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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A right-sided traumatic diaphragmatic hernia was present in a woman who was 24 weeks pregnant, 8 years after a motor vehicle injury. The hernia had not been diagnosed previously. Correction of severe anaemia and surgical repair of the diaphragmatic defect were successful.
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PMID:Traumatic diaphragmatic hernia presenting pregnancy. A case report. 42 39

The incidence of anemia in 259 patients with a diaphragmatic hernia large enough to be seen on a routine chest roentgenogram was compared with that in 259 age- and sex-matched controls. Eighteen patients with diaphragmatic hernia were anemic, compared to one control subject (P less than 0.001). In thirteen patients with diaphragmatic hernia and in one control the anemia was proven to be caused by iron deficiency. The findings provide additional evidence that a large diaphragmatic hernia can cause anemia secondary to chronic gastrointestinal blood loss, which is usually not the result of reflux esophagitis.
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PMID:Incidence of iron deficiency anemia in patients with large diaphragmatic hernia. A controlled study. 108 35

From November 1970 to August 1974 small intestinal bypass was performed in 475 patients for morbid obesity with an operative mortality of 1.6%. Immediate postoperative complications were superficial wound infection (17 patients), pulmonary complications (seven patients), cardiac complications (five patients), wound dehiscence (nine patients), intestinal tract fistula (four patients), and miscellaneous complications (14 patients). Delayed complications included hypokalemia (28%), hypocalcemia (9%), anemia (11%), calcium oxalate urinary calculi (6%), gout (2%), and hepatic failure (1.4%). Fourteen patients died of late complications. Ventral incisional hernia occurred in 3% of the patients; failure to lose sufficient weight in 21%, all but one occurring in patients with end-to-side shunts. Thirteen end-to-side shunts have been converted to end-to-end shunts because of insufficient weight loss. A team concept is important in the handling of the morbidly obese. Small bowel bypass is effective in producing sustained weight reduction in these patients. Careful and continued study of these patients for the rest of their lives is of paramount importance.
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PMID:Metabolic intestinal surgery. Its complications and management. 113 Oct 9

Patients with large diaphragmatic hiatal hernias occasionally manifest severe iron deficiency anemia. The etiology is believed to be that of small erosions at the waist of the hernia which bleed slowly. Our study attempts to determine the incidence of this condition in clinical practice, and whether acid plays a role in the pathophysiology. Sixteen such patients were identified prospectively in a series of 5219 consecutive patients (0.31%) accrued over a 5-yr interval. Anemia was the presenting feature, rather than symptoms of gastroesophageal reflux disease. The erosions were endoscopically identified and biopsied. Anemia was treated and recurrence was prevented for a mean of 24.6 months with long-term iron replacement. Of eight patients treated with iron alone, four were willing to undergo follow-up endoscopy. Of these four, none demonstrated healing. Three of these nonhealers and eight additional patients were treated with both iron and H2 antagonists. Thus, 11 patients were treated with H2 antagonists and iron, whereas four patients were treated with iron alone. At 6 wk, reendoscopy showed healing of the erosions in seven of 11 patients on H2 antagonists, but in none of those treated with iron alone (p less than 0.05). The anemia was corrected in all patients with iron therapy. We conclude that 1) gastric acid appears to have some role in the pathogenesis of this lesion; 2) short-term therapy with H2-receptor antagonists promote healing of the erosions; and 3) long-term iron therapy alone is adequate for initial and maintenance therapy of the anemia.
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PMID:Large hiatal hernias, anemia, and linear gastric erosion: studies of etiology and medical therapy. 159 51

During a 25-year period, 40 patients with paraoesophageal hiatus hernia were operated on by narrowing of the hiatus and gastropexy. The main symptoms were: epigastric pain (40%), reflux symptoms (25%), cardiac symptoms (20%), dysphagia (20%) and dyspnea (8%). Six patients were free of symptoms. Anaemia was present in 33%, gastric ulcer in 15%. Six patients (18%) had to be operated on as emergencies because of gastric ulcer complications in 4 (3 perforations, 1 severe bleeding) and incarceration in 2 patients. Considering the important risk of acute complications in paraoesophageal hernia an elective gastropexy seems generally advisible--also in patients with few or no symptoms, provided there are no contraindications.
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PMID:[Paraesophageal hiatal hernia--risks and surgical indications]. 277 98

