About hernia, false statements -a) In children, indirect inguinal hernia is treated medicallyb) In Richter’s hernia, absolute constipation seenc) Indirect inguinal hernia is the MC typed) Deep inguinal ring is lateral & above the pubic tubercle
Correct Answer: abd
Description: Surgery is the only treatment option for hernia in any age group. There is no role of medical t/t.
the basic operation is inguinal herniotomy which entails dissecting out and opening the hernial sac, reducing any contents and then transfixing the neck of the sac and removing the remainder.
herniotomy is employed either by itself or as the .first step in a repair procedure (herniorrhaphy). By itself herniotomy is sufficient for the treatment of hernias in infants, adolescents and young adults.
Deep inguinal ring
is situated 1.25 cm above the inguinal ligament, midway b/w the symphysis pubis & ASIS (anterior superior iliac spine)
Deep inguinal ring is an opening in the fascia transversalis
Superficial inguinal ring
lies immediately above the pubic tubercle as a triangle with its centre 1 cm above and lateral to the pubic tubercle
Superficial inguinal ring is a triangular gap in the external oblique aponeurosis.
Richter's hernia
In Richter's hernia only a part of the circumference of the bowel enters the hernial sac, therefore complete obstruction and absolute constipation is rare, even after the hernial contents get incarcerated and strangulated.
Bailey writes "Strangulated Richter's hernia is particularly noteworthy as operation is frequently delayed because the clinical features mimic gastroenteritis. The local signs of strangulation are often not obvious, the patient may not vomit and, while colicky pain is present, the bowels are often opened normally or there may be diarrhea; absolute constipation is delayed until paralytic ileus sup ervenes.
For these reasons gangrene of the kunckle of bowel and perforation have often occurred before operation is undertaken"
Category:
Surgery
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