Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- groin discomfort or pain with bulge
- groin mass
- abdominal discomfort or pain
Outros fatores diagnósticos
- acute abdomen
- nausea and vomiting
- constipation
Fatores de risco
- male sex
- older age
- family history
- prematurity
- abdominal aortic aneurysm (AAA)
- defective transversalis fascia
- chronic bronchitis or emphysema
- Marfan syndrome
- Ehlers-Danlos syndrome
- lathyrism
- smoking
- heavy lifting
- pregnancy
- ascites
- prostatectomy
- appendectomy
- benign prostatic hypertrophy
- urethral stricture
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical diagnosis
Investigações a serem consideradas
- ultrasound scan of groin
- CT scan
- MRI of groin
Algoritmo de tratamento
incarcerated or strangulated hernia
small, asymptomatic hernia
large or symptomatic uncomplicated hernia
Colaboradores
Autores
Richard Burney, MD
Professor Emeritus of Surgery
Section of General Surgery
University of Michigan
Ann Arbor
MI
Declarações
RB declares that he has no competing interests.
Agradecimentos
Dr Richard Burney would like to gratefully acknowledge Dr LS Wong and Dr EA Agaba, the previous contributors to this monograph. LSW and EAA declare that they have no competing interests.
Revisores
Mark Carlson, MD, FACS
Department of Surgery
University of Nebraska Medical Center
Omaha
NE
Declarações
MC declares that he has no competing interests.
Patrick J. O'Dwyer, MBChB BAO, FRCS, MCh
Professor of Gastrointestinal Surgery
University Department of Surgery
Western Infirmary
Glasgow
UK
Declarações
PJOD declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Itani KMF, Fitzgibbons R. Approach to groin hernias. JAMA Surg. 2019 Jun 1;154(6):551-2.Texto completo Resumo
Fitzgibbons RJ Jr, Ramanan B, Arya S, et al. Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias. Ann Surg. 2013 Sep;258(3):508-15. Resumo
Montgomery J, Dimick JB, Telem DA. Management of groin hernias in adults-2018. JAMA. 2018 Sep 11;320(10):1029-30. Resumo
Neumayer L, Giobbie-Hurder A, Jonasson O, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004 Apr 29;350(18):1819-27.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Undescended testis
- Lymphadenopathy
- Femoral hernia
Mais Diagnósticos diferenciaisDiretrizes
- ACR appropriateness criteria: hernia
- International guidelines for groin hernia management
Mais DiretrizesFolhetos informativos para os pacientes
Inguinal hernia: what is it?
Inguinal hernia: what are the treatment options?
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