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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

Triorchidism, a rare anatomical phenomenon has been reported in 24 cases and in only 6 has spermatogenesis occurred. One of these 6 is a 45 year old man who had been bilaterly vasectomized without semen analysis following surgery. The patient's wife, complaining of 4 months amenorrhea, was thought to be pregnant. Examination of the patient revealed 2 lumps detected in the right hemi-scrotum which felt like small testes and did not permit transillumination. The left testis was normal and laboratory tests including excretory urography were normal. Semen analysis revealed normal spermatogenesis. At operation under local anesthesia, 2 vasa deferentia were detected in the right scrotum one of which had been partly resected. At no point did the 2 structures communicate. Resection of the supernumerary vas deferens was completed and biopsies of both right hemiscrotal testes proved normal. Moreover, the testis with intact vas deferens showed normal spermatogenesis. In the left scrotum a second resection was performed on the upper end because it had been only partly resected. Histological examination of the resected vasa deferentia confirmed triorchidism with normal spermatogenesis. This condition may be associated with other congenital abnormalities such as anomalous union between the testis and its epididymis, absence of a rete testis and hernia and hydrocele. Urogenital examinations before vasectomy and post vasectomy semen analyses should be done to prevent similar occurrences.
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PMID:Triorchidism with normal spermatogenesis: an unusual cause for failure of vasectomy. 117 4

Controversy exists regarding the role of the epididymis in testicular descent, as epididymal abnormalities have been reported in 36 to 79% of boys with an undescended testis. Although most undescended testes are associated with a patent processus vaginalis, the incidence of epididymal abnormalities in descended testes with a patent processus has not been reported. Epididymal morphology was examined in 81 boys with a hydrocele/hernia without cryptorchidism (90 testes) and 100 children undergoing orchiopexy (115 testes). Boys with an intra-abdominal undescended testis were excluded. Among 48 boys with a hydrocele/hernia 24 (50%) had an epididymal abnormality if the processus was patent and communicated with the testis (complete hernia), compared to 4 of 42 patients (10%) if there was not a communication with the testis (p less than 0.01). Among the 96 children with an undescended testis 68 (71%) had an epididymal abnormality if there was a patent processus, compared to 3 of 19 boys (16%) without a patent processus (p less than 0.01). These data suggest that most epididymal abnormalities probably do not contribute to testicular maldescent.
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PMID:Epididymal anomalies associated with hydrocele/hernia and cryptorchidism: implications regarding testicular descent. 135 42

The most common surgical diseases in childhood that need a planned operation, are described--especially the indications and the timing of operation. Inguinal hernia, hydrocele, cryptorchism, umbilical hernia and phimosis are presented.
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PMID:[Indications and timing of the most frequent elective pediatric surgery interventions]. 136 44

We report on a case of polyorchidism associated with left-sided inguinal hernia and hydrocele. Biopsies of both testes revealed normal histological pattern. After the hernia repair and hydrocelectomy both testes were left at their original places in the scrotum and fixed. Polyorchidism and its management are discussed briefly.
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PMID:Polyorchidism: a case report and review of the literature. 142 79

Laparoscopic inguinal "exploration" was undertaken in 22 consecutive pediatric patients to assess the value of this technique in detecting the presence or absence of occult inguinal hernias on the asymptomatic side of patients with unilateral disease. After a CO2 pneumoperitoneum was established using a Veress needle, a 2 mm 0 degree laparoscope was passed via a 3 mm cannula and both inguinal rings were inspected. Eleven cases (50%) had previously unsuspected bilateral disease diagnosed at laparoscopy and had bilateral inguinal hernias confirmed at exploration. Nine cases, in which the asymptomatic side was assessed as being negative at laparoscopy, were confirmed negative by open exploration. In one misdiagnosed case of bilateral hernias, no hernias were found at laparoscopy and one side had a non-communicating hydrocele at exploration. There was one failure, an infant less than 2 months of age, in whom the inguinal anatomy could not be adequately visualized at laparoscopy and a hernia was found at exploration. There were no complications. Thus, laparoscopic inguinal "exploration" was 96% accurate in this initial evaluation. The adoption of this approach to the assessment of the asymptomatic contralateral side in infants with unilateral hernias would eliminate many inguinal operations and the complications associated with unnecessarily manipulating the delicate cord structures.
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PMID:Inguinal hernias in pediatrics: initial experience with laparoscopic inguinal exploration of the asymptomatic contralateral side. 149 4

Early and accurate diagnosis will not only prevent the catastrophe of gangrenous bowel in infants and children with inguinal and femoral hernia, but in the case of hydrocele will also avoid unnecessary parental anxiety. An accurate diagnosis and knowledge of the natural history of inguinal conditions can avoid unnecessary referral to surgical consultants. Finally, an understanding of the surgical expectations, ie, orchiopexy for the undescended testis, will provide parents and patients with realistic expectations.
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PMID:Inguinal and scrotal problems in infants and children. 256 10

Of 158 boys consecutively referred for undescended testis, 77 were found to have true cryptorchidism. Human chorionic gonadotropin (HCG) was given to 60 boys (63 undescended testes) in a dose of 5,000 U (patient age 4-6 years) or 10,000 U (7-9 years). The parents of seven others preferred direct referral for orchiopexy. Minor side effects occurred in 18 boys. Significant increase in weight increment velocity was seen among 7-9-year-olds. Descent of testis occurred in 59% (95% cl 46-71%), with the incidence significantly higher in the older group. Mobile testes were more likely to descend. At surgery following failed HCG treatment, hernia or hydrocele was unexpectedly found in 77% of cases, and 19% of the testes were ectopic in the superficial inguinal pouch. The risk of repeat orchiopexy was not less than in a previous series of primary orchiopexy. Although surgery could be avoided in approximately half of the patients in this series, it is not yet decisively established if HCG should be used diagnostically or therapeutically. Improved pre-treatment identification of ectopia and hernia is required.
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PMID:Prospective evaluation of human chorionic gonadotropin in the treatment of cryptorchidism. 257 29

A method to prevent inguinoscrotal haematoma following hernia and hydrocele repair is presented. The technique was used in 34 consecutive patients, none of whom developed a significant postoperative haematoma or complications.
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PMID:The 'hitch-stitch' and drain technique for the prevention of inguinoscrotal haematoma following complicated inguinoscrotal surgery. 265 40

Benign mass lesions of the scrotum include spermatocele, hydrocele, varicocele, sperm granuloma after vasectomy, tuberculous masses, and epididymitis. A careful history and physical examination are paramount in making the diagnosis of a scrotal mass. Referral to a urologist is indicated for masses that do not transilluminate, are solid or fixed to the testicle, or for epididymitis that does not respond to antibiotics. Hydroceles associated with significant symptoms or with hernia and varicoceles with symptoms or associated infertility are also reasons for referral. After a sexual history is obtained, lesions of the anogenital area should be carefully inspected. Male partners of women with cervical dysplasia should be examined for evidence of human papillomavirus infection. Treatment of anogenital lesions resulting from a sexually transmitted disease involves both partners.
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PMID:Benign conditions of the external genitalia. 269 49


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