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

Pulmonary sequestration is an uncommon congenital abnormality in which nonfunctioning lung tissue is supplied by an anomalous systemic artery. Both the extralobar and intralobar forms probably develop from an accessory lung bud from the primitive foregut. Both forms are situated on the left side in about two-thirds of patients. The anomalous arterial supply usually originates from the descending thoracic aorta, and there may be a large left-to-left or left-to-right shunt through the sequestration. The sequestration may have a fistulous communication with the upper gastrointestinal tract. Congenital anomalies, particularly diaphragmatic hernia, are frequently associated with the extralobar form. Intralobar sequestration occasionally is an incidental finding on roentgenograms of the chest in an asymptomatic patient; however, the disorder is usually symptomatic and the most common presentation is recurrent pulmonary infection. Presentation may be characterized by gastrointestinal symptoms, congestive heart failure, hemoptysis or hemothorax. Extralobar sequestration is usually an incidental finding on routine roentgenograms of the chest or during the management of some other congenital anomaly. Infrequently, extralobar sequestration presents with symptoms similar to those seen with the intralobar form. Roentgenograms of the chest, upper gastrointestinal series and arteriography are the most helpful diagnostic aids. The usual treatment is resection of the sequestration by removal of only the sequestration in patients with the extralobar form and by lobectomy or segmental resection in patients with the intralobar form. The reported results of operation have generally been excellent.
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PMID:Pulmonary sequestration. 36 Apr 52

In addition to echinococcal cysts and mycetomas, a wide variety of disorders can occasionally produce an air meniscus sign on a chest radiograph. A proposed classification follows: I. Infections A. Lung abscess (with or without pulmonary gangrene) B. Fungus ball C. Bacterial ball D. Tuberculoma E. Blood clot in tuberculous cavity, Rasmussen aneurysm F. Echinococcal lung cyst II. Neoplastic A. Bronchogenic carcinoma B. Primary lung sarcoma C. Metastatic carcinoma, sarcoma to lung D. Bronchial adenoma E. Cystic hamartoma III. Developmental A. Bochdalek hernia (pseudocavity) IV. Traumatic A. Pulmonary hematoma V. Hemodynamic A. Congestive heart failure (with or without bullae)
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PMID:The air meniscus as a radiographic finding: a review of the literature and presentation of nine unusual cases. 75 77

The false diagnosis of "phlebitis" is extremely frequently made: 1) They often relate to the poor interpretation of aspecific clinical signs: oedema, tumefaction, erythema and especially Homan's sign, myalgia, tendinitis, haematoma, hypodermitis, insect bites, thrombosis and varicose sclerosis. 2) The haemostatic syndrome can indicate to the experienced phlebologist: cardiac decompensation, cirrhosis, atonia and post-traumatic muscle atrophy, compressive affections (aneurysms, hernia and especially malignant tumours) and automutilation. 3) Finally, false diagnoses are made more and more frequently because the results of para-clinical tests are taken into account without fitting them into the total clinical picture itself.
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PMID:[False diagnosis of phlebitis]. 745 5

Anderson Area Medical Center physicians have been provided disease and procedure specific profiles of their practice experience for more than five years. For four years, physicians were provided reporting, in a variety of formats, detailing their clinical outcomes and consumption of hospital resources in treating patients with acute myocardial infarction (AMI), pneumonia, cholecystectomy, stroke, congestive heart failure (CHF), and total hip replacement. For the past eighteen months physicians have been provided a uniform format of monthly physician-specific reporting for stroke, AMI, pneumonia, diabetes, CHF, cholecystectomy, total hip replacement, newborn delivery, angina, and hernia repair. Using only a modest PC platform with database, word processing, and graphics programs operating in a DOS environment, an effective disease/procedure reporting program is provided to medical staff with 3 person-days of effort per month.
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PMID:Lowering physician hospital resource consumption using low-cost low-technology computing. 856 69

Anderson Area Medical Center physicians have been provided disease-specific and procedure-specific profiles of their practice experiences for more than 5 years. For 4 years, physicians were provided reports, in a variety of formats, detailing their clinical outcomes and consumption of hospital resources in treating patients with acute myocardial infarction (AMI), pneumonia, cholecystectomy, stroke, congestive heart failure, and total hip replacement. For the past 18 months, physicians have been provided a uniform format of monthly physician-specific reporting for stroke, AMI, pneumonia, diabetes, congestive heart failure, cholecystectomy, total hip replacement, new-born delivery, angina, and hernia repair. Using only a modest PC platform with database, word processing, and graphics programs operating in a DOS environment, an effective disease-reporting and procedure-reporting program is provided to medical staff with 3 person-days of effort per month. Education-based physician-practice reporting is effective in encouraging more resource-efficient decision making on the part of medical staff members. Average length of stay and total charges can be reduced significantly by providing physicians with profiles that show them their relative ranking with peers of several outcome and resource variables. Actual aggregate reductions in average total charges for each of three groups of patients profiled following educational reporting to physicians were $203,680 (AMI), $220,296 (pneumonia), and $146,832 (hip replacement). Total benefit for these three educational reports was $570,808. If educational effects persist for 1 year in the physician groups, the annualized estimate of aggregate charge reductions for 390 AMI patients, 483 pneumonia patients, and 52 hip-replacement patients is $1,568,644. Cost savings to the hospital would be near $706,000.
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PMID:Lowering physician hospital resource consumption using low-cost, low-technology computing. 1016 17

