7/25/2019 Hernia Rza Fix

1/20

Muhammad RezaResident Pediatric surgerydivision

7/25/2019 Hernia Rza Fix

2/20

History

First introduced on 1500 BC

Hernia surgery performed on 1200 BC

a!en descri"ed anatomy of herniaa"out# hernia $as a rupture

Cooper on 1%0&

7/25/2019 Hernia Rza Fix

3/20

Epidemiology

'ncidence ( 0)% * &+

,ge ( Pea- age in premature infants

.e/ ( ma!e fema!e range (1 to10(1

.ide ( 0 + right side

10 + Bi!atera!Fami!y history ( 11#5 + patientshave fami!y history

7/25/2019 Hernia Rza Fix

4/20

Factor contributing to the

development of inguinalhernia

7/25/2019 Hernia Rza Fix

5/20

Con3gurations of hydroce!e and hernia inre!ation to patency of the processus

vagina!is

7/25/2019 Hernia Rza Fix

6/20

Clinical manifestation

Found during "ath time "y parentsand

during $e!!chi!d e/amination History of intermittent "u!ge in

groin# !a"ia# or scrotum)

Bu!ging apparent $hen pressureintraa"domina! increases

4!der chi!dren comp!ain groin oringuina! discomfort

7/25/2019 Hernia Rza Fix

7/20

Physical examination

'nspection

'nguina! mass or asymmetric in the

pu"ic region Pa!pation

Bu!ging# mo"i!e

4!der Chi!d6 7a!sava maneuver'nfant 6 ,!!o$ to strain or cry#

.i!- string sign# p!astic "aggie sign

7/25/2019 Hernia Rza Fix

8/20

7/25/2019 Hernia Rza Fix

9/20

Management

8onoperation

4peration

7/25/2019 Hernia Rza Fix

10/20

7/25/2019 Hernia Rza Fix

11/20

Time of surgery

'f hernia does not reso!vespontaneous!y # surgica! c!osurea!$ays indicated

Recommend repair as soon aspossi"!e

7/25/2019 Hernia Rza Fix

12/20

Routine contra!atera! e/p!oration isnot 9usti3ed

:eftsided initia! hernia repairs may"e associated $ith an increased ris-of contra!atera! disease)

7/25/2019 Hernia Rza Fix

13/20

7/25/2019 Hernia Rza Fix

14/20

7/25/2019 Hernia Rza Fix

15/20

7/25/2019 Hernia Rza Fix

16/20

7/25/2019 Hernia Rza Fix

17/20

7/25/2019 Hernia Rza Fix

18/20

7/25/2019 Hernia Rza Fix

19/20

COMPLICATIONS

Incarceration

Recurrence

Injury to Cord/Testis

7/25/2019 Hernia Rza Fix

20/20

Referencesrosfe!d# ;ay :) 4# Murphy ;P) ,shcraft