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

1. In three articles, inguinal, femoral, and ventral herniae have been discussed, one of the aims being to draw the attention of those who are new to surgery in the tropics to some of the things the author thought were peculiar to these herniae. Experiences in the 1,100-bed Korle Bu Hospital, Accra, where a retrospective survey showed that 609 external herniaw were mended in 15 months, formed the basis of the discussions. 2. The applied anatomy of the inguinal canal of adult Ghanaians was described. Three things were pointed out: the infantile type of inguinal hernia was the rule not the exception; the floor and the conjoint tendon were well developed and useful for repair; the pubic branch of the inferior epigastric artery was normal not aberrant. 3. IN Accra inguinal herniae are big and a man's disease. The differential diagnosis of scrotal hernia includes vaginal hydrocele, scrotal elephantiasis, testicular tumours, and tuberculous epididymoorchitis. A case was made in favour of differentiating between direct and indirect inguinal herniae preoperatively. 4. Elective herniorrhaphy was recommended as the treatment of choice and operative techniques were described. The suture material to employ for the Bassini repair must be non-absorbable, e.g. silk or nylon. Whereas herniotomy is adequate in children, in women herniorrhaphy is combined with clearance and obliteration of the inguinal canal. 5. The author did not recommend a truss for an inguinal let alone a femoral hernia. There is suggestive evidence that even in the tropics a man's hernia could be safely repaired on an out-patient basis. 6. Since femoral hernia is rare, it was recommended that in the interest of the patients, skillful surgeons should repair them. 7. The surgical anatomy of the femoral canal, and clinical features of femoral hernia were described. The differential diagnosis included inguinal hernia, abscesses in the groin, hydrocele of the femoral canal, saphena varix, lymphadenopathy, simple tumours and aneurysm of the femoral artery. 8. The treatment of choic is a surgical operation of which three were named and one described ("the low" operation of Lockwood). Recurrence is rare...
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PMID:External herniae: ventral herniae and summary. 112 50

This article presents endoscopic evaluation of the pleural cavity, or thoracoscopy, an effective diagnostic technique that can be employed to provide additional diagnostic information in cases of intrathoracic disease. The techniques of thoracoscopy are described, and normal and abnormal findings are discussed. Thoracoscopy allows visual examination of the pleural space and surrounding structures without surgical exploration. The stress, expense, morbidity, and mortality of thoracoscopy are far less than those of thoracotomy. Disease for which thoracoscopy has been employed diagnostically include primary and metastatic neoplasia, hilar lymphadenopathy, pericardial effusion, spontaneous pneumothorax, and diaphragmatic hernia. Therapeutically, thoracoscopy has been used for drainage of pericardial effusion.
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PMID:Thoracoscopy. 223 74

From examination of 69 pelvic CT scans from 25 patients, the role of CT after hemipelvectomy is examined. A brief description of the various types of hemipelvectomy, including simple, extended, compound, and modified, is presented. The new variants of internal and modified internal hemipelvectomy are also included. The normal post-surgical changes in the musculoskeletal structures and pelvic viscera are described and illustrated. Postoperative abnormalities detected included hematoma, inflammatory changes, incisional hernia, ureteral obstruction, adenopathy, and local recurrence. An example of the usefulness of CT in CT-guided biopsy and CT-guided thermocouple placement is provided. CT of the pelvis is advocated as the method of choice to follow these patients, because of its ability to detect postoperative recurrence and complications.
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PMID:CT evaluation of the pelvis after hemipelvectomy. 387 28

Five cases of hydrocele of the spermatic cord are presented. All five patients had a firm inguinal mass, and ultrasonography, performed to exclude adenopathy, incarcerated hernia, and paratesticular tumor, showed an avascular cystic mass superior to and separate from the testicle. A testicular hydrocele did not coexist. This typical appearance should lead to a confident diagnosis of this benign but rare anomaly. Elective surgery may prevent the development of an acquired indirect hernia.
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PMID:Hydrocele of the spermatic cord: embryology and ultrasonographic appearance. 875 64

