TY  - CHAP
M1  - Book, Section
TI  - Abdominal Hernias
A1  - Barlotta, Kevin S.
A1  - Stack, Lawrence B.
A1  - Knoop, Kevin J.
A2  - Knoop, Kevin J.
A2  - Stack, Lawrence B.
A2  - Storrow, Alan B.
A2  - Thurman, R. Jason
PY  - 2021
T2  - The Atlas of Emergency Medicine, 5e
AB  - A  hernia  is  a  defect  in  the  abdominal  wall  allowing  intra-abdominal  contents  to  protrude  outside  the  abdominal  cavity.  Most  abdominal  wall  hernias  occur  at  the  groin  and  umbilicus.  Incarceration  is  defined  as  the  inability  to  reduce  the  protruding  tissue  to  its  normal  position.  Strangulation  occurs  when  the  blood  supply  of  the  hernia’s  contents  is  obstructed  and  tissue  necrosis  ensues.  An  incisional  hernia  may  manifest  clinically  as  a  mass  or  palpable  defect  adjacent  to  a  surgical  incision  and  can  be  reproduced  by  having  the  patient  perform  the  Valsalva  maneuver.  Peristomal  hernias  are  a  type  of  incisional  hernia  where  the  abdominal  wall  opening  is  too  large,  allowing  intra-abdominal  contents  to  accumulate  outside  the  abdominal  cavity.  Obesity  and  wound  infection,  which  interfere  with  wound  healing,  predispose  to  the  formation  of  incisional  hernias.  The  defect  of  an  indirect  inguinal  hernia  is  the  internal  (abdominal)  inguinal  ring  and  may  be  manifest  in  either  sex  by  a  bulge  over  the  midpoint  of  the  inguinal  ligament  that  increases  in  size  with  Valsalva  maneuver.  A  fingertip  placed  into  the  external  ring  through  the  inguinal  canal  may  palpate  the  defect.  A  direct  hernia  may  be  manifested  by  a  bulge  midway  adjacent  to  the  pubic  tubercle  and  may  be  felt  by  the  pad  of  the  finger  placed  in  the  inguinal  canal.  The  defect  is  in  the  posterior  wall  of  the  inguinal  canal.  Direct  inguinal  hernias  are  usually  painless  and  occur  in  males.  Femoral  canal  hernias  are  more  common  in  women  and  are  prone  to  both  strangulation  and  incarceration.  
SN  - 
PB  - McGraw-Hill
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessemergencymedicine.mhmedical.com/content.aspx?aid=1198097717
ER  -