Hiatal hernia

FOR NURSING STUDENTS

1. Powerpoint TemplatesHERNIAS
HERNIA
Presented By
Monika Devi
M.Sc.(N)
HCN,SRHU

2. HERNIA
A hernia is the protrusion of an organ or the
fascia of an organ through the wall of the cavity
that normally contains it.

3. TYPES
1.Inguinal hernia
2.Femoral hernia
3.Umbilical hernia
4.Diaphramatic hernia
5.Hiatal hernia
6.Incisional hernia

4. CONT…
INGUINAL HERNIA:
It is a protrusion of abdominal contents into the
inguinal canal.
1. Direct:
It is a protrusion of abdominal contents
through the weakness in the posterior inguinal
wall.
2. Indirect:
It is a protrusion of abdominal contents into
the inguinal ring.

5. CONT..
FEMORAL:
Femoral hernias occur just below the inguinal
ligament, when abdominal contents pass into
the weak area at the posterior wall of the
femoral canal.
UMBILICAL:
Protrusion of intra abdominal contents through
a weakness at the site of passage of the
umbilical cord through the abdominal wall.

6. CONT..
INCISIONAL:
An incisional hernia occurs when the abdominal
contents protruded through an incompletely healed
surgical wound.
DIAPHRAMATIC:
It results when part of the stomach or intestine
protrudes into the chest cavity through a defect in
the diaphragm.
HIATAL (HIATUS):
Hiatal hernia is a condition in which part of the
stomach sticks upward into the chest, through an
opening in the diaphragm (hiatus).

7. ACCORDING TO THE CHARACTER OF HERNIA
Reducible:Hernias that easily return to the
abdominal cavity.
Irreducible or incarcerated:If the hernia cannot be
placed back into the abdominal cavity.
Congenital:occur prenatally / in the first year(s) of
life, caused by congenital defect
Acquired:It develop later on in life.

8. CONT…
Complete:organ completely protrude into the
weakness.
Incomplete:organ partially herniateinto the
weakness
External:organs herniateto the outside world
Internal:organs protrude from their normal
compartment to another.

9. CAUSES
1.Improper heavy weight lifting
2.Hard coughing bouts
3.Sharp blows to the abdomen
4.Tight clothing
5.Incorrect posture
6.Obesity
7.Straining during a bowel movement or urination
8.Chronic lung disease
9.Fluid in the abdominal cavity
10.Poor nutrition
11.Smoking
12.Overexertion

10. RISK FACTORS
Unknown
Weakening of the supporting tissue
# Poor nutrition
# Smoking
# Overexertion
Increasing age
Obesity
Smoking
Congenital

11. CLINICAL MANIFESTATIONS
In Reducible Hernias:
Presence of A bulge in the groin or in another
abdominal area.
When standing, such bulge becomes more
obvious.
Pain in the groin.
heavy or dragging sensation.
Pain and swelling in the scrotum around the
testicular area.

12. In Irreducible Hernias
1.It cannot return to the abdominal cavity
when pushed in
2.Painless, and can lead to strangulation.
3.Nausea & vomiting
4.Fever
5.Hernia bulge may turn red, purple or dark
and pink

13. IN STRANGULATED HERNIA
Always painful and pain is followed by
tenderness.
Nausea and vomiting
Fever

14. CLINICAL FEATURES
Chest pain
Heartburn, worse when bending over or lying
down
Swallowing difficulty
Pain and discomfort -reflux of gastric acid, air, or
bile
GERD
Nausea

15. DIAGNOSTIC MEASURES
X-Ray
History collection
Physical examination
Multidetector CT
Esophagogastroduodenoscopy
Barium swallow

16. MANAGEMENT
Laparascopic repair of hernia
Herniorrhaphy
Resection of the herniated part
Hernioplasty -Mesh prosthesis placement
Placement of truss with belt

17. COMPLICATIONS
Inflammation
Irreducibility
Obstruction of any lumen
Strangulation
Haemorrhage
Pulmonary aspiration
Slow bleeding and iron deficiency anemia
Strangulation of the hernia

18. NURSING MANAGEMENT
If the patient wears a truss –check for skin
irritation
After hernia repair –observe for distended
bladder
Record intake & output
Provide scrotal support
Apply ice bag to reduce pain

19. NURSING MANAGEMENT
Advice to avoid coughing
Encourage -deep breathing & turning
While coughing or sneezing -splint the incision
& cough/sneeze with mouth open
Advice to avoid heavy lifting for 6-8 weeks

20. SUMMARY

21. REFERENCES