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

An enterocele is a hernia of the small intestine into the vagina. First described in 1736, it is an uncommon but potentially quite symptomatic clinical entity. Despite increased interest in enterocele during the past 50 years, there are few large series reported, and follow-up on surgical results has generally been poor. Many enteroceles follow vaginal or abdominal hysterectomy. Various surgical techniques for repair of enterocele are presented herein, including the classical repairs by Ward and Moschcowitz. Because enterocele frequently coexists with vaginal vault prolapse, contemporary procedures for simultaneous repair are described. Emphasis is placed upon prophylactic vaginal vault suspension and cul-de-sac obliteration at the time of abdominal or vaginal hysterectomy. The complications of failure to recognize enterocele are spontaneous vaginal evisceration, although rare, and progressive symptomatology. Attempted repair may also engender complications, some life-threatening.
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PMID:Enterocele: a review. 820 2

In a prospective randomized trial between totally pre peritoneal (TPP) laparoscopic surgery ant Stoppa procedure (open), 100 patients with groin hernia 'Nyhus IIIA, IIIB, IV) were included and followed during 3 years. Both groups were comparable. In the "laparoscopic" group, operating time was significatelly longer (p = 0.01) but hospital stay (3.2 vs 7.3 days) and delay to return to work (17 vs 35 days) were significantely reduced (p = 0.01 =. Post operative comfort (less pain) was better (p = 0.001) after laparoscopy. In this group, morbidity was also reduced (4% vs 20% p = 0.02). The mean follow up was 605 days and 93 per cent of the patients were reviewed at three years. There was 3 (6%) recurrence after TTP, specially in the beginning of the surgeon experience (learning curve) versus for the Stoppa (ns). In case of bilateral hernia, the authors suggest to use a large prosthesis than two little one to prevent recurrences. In these conditions, laparoscopics (TPP) approach of groin hernia treatment will have the same recurrence rate as open (Stoppa) procedure, but a real advantages in the early post operative period.
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PMID:[Inguinal hernia. Pre-peritoneal laparoscopic surgery vs. the Stoppa procedure. A prospective randomized trial: 100 cases]. 894 71

This report describes the case of an 81-year-old woman with sudden evisceration of the small intestine through the vagina. It occurred one year after repair of a vaginal vault prolapse, which was initially treated by vaginal hysterectomy and colporrhaphy three years prior to the repair. On examination, we found a 70-80-cm loop of bowel prolapsing through a 3-cm oval defect in the vaginal vault. The patient underwent emergency exploratory laparotomy under general anesthesia. After careful reduction of the eviscerated small intestine, the hernia hiatus was closed and the widened cul-de-sac was obliterated by performing a Moschcowitz culdoplasty. Rapid intervention by abdominovaginal surgery may enable smooth repositioning of the eviscerated intestine, thus preventing subsequent morbidity.
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PMID:Evisceration occurred 1 year after vaginal vault repair for relapsed pelvic organ prolapse. 2257 40