Hernia Hernia Complications and Emergencies 3

Question 1

A patient presents 6 months post-inguinal hernia repair with chronic burning groin pain worsening with hip extension. What is the most likely cause?

Accepted Answer

Genitofemoral nerve entrapment

Answer

Genitofemoral nerve entrapment in mesh or suture causes burning inguinal and thigh pain that worsens with hip extension, a hallmark of neuropathic post-herniorrhaphy pain.

Question 2

What is the significance of a 'pneumatized' hernia sac on CT scan?

Accepted Answer

Air in the bowel wall (pneumatosis) within the hernia suggests ischemic or infarcted bowel

Answer

Pneumatosis intestinalis (air in the bowel wall) within a hernia sac on CT is an ominous sign of bowel ischemia or infarction requiring emergency surgery.

Question 3

Which sign indicates that a Richter hernia has progressed to bowel necrosis on physical exam?

Accepted Answer

Skin erythema, firmness, and local tenderness over the hernia site

Answer

Skin changes—erythema, warmth, and extreme tenderness—over the hernia indicate underlying bowel necrosis and impending perforation.

Question 4

What is the recommended management of an asymptomatic small umbilical hernia in an otherwise healthy adult?

Accepted Answer

Watchful waiting, as most remain asymptomatic

Answer

Watchful waiting is acceptable for small, asymptomatic umbilical hernias in adults, as risk of complications is low and many remain stable for years.

Question 5

Post-operative urinary retention after hernia repair is most common following which type of repair?

Accepted Answer

Open inguinal repair under spinal or general anesthesia, especially in older men

Answer

Urinary retention after hernia repair is most prevalent in older males undergoing open inguinal repair, related to anesthesia effects and prostatic hypertrophy.

Hernia Practice Test

Hernia Practice Test

Hernia Hernia Complications and Emergencies 3