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Inguinal hernia
- 1. Inguinal hernia Done by: Dr.Kawther A Alsadady. Supervised by : Prof. Ahmad K. Elbana. Faculty of Medicine Dar Al Uloom University
- 2. What Is hernia? When part of an organ protrudes through an abnormal opening or in an abnormal way, this is called a hernia. A groin (inguinal) hernia occurs when part of the intestine bulges through a weak spot in the abdominal wall at the inguinal canal. Inguinal hernias are up to 10 times more common in men than in women.
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- 4. Inguinal canal : Theinguinal canal is a passageway through the abdominal wall from superficial to deep inguinal ring. 1- Superficial Inguinal Ring: - It is triangular aperture in the aponeurosis of the external oblique muscle - lie 1.25 cm above the pubic tubercle.
- 5. 2- Deep InguinalRing: - It is U shape condensation of transversalis fascia - it lies 1.25 cm above inguinal ligament.
- 6. Types of inguinalhernia ?
- 7. 1- direct Inguinalhernia : Who ? Direct inguinal hernia become more common in the elderly. Where ? A direct inguinal hernia comes out directly forward through posterior wall of inguinal canal. When ? This occurs when a portion of the intestine protrudes through a weakness in the abdominal muscles along the wall of the inguinal canal.
- 8. 2- Indirect Inguinalhernia : who ? Is most common hernia of all especially in young children. where ? An indirect hernia travels down the canal on the outer (Lateral & anterior) side of spermatic cord. When ? This occurs when the internal opening of the inguinal canal, which usually closes around the time of birth, remains open. This allows a portion of the intestine to slip through the inguinal canal.
- 9. Inguinal hernia signsand symptoms in Adult include: 1. A bulge in the area on either side of your pubic bone 2. A burning, gurgling or aching sensation at the bulge 3. Pain or discomfort in your groin, especially when bending over, coughing or lifting 4. A heavy or dragging sensation in your groin 5. Weakness or pressure in your groin 6. Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum
- 10. Signs and symptomsin children : Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia may be visible only when an infant is crying, coughing or straining during a bowel movement. In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period of time
- 11. 1. Increased pressurewithin the abdomen . 2. A pre-existing weak spot in the abdominal wall . 3. A combination of increased pressure within the abdomen and a pre-existing weak spot in the abdominal wall . 4. Straining during bowel movements or urination . 5. Heavy lifting . 6. Fluid in the abdomen (ascites) . 7. Pregnancy . 8. Excess weight . 9. Chronic coughing or sneezing .
- 12. Treatment : 1- Herniorrhaphy In this procedure, also called an open hernia repair, the surgeon makes an incision in your groin and pushes the protruding omentum or intestine back into your abdomen. The surgeon then sews together the weakened or torn muscle. The weak area often is reinforced and supported with a synthetic mesh (hernioplasty). After the surgery, four to six weeks before you're fully able to resume your normal activities
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- 15. 2- Laparoscopy Inthis minimally invasive procedure, the surgeon operates through several small incisions in your abdomen. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through another incision to repair the hernia using synthetic mesh.
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- 17. References : • Clinicalanatomy by region for Snell • Mayo clinic.org • inguinalherniatreatment.co.uk • Webmd.com