ABDOMINAL WALL HERNIAS 2 ventral hernias

 ETIOLOGY

Hernias  may result from congenital weakness of the wall  or  the

weakness may develop secondarily during later life. The Secondary

hernia are usually considered to be traumatic or acquired due  to

sudden lifting of weights.

The development of a hernia in the groin, during middle life  may

also  be  because  of increased intra  abdominal  pressure.  Thus

chronic  cough,  symptoms of  genitourinary  or  gastrointestinal

tract obstruction may preceed herniation.

Some  young  male adults first discover a hernia  after  vigorous

physical exercise.

3. VENTRAL HERNIAS

Ventral  hernias are situated on the anterior abdominal wall  and

same are in the midline  and include

UMBILICAL DEFECTS

During  the  embryonic period at about the tenth  week  of  fetal

life; the viscera normally return to the abdominal cavity and the

abdominal wall closes slowly during subsequent fetal development.

At birth, many infants will show a small umbilical hernia because

this  process has not been completed (Fig. 24.8b).  In most  cases

spontaneous closure occurs within the first three years of life.

Rarely,  the  process  of  abdominal  wall  closure  is   totally

incomplete  at birth and omphalocele is present.  The  defect  at

the umbilicus is covered only by a peritoneal sac.

In a few cases, the embyrologic duct from small bowel to the yolk

sac (vitillo-intestinal duct) remains patent and attached to  the

umbilical cord at birth.

This  duct  is  likely  to be included  in  the  tie.   When  the

umbilical remanent sloughs later; a fistula into the small gut is

created.

In  other cases; the tract from the bladder; the  urachus  enters

the  umbilical arteries.  The remnant of the cephalic portion  of

the  embryonic  urinary  bladder is  usually  obliterated  before

birth;  if  it  remains patent, it may  become  involved  in  the

umbilical  cord  ligature  and a  draining  umbilical  sinus  may

present.

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