A 57-year-old man with a history of pulmonary asbestosis was incidentally found to have benign mesothelial hyperplasia of the peritoneum at hernia repair. Five months later he developed a Coombs positive haemolytic anaemia of the IgG-C3d type caused by non specific IgG antibodies. At that time no underlying cause for the anaemia was found. The anaemia responded to steroids, but remained steroid dependent. Six months after the diagnosis of the anaemia, a malignant peritoneal mesothelioma was found at laparotomy. The association between malignant mesothelioma and autoimmune haemolytic anaemia has been reported on one previous occasion. The description of a second case suggests that the association is not purely coincidental and that malignant mesothelioma should be added to the list of solid tumours that can be associated with autoimmune haemolytic anaemia. The finding of red blood cells coated with IgG and C3d in this as well as in other cases adds further evidence to the hypothesis that a quinidine type mechanism of haemolysis might be responsible for Coombs positive haemolytic anaemia associated with solid tumours.
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PMID:Autoimmune haemolytic anaemia associated with malignant peritoneal mesothelioma. 281 28

A prospective study was undertaken to identify mucosal lesions that might cause chronic blood loss anemia in patients with large diaphragmatic hernia. Patients with one-third or more of the stomach above the diaphragm on barium x-ray were examined by a gastroscopist who was given no clinical information. A total of 109 patients were included: 55 with anemia and 54 with a large hernia but no anemia. The incidence of esophagitis and peptic ulcer did not differ significantly in the anemic and nonanemic groups. Linear gastric erosions were found on the crests of mucosal folds at or near the level of the diaphragm in 23 anemic patients and 13 without anemia (p less than 0.05). Blood on the surface of a linear erosion was found in 14 anemic patients and 4 without anemia (p less than 0.05). We suggest that these erosions are due to trauma and can cause chronic blood loss anemia in hernia patients.
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PMID:Linear gastric erosion. A lesion associated with large diaphragmatic hernia and chronic blood loss anemia. 348 79

The present paper communicates a case of acute fetal posthemorrhagic anemia. In the case in question, this rare event occurred during birth and had no consequences for the infant thanks to rapid neonatologic intervention. The cause was found to be an incomplete funicular hernia associated with velamentous insertion. The importance of funicular hernias as the most serious umbilical cord complication is discussed with reference to this case and the literature.
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PMID:[Acute fetal posthemorrhagic anemia in incomplete rupture of the umbilical cord]. 358 29

Fifty-five operations for paraesophageal hiatus hernia were performed at the Lahey Clinic, Burlington, Mass, between January 1970 and October 1985. Pain was present in 35 of 51 patients. Other less common symptoms were anemia and vomiting. Reflux symptoms were rare. Esophageal manometry disclosed a mean lower esophageal sphincter pressure of 18.2 mm Hg and a length of 3.5 cm. An anterior crural repair (Collis procedure) was employed in all patients. In 22 patients Stamm gastrostomies were also performed. In two patients, a Nissen fundoplication was also carried out because of coexisting gastroesophageal reflux. One patient died postoperatively of a pulmonary embolus. Of the patients, 88.4% benefited from the operation. Of the five poor results, four were due to hernial recurrence and only one was due to severe reflux symptoms. Gastroesophageal reflux is rare in patients with paraesophageal hiatus hernia. An antireflux procedure should be added to surgical correction of the anatomic defect only if evidence of a hypotensive lower esophageal sphincter is clearly present preoperatively or intraoperatively. The addition of gastrostomy to the procedure protects against recurrence of hernia.
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PMID:Paraesophageal hiatus hernia. 395 87

This retrospective analysis of 140 continuous ambulatory peritoneal dialysis patients followed during a 4 year period revealed a 5 percent incidence of abdominal wall hernias. Inguinal hernias were frequently manifested as unilateral scrotal swelling. Hernias too small to be appreciated by physical examination were easily demonstrable with intraperitoneal instillation of technetium 99m sulfur colloid through the continuous ambulatory peritoneal dialysis catheter. This procedure was also useful when differentiating dialysate leaks from inguinal hernia in the early and late postoperative periods. Recurrences developed in 27 percent of the herniorrhaphies. Factors contributing to the development of abdominal wall hernias in continuous ambulatory peritoneal dialysis patients include uremia, obesity, anemia, and chronically elevated intraperitoneal pressures.
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PMID:Abdominal wall and inguinal hernias in continuous ambulatory peritoneal dialysis patients. 403 96


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