SEARCH RESULTS FOR: Acquired-Inguinal-Hernias

hernias-inguinales-adquiridas-indirecta-directa

hernias-inguinales-adquiridas-indirecta-directa

Acquired Inguinal Hernias

Acquired Inguinal Hernias: Indirect & Direct Abdominal fluid or mass Constipation Pregnancy Chronic cough ↑ intraabdominal pressure Stretching of musculoaponeurotic structures & weakening of the abdominal fibromuscular tissue Direct Inguinal Hernia Authors: Adam Bubelenyi Jeffery Lindgren Peter Bishay Reviewers: Sophia Khan Shahab Marzoughi Brandon Hisey Vadim Iablokov Usama Malik Dr. Sylvain Coderre* * MD at time of publication Developmental Ehlers-Danlos & Marfan syndrome (genetic disorders characterized by impaired connective tissue development) Collagen deficiency ↑ Protease activity Smoking Aging Malnutrition Collagen breakdown Long-term glucocorticoid use Fibroblast (cells which produce collagen) suppression causing ↓ collagen production Thinning of skin & soft tissues Incomplete obliteration of the processus vaginalis (peritoneal tunnel through which the testes migrate toward the scrotum during embryological development) Failed closure leaves an opening for organs to herniate through Intestinal loops entrapped within herniation Weakening of connective tissues Indirect Inguinal Hernia Protrusion of abdominal and/or pelvic contents through deep inguinal ring Protrusion of abdominal and/or pelvic contents through the Hesselbach triangle (anatomic area defined by the rectus abdominis medially, inferior epigastric vessels laterally, and the inguinal ligament inferiorly) Herniated contents become entrapped Inguinal mass +/- pain that is worse with straining Abdominal distension & tenderness Rhythmic contractions of the intestine attempting to push contents past the blockage site Colicky pain Incarceration (Surgical Emergency) Reduced vascular supply to entrapped contents Strangulation (Surgical Emergency) Constriction & ischemia of hernial contents Gangrenous skin changes (swelling, blue/purple colour, ↑ temperature, ulceration, ↓ sensation) Inflammation of the herniated contents to larger than the hernial opening Irreducible hernia (a hernia which cannot be manually reduced) Bowel Obstruction (Surgical Emergency) Obstruction of intestinal lumen impairs passage of intestinal contents Stimulation of stretch receptors in the bowel wall Nausea +/- vomiting Herniated tissue undergoes necrosis (irreversible cell death), perforating the gastrointestinal wall Obstipation (complete inability to pass stool or gas) Bowel perforation (surgical emergency) Leakage of gastrointestinal contents allows bacteria to infect the abdominal cavity Sudden ↑ pain Abscess (localized collection of pus) Peritonitis (inflammation of the peritoneum) Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Jun 3, 2018; updated dec 29, 2024 on www.thecalgaryguide.com