms of a Hiatal hernia include-
chest pain,
Bloating and problems swallowing caused by the restriction
of the stomach.

18. EPIGASTRIC HERNIA
It is protrusion of intestine through an opening in the
midline in the linea alba above the umbilicus. It
requires surgical correction.

19. FEMORAL HERNIA
If a portion of tissue pushes through the wall of the femoral canal,
it's called a femoral hernia. A femoral hernia will appear as a
bulge near the groin or thigh.

20. Signs and symptoms
They typically present when standing as a
groin lump or bulge, which may differ in size
during the day, based on internal pressure
variations of the intestine. The bulge or lump
typically is smaller or may not be visible in a
prone position.

21. Umbilical hernia
An umbilical hernia is a sac (pouch) formed from the inner lining
of belly (abdominal cavity) that pushes through a hole in the
abdominal wall at the belly button.
Occurs when the rectus muscles is weak or the umbilical opening
fails to close after birth.

22. Incisional hernia
Due to weakness of the abdominal wall at the
site of previous incision.

23. DIAGNOSIS
History collection
Physical examination of the groin
Ultrasonography,
CT or MRI
Abdominal x-ray

24. Complication
●Inflammation
●Obstruction
●Strangulation
●Hydrocele
●Haemorrhage

25. MANAGEMENT OF HERNIA
1.“Open” hernia repair-
Herniorrhaphy; an operation for hernia that involves opening the
hernial sac, returning the contents to their normal place,
obliterating the hernial sac, and closing the opening with strong
sutures.
Hernioplasty; is a surgical procedure that treats different types of
hernia, especially inguinal hernia, by pushing the organs back to
their original position and adding a synthetic meshwork or patch to
act as support.
2.Laparoscopy

27. Complications of Surgery
Risk of general anesthesia
Hernia recurrence
Bleeding.
Wound infection
Painful scar
Injury to internal organs

28. NURSING DIAGNOSIS
1. Pain related to swelling and pressure
Goal: - patient will experience relief of pain.
2. Activity Intolerance related to immobility weakness
secondary to surgical incision and pain
Goal: - patient will experience feeling of comfort

29. 3. Impaired Skin Integrity related to invasive procedure
Goal: - Minimizing Complications of Skin Impairment
4. Risk for Infection related to surgical incision
Goal: - Preventing Infection, patient will be free from
sign and symptom of infection

30. 6.Imbalanced nutrition less than body requirement
related to surgery and decreased intake.
Goal: - The patient will maintain adequate nutrition
and hydration status.
7.Knowledge deficit about disease and about wound care
Goal: - Patient will have good knowledge about disease
and about wound care