Case Reflection

PATHOPHYSIOLOGY of
HERNIA
Consultant Doctor:
dr. Welman , MSc ., Sp.B

Written by :
AMARO YUDHO WIBOWO
20110310215
 Hernia

A invasion process of
mass/organ in abdomen, that
passed the wall cavity
abdomen trough the defect or
the weaker place in wall cavity
abdomen it self.
Factors that influence hernia happen:

1. The procecus vaginalis was opened

2. The increasing of intra abdomen pressure
3. The muscles in abdomen wall becoming
weak because of aging

# for the baby and child, usually happen

abnormalities (congenital) such as
procecus vaginalis was opened because
the deceleration process of testis into
scrotum.
1. Hernia Inguinalis Medialis/
Direct
The increasing intra The muscle wall of Trigonum
abdomen pressure Hasselbach becoming weak

The invasion organ to the front

(inferior) side with pass the Trigonum
Hasselbach.

The formation of invasion

usually happens in bilateral
form.
(ex: old man)
2. Hernia Inguinalis Lateralis/
Indirect
Peritoneum cavity

Anulus Inguinalis Internus

Canalis Inguinalis

Scrotum
3. Hernia Femoralis

Anulus Femoralis

Canalis Femoralis

Fossa Ovalis
4. Other kinds of Hernia
Hernia Diaphragmatic: defect (congenital) in

diaphragm because there is disturbance in closing

diaphragm it self in embryonic phase. {(1.
Bochdalek/posterolateral)(2.
Morgagni/anteromedial)}
Hernia Umbilicus: the invasion of organ in

abdomen cavity with pass the umbilicus ring cause

by the increasing of intra abdomen pressure.
Hernia Paraumbilicus: Trough the hole in the

midline of lateral cranial umbilicus side.

Hernia Epigastrica: trough to the defect in linea

alba between umbilicus and procecus xiphoideus.

 Hernia Concept and Pain Mechanism
Intra abdomen Congenital
Muscle Weakness
pressure Disorder

Deceleration internal organ

Hernia Inguinalis

Mesenteries Hernia ring

distention compression
Peripheral nerve O2 and Blood
compression supply
Chemical Mediators
Tissue ischemic
release

Nerve stimulating Tissue necrosis

Pain processing Perforation

Spreading
Pain
infection risk
ADDITION FOR PAIN
Pain that located in
epigastric/paraumbilicum is a visceral
pain. Distention of mesenteries when
there is 1 segment of intestine come in
to hernia ring.
Pain with vomiting will appear in illeus
because of necrosis in hernia
strangulata.
THANK YOU