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

Two cases of strangulated retrocostoxiphoid hernia (Morgagni-Larrey hernias) are reported. This is a relatively rare complication, as only 66 cases have been reported, and it has a poor prognosis. The clinical picture includes three main symptomatological groups: occlusion of the colon, gastric volvulus, and small intestine occlusion. Radiological examination of the lungs by frontal and profile films is usually sufficient to establish the diagnosis rapidly, and whether surgery is indicated. In some cases, however, the symptoms are such that opacification with water soluble agents is required. Reduction of the visceral hernia and closure of the orifice is carried out after laparotomy, resection of viscera being rarely required.
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PMID:[Strangulated retrocostoxiphoid hernia. Review of the published literature and report on two cases (author's transl)]. 701 64

This is a review of 146 patients operated upon over a period of five years, for 150 episodes of mechanical intestinal obstruction, in a developing country in the tropics. The pattern of intestinal obstructions reveals that external hernia accounts for the largest number of cases followed by volvulus which today still forms the second largest group. Operative mortality was 28%. The major adverse factors were gangrenous bowel and large bowel obstruction. The highest mortality rate (about 41.3%) was found in volvulus.
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PMID:The pattern of acute intestinal obstruction in a peripheral district of eastern India. 709 1

Surgery was performed on a rare case of incarcerated Chilaiditi's syndrome, a syndrome that has been known for 10 years. The patient was in the state of ileus with volvulus of the stomach and hepatodiaphragmatic interposition of the stomach, transverse colon, and omentum majus. The patient was at high risk--77 years old and in bad condition due to hyperemesis and abdominal pain. Preoperative intensive care was necessary. During the operation the intestinal structures were repositioned, the diaphragmatic hernia was resected, and the muscular parts were sewn tight. The right position of the liver was reconstructed by sewing the ligaments. Colon resection was inevitable because the colon loop could not be separated and because there was lack of intraabdominal space. For indication of preventive and elective surgery, we propose that the diagnostics be enhanced when Chilaiditi's syndrome is found by chance and is still asymptomatic. These techniques may include a complete radiological examination with contrast medium, intestinal endoscopy, and computer tomography of the thoracoabdominal region.
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PMID:[Incarcerated Chilaiditi disease. A rare indication for surgery]. 726 6

Although anomalies of rotation and fixation of the gastrointestinal tract are recognized to be associated frequently with anomalies of the abdominal wall and diaphragmatic hernia, the frequency with which these common anomalies are associated with other congenital and acquired lesions of the gastrointestinal tract has not been sufficiently emphasized. Sixty-two percent of our series of 34 patients were associated with such lesions as upper gastrointestinal atresias and stenoses, intussusception, and Hirschsprung's disease. The embryologic and anatomic features of rotational anomalies, their clinical presentation, and radiologic features are presented with the suggestion that knowledge of this information, along with the appreciation of the frequent association of malrotation with other common congenital and acquired abnormalities, will help to prevent the devastating morbidity and mortality of undiagnosed midgut volvulus.
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PMID:Malrotation - the ubiquitous anomaly. 727 64

A retrospective study of 115 patients who presented to the University of Benin Teaching Hospital with intestinal gangrene over a 5 year period is presented. Although hernia is the most common cause of bowel gangrene, more patients with volvulus end up with gangrenous bowel. Because Nigerian patients present with late intestinal obstruction, more dead bowel would have been expected than is currently noted. Is it possible that the African is resistant to intestinal strangulation?
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PMID:Gangrenous bowel. Benin experience. 730 20

Complications associated with jejunoileal bypass for morbid obesity are being recognized more frequently. A variety of mechanical obstructions in the defunctionalized small-bowel segment have recently been corrected in seven surgical patients. Volvulus of the defunctional limb was the most frequent cause of obstruction. Intussusception, bypass enteritis, fascial hernia, and adhesive bands were also causes of obstruction. Radiographic contrast studies were valuable in establishing the preoperative diagnosis. The altered small-intestinal anatomy predisposed these patients to a uniquely subtle and dangerous form of closed-loop obstruction. Prompt recognition was based on patient history and physical findings. Characteristic roentgenographic findings often confirmed the diagnosis. Clinical suspicision of these small-bowel obstructive syndromes may lead to early surgical treatment.
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PMID:Obstruction of defunctionalized small bowel: its occurrence after bypass surgery for morbid obesity. 741 49

