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HERNIA INGUINALIS
LATERALIS
PRESENTED BY
Dr. M. Ikhlas Yakin
Lasinrang Hospital, Pinrang
PATIENT IDENTITY
Mr. A
MR 128***
Farmer
Examination Date ; 11
- 9 -2017
ANAMNESIS
Chief
complaint Enlarge History
lump in when pain (-) Digestive of
the left Since 3 Reponibl cough or
iliac years ago e lifting Hiperemi problem (- another
)
region heavy s (-) disease
through object (-)
the groin
PHYSICAL EXAMINATION
General Condition:
Well nourished/Compos mentis
Vital Sign
Blood Pressure : 120/80mmHg
Pulse : 88 bpm
Breathing : 20 x/min
Temp : 36,5oC
General Examination
HEAD
Conjungtiva ; anemic (-) Sclera ; icteric (-)
Nose ; Oedema of the concha (-) , Ear ; Otorrhea (-) Tophy (-) , Lips ;
Cyanotic(-)
THORAX COR
Inspection ; Symmetrical, Breathing movement (+) Inspection ; ictus cordis (-)
Palpation; Pain (-) , Mass (-), Crepitation (-) Palpation ; ictus cordis (-)
Percussion ; Sonor Percussion ; Dull
Auscultation; Vesiculer, Ronkhi(-) Wheezing (-) Auscultation ; HS1&2 reguler
ABDOMEN
Inspection : Flat
Auscultation : peristaltic (+)
Percussion : tympani
Palpation : pain (-), hepar/lien not palpable
EXTREMITY
Limb : warm, parese (-), hipestesia (-)
Oedema : (-) , pitting oedem (-)
LOCAL SIGN
REGIO INGUINALIS SINISTRA
Mass 10x4
Pain (-)
cm, mobile
Transiluminasi
Hiperemis (-)
(-)
Thumb test ;
Reponible no lump
appeared
LABORATORIUM
Type Result Normal Limit
WBC 9,6 X 103/mm3 (4,0-10,0x103/mm3)
HGB 15,0 gr/dl (13,0-17,0 gr/dL)
HCT 42,6% (40-54%)
PLT 306x103/mm3 (150-500x103/mm3)
UREUM 27,7 mg/dL (15,0-43,2 mg/dl)
CREATININ 1,02 mg/dL (0,8-1,30 mg/dl)
SGOT 25,4 u/L (0,0-37,0 u/L)
SGPT 17,6 u/L (0,0-41,0 u/L)
GDS 156 mg/dL (74-106 mg/dl)
THORAX PA
11 09 - 2017
cor: normal, aorta: dilatation
difragma normal
Intact bones
RESUME
DIAGNOSI
S
HERNIA INGUINALIS
LATERALIS REPONIBLE
SINISTRA
MANAGEMEN
T
HERNIORRAPHY
DISCUSSION
HERNIA ?
1. Protrution or lump of the
cavity that passed through
the defect of the organ. (1)
2. Protrution of the
abdominal cavity through
the defect of the fascia or
musculoaponeurotic of
the abdominal wall,
congenitally or as a result
of many risk factors (2)
Reponibilis
Irreponibilis
Hernia clinically
Strangulata
Inkaserata
Interna
Direction
eksterna
EPIDEMIOLOGI
Hernia 100% 1%
2% 16%
Inguinalis Femoralis Incisional 80%
34%
Umbilikus other 60% 97%
40%
3% 4% 50%
20%
0%
10% MALEFEMALE
8% Inguinalis Femoralis Lain-Lain
75%
1. Sjamsuhidayat. 2010
2. Rasjad C. 2010
ETIOLOGY
Opening of the processus vaginalis
Increasing of the intraabdominal pressure
Age
Diet
DIRECT VS INDIRECT
ANAMNESIS
Lump Consistency?
Retractable?
Inflammation sign?
Problem of the
passage?
Pain
PHYSICAL EXAMINATION
Thumb test
Finger test Ziemen test
Hernia exam dr. khaleed milad , www.youtube.com
INCARSERATA vs STRANGULATA
Gejala/tanda Obstruksi usus pada hernia inkarserata Nekrosis/gangren pada hernia strangulata