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hernia

hernia. Peresented by amirhosein kalantar. Definition Reducible Non-reducible ( incarcerated) Strangulated Internal External Interparietal. Location. Umbilicus Lumbar triangles Linea alba (epigastric) Surgical incisions Semi-lunar line Diaphragm Pelvis. Umbilical Hernia.

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hernia

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  1. hernia Peresented by amirhosein kalantar

  2. Definition • Reducible • Non-reducible ( incarcerated) • Strangulated • Internal • External • Interparietal

  3. Location • Umbilicus • Lumbar triangles • Linea alba (epigastric) • Surgical incisions • Semi-lunar line • Diaphragm • Pelvis

  4. Umbilical Hernia • Women> men(3/1) • Incidence:10% • more common in African American children • Risk factors • Obesity • Pregnancy • abdominal distension • ascites

  5. Richter’s hernia • incarceration of a portion of the wall of the small bowel in a hernia.

  6. Lumbar Hernia • Congenital, spontaneous or traumatic • Grynfeltt’s triangle • 12th rib, internal oblique and sacrospinalis muscle • Covered by latissimus dorsi • Petit’s triangle • Latissimus dorsi, external oblique and iliac crest • Covered by superficial fascia

  7. Lumbar Hernia • Develops at Petit’s Triangle • Between abdominal and back muscles • Fascia in this region is thin

  8. Littre’s hernia • hernia containing a Meckel’s diverticulum.

  9. Epigastric hernia • In midline Between xiphoid and umbilicus • Incidence 3-5% • Men> women(3/1) • 12% multiple • Etiology: multiple factors: • congenitally weakened linea alba from a lack of decussating midline fibers • increase in intra-abdominal pressure • surrounding muscle weakness • chronic abdominal wall strain

  10. Spigelian Hernia • occurs along the semilunar line • Rare • Ultrasound examination&ct scan • operative repair is mandatory once the hernia is confirmed on diagnosis

  11. Pelvic Hernia • Obturator hernia • Most commonly in women • Howship-Romberg sign • Sciatic hernia • Perineal hernia

  12. Obteratour hernia • Very rare • Seen in elderly, emaciated patients • Develops in obturator fossa • Not visible or palpable on outside • Can strangulate, cause bowel obstruction • ……

  13. Incisional Hernia • Risk factors • Laparoscopic . open repair • Gold standard

  14. Parastomal Hernia • Variant of incisional hernia • Paracolostomy > paraileostomy • Low rate if through rectus muscle • Laparoscopic repair

  15. Hiatal hernia

  16. Thank you Refrence: • schwartzs principles of surgery • Uptodate:Overview of abdominal wall hernias(Author:david C brooks, MD) • Clinical Correlation: Abdominal Wall Hernias(Richard E. Burney, MD,Professor of Surgery)

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