Twenty-four patients with repaired diaphragmatic hernia had upper gastrointestinal series to assess the rotation and fixation of the bowel. A spectrum of rotational abnormalities was present in almost all patients, although those with repaired right-sided hernias demonstrated a more obvious anomaly of rotation than those with repaired left-sided hernias. No patient developed a midgut volvulus despite the presence of malfixation. Postoperative adhesions likely limit the occurrence of volvulus.
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PMID:Midgut malfixation in patients with congenital diaphragmatic hernia: what is the risk of midgut volvulus? 756 30

We report a case of Bochdalek's hernia with volvulus of the stomach and extrapulmonary sequestration in an adult. A 27-year-old woman presented acute respiratory failure, pain in the left side of the chest and recurrent vomiting of sudden onset. Upon examination there was pain in the left hypochondrium that was not tolerated in decubitus position. A chest film showed an "arch" at the base on the left side and an upper gastrointestinal series revealed volvulus of the stomach. After a left thoracotomy, the stomach, spleen and greater omentum were found displaced into the thoracic cavity. After the viscera were confined to the abdomen, the hernia was repaired and the pulmonary sequestration was removed. Two years later, the patient was asymptomatic and a chest film was normal.
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PMID:[Bochdalek's hernia in an adult with stomach volvulus and extrapulmonary sequestration]. 762 24

Intra-abdominal pressure (IAP) was indirectly measured, using a transurethral catheterization technique, in 20 client-owned dogs before and after elective ovariohysterectomy. Mean preoperative IAP was 4.50 +/- 0.44 cm H2O. Elective abdominal surgery caused significant elevations in mean postoperative IAP (mean 7.50 +/- 0.45 cm H2O, range 0 to 15 cm H2O) that persisted for at least 24 hours. However, the increase in IAP caused no clinically evident complications; thus, after elective abdominal surgery an elevation in IAP up to 15 cm H2O is to be expected. Intra-abdominal pressure was also measured in 20 consecutive clinical cases with gross abdominal distension, before or after laparotomy, or both. Included in this group were dogs with gastric dilation and volvulus, closed pyometra, hemoperitoneum, acute ascites, and diaphragmatic hernias. All dogs with gross abdominal distension had an elevated IAP (> or = 16 cm H2O) either before or after surgery. Severe elevations of IAP were associated with anuria in two dogs, necessitating surgical decompression; one with hemoperitoneum (47 cm H2O) and one after repair of a chronic diaphragmatic hernia (30 cm H2O).
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PMID:Clinical determination of preoperative and postoperative intra-abdominal pressures in dogs. 765 32

Over a four year period, from August 1987 to July 1991, thirteen cases of chronic and recurrent gastric volvulus were encountered comprising six paediatric and seven adult patients. In none of the patients was the condition clinically suspected; diagnosis being made only at meticulous upper gastro-intestinal (UGI) barium series. The paediatric patients typically presented with obstructive symptoms of projectile vomiting especially after meals and failure to thrive. The adults had variable symptoms of dyspepsia, recurrent intermittent upper abdominal discomfort or pain, occasionally accompanied by vomiting or retching mimicking many different upper abdominal conditions, such as peptic ulcer, biliary tract or pancreatic disease but with negative findings at endoscopy and abdominal ultrasound scanning. All cases were organo-axial type of gastric volvulus. Associated conditions were small sliding hiatus hernia in two adult cases; partial small bowel malrotation in two cases, high jejunal obstruction also in two cases and congenital hip dislocation in one patient. An infant had umbilical hernia, previous meconium cyst and meconium peritonitis. The condition seems not as uncommon as previously thought; the key to diagnosis being constant awareness, a high index of clinical suspicion and a carefully performed UGI barium series especially during the attack of pain.
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PMID:Gastric volvulus: more common than previously thought? 765 6


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