Def :

- Protrusion of organ
- From normal position
- Through weak part of the wall

External Hernia :
- Protrusion of viscus
- From peritoneal cavity
- Through weak part of abdominal wall
Commond find :
- Inguinal hernia :
- indirect (lateral)
- direct (medial)
- Femoral hernia
- Umbilical hernia
- Obturator hernia
- Semilunar hernia
- Lumbal hernia
- Incisional hernia
- Diafragmatic hernia
Causative factors :
1. Predisposing factor :
a. Congenital
- Persistent proc. Vaginalis
- Persistent canalis nuck
- Non obliterated umbilicus
b. Acquisita
- Operation wound
- Gravidity
- Malnutrision
- Ageing
- Nerve disturbance
2. Presipitating factor :
- Chronic cough
- Constipation
- Urinary retention
- Parturition
- Massive vomiting
- Ascites
Component of hernia :
1. Sacs
2. Content
3. Port (exite through)

Based on content condition :

1. Reducible (Reponibilis)
2. Irreducible (Irreponibilis)
3. Incarcerated
4. Strangulated
Indirect Inguinal Hernia ( I.I.H)

Internal inguinal ring

Inguinal canal

External inguinal ring

Scrotum
Layers in indirect inguinal hernia :
1. Skin
2. External spermatic fascia
3. Cremasteric fascia & muscle
4. Internal spermatic vascia
5. Preperitoneal fat
6. Peritoneum
Direct inguinal hernia (DIH)

Hasselback triangle

External inguinal ring

or
Tears of apponeurosi MOAE

Subcutis
Layers of direct inguinal hernia :
1. Skin
2. Fascia abdominalis superficiliasis
3. Fascia transversalis abdominis

Direct inguinal hernia usually accuired :

Except H. ogilve

Pantalon hernia :
Indirect Inguinal hernia and direct inguinal hernia in I
side
Femoral hernia (FH)
Femoral ring

Femoral canal

Subcutis

Layers of femoral hernia

1. Skin
2. Fascia cribriformis
3. Fascia lata
4. Preperitoneal fat
5. Peritoneum
Sacs :
- Peritoneum
- Except sliding hernia

Content :
- Omentum (Omentocele)
- Gut (Enterocele)
- Part of quts circle (Richters Hernia)
- Meckels diverticulum (Littree Hernia)
- More than one loop of qut (Maydles Hernia)
- Urinary bladder (Vesicocele)
- Ovarium & Tuba
Physical :

IIH DIH FH
Age all old old

Sex

To. Lig.Inguinal Upper site Upper site Lower site

Fingger test Tip of finggers Side of fingers -

Principle of Treatment :
- Nothing to do
# if reducibe & poor patients condition
- Trust (Hernial belt)
- Operation :
Pre op : control to the precipitating factor
Post op : Continue to control precipitation factor.