13. Which are the three most common types of hernia to strangulate, in order of frequency from most common to least?
Correct answer: (1) Femoral. (2) Indirect inguinal. (3) Umbilical.
12. What are the clinical features of a strangulated hernia?
Correct answer: If strangulation supervenes, the patient complains of severe pain in the hernia of sudden onset and also of central abdominal colicky pain. The other symptoms of intestinal obstruction – vomiting, distension and absolute constipation – soon appear. Examination…
11. What are the clinical features of an irreducible hernia?
Correct answer: If the hernia will not reduce but is painless and there are no other symptoms, irreducibility is diagnosed. The absence of a cough impulse alone does not indicate strangulation, because in an irreducible femoral hernia, for example, the…
10. What are the clinical features of a reducible hernia?
Correct answer: A reducible hernia simply presents as a lump that may disappear on lying down and that is usually not painful, although it may be accompanied by some discomfort. Examination reveals a reducible lump with a cough impulse.
9. What is a strangulated hernia?
Correct answer: When strangulation occurs, the contents of the hernia are constricted by the neck of the sac to such a degree that their circulation is cut off. Unless relieved, gangrene is inevitable and, if gut is involved, perforation of…
8. What is an irreducible hernia?
Correct answer: A hernia becomes irreducible usually because of adhesions of its contents to the inner wall of the sac, or sometimes as a result of adhesions of its contents to each other to form a mass greater in size…
7. What is a reducible hernia?
Correct answer: The contents of a reducible hernia can be replaced completely into the peritoneal cavity.
6. What are the three varieties of hernia at any site?
Correct answer: (1) Reducible. (2) Irreducible. (3) Strangulated.
5. Which six pathological processes can cause an increase in intra-abdominal pressure and give rise to a hernia?
Correct answer: (1) Chronic cough, secondary to chronic bronchitis.(2) Constipation, perhaps due to colonic carcinoma.(3) Urinary obstruction, due to prostatic disease.(4) Pregnancy.(5) Abdominal distension with ascites.(6) Weak abdominal muscles, e.g. in gross obesity or muscle wasting in cachexia.
4. What is the aetiology behind the formation of a hernia?
Correct answer: Hernias occur at sites of weakness in the abdominal wall. The weakness may be congenital, e.g. persistence of the processus vaginalis of testicular descent giving rise to a congenital inguinal hernia, or failure of complete closure of the…
