Hopp til hovedinnhold

Brokk

Sist oppdatert: Sist revidert:
Sist revidert av:


Definisjon:
Et brokk er en utposning fra magehulen, der indre strukturer kan passere gjennom en svakhet i kroppsveggen. Lyskebrokk, femoralbrokk og navlebrokk er de hyppigste typene
Forekomst:
Kan opptre i alle aldre, livstidsrisiko for menn er 27%, for kvinner 3%. Operasjon for lyskebrokk er det hyppigste generellkirurgiske inngrepet utført i Norge
Symptomer:
Svie og ubehag kan av og til komme en tid før brokket blir synlig, tyngdefornemmelse er også vanlig. Inneklemt brokk gir akutte, sterke smerter
Funn:
Undersøkelse kan avdekke kul som kommer til syne når pasienten står, hoster eller på annen måte presser ut magen
Diagnostikk:
Ingen relevante bildeundersøkelser
Behandling:
Ved lyskebrokk foreligger operasjonsindikasjon hos små barn og unge voksne, hos voksne kun ved sjenerende plager. Laparoskopisk nettplastikk foretrekkes. Alle femoralbrokk må vurderes for operasjon
  1. Brooks DC. Classification, clinical features, and diagnosis of inguinal and femoral hernias in adults. UpToDate, last updated Jan 04, 2018. UpToDate  
  2. Mjåland O, Bakken IJ. Lår- og lyskebrokkirurgi i Norge. Kirurgen, 18. mai 2009. kirurgen.no  
  3. de Goede B, Timmermans L, van Kempen BJ, et al. Risk factors for inguinal hernia in middle-aged and elderly men: Results from the Rotterdam Study. Surgery 2015; 157: 540-6. pmid:25596770 PubMed  
  4. Shakil A, Aparicio K, Barta E, Munez K. Inguinal Hernias: Diagnosis and Management. Am Fam Physician. 2020 Oct 15;102(8):487-492. PMID: 33064426. PubMed  
  5. Halleran DR, Minneci PC, Cooper JN. Association between Age and Umbilical Hernia Repair Outcomes in Children: A Multistate Population-Based Cohort Study. J Pediatr 2019. pmid:31711762 PubMed  
  6. HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018 Feb;22(1):1-165. Epub 2018 Jan 12. PMID: 29330835 PubMed  
  7. Fitzgibbons RJ, Giobbie-Hurder A, Gibbs JO, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men. JAMA 2006; 295: 285-92. PubMed  
  8. Rosenberg J, Bisgaard T, Kehlet H, et al. Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults. Dan Med Bull 2011; 58:C4243. PubMed  
  9. Koivusalo AI, Korpela R, Wirtavuori K, et al. A single-blinded, randomized comparison of laparoscopic versus open hernia repair in children. Pediatrics 2009; 123: 332-7. Pediatrics  
  10. OʼReilly EA, Burke JP, Oʼconnell PR. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia. Ann Surg 2012; 255: 846-53. PubMed  
  11. Bullen NL, Massey LH, Antoniou SA, Smart NJ, Fortelny RH. Open versus laparoscopic mesh repair of primary unilateral uncomplicated inguinal hernia: a systematic review with meta-analysis and trial sequential analysis. Hernia. 2019;23(3):461-472. PMID: 31161285. PubMed  
  12. Inaba T, Okinaga K, Fukushima R, et al. Chronic pain and discomfort after inguinal hernia repair. Surg Today 2012; 42:825. PubMed  
  13. Alfieri S, Amid PK, Campanelli G, et al. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia 2011; 15: 239. PubMed  
  14. Holleran TJ, Napolitano MA, Sparks AD, et al. Trends and outcomes of open, laparoscopic, and robotic inguinal hernia repair in the veterans affairs system. Hernia 2022; 26: 889-899. pmid:33909151 PubMed  
  15. Sajid MS, Leaver C, Baig MK, et al. Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair. Br J Surg. 2012;99(1):29–37.
  16. Sanabria A, Dominguez LC, Valdivieso E, Gomez G. Prophylactic antibiotics for mesh inguinal hernioplasty: a meta-analysis. Ann Surg 2007; 245: 392-6. PubMed  
  17. Tolver MA, Strandfelt P, Forsberg G, et al. Determinants of a short convalescence after laparoscopic transabdominal preperitoneal inguinal hernia repair. Surgery. 2012;151(4):556–563.
  18. Zinther NB, Wara P, Friis-Andersen H. Laparoskopisk operation for incisionelt hernie. Ugeskr Læger 2007; 169: 3559. PubMed  
  19. Burger JW, Luijendijk RW, Hop WC et al. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 2004; 240: 578-83. PubMed  
  20. Goodney PP, Birkmeyer CM, Birkmeyer JD. Short-term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis. Arch Surg 2002; 137: 1161-5. PubMed  
  21. Gallegos NC, Dawson J, Jarvis M, Hobsley M. Risk of strangulation in groin hernias. Br J Surg 1991;78: 1771-3. PubMed  
  22. Page B, Paterson C, Young D, O'Dwyer PJ. Pain from primary inguinal hernia and the effect of repair on pain. Br J Surg 2002;89: 1315-8. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim