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Hernia Case

This document presents a case study of hernia. It defines hernia as the abnormal protrusion of an organ or tissue through the structure containing it. Hernias most commonly occur in the abdominal cavity when a portion of the bowel protrudes through due to a weakness. While usually harmless, hernias risk having their blood supply cut off, which requires emergency surgery. The case study aims to increase knowledge of hernia factors, management, care, and raise awareness to prevent complications.

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Fatima Love Ariate-Arcasetas
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343 views9 pages

Hernia Case

This document presents a case study of hernia. It defines hernia as the abnormal protrusion of an organ or tissue through the structure containing it. Hernias most commonly occur in the abdominal cavity when a portion of the bowel protrudes through due to a weakness. While usually harmless, hernias risk having their blood supply cut off, which requires emergency surgery. The case study aims to increase knowledge of hernia factors, management, care, and raise awareness to prevent complications.

Uploaded by

Fatima Love Ariate-Arcasetas
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CASE PRESENTATION HERNIA.

2012 JULY 6

Introduction of the Case.


Hernia, an abnormal protrusion of an organ tissue, or part of an organ through the structure that normally contains it. Hernias most commonly occur in the abdominal cavity when a section of the bowel protrudes through as a result of a congenital or acquired weakness of abdominal musculature. Hernias by themselves usually are harmless, but nearly all have a potential risk of having their blood supply cut off. If the blood supply is cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency.

Rationale for Choosing the Study.


We chose this case because we wanted to acquire more knowledge about Hernia. By studying and presenting this case we can now know the factors that can help to alleviate and aggravate this condition and by that knowledge we can give proper care to our future patient who will be having the same kind of condition. By choosing this study we can also make the readers be aware and inform them in the course of this condition.

Significance of the study.


This study will help the nursing profession by providing information about the paper management and care for patient with Hernia. It will also educate the people and vulnerable individuals to seek care in order to prevent complications. It will increase awareness about the importance of having checkups.

Objective of the Case.


Identify patients at risk for hernias Understand the etiology and pathophysiology of hernias Understand the layers of the abdominal wall and their relationship to the inguinal canal

CASE PRESENTATION HERNIA.

2012 JULY 6

Discuss common hernia locations and associated signs and symptoms Understand why (or why not) a hernia should be repaired Provide an overview of techniques for hernia repair and associated controversies

Anatomy & Physiology

CASE PRESENTATION HERNIA.

2012 JULY 6

Pathophysiology.
Predisposing factors Heavy lifting IAP pregnancy Muscle defect Hereditary Obesity Coughing trauma Age Injury Weakened tissue

Weakness in peritoneum or inguinal ligament.

Increase pressure in peritoneum

Protrusion of fat tissue or organ into abdominal cavity Reducible (can be manipulated) Irreducible and incarcerated (cannot be manipulated)

Hernia ring pressure around segment of bowel

Cuts of blood supply to hernia sac.

Emergency surgery.

Tissue becomes necrotic and gangrenous.

Surgery for removal of gangrenous tissue

If not treated can be fatal due to infection from the gangrenous tissue.

CASE PRESENTATION HERNIA.

2012 JULY 6

Medical Management:
Hernias can be mechanically reduced a truss, a firm pad help in place by a belt.

Nursing Management: Apply truss daily before arising. Teach patient to carefully inspect skin under truss for any signs of breakdown.

Surgical Management.
Herniaplasty: surgical repair of a hernia sometimes specifically that using a mesh patches or plug for reinforcement. Herniarhaphy: surgical repair of a hernia sometimes specifically by apposition and suturing of the edges of the defect.

Nursing management. Pre-op Confirm right patient and right procedure.(consent) Place on OR table and hook oxygen and pulseoximeter. Prepare necessary equipment needed for the procedure. skin test( check for any known allergies to medication) Skin preparation and catheterization. Intra-op Place patient in a supine position Place sterile drapes. Post-op Apply the dressing (sterile method.) Clean patients area of surgery. Apply abdominal binder on the patient. Endorse patient to MS ward.