The purpose of this study was to describe the ultrasonographic appearance of non-cardiac diseases of the small animal thorax. Ultrasound images from a total of 75 animals (26 cats and 49 dogs) were compared to cytologic, histopathologic, and necropsy findings. Clinical diagnoses included neoplasia of the mediastinum, pleura, or lungs (43); idiopathic mediastinal cyst (3); diaphragmatic or peritoneopericardial hernia (4); lung lobe torsion (1); pulmonary eosinophilic infiltrates (1); and idiopathic, chylous, congestive heart failure, or lymphangiectasia associated pleural effusion (14). In the remaining 9 patients, a definitive diagnosis was not obtained. Ultrasound-guided fine needle aspirate was performed in 56 patients; 1 of these also had an ultrasound-guided tissue core biopsy. Of the fine needle aspirates, 51 (91%) were diagnostic. Ultrasound examination, particularly when accompanied by guided tissue sampling, can be a valuable tool in the diagnosis of non-cardiac intrathoracic lesions.
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PMID:Non-cardiac thoracic ultrasound in 75 feline and canine patients. 1077 76

This article gives an overview, citing animal and clinical studies, of the effects of increased intra-abdominal pressure (IAP) in severe obesity. Animal studies demonstrate that increased IAP increases pleural pressure, cardiac filling pressures, femoral venous pressure, renal venous pressure, systemic blood pressure, and vascular resistance, renin and aldosterone levels, and intracranial pressure. Thus, the comorbidities presumed secondary to increased IAP in obese patients include congestive heart failure, hypoventilation, venous stasis ulcers, gastroesophageal reflux, urinary stress incontinence, incisional hernia, pseudotumor cerebri, proteinuria, and systemic hypertension.
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PMID:Effects of increased intra-abdominal pressure in severe obesity. 1158 45

Cirrhosis is a significant marker of adverse postoperative outcome. A large national database was analyzed for abdominal wall hernia repair outcomes in cirrhotic vs. non-cirrhotic patients. Data from cirrhotics and non-cirrhotics undergoing inpatient repair of abdominal wall hernias (excluding inguinal) from 1999 to 2004 were obtained from the University HealthSystem Consortium (UHC) database. Differences (P < 0.05) were determined using standard statistical methods. Inpatient hernia repair was performed in 30,836 non-cirrhotic (41.5% male) and 1,197 cirrhotic patients (62.7% male; P < 0.0001). Cirrhotics had a higher age distribution (P < 0.0001), no race differences (P = 0.64), underwent ICU admission more commonly (15.9% vs. 6%; P < 0.0001), had a longer LOS (5.4 vs. 3.7 days), and higher morbidity (16.5% vs. 13.8%; P = 0.008), and mortality (2.5% vs. 0.2%; P < 0.0001) compared to non-cirrhotics. Several comorbidities had a higher associated mortality in cirrhosis: functional impairment, congestive heart failure, renal failure, nutritional deficiencies, and peripheral vascular disease. The complications with the highest associated mortality in cirrhotics were aspiration pneumonia, pulmonary compromise, myocardial infarction, pneumonia, and metabolic derangements. Cirrhotics underwent emergent surgery more commonly than non-cirrhotics (58.9% vs. 29.5%; P < 0.0001), with longer LOS regardless of elective or emergent surgery. Although elective surgical morbidity in cirrhotics was no different from non-cirrhotics (15.6% vs. 13.5%; P = 0.18), emergent surgery morbidity was (17.3% vs. 14.5%; P = 0.04). While differences in elective surgical mortality in cirrhotics approached significance (0.6% vs. 0.1%; P = 0.06), mortality was 7-fold higher in emergencies (3.8% vs. 0.5%; P < 0.0001). Patients with cirrhosis carry a significant risk of adverse outcome after abdominal wall hernia repair compared to non-cirrhotics, particularly with emergent surgery. It may, however, be safer than previously thought. Ideally, patients with cirrhosis should undergo elective hernia repair after medical optimization.
Hernia 2005 Dec
PMID:Poor outcomes in cirrhosis-associated hernia repair: a nationwide cohort study of 32,033 patients. 1613 87

Dyspnea is an alarming symptom for both the patient and the emergency physician. There are many causes of dyspnea, some of which are life-threatening, especially in the elderly patient. In addition to the usual cardiac and pulmonary causes such as congestive heart failure, asthma exacerbation, COPD, pneumonia, and pulmonary embolism, there are less common causes of dyspnea, which if not diagnosed and managed expeditiously may have dire consequences for both the patient and physician. We present a case of an elderly patient with a life-threatening unusual cause of acute shortness of breath, a diaphragmatic hernia with sepsis.
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PMID:An unusual cause of dyspnea. 1679 52

Hernia sac laparoscopy (laparoscopy through an inguinal hernia sac) is a useful method to evaluate the viability of the self-reduced bowel of incarcerated inguinal hernia that is suspected for strangulation, and avoid unnecessary exploratory laparotomy. On the other hand, peritoneal insufflation for laparoscopy is best avoided in patients with severe chronic obstructive pulmonary disease or poor cardiac output. Here, we describe a 78-year-old male with chronic obstructive pulmonary disease and congestive heart failure, whose incarcerated inguinal hernia self-reduced when he was given spinal anesthesia. Bowel viability was in question, so hernia sac laparoscopy without gas was performed, which allowed us adequate evaluation of the reduced bowel by positioning alone, avoiding both exploratory laparotomy and peritoneal insufflation. In our case, hernia sac laparoscopy under spinal anesthesia without pneumoperitoneum was sufficient to obtain necessary information with minimal surgical stress.
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PMID:Hernia sac laparoscopy under spinal anesthesia for evaluation of reduced incarcerated inguinal hernia. 1744 Jul 93


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