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

Abdominal wound healing was studied in 48 patients undergoing laparotomy for jaundice and 281 anicteric patients undergoing elective operations for cholelithiasis at the Sheffield Royal Infirmary during the period 1967 to 1976. Wound dehiscence or incisional hernia occurred in 27.1 per cent of jaundiced patients and in 4.3 per cent of anicteric patients (P less than 0.001). There was a slightly higher incidence of dehiscence and herniation in deeply icteric patients (plasma bilirubin greater than 170 mu mol/l), but patients who developed these complications did not appear to have a more severe degree of malnutrition or impaired liver function. The results of the study suggest that malignant disease may be an important factor in the pathogenesis of wound complications in jaundiced patients. Wound dehiscence or incisional hernia occurred in 59.1 per cent of patients with obstructive jaundice resulting from malignant disease but patients with jaundice resulting from biliary stones or benign pathology did not develop these complications.
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PMID:Abdominal wound healing in jaundiced patients. 66 51

A 10-year experience with 2,441 patients over 65 years of age undergoing operations for non-upper gastrointestinal tracts was reviewed to evaluate both the incidence of postoperative upper gastrointestinal bleeding and the clinical risk factors associated with the complication. A total of 18 (0.7%, 7 males and 11 females) patients had overt postoperative upper gastrointestinal bleeding of non-variceal origin documented by endoscopic findings or blood transfusions. Of these, the complication developed in 10 (1.5%) of 646 patients after an operation for biliary or pancreatic disease, 1 (1.5%) of 64 for aneurysmal or obstructive arterial disease, 5 (1.1%) of 43 for colorectal cancer and 2 (0.3%) of 916 for hernia. The incidences of bleeding after an operation for obstructive jaundice (3.8%), for biliary or pancreatic malignancy (4.5%), and of unavoidable diversion colostomy for colorectal anastomosis (3.1%) were significantly higher than for non-jaundice (0.6%), for non-malignancy (1.1%) and of postoperative upper gastrointestinal bleeding in the present study. The origins of bleeding were gastric ulcer in 11, acute gastric mucosal lesion in 4, duodenal ulcer in 1 and other in 2. All cases of bleeding were treated and met success in hemostasis using H2-blockers. Of these, however, 5 patients died of multiple organ failure despite discontinued hemorrhage, prophylactic use of H2-blockers showed a decrease in occurrence of postoperative upper gastrointestinal bleeding in the present study.
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PMID:[Post operative upper gastrointestinal bleeding in the aged]. 149 79

An unusual case of obstructive jaundice due to foramen of Winslow hernia is presented. The hernia re-entered into the general peritoneal cavity through the lesser omentum and this appeared to be important in the pathogenesis of jaundice in this patient. Accurate pre-operative diagnosis of this uncommon condition remains difficult despite the advent of modern imaging techniques such as computerized tomography. Optimal outcome demands a high index of suspicion and early surgical intervention, together with operative measures to prevent future recurrence. The pathoanatomy of caecal herniation through the foramen of Winslow is also discussed.
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PMID:Obstructive jaundice due to foramen of Winslow hernia: a case report. 205 82

A case of infantile obstructive jaundice caused by a right-sided foramen of Bochdalek's diaphragmatic hernia is reported. This association has not previously been reported in an infant. At operation, extrahepatic biliary obstruction was relieved by reduction of the contents of the hernia. This unusual presentation of a right-sided congenital diaphragmatic hernia underscores the usual diagnostic delay seen with such lesions.
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PMID:Congenital foramen of Bochdalek's hernia in an infant with obstructive jaundice. 291 83

Most cases of congenital diaphragmatic hernia present as acute respiratory emergencies in the newborn period. Delayed presentation may be heralded by symptoms referred to the respiratory or gastrointestinal tract. An infant with unrecognized right-sided foramen of Bochdalek hernia presented with obstructive jaundice due to compression of the herniated common bile duct by the rim of the diaphragmatic defect. To our knowledge, this occurrence has not been previously observed in infancy or childhood.
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PMID:Obstructive jaundice. An unusual delayed presentation of congenital diaphragmatic hernia. 328 15

Wound healing has been investigated in 373 patients undergoing surgery for obstructive jaundice and 760 anicteric patients undergoing cholecystectomy. Reduced wound healing manifested by a higher frequency of wound dehiscence (3.2 per cent vs. 0.5 per cent) and incisional hernia (10.3 per cent vs. 1.8 per cent) was seen in the jaundiced patients. The factors related to this reduced wound healing have been analysed by univariate and multivariate analysis. The independent factors related to wound dehiscence in the 373 jaundiced patients were: an initial low haematocrit (less than 30 per cent), an initial low plasma albumin (less than 30 g/l], a history of pancreatitis, a malignant obstructing lesion, and postoperative wound and/or abdominal sepsis. Haematocrit, albumin and postoperative wound and/or abdominal sepsis were also independent factors for incisional hernia. A raised plasma bilirubin was not of independent significance for either wound dehiscence or incisional hernia. It is concluded that reduced wound healing occurs in jaundiced patients and that this is due to the associated features of poor nutritional status (manifested by low haematocrit and low albumin) and malignancy and not to the raised bilirubin per se.
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PMID:Wound healing in obstructive jaundice. 670 75

