Слайд 2
![Classification by etiology: congenital acquired recurrent hernia inguinal Umbilical diaphragmatic traumatic postoperative artificial primary](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-1.jpg)
Classification by etiology:
congenital
acquired
recurrent hernia
inguinal
Umbilical
diaphragmatic
traumatic
postoperative
artificial
primary
Слайд 3
![](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-2.jpg)
Слайд 4
![Anatomy of Hernia Sac](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-3.jpg)
Слайд 5
![Anatomy of abdominal wall Внутренняя поверхность передней стенки живота (по Р.Д.Синельникову).](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-4.jpg)
Anatomy of abdominal wall
Внутренняя поверхность передней стенки живота (по Р.Д.Синельникову).
Слайд 6
![](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-5.jpg)
Слайд 7
![Indirect Hernia Direct Hernia](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-6.jpg)
Indirect Hernia
Direct Hernia
Слайд 8
![](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-7.jpg)
Слайд 9
![Umbilical Incidence Reported ~10% several times greater in Black children](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-8.jpg)
Umbilical
Incidence
Reported ~10%
several times greater in Black children
more common in premature children
all races
Most close spontaneously by age 2 or 3
Acquired rather than congenital in adults
Female to male ratio 3:1
Слайд 10
![Epigastric Clinical Often asymptomatic, incidental finding If symptomatic, vague abdominal](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/62312/slide-9.jpg)
Epigastric
Clinical
Often asymptomatic, incidental finding
If symptomatic, vague abdominal pain above the umbilicus
exacerbated by standing or coughing; relieved in supine position
Severe pain secondary to incarceration/strangulation of preperitoneal fat (often no peritoneal sac) or omentum
Exam: palpate small, soft, reducible mass superior to the umbilicus
RARE to have strangulated bowel
Tx
Excise fat and sac, close primarily