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

In a retrospective study the case sheets of 42 neonates are examined. They were infants with oesophageal atresias, small and large intestinal atresias, exomphalos and gastroschisis, diaphragmatic hernia, intestinal obstruction as well as two children with a ruptured spleen secondary to birth trauma. Various laboratory investigations such as the pH, pCO2, standard bicarbonate and serum electrolytes as well as the child's weight on admission and, if possible, the birth weight were evaluated. There was no definite relationship between the preoperative laboratory values and the chances of survival of surgical neonates except if the values were extreme. Infections and septicaemia were the most important causes of postoperative complications.
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PMID:Preoperative condition of neonates who have ultimately died. 52 38

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

In a prospective follow-up study of 5,571 general surgical patients at 11 hospitals (23 departments) in Israel, 1,487 patients underwent operations for hernia (all types) and were screened daily for the development of postsurgical wound infection. Infection developed in 68 (4.6 per cent) at the site of the incision. Fourteen factors were analyzed for the presumed effect on the risk of infection; only four were significant in a multivariate model. Of these factors (old age, incarcerated or recurrent hernia, coexistent infection and drains), the introduction of drains had the strongest effect (relative risk equaled 4.1; p less than 0.001). Drains increased the risk in all the participating hospitals and in any category of patient. They prolonged the period a wound was susceptible to bacterial infection from nine to 16 days. The risk increased linearly with the duration of the drainage. The over-all proportion of patients who had a drain inserted was 19 per cent, with hospitals varying from 9 to 40 per cent of patients operated upon (p less than 0.001). Our findings suggest that the risk of an infection associated with drains may outweight their worth. Furthermore, there is no concensus among surgeons on the need for drains. Some surgeons use drains indiscriminately and others, rarely.
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PMID:The Israeli Study of Surgical Infection of drains and the risk of wound infection in operations for hernia. 218 14

Fifteen rural Wisconsin acute care community hospitals with an average approved bed size of 55 and an average daily census of 28 patients participated in a nosocomial infection control project. Each hospital Infection Control Practitioner (ICP) was trained and conducted prospective nosocomial infection surveillance on all patients admitted to the hospital for 6 consecutive months between May 1, 1984 and April 30, 1985. Two hundred twenty nosocomial infections were reported among 13,420 discharged patients for an incidence rate of 1.64 infections per 100 discharged patients. One hundred sixty-four patients had one nosocomial infection. Twenty-three patients had two or more. Infection rates were highest among gynecology--4.9% and general surgery patients--4.0%, and lowest among newborns--0.3% and pediatric patients--0%. 39.7% of the infections were of the urinary tract, 27.9% of surgical wounds, 16% pneumonia, and 1.4% primary bacteremia. The other infections were in seven additional sites. Risk factors associated with acquisition of infections included old age, urinary catheterization, and/or a surgical procedure. The overall nosocomial surgical wound infection incidence for inpatient procedures was 1.9%, with incidences of 0.4% for hernia repair, 1.3% for cholecystectomy, 3.3% for appendectomy, 4.0% for total abdominal hysterectomy, and 3.9% for cesarean sections. The incidence of nosocomial infections was 2.7 infections per 100 discharged patients age 65 years or over and 0.9 infections per 100 discharged patients less than 65 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nosocomial infections in 15 rural Wisconsin hospitals--results and conclusions from 6 months of comprehensive surveillance. 352 17

A thorough explanation of vasectomy is important for couples considering male sterilization in order to distinguish it from castration and to emphasize that the male sexual organs are not the focus of surgery and that there is no change in the hormones controlling male sexual behavior. Patients should be informed of the possibility of spontaneous canalization and the uncertainty of surgical reversal. Sterility after vasectomy is not immediate and a semen analysis should be prepared after 20 ejaculations. 2 successive analyses demonstrating absence of sperm are usually considered to indicate sterility. A complete general and local examination should be performed before vasectomy. Local anesthesia may be used unless the patient is tense or has a varicocele, hydrocele, or a large inguinal or scrotal hernia, in which case general anesthesia and extended surgical facilities are needed. During surgery, the cut ends of the vas should be microcauterized. Spontaneous canalization has occurred despite removal of a section of the vas, coagulation of the lumen with diathermy, and ligation of the ends with silk after turning them back. A recent study of 40 patients showed that placing the 2 cut ends of the vas in different fascial planes did not reduce the risk of spontaneous canalization. Among complications, bruising is common but resolves within a few weeks without treatment. In 1 series, minor hematomas occured in 3-5%, .7% of which required treatment. Large hematomas can require hospitalization or surgical drainage. Infection in the scrotum is potentially serious and occurs in 1.5-4.3% of patients. Sperm granuloma formation is a complication in 20-50% of cases, but a sperm granuloma at the vasectomy site allows decompression of the vas and epididymis, assuring good quality sperm in the vas fluid and improving the prospects for future reversal. Surgery in the genital area can cause castration anxiety even in normal, well-adjusted men, but problems can be prevented by preoperative assessment and counseling. 3 factors are most important to successful reversal: meticulous surgical technique at vasectomy and anastomosis, the length of time since vasectomy, and the presence of a sperm granuloma. It has been suggested that successful reversal is more likely if the vasectomy was performed at a distance from the epididymis, not more than 1 cm of the vas was removed, and the stumps were buried in different fascial planes.
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PMID:Vasectomy. 650 43