Aid physician in the surgery. Counting of the instrument.

CASE PRESENTATION HERNIA.

2012 JULY 6

Signs and Symptoms.


Hernias present as bulges in the groin area that can become more prominent when coughing, straining, or standing up. They are rarely painful, and the bulge commonly disappears on lying down. The inability to reduce, or place the bulge back into the abdomen usually means the hernia is 'incarcerated which requires emergency surgery. As the hernia progresses, contents of the abdominal cavity, such as the intestines, can descend into the hernia and run the risk of being pinched within the hernia, causing an intestinal obstruction. If the blood supply of the portion of the intestine caught in the hernia is compromised the hernia is deemed strangulated gut ischemia and gangrene can result, with potentially fatal consequences.

Complications,
Complications may arise post-operation, including rejection of the mesh that is used to repair the hernia. In the event of a mesh rejection, the mesh will very likely need to be removed. Mesh rejection can be detected by obvious, sometimes localized swelling and pain around the mesh area. An untreated hernia may complicate by:

Inflammation Irreducibility Obstruction Strangulation Hydrocele of the hernia sac Hemorrhaged Autoimmune problems.

CASE PRESENTATION HERNIA.

2012 JULY 6

Types of Hernia.
Inguinal hernia By far the most common hernias are the so-called inguinal hernias. Much insight is needed in the anatomy of the inguinal canal. Inguinal hernias are further divided into the more common indirect inguinal hernia in which the inguinal canal is entered via a congenital weakness at its entrance and the direct inguinal hernia type where the hernia contents push through a weak spot in the back wall of the inguinal canal. Inguinal hernias are the most common type of hernia in both men and women. Femoral hernias occur more often in women than men, but women still get more inguinal hernias than femoral hernias. Femoral hernia Femoral hernias occur just below the inguinal ligament, when abdominal contents pass into the weak area at the posterior wall of the femoral canal. They can be hard to distinguish from the inguinal type however, they generally appear more rounded, and, in contrast to inguinal hernias. Umbilical hernia Umbilical hernias are especially common in infants of African descent, and occur more in boys. They involve protrusion of intra-abdominal contents through a weakness at the site of passage of the umbilical cord through the abdominal wall. These hernias often resolve spontaneously. Incisional hernia An incisional hernia occurs when the defect is the result of an incompletely healed surgical wound. When these occur in median laparotomy incisions in the linea alba, they are termed ventral hernias. These can be the most frustrating and difficult to treat, as the repair utilizes already attenuated tissue.

CASE PRESENTATION HERNIA. Diaphragmatic hernia

2012 JULY 6

Higher in the abdomen, an diaphragmatic hernia results when part of the stomach or intestine protrudes into the chest cavity through a defect in the diaphragm.

Location sites of hernia.

CASE PRESENTATION HERNIA.

2012 JULY 6

Laboratory Results.

CR-S

Results 12.9 mg/dL 1144.34 umol/L

Conventional 0.62-1.28 55-113

SI

Urea Nitrogen

Results 81. mg/dL

Normal 9.-20.

Potassium

Results 4.2 mmol/L 4.20 mmol/L

Conventional 3.60-5.00

SI 3.60-5.00

Results Percent Activity Prothrombin INR 82.6% 11.8 sec 0.98 9.8-12.7

Normal

Results WBC HGB HCT PLT NEUT% LYMPH EO BASO 6.03 111.0 0.33 255.00 0.45 0.29 0.15 0

Normal 4-10 140-180 0.42-0.54 150-450 0.5-0.7 0.2-0.4 0-0.14 0-0.01

CASE PRESENTATION HERNIA.

2012 JULY 6

Results RBC MCV MCH MCHC 3.43 95.90 32.40 33.70 2.5-5.5 80-94 27-31 33-37

Normal

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