Hernias 02ppt

8/11/2019 Hernias 02ppt

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What is a hernia

Hernia is derived from the Latin for "rupture"

It is the protrusion of an organ or part ofan organ through a defecte in the wa of the

cavity normay containing it.


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Hernia is classifed into three types:

! Reducibe, ernias can be reducibe ifthe hernia can be easiy manipuated bac#into pace.! Irreducibe or incarcerated, this cannotusuay be reduced manuay because

adhesions form in the hernia sac.

! %tranguated, if part of the herniatedintestine becomes twisted or edematous

and causing serious compications,


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Types o herniaInguinal

Indirect or indirect

Inguina hernias can be direct which is herniationthrough an area of musce wea#ness, in the

inguina cana,and inguina hernias indirect herniation throughthe inguina ring. Indirect hernias, the morecommon form, can deveop at any age but areespeciay prevaent in infants younger than age &.

'his form is three times more common in maes.

Femoral Herniation through the femora cana


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Types o herniaIncisional Herniation

through an area wea#ened by a scar

UmbilicalParaumbilical

(c)uired defect above or beow theumbiicus

Epigastric

in the midine of abdomen above theumbiicus caused by a defect in inea aba.


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Groin Hernias

Incidence:

*roin hernias are found in +of mae popuation.

- Represents /of a hernia cases.

- It occurs +times more often in maesthanfemaes.

- Inguina 0/1 indirect 2+, direct 3+4.

- Biatera in 35of cases - Right sided hernias are more fre)uent than

eft sided ones

- 6emora 7.


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!irect Inguinal Hernia

Incidence8 3+ of hernia cases

'he hernia contents enter the inguina cana.

'hese hernias are generay considered to beac)uired, and may be associated with heavyifting, straining due to constipation, coughing,or prostatic enargement.


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"ilateral Hernia

De9nition8 %imutaneous Right and LeftInguina ernia

:ommon in chidren and edery menIf a eft inguina hernia is present, there is a

3+ ris# of an occut right inguina hernia


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#ymptoms

(. ;ften asymptomatic 1especiay in directhernias4

B. Pain or du sensation in groin


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$omplications (. Bowe incarc


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FE%&'() HE'*I(

I. Epidemiology

(. (ccounts for 7 of *roin ernias 10/ are inguina4

B. =ore common in edery women

:. *ender predisposition8 6emae by > to & ratio &. 6emora seen ess than Inguina ernia even in

women

II. Pathophysiology

(. (ssociated with increased intraabdomina pressure

B. ernia sac buges into femora cana

. 6emora cana ies immediatey media to femora

vein


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I*$I#I&*() HE'*I(I. Pathophysiology (. 'ype of ?entra ernia

B. Deveops in scar of prior aparotomy or drain site :. Ris#s for postoperative hernia deveopment &. ?ertica scar more commony a@ected than

horiAonta 3. ound infection

>. ound dehiscence 7. =anutrition +. ;besity /. 'obacco abuse


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Treatment &ptions

( hernias shoud be surgicay corrected to removethe ris# of incarceration and stranguation.

If there are compeing co-morbid medica conditions

that precude surgery, then a truss, or support herniabet may be empoyed. ( truss does not repair thehernia defect, but wi a@ord some reief of symptoms.

=odern methods of repair incude open primary cosureof the defect with sutures 1%houdice or ":anadian"Repair, Bassini Repair4C patch cosure with prostheticmaterias 1Poypropyene or *orte4 tension-free1Lichtenstein-type4 and aparoscopic repair.


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(ssessment

Inspectionmay revea an obvious sweing inthe inguina area. If he has a sma hernia, thea@ected area may simpy appear fu.

(s part of your inspection, have the patient iedown. If the hernia disappears, itEs reducibe(uscultationshoud revea bowe sounds.'he absence of bowe sounds may indicate

incarceration or stranguation.Palpationheps to determine the siAe of an

obvious hernia. It aso can discose thepresence of a hernia in a mae patient.


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Primary Nursing Diagnosis8 Pain reated to sweingand pressurePrimary nursing ;utcomes8 Pain, disruptive e@ectsCpain evePrimary nursing Interventions8 (nagesicadministrationC pain management

:ommon Nursing diagnoses found on Nursing carepan for Inguina ernia(cti+ity intolerance(cute pain

Ine@ective tissue perfusion8 *IRis# for infection

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Hernias 02ppt