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Chapter-28 Hernia

BOOK TITLE: Clinical Surgery: A Text and Atlas

Author
1. Chumber Sunil
2. Asuri Krishna
3. Misra Mahesh Chander
4. Saha Sudipto
ISBN
9789351526797
DOI
10.5005/jp/books/12698_29
Edition
1/e
Publishing Year
2016
Pages
17
Author Affiliations
2. All India Institute of Medical Sciences, New Delhi, India
3. All India Institute of Medical Sciences, New Delhi, India
4. Lady Hardinge Medical College, New Delhi, India
Chapter keywords
Richter’s hernia, sliding hernia, scrotum, deep ring occlusion test, testis, epididymis, spermatic cord, urethra, femoral hernia, umbilicus, epigastric herniae

Abstract

Hernia is a protrusion of a viscus through an opening in the wall of the cavity in which it is contained. Groin herniae are the most common herniae seen in clinical practice. Groin hernia may be inguinal or femoral hernia. Inguinal hernia can be either direct or indirect. Femoral hernia comes out through the femoral canal and becomes superficial through the saphenous. Other hernias — incisional and epigastric — are less common, while obturator, lumbar, gluteal and spigelian hernias are extremely rare. This chapter discusses different types of hernias, their signs and symptoms and the differential diagnosis of them through various methods, including physical examination of a patient. An incisional hernia develops at the site of a previous operation. It is a frequent complication of abdominal surgery and occurs in 2 to 10 percent of all abdominal operations. The umbilical hernias are classified by their actual time of development in life—the congenital hernia, also called omphalocele, the infantile type and the adult umbilical hernia. The omphalocele may be fetal or embryonic type. Spigelian hernia is a variety of interparietal hernia occurring at a level of the arcuate line. It usually presents as soft reducible mass lateral to the rectus muscle, below the umbilicus. However, it may not be apparent on examination if it lies beneath the internal oblique muscle.

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