Two cases of postoperative abnormal prothrombinemia presumably caused by the administration of cefoperazone are herein described. One patient, who had bile duct cancer with obstructive jaundice, underwent resection of the extrahepatic bile duct with hepaticojejunostomy (Roux-en-Y anastomosis) and partial resection of the liver following percutaneous transhepatic cholangial drainage. He developed abnormal prothrombinemia and bleeding 10 days after surgery. The other patient, who had undergone a total gastrectomy 17 years earlier, suffered from pulmonary tuberculosis. She was initiated anti-tuberculous regimen and simultaneously was worked-up for her severe anemia, and was found to have ascending colon cancer. She underwent a right hemicolectomy, cholecystectomy, and repair of ventral incisional hernia, and subsequently developed abnormal prothrombinemia and bleeding 12 days after surgery. Both patients received a chemical bowel preparation prior to surgery. Prothrombin time was normal preoperatively in both patients. Both patients were treated with fresh frozen plasma and intravenous menatetrenon, which improved the clotting disorder within 24h. Antibiotics containing the N-methyl-thio-tetrazol side chain should thus be used with particular prudence in patients with abnormal prothrombinemia and a tendency to develop bleeding disorders.
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PMID:Postoperative abnormal prothrombinemia in patients with cefoperazone: report of two cases. 952 19

The experience of effective work of endoscopic service in district hospital, including surgeon and gynecologist in laparoscopic team is presented. The results of 1000 laparoscopic cholecystectomies were analyzed. In 868 cases the operation was performed for chronic and in 132 cases--for acute calculous cholecystitis. The additional endoscopic retrograde pancreatocholangiography and papillosphincterotomy (if it was necessary) was performed in patients with cholangitis and obstructive jaundice and also with choledocholithiasis, revealed during elective examination. In 33 cases in thick infiltrate of gall bladder neck or neck congenital anomalies, laparotomy was performed, 30 patients underwent minilaparotomy. Simultaneous operations were performed in 116 (11.6%) patients. In early postoperative period, the complications were seen in 8 patients. In 2 cases the injury of common hepatic duct was observed. Suppuration of paraumbilical wound was seen in 13 patients, postoperative paraumbilical hernia (4-6 months after operation)--in 18 patients. There were no cases of lethal outcomes.
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PMID:[Experience of 1000 laparoscopic cholecystectomies in district hospital]. 1107 Jun 68

A male newborn was admitted to our Unit because of early sepsis and shock. He required antimicrobial therapy and mechanical ventilation and initially did well, although he exhibited jaundice and cholestasis. During the second week he deteriorated, with radiological opacification of the right hemithorax and pleural effusion, and did poorly in spite of antibiotical therapy and drainage of the effusion. In the third week, the X-ray suggested some bowel loops in the right hemithorax. A right-sided diaphragmatic hernia was confirmed by a CT-scan, and surgery was performed with good outcome. The association of delayed-onset right-sided CDH following early sepsis and obstructive jaundice has not been published before, and illustrates a scarcely known form of presentation of this condition.
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PMID:Early sepsis, obstructive jaundice and right-sided diaphragmatic hernia in the newborn. 1122 44

A 45-year-old man was suffering from abdominal pain and vomiting. He was admitted to our hospital with a diagnosis of ileus and obstructive jaundice. He had undergone Roux-en-Y anastomosis for choledocholithiasis 14 years earlier. A computed tomography scan revealed a dilated afferent loop and dilated intrahepatic bile duct. Upper gastrointestinal examination with contrast medium and percutaneous transhepatic cholangiography showed a high intestinal obstruction around the jejunojejunal anastomosis. The patient underwent laparotomy based on a diagnosis of obstructive jaundice due to ileus. During the operation, he was found to have internal herniation of the small bowel through a rent in the mesentery around the Roux-en-Y anastomosis for choledochojejunostomy. The hernia was reduced, and bowel resection was performed due to stenosis of the afferent loop. Jejunojejunal anastomosis was re-performed and the defect in the mesocolon was closed. Internal herniation after Roux-en-Y anastomosis is a rare sequela, but it should be recognized that this complication can occur after Roux-en-Y anastomosis. For prevention of internal herniation around the Roux-en-Y limb, secure closing of the mesenteric defects is important.
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PMID:Obstructive jaundice due to internal herniation: a case report and review of the literature. 1214 94


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