inguinal hernia

1. Inguinal hernia
Done by:
Dr. Kawther A Alsadady.
Supervised by :
Prof. Ahmad K. Elbana.
Faculty of Medicine
Dar Al Uloom University

2. What Is hernia ?
 When part of an organ protrudes through an abnormal
opening or in an abnormal way, this is called a hernia.
 A groin (inguinal) hernia occurs when part of the
intestine bulges through a weak spot in the abdominal
wall at the inguinal canal.
 Inguinal hernias are up to 10 times more common in
men than in women.

3. Sites of Hernia

4. Inguinal canal :
The inguinal canal is a passageway
through the abdominal wall from
superficial to deep inguinal ring.
1- Superficial Inguinal Ring:
- It is triangular aperture in the
aponeurosis of the external
oblique muscle
- lie 1.25 cm above the pubic
tubercle.

5. 2- Deep Inguinal Ring:
 - It is U shape
condensation of
transversalis fascia
 - it lies 1.25 cm above
inguinal ligament.

6. Types of inguinal hernia ?

7. 1- direct Inguinal hernia :
 Who ?
Direct inguinal hernia become more common in
the elderly.
 Where ?
A direct inguinal hernia comes out directly
forward through posterior wall of inguinal
canal.
 When ?
This occurs when a portion of the intestine
protrudes through a weakness in the abdominal
muscles along the wall of the inguinal canal.

8. 2- Indirect Inguinal hernia :
 who ?
Is most common hernia of all especially in young
children.
 where ?
An indirect hernia travels down the canal on the
outer (Lateral & anterior) side of spermatic cord.
 When ?
This occurs when the internal opening of the
inguinal canal, which usually closes around the time
of birth, remains open. This allows a portion of the
intestine to slip through the inguinal canal.

9. Inguinal hernia signs and symptoms in Adult
include:
1. A bulge in the area on either side of your
pubic bone
2. A burning, gurgling or aching sensation at the
bulge
3. Pain or discomfort in your groin, especially
when bending over, coughing or lifting
4. A heavy or dragging sensation in your groin
5. Weakness or pressure in your groin
6. Occasionally, pain and swelling around the
testicles when the protruding intestine
descends into the scrotum

10. Signs and symptoms in children :
 Inguinal hernias in newborns and children result from a
weakness in the abdominal wall that's present at birth.
Sometimes the hernia may be visible only when an
infant is crying, coughing or straining during a bowel
movement. In an older child, a hernia is likely to be
more apparent when the child coughs, strains during a
bowel movement or stands for a long period of time

11. 1. Increased pressure within the abdomen .
2. A pre-existing weak spot in the abdominal wall .
3. A combination of increased pressure within the
abdomen and a pre-existing weak spot in the
abdominal wall .
4. Straining during bowel movements or urination .
5. Heavy lifting .
6. Fluid in the abdomen (ascites) .
7. Pregnancy .
8. Excess weight .
9. Chronic coughing or sneezing .

12. Treatment :
1- Herniorrhaphy
 In this procedure, also called an open hernia repair, the surgeon
makes an incision in your groin and pushes the protruding
omentum or intestine back into your abdomen. The surgeon then
sews together the weakened or torn muscle. The weak area
often is reinforced and supported with a synthetic mesh
(hernioplasty).
 After the surgery, four to six weeks before you're fully able to
resume your normal activities

13. Herniorrhaphy

15. 2- Laparoscopy
 In this minimally invasive procedure, the surgeon
operates through several small incisions in your
abdomen. A small tube equipped with a tiny camera
(laparoscope) is inserted into one incision. Guided by
the camera, the surgeon inserts tiny instruments
through another incision to repair the hernia using
synthetic mesh.

16. Laproscope

17. References :
• Clinical anatomy by region for Snell
• Mayo clinic.org
• inguinalherniatreatment.co.uk
• Webmd.com