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Hernia

Yuhamy Curbelo-Peña, MD, Yulibeth Curbelo-Peña, MD and Adrian Medina-Gallardo, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

Areas of weakness or disruption of the abdominal wall through which intracavity structures pass 
  • Types

    • Inguinal

      • Direct: acquired; herniation through defect in transversalis fascia o...

DIAGNOSIS

HISTORY

  • May observe protrusion through abdominal wall during increased intra-abdominal pressure (Valsalva maneuver or cough)

  • Pain, nausea, vomiting, bloating; relieved with reclining; may sign...

TREATMENT

  • Elective

    • Elective surgical repair is associated with significantly lower morbidity and mortality.

  • Acute setting

    • Pain management for symptomatic hernias

    • Strangulated hernias should be surgica...

ONGOING CARE

PATIENT EDUCATION

REFERENCES

1
Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. Surg Endosc. ...

ADDITIONAL READING

  • Abi-Haidar Y, Sanchez V, Itani KM. Risk factors and outcomes of acute versus elective groin hernia surgery. J Am Coll Surg.  2011;213(3):363–369. [View Abstract on OvidMedline...

SEE ALSO

Algorithms: Abdominal Pain, Lower; Intestinal Obstruction; Pelvic Pain 

CODES

ICD10

  • K46.9 Unspecified abdominal hernia without obstruction or gangrene

  • K40.90 Unil inguinal hernia, w/o obst or gangr, not spcf as recur

  • K41.90 Unil femoral hernia, w/o obst or gangrene, not spcf...

CLINICAL PEARLS

  • Inguinal hernias are either direct or indirect:

    • Direct inguinal: acquired; herniation through defect in transversalis fascia of abdominal wall medial to inferior epigastric vessels

    • Ind...

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