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

Volvulus of the small intestine was diagnosed as a complication of acquired inguinal herniation in 2 horses. One of the horses continued to have signs of pain after reduction of the hernia. The volvulus was diagnosed at a second surgery, but the intestine was devitalized, and the horse was euthanatized. Ventral midline exploratory surgery was performed on the second horse, in conjunction with an inguinal approach. The small-intestinal volvulus was diagnosed and corrected at this time. It is suggested that ventral midline abdominal exploration be performed when acquired inguinal herniation causes acute small-intestinal obstruction in horses.
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PMID:Small-intestinal volvulus as a complication of acquired inguinal hernia in two horses. 206 Nov 59

Caudal epidural anesthesia has become widely accepted as a means of providing postoperative pain relief and intraoperative supplementation to general anesthesia for children. To determine the best concentration of bupivacaine for combined general-caudal anesthesia in children, 122 children aged 1-8 yr scheduled for outpatient inguinal herniorrhaphy were randomized to receive, in a double-blind fashion, caudal anesthesia with bupivacaine in one of six concentrations (0.125, 0.15, 0.175, 0.2, 0.225, or 0.25%). After incision, a programmed reduction in inspired halothane resulted, if tolerated by the subject, in an inspired halothane concentration of 0.5% 10 min after incision. End-tidal halothane concentration at hernia sac ligation for subjects receiving 0.175% bupivacaine (0.55 +/- 0.03%) was less than that for subjects receiving 0.15% bupivacaine (0.75 +/- 0.05%; P less than 0.05). Subjects receiving 0.175% bupivacaine also were discharged earlier from the postanesthesia care unit (PACU) (