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Ultrasound showing an indirect inguinal hernia [18] Incarcerated inguinal hernia [19] An indirect inguinal hernia results from the failure of embryonic closure of the deep inguinal ring. In the male it can occur after the testicle has passed through the deep inguinal ring. It is the most common cause of groin hernia.
Incarcerated hernia leads to impairment of intestinal flow, and strangled hernia obstructs blood flow in addition to intestinal flow. [1] Inguinal hernia can make a small lump in the groin region which can be detected during a physical exam and verified by imaging techniques such as computed tomography (CT).
They can be hard to distinguish from the inguinal type (especially when ascending cephalad) [clarification needed]: however, they generally appear more rounded, and, in contrast to inguinal hernias, there is a strong female preponderance in femoral hernias. The incidence of strangulation in femoral hernias is high.
Amyand's hernia is a rare form of an inguinal hernia (less than 1% of inguinal hernias) [2] which occurs when the appendix is included in the hernial sac and becomes incarcerated. The condition is an eponymous disease named after a French surgeon , Claudius Amyand (1660–1740), [ 3 ] who performed the first successful appendectomy in 1735.
A Richter's hernia occurs when the antimesenteric wall of the intestine protrudes through a defect in the abdominal wall. This is distinct from other types of abdominal hernias in that only one intestinal wall protrudes through the defect, such that the lumen of the intestine is incompletely contained in the defect, while the rest remains in the peritoneal cavity.
It is more often seen in men, and predominantly on the right side. Maydl's hernia should be suspected in patients with large incarcerated herniae and in patients with evidence of intra-abdominal strangulation or peritonitis. Postural or manual reduction of the hernia is contra-indicated as it may result in non-viable bowel being missed. [2]
In either case it would be at risk of injury during the operation to repair a femoral hernia, whether the hernia is reducible, incarcerated or strangulated. When the obturator artery travels along the lacunar ligament, it nearly encircles the femoral ring and can be lacerated during a femoral hernia repair.
A strangulated femoral hernia occurs when a constriction of the hernia limits or completely obstructs blood supply to part of the bowel involved in the hernia. Strangulation can occur in all hernias, but is more common in femoral and inguinal hernias due to their narrow "weaknesses" in the abdominal wall. Nausea, vomiting, and severe abdominal ...
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