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

The article describes a 65 year-old female with a 40 years' history of abdominal discomfort and a supposed intrathoracal lipoma who was admitted to hospital with acute obstruction of the large bowel. Emergency laparotomy revealed a subcostosternal diaphragmatic hernia (hernia of Morgagni) containing omentum and a segment of transverse colon.
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PMID:[Morgagni Hernia]. 236 50

Although a radiologic evaluation of the diaphragm is important in many clinical situations, visualization of the diaphragm is difficult because of its thinness, its domed contour, and its contiguity with abdominal soft tissues. Each clinical situation involving the diaphragm presents its own imaging difficulties, and each radiographic technique has advantages and disadvantages. No one modality is best for all situations. Often, several imaging modalities must be used to resolve the clinical question. The particular difficulties in diaphragmatic imaging are (1) distinguishing eventration from paralysis or hernia, (2) distinguishing lipoma from herniated omental fat, and (3) distinguishing unilateral paralysis from weakness and bilateral paralysis from respiratory fatigue. By selecting and applying the appropriate radiographic techniques, the radiologist can serve an essential role in assessing the disorders of the diaphragm.
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PMID:Imaging the diaphragm and its disorders. 264 11

Two cases of asymptomatic Bochdalek hernia in adults with identical roentgenographic findings are reported. Computed tomography (CT) in each case revealed a round mass with a low attenuation coefficient identical to that of adipose tissue, abutting the thoracic surface of the diaphragm and connecting with the subdiaphragmatic density through a diaphragmatic defect. A case of diaphragmatic lipoma was also presented for demonstration of the CT differentiation between lipoma and hernia of the diaphragm. The CT findings for a Bochdalek hernia are characteristic enough for making a definite diagnosis and render other diagnostic modalities unnecessary.
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PMID:Bochdalek hernia of diaphragm in the adult. Diagnosis by computed tomography. 367 19

The value of routine pathologic study of specimens taken at herniorrhaphy performed upon adults was assessed. All 789 patients who underwent inguinal or femoral herniorrhaphy at the Long Island Jewish Medical Center from January 1983 through July 1984 were studied. Patients were classified into five groups; 1, no specimen was sent for pathologic evaluation; 2, confirmation of hernia sac; 3, confirmation of hernia sac with additional expected pathologic findings (such as lipoma or hydrocele); 4, unexpected additional pathologic findings which appeared abnormal at operation, and 5, unexpected additional pathologic findings which appeared normal at operation. During this time period there were 935 herniorrhaphy procedures performed. Three of 1,020 specimens examined contained unexpected pathologic findings (groups 4 and 5): non-Hodgkin's lymphoma, liposarcoma and atypical lipoma. Only one specimen (group 5) with an abnormal pathology report showed an atypical lipoma which appeared normal at operation (0.098 per cent). The outcome of the operation was not altered by the pathology results in these three patients from either group 4 or 5. Aggregate charges for all specimens was $30,528.00 (a mean charge per patient of $48.00). Annual savings to the health care system of the United States by omitting routine pathologic examination of specimens from groups 1, 2 and 3 would be $18 million. Although there may be some justification for routine tissue testing for medical and legal reasons and quality assurance purposes or for specimens which appeared abnormal at operation, these data suggest that for patients who undergo herniorrhaphy, little positive effect on the outcome is gained from routine pathologic examination of specimens which appeared normal at operation.
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PMID:Value of routine pathology in herniorrhaphy performed upon adults. 378 25

We describe herein the successful utilization of a video-assisted thoracic surgical approach to repair Morgagni's hernia. The patient was a 62-year-old woman in whom a routine chest X-ray had revealed an asymptomatic mass, which was presumed to be a pericardial lipoma or Morgagni's hernia. The video-assisted thoracic surgical approach was combined with a right submammary minithoracotomy to successfully repair the hernia without performing a laparotomy. The patient's postoperative course was uneventful and she was discharged 14 days after surgery. Thus, we believe that video-assisted thoracic surgery may be a useful and effective method for repairing Morgagni's hernia.
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PMID:Successful utilization of a video-assisted thoracic approach to repair Morgagni's hernia: report of a case. 754 82

