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

The case of an elderly, emaciated female patient with recurrent lower abdominal and hip pain associated with nausea and vomiting due to an incarcerated obturator hernia is described. The presence of a Howship-Romberg sign and a tender mass on digital rectal examination in this thin, elderly woman with a small bowel obstruction led to the rapid diagnosis of an obturator hernia by computed tomography (CT). The high mortality rate associated with this most lethal of all abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and surgical intervention if the survival rate is to be improved.
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PMID:Strangulated obturator hernia: still deadly. 1121 52

The differential diagnosis of hip pain is broad and includes intra-articular pathology, extra-articular pathology, and mimickers, including the joints of the pelvic ring. With the current advancements in hip arthroscopy, more patients are being evaluated for hip pain. In recent years, our understanding of the functional anatomy around the hip has improved. In addition, because of advancements in magnetic resonance imaging, the diagnosis of soft tissue causes of hip pain has improved. All of these advances have broadened the differential diagnosis of pain around the hip joint and improved the treatment of these problems. In this review, we discuss the causes of intra-articular hip pain that can be addressed arthroscopically: labral tears, loose bodies, femoroacetabular impingement, capsular laxity, tears of the ligamentum teres, and chondral damage. Extra-articular diagnoses that can be managed arthroscopically are also discussed, including: iliopsoas tendonitis, "internal" snapping hip, "external" snapping hip, iliotibial band and greater trochanteric bursitis, and gluteal tendon injury. Finally, we discuss extra-articular causes of hip pain that are often managed nonoperatively or in an open fashion: femoral neck stress fracture, adductor strain, piriformis syndrome, sacroiliac joint pain, athletic pubalgia, "sports hernia," "Gilmore's groin," and osteitis pubis.
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PMID:Differential diagnosis of pain around the hip joint. 1903 13

We report an 86-year-old women with an obturator hernia presenting with recurrent right hip pain. Obturator hernia is a diagnostic challenge because the hernial mass is usually concealed beneath the pectineus. It should be suspected in emaciated, multiparous, elderly women presenting with unexplained pain in the groin, hip, thigh, or knee. High levels of clinical suspicion of the high-risk patients and recourse to investigation by computed tomography are important, as delay in diagnosis and treatment is associated with increased morbidity and mortality.
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PMID:Obturator hernia presenting as hip pain: a case report. 2325 56

Obturator hernia (OH) is a rare type of pelvic hernia. It can cause significant morbidity and mortality, especially in the elderly age group. Delayed treatment is associated with high rates of strangulation (25-100%). We present an 88-year-old woman who presented with symptoms of bowel obstruction and right hip pain. Computed tomography (CT) abdomen revealed bilateral OHs and bowel obstruction secondary to the right OH. She was managed conservatively due to her age and co-morbidities and her bowel obstruction subsequently resolved. She was discharged, only to re-present 1 month later with similar complaints. A repeat CT scan revealed bilateral OHs and bowel obstruction due to the left OH. She underwent midline laparatomy and both OHs were reduced. The right OH was fixed with polypropylene mesh plug and the left OH was fixed with primary closure. The patient recovered and no recurrence was noted during follow-up.
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PMID:Small bowel obstruction secondary to bilateral obturator hernia: a rare occurrence. 2487 74

Surgical repair of difficult or nonunion fractures is frequently performed with autogenous bone grafts, most commonly from the iliac crest. Complications from this procedure may include vessel injury, nerve injury, pelvic instability, bowel herniation, and ileus. The authors report a case of iliac crest herniation in a patient presenting with a small-bowel obstruction 2 years after anterior iliac crest graft harvest for an open reduction and internal fixation repair of a right humeral shaft fracture. An emergency operation revealed that the right colon had herniated through an opening in the right iliac crest. The appendix had adhered to new osseous bone formed postoperatively, requiring an appendectomy. The hernia defect was successfully repaired with polypropylene mesh. A high index of suspicion for graft site herniation is needed for patients with a history of iliac crest bone grafting who present with symptoms of abdominal pain, flank or hip pain, ileus, or small-bowel obstruction.
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PMID:Iliac Crest Herniation Secondary to Autogenous Bone Grafting Found on Osteopathic Examination. 2621 26

BACKGROUND Richter's obturator hernia is a rare abdominal hernia that is difficult to diagnose. The purpose of this case report is to show an unusual presentation of a fatal Richter's obturator hernia that was accompanied by a femoral abscess. CASE REPORT An 89-year-old woman complained of sudden left coxalgia and a gait disorder but no abdominal symptoms. She had no history of trauma or surgery in the inguinal area. Twenty-three days after her first complaint of coxalgia, the patient was admitted in a coma with necrotizing fasciitis in the left inguinal area. The patient died of asystole due to hyperkalemia. During surveillance for the cause of death, a Richter's type of incarcerated obturator hernia was identified at autopsy. The incarcerated small intestine had penetrated into the left obturator foramen to form an abscess that extended into the deep femoral region. CONCLUSIONS Obturator hernia accompanied by femoral abscess is extremely rare, but it should be suspected when a patient with no history of trauma or surgery has a femoral abscess, even in the absence of abdominal symptoms.
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PMID:Richter's Type of Incarcerated Obturator Hernia that Presented with a Deep Femoral Abscess: An Autopsy Case Report. 2781 87

Obturator hernia is a rare disease usually occurring in debilitated elderly women. Pain radiating down the medial thigh and knee (Howship-Romberg sign) is a specific sign of the disease. Presently described is a case of obturator hernia in a 73-year-old female patient who presented with severe left hip pain radiating down the medial thigh and knee, nausea, and loss of appetite. Initially, vertebral disc herniation was thought to be cause, but abdomino-pelvic computed tomography scan revealed left strangulated obturator hernia. Diagnosis of obturator hernia can be challenging. Physicians should consider obturator hernia in the differential diagnosis of knee and hip pain, and investigate for Howship-Romberg sign. Early diagnosis of the disease not only decreases morbidity and mortality, but also presents opportunity to treat with minimally invasive methods.
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PMID:Obturator hernia should be considered in the differential diagnosis of hip and knee pain. 2807 54

Herniation pits are small benign lucent oval lesions within the anterior aspect of the superolateral femoral neck and were first described in 1982 by Michael J. Pitt. They are widely believed to occur as a result of mechanical forces from the overlying capsule resulting in herniation of soft tissues and synovium through a small bony defect. More recently, there has been evidence to suggest that femeroacetabular impingement may have a role in their aetiology. We present a case of a 59 -year -old male patient who developed hip pain following a jump from a wall. MRI was performed following failure of conservative management and demonstrated a small herniation pit with surrounding bone oedema. Following flouroscopic intra-articular steroid injection there was complete resolution of the patient's symptoms and the bone oedema surrounding the herniation pit. We review the potential causes, imaging appearances and potential treatment of synovial herniation pits with an emphasis on the role of radiologically guided intra-articular steroid injection.
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PMID:Symptomatic synovial herniation pit-MRI appearances pre and post treatment. 3036 91