Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Type of Hernia | Clinical Presentation | Tests and Diagnosis | Management |
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Inguinal Hernia |
Most common hernia, particularly in men.
Bulge in the groin, especially when standing or coughing. May present with pain, discomfort, and possibly irreducibility. Strangulated hernia may cause severe pain, vomiting, or fever. |
Physical Exam: Bulge in the groin, more visible with straining or Valsalva maneuver.
Ultrasound: Useful in uncertain cases. CT Scan or MRI: For complex or recurrent cases. |
Conservative: Watchful waiting for asymptomatic or minimally symptomatic cases.
Surgical Repair: Recommended for symptomatic, incarcerated, or strangulated hernias. Laparoscopic or Open Herniorrhaphy: Options for repair. |
Femoral Hernia |
More common in women, presenting as a bulge below the inguinal ligament.
Discomfort or pain in the groin, often exacerbated by activity. High risk of strangulation, leading to bowel obstruction. |
Physical Exam: Bulge below the inguinal ligament.
Ultrasound or CT Scan: Helps confirm diagnosis if unclear. |
Surgical Repair: Usually recommended due to high risk of complications.
Laparoscopic or Open Repair: Depending on the patient and clinical situation. Emergency Surgery: For strangulated hernia. |
Umbilical Hernia |
Common in infants and pregnant women.
Bulge at or near the umbilicus, especially when crying (in infants) or straining. Often asymptomatic, but may cause discomfort in some cases. |
Physical Exam: Soft, reducible bulge at the umbilicus.
Ultrasound: Rarely needed but can be used to confirm diagnosis. |
Observation: In children, most umbilical hernias close by age 5.
Surgical Repair: Recommended in adults or if hernia persists in children. |
Incisional Hernia |
Occurs at the site of previous surgical incisions.
Visible bulge at incision site, may become more pronounced with activity. May cause pain or discomfort at the site, especially with exertion. |
Physical Exam: Bulge or defect at a previous surgical site.
CT Scan: For detailed evaluation of large or recurrent hernias. |
Surgical Repair: Most incisional hernias require surgical correction.
Mesh Repair: Common to reduce recurrence rates. |
Hiatal Hernia |
Protrusion of the stomach through the diaphragm into the chest.
Symptoms include heartburn, regurgitation, dysphagia, and chest pain. Large hernias may cause difficulty swallowing or shortness of breath. |
Barium Swallow X-ray: To assess hernia size.
Endoscopy: To evaluate for esophagitis or other complications. pH Monitoring: For evaluating acid reflux severity. |
Lifestyle Modifications: Weight loss, avoiding large meals.
Medications: Proton pump inhibitors (PPIs) for reflux control. Surgical Repair (Fundoplication): For symptomatic or large hernias. |
Epigastric Hernia |
Occurs in the midline between the umbilicus and the lower part of the rib cage.
May cause a small bulge and discomfort, especially with activity. Often asymptomatic, but some patients may experience pain. |
Physical Exam: Small bulge in the upper abdomen.
Ultrasound or CT Scan: Can confirm diagnosis. |
Surgical Repair: Recommended for symptomatic hernias.
Laparoscopic or Open Repair: Depends on size and complexity of the hernia. |