A 30-year-old male patient presented to the hospital with left lower abdominal pain that began 7 months ago after a fall. On physical examination, he was found to have a bulge in the right inguinal area that increased with coughing. An ultrasound confirmed the diagnosis of an indirect inguinal hernia. The patient's treatment plan included a herniotomy to repair the defect in the abdominal wall muscles.

2. CONTENTS …
SOPEPEL
• Subjective
• Objective
Inguinal
hernia
TREATMENT
• Diagnose
• Treatment
• Anatomy
• Definition
• Risk factor
• Cause
• Sign / symptom

3. SOEPEL …
SUBJECTIVE :
A MIDDLE AGE MALE PATIENT ENTER THE HOSPITAL WITH LEFT LOWER
ABDOMINAL PAIN .
HISTORY:
MR.A 30 YEARS OLD , FALL DOWN BEFORE 7 MONTHS AND THE PAIN STARTED.
NO HISTORY OF GLYCEMIA , BP, AND ASTHMA.

4. PAIN ANALYSIS
1.
SITE: R. ILEAC FOSSE.
2.
ONSET: SUDDENLY.
3.
CHARACTER: SHARP.
4.
RADIATION: TO BACK.
5.
ASSOCIATED FACTORS: DURING COUGHING.
6.
TIME/DURATION: START BEFORE 3 MONTHS.
7.
EXAGGERATED AND RELIEVING FACTORS:
8.
SEVERITY: MODERATE.

5. •O
•E
•P
•E
•L
BJECT: ABDOMINAL EXAMINATION
VALUATION “DD, VAGINAL HYDROCELE, FEMORAL HERNIA.
LAN: ULTRASOUND,.
LABORATION: HERNIOTOMY.
EARNING GOAL: INGUINAL HERNIA.

6. DEFINITION …
• IS AN AREA OF MUSCULAR WEAKNESS OR A “HOLE” IN THE
LOWER ABDOMEN OR GROIN THROUGH WHICH A PERSON’S
INTESTINES CAN PROTRUDE.

7. ANATOMY …

8. TYPES
• DIRECT INGUINAL HERNIA: THE SAC PASSES THROUGH A
WEAKNESS OR DEFECT OF THE TRANSVERSALIS FASCIA IN
THEPOSTERIOR WALL OF THE INGUINAL CANAL.
• INDIRECT INGUINAL HERNIA: THE HERNIATION IS THROUGH THE
INTERNAL RING WITH BOWEL OR OMENTUM TRAVELING DOWN
THE INGUINAL CANAL AND MAY PROTRUDE THROUGH THE
EXTERNAL RING INTO THE SCROTUM.

9. INDIRECT INGUINAL HERNIA

10. SIGN AND SYMPTOMS …
• A BULGE IN THE AREA ON EITHER SIDE OF YOUR PUBIC BONE
• A BURNING, GURGLING OR ACHING SENSATION AT THE BULGE
• PAIN OR DISCOMFORT IN YOUR GROIN, ESPECIALLY WHEN BENDING OVER,
COUGHING OR LIFTING
• A HEAVY OR DRAGGING SENSATION IN YOUR GROIN
• WEAKNESS OR PRESSURE IN YOUR GROIN
• OCCASIONALLY, PAIN AND SWELLING AROUND THE TESTICLES WHEN THE
PROTRUDING INTESTINE DESCENDS INTO THE SCROTUM

11. CAUSES …
• INCREASED PRESSURE WITHIN THE ABDOMEN
• STRAINING DURING BOWEL MOVEMENTS OR URINATION
• HEAVY LIFTING
• FLUID IN THE ABDOMEN (ASCITES)
• PREGNANCY
• EXCESS WEIGHT
• CHRONIC COUGHING OR SNEEZING

12. RISK FACTORS …
• BEING MALE.
• FAMILY HISTORY.
• CERTAIN MEDICAL CONDITIONS.
• CHRONIC COUGH.
• CHRONIC CONSTIPATION.
• EXCESS WEIGHT.
• PREGNANCY
• PREMATURE BIRTH.
• HISTORY OF HERNIAS.

13. DIAGNOSE
Physical examination

14. TREATMENT
• HERNIOTOMY: ENTAILS DISSECTING OUT AND OPENING THE HERNIAL SAC,
REDUCING ANY CONTENTS AND THEN TRANSFIXING THE NECK OF THE SAC
AND REMOVING THE REMAINDER
• LAPAROSCOPIC.

15. REFRRENCE
• BAILEY AND LOVE'S.
• OXFORD AMERICAN CLINICAL EXAMINATION.
• KUMAR AND CHLARK.