hernia分析课件文档.pptVIP

Femoral hernia The defect is in the transversalis fascia overlying the femoral ring at the entry to the femoral canal. The hernia passes through the femoral canal and presents in the groin, below and lateral to the pubic tubercle. It is more common in females and carries a higher risk of strangulation. Femoral canal-ant.by inguinal ligament,post by fascia over pectineus muscle,lat. by femoral vein n medial by lacunar ligament * . Femoral hernia Signs symptoms: A lump occurs below and lateral to the pubic tubercle. It may be reducible. It may not be noticed until it becomes tender and painful. This type of hernia should be carefully sought in the obese patient who presents with signs of intestinal obstruction without an obvious cause. DD’s-saphena varix,enlarged inguinal LN,femoral artery aneurysm,rare femoral abscess. * . Femoral hernia Surgical repair: An incision is made directly over the swelling. The sac is opened and the contents reduced and the sac removed. Femoral canal obliterated with 3 interrupted non absorbable suture. Treatment of strangulation or obstruction, if present. There is no place for a truss in the treatment of femoral hernia. * . Femoral hernia * . Umbilical hernia This occurs in children because of incomplete closure of the umbilical orifice. The majority close spontaneously during the first year of life. Surgical repair should only be carried out if the hernia has not disappeared by the age of 3 and the fascial defect is greater than 1.5cm in diameter. * . Para-Umbilical hernia It occurs just above or just below the umbilicus, and is more common in obese females. Predisposing factors multiple pregnancies and obesity. * . Para-Umbilical hernia The neck of the sac is usually narrow and therefore there is a high risk of strangulation. The most common content is omentum ,then transverse colon and small intestine. Treatment: is by Contents of sac freed from it’s wall,excision of the sac, and fascial defect repaired by Upper flap over