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

We present a case of surgically proved acute appendicitis strangulated in a femoral hernia sac. Multidetector computed tomography with multiplanar reformations was thought to be helpful in evaluating acute appendicitis in a femoral hernia sac. An awareness of computed tomographic findings may avoid a delay in recognition and management of a patient with this unusual condition.
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PMID:Acute appendicitis within a femoral hernia: multidetector CT findings. 1580 25

The paper presents two unusual pathological aspects of a hernia and an appendicitis. It is about a massive old inguinal hernia, with strangulation and an intra-saccular congestive acute appendicitis that occurred after a traumatic injury of the region. The presumptive diagnosis through a dynamic monitoring of the patient, clinical and biological analysis has made possible a favorable solution of the case.
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PMID:[Post-traumatic acute appendicitis in hernia's sac]. 1595 64

Groin hernia may have very unusual sac content. Vermiform appendix, acute appendicitis, ovary, fallopian tube and urinary bladder have been rarely reported. We aimed to present our experience with these unusual hernia contents. Records of 1,950 groin hernia patients were retrospectively analyzed. Vermiform appendix was found in 0.51% and acute appendicitis was found in 0.10% of groin hernia sacs. The incidence of appendix in femoral hernia was 5%, while inguinal hernia sac contained ovary and fallopian tube in 2.9% of the cases. The incidence of groin hernias containing urinary bladder was 0.36%. We also had 1 patient with incarcerated bladder diverticula in an indirect hernia sac. Iatrogenic bladder injury occurred in 2 patients. Although rare, a groin hernia sac may contain vermiform appendix and exceptionally acute appendicitis. Tubal and ovarian herniation in inguinal hernias can be found in adult and perimenopausal women with an incidence as high as in children. Urinary bladder hernia occurs with a similar incidence of tuba-ovarian hernia, however, it requires special attention because of a high risk of iatrogenic bladder injury during the inguinal dissection. Every effort should be made to preserve the organ found in hernia sac for an uneventful postoperative period.
Hernia 2006 Apr
PMID:Uncommon content in groin hernia sac. 1617 1

Pseudomyxoma peritonei is a rare neoplastic condition characterized by diffuse collections of gelatinous fluid associated with mucinous implants on the peritoneal surfaces and omentum. Typical presentations include suspected acute appendicitis, increasing abdominal girth, new onset hernia and in women, an ovarian mass. The exact pathological origin, classification, and ideal treatment have been the subject of debate in the literature. Although optimum treatment is debatable, most expert opinion favors extensive surgical debulking with or without adjuvant therapy. We present a case of a 51-year-old man who presented with an inguinal hernia that was, in fact, secondary to pseudomyxoma peritonei. It is best practice, we believe, that any mucoid fluid encountered during hernia repair should be recovered and, along with the hernial sac, be assessed histologically.
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PMID:Pseudomyxoma peritonei: a case of mucinous adenocarcinoma of the appendix presenting as inguinal hernia. 1651 67

To determine the pattern of antibiotic therapy and clinical outcome a prospective survey of all patients operated on for acute generalized peritonitis was undertaken. The male to female ratio was 1.7:1, and the mean age was 27.6 +/- 18.3 years. Operative findings were typhoid ilea perforation in 75 (38.1%), complicated acute intestinal obstruction in 44 (22.3%), complicated and uncomplicated acute appendicitis in 34 (17.3%), peptic ulcer perforation in 18 (9%) and traumatic intestinal injury in 11 (5.6%), representing the majority of the patients. A combination of chloramphenicol, gentamicin and metronidazole was given to 80 (40.6%), ampiclox, gentamicin and metronidazole to 72 (36.5%), ampiclox and gentamicin to 21 (10.6%) and other combinations to 5. A single antibiotic was administered in 13 (6.6%), that is clavulanate-amoxicillin, ampiclox, and cefuroxime. Antibiotics were changed in 37 patients (18.8%): to amoxicillin-clavulanate in 13, cefuroxime in 11, ceftriazone in 7, cefuroxime and metronidazole in 4 and amoxicillin-clavulanate and metronidazole in 2 patients. Postoperative complications were mainly wound infection in 105 (42.6%), wound dehiscence in 33 (16.7%), residual intra-abdominal sepsis in 19 (9.6%), residual intra-abdominal abscess in 17 (8.6%), postoperative chest infection in 14 (7%), incisional hernia in 11 (5.6%), anaemia in 6, faecal fistula in 5 and there was a mortality of 15.7%.
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PMID:Pattern of antibiotic therapy and clinical outcome in acute generalized peritonitis in semi-urban and rural Nigerians. 1656 39