We present an unusual case of a ganglion of the hip. The patient presented with a groin mass initially thought to be inguinal lymphadenopathy, related to a scrotal malignant melanoma excised 2 years earlier. Five similar cases have been previously reported. In all cases the pre-operative diagnosis was wrong (femoral hernia, inguinal lymphadenopathy, inguinal abscess). Only at operative exploration was the correct diagnosis made. The diagnosis of hip ganglion should be borne in mind when a patient presents with an inguinal swelling.
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PMID:Hip ganglion: case report and review of the literature. 899 31

The adult hip is a new and challenging site for evaluation with ultrasound (US). Clinically, diseases involving the hip region may be difficult to diagnose without the help of imaging. The hip region is a crossroad for numerous vascular, nervous, and muscular structures that pass between the trunk and the lower extremity. Thus, inflammatory processes and neoplasms may spread to and from the hip, buttock, thigh, pelvis, and retroperitoneum, and trauma may also effect the adjacent areas of the trunk and thigh. Because it is a crossroad, many conditions that are not specific to the hip occur in this area, including inguinal lymphadenopathy, pathology from the abdomen or the genitalia (intestinal hernia, inflammation, and infection), and even referred pain from spinal disorders. The goals of US imaging are the detection and localization of these pathological processes, the differentiation of intra-articular andextra-articular pathology, and the performance of diagnostic and therapeutic interventional procedures. This article reviews the hip anatomy, followed up by a discussion of the US evaluation and differential diagnosis of common pathology occurring in the hip area. This includes joint effusion, arthritis, loose bodies, bursitis, pseudoaneurysm, muscle and tendon diseases, as well as tumor and tumor-like lesions such as hematoma, abscess, and lymphadenopathy.
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PMID:Ultrasound of the adult hip. 1099 90

CASE 1: A 64-year-old, otherwise healthy woman was referred to the surgery clinic for a presumed umbilical hernia. On physical examination, a cutaneous nodule was noted on the umbilical region and the patient was referred to the dermatology clinic. The patient was reexamined and an erythematous nodule was observed in the umbilicus measuring 2.5 cm in diameter. The patient denied pain, change in bowel habits, or weight loss. There were no other abdominal masses, no sign of ascites, and no regional lymphadenopathy. A skin biopsy from the nodule showed mucinous adenocarcinoma. Immunohistochemical staining was positive for carcinoembryonic antigen, and negative for cytokeratin (CK)7 and CK20. These results were consistent with a Sister Mary Joseph's nodule and led to the diagnosis of an occult colon carcinoma. The patient had no risk factors for colorectal carcinoma. The patient underwent surgery in another hospital, and died 3 months after the initial diagnosis of Sister Mary Joseph's nodule. CASE 2: A 73-year-old woman was referred to the dermatology clinic for evaluation of a painful, ulcerated, 3-cm lesion in the umbilicus (Figure 1). She was otherwise asymptomatic. A skin biopsy showed neoplastic glandular cells infiltrating among collagen bundles (Figure 2). Stainings for mucin and for CK7 were positive, while staining for CK20 was negative. An abdominopelvic CT scan demonstrated a 3.5-cm space-occupying lesion in the liver. Results of gastroscopy, colonoscopy, chest computed tomographic (CT) scan, and mammography were normal. Serum levels of the tumor-associated protein CA125 were elevated to 164 units, while those of CA 19-9 and carcinoembryonic antigen were within normal range. A gynecologic examination and a transvaginal ultrasound were normal. The patient had no personal or family history of any malignancy or any risk factors for developing a carcinoma. The patient was scheduled for a palliative resection of the umbilical nodule, combined with a laparoscopic inspection in search of the undetected primary tumor. She refused surgery and was lost to follow-up. She died 4 months after the initial diagnosis of umbilical metastasis. CASE 3: A 51-year-old man was aware of a silent mass in his umbilicus for 2 years without seeking medical advice. Following 2 weeks of increasing pain in this area, he was referred to the emergency room for a suspected incarcerated umbilical hernia. Surgery revealed a mass attached to the fascia and peritoneal fat. The mass was removed and diagnosed as a poorly differentiated adenocarcinoma, staining positively for carcinoembryonic antigen, and negatively for CK20, CK7, prostate-specific antigen, and prostatic acid phosphatase. Both gastroscopy and colonoscopy failed to detect the primary tumor. An abdominopelvic CT scan was normal, but a CT scan of the chest disclosed a nodule measuring 2.5 x 1.5 cm in the lower lobe of the right lung. On bronchoscopy, it was found to be an invasive adenocarcinoma, consistent with a primary tumor of the lung. The patient was a heavy smoker (45 pack-years). The patient received 4 cycles of combined chemotherapy with carboplatine and gemcitabine, with no improvement. A month later, the patient complained of abdominal pain. Following demonstration of intra-abdominal spread of disease by CT scan, a second line chemotherapy was instituted with paclitaxel. A month later the patient's condition deteriorated and he complained of cough, sweating, and pain along the right leg. A bone scan revealed bone metastases in the right femur and left tibia. Two weeks later he was admitted to the hospital with intestinal obstruction and underwent laparotomy. He had massive intra-abdominal spread of cancer and ascites. Only a palliative colostomy was performed. The patient died 3 weeks later, 9 months after the diagnosis of adenocarcinoma of the lung. The clinical data on the three patients are summarized in Table I.
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PMID:Sister Mary Joseph's nodule as a presenting sign of internal malignancy. 1695 43

