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

One of the main advantages of laparoscopy in children is the fact that it enables a magnified view and the possibility to explore the whole abdominal cavity. This case report clearly shows these advantages. We report the case of a 3-yr-old girl, suffering from severe GERD and right inguinal inguinal hernia, who had already been operated at birth for esophageal atresia. We performed a laparoscopic fundoplication according to Nissen and, at the end of procedure, we decided to turn the optic down to control the right inguinal region to confirm the presence of an inguinal hernia. To our great surprise we found a right oblique external hernia as well as a direct inguinal hernia on the same side. Both hernias was treated successfully in laparoscopy. At a 1-year follow-up, the patient presented no reflux and no recurrence of the inguinal hernias. The laparoscopy in this case permitted operation on two different pathologies involving the upper and lower parts of the abdominal cavity using the same ports and without enlarging the incision, as would happen in laparotomy. The main relevance of this case is that laparoscopy allowed the detection of an associated pathology like a direct inguinal hernia that would have been certainly overlooked in open surgery and could have caused a recurrent hernia if operated via open surgery.
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PMID:The efficacy of laparoscopy in detecting and treating associated congenital malformations in children. 1204 9

Endoscopic surgery has been established in various surgical conditions in children and infants for the past 10 years after pioneering work by experts specializing in pediatric endosurgery. These include pull-through for Hirschsprung's disease and anorectal malformations, pyloromyotomy, hernia repair, and endoscopic surgery for malignancies, malrotation, intussusception, etc. Laparoscopic pull-through is now accepted as a standard modality for the treatment of Hirschsprung's disease. Advanced endoscopic procedures such as esophageal atresia repair or fetal tracheal occlusion have also been performed. An efficient system for training is needed to compensate for the small number of patients and varieties of specific illness in children.
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PMID:[Endoscopic surgery in children: current status and problems]. 1241 45

The quality of neonatal surgical care and scientific publications are reliable yardsticks that were used to assess the status of pediatric surgery in India. A specific questionnaire to assess neonatal care and surgical outcome was mailed to all institutes imparting pediatric surgery training. Data were obtained regarding the outcome of important neonatal surgical conditions for the year 1998 and a PubMed literature search was performed to identify scientific articles between 1995 and 2000. Though a literature search was done to compile a complete list of publications of all the consultants in all the institutes, of the 24 questionnaires mailed, only 11 (45.8%) institutes provided data. The mean (range) annual neonatal admissions in neonatal surgical units was 137 (42-263). The mean newborn admissions requiring surgical intervention per surgeon per year was 36 (17-80). The overall survival was 57.2% (30%-75%), 70.8% (40%-100%), 90.4% (75%-100%), 74.7% (30%-100%), and 59.1% (0%-100%) for esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), congenital diaphragmatic hernia, anorectal malformations, intestinal atresia, and abdominal-wall defects, respectively. The center that had the lowest survival in EA/TEF and CDH had the highest workload per consultant. Between 1995 and 2000, the mean number of scientific articles published in indexed journals compiled from all the institutes (n = 24) was 10.7 (0-84). In conclusion, this is a preliminary study toward setting up national databases of neonatal surgery in different parts of the world to set goals for improvement.
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PMID:Pediatric surgery in India - a specialty come of age? 1259 56

With the present-day development and understanding of anesthetic methods, fluid and electrolyte therapy, antibiotic medications and pediatric care, many congenital anomalies once uniformly fatal are now being successfully treated by emergency operations in the neonatal period. The eight most common of these which demand emergency operation in the immediate postnatal period are esophageal atresia and tracheoesophageal fistula, diaphragmatic hernia with dislocation of the abdominal viscera into the chest, malrotation of the intestine with obstruction, intestinal atresia, meconium ileus, imperforate anus, omphalocele and myelomeningocele. Although infants born with any of these serious problems often are born prematurely and often have more than one congenital anomaly, survival rates in the surgical treatment of these conditions are steadily improving. Early diagnosis and prompt treatment are the most important factors in the continued improvement of these survival rates.
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PMID:Emergency operations in the newborn. 1351 Dec 14

The paraesophageal hernia is rarely seen in the neonatal period. Presentation in neonatal period can be confused with the possibility of esophageal atresia or esophageal web. The upper gastrointestinal tract contrast study is diagnostic in this disease, but careful viewing of the plain X-ray of the chest can also lead to suspicion of the diagnosis. Two neonates with para-esophageal hernia are reported, one with the mesenterico-axial volvulus and the second neonate without volvulus.
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PMID:Paraesophageal hernia in the neonatal period: suspicion on chest X-ray. 1500 8

The occurrence of coexisting congenital diaphragmatic hernia (CDH) and esophageal atresia (EA) with distal tracheoesophageal fistula (TEF) is extremely rare and is considered highly lethal. The combination of CDH with EA/TEF and truncus arteriosus communis (TAC) has not been reported in the literature to date. The authors describe a premature neonate with this association.
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PMID:Congenital diaphragmatic hernia associated with esophageal atresia, tracheoesophageal fistula, and truncus arteriosus in a premature newborn. 1593 89

Respiratory distress due to either medical or surgical causes occurs commonly in neonates. It is the most common cause of admission to a neonatal surgical intensive care facility in a tertiary care hospital. The distress can be caused by a variety of clinical conditions; common conditions treated in medical intensive care units are transient tachypnea of the new born, respiratory distress syndrome, pulmonary air leak and pneumothorax. In surgical causes of respiratory distress in neonates the underlying mechanisms include airway obstruction, pulmonary collapse or displacement and parenchymal disease or insufficiency; the common causes are congenital diaphragmatic hernia, congenital cystic adenomatoid malformation, congenital lobar emphysema and esophageal atresia with or without tracheo-esophageal fistula. Obstructive lesions of the new born airway include choanal atresia, macroglossis, Pierre-Robin syndrome, lymphangioma, teratoma or other mediastinal masses, cysts, subglottic stenosis and laryngo tracheomalacia. Imaging plays a very major role in the pre-operative diagnosis of these conditions and proper pre-operative resuscitation helps in improving the results of surgery dramatically.
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PMID:Respiratory distress in neonates. 1597 26

Surgical stress induces systemic endocrine-metabolic responses that influence the function of endothelial cells (EC) to cause various systemic reactions. Intercellular adhesion molecule (ICAM)-1 is an adhesion molecule that plays an important role in inflammation, and increased expression of ICAM-1 on EC is a reflection of EC activation. In this study, we investigated the ICAM-1 response to surgical stress in neonates undergoing major surgery. Fifteen neonates (mean age at surgery: 3.5 +/- 1.2 days) were divided into two groups according to indications for surgery: Group I: Congenital diaphragmatic hernia without persistent pulmonary hypertension (n = 5); Group II: Gastrointestinal surgery [n = 10: duodenal atresia (n = 3), intestinal atresia (n = 6), and esophageal atresia (n = 1)]. Serum samples were obtained preoperatively, immediately after completion of surgery (time zero), and 24, 48, 72, 96, and 120 h after surgery to measure ICAM-1 levels using an enzyme-linked immunosorbent assay, C-reactive protein (CRP), and white blood cell count (WBC). Postoperative recovery was uneventful in all cases. ICAM-1 levels in both groups increased significantly within 24 h of surgery (Group I: P = 0.0038, Group II: P = 0.0320). In Group I, ICAM-1 peaked 72 h postoperatively while in Group II it continued to rise until 96 h postoperatively. The difference between peak levels reached was not significant. CRP was first detected 24 h postoperatively in both groups and continued to increase until 48 h postoperatively. Again, the difference between peak levels reached was not significant. No significant changes in WBC were observed in either group. We found that ICAM-1 increases in response to surgical stress in neonates, although there was no significant difference in levels. However, surgical stress as represented by serum ICAM-1 would appear to last longer with intestinal surgery than with non-intestinal surgery. Further research is required to establish the usefulness of ICAM-1 as an easily detectable substance associated with endothelial damage that reflects the host's response to major surgical stress.
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PMID:Intercellular adhesion molecule (ICAM-1) response after major neonatal surgery. 1609 95

There are many contradictory data available in the literature on the trends of diagnosed congenital malformations, including those requiring emergency treatment in neonatality. An examining specialist must make use of the algorithm to determine the condition of a neonate, which allows him to qualitatively define the time of surgical treatment and to predict the further course of disease, including its postoperative course. Problems can be solved in the context of evidence-based medicine. To compare the degree and causes of the critical condition of neonatal infants with developmental malformations, the authors have developed a severity rating scale for the newborn with developmental malformations at a gestational age of 35 weeks and a body weight of more than 2 kg, treated at an intensive care unit, by using the results of clinical, laboratory, and morphological studies and estimating the scores. Infants with esophageal atresia, diaphragmatic hernia, anterior abdominal wall and intestine were used as an example to determine changes and causes of the severity of neonates before and after surgery, by taking into account their scores.
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PMID:[Causes of the critical status of neonatal infants with developmental malformations in intensive care units]. 1746 Sep 87

The paper presents data on the varieties and modes of the present artificial ventilation and high-frequency artificial ventilation (AV). It describes the basic impact of various ventilation modes on gas exchange, hemodynamics, and mechanical lung properties. The data on the use of high-frequency AV in neonatal infants with various surgical diseases are given. Its place and indications in malformations, such as diaphragmatic hernia and esophageal atresia, are defined. High-frequency oscillatory AV may be recommended for use as an alternative method in the treatment of respiratory failure in neonates with difuse lung lesion and in those with congenital surgical diseases when it is impossible to ensure adequate gas exchange.
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PMID:[High-frequency oscillatory lung ventilation in neonatal infants with surgical diseases]. 1837 88


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