Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present a case of gallbladder hernia into the foramen of Winslow. During the diagnosis of hernia, ultrasonography, computed tomography and intravenous computed tomography, cholangiography of the abdomen were performed. Ultrasonography detected gallstone, but did not provide sufficient information to diagnose gallbladder hernia. Computed tomography yielded the correct diagnosis. At laparoscopic cholecystectomy, the diagnosis was confirmed.
 ...
PMID:Gallbladder hernia into the foramen of Winslow: CT findings. 1895 15

In recent years, a growing number of severely obese adolescents and their families have sought out surgical treatment because behavioral or medical therapies were not successful. A number of reports have suggested that bariatric surgery for this patient group is safe and can provide durable weight loss. However, most of these reports have been retrospective studies with short-term outcomes, and more long-term, prospective studies are needed to optimize care for these patients. Evaluation of the severely obese patient for surgery involves multiple factors, including the overall maturity of the patient; joint discussions with the patient and his or her family; a complete medical evaluation; evaluation by a child psychologist or psychiatrist; and a minimum of 6 months of private, interdisciplinary, multifaceted lifestyle preparation. Surgical options are restricted to severely overweight adolescents without endocrine disorders who have achieved puberty and have failed more conservative therapies. The Roux-en-Y gastric bypass is the most commonly performed procedure in adolescents, but the laparoscopic adjustable gastric band procedure is growing in popularity. Postoperatively, patients are evaluated 2 weeks after surgery and then every 1 to 2 months for the first postoperative year; every 2 months to 6 months in the second year, depending on the individual case; and then annually for life. A careful diet plan backed by continuing family support is essential. Short- and long-term complications are similar to those seen in adults, and include bowel obstruction, bleeding, blood clots, nausea, gallstones, hernia, and vitamin and iron deficiencies.
 ...
PMID:Bariatric surgery for the severely obese adolescent. 1908 45

Laparoscopic cholecystectomy has become gold standard for cholecystectomy. The tendency of minimizing surgical trauma encourages the use of new approaches in laparoscopic surgery. Single incision laparoscopic surgery (SILS) cholecystectomy was first performed ten years ago; however, it is only recent technologic development that has enabled its wider acceptance. We report on a case of a 69-year-old female patient scheduled for elective laparoscopic cholecystectomy due to symptomatic ultrasonography verified cholelithiasis. A single 2.5-cm long semicircular supraumbilical skin incision was used. Pneumoperitoneum was established with the Veress access needle. Abdominal cavity was entered through three trocars: 10-mm trocar for camera and two 5-mm trocars, each placed 1 cm laterally and cranially from the 10-mm trocar. Antegrade cholecystectomy was performed without stay suture placement. Postoperative course was uneventful. The benefits of transition from standard laparoscopic approach to SILS will not be as obvious as was the transition from open to laparoscopic cholecystectomy. However, it cannot be overstated that every additional incision and trocar placement poses a risk of bleeding, organ damage and incisional hernia. SILS approach is feasible with standard and slightly modified instruments for standard laparoscopic cholecystectomy, thus posing minimal additional challenge to the laparoscopic surgeon. Accordingly, we believe that the use of this approach for cholecystectomy is worthwhile.
 ...
PMID:Single incision laparoscopic surgery (SILS) cholecystectomy: where are we? 1938 73

Small bowel obstruction is caused by postoperative adhesions in most patients. The traditional surgical treatment has been laparotomy with adhesiolysis and possible resection of the ischaemic intestine. The laparoscopic approach has proved feasible but not without risks. We analysed our experience in the management of acute small bowel obstruction and then reviewed the literature in an attempt to identify the real role of laparoscopy. From January 2003 to June 2008, 19 patients operated on for small bowel obstruction were identified. We evaluated our performance in terms of the aetiology of the obstruction, operative time, length of postoperative hospital stay, conversion rate, and major morbidity and mortality. Postoperative adhesions were responsible for the occlusion in 13 cases; a single band was identified in 47% of patients (9 cases). Neoplastic disease (3 cases), a gallstone ileus, Crohn's disease and an internal hernia were the remaining cases. Laparoscopic treatment was only possible in 7 patients with single adhesions (77%), and a conversion was carried out in the remaining 12 cases (63%), including "laparoscopy-assisted" cases (6 cases). The duration of the intervention (89 +/- 21 min vs 135 +/- 27.5 min) and postoperative hospitalisation (3.6 +/- 1 days vs 6.25 +/- 1.6 days) were in favour of the completely laparoscopic group as compared to the laparoscopy-assisted group. A case of postoperative peritonitis due to bowel perforation required a second intervention. With an appropriate selection of patients, confirming the high incidence of the single adhesions responsible for the occlusion and the resulting high success rate of laparoscopy, we believe that only an initial laparoscopic approach can help identify such favourable situations.
 ...
PMID:[Role of laparoscopy in acute obstruction of the small bowel: personal experience and analysis of the literature]. 1939 38

During last ten year laparoscopic procedures have become the part of digestive surgery. Almost all digestive surgery operations were also done laparoscopically. The number of these operations is increasing every day, but some of them are not accepted completely. Various laparoscopic procedures are reviewed, their indications, the advantages and disadvantages. While laparoscopic cholecystectomy is accepted as the treatment of choice for cholelithiasis, other laparoscopic procedures are still not. Appendectomy, endoscopic groin hernia repair, and some gastric procedures have the best chances to be accepted. For other operations it is important to find the best technique and compare the results of these operations with open procedures.
 ...
PMID:[Laparoscopic procedures in digestive surgery]. 1965 52

This paper refers to 50 unusual cases of 542 consecutive adult patients who underwent surgery because of acute intestinal obstruction. Of the 38 small bowel cases, 5 were caused by hernias in anomalous recesses (1 prevesical, 2 left paraduodenal, and 2 paracecal hernias), 6 by a gallstone ileus, 14 to the presence of a bezoar or foreign body, 8 to extended postradiation perivisceritis, 3 to Meckel diverticulum volvulus, 1 to transepiploic hernia, and 1 to ileus-Meckel hematoma during anticoagulation treatment. The 12 large bowel cases included 3 diaphragmatic hernias (1 late post-trauma), 3 cases of colo-colic intussusception, 1 case of obstructive cholecystitis, and 5 cases of Ogilvie's syndrome. Major technical problems have to be immediately solved in the case of left paraduodenal, prevesical, or diaphragmatic hernias; however, during laparotomy, there may also be some difficult and unpredictable problems caused by widespread postradiation perivisceritis.
 ...
PMID:Unusual causes of acute intestinal obstruction in adults. 2010 11

Gallbladder diverticula have the appearance of hernia-like protrusions of the gallbladder wall. This disorder may not be diagnosed until surgically resected because it has no clinical significance unless there are associated diseases. Gallbladder pseudodiverticula have an acquired cause, multiple fundal lesions, an association with gallstones, internal saccular lesions without external hernia-like protrusions, and little to no smooth muscle in the gallbladder wall. We report a unique anomaly of multiple pseudodiverticula presenting with calculous cholecystitis, which was pathologically different from true diverticula and had a unique shape similar to a bunch of grapes and a septation infilling pattern on endoscopic retrograde cholangiography.
 ...
PMID:Gallbladder pseudodiverticulosis mimicking a multiseptate gallbladder with stones. 2043 37

Small bowel obstruction (SBO) is a common cause of hospital admission. Our objective is to determine variables that correlate with failure of the laparoscopic approach for SBO. Twenty-three consecutive patients underwent diagnostic laparoscopy with curative intent for treatment of SBO by a single surgeon over a 3-year period. The laparoscopic approach was successful in 18 patients (78%); there were five (22%) conversions to laparotomy. The causes of obstruction included adhesive band in 16 patients; and small bowel lymphoma, metastatic esophageal cancer, small bowel gangrene, Meckel diverticulum, gallstones ileus, and incarcerated incisional hernia in two. Using the Fisher two-sided test, no significant predictor for conversion was identified using gender, American Society of Anesthesiologists class, previous bowel obstruction, history of adhesiolysis, abdominal distention, pelvic surgeries, chemotherapy, radiation, malignancy, chronic obstructive pulmonary disease, asthma, coronary artery disease, hypertension, or hypercholesterolenemia. The Wilcoxon two-sided test did not show significance for age, weight, number of previous abdominal surgeries, or small bowel diameter. The postoperative hospital stay was significantly shorter in the laparoscopic group compared with those who needed conversion (3 vs. 9 days) with P = 0.0019. No mortality was noted in any patients. The laparoscopic is safe and feasible for the management of SBO. We believe that the laparoscopic approach should be offered to all patients with SBO unless there is an absolute contraindication to laparoscopic surgery.
 ...
PMID:Predictors of failure of the laparoscopic approach for the management of small bowel obstruction. 2083 40

Among 450 patients who underwent lung transplantation (LuT) between April 1994 and April 2009 at a single academic hospital, 75 received surgical consultation, and 52 underwent 65 abdominal operations. Operations included colectomy (17), cholecystectomy (14), exploratory laparotomy (10), ulcer repair (five), hernia repair (four), Nissen fundoplication (four), pancreatic debridement (four), ostomy takedown (two), drainage of intra-abdominal abscess (two), and major vascular procedure, gastrostomy, splenectomy, fascial closure, laparoscopic common bile duct exploration, and small bowel resection (one each). Fourteen patients (27%) died within 30 days of surgery. On univariate analysis, age, race, comorbidities, history of previous abdominal surgery, transplant type, and timing of surgery after transplant were similar between the patients who survived and died. On multivariate analysis, emergent surgery, multiple medical comorbidities, and male gender were predictive of 30-day mortality (P < or = 0.05). Ulcer repair, major vascular procedures, pancreatic surgery, splenectomy, and exploratory laparotomy were associated with > or =50 per cent 30-day mortality. This is the largest series reporting outcomes of abdominal operations after LuT. Elective operations in LuT patients are safe, whereas emergent operations carry an extremely high short-term mortality rate. Aggressive prophylaxis for ulcer disease and early elective intervention for potential surgical problems, such as gallstones and uncomplicated diverticulitis, should be considered.
 ...
PMID:Abdominal surgery after lung transplantation. 2110 27

The Nyhus-Wantz Lectureship honors two giants who represent the few who formed a new surgical specialty: herniology. My topics are etiology, herniosis, diverticulosis coli, and cancer. Hippocrates blamed wear and tear for herniation. Russell's (Lancet 1:1519-1523, 1902) explanation was congenital peritoneal "buds" extending down to the pelvis. Harrison (Arch Surg 4:680-689, 1922) attributed herniae to transversalis fascial degradation. Keith (Lancet 2(17):1398-1399, 1906) concluded that pathology was involved, even though Russell (Lancet 1:1519-1523, 1902) had denied it. Nevertheless, the congenital theory prevailed. According to McVay (Christopher's textbook of surgery, W.B. Saunders, Philadelphia, 1960, p. 159), defects arise in normal musculo-aponeurotic structures. Research showed that atrophy was caused by damaged fibroblasts producing less collagen, which was abnormal (having a reduced I/III ratio). The disease was systemic, later named herniosis. Nicotine addiction increased the incidence of herniation by an inflammatory process named metastatic emphysema. In 1948, Saint's Triad, an aggregation of hiatus hernia (later, any primary hernia), gallstones, and diverticulosis coli, was introduced. This association occurred eight times more often than expected, with herniosis appearing to be its cause, abetted by high blood cholesterol causing gallstones. In 2006, Krones et al. (Int J Colorectal Dis 21:18-24, 2006) provided evidence that colon cancer is accompanied by a reduction in diverticula. Klinge et al. (Hernia 8(4):300-301, 2004) showed that these entities require different extracellular matrices (ECMs). Ghajar and Bissell (Histochem Cell Biol 130:1105-1118, 2008) pointed out that the ECM, which comprises 80% of the breast, influences its epithelial genetic expression, likewise with other organs (kidney, skin, lung, colon, and ovaries). Recently, a fundamental change in our understanding of cancer growth and metastasis has taken place. Whereas the degradation of connective tissue was thought to encourage invasion, eliciting concern for the herniated, now, investigators report the reverse, a reactive vascularized stroma resembling wound healing with an increase in fibroblasts and collagen I. Words such as desmoplasia, fibrosis, and stiffening abound. In conclusion, degradation of the ECM may be why herniosis appears to be hostile to the development of cancer throughout the body. Studies are needed of patients with and without a history of hernia to determine their incidence of cancer. Data from smokers should be separated, since they carry their own high risk of malignancy.
Hernia 2011 Oct
PMID:The Nyhus-Wantz lectureship: etiology, herniosis, diverticulosis coli, and cancer. 2159 Apr 41


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>