Cross-sectional imaging techniques allow excellent visualization of the cardiophrenic space. Under normal conditions, the cardiophrenic space is occupied by fat, the amount of which is usually increased in overweight individuals. It has been suggested that this fat accumulation correlates with the risk of cardiovascular disease. Several alterations originating above or below the diaphragm can affect the cardiophrenic space. Inflammatory lesions such as pericardial fat necrosis and tumoral masses are sometimes seen. Lymphoma is a major but not exclusive cause of cardiophrenic adenopathy and must be differentiated from lymphatic seeding of supradiaphragmatic and infradiaphragmatic malignancies. In patients with portal hypertension, cardiophrenic space varices are not uncommon. Other masses or pseudomasses occurring in this region include pericardial cysts, mediastinal tumors, and diaphragmatic hernia. Computed tomography and magnetic resonance imaging of the thorax are helpful in characterizing cardiophrenic lesions initially identified at plain radiography. Such characterization helps narrow the differential diagnosis when lesions are detected in this location.
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PMID:Lesions of the cardiophrenic space: findings at cross-sectional imaging. 1723 96

Destruction of the groin ligament is an unusual occurrence, often of traumatic or surgical origin. In the event of recurrent inguinal hernia with a destroyed inguinal ligament, the reconstruction of the wall with the surgical techniques currently available yields prognostically unfavourable results with frequent recurrence in only a short space of time. The aim of this report was to present a hernioplasty technique using the "three-sheet" implant involving reduction of the hernia sac and the affixing of two reinforcement nets in Prolene in an attempt to reconstruct the destroyed groin ligament. The three-sheet prosthesis simply consists of three sheets positioned in such a way (two polypropylene prosthesis are sutured one on top of the other perpendicularly and medially) as to form a new inguinal ligament; the first sheet reinforces the wall, reconstructing the posterior wall of the canal, and the second and third sheets support the peritoneum as in a hammock. From September 1995 to July 2006, 11 patients underwent such reconstruction operations in our division, 8 of them for recurrent inguinal hernia for multiple failure, 1 for an inguinal hernia with Cloquet's adenopathy and 2 secondary to femoro-femoral and iliac-femoral by-passes. To date, after a mean follow-up of 5 years, no recurrence has taken place. This method has proved safe and effective, with minimal risk of trauma and complications, and may therefore be indicated for the management of recurrent inguinal hernia with rupture of the inguinal ligament.
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PMID:[Reconstruction of the inguinal ligament in recurrent inguinal hernia using the "three-sheet" technique]. 1796 76

Lesions of the groin include hernia, hydrocele, spermatic cord cyst, undescended testes, lymphadenopathy, and abscess. Hydatid cysts are endemic in certain regions of the world. They are usually located in the liver, lung, spleen, brain, and kidney. Although many uncommon locations have been reported, hydatid disease has been reported 3 times in the spermatic cord. This is the first report of a child with hydatid disease in the spermatic cord. A 9-year-old boy with a spermatic cord cyst proven to be a hydatid cyst is reported.
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PMID:Spermatic cord hydatid cyst: an unusual localization. 1808 84


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