CHAPTER DC 



The Abdomen — ^Continued 



Hernia 



ABDOMINAL HERNIA IN GENERAL. 



The term Hernia is applied to any protrusion consisting of an 

 organ or part which has escaped from the abdominal cavity where it 

 normally belongs and protrudes through some natural or accidental 

 opening in the walls of the latter. 



The contents of an abdominal hernia may consist of portions of 

 the bowel alone (enterocele), of the omentum alone (omentocele, 

 epiplocele), or of both these together (entero-epiplocele), of the 

 round ligament with more or less of the broad ligament (mesome- 

 trocele), and of one or both uterine cornua in addition to the latter 

 (metro-mesometrocele). The bladder, enlarged prostate gland, 

 spleen, and pancreas have been found present in a limited number of 

 cases. A peculiar instance of protrusion through the abdominal wall 

 has been recorded by Edgar, two fatty ( ?) tumors being found at- 

 tached to the uterus, one of which had grown through the abdominal 

 muscular wall. 



The protruding organs are contained in a sac which consists 

 of an extension of the peritoneum. In some forms, such as the 

 scrotal and perineal, no true sac of neoformation exists, the pro- 

 truding organs passing into dilated cavities which are already lined 

 with prolongations of the peritoneum. The sac is covered by the 

 integument and subjecent connective tissue. 



Hernia may be congenital or acquired. A familiar example of 

 the former is often seen in puppies soon after birth when the umbi- 

 licus remains patulous and a portion of the omentum passes through 

 to form a subcutaneous swelling. The inguinal ring is also occa- 

 sionally the seat of congenital hernia in females, in whom the round 

 ligament and part of the broad form the protrusion. Acquired 

 hernia is the result of either increased intraabdominal pressure, 

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