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

The type of first aid given to patients requiring emergency pediatric surgery is decisive for the prognosis in many cases. With this aspect in mind, individual disease pictures from the group of connatal deformities (esophageal atresia, intestinal atresia, gastroschisis, diaphragmatic hernia and defect, myelomeningocele), from emergency surgical situations beyond the neonatal stage (acute abdomen and ileus, esophageal varices, pneumothorax), and accident injuries (blunt abdominal trauma, cranio-cerebral trauma, burns) are selected and the most important first aid measures described. But for all diseases, the general rule for the treatment of all seriously ill children applies: provision of a safe venous access, readiness to intubate, adequate oxygenation and control of the acid-base, water and electrolyte balances.
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PMID:[First aid measures in emergency pediatric surgery (author's transl)]. 41 88

The authors describe external intestinal fistulae found within 11 years at 5000 urgent operations on abdominal organs in 56 patients. 20 of them showed fistulae of appendicular origin, 15 developed fistulae following various traumas of abdominal organs, 1--after intestinal ileus, in 3 cases fistulae were due to incarceration of hernia, in 17 cases external fistulae were applied in intestinal neoplasms. Small gut fistulae were noted in 15, colon fistulae--in 41 patients. The total of 19 patients died, most of them had malignant intestinal neoplasms.
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PMID:[External intestinal fistulae]. 45 6

From 1966 up to 1975 164 patients with a hernia incarcerata were seen. 21,3% of them died, in most cases of delayed diagnosis bowel resection was necessary. The prognosis depends on ileus (11,8%) and multimorbidity of the aged. The death was mainly related to peritonitis (43%) and pneumonia (26%). Only no delay in diagnosis, early surgery, intensive pre- and postoperative care will improve the results.
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PMID:[Hernia incarcerata in the aged (author's transl)]. 63 4

The omphalocele is very often combined with congenital malformations and is primarely to be looked at as a medical and surgical disease. The radiological examination possibly can help to decrease the rate of mortality by disclosing the malformations. These very often consist of malformations, complicating ileus and Bochdalek's hernia. We present 23 cases with omphalocele with special regard to the congenital malformations, complications postoperatively and the causes of death.
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PMID:[Exomphalos. A review of 23 cases (author's transl)]. 69 86

Anal sphincter sclerosis, which leads to recurrent subileus and finally to the complete picture of ileus, is presented in relation to 6 of our own observations. Ileus conditions are triggered off by: 1. years of abuse of laxatives, 2. intraperitoneal adhesions supporting the tendency to ileus (postoperative hernia, soft abdominal wall, intestinal atony), 3. viscerovisceral reflexes initiated by other diseases (heart, lung, gallbladder, liver, kidney etc.), 4. chronic recurrent changes with irritation of the terminal organ itself. Women seem predestined for this disease. The existing subileus or ileus condition can be eliminated in all cases by stretching the sphincter and partial sphincterotomy, so that the patients could be spared a laparotomy.
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PMID:[Sclerosis of the anal sphincter from the point of view of mechanical ileus (author's transl)]. 80 97

