1. HERNIA
NURSYUHAIDA NADILA
SITI FARIHA
SITI AISHAH
WAN FATIMAH

2. DEFINITION OF HERNIA
A hernia is a protrusion of an organ or
structure through a defect in the mascular wall
of the abdomen. Hernia are generally composed
of the covering skin and subcuteneous tissues, a
peritoneal sec, and the underlying viscera, such
as loops of bowel or other internal organs.
Hernia may be congenital,cause by structural
closure defect, or acquired.

3. TYPES OF HERNIA
UMBILICAL HERNIA
INGUINAL HERNIA
- Indirect inguinal hernia
- Direct inguinal hernia
FEMORAL HERNIA
INCISIONAL HERNIA

4. UMBILICAL HERNIA
An umbilical hernia occurs when part of the
intestine protrudes through an opening in the
abdominal muscles. Umbilical hernias are most
common in infants, but they can affect adults as
well. In an infant, an umbilical hernia may be
especially evident when the infant cries, causing
the baby's bellybutton protrude. This is a classic
sign of an umbilical hernia.

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Most umbilical hernias close on their own by age
1, though some take longer to heal. To prevent
complications, umbilical hernias that don't
disappear by age 4 or those that appear during
adulthood may need surgical repair.
Umbilical hernia is a common and typically
harmless condition

7. CAUSE
During pregnancy, the umbilical cord passes
through a small opening in the baby's abdominal
muscles. The opening normally closes just
before birth. If the muscles don't join together
completely in the midline of the abdomen, this
weakness in the abdominal wall may cause an
umbilical hernia at birth or later in life.
In adults, too much abdominal pressure can
cause an umbilical hernia. Possible causes in
adults include:

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Obesity
Heavy lifting
A long history of coughing
Multiple pregnancies
Fluid in the abdominal cavity (ascites)

9. SYMPTOMS
Soft swelling or bulge near the navel
(umbilicus).
The bulge may range from less than 1/2 inch to
about 2 inches (about 1 to 5 centimeters) in
diameter.
Baby will crying because pain
The baby begins to vomit
The bulge becomes tender, swollen or
discolored

10. INGUINAL HERNIA
An inguinal hernia is a condition in which intra-
abdominal fat or part of the small intestine, also
called the small bowel, bulges through a weak
area in the lower abdominal muscles. An inguinal
hernia occurs in the groin—the area between
the abdomen and thigh. This type of hernia is
called inguinal because fat or part of the
intestine slides through a weak area at the
inguinal ring, the opening to the inguinal canal.

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An inguinal hernia appears as a bulge on one or
both sides of the groin. An inguinal hernia can
occur any time from infancy to adulthood and is
much more common in males than females.
Inguinal hernias tend to become larger with
time.

12. AN INGUINAL HERNIA SHOWING THE SMALL INTESTINE
DESCENDING THROUGH THE INGUINAL CANAL.

13. CAUSE
The two types of inguinal hernia have different
causes.
Indirect inguinal hernia. Indirect inguinal hernias
are congenital hernias and are much more common
in males than females because of the way males
develop in the womb. In a male fetus, the spermatic
cord and both testicles—starting from an intra-
abdominal location—normally descend through the
inguinal canal into the scrotum, the sac that holds the
testicles

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Sometimes the entrance of the inguinal canal at
the inguinal ring does not close as it should just
after birth, leaving a weakness in the abdominal
wall. Fat or part of the small intestine slides
through the weakness into the inguinal canal,
causing a hernia. In females, an indirect inguinal
hernia is caused by the female organs or the
small intestine sliding into the groin through a
weakness in the abdominal wall.

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Indirect hernias are the most common type of
inguinal hernia. Premature infants are especially
at risk for indirect inguinal hernias because
there is less time for the inguinal canal to close.

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Direct inguinal hernia. Direct inguinal hernias are
caused by connective tissue degeneration of the
abdominal muscles, which causes weakening of the
muscles during the adult years. Direct inguinal
hernias occur only in males. The hernia involves fat
or the small intestine sliding through the weak
muscles into the groin. A direct hernia develops
gradually because of continuous stress on the
muscles. One or more of the following factors can
cause pressure on the abdominal muscles and may
worsen the hernia:

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sudden twists, pulls, or muscle strains
lifting heavy objects
straining on the toilet because of constipation
weight gain
chronic coughing
Indirect and direct inguinal hernias usually slide back
and forth spontaneously through the inguinal canal
and can often be moved back into the abdomen with
gentle massage.

18. SYMPTOMS
Symptoms of inguinal hernia include
a small bulge in one or both sides of the groin that
may increase in size and disappear when lying down;
in males, it can present as a swollen or enlarged
scrotum
discomfort or sharp pain—especially when straining,
lifting, or exercising—that improves when resting
a feeling of weakness or pressure in the groin
a burning, gurgling, or aching feeling at the bulge

19. FEMORAL HERNIA
A femoral hernia is a bluge in the upper part of the
thigh near the groin.
A hernia occurs when the contents of the abdomen
(usually part of the small intestine) push through a
weak point or tear the thin muscular wall of the
abdomen, which holds the abdominal organs in place.

20. CAUSE
Most of the time, there is no clear cause of a
hernia. Some hernias may be present at birth
(congenital), but are not noticed until later in
life.
Some factors that contribute to the
development of a hernia include:
Chronic constipation

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Chronic cough
Heavy lifting
Obesity
Straining to urinate because of an enlarged
prostate
Femoral hernias tend to occur more often in
women than in men.

22. SYMPTOMS
You may see a bulge in the upper thigh next to
the groin.
Most femoral hernias cause no symptoms. There
may be some groin discomfort that is worse
when you stand, lift heavy objects, or strain.
Sometimes, the first symptoms are abdominal
pain, nausea, and vomiting. This may mean that
the intestine is blocked, which is an emergency.

23. INCISIONAL/VENTRAL HERNIA
A hernia is the protrusion of an organ through the
wall that normally contains it. An incisional hernia
occurs in the abdomen in the area of an old surgical
scar. A part of an organ in the abdomen, such as the
bowel or intestines, protrudes through the weakened
area of the abdominal wall.

24. CAUSE
incisional hernias are caused by thinning or
stretching of scar tissue that forms after
surgery. This weakened scar tissue then creates
a weakness in the abdominal wall.

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Excessive weight gain, physical activity that
places pressure on the abdomen, pregnancy,
straining during bowel movements because of
constipation, severe vomiting, or chronic and
intense coughing causes the scar tissue to thin
or stretch. Because the abdominal wall is weak,
the hernia occurs during abdominal strain.

26. SYMPTOMS
An incisional hernia causes a bulge in the
abdominal area. This type of hernia is often
painless, but may be tender and can cause
discomfort during any type of physical strain,
such as lifting or coughing. The bulge may
disappear when the patient is lying down, and be
more visible when standing up. A hernia can
often be pushed gently back into place.

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This is called a reducible hernia. When a hernia
cannot be pushed back into place, it means a
piece of the organ has become trapped, or
incarcerated. Symptoms include pain, nausea,
vomiting, inability to have a bowel movement,
and a bulge that remains even when lying down.

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When a portion of an organ is incarcerated, its
blood supply can be cut off, which means the
organ’s tissue will die. This condition is called a
strangulated hernia. Incisional hernias can
increase in size with time.