https://www.slideshare.net/gamsoli/heart-diseases-42359485

1. Hernia
Presented by
Instructor
Amer M. Naser
Internal Medicine

2. Definition
A hernia is the abnormal exit of tissue or an organ,
such as the bowel, through the wall of the cavity in
which it normally resides

3. Causes of hernia
• Improper heavy weight lifting,
• Hard coughing
• Sharp blows to the abdomen, and incorrect
posture.
• Obesity, straining during a bowel movement or
urination (constipation, enlarged prostate),

4. • Classification by Severity
• Irreducible.
• Incarcerated.
• Strangulated

5. Types of the hernia
Classification according to Sites:
1.Inguinal hernia
2.Femoral hernia.
3.Umbilical hernia.
4.Incisional hernia.
5.Epigastric hernia.
6. Hiatal hernia

6. causes
• Chronic lung disease,
• Fluid in the abdominal cavity (ascites).
• Muscles are weakened due to poor nutrition,
• Smoking and overexertion hernias are more
likely to occur.
• Previous surgery

7. Inguinal hernia:
Occurs when a small portion of the bowel bulges
out through the inguinal canal-a passage or
opening through the muscles of the abdominal
(belly) wall-into the groin. The bulge usually
contains tissue lining the inside of the abdomen
as well as fatty tissue from inside the abdomen.

8. Femoral hernia:
The femoral canal is the path through which 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) to protrude into the canal. A femoral
hernia causes a bulge just below the inguinal crease in
roughly the middle of the upper leg.

9. Umbilical hernia:
These common hernias (10%-30%) are often noted in a child
at birth as a protrusion at the belly button (the umbilicus). An
umbilical hernia is caused when an opening in the child's
abdominal wall, which normally closes before birth, doesn't
close completely. If small (less than half an inch), this type of
hernia usually closes gradually by age 2. Larger hernias and
those that do not close by them usually require surgery when a
child is 2 to 4 years of age.

10. Incisional hernia:
Abdominal surgery causes a flaw in the abdominal
wall. This flaw can create an area of weakness
through which a hernia may develop. This occurs
after 2%-10% of all abdominal surgeries, although
some people are more at risk. Even after surgical
repair, incisional hernias may return.

11. Epigastric hernia
Occurring between the navel and the lower part of the rib
cage in the midline of the abdomen, epigastric hernias are
composed usually of fatty tissue and rarely contain
intestine. Formed in an area of relative weakness of the
abdominal wall, these hernias are often painless and
unable to be pushed back into the abdomen when first
discovered.

12. Hiatal hernia:
This type of hernia occurs when part of the stomach
pushes through the diaphragm. The diaphragm
normally has a small opening for the esophagus.
This opening can become the place where part of
the stomach pushes through. Small hiatal hernias
can be asymptomatic (cause no symptoms), while
larger ones can cause pain and heartburn.

13. • • Management
Mechanical (reducible hernia only).
• A- A truss is an appliance with a pad and belt that is held snugly
over a hernia to prevent abdominal contents from entering the
hernial sac.
• B- hernia is often managed with a hernia support belt with Velcro,
• C - Conservative measures—no heavy lifting, straining at stool, or
other measures that would increase intra-abdominal pressure.
• 2-Surgical—recommended to correct hernia before strangulation
occurs, which then becomes an emergency situation.
• A-Herniorrhaphy—removal of hernial sac;
• B- Hernioplasty involves reinforcement of suturing (often with mesh)
for extensive hernia repair.
• C-Strangulated hernia requires resection of ischemic bowel in
addition to repair of hernia.

14. Complications
Inflammation
Obstruction such as bowel obstruction in intestinal hernias
Strangulation
Hydrocele of the hernial sac
Hemorrhage
Autoimmune problems