Lumbar hernias are rare (2% of abdominal wall hernias). Symptomatology consists frequently only of an arch formation seen best with the patient sitting and when coughing. In adults it is twice as frequent in women and on the left side. Acute events, dominated by incarceration of a digestive segment, particularly colic, often suggest the diagnosis (10% of cases). Diagnosis is simple when confronted with a large hernia, but difficulties arise with those less than 5 cm in diameter, often diagnosed as a lipoma or parietal tumor. Conventional radiographs and ultrasound images are usually sufficient to establish the correct diagnosis and to determine the content of the hernial sac, but computed tomography scans can provide data on the exact limits of the defect and allow evaluation of possible problems during surgical repair. Rarely congenital (10%), these hernias occur either secondary to a violent lumbo-abdomino-pelvic injury (25%) or following surgical intervention to the lumbar region (50% of cases). Small hernias can be repaired using the direct approach but larger deficits require the insertion of a reinforcing non absorbable prosthesis. Long term results, both for the 4 cases reported and those published in the literature, were assessed as satisfactory.
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PMID:[Lumbar hernias in adults. Apropos of 4 cases and review of the literature]. 827 8

Two cases of Morgagni's hernia comprising protrusion of the omentum alone are reported. The treated patients were 65- and 63-year-old obese women. They were referred to our hospital because of chest pain or vomiting accompanied by abnormal shadow in right cardiophrenic angle on chest roentgenogram. Computed tomogram (CT) demonstrated a mass of fat density behind the sternum for the both patients. The first patient was diagnosed as Morgagni's hernia by pneumoperitoneum, and surgical repair was done by the transabdominal approach. Magnetic resonance imaging (MRI) was carried out for the second patient, and showed intrathoracic mass lesion which was continuous with the subphrenic tissue. Although the second patient was diagnosed as mediastinal lipoma, median sternotomy revealed that the mass lesion was Morgagni's hernia. Postoperatively, both patients recovered uneventfully. The Morgagni's hernia has been reported to be about 3% of all diaphragmatic hernia. This disease may be discovered either because it causes respiratory or gastrointestinal complaints, or because an abnormal shadow in right cardiophrenic angle on a chest roentgenogram. If air-filled structures are present in the hernia, a barium study will confirm the diagnosis. In a case with a hernia containing only omentum, the diagnosis is difficult. CT has been regarded as the procedure of choice by several authors. The coronal and sagittal views of MRI can demonstrate the relationship between the herniated structures and the diaphragm, heart, pericardium. We emphasize the role of MRI for the diagnosis of Morgagni's hernia.
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PMID:[Two cases of Morgagni's hernia]. 847 1

We herein present a patient with Morgagni hernia which was diagnosed by magnetic resonance imaging (MRI). The patient had a progressively enlarging mass in the right cardiophrenic angle on chest roentgenogram. On computed tomography (CT) scans, the mass was revealed to have fat density and therefore was suspected to be either a lipoma or liposarcoma. MRI clearly demonstrated that the mass shadow was composed of omental fat herniating into the right thorax through the diaphragmatic hiatus. MRI is thus considered to be a useful noninvasive modality for the evaluation of lower anterior mediastinal masses demonstrating fat density on CT.
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PMID:Morgagni hernia diagnosed by MRI. 878 6

The liposarcoma is mainly located in the retroperitoneum and rarely involves the spermatic cord. Dissemination occurs more often via haematogenous way than by lymphatic way. The incidence of local recurrence is higher than distant metastases. The treatment of choice is the wide excision. Adjuvant radiotherapy is recommended in the well differentiated and myxoid type of tumors if the local control during excision is not complete or wide enough. Benefit of chemotherapy is still controversial and limited. Case report of a stage 1 liposarcoma of the spermatic cord, four years after excision of a large lipoma during a hernia repair. The treatment consisted in radical excision of this liposarcoma without any adjuvant therapy. Follow-up of 30 months without recurrence.
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PMID:[Liposarcoma of the spermatic cord]. 898 55

Interest in day-care surgery is on the increase world-wide, with various surgical specialties embracing this mode of health service. In a period of 5 years (January 1989-December 1993), 286 patients attending a Plastic Surgical Unit were operated on a day care basis. This represented 22.7% of all cases done within the period. The most frequently performed procedure was keloid excision and suture/flap cover (29.7%) followed by inguinal hemiorrhaphy (10.8%) ganglionectomy (8%), excision of lipoma (8%), scar revision (5.2%), suture of skin lacerations (4.5%), breast lumps biopsy (5.9), release, grafting or plasty of flexion deformity of fingers (3.4%). Other problems dealt with on day care basis included repair of human bite losses of face (3.2%); Excision of gynaccomastia (3.1%) umbilical hernia repair (2.4%); breast augmentation with implant 0.3%. Excision of planter wart, hairy naevus, chronic neck folliculitis, sebaceous cyst, dermoid cyst and polydactylism constituted the rest of problems dealt with as day cases. Readmission represents failure of day care surgery and constituted 2.4% of all cases. This was due mainly to social factors and bleeding at home. Significant wound breakdown occurred in 0.69% of cases. We conclude that day care plastic surgery in our subregion is safe and effective.
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PMID:Scope and problems of day-care surgery in a plastic surgical unit. 902 Jun 4


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