Ch. 346 - Inguinal hernias Flashcards Preview

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Flashcards in Ch. 346 - Inguinal hernias Deck (15):

MC surgical procedure performed in pediatric surgical practice

Inguinal hernia


The overwhelming majority of inguinal hernias in infants and children are ___ (99%) as a consequence of a patent processus vaginalis (PV)

congenital indirect hernias


Least common type of hernia

Femoral hernia


Approximately 50% of inguinal hernias manifest clinically when

the 1st yr of life, most in the 1st 6 mo


risk of incarceration and possible strangulation of an inguinal hernia is also greatest in what age group

the 1st yr of life (30-40%)


Anatomy of direct inguinal hernia

originates medial to the deep inferior epigastric vessels and is external to the cremasteric fascia; the hernia sac directly through the posterior wall of the inguinal canal


Anatomy of a femoral hernia

originates medial to the femoral vein and descends inferior to the inguinal ligament along the femoral canal


Testes descend to the area of the internal ring by about ___ AOG

28 weeks


Testes descend into the scrotum between ___ AOG

28 and 36 weeks


Inguinal hernias: M vs F

M (6:1)


Inguinal hernias: 60% occur on ___, 30% ___, 10% ___

Right, left, bilateral


Hallmark sign of an inguinal hernia on PE

Smooth, firm mass that emerges through the external inguinal ring lateral to the pubic tubercle and enlarges with increased intraabdominal pressure


Describes the feeling of the layers of the hernia sac as they slide over the spermatic cord structures, with rolling of the spermatic cord beneath the index finger at the pubic tubercle

Silk glove sign


T/F In infants <1 yr of age with inguinal hernia, repair should proceed promptly

T, as many as 70% of incacerated inguinal hernias requiring emergency surgery for reduction and repair occur in the 1st yr of life


T/F An incarcerated, irreducible hernia without evidence of strangulation in a clinically stable patient should initially be managed non-operatively