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

Congenital diaphragmatic hernia (CDH) is a common cause of severe respiratory distress in the newborn. However, the presentation of CDH in older children and adults is rare, and, therefore, little is known concerning its symptoms, operative management, and postoperative complications. Thirteen patients (age range: 2 months to 26 years; 5 males, 8 females) presented with CDH. Four patients had right-sided hernias, eight left-sided hernias, and one bilateral hernias. Symptoms included chronic respiratory tract infections in 6 patients, vomiting in 5, weight loss in 1, severe failure to thrive in 2, and severe respiratory distress in 3; one patient was asymptomatic. Physical signs included the absence of breathing sounds or bowel sounds in the chest in eight patients, hyperresonance in one, and cachexia in two. The diagnosis was confirmed in each patient by chest roentgenogram or gastrointestinal contrast radiograph. All patients underwent immediate repair. After reduction of the viscera, 12 of 13 patients underwent primary diaphragm repair, whereas one patient required a prosthetic diaphragm patch. Twelve of 13 patients (92%) survived. Postoperatively, 7 of the 12 survivors (58%) developed severe gastric atony, and four required further operative therapy. In contrast to newborns, CDH in the older child and adult is frequently seen on the right side, rarely presents with severe respiratory distress, and is occasionally asymptomatic. Postoperative gastric atony is a major cause of morbidity, making transabdominal repair with simultaneous pyloroplasty and/or feeding jejunostomy the preferred operative approach.
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PMID:Congenital diaphragmatic hernia beyond infancy. 167 Feb 42

During a national survey of Hunter's syndrome, 52 boys with the severe form were ascertained. The average ages of onset and death were 2.47 and 11.77 years respectively. Most patients had a large head and short stature. Persistent diarrhoea was noted in 65 per cent of the patients. 76 per cent had an umbilical hernia. Right and left inguinal herniae were noted in 51 and 32 per cent respectively. Evidence of cardiovascular disease was found in 65 per cent of cases; and serious lower respiratory-tract disease occurred in 84 per cent. Induction of anaesthesia proved difficult or impossible in five boys. The disease pattern was dominated by the effects of neurological involvement, with initial developmental delay and behavioural disturbance, followed by regression, with convulsions and pyramidal tract signs. Death was due primarily to this neurodegenerative cachexia, with superimposed respiratory disease.
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PMID:The natural history of the severe form of Hunter's syndrome: a study based on 52 cases. 641 86

A patient with unexplained low back pain, weight loss, and pulmonary infiltrate underwent an inguinal herniorrhapy. Histologic examination of the grossly normal hernia sac revealed metastatic adenocarcinoma. The patient died of cachexia 10 months later. This case observation suggests the necessity of histologic examination of grossly normal hernia sacs.
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PMID:Metastatic carcinoma in inguinal hernia sac. 671 21

This report presents the case of a 73-year-old woman who was admitted with sepsis, cachexia and confusion secondary to a strangulated femoral hernia containing both the appendix (De Garengeot hernia) and a Meckel's diverticulum (Littre's hernia). She underwent successful operative management and was discharged from hospital on the 10th post-operative day. This is the first report in the literature of a combined De Garengeot and Littre's hernia within a femoral hernia sac.
Hernia 2012 Dec
PMID:Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia. 2144 31

In cancer patients with tumors of the upper gastrointestinal tract, dysphagia and cachexia require gastrostomy or jejunostomy as the only options for enteral access for long-term feeding. In this article, the authors describe a modified placement of laparoscopic feeding jejunostomy applied during laparoscopic oncology layering technique. After performing an exploratory laparoscopy, a feeding jejunostomy is performed using a Foley silicon catheter, through an eyelet in the mesentery of the descending colon. After completing the introduction of the jejunal probe according to the Witzel technique, the intestinal segment of jejunum is attached to the internal sheath of the mesocolon using sutures polysorb 2/0, with the aim of removing the possible internal hernia and a jejunal torque that could cause an intestinal obstruction. There were no intraoperative complications or mortality. The technique described here provides most of the benefits of laparoscopic jejunostomy feeding, avoiding the possible internal hernia.
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PMID:Laparoscopic surgical transmesocolic jejunostomy: A new surgical approach. 3002 85

Postoperative diaphragmatic hernia (PDH) is an increasingly reported complication of esophageal cancer surgery. PDH occurs more frequently when minimally invasive techniques are employed, but very little is known about its pathogenesis. Currently, no consensus exists concerning preventive measures and its management. A 71-year-old man underwent minimally invasive esophagectomy for esophageal cancer. Three months later, he developed a giant PDH, which was repaired by direct suture via laparoscopic approach. A hypertensive pneumothorax occurred during surgery. This complication was managed by the anaesthesiologist through a high fraction of inspired O2 and several recruitment manoeuvres. The patient remained free of hernia recurrence until he died of neoplastic cachexia 5 months later. Laparoscopic repair of PDH may be safe and effective even in the acute setting and in the case of massive herniation. However, surgeons and anaesthesiologists should be aware of the risk of intraoperative pneumothorax and be prepared to treat it promptly.
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PMID:Emergency Laparoscopic Repair of Giant Left Diaphragmatic Hernia following Minimally Invasive Esophagectomy: Description of a Case and Review of the Literature. 3029 14

An 84-year-old woman with a history of weight loss, anorexia and episodic vomiting was admitted to hospital where she died soon afterwards. Her diagnosis was acute renal injury due to dehydration and malnutrition. At autopsy the body was cachectic with a small intestinal obstruction due to herniation through a defect at the anterolateral aspect of the obturator foramen. A poorly differentiated adenocarcinoma of the gastroesophageal junction was also identified with small peripheral pulmonary thromboemboli. Death was due to small bowel obstruction from a left obturator hernia with scattered peripheral pulmonary thromboemboli complicating cachexia due to gastroesophageal adenocarcinoma. Obturator hernias are called the "little old lady's hernia" and occur mainly in elderly, multiparous and malnourished women. The broader female pelvis and wider obturator canal with laxity of ligaments and loss of preperitoneal adipose tissue padding around the canal predispose to herniation. This rare hernia is often first identified at autopsy.
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PMID:Obturator hernia and the elderly. 3039 70

A 4-month-old intact male domestic shorthair kitten living in St Kitts, West Indies presented with respiratory distress, cachexia, and mucopurulent nasal discharge. Thoracic radiographs revealed a diaphragmatic hernia. The diaphragmatic hernia as well as subpleural pulmonary nodules suspicious for verminous pneumonia were identified during a postmortem examination. Histology showed multifocal to coalescing pyogranulomatous and eosinophilic pneumonia centered on larvae and morulated eggs. The lesion and nematode morphology were consistent with Aelurostrongylus abstrusus. Although Aelurostrongylus abstrusus has been reported worldwide, this is the first report of a metastrongyloid lungworm in cats in St. Kitts and for the West Indies. This case report should increase the awareness of A. abstrusus pneumonia in cats from St. Kitts and other locations in the eastern Caribbean.
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PMID:First report of Aelurostrongylus abstrusus in St. Kitts. 3205 93

Spontaneous evisceration is a rare complication that becomes life-threatening in direct inguinal hernia. A female at the age of 44, weighing 50 kg looked cachectic and was suffering from swelling on the left groin for the last several years. The evisceration of the small intestine as separated from the mesenterium transpired in the subsequent stage of a spontaneous rupture in the left inguinal region after severe coughing. The region ruptured was sealed after small intestine resection carried out through the incision perforated; mesh herniorrhaphy was implemented at the end of the 3rd month. The spontaneous rupture may transpire depending on malnutrition and cachexia not only after the complications by hernia, such as incarceration, strangulation but also after factors increasing intra-abdominal pressure. Elective surgical treatment must be implemented in hernia regardless of its kind. Complications likely to transpire in cases where intervention is conducted too late may threaten the patient's life.
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PMID:Spontaneous direct inguinal hernia rupture and intestinal mesenteric separation: A case report. 3258 35