Health-Process-Evidence-based Clinical Practice Guidelines
on Inguinal Hernias

Clinical Questions

What is an operational concept of  hernias?

Ans:

            a protrusion of a viscus through an opening in the wall of the cavity in which it is contained.

Clinical Questions

2. What are the two general categories of groin hernia?

Ans:   Inguinal hernia

                           Femoral hernia

Hernias arising above the abdominocrural crease are inguinal (Latin, groin), and those arising below the crease are femoral (Latin, thigh) or crural (Latin, leg).

Clinical Questions

3. What are the two sub-categories of inguinal hernia?

Ans:   Indirect Inguinal Hernia

                           Direct inguinal Hernia

Clinical Questions

4. What are reliable symptoms and signs (more than 90% certainty) that will indicate that patients has an indirect inguinal hernia?

Ans:   on and off inguinoscrotal mass

More prominent      = increased abdominal                                                           pressure

Clinical Questions

5. What are reliable symptoms and signs (more than 90% certainty) that a patient has incarcerated indirect inguinal hernia?

Ans:

            Inguinoscrotal mass

            Abdominal pain/tenderness

            Vomiting

Clinical Questions

6. If a paraclinical diagnostic procedure is needed in a patient with suspected inguinal hernia, what is the most cost-effective procedure?

Ans:

                        -testicular ultrasound

Results

Formulated Answers

7. What is the best surgical option?

Recommendations

Large* hernia defect  = open with mesh

Small hernia defect     = open without mesh

*No data on literature as to size

Preoperative: 4 cm, base of inguinal bulge, external inguinal ring

Results

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