We report a case of acute appendicitis occurring within a right inguinal hernia-also known as Amyand's hernia-in a 59-year-old man. The correct diagnosis was made via preoperative inguinal sonography and was confirmed via CT, allowing prompt appropriate surgical management.
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PMID:Sonographic diagnosis of appendicitis within a right inguinal hernia (Amyand's hernia). 1702 70

To review the clinical presentation, outcome and causes of acute appendicitis presenting within a groin hernia. A comprehensive review of the past 70 years of English language surgical literature was conducted pertaining to acute appendicitis presenting within an inguinal or femoral hernia. Thirty-four reports describing 45 patients were reviewed to determine age, position, gender, pathologic stage at presentation, causal suppositions, and clinical outcomes. Hernial appendicitis presented as an inguinal abscess or a tender inguinal mass, often in the femoral position, and most commonly at the extremes of age. It was almost never recognized preoperatively, and, because of the sequestered nature of the inflammatory process, presented with few classic systemic signs or symptoms suggestive of acute appendicitis. Advanced pathologic stage and death correlated with the patient's age, delay in presentation, and delay in recognition. Evaluation of an inguinal abscess or a nonreducible tender groin hernia presenting in a patient at the extremes of age, should include computed tomography to rule out an occult acute appendicitis within the hernia, as systemic signs and symptoms of appendicitis are rarely evident. The condition appears to be caused by inflammatory adhesions caused by appendicitis occurring within an enlarged hernial orifice rather than appendicitis caused by external compression of the appendix base. Early recognition of this unique presentation of appendicitis allows trans-hernial appendectomy and immediate herniorraphy. Delayed diagnosis requires drainage of abscess with appendectomy and interval hernia repair.
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PMID:Review article: appendicitis in groin hernias. 1739 46

Acute appendicitis with the vermiform appendix located in a groin hernia is a rare condition. The preoperative diagnosis is important to decrease morbidity. We describe the computed tomography imaging characteristics of three cases of normal and inflamed appendices in inguinal and femoral hernias. We provide a review of the literature and consider the implications for surgical management.
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PMID:CT findings of normal and inflamed appendix in groin hernia. 1740 13

We report all the procedures performed in pregnant patients in our institute. There were 2 cases of laparoscopic mesh repair (for posterolateral diaphragmatic Bochdalek hernia and laparoscopic Heller cardiomyotomy) and 1 laparoscopic cystectomy for torsion of an ovarian cyst; 7 laparoscopic appendectomies (6 for acute appendicitis and 1 for perforated appendix); and 9 laparoscopic cholecystectomies (8 for acute cholecystitis and 1 for gallbladder empyema). All these patients were in their second trimester of pregnancy. All the laparoscopic procedures were successful: there was no mortality, morbidity, or conversions. There were no complications for either mother or child related to general anesthesia. The changes in physiology of the pregnant patient have to be adequately addressed and proper precautions taken to ensure safety. The second trimester is the ideal time to do laparoscopic surgery, though procedures have been performed in all trimesters. Our initial experience is satisfactory, although more data are essential to standardize laparoscopic procedures in pregnancy. We conclude that laparoscopic surgery is proving to be as safe as open surgery in pregnancy.
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PMID:Safety and efficacy of laparoscopic surgery in pregnancy: experience of a single institution. 1748 45

The finding of a normal or inflamed vermiform appendix within an inguinal hernia is termed Amyand's hernia. It is extremely rare in children, especially in infants and neonates. When it occurs, it is usually misdiagnosed as an irreducible or strangulated inguinal hernia, and the accurate diagnosis is made intraoperatively. We report two cases of Amyand's hernia in premature neonates. Both patients presented on admission with signs and symptoms indicating a strangulated right inguinal hernia, and the accurate diagnosis was made intraoperatively. One of them had progressed to local peritonitis. Appendicectomy and hernia repair were made at the same time through an inguinal transverse incision, and the postoperative course was uneventful in both. We point out the need to consider acute appendicitis in the differential diagnosis of strangulated right inguinal hernia.
Hernia 2007 Dec
PMID:Amyand's hernia in premature neonates: report of two cases. 1754 92


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