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

The possible association of Down syndrome (DS) with omphalocele is controversial. We reviewed the 2,979 live births and stillbirths with DS born from 1983 to 1993 in the catchment area of the California Birth Defects Monitoring Program (CBDMP). We observed one infant with both defects, a number that did not differ significantly from what was expected (P < 0.40). We also reviewed the pathological reports of one of us (L.H.H.) from a series of 36 DS fetuses and neonatal deaths; none had an omphalocele. We then reviewed the literature for epidemiological studies of DS and for epidemiological, surgical, prenatal, and familial studies of omphalocele. Possible biases inherent in each type of study were evaluated. The majority of epidemiological studies showed no association of DS with omphalocele. In surgical series, the occasional infant with both defects was more likely to undergo surgery than infants with omphalocele and trisomies 13 and 18 or other severe birth defects. Inclusion of both omphalocele and umbilical hernia in the same ICD-9 code may explain some of the correlations with DS noticed in a few epidemiological studies. In conclusion, our data suggest that trisomy 21 does not predispose the fetus to an increased risk for an omphalocele.
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PMID:Is there an association of Down syndrome and omphalocele? 1006 20

We present the laparoscopic repair of a large incisional hernia secondary to placement of a subcostal ICD pulse generator. Laparoscopic repair of large incisional hernias provides a unique and technically feasible form of repair in the 2%-13% of patients who will develop an incisional hernia following an abdominal surgery. This form of hernia repair is associated with minimal morbidity and prompt resumption of patient activities and work.
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PMID:Laparoscopic hernia repair of an incisional hernia secondary to placement of an implantable cardioverter defibrillator. 967 Feb

The management of large ventral hernias in patients undergoing elective colorectal surgery is controversial considering the reluctance to use a mesh during a clean-contaminated case. We retrospectively reviewed the charts of all patients having undergone at our institution any colorectal surgery along with ventral hernia repair with mesh as identified by the ICD-9 codes between 1997 and 2003. Three patients underwent incisional mesh herniorrhaphy along with elective colorectal surgery, including a right hemicolectomy, a colostomy closure, and a diverting colostomy. Hernia size varied between 330 and 1,243 cm(2). All hernias were repaired using polypropylene mesh in an onlay fashion. Average operative time was 199 min. Two patients developed postoperative wound infection, one of them requiring incision and drainage of a part of the wound. One patient developed skin necrosis of the lower aspect of his incision requiring skin excision and open wound. All open wounds granulated well and healed by secondary intention despite presence of exposed mesh. Therefore prosthetic ventral hernia repair using polypropylene mesh can be performed concomitant to elective colorectal operations, thus avoiding another laparotomy. The incidence of wound complications is, however, high but does not usually require mesh excision.
Hernia 2005 Mar
PMID:Mesh herniorrhaphy during elective colorectal surgery. 1536 81

ICD chapters and three-digit categories are not always appropriate for epidemiological analysis; the former are too generic and the latter too numerous. When the epidemiological focus is not on a specific clinical diagnosis, an intermediate grouping proposal between these two possibilities becomes necessary. Such proposals are not frequent in the literature. We used a two-stage grouping proposal based on hospital admissions volume, internal clinical coherence in each group, and the results of a Cox multivariate model for real data. As a result, we obtained 26 groups for adults and 19 groups for children, among which we chose hernia as the reference category for adults and appendiceal disease for children. The grouping proved adequate for the analysis of readmissions in a large Brazilian general hospital. Procedures similar to those described in this research report can be used to analyze other health problems.
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PMID:[Grouping of the International Classification of Diseases for analysis of hospital readmissions]. 1569 66

Congenital diaphragmatic hernia (CDH) remains one of the most challenging conditions to treat within the pediatric surgical and medical communities. In spite of modern treatment modalities, including extracorporeal membrane oxygenation (ECMO) and improved ventilatory support, mortality remains high. The present study analyzes a US database containing information from nearly 93 million discharges in the US. Infants with congenital diaphragmatic hernia who underwent surgical repair were identified by ICD-9 procedure code and inclusion criteria including an age at admission of less than 1 year. Variables of gender, race, age, geographic region, co-existing diagnoses and procedures, hospital type, hospital charges adjusted to 2006 dollars, length of stay, and inpatient mortality were collected. A total of 89% of patients were either treated initially or rapidly transferred to urban teaching hospitals for definitive treatment of CDH. The inpatient mortality rate was 10.4% with a median length of stay of 20 days (interquartile range of 9-40 days). The median inflation-adjusted total hospital charge was $116,210. Respiratory distress was the most common co-existing condition (68.8%) followed by esophageal reflux (27.8%). The most common concomitant procedures performed were ECMO (17.8%) and fundoplication (17.6%). This study, which represents the largest characterization of US infants who have undergone CDH repair using data from a nationally representative non-voluntary database, demonstrates that surgical repair is associated with significant mortality and morbidity.
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PMID:Congenital diaphragmatic hernia: outcome review of 2,173 surgical repairs in US infants. 1972 69

Introduction: Diverting ostomy is a commonly perfomed procedure but may be associated to its own morbidity (early or late complications). Colostomy-related evisceration is a rare but potentially life threatening condition (requiring emergency surgery), relatively undocumented for its mechanisms. Case report: A male aged 84 was admited for chronic low digestive occlusion due to a locally advanced, stenosing, rectal adenocarcinoma. Prior to neoadjuvant therapy, a loop sigmoidostomy was indicated using a left iliac open aproach, with no preparation of the colic content. The sigmoid was loaded with hard stools. The parietal breach was reaproximated by 2 monofilament nylon sutures, fascial and colocutaneus fixation. Colostomy was opened two days later, but was not functional (postoperative paralytic ileus). Parastomal evisceration of ileum in day 3, dehiscence of parietal suture. Emergency operation, using the same aproach. Results: Favourable outcome. Thoraco-abdominal CT scan: N0,M0. Pelvic MRI: proliferative mass of inferior and middle rectum, involving mesorectum fascia, levator ani and a few regional lymphatic nodes. Radio-chemotherapy and abdomino-perineal resection. Pathologic result: colorectal adenocarcinoma, G2, ypT1ypN0, ICD-O: 8140/3. Conclusions: We rewiewed 8 case reports published since 2011, equally distributed as late or early complications. There was no connection with the princeps indication (colorectal cancer in half of cases); neither related to topography (transverse or sigmoid) or type of colostomy (loop or end). Occurence of the complication is not time-dependent (5 to18 months in late, 3 to 12 days for early eviscerations). The main premise is colostomy itself (a place of reduced parieto-abdominal resistence), stressed by increassed intra-abdominal pressure (eg. bronchopulmonary disease, digestive obstruction). Predisposing factors for late evisceration seems to be related to spontaneous rupture of parastomal hernia/colostomy prolapse. As for early evisceration, both technical details and surgical strategy must be considered (indequate fixation; creation of a larger than necessary colostomy aperture).
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PMID:Paracolostomy Evisceration: Short Review and a New Case Report. 3215 4