The Mentor inflatable penile prosthesis is manufactured from Bioflex polyurethane, a material which is less elastic and more durable than silicone. Use of this new biocompatible polymer eliminates cylinder aneurysms and wear-induced cylinder leaks. The new prosthesis also incorporates a snap-on connector system designed to eliminate connector leaks and decrease operative time. The Mentor prosthesis has been implanted in 52 patients with organic impotence. The patients have been followed up for 2 to 16 months (average 8.3), the follow-up exceeding 1 year in 15 patients. A satisfactory cosmetic and functional result was achieved in 51 cases. Infection necessitated removal of the prosthesis in one patient. There were no pump, reservoir or tubing failures. After early connector failures there were no connector failures in the subsequent 48 patients. Additional complications included an incisional hernia and a cylinder failure which resulted from a manufacturing defect. There were no failures attributable to wear or material fatigue. The inherent reliability of this new prosthesis and the excellent functional and cosmetic results it produces justify its use in any patient who is a candidate for a penile prosthesis.
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PMID:Mentor inflatable penile prosthesis: clinical experience in 52 patients. 653 55

The author reports a 4-year experience of external abdominal hernias in children in the Paediatric Surgical Unit of the Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. A general surgeon with wide experience of paediatric surgery and his well tutored assistants performed operations on various abdominal hernias in 311 children aged from 2 weeks to 12 years (mean age: 3.2 years). Fourteen children had a strangulated inguinal hernia and seven others a strangulated umbilical hernia. Two bowel resections were performed on each type. The majority of patients were followed up for periods of from 3 months to 2 years. Eighty patients with uncomplicated inguinal hernia developed mild scrotal oedema. Infection was limited to the operation site in 15 patients, in addition to two scrotal wound infections in two of those who had bowel resection. There were two early recurrent groin hernias, and no deaths. There was no overt testicular ischaemia in patients with strangulated groin hernias. Our results were comparable with those from similar and specialist centres elsewhere.
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PMID:Paediatric external abdominal hernias in Zaria, Nigeria. 759 42

Infection following median sternotomy is a devastating and potentially life-threatening complication. The use of muscle flaps has become widely accepted as a mainstay in the treatment of these problems. We have previously described our successful use of a bipedicle muscle flap for reconstruction of sternal defects in 16 patients. In this paper, we describe follow-up in those patients as well as an evaluation of this procedure in an additional 26 patients. All records of those patients who had sternal reconstruction using the bipedicle pectoralis major-rectus abdominis flap were reviewed. Factors analyzed included the type of cardiac surgery, associated conditions, complications of surgery, and outcome. There were 42 patients in this group from 1989 to 1996. There were a variety of cardiac procedures represented. Associated conditions included diabetes, chronic hypertension, prolonged postcardiotomy hypotension, prior radiation therapy, pulmonary failure, and steroid use. There were no deaths in this series. There was one flap failure, one persistent infection, one pneumothorax, and one hernia in this series. Three patients developed hematomas after surgery. The most common complication was a skin slough, which occurred in nine patients. This technique provides a large flap that can fill the entire mediastinum. The dissection is rapid, and the complication rate compares favorably to that of other methods.
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PMID:Bipedicle muscle flaps in sternal wound repair. 946 66

Brain tissue with or without its dural covering may protrude into the temporal bone through a defect in the tegmen tympani. Infection or granulation tissue, with or without cholesteatoma may make diagnosis difficult. While computed tomography (CT) may demonstrate a bony defect, it is difficult to distinguish between herniated brain, cholesteatoma or granulation tissue. Magnetic resonance imaging (MRI) clearly demonstrates healthy herniated brain tissue, but ischaemic or necrotic elements may mimic other lesions. We present a series of five patients with brain hernia, highlighting the spectrum of preoperative radiological appearances, and some of the difficulties encountered in interpreting these images. MRI demonstrated herniation of healthy brain in two patients but in three, showed irregular soft tissue with signal characteristics consistent with cholesteatoma. Surgery in these three patients demonstrated necrotic brain with coexisting cholesteatoma in two. Brain hernias are often necrotic and may have morphological and signal characteristics similar to cholesteatoma with which they may coexist.
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PMID:Imaging of temporal bone brain hernias: atypical appearances on magnetic resonance imaging. 1047 69

The results after 230 initial open tension-free hernioplasties a.m. Lichtenstein for groin hernias are evaluated 24 months after operation. Of the 167 primary operations 57% were performed under local analgesia, and 68% of the patients were discharged on the day of operation after primary herniotomy. Infection occurred after 2.7% of the operations, but in no case did the mesh have to be removed. Complications occurred after 7.4% of the operations, necessitating reoperation after 4.3% of the operations. After 24 months 96% of live patients were controlled for recurrences. After 154 primary herniotomies 2.6% recurred. No indirect hernia recurred, 3.6% of direct hernias recurred. After 57 operations for secondary hernias 7.0% recurred. Thirty-eight different surgeons operated 1-19 hernias (median 4). It is concluded that recurrences after open tension-free hernia-repairs are rare, complications few, the operation is simple to perform and can be done under local analgesia in a same day regime.
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PMID:[Tension-free herniotomy using the Lichtenstein's method. Results of five years' experience]. 1086 11


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