ABDOMINAL WALL HERNIAS
1. DEFINITION
1.1
A hernia is the protursion of an organ through the wall
of
the cavity in which it is normally
present. The different parts
of a hernia are shown in Fig. 24.1.
The
common cause for
abdominal hernias is a
congenital or
acquired weakness
in the abdominal wall. Thus
the contents
(viscera) cannot be retained in the abdominal cavity
because of
this weakness of the wall.
1.2
The largest number of hernias occur in
the Inguinal or
Femoral regions
and are usually classified as
groin hernias
1.3 If the contents of the hernia can
be returned to their normal
intra abdominal position, the hernia
is defined as reducible.
1.4 In an irreducible hernia, the
contents cannot be pushed back
into the abdominal cavity probably
because of adhesions but there
are no symptoms.
1.5
An obstructed hernia is irreducible and
shows signs of
intestinal obstruction, however, the
blood supply to the contents
has as yet not been compromised.3
1.6
If compromise of the blood supply
of the
contained organ
occurs, it is an incarcerated
(stragulated)
1.7
When a portion of the wall of the hernial sac is made up by
an
organ such as the cecum or the sigmoid colon, it is referred
to as a "sliding hernia".
1.8 A hernia containing a loop of
bowel is an enterocele and that
containing omentum is an omentocele.
1.9
When a part of the circumference of the bowel is
in the
hernial sac, it is called Richter's
hernia.
1.10 A hernia containing the Meckel's
diverticulum is a Littre's
hernia.
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