Definition : Hernia may be defined as protrusion of a viscus or part of a viscus through an abnormal opening in the walls of its containing cavity.

We have described in article :

Classification of hernia

Causes of hernia

Composition of hernia

what are the groin hernia

Classification of hernia

A). Clinical classification:

  1. Occult: Not detectable clinically, may cause severe pain.
  2. Reducible: A swelling which appears and disappears.
  3. Irreducible: A swelling which cannot be replaced in the abdomen, high risk of complications.
  4. Obstructed: Bowel in the hernia has good blood supply but bowel is obstructed.
  5. Strangulated: Painful swelling with vascular compromise, requires urgent surgery.
  6. Infarcted: When contents of the hernia have become gangrenous, high mortality.

B) According to the anatomical sites:

  1. Inguinal hernia.
  2.  Femoral hernia.
  3. Umbilical hernia.
  4. Para umbilical hernia.
  5. Epigastric.
  6. Obturator.
  7. Incisional.
  8. Gluteal.
  9. Lumber.
  10. Sciatic.
  11. Pernial hernia.
  12. Diverticulation.

The causes of hernia. 

Aetiology / predisposing factors of hernia :

> Weakness of the abdominal wall:

1) Congenital:

  • Presence of congenital sac (indirect inguinal bemis in male)
  • Patent canal of Nuck (indirect inguinal hernia in female).
  • Failure of transvenalis fascia.

2) Acquired:

  • latrogenic surgical incision.
  • Muscle weakness following obesity, repented pregnancy, nerve division, muscle wasting.

Continued & repeated raised intra-abdominal pressure :

  • Chronic cough e.g. chronic bronchitis, smokers
  • Constipation Urinary obstruction.
  • Vomiting.
  • Ascites.
  • Severe muscular effort.

Genetic : High incidence seen in Eskimon (HLA B27)

Collagen metabolic abnormality: Generalized deficiency in collagen particularly smokers.

Others (Great inguinal hernia) : 

  • Aging
  • Smoking
  • Failure of posterior inguinal wall or fascia.
  • Failure of medial half of transversalis fascia.

Enumerate the composition of hernia.

Composition of hernia : Hernia consists of 3 parts — 

The sac :  formed by parietal peritoneum.

  • Mouth
  • Neck
  • Body
  • Funds

> Coverings : Coverings are derived from the layers of the abdominal wall through which the sac passes.

> Contents : 

  • Omentum =  Omentocele.
  • Intestine – Enterocele
  • A portion of the bladder (or a diverticulum)
  • Ovary with or without the corresponding fallopian tube.
  • A Meckel’s diverticuluma Litre’s henia.
  • Fluid, as part of ascites or as a residuum thereof.

Groin hernias

  1. Inguinal hernia : Direct & indirect.
  2. Femoral hernia.

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