疝病理ppt课件.ppt

Abdominal wall hernias general consideration inguinal hernias femoral hernia incisional hernia umbilial hernia hernia of linea alba Differences between indirect and direct hernia * * general consideration Definition Hernia means a sprout, and protrusion. External abdominal wall hernia is an abnormal protrusion of intra-abdominal tissue or the whole or part of a viscera through an opening or fascial defect in the abdominal wall. most occur in the grion Etiology 1. intensity of abdominal wall decreased common factors: 1) site that some tissues pass through the abdominal wall, eg. Spermatic cord, round ligament of uterus 2) bad development of abdominal white line 3) incision, trauma, infection et al. defect in collagen synthesis or turnover 2. any condition which increases intra-abdominal pressure chronic cough, chronic constipation, dysuria, ascites, pregnancy, cry Pathological anatomy composed of: covering tissue: skin, subcutanous tissue hernial sac: protrusion of peritonum, neck of the sac: is narrow where the sac emerges from the abdomen body of the sac hernial contents: small intestine, major omentum Clinical types 1. reducible hernia is one in which the contents of the sac return to the abdomen spontaneously or with manual pressure when the patient is recumbent. 2. irreducible hernia is one whose contents or part of contents cannot be returned to the abdomen, without serious symptoms. hernias are trapped by the narrow neck Sliding hernia is one in which the wall of a viscus forms a portion of the wall of the hernia sac. It is may be colon ( on the left), caccum (on the right) or bladder (on either side). Belongs to irreducible hernia 3. incarcerated hernia: is one whose contents cannot be returned to the abdomen, with severe symptoms. 4. strangulated hernia: denotes compromis