3.

Hernias
In this episode, Dr. Parveen Boora discusses hernias.
Topics covered include:
what a hernia is and the different types of hernias
anatomy and where hernias may be found
risk factors
complications
options for treatment
Introduction

hernias of abdominal wall one of most common reasons for seeing a

general surgeon
can present at any age from pediatric to geriatric
can present as a benign incidental finding or dramatic, life-threatening
condition

Definition

abdominal wall hernia is protrusion of intra-abdominal contents

through a defect in the fascia of the abdominal wall
can be congenital or acquired
risk factors for development are male, older age, obesity
and any cause of increased intra-abdominal pressure
most common hernias are groin hernias, with inguinal and femoral
hernias also included in this group
other major group of are ventral hernias, which include incisional,
umbilical and epigastric hernias

Copyright The Surgery 101 team (www. surgery101.org) 2012

Categories of Hernias

reducible hernia
contents can be pushed back inside the abdomen
repair is either deferred or done electively
incarcerated hernia
cannot be reduced
may become progressively engorged
is indication for emergency surgery if contains small
bowel
are otherwise repaired electively
strangulated hernia
when pressure in hernia sac compromises inflow of
arterial blood and herniated tissues begin to die
is a surgical emergency
differentiate from incarcerated hernia by presence of
extreme pain, tenderness and erythema of overlying skin

Summary

A hernia is the abnormal protrusion of an intra-abdominal structure through the

abdominal wall via a defect in the fascia.
Abdominal wall hernias include groin hernias and ventral hernias. Groin hernias
include inguinal hernias both direct and indirect - and femoral hernias. Ventral
hernias include incisional, umbilical and epigastric hernias.
Hernias may be reducible, meaning that they can be pushed back into the
abdomen; irreducible, meaning that they cannot be pushed back into the
abdomen; or strangulated, meaning that the blood supply of the hernia contents
has been compromised, eventually leading to necrosis.
Emergent hernia repair is indicated in strangulated hernias or hernias causing
bowel obstruction.
Most hernias are repaired in an elective fashion when they become symptomatic.
Open and laparoscopic approaches exist for hernia repair, with most repairs
involving the use of synthetic mesh.

Copyright The Surgery 101 team (www. surgery101.org) 2012