Hernias

• Hernia


  Abnormal protrusion or projection of an organ, tissue or part of an organ through the structure that normally contains it
• Inguinal Hernia


  Portion of the intestine or abdominal tissue protrudes through a weak spot in the lower abdominal wall, near the inguinal canal
• Inguinal Hernia


  • Common in men due to the space allowed for the descent of testes
  • Can be indirect (through the inguinal ring) or direct (through a weakened area of the abdominal wall)
• Umbilical Hernia


  Abdominal contents, such as intestine or fat, protrude through a weakness or opening in the abdominal muscles around the umbilicus (belly button)
• Hydrocele


  Accumulation of fluid in the scrotum
• Spermatocele


  Accumulation of sperm-containing fluid in the scrotum
• Hydrocele or spermatocele


  • Can cause scrotal swelling and discomfort
• Post-herniorrhaphy pain syndrome


  Chronic pain at the surgical site following hernia repair surgery
• Hernia


  Protrusion of an organ or tissue through an abnormal opening
• Chronic pain can affect daily activities
• Diagnosis - History


  1. Obtain comprehensive medical history

  2. Ask about onset and duration of symptoms

  3. Inquire about family history
• Diagnosis - Physical Examination

  1. Perform inspection, palpation, and auscultation

  2. Examine patient in supine and standing positions

  3. Identify hernia sac and fascial defect

  4. Assess appearance, size, and reducibility of hernia
• Diagnosis - Umbilical Hernias


  Inspect area around belly button for soft bulge or protrusion
• Diagnosis - Inguinal Hernias

  1. Palpate groin area for palpable bulge or swelling

  2. Attempt to reduce hernia by applying pressure
• Diagnosis - Additional Tests

  1. Abdominal X-ray to rule out strangulated hernia

  2. Ultrasound or CT scanning for more accurate diagnosis

  3. Blood tests (FBC, Hb, grouping and cross-matching)

  4. Urinalysis to assist with differential diagnosis
• Emergency surgery is done for strangulated hernias
• Hydrocele


  A fluid-filled sac that forms around the testicle, causing the scrotum to swell and feel heavy or uncomfortable. Usually present at birth or due to injury/inflammation.
• Spermatocele


  A cyst that forms on the epididymis, causing a small, painless lump on the scrotum. Usually harmless but can cause discomfort or pain if large. More common in men over 40.