Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 74-year-old woman with coronary artery disease had undergone coronary artery bypass grafting (CABG) with autologous vein grafts in 1999. She subsequently had recurrenct angina and underwent a second CABG in 2001 with the right gastroepiploic artery (GEA). The GEA pedicle was placed anterior to the stomach. In November 2004, the patient was admitted to the emergency room for back pain with nausea and vomiting. A repeat electrocardiogram did not show transient myocardial ischemia. A plain radiograph of the chest revealed the gas-filled dilatation of the stomach with fluid levels in the left base of the thorax. An upper gastrointestinal radiographic series using stomach tube revealed a strangulated intrapericardial gastric hernia. A computed tomographic scan with sagittal plane showed an intrapericardial hernia above the left lobe of the liver. Although herniation of the abdominal contents is a rare complication, it may be preventable. Techniques such as keeping the GEA pedicle small, minimizing the length of the diaphragmatic incision, placing interrupted sutures perpendicular to the musculotendinous fibers of the diaphragm, performing a gastropexy, and reinforcing the diaphragmatic incision with mesh may prevent this complication.
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PMID:Strangulated intrapericardial herniation of the stomach after use of the right gastroepiploic artery for coronary artery bypass grafting. 1767 Mar 83

Progression of spondylolysis to spondylolisthesis in adults is very rare. It is always accompanied by disc degeneration at the slip level, or at a lower level. The intervertebral disc is indeed the main structure that opposes the anteriorly directed shear forces. Of course, the disc degeneration might also be a consequence, rather than a cause of the slip. The authors describe an unusual case of progression of spondylolysis to spondylolisthesis in an adult, without any disc degeneration. They are not aware of a similar case in the literature. In 1999, an aircraft engineer with known asymptomatic spondylolysis was involved in a low impact motorcycle accident, after which a Grade I spondylolisthesis L4 was diagnosed. There was no predisposing disc space narrowing at any vertebral level. There may have been a certain degree of microscopic disc degeneration L4L5, a possibility which was confirmed by the development of a disc hernia L4L5, seven years after trauma. This case illustrates the potential for progression of spondylolysis to spondylolisthesis in an adult, without radiographical signs of disc degeneration at any level. The minimal trauma might have played a role. The authors recommend that patients with known spondylolysis who sustain acute exacerbation of their back pain should have standing radiographs.
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PMID:Progression of spondylolysis to isthmic spondylolisthesis in an adult without accompanying disc degeneration: a case report. 1841 18

Approximately 80% of the adult population suffers from chronic lumbar pain with episodes of acute back pain. The aetiology of this disorder can be very extensive: degenerative scoliosis, spondiloarthritis, disc hernia, spondylolysis, spondylolisthesis and, in the most serious cases, neoplastic or infectious diseases. For several years, the attention of surgeons was focused on the articular facets syndrome (Lilius et al. in J Bone Joint Surg (Br) 71-B:681-684, 1998), characterised clinically by back pain and selective pressure soreness at the level of the facets involved. The instrumental framework highlights widespread zigoapophysary arthritis and hypertrophy/degeneration of articular facets due to a functional overload. This retrospective study analyses the patients who arrived at our observation and were treated with a neuroablation using a pulsed radiofrequency procedure, after a CT-guided infiltration test with anaesthetic and cortisone. From the data collected, it would seem that this procedure allows a satisfactory remission of the clinical symptoms, leaving the patient free from pain; furthermore, this method can be repeated in time.
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PMID:Articular facets syndrome: diagnostic grading and treatment options. 1943 Aug 20

The study was to present the results of the surgical treatment using the spinal instrumentation toe resolve the osteoporotic vertebral compression fracture in the elderly patients having the clinical symptoms of pain and the neurological compromise. Sixty elderly patients who underwent the surgical treatment of the osteoporotic vertebral compression fracture were retrospectively reviewed. Their average age was 72 years; the range was 60-90. The average follow-up period for these patients was 4.2 years; the range was 3-7. Twenty-four patients were performed by the posterior stabilization enhanced by the pedicle screws and rods with the transpedicular bone grafting. Thirty-two patients were performed by the anterior corpectomy with the interbody fusion and the anterior spinal instrumentation. Four patients were performed by two-step surgical treatment: firstly the posterior stabilization enhanced by pedicle screws and rods, and finally, the anterior corpectomy with the interbody fusion. The sagittal Cobb angle and the back pain were improved in all patients. The neurological deficits were improved in 14 patients out of the 16 patients. Twelve patients had the post operative complications: late implants loosening in 5 patients, subcutaneous wound infections in 4 patients, painful neuromas at thoracic cage in 2 patients and incisional hernia in one patient. Although the surgical treatment with spinal implants in the osteoporotic compression fracture was performed in the selected patients, the complication rate was still high, i.e. twenty percent. All of them, nevertheless, were not the mortal complications. The anterior column support could maintain the sagittal alignment better than the posterior spinal fusion alone in the long-term follow up period while the VAS of pain was improved in the similar results.
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PMID:The surgical treatment of the osteoporotic vertebral compression fracture in the elderly patients with the spinal instrumentation. 1989 85

Incidental or intentional durotomy causing cerebrospinal fluid (CSF) leakage, leading to the formation of a pseudomeningocele is a known complication in spinal surgery. Herniation of nerve roots into such a pseudomeningocele is very rare, but can occur up to years after initial durotomy and has been described to cause permanent neurologic deficit. However, cauda equina fiber herniation and entrapment into a pseudomeningocele has not been reported before. Here, we present a case of symptomatic transdural cauda equina herniation and incarceration into a pseudomeningocele, 3 months after extirpation of a lumbar Schwannoma. A 59-year-old man, who previously underwent intradural Schwannoma extirpation presented 3 months after surgery with back pain, sciatica and loss of bladder filling sensation caused by cauda equina fiber entrapment into a defect in the wall of a pseudomeningocele, diagnosed with magnetic resonance imaging. On re-operation, the pseudomeningocele was resected and the herniated and entrapped cauda fibers were released and replaced intradurally. The dura defect was closed and the patient recovered completely. In conclusion, CSF leakage can cause neurological deficit up to years after durotomy by transdural nerve root herniation and subsequent entrapment. Clinicians should be aware of the possibility of this potentially devastating complication. The present case also underlines the importance of meticulous dura closure in spinal surgery.
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PMID:Cauda equina entrapment in a pseudomeningocele after lumbar schwannoma extirpation. 1992 48

We report 48 patients operated on for lumbar disc herniation in the second decade of life (aged 13-20 years) in our Neurosurgical Division. To analyze the clinical and diagnostic features and surgical outcome of the disease in teenagers and to point out any differences from adults, we made a detailed study of over 900 juvenile cases and compared them with 11000 adult cases reported in the literature. Low-back pain proved to be less frequent among youngsters both as a first symptom and at diagnosis, while sensorimotor deficits have the same frequency in the two age groups. Herniation occurs more often at L4-L5 and is more frequently median among teenagers. The long-term surgical results in children and adolescents are better than in adults.
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PMID:Lumbar disc herniation in teenagers. 2005 43

Bochdalek hernia is usually diagnosed in pediatric patients and not in the elderly. In adults, there are some cases resulting in misdiagnosis of pneumonia, pleural effusion, congenital bulla, and pneumothorax by chest roentgenogram. We present here a rare case of Bochdalek hernia in an elderly patient who suffered from sudden back pain and had the hernia repaired with laparotomy.
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PMID:Case of Bochdalek hernia in the elderly: success with laparotomy. 2030 31

Lumbar hernia is a rare condition. Lumbar hernia should be considered a rare differential diagnosis to unexplained back pain. Symptoms are scarce and diffuse and can vary with the size and content of the hernia. As there is a 25% risk of incarceration, operation is indicated even in asymptomatic hernias. We report a case of lumbar hernia in a woman with a slow growing mass in the lumbar region. She presented with pain and a computed tomography confirmed the diagnosis. She underwent open surgery and fully recovered with recurrence within the first half year.
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PMID:[Lumbar hernia]. 2033 99

The pathological entities commonly associated with lumbosacral pain are the intervertebral discs, facet joints or surrounding muscle. However, in the absence of diagnostic confirmation of the aforementioned structures, the diagnosis may become confusing and intractable. Sacroiliac fascial lipocele (SFL), namely, pannicular hernia, could be a neglected cause. First reported by Ficarra et al in 1952, it was highlighted by the formation of lipocele in the sacroiliac fascia. Mostly, it could be spontaneously eliminated under conservative therapy. However, for intractable pain, surgical intervention may be the only choice. We will first present a typical case of SFL which was treated by percutaneous endoscopic surgery. Ultimately, a satisfactory outcome was achieved and maintained at 12 months follow-up. It is important to distinguish SFL some cases with lumbosacral back pain. Detailed physical examination, superficial ultrasonography and diagnostic nerve block are extremely valuable for acquiring a precise diagnosis. Overall, when considering the clinical outcome of such cases and the foregoing benefits, percutaneous endoscopic treatment could be an efficacious alternative treatment for SFL-related lumboscral back pain.
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PMID:Sacroiliac fascial lipocele could be a neglected cause of lumbosacral pain: case study of percutaneous endoscopic treatment. 2579 33

Ureterosciatic herniation, the protrusion of the hernia sac through the sciatic foramen, is an extremely rare cause of ureteral obstruction. We describe a case revealed by severe left back pain in a 72-year-old female. She was referred to our hospital for urological assessment of left hydronephrosis observed by ultrasonography. Intravenous ureterography (IVU) showed findings compatible with a left sciatic ureter, a dilated ureter with a fixed kinking, which is known as the 'curlicue' sign. We decided to attempt recovery of the herniated ureter using a retrograde approach. Ureteral stent placement was performed to decompress the dilated upper urinary tract. The ureterosciatic hernia was relieved with the passage of a flexible guide wire and a double-pigtail stent. Three months after ureteral stenting, she refused continuing to have an indwelling stent and the stent was removed. Thereafter, IVU revealed recurrent ureterosciatic hernia; however, there was no hydroureter or hydronephrosis. The patient is currently being under observation for 6 years after stenting and continues to be without hydronephrosis or symptoms. Placement of an internal stent possibly provides the rigidity to the ureter, thereby reducing the hernia and urinary obstruction. In the previous reports, most symptomatic patients have been treated surgically, with conservative therapy reserved for asymptomatic patients. For the patient who is elderly or a poor surgical candidate, retrograde stenting may provide safe reduction and efficacious treatment. This endourological approach provides a minimally invasive means for the management of urinary obstruction caused by ureterosciatic herniation.
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PMID:Minimally Invasive Endourological Techniques may Provide a Novel Method for Relieving Urinary Obstruction due to Ureterosciatic Herniation. 2584 69


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