Inguinal hernias

Inspection Upon inspection, pronounced cases of ascites are characterized by marked protrusion of the abdomen. The umbilicus becomes everted or bulging. The distance between the navel and the symphysis appears diminished as a result of caudal displacement of the former. With large quantities of ascitic fluid, the abdominal skin is taut and shiny. In long-standing cases of ascites, striae distensae, together with expanded collateral veins radiating from the navel, may be visible. Increased ascitic pressure sometimes causes the occurrence of a hernia (inguinal, femoral, umbilical or cicatricial). (S. fig. 16.7) (41, 48, 57)... 

Ju He is pungent, bitter and neutral, and enters the Liver and Kidney meridians. It is effective for regulating Qi, dissipating nodules and stopping pain. According to the concept that seeds move downwards, it is especially applied to treat cold accumulation in the Liver meridian that is manifested as cramping pain on the lateral sides of the lower abdomen with a cold sensation, such as in dysmenorrhea, amenorrhea, inguinal hernia and hydrocele of the testis. 

Ryley DA, Moorman DW, Hecht JL, Alper MM. A mesothelial cyst of the round ligament presenting as an inguinal hernia after gonadotropin stimulation for in vitro fertilization. Fertil Steril 2004 82 944-6. 

Genitourinary cryptorchidism (failure of the testes to descend into the scrotum) and inguinal hernia Others epilpsy, hyperreflexia, gynecomastia (excessive development of the male mammary glands)... 

Fig. 16.13 Enonnous refractory ascites in alcoholic cirrhosis. Bilateral inguinal hernia with scrotal oedema. Muscular atrophy. Hepatic encephalopathy (II—III) (same patient as in fig. 16.14)...

After a barium enema, perforation occurs rarely in children and debilitated adults or when the colon is already weakened by inflammatory, malignant, or parasitic diseases. Perforation can be triggered by manipulations involved in giving the barium enema or can result from hydrostatic pressure. In one case, perforation followed air contrast insufflation for barium enema in a patient in whom the sigmoid colon became trapped in an inguinal hernia. 

Early ambulation has previously been implicated in transient radicular irritation. However, in a randomized trial there was no difference between early and late mobilization in patients who received intrathecal lidocaine 2% for inguinal hernia repair the incidence was 23% in both groups (256). 

Pettersson N, Emanuelsson BM, Reventlid H, Hahn RG. High-dose ropivacaine wound infiltration for pain relief after inguinal hernia repair a clinical and pharmacokinetic evaluation. Reg Anesth Pain Med 1998 23(2) 189-96. 

BIH bilateral inguinal hernia benign intracranial hypertension... 

The day surgery nurse is admitting a client for repair of an inguinal hernia. Which information provided by the client would be important to report to the surgical team ... 

MINOR Inguinal hernia repair Colonoscopy Mild febrile illness Mild/moderate nausea and vomiting Gastroenteritis 25 mg of hydrocortisone (or 5 mg of methylpred-nisolone) IV on day of procedure... 

Satoskar et al. evaluated the anti-inflammatory properties of curcumin in patients with postoperative inflammation. They studied 46 male patients (between the ages of 15 and 68 years) having inguinal hernia and/or hydrocoele. After the hernia operation, spermatic cord edema, and tenderness were evaluated. Either curcumin (400mg) or placebo (250mg lactose) or phenylbutazone (lOOmg) was administered three times a day for a period of 5 days from the first postoperative day. Curcumin was found to be quite safe, and phenylbutazone and curcumin produced a better anti-inflammatoiy response than placebo. ... 

For hip surgeries, the protection of the acetabulum is provided by a deposit on the metal of the prosthesis of a layer of polyethylene with a very high cross-linked mass using y radiation. Inguinal hernias are treated by the introduction of a polypropylene membrane. Cataracts are treated by the extraction of the natural crystalline lens, and replacing it with a substitute in polymethylmethacrylate. 

The diagnosis of bowel obstruction is established on clinical grounds and usually confirmed with plain abdominal radiographs. Plain radiographs usually show distended bowel loops with air-fluid levels (Fig. 1.66). In inguinal incarcerated hernia, plain film will also show thickening of the... 

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