Greenfield Questions

1
Greenfield Questions

• Q1 Management of patients with strangulated
  hernias include the following excepta.
  antibioticsb. immediate attempts to reduce
  hernia through taxis c. NG  suction d.
  end to end anastomosis of the bowel

2
Answer

• b. No attempts should be made to reduce hernia,
  strangulation of a hernia is a life threatening
  condition in which the hernial contents become
  ischemic and nonviable,gangrenous bowel should
  be removed and end to end anastomosis should be
  performed with subsequent bowel reduction into
  theabdominal cavity.

3

• Q2  What is the prime cause of an indirect
  inguinal hernia?

4

• AnswerA patent processus vaginalis, which is a
  direct result ofthe migration of the testis from
  its abdominal location of the scrotum.

5

• Q3 Differential diagnosis of a groin hernia
  include the followinga. hydroceleb. psoas
  abscessc. testicular tumord. femoral artery
  aneurysme. a and c onlyf. all of the above

6

• AnswerF. All of the above, other conditions
  that can be mistaken for a hernia include
  varicocele, torsion of the testis, undescended
  testis, lipoma of spermatic cord,
  inguinallymphadenopathy.

7

• Q4 Describe the incision that is performed
  during the Lichtenstein repair of a hernia.

8

• AnswerIncision starts at the pubic tubercle and
  is extended laterally for about 10 cm.

9

• Q5 According to Greenfield what is the most
  important layer in the groin, in which the aim of
  hernia repairs should be to return this layer to
  normal? 

10

• AnswerThe transversus abdominis muscle and its
  aponeurosis, the laparoscopic repair uses this
  concept by strengthening thepreperitoneal area,
  allowing the restoration of this muscle layer.

11

• Q6  What is the most common agent in vascular
  injury during laparoscopic repair of a hernia?

12

• AnswerThe insufflation needle.  

13

• Q7 The management of umbilical hernias is
  conservative in children up to the age of ___
  years.

14

• Answer 2 years, 80 heal spontaneously heal by
  the time patient reaches this age.

15

• Q8 Describe the location and contents of a
  Littre's Hernia?

16

• Answer
• Located in the groin hernia, contains Meckel's
  diverticulum, and sometimes also may contain the
  appendix.