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

The etiology of intestinal obstruction (I.O.) has changed markedly since the beginning of this century. In this series, the authors studied 121 cases of I.O. treated surgically; adhesions were the commonest cause of high intestinal obstruction, accounting for 43.03 percent in a total of 79 patients, with hernia being the obstruction lesion in 16.45 percent. Colo-rectal cancer were the commonest cause of low intestinal obstruction accounted for 73.81 percent, with volvulus of the sigmoid colon in 14.28 percent. Complications occurred in 15.7 percent of patients following operative intervention; wound infection was the most common postoperative complication. The overall operative mortality was 9.09 percent.
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PMID:[Surgical treatment of intestinal obstruction]. 213 92

3 unusual late complications of laparoscopic sterilization, previously unreported, are described. The 1st woman had a laparoscopic sterilization by placement of 4 Filshie clips 2 years before. She was admitted with fever, tenderness in the right iliac fossa, but a normal pelvic examination. Laparotomy revealed appendicitis, with a Filshie clip within the lumen, associated with transmural inflammation distal to the clip. 2 clips were located, 1 on each tube, on x-ray. The remaining clip was not seen. The 2nd case was a 30-year old woman who had been sterilized 3 days before, with intestinal obstruction caused by prolapse of a loop of distal ileum through a defect in the broad ligament. The 3rd woman, who had been sterilized a year ago at age 36, described tender swelling below the umbilicus that became painful during menses. The lesion, thought to be a paraumbilical hernia, was a solid nodule of typical endometrial glands and stroma with a fibrous scar. While endometriosis in the umbilical skin has been observed in a surgical scar, none have been reported after laparoscopy. It would be wise not to perform laparoscopy during menstruation.
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PMID:Uncommon complications of laparoscopic sterilisation. 214 62

During a 17 year period 55 patients with abdominal wall defects were treated. A questionnaire concerning late surgical problems was distributed to the parents of the 47 surviving children and 44 (94%) answers were received. The mean follow up time was 5.4 years. There was no mention of remaining problems regarding 16 of the 28 omphalocoele patients and 10 of the 16 gastroschisis patients. Postoperative abdominal wall hernia was reported in 7 cases with omphalocoele and in 6 with gastroschisis; postoperative intestinal stoma occurred in 1 child with omphalocoele associated with anal atresia, and in 1 with gastroschisis and postoperative intestinal obstruction in 4 cases with omphalocoele and in 1 with gastroschisis. The other complaints related to abdominal pain, cryptorchidism, constipation and difficulties with care of the intestinal stoma. No difference in results was found between the two types of closure of the abdominal wall defects irrespective of the primary treatment. All the remaining problems could be corrected and the long term results in both conditions were good.
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PMID:Late surgical problems in children born with abdominal wall defects. 214 63

Treating ectopic pregnancy with laparoscopy requires special training, but it results in decreased morbidity, discomfort, and pain; reduced recuperative time; and lower cost to the patient and hospital. Many conditions mimic ectopic pregnancy. Therefore, to make the diagnosis, a complete history must be taken, a careful physical examination must be performed, and certain diagnostic tests must be made. Contraindications include bowel obstruction, ileus, abdominal hernia, peritonitis, brisk intraperitoneal bleeding, diaphragmatic hernia, severe cardiac disease, extremes of body weight, previous surgery, or presence of a large abdominal mass.
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PMID:Pelviscopy for ectopic pregnancy: a safer and quicker alternative. 214 37

We have presented the case of an elderly woman with severe kyphoscoliosis, osteoarthritis and left knee effusion who had symptoms and signs of intermittent intestinal obstruction. Operation showed a left-sided obturator hernia. In any elderly, debilitated, chronically ill woman, symptoms and signs of recurrent small-bowel obstruction (without a history of abdominal surgery or external hernias) and pain along the ipsilateral thigh and knee (Howship-Romberg sign) should raise suspicion for an obturator hernia. If the hernia is not palpable by physical examination, a CT scan of the pelvis and upper aspect of the thigh would confirm the diagnosis before operation and allow prompt treatment and better chance of patient survival.
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PMID:Obturator hernia: a difficult diagnosis. 219 70

Congenital or traumatic hernia complicating pregnancy is a rarity but death occurs in half of the cases. Complications (respiratory distress, intestinal obstruction) are more frequent during the third trimester, during delivery and in the post-partum hours. In the asymptomatic patient, surgery should be performed specially in the first and second trimesters. During the third trimester, fetal maturity should be watched and the defect should be repaired at the time of elective cesarean section. Active labor should be avoided because of the increased abdominal pressure produced during the expulsion period. If an unexpected labor occurs, forceps application, if cesarean section could not be performed, should be realised. If signs of respiratory distress or of obstruction arise at any time, immediate repair should be undertaken, regardless of the age of pregnancy. An hernia operated before the pregnancy could recur during this one (this is the case of the author). Il is possible that some diaphragmatic hernias no complicated during previous pregnancies could be aggravated without symptoms and are complicated during a further pregnancy.
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PMID:[Diaphragmatic hernia and pregnancy]. 219 60

A unique case of a type of omental hernia is presented, which caused small bowel obstruction. The hernia is described and possible aetiological factors discussed.
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PMID:An unusual omental hernia. 221 43

Thirty-six thousand two hundred fifty abdominal hernia repairs were performed in U.S. Army medical treatment facilities during a five-year period. This study presents data about the type of hernia, incidence of complications by obstruction or strangulation, age, sex, and mortality. Hernias occurring with intestinal obstruction or gangrene (strangulation) are referred to as complicated hernias. Inguinal hernias in children less than two years of age, femoral hernias, and unusual (such as internal or obturator) hernias were found to have an increased incidence of complications. Surgical repair of ventral, umbilical, and femoral hernias was done with a low surgical risk and the presence of complications did not significantly increase this risk. An increased risk of mortality is associated with the repair of complicated unusual hernias and complicated inguinal hernias in patients more than 60 years of age.
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PMID:A five-year U.S. Army experience with 36,250 abdominal hernia repairs. 222 7

Twenty cases of cystic adenomatoid malformation of the lung were observed: 2 had died in utero; the diagnosis was made at birth in 13 infants of which 3 were premature. A Bochdalek's hernia had been diagnosed before birth in 2 cases by echo-tomography. The correct antenatal diagnosis had been made in 2 cases. Two infants had no symptoms, 3 were dyspneic, 8 were in respiratory distress and had to be intubated and ventilated. Two had a prune belly syndrome. Eight infants had a thoracotomy during their first week of life. Pulmonary resections concerning those 13 patients comprised 10 lower lobectomies, 1 of which was associated with a lingulectomy, and 2 upper lobectomies, 1 of which was associated with a middle lobe resection. Five patients were diagnosed and operated upon between 10 months and 8 years of age; 4 had recurrent bronchitis and 1 was diagnosed during the treatment of a gastroenteritis. They had 3 lower and 2 upper lobectomies. Recovery was uneventful in all patients except for 1 who was reoperated upon for intestinal obstruction. Antenatal diagnosis of cystic adenomatoid malformation should become standard. The malformation may be mistaken for a pulmonary sequestration or bronchogenic cyst. Differential diagnosis of a congenital hernia is important.
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PMID:Congenital cystic adenomatoid malformation of the lung. 222 14

We have reported two cases of intestinal obstruction due to traumatic diaphragmatic hernia, both resulting from apparently trivial knife wounds. When TDH is due to a penetrating injury, it tends to produce symptoms of intestinal obstruction. A high index of suspicion, a chest x-ray film, and barium studies of the gastrointestinal tract are usually needed to make the diagnosis, though CT scans, ultrasonography, laparoscopy, and radionuclide scanning may also be useful. Surgeons and emergency physicians should be aware of the potential for TDH when there is a history of a penetrating wound of the chest or abdomen.
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PMID:Traumatic diaphragmatic hernia and intestinal obstruction due to penetrating trunk wounds. 223 72


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