Incisional Hernia Examination

General : Obese
fever
anaemia
jaundie
Oedema

Local:
Inspection : Abdomen - flat / diastanded
move with respiration
flanks are normal or full
umbilicus is ____
visible peristalsis present or not
old striae present or not in female

Old scar : type - lower midlie incision /.../......
size - ___ cm long
suture - by alternative stitch / continuous
healing - primary / secondary union
stitchs are out or not

swelling : beneath or beside of old scar
reducibility present or not
ေခ်ာင္း ဆိုး ၾကည့္ ခိုင္း - visible cough impulse present or not
ulcer
discharge
skin discolouration

Test : Raising test - postive or not

Palpitation : Light palpitation - 9 regions ကို နာ တဲ့ ေန ရ ာ ရွိ လား အ ရ င္ ေမး ၿပီးမ ရွိ မွဆက္ စမ္း ပါ ။
tenderness
mass
size of hernia neck
defect in anterior abdominal wall ( hernia အရင္း က အေပါက္ မွာ လက္ ညွုိးနဲ ့ လွည့္ပတ္စမ္း ပါ ။)

test : raising test - umblical hernia ၇ွိ ရ င္ ေပၚလာ မယ္ ။

Percussion : shifting dullness and fluid thrill စမ္း ေပး ပါ ။ ( လို အပ္ တယ္ ထင္ မွ သာ )

Auscultation : bowel sound ( normal or increase )

Other system ဘာ စမ္း ခ်င္ ေသး လဲ ေမး ရ င္ Chest for respiratory ( cough )
vaginal examination ( ovarian tumour )
perrectal examination ( BPH )

Diagnosis : 40 or more YEAR obese female with incisional hernia ( female မွာ အ ျဖစ္ မ်ား)

Point for diagnosis : moe than 40 year
female
swelling protrudes form old scar
cough impalsepresent
raising test positive
scar is secondary union

Treatment : (1) conservative treatment with abdominal belt
( 2) surgery - simple apposition ( cattle's operation )
- complex apposition ( Mayo or Keel Operation)
- Hernioplasty by Mesh Repair