The significant increase in the number of people older than seventy forces the physician to be acquainted with both psychological and physical alterations induced by aging and to devote an ever increasing proportion of time for recognition and treatment os such alterations. In the medical sense, the biological and physiological age is more important than the chronological age. With increasing age there is--especially concerning the digestive tract and its accessory organs--a rise in the incidence of organic affections and a decline in the frequency of functional disorders. Besides it is wise to know, that the increasing age there is often a coexistence of multiple degenerative disorders and disease states, involving many body systems and organs. On the background of this recognition it is also important to know, that prognosis too varies with age because of the coexistence of individually prognosticated disease states and moreover to realize, that elderly patients do not tolerate invasive and prolonged surgical procedures. Structural or functional disturbances of the digestive organs by aging processes do not cause death per se, but can become one important factor; degenerative sclerotic vascular alterations bear relationship to the poorly contractile vasculature that brings up difficulties in the control of hemorrhagic gastroduodenal ulcers. Many gastrointestinal disorders in elderly patients occur with an equal frequency in younger patients, some are more common in the geriatric population; these include hiatal hernia, carcinoma of esophagus, stomach, pancreas, bile ducts and colon, intestinal obstruction (ileus) by neoplastic growth, gallstone ileus, external hernia and operative adhesions and especially diverticular diseases of the colon and its complications and ischemic colitis by mesenteric vascular occlusion. Cirrhosis of the liver is often diagnosed for the first time in the older age groups while acute viral hepatitis uses to run a cholestatic course and is therefore often misdiagnosed as mechanical obstruction. In general history is difficult to obtain, the response of the organism with temperature and white blood count to stress is often delayed and rigidity associated with an underlying inflammatory disease involving the peritoneum is often delayed and rigidity associated with an underlying inflammatory disease involving the peritoneum is often atypical. Because of this limited reaction to severe stress, early surgical intervention is imperative in the elderly patients.
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PMID:[Problems of the so-called geriatric gastrointestinal diseases]. 120 46

Two cases of gall-stone ileus during the past months have encouraged us to discuss the epidemiology, pathogenesis, diagnosis and therapy. This pathology is not as rare as one thinks and represents 23% of cases of mechanical ileus of the small intestine in patients over 65 years of age, thus being the third cause after stenosis due to carcinoma and incarcerated hernia. The importance of this illness is due to two factors: the diagnostic difficulties because of a periodic symptomatology with often a lack of typical radiologic signs and the still important mortality of 5 to 10% today. We present the casuistic of seven cases which have occurred over the last 15 years in our hospital and compare our experience with those of the literature. We discuss the therapeutic problem of enterolithotomy or one-stage repair. The main point for a reduction in mortality is an early diagnosis with the consequent reduction of the time from the appearance of the ileus to the operation.
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PMID:[Gallstone ileus--still a current disease]. 159 51

We analyzed 237 patients who underwent total cystectomy with ileal conduit urinary diversion or cutaneous ureterostomy at the Center for Adult Diseases, Osaka. One-hundred and eighty-eight patients underwent ileal conduit diversion and 49 patients underwent cutaneous ureterostomy. No patient died within 30 days after the operation, but two patients who underwent ileal conduit diversion died of postoperative complications within 2 months. Early complications occurred in 94 patients (50%) in the ileal conduit group and in 18 patients (37%) in the ureterostomy group. Late complications occurred in 85 patients (45%) in the ileal conduit group and in 23 patients (47%) in the ureterostomy group. Frequent early complications in the ileal conduit group were wound infection (29%), and intestinal complications (13%) which included ileus and upper urinary tract complications (12%). The most frequent late complications were stomal complications (26%) which included peristomal dermatitis stomal stenosis, parastomal hernia, and stomal prolapse, and upper urinary tract complications which were noted in 27 patients (14%).
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PMID:[Incontinent urinary diversion]. 178 82

A total of 74 patients, additionally treated with a pedicled omentoplasty, were studied retrospectively with regard to the complications. The pedicled omentoplasty was used extra- or intra-abdominally to reconstruct large soft-tissue defects, to treat radiation necrosis or to prevent radiation enteritis. Gastro-intestinal complaints were seen in six patients, three developed an ileus and needed a relaparotomy, one patient had herniation of the stomach through a diaphragm defect. Total necrosis of the omental flap was seen in two patients and infection in seven patients with an extra-abdominally used omentoplasty. An abscess in the pelvic cavity occurred five times in an intra-abdominally placed omentoplasty. In seven patients, an operative correction of an incisional hernia was necessary. One patient died of massive pulmonary embolism. This study indicates that the pedicled omentoplasty is a safe procedure and is associated with a moderate number of postoperative complications, which can be reduced if the right surgical technique is used.
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PMID:Complications of the pedicled omentoplasty. 178 2

Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificity of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecystitis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echogenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus.
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PMID:[Plain radiographic examination and abdominal echography in intestinal occlusion syndrome. Preliminary note]. 201 34


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