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

Incisional hernias occur in <1% of women undergoing operative laparoscopy and are mostly limited to trocar sites > or =10 mm. This is a report of a 54-year-old woman with endometrial cancer who presented with nausea, vomiting and abdominal pain 1 week following laparoscopically-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. Abdominal radiographs and computed tomography demonstrated small bowel obstruction and herniation through a 5-mm trocar site. Reduction of the hernia and closure of the fascial incision were performed at exploratory laparotomy with normal recovery. Bowel herniation can occur through 5-mm trocar sites following prolonged operative laparoscopy. The peritoneum and fascia of these incisions should be closed.
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PMID:Small bowel obstruction secondary to herniation through a 5-mm laparoscopic trocar site following laparoscopic lymphadenectomy. 1047 21

Internal abdominal hernias are an unusual cause of intestinal occlusion. They are responsible for 2% of all the intestinal obstructions. Various types of hernia have been described. The diagnosis is difficult, but should be suspected in patients suffering from intestinal obstruction who have undergone earlier laparotomy. Diagnosis is even more difficult in cases of congenital internal hernia. The authors report a case of left paraduodenal hernia (congenital), and a case of transmesenteric hernia (acquired). Both patients complained of a short history of abdominal pain and characteristic symptoms of acute abdomen (nausea, vomit, cramps and obstipation). Emergency surgery using laparotomy enabled diagnosis and treatment. The authors underline the difficulty of diagnosing these hernias and emphasise the diagnostic and therapeutic importance of emergency surgery.
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PMID:[Internal abdominal hernia. Unusual cause of intestinal occlusion]. 1083 4

Paraduodenal hernia (PDH) is an unusual condition that is caused by congenital intestinal malrotation. Noncatastrophic presenting symptoms and their responses to surgery have not been well-characterized. Barium upper gastrointestinal (UGI) series and small bowel follow-up x-rays, performed from December 1995 to September 1996, were sequentially reviewed by one radiologist (J.M.) to identify patients with small bowel series compatible with a PDH. Case histories were reviewed for symptomatic presentation, associated evaluation, and treatment. Based on the 294 UGIs and small bowel follow-throughs performed during this 10-month period, 6 cases were suspected to have a PDH. A right PDH was confirmed in the three patients who underwent surgical exploration (prevalence 1%). Preoperative patient symptoms included nausea, bilious vomiting, and right upper quadrant pain. Repair of the hernia defect resulted in complete resolution of chronic symptoms. Preoperative upper endoscopy, performed in three patients, was not helpful in identifying the disorder. Preoperative computerized tomography obtained in two patients was diagnostic for a right PDH. One symptomatic patient with vomiting and gastric stasis did not have surgery because of a terminal illness. The remaining two patients had no symptoms attributable to PDH. Patients with PDH frequently have chronic UGI symptoms. An upper endoscopy cannot be used to exclude this entity. After surgery, UGI symptoms from PDH are likely to resolve.
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PMID:Paraduodenal hernia: a treatable cause of upper gastrointestinal tract symptoms. 1103 2

Although it is a rare occurrence among all pelvic hernias diagnosed the obturator hernia continues to be a diagnostic challenge for surgeons today. These patients, who often have multiple concurrent medical problems, are subject to high morbidity and mortality rates resulting from late presentation and delayed surgical intervention. The vast majority of patients with obturator hernias are admitted with signs and symptoms of intestinal obstruction, namely anorexia, nausea, vomiting, constipation, and distension of 2 to 3 days' duration. In this paper, however, we highlight a small subset of obturator hernia patients who present without obstructive symptoms and do well after elective repair. The case reports that follow serve to compare and contrast two very different presentations of this surgical problem.
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PMID:Typical versus atypical presentation of obturator hernia. 1124 49

Gallbladder perforation with loss of calculi in the abdomen is frequent during laparoscopic cholecystectomy and can cause serious late complications. We report on a 65-year-old woman who underwent laparoscopic cholecystectomy for gallbladder empyema, during which a stone spilled into the peritoneal cavity. The spilled gallstone was not noticed during the initial operation. Three months later, she reported left upper quadrant pain of recent onset without associated symptoms such as fever, nausea, or weight loss. On examination, a palpable 2-cm tender subcutaneous mass was found. Abdominal ultrasound demonstrated an incarcerated hernia, and computed tomography (CT) scan showed an intraperitoneal abscess located in the back of the anterior abdominal wall in the left upper quadrant, which contained a recalcification figure. The patient was brought to surgery, at which time an incision was made over the mass. A chronic abscess in the back of the abdominal wall, also spreading into the subfascial space, was drained, and purulent material was obtained with a large stone, 2.8 cm in diameter, which had become lodged in the rectus abdominis after an undetected stone spillage during laparoscopic cholecystectomy. The patient continued receiving antibiotic treatment for 7 days, recovered well, and was discharged 7 days after drainage of the abscess.
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PMID:Intraperitoneal abscess after an undetected spilled stone. 1126 67

A Bochodalek hernia is rarely seen in adults. An 18-year-old man was referred to our institute with the chief complaint of a sudden onset of left subcostal pain, nausea, and vomiting. A radiograph and a computed tomographic scan of the chest revealed a Bochodalek hernia. Emergency surgery was thus performed. The herniated organs were put back into the peritoneal cavity and the hernial hilum was closed. The postoperative course was uneventful. A routine chest radiograph 1 month before had shown a slight elevation of the left hemidiaphragm and further examination using computed tomography suggested a Bochodalek hernia, but he had merely been followed up since there were no symptoms. As soon as a diagnosis is made, specific repairs should be carried out even if no symptoms are present, to prevent such complications as strangulation or perforation.
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PMID:Bochodalek hernia in a young adult: report of a case. 1132 41

In a 53-year-old woman with abdominal pain, nausea and vomitus lasting for a month and leading to weight loss, abdominal CT showed abdominal spigelian hernia.
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PMID:[Diagnostic image (74) A woman with stomach cramps and vomiting]. 1185 Oct 81

Diaphragmatic hernias after blunt traumatic damage are serious complications, and diagnosis often might be delayed. In most cases, early symptoms are missed, but in the further posttraumatic period, patients experience recurrence of pulmonary dysfunction or intestinal symptoms such as obstruction, nausea, and pain. Most of these defects are diagnosed by laparotomy performed to investigate other major abdominal lesions. These diaphragmatic ruptures are managed by suturing using a thoracic or abdominal approach. An original diaphragmatic repair technique using a patch is presented. A 40-year-old woman was admitted to our clinic because of chronic abdominal pain. Chest x-ray and computed tomography scan showed a migration of the large intestine into the left hemithorax. A large diaphragmatic hernia was diagnosed and repaired laparoscopically using a patch. In the reported patient, laparoscopic suture of a diaphragmatic hernia using a polytetrafluoroethylene (PTFE) (GORETEX) patch proved to be safe, successful, elegant, and uneventful.
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PMID:Repair of diaphragmatic rupture by laparoscopic implantation of a polytetrafluoroethylene patch. 1208 34

In order to define current issues and outcomes of living kidney donation, 100 consecutive living donors operated on between July 1996 and March 2001 were evaluated. The 64 women and 36 men ranged in age from 19 to 72 yr (mean 42.5 yr), and 65 were related to the recipient while 35 were unrelated donors. Hospital admission the morning of surgery and use of a minimal open approach to the donor kidney were standard, as were post-operative epidural pain control and plans for short hospital stay. The 100 donors were hospitalized for 2 (25), 3 (48), 4 (18), 5 (8), or 6 (1) days, with an average length of stay of 3.12 d (range 2-6 d). The mean charge for kidney donor hospitalization was 14,470 dollars (range 9671-22,808 dollars). There were no major intra or immediate post-operative complications. Six rehospitalizations occurred for post-donation nausea, vomiting, dehydration (n = 2); spinal headache; pneumonia and wound haematoma; and late wound reexploration (one hernia and one nerve entrapment). All donors returned to pre-operative functional status within 6 d to 6 wk of donation. All kidneys functioned immediately in the 100 recipients (50 women, 50 men) who averaged 46.6 yr of age (range 17-69 yr); recipient length of stay averaged 3.81 d (range 2-15 d). All donors survived in excellent health; recipient graft and patient survival, respectively, are 87 and 90% through the entire 5-yr period. Excellent long-term outcomes for living kidney donors may be accomplished using minimal open surgical technique, post-operative epidural pain control and plans for a brief hospitalization. Expansion of living donor resources in renal transplant programs may grow as unrelated kidney donation and non-directed donation as well as minimally invasive (open and laparoscopic) techniques evolve.
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PMID:One hundred consecutive living kidney donors: modern issues and outcomes. 1237 47

Sigmoid mesocolon hernia is an uncommon type of internal hernia. A 63-year-old man who presented with pain in the left side of the abdomen and nausea was referred to our department for treatment of ileus. He was initially managed conservatively, but as his symptoms became progressively worse, a laparoscopy was done, which revealed hemorrhagic ascites and necrosis of the small intestine in the lower abdomen. An open laparotomy was subsequently performed and the intraoperative findings were consistent with a transmesosigmoid hernia. There was an abnormal defect in the sigmoid mesocolon and protrusion of about 30 cm of small bowel through this abnormal opening, which had resulted in strangulation of the bowel. The necrosed part of the intestine was resected and the defect was closed.
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PMID:Transmesosigmoid hernia: report of a case. 1254 Oct 31


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