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

Seventy-eight cardiac transplantations were performed between July 1982 and March 1989. The perioperative death rate was 10%. Overall survival was 86%. Among the long-term survivors, 14 patients underwent 16 noncardiac surgical procedures. Seven of them required emergency laparotomy, four for biliary tract disease, one for ruptured abdominal aortic aneurysm, one for suspected abdominal sepsis and one for enterocolitis. Elective surgical interventions included repair of symptomatic abdominal wall hernia, treatment of hemorrhoids or perianal condylomas, total hip arthroplasty, maxillary sinus drainage and resection of a duodenal villous adenoma. Preoperatively, all patients received cyclosporine orally. Ten of the 14 patients were on triple-drug immunosuppression (cyclosporine, azathioprine and low-dose prednisone [less than 0.20 mg/kg daily]). The remaining four patients took cyclosporine with either azathioprine or prednisone. There were no deaths. Complications were limited to residual choledocholithiasis treated by percutaneous removal, two cases of wound infection and an incisional hernia. The authors' experience indicates that noncardiac surgical procedures may be safely performed in patients who have received a heart transplant.
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PMID:General surgical procedures after heart transplantation. 235 Jul 41

The role of intraoperative cholangiography during laparoscopic cholecystectomy is controversial. Between July 1990 and June 1991, 82 of 84 consecutive patients (mean age, 46 +/- 14 years) with symptomatic cholelithiasis successfully underwent laparoscopic cholecystectomy with only one intraoperative cholangiogram. Fourteen patients underwent preoperative endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis of which two demonstrated common duct stones and underwent sphincterotomy. Complications of laparoscopic cholecystectomy included one each of bilioma, umbilical wound infection, epigastric trocar site hernia, and flank seroma. No major bile duct or vascular injury occurred. Follow-up data was available on all patients for a mean of 7.4 months (range, 3-13 months). Three patients developed symptoms suggestive of biliary tract disease at 0.25, 4, and 8 months postoperatively. Symptoms spontaneously resolved in all three; all underwent ERCP, of which two were normal and one unsuccessful. We have concluded that (a) a meticulous operative dissection resulted in no major bile duct or vascular injury; (b) patients with unsuspected choledocholithiasis preoperatively rarely developed postoperative symptoms; and (c) the practice of laparoscopic cholecystectomy can be conducted safely without intraoperative cholangiography.
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PMID:Safe laparoscopic cholecystectomy without intraoperative cholangiography. 826 73

The management of biliary tract disease has changed completely as a result of minimally invasive treatment. For most patients with gallstones that cause symptoms a laparoscopic cholecystectomy will treat the condition with minimal morbidity and a short recovery period. If complications are encountered, conversion to a mini-cholecystectomy gives results that are nearly as good. Acute cholecystitis can be treated by percutaneous drainage followed either by percutaneous cholecystolithotomy or a laparoscopic cholecystectomy. Gallstones in the bile duct are best treated by endoscopic sphincterotomy with duct clearance. The day of the large cholecystectomy scar with its subsequent incisional hernia has gone.
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PMID:General surgery: biliary surgery. 831 78

An ileal perforation resulting from a migrated biliary stent is a rare complication of endoscopic stent placement for benign or malignant biliary tract disease. We describe the case of a 59-year-old woman with a history of abdominal surgery in which a migrated biliary stent resulted in an ileal perforation. Patients with comorbid abdominal pathologies, including colonic diverticuli, parastomal hernia, or abdominal hernia, may be at increased risk of perforation from migrated stents.
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PMID:An unusual cause of ileal perforation: report of a case and literature review. 1949 1

Endoscopic biliary stent insertion is a well-established treatment for hepatic, biliary or pancreatic disorders. A routine change of endoprostheses after 3 mo is a common practice but this can be prolonged to 6 mo. An bowell perforation resulting from a migrated biliary stent is a rare complication of endoscopic stent placement for benign or malignant biliary tract disease. We describe the case of a 84-year-old woman with a history of abdominal surgery in which a migrated biliary stent resulted in an ileal perforation. Patients with comorbid abdominal pathologies, including abdominal hernia, parastomal hernia, or colonic diverticuli, may be at increased risk of perforation from migrated stents.
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PMID:[Perforation of the intestine--rare complication of choledocholithiasis]. 2058 62

Introduction: The revised Ghent nosology presents the classical features of Marfan syndrome. However, behind its familiar face, Marfan syndrome hides less well-known features.Areas covered: The German Marfan Organization listed unusual symptoms and clinical experts reviewed the literature on clinical features of Marfan syndrome not listed in the Ghent nosology. Thereby we identified the following features: (1) bicuspid aortic valve, mitral valve prolapse, pulmonary valve prolapse, tricuspid valve prolapse, (2) heart failure and cardiomyopathy, (3) supraventricular arrhythmia, ventricular arrhythmia, and abnormal repolarization, (4) spontaneous coronary artery dissection, anomalous coronary arteries, and atherosclerotic coronary artery disease, tortuosity-, aneurysm-, and dissection of large and medium-sized arteries, (5) restrictive lung disease, parenchymal lung disease, and airway disorders, (6) obstructive- and central sleep apnea, (7) liver and kidney cysts, biliary tract disease, diaphragmatic hernia, and adiposity, (8) premature labor, and urinary incontinence, (9) myopathy, reduced bone mineral density, and craniofacial manifestations, (10) atrophic scars, (11) caries, and craniomandibular dysfunction, (12) headache from migraine and spontaneous cerebrospinal fluid leakage, (13) cognitive dysfunction, schizophrenia, depression, fatigue, and pain, (14) and activated fibrinolysis, thrombin, platelets, acquired von Willebrand disease, and platelet dysfunction.Expert commentary: Future research, nosologies, and guidelines may consider less well-known features of Marfan syndrome.
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PMID:Features of Marfan syndrome not listed in the Ghent nosology - the dark side of the disease. 3182 51