Table of Contents
What is a Richter hernia?
By definition, a Richter hernia is a herniation of only a portion of the circumference of the bowel wall through the fascial defect. Most commonly, it is the anti-mesenteric portion of the bowel. These hernias often develop in small fascial defects.
Why is it difficult to diagnose Richter hernia?
Richter’s hernia is the protrusion and/or strangulation of part of the intestine’s antimesenteric border through a rigid small defect in the abdominal wall. This hernia is difficult to diagnose because the signs and symptoms of development are innocuous.
Can a hernia be seen on a CT scan?
Cross-sectional CT scans can show hernias and the contents of the peritoneal sac. More important, CT findings can be used to diagnose unsuspected hernias and to distinguish hernias from masses of the abdominal wall, such as tumors, hematomas, abscesses, undescended testes, and aneurysms.
Where is hiatal hernia pain?
A hiatal hernia can also put undue pressure on your stomach, by squeezing or twisting it. This pressure can make your stomach retain acid, which can then flow up into your esophagus. You could develop chest pain, gastroesophageal reflux disease, and/or heartburn, and have trouble swallowing or even breathing.
What is the difference between incarcerated and strangulated hernia?
If the contents of the hernia are not able to be reduced, the hernia is considered incarcerated. A strangulated hernia occurs when the hernia contents are ischemic due to a compromised blood supply.
Is hernia surgery advisable for an 80 year old?
Conclusions. Data collected in this study show that hernia repair can be safely offered to elderly patients with no significant increase in complications and unplanned admissions compared with younger patient, also in over 85 patients, despite the higher percentage of comorbidity found.
Can a Richter hernia be seen on a CT scan?
A Richter hernia will appear as a protrusion of only the antimesenteric portion of a loop of bowel through a defect on computed tomography. CT offers more precise spatial resolution to identify the herniated portion of bowel that ultrasound can miss and can assess for bowel viability.
This herniation is usually through a small, firm defect in the abdominal wall. Although any part of the bowel can be affected, the terminal ileum is most frequently involved. Richter hernias can occur at 2: femoral ring (36-88%)
What is the prognosis of an incarcerated Richter hernia?
As discussed, because of this, patients with an incarcerated Richter hernia may have a prolonged subclinical course and may present only when the process is advanced, and there is a high risk for bowel ischemia. Due to this, there is a crucial need for interprofessional discussion.
How is a Richter’s hernia differentiated from a horseshoe kidney?
Two loops of herniating small bowel, with one loop obstructed and not incarcerated, and another which is incarcerated but not obstructed – conforming to a Richter’s hernia. Incidental horseshoe kidney with a left ureteric stent. Richter’s hernias involve only one side of the bowel wall.