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

Almost 2/3rds of obturator hernias occur after 70 years. Favoured by changes in pelvic and spinal position, this hernia is uncommon in women and exceptional in men. Revealed by strangulation, it is in one third to one quarter of cases, unrecognised before operation, often due to failure to recognise the cause of crural neuralgia in a patient with acute intestinal obstruction. Even when the diagnosis is made, laparotomy is the best approach. It makes intestinal resection easier, this is necessary in 50% of cases, and above all, it is easier to cure the hernia for which the authors propose the use of the round ligament folded on itself and fixed to the borders of the hernial orifice. Delay in treatment explains the high mortality in this rare hernia.
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PMID:[Surgery of obturator hernia by closure of the obturator canal with the round ligament]. 63 31

A semiologic study is performed and therapeutic proposals are made on the basis of the anatomical and physiopathological data relating to residual neuralgia after the cure of a hernia. A series of 47 patients, 41 of whom were treated at the Multidisciplinary Pain Treatment Center of Avicenne Hospital (Bobigny) is analysed. The results are the following: 16 cures, 22 improvements, 6 failures, 3 patients lost to follow-up. The authors emphasize the difficulties of treatment, the poor effectiveness of second surgery as a rule, and the necessity of a general management.
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PMID:[Treatment of neuralgia after surgical repair of inguinal hernia. Apropos of 47 cases]. 177 58

The cause of severe and persistent neuralgia after hernia surgery is due to sensory nerve crushing. An operative technique has been described that prevents inadvertent crushing or division of the sensory nerves to the groin. With persistent postoperative pain, the offending nerve is usually difficult to identify. A protocol has been suggested to differentiate ilioinguinal from genitocrural causalgia. When the particular nerve is incriminated, its division will ordinarily cure the problem.
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PMID:Cause and prevention of postherniorrhaphy neuralgia: a proposed protocol for treatment. 337 20

Lumbar hernias occur in the region of the flank bounded by the 12th rib, the iliac crest, and the erector spinae and external oblique muscles. We present the CT findings of seven lumbar hernias: six traumatic (four secondary to postoperative flank incisions, one secondary to an iliac bone-graft donor site, one secondary to nonunion of an iliac fracture) and one spontaneous. Because CT portrays the anatomic relationships in this region so well, it may be the only radiographic procedure necessary to make the diagnosis of a lumbar hernia. Furthermore, it can be helpful in the assessment of symptomatic patients after flank incision, to differentiate postincisional muscular weakness and intercostal neuralgia from a lumbar hernia.
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PMID:Lumbar hernia: diagnosis by CT. 349 86

Discal L4 crural neuralgia is conventionally considered secondary to a hernia of the L3-L4 disc. Now, another source of discoradicular conflict exists on the path of the L4 root: hernia of the link canal of the L4-L5 canal through which the root leaves the rachidian canal. Of 27 discal neuralgias operated upon, 9 were linked to a hernia of the L3-L4 disc, while 18 were secondary to a hernia of the L4-L5 foramen, that is 2 foramina hernias for 1 "intrarachidian" hernia. The diagnostic difficulties resulting from foramina hernias probably reflect a rarity that is more apparent than real. The etiology of crural neuralgia is conventionally sought at the L3-L4 disc. This search is often unsuccessful: one speaks of "essential crural neuralgia". The scanner provides the only certain way of revealing foramina hernias, and will probably detect increasing numbers and thus reduce the number of "idiopathic crural neuralgias".
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PMID:[L4 crural neuralgia and disc hernia of the L4-L5 intervertebral foramen]. 370 29

In a prospective, randomized study of 520 inguinal hernioplasties, the incidence of early and late complications was compared after suture with Mersilene or Dexon. The respective overall recurrence rates were 5.1 and 4.9%. Persistent neuralgia was more common in the Mersilene group, necessitating late resection of the ilioinguinal nerve in two patients. Suture fistula occurred after one Mersilene repair. The study indicates that Dexon (absorbable polyglycolic acid) suture is reliable for preventing recurrent hernia. No serious complications were associated with its use.
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PMID:Polyglycolic acid (Dexon) versus Mersilene in repair of inguinal hernia. 609 82

After a very precise anatomical review, the authors report the results of an anatomo-radiological study involving 244 urography films. The usual length of the 12th rib is 11 cm, with a width of 1 cm in the female and 1.5 cm in the male. The costo-lumbar angle was 45 degrees in 3/4 of the films. The kidney was often lower in the female than in the male. The renal artery was almost always given off at the level of the 12th rib or below, whilst at the level of the hilum, the renal artery and 12th rib having crossed, the artery was always above the 12th rib. Study of 173 usable cases of patients operated upon by lumbotomy revealed the following data: --lumbotomies on the 12th rib never opened the pleura, and gave rise to transient wall pain (7%) and one single case of abdominal wall hypotonia (1.4%) with no incisional hernias; --lumbotomies over the 11th rib were associated with 13% of cases of damage to the pleura, 16% of spontaneously resolving wall pain, 7 cases of prolonged parietal hypotonia and one incisional hernia out of 60 lumbotomies; --lumbotomies sub-jacent to the 12th rib were associated with residual abdominal wall pain in 3 cases out of 16. Lumbotomies over the 11th rib are associated with the risk of section of the superficial and deep abdominal branch of the 12th nerve and are hence those exposing to the greatest risk of abdominal wall hypotonia and neuralgia. Incision over the 12th rib would thus appear to be that associated with the least abdominal wall complications.
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PMID:[Anatomical study of the twelfth intercostal nerve and oblique lumbotomies (author's transl)]. 727 7

Three cases of obturator hernia are reported. An association of small bowel obstruction and obturator neuralgia in an elderly woman is strongly suggestive of the diagnosis. Anatomy, etiology and treatment are briefly discussed.
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PMID:[Obturator hernia, an equivocal diagnosis]. 739 53

The technical problems, early complications and short-term results of a tension-free method of 1098 inguinal hernia repairs in 1017 patients have been assessed. The operation was conducted under local anaesthesia, and the inguinal canal floor was reinforced by a polypropylene mesh. Patients were discharged home the same day. There was no mortality, no urinary complications and one case of venous thrombosis. There was one recurrence after a primary hernia repair and two patients have developed recurrences after repair of a recurrent hernia. The overall sepsis rate was 0.9% and 1% of patients had persistent neuralgia. No prosthesis required removal. In all, 49.6% of office workers returned to work in 1 week or less and 61% of manual workers in 2 weeks or less. The major advantages of the tension-free mesh repair under local anaesthesia are simplicity, substantial cost savings and very low rates of complications.
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PMID:Tension-free mesh hernia repair: review of 1098 cases using local anaesthesia in a day unit. 854 Jun 80

The Authors report their three-year experience in the laparoscopic management of bilateral or recurrent hernia using a polypropylene mesh through a transabdominal extraperitoneal approach: out of a total of 500 laparoscopic hernioplasties performed, 162 patients with bilateral hernias and 51 with recurrent hernia underwent this procedure. In bilateral hernias a single wide patch was used to cover both the myopectineal foramen, therefore performing a Stoppa procedure by laparoscopy. Two major complications were registered in this series: 1 bleeding and 1 intestinal obstruction, both managed laparoscopically. Minor complications were: 2 cases of neuralgia and 6 seromas which required single or multiple evacuations. Patients were carefully followed up (1-31 months), and no relapses were recorded. Although the follow up is still too short, the Authors stress the characteristics of this technique which shows great advantages mainly represented by a good compliance, quick return to normal work and sport activity; in fact, recovery is obtained in a shorter period as compared to traditional surgery even when the latter includes the use of prosthetic mesh.
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PMID:[Laparoscopic repair of bilateral and/or recurrent inguinal hernia]. 772 19


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