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

Almost 2/3rds of obturator hernias occur after 70 years. Favoured by changes in pelvic and spinal position, this hernia is uncommon in women and exceptional in men. Revealed by strangulation, it is in one third to one quarter of cases, unrecognised before operation, often due to failure to recognise the cause of crural neuralgia in a patient with acute intestinal obstruction. Even when the diagnosis is made, laparotomy is the best approach. It makes intestinal resection easier, this is necessary in 50% of cases, and above all, it is easier to cure the hernia for which the authors propose the use of the round ligament folded on itself and fixed to the borders of the hernial orifice. Delay in treatment explains the high mortality in this rare hernia.
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PMID:[Surgery of obturator hernia by closure of the obturator canal with the round ligament]. 63 31

Five cases presenting in late infancy and childhood with symptoms and signs referable to malrotation of the midgut are described. The condition may present with jaundice, malabsorption or the signs and symptoms of intestinal obstruction due to internal hernia or volvulus. It may also result in volvulus and gangrene of the midgut. A short root of the mesentery predisposing to this event will be seen on a barium meal and follow through examination and will warn of its impending occurrence.
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PMID:The misplaced caecum and the root of the mesentery. 65 37

Authors report two cases of internal hernia through Treves avascular field defects, at the ileal level and another case in which this mesenteric mishape was incidentally found during operation for intestinal obstruction due to adhesions. In this particular case it can be speculated that the defect could have been the cause of a former neonatal obstruction for which operation did not offer an explanation. This type of internal hernia is one of the rarest in pediatric surgical practice. The clinical picture is that of an intestinal strangulation and therefore diagnosis can hardly be made preoperatively. The ileal terminal location of the strangulated loop can, in their opinion, justify a resection extending to the caecum in order to avoid vascular risks on the anastomosis in spite of the sacrifice of the ileo-cecal valve. The three patients survived. Literature on this topic is briefly reviewed.
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PMID:[Internal hernia through Treves' avascular field defect (author's transl)]. 72 11

An incarcerated internal hernia through the foramen of Winslow is an extremely rare cause of intestinal obstruction and about 105 such cases have been reported. An additional patient, in whom a part of jejunum was incarcerated through the foramen into the lesser sac and who was successfully treated surgically, is reported. The etiology, diagnosis, treatment and prognosis of this rare condition are discussed.
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PMID:Hernia through the foramen of Winslow. 74 19

Obturator hernia is an uncommon problem that occurs predominantly in elderly, debilitated women. The diagnosis should be suspected in such patients who have evidence of small bowel obstruction, often initially intermittent, and who complain of pain along the anteromedial aspect of the thigh. We present experience with three patients that characterizes the difficulties in diagnosis and treatment. Most patients require resection of the incarcerated bowel. Mortality is variable and is related to the condition of the patient.
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PMID:Obturator hernia: an elusive diagnosis. 88 32

The interposition of the colon between the diaphragm and the liver is reported in an infant aged 12 days who presented in the neonatal period with intestinal obstruction. The syndrome which was described by Chilaiditi in 1910 under the name of hepatoptosis or diaphragmatic-hepatic interposition of the colon, is rare in adults and exceptionally rare in children. Nevertheless it is important to recognise at it is part of the differential diagnosis of pneumoperitoneum and a right sided diaphragmatic hernia. The treatment was surgical in our case.
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PMID:[Hepato-diaphragmatic interposition of the colon in children. Chilaiditi's syndrome]. 88 97

A case of hernia reduction en masse is reviewed. Discussion of the pathogenesis, diagnosis, and operative approach suggests that the use of taxis in the reduction of incarcerated hernia should be tempered by awareness of potential complications including mass reduction. Diagnosis is by history with the persistence of intestinal obstruction after reduction is a key feature. A preperitoneal approach is recommended for facility of reduction, resection, and anatomic hernia repair.
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PMID:Hernia reduction en masse. 90 Jun 56

Herniation into the lesser omental sac through the foramen of Winslow is a rare cause of intestinal obstruction. A successfully managed case is presented. The clinical history and physical findings are reviewed, and radiographic findings are discussed. The proper interpretation of these findings should suggest the diagnosis. Treatment is prompt surgical correction, and various technical maneuvers that may be necessary are outlined.
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PMID:Herniation through the foramen of Winslow: report of a case. 90 50

A retrospective review of experience with small-bowel obstruction at the University Hospital in Birmingham for a ten-year period (January 1963 through December 1972) revealed 465 episodes of obstruction in 415 patients. The mortality was 4% in obstruction due to adhesions, and 28% in obstruction caused by carcinoma; overall mortality was 8%. Intra-abdominal adhesions were the cause of 69% of cases. Malignant obstruction (mostly from metastatic disease) was the second most common cause of obstruction, and external hernia was third. Delay in diagnosis and inappropriately prolonged used of long intestinal tubes added to the mortality and can be avoided. We suggest a plan for prompt, consistent diagnosis and recommend more liberal use of the barium meal in questionable cases.
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PMID:Small-bowel obstruction: a review of 465 cases. 93 2

Gangrenous bowel most often results from hernia, adhesions and mesenteric insufficiency. The overall mortality rate for 151 cases was 37%. This figure was 20% for hernia, 23% for adhesions and 74% for mesenteric insufficiency. In the latter category where bowel resection was feasable the mortality rate was 40%. Other causes of bowel gangrene had a mortality rate of 28%. In many instances the pathophysiologic processes were of such a nature that current medical expertise has not reached a level of development to effectively cope with the situation. There were, however, a significant number of cases where survival may have been achieved had it not been for deficiences on the part of the patient, the primary health care personnel or those in attendence at the referral center. The basic keystone for a successful outcome in the management of patients with the gangrenous bowel problem is early surgical intervention. All will be lost if patient exposure to this source of lethal toxins is allowed to proceed to an irreversible stage. Liberal antibiotic administration probably postpones the arrival of intractable hypotension. Other factors which can be expected to improve the survival rate include minimization of technical errors, repair of incidental hernias, elemination of dependence upon nasogastric tubes for the definitive management of patients with complete bowel obstruction (with one or two exceptions), and a firm commitment to the diligent pursuit and early definitive management of postoperative complications.
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PMID:A current appraisal of problems with gangrenous bowel. 97 52


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