Strangulated hernia

Strangulated hernia

Q. 1 Which of these would you like to do for a case of strangulated hernia –

 A X-ray abdomen

 B

USG abdomen

 C

Aspiration of contents of sac

 D

Correction of hypovolemia

Q. 1

Which of these would you like to do for a case of strangulated hernia –

 A

X-ray abdomen

 B

USG abdomen

 C

Aspiration of contents of sac

 D

Correction of hypovolemia

Ans. D

Explanation:

Ans is ‘d’ i.e. Correction of hypovolemia

  • Strangulated hernia is a surgical emergency and needs immediate operation. “Vigrous resuscitation with intravenous fluids, nasogastric aspiration and antibiotics is essential, although operation should not be unduly delayed in moribund patients.” – Bailey
  • The diagnosis of strangulation is made on clinical grounds (The clinical features of strangulation are dramatic). In addition to the patient having developed an irreducible hernia and an intestinal obstruction, the pt. develops sudden pain at first situated over the hernia, followed by generalized abdominal pain. The hernia is tense and extremely tender. The overlying skin may be discoloured with a reddish or bluish tinge. There is no expansile cough impulse).

Q. 2

Treatment of strangulated hernia is ‑

 A Observation

 B

Immediate surgery

 C

Manual reduction

 D

Analgesics

Ans. B

Explanation:

Ans. is ‘b’ i.e., Immediate surgery 


Q. 3

While operating upon strangulated hernia, the sac is opened at:    

September 2009

 A

Neck

 B

Body

 C

Fundus

 D

Mouth

Ans. C

Explanation:

Ans. C: Fundus

Strangulated hernias refer to hernias that have their blood supply cut off.

When this occurs, any tissue in the hernia, such as intestines, can become ischemic and die quickly. This means that quick surgery is imperative to save the herniated tissue.

Strangulated hernias can be differentiated from regular hernias in that they are irreducible, are always painful, are tender to the touch, and sometimes are accompanied by symptoms of nausea, vomiting and fever.

The treatment of strangulated hernia is by emergency operation.

Body and fundus of the sac together with its coverings is delivered.

Each layer covering the anterior surface of the body of the sac near the fundus is incised and stripped off the sac and then the sac is incised.



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