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

Obturator hernia may occur bilaterally in association with another hernia, which is usually of the femoral type. We present a 77-year-old-woman who had abdominal pain with nausea and vomiting together with swelling of the right groin for 3 days. Incarcerated right femoral hernia and consequent mechanical small-bowel obstruction was diagnosed, and urgent operation was undertaken. As the incarcerated femoral hernia reduced spontaneously during the induction of anesthesia, a lower median incision was performed. During exploration, the real cause of mechanical intestinal obstruction was found to be a small intestinal loop strangulated in the left obturator hernia. Right femoral and left obturator hernia were repaired with preperitoneal polypropylene mesh. If there is enough time and general condition of the older patient is suitable, further diagnostic techniques for concomitant obturator hernias may be useful in patients who present with signs of incarcerated inguinal hernia and intestinal obstruction.
Hernia 2006 Jun
PMID:A rare cause of intestinal obstruction: incarcerated femoral hernia, strangulated obturator hernia. 1652 Aug 87

A 47-year-old woman had experienced paroxysmal pain in the lower abdomen, nausea and vomiting for the last 12 hours. Laparoscopy revealed a 60-cm hernia of ileum through the ligamentum latum, which had led to ileal necrosis. After resection of a portion of the small intestine, the patient recovered. Defects in the ligamentum latum can arise from congenital or acquired causes. The most common congenital cause is the rupture of a cystic structure in the ligamentum latum. Acquired causes include surgical intervention, pelvic inflammatory disease and traumatic injury sustained during gravidity or parturition. These causes all lead to local weakening of or direct damage to the ligamentum latum.
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PMID:[Abdominal pain caused by herniation of the small intestine through the ligamentum latum uteri]. 1692 55

Benign multicystic peritoneal mesothelioma (BMPM) is a rare tumor that occurs mainly in women in their reproductive age. The pathogenesis of BMPM is unclear and a controversy regarding its neoplastic and reactive nature exists. The biological behavior of BMPM is characterized by its slowly progressive process and high rate of recurrence after surgical resection. In addition this lesion does not present a strong tendency to transform into malignancy. Today approximately 130 cases have been reported. We here report a 62-year-old woman who had diffuse abdominal pain, nausea and vomiting. Physical examination revealed a painful mass in her upper abdomen. She reported a mild dehydration, but the vital signs were normal. Peristaltic rushes, gurgles and high-pitched tinkles were audible. Upright plain abdominal film revealed small bowel loops with air-fluid levels. She was diagnosed having an incarcerated incisional hernia that resulted in intestinal obstruction. The patient underwent surgery during which a cystic mass of the right ovary measuring 6 cm multiply 5 cm multiply 4 cm, four small cysts of the small bowel (1 cm in diameter) and a cyst at the retroperitoneum measuring 11 cm multiply 10 cm multiply 3 cm were found. Complete resection of the lesion was performed. The patient had an uneventful recovery and had no recurrence two years after surgery.
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PMID:Benign multicystic peritoneal mesothelioma: a case report and review of the literature. 1700 34

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

Intussusception has been considered an operative indication in adults as a result of the risk of ischemia and the possibility of a malignant lead point. Computed tomographic (CT) scans can reveal unsuspected intussusception. All CT reports from July 1999 to December 2005 were scanned electronically for letter strings to include the keyword intussusception. Identified CT scans were analyzed to characterize the intussusception and associated findings. Clinical, laboratory, pathological, and follow-up variables were gleaned from medical records. Findings were analyzed by treatment and findings at operation. Review of 380,999 CT reports yielded 170 (0.04%) adult patients (mean age, 41 years) with intussusceptions described as enteroenteric in 149 (87.6%), ileocecal in eight (4.7%), colocolonic in 10 (5.9%), and gastroenteric in three (1.8%). Radiological features included mean length of 4.4 cm (range, 0.8-20.5 cm) and diameter of 3.2 cm (range, 1.6-11.5 cm). Twenty-nine (17.1%) had a lead point, and 12 (7.1%) had bowel obstruction. Clinically, 88 (48.2%) patients reported abdominal pain, 52 (30.6%) had nausea and/or vomiting, and 74 (43.5%) had objective findings on abdominal examination. Thirty of 170 (17.6%) patients underwent operation, but only 15 (8.8%) patients had pathologic findings that correlated with CT findings. Seven had,enteroenteric intussusceptions from benign neoplasms (two), adhesions (one), local inflammation (one), previous anastomosis (one), Crohn's disease (one), and idiopathic (one). Three had ileocolic disease, including cecal cancer (one), metastatic melanoma (one) and idiopathic (one; whereas five patients had colocolonic intussusception from colon cancer (three), tubulovillous adenoma (one), and local inflammation (one). Of the 15 without intussusception at exploration, five had pathology related to trauma, four had nonincarcerated internal hernia after Roux-en-Y gastric bypass, four had negative explorations, one had adhesions, and one had appendicitis that did not correlate with CT findings. No patient in the observation group required subsequent operative exploration for intussusception at mean 14.1 months (range, 0.25-67.5 months) follow up. All operative patients demonstrated gastrointestinal symptoms versus 55.3 per cent of the observation group (P < 0.006). Analysis of CT features demonstrated differences among patients observed without operation, those without intussusception at exploration, and confirmed intussusception with regard to mean intussusception length 3.8 versus 3.8 versus 9.6 cm, diameter 3.0 versus 3.2 versus 4.8 cm, lead point 12.1 per cent versus 30 per cent versus 53.3 per cent, and proximal obstruction 3.8 per cent versus 0 per cent versus 46.7 per cent, respectively. Intussusceptions in adults discovered by CT scanning do not always mandate exploration. Most cases can be treated expectantly despite the presence of gastrointestinal symptoms. Close follow up is recommended with imaging and/or endoscopic surveillance. Length and diameter of the intussusception, presence of a lead point, or bowel obstruction on CT are predictive of findings that warrant exploration.
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PMID:Approach to management of intussusception in adults: a new paradigm in the computed tomography era. 1809 41

An elderly emaciated female patient presented with recurrent lower abdominal pain associated with nausea and vomiting due to obstruction of the small bowel. Although the Howship-Romberg sign and tender mass on digital rectal examination could not ascertained but plain X-ray abdomen shows features of acute intestinal obstruction. After resuscitation laparotomy was done and diagnosed as case of strangulated obturator hernia of Ricters type. Reduction of hernial content and resection of the gangrenous part of small bowel with end-to-end anastomosis done. The hernial defect is repaired by a proleine mesh. Abdomen closed in layers keeping a drain in right iliac fossa and pelvic cavity. The postoperative recovery was uneventful. Patient discharge with advice on 9th postoperative day.
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PMID:Obturator hernia. 1828 41

Right paraduodenal hernia is an unusual congenital malformation that causes intestinal obstruction. It is seldom diagnosed preoperatively and a small bowel follow-through series is the best diagnostic method. However, multidetector computed tomography (MDCT) can be an alternative diagnostic method. We report the first case of right paraduodenal hernia that was diagnosed preoperatively by MDCT. A 15-year-old boy presented with right lower abdominal pain, nausea and vomiting. Abdominal MDCT with coronal reformation images clearly revealed encapsulated small bowel loops in the right side of the abdomen and displacement of the ascending colon to the left side. He received surgical repair and recovered uneventfully.
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PMID:Preoperative diagnosis of right paraduodenal hernia by multidetector computed tomography. 1858 22

Three patients, three women aged 40, 64 and 75, suffered from a trocar hernia, a specific complication of laparoscopic surgery. This type of hernia may result in small bowel obstruction and normally appears within two weeks after laparoscopy. The usual presentation is that of abdominal pain with nausea and vomiting. Trocar herniation implicates the necessity of reposition and might result in bowel resection with prolonged hospital stay. The advice for prevention is to use a trocar with a diameter as small as possible, as the chance of a hernia occurring increases withthe use of larger trocars. Fascial closure is advised for trocars to mm and larger. With a growing number of procedures being performed laparoscopically, the importance of recognizing and preventing this complication is evident. Three cases illustrate the importance of early recognition of small bowel obstruction resulting from trocar herniation.
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PMID:[Abdominal pain and transit disorders following a laparoscopic procedure: be alert to a trocar hernia]. 1905 1

Hyperemesis gravidarum is a frequent presentation to the ED, which usually resolves with fluid rehydration and antiemetics. Early incarcerated maternal diaphragmatic hernia might be misdiagnosed as relatively benign hyperemesis gravidarum in the first two trimesters of pregnancy. Diagnosis is missed because of non-specific presentation with abdominal pain, nausea and vomiting. Hernias rarely become symptomatic even in latter stages of pregnancy, as the uterus increases in size with each trimester and with raised intra-abdominal pressure from uterine contraction during labour. Symptoms progress with incarceration and strangulation of abdominal contents within the thoracic cavity, compression of the lung and disruption of caval venous return. A woman at 19-week gestation presented with delayed diagnosis of strangulated diaphragmatic hernia, representing the earliest gestation in the published literature when this has occurred. She had repeatedly been misdiagnosed with hyperemesis gravidarum. It is worthwhile considering incarcerated maternal diaphragmatic hernia as an unusual cause of refractory vomiting in pregnancy, when associated with clinically significant upper abdominal pain and progressive respiratory embarrassment. This might occur as early as the mid-second trimester, and without uterine contraction.
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PMID:Difficult diagnosis in the emergency department: hyperemesis in early trimester pregnancy because of incarcerated maternal diaphragmatic hernia. 1897 43

We report a rare case of a giant ovarian tumor presenting as an incarcerated umbilical hernia. A 61-yr-old woman was admitted to the hospital with severe abdominal pain, an umbilical mass, nausea and vomiting. On examination, a large, irreducible umbilical hernia was found. The woman underwent an urgent operation for a possible strangulated hernia. A large, multilocular tumor was found. The tumor was excised, and a total abdominal hysterectomy and bilateral salphingo-oophorectomy were performed. The woman was discharged 6 days after her admission. This is the first report of incarcerated umbilical hernia containing a giant ovarian tumor within the sac.
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PMID:Giant ovarian tumor presenting as an incarcerated umbilical hernia: a case report. 1954 24


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