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Hernia

Yulibeth Curbelo Peña, MD, Yulibeth Curbelo, MD and Nolberto Adrián Medina-Gallardo, MD, PhD Reviewed 06/2019
 


BASICS

DESCRIPTION

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

    • Inguinal

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

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 surgically ...

ONGOING CARE

PATIENT EDUCATION

PROGNOSIS

  • Groin (pediatric): low recurrence rates (<3%) with surgery; may spontaneously...

REFERENCES

1
Lockhart K, Dunn D, Teo S, et al. Mesh versus non-mesh for inguinal and femoral hernia repair. Cochrane Database Syst Rev.  2018;(9):CD011517. [View Abstract on OvidMedline]
2
Buckley F...

ADDITIONAL READING

  • Pereira JA, López-Cano M, Hernández-Granados P, et al. Initial results of the National Registry of Incisional Hernia. Cir Esp.  2016;94(10):595–602. [View Abstract on OvidMedli...

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

    • Indirect: conge...

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