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Hernia - General Information

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Hernia - General

	Common Hernias : Inguinal, Incisional, Femoral, Umbilical
	Acquired Hernia - Incisional
	Hernias d.t. obesity - Direct inguinal, Paraumbilical, Hiatus hernia.
	Classification

Internal

	Diaphragmatic hernia - congenital or acquired
	Duodenum herniating in the paraduodenal pouch
	Intestine into the lesser sac.
	Into hole in mesentery.
	Into hole in transverse mesocolon
	Into defect in broad ligament.
	Into Ileocaecal fossae - superior & inferior
	Into retrocaecal fossa

External

Anterior

Inguinal - indirect & direct

Femoral

Umbilical - Exomphalos (major & minor), & child umbilical hernia.

Paraumbilical

Epigastric

Divarication of Rectii

Spigelian

Obturator

Interstitial / Interparietal - 4 types

	Pro-peritoneal - diverticulum from inguinal or femoral hernia.
	Intermuscular - common in obese patients - spreads between EO & IO - narrow neck - tendency to strangulation.
	Inguinosuperficial - hernia into the superficial inguinal pouch - associated commonly with an ectopic testis in the pouch.
	Spigelian - occurs at lateral border of rectus sheath at level of arcuate line.

Posterior

	Lumbar - superior & inferior. May be a phantom hernia - d.t. local muscular paralysis e.g. polio.
	Gluteal - through greater sciatic foramen.
	Sciatic - through lesser sciatic foramen.

Perineal hernia - 4 types

	Post - operative - after AP resection of rectum.
	Median sliding hernia - complete rectal prolapse.
	Antero-lateral - in females - swelling of one side labium majus.
	Postero-lateral - through levator ani muscle into the ischirectal fossa.

Para-ileostomy hernia

Para-colostomy hernia

Types of indirect inguinal hernias

	Complete / Scrotal / Vaginal
	Bubonocele
	Funicular indirect hernia
	Infantile - (2) + a diverticulum from the tunica which extends anteriorly upto the external ring.