Dr.

Thoalfakar Bae
General surgeon
Sep.2023
‫ﻛﻠﻳﻪ ﺍﻟﻁﺏ ﻓﺭﻉ ﺍﻟﺟﺭﺍﺣﻪ‬
Abdominal wall, umbilicus and Hernias

Dr.Thoalfakar Bae
General surgeon
Sep.2023
 ‫ﻳﻣﻛﻧﻛﻡ ﺍﻟﺣﺻﻭﻝ ﻣﻥ ﺍﻟﻣﺟﺎﻧﻳﻪ ﻋﻠﻰ ﺍﻟﻛﺗﺎﺏ ﺍﻟﻣﻧﻬﺟﻲ‬

Courtesy Hamilton Bailey’s Demonstrations of Physical Signs in Clinical Surgery 19th Edition
Courtesy BROWSE’S INTRODUCTION TO The Investigation and Management of Surgical Disease
Courtesy Browse’ s introduction to the symptoms & signs of surgical disease 4th edition
 DR.Thoalfakar Bae
General surgeon
Sep.2023

Divarification
Courtesy A Bailey & Love short practice 28th edition. Richter’s hernia
Courtesy A Bailey & Love short practice 27th edition.
Incarcerated inguinal hernia

A 2-year-old boy has been sent in as an

emergency with vomiting for 24 hours. According
to the parents, the vomitus was greenish to start
with but over the past few hours has consisted
of dirty brownish fluid. There has been no bowel
action. On examination the child
looks toxic and is dehydrated — sunken eyes,
depressed fontanelles, loss of skin turgor.
There is a tympanitic abdomen with a red,
irreducible swelling in the right groin not noticed
by the parents.
Courtesy MCQs and EMQs in Surgery - Datta, Pradip K.
Incarcerated inguinal hernia

A 72-year-old patient presented to the emergency

with vomiting for 24 hours. The vomitus was
greenish in color then changed to brownish
feculent in character. There has been no bowel
action.
On examination he looks toxic and signs of
dehydrated are obvious( sunken eyes, coated
tongue and loss of skin turgor).
There is a distended abdomen with a red,
irreducible swelling in the left groin.

Courtesy MCQs and EMQs in Surgery - Datta, Pradip K.

Why did this sequence of vomiting occur?

As obstruction progresses the vomitus

alters from digested food to faeculent
material, this result from the presence of
enteric bacterial overgrowth.

Incarcerated inguinal hernia typically

produces bile-stained vomiting.

Courtesy A Bailey & Love short practice 27th edition.

Management & Treatment

It is by emergency operation.

Preoperative
■Vigorous resuscitation with intravenous fluids,
■nasogastric aspiration
■antibiotics ,
■bladder catheterisation.

Courtesy A Bailey & Love short practice 25th edition.

Courtesy https://www.intechopen.com/online-first/1141753
Courtesy A Bailey & Love short practice 27th edition.

https://www.acquaintpublications.com/article/strangulation-in-a-premature-infant-with-an-inguinal-hernia-in-the-neonatal-intensive-care-unit
Reduction by taxis
Do not attempt taxis!

For children reduction by sustained

gentle compression (‘taxis’) aided
by cautious analgesia, this attempt
is for professional, next year the
professor of pediatric surgery will
explain this for you.
Courtesy A Bailey & Love short practice 27th edition.
Courtesy A Bailey & Love short practice 27th edition.
 ‫?‬

‫ﺃ‪.‬ﻡ‪.‬ﺩ ﺟﻣﺎﻝ ﺍﻟﺧﺿﻳﺭﻱ‪courtesy‬‬

‫ﺃ‪.‬ﻡ‪.‬ﺩ ﺟﻣﺎﻝ ﺍﻟﺧﺿﻳﺭﻱ‪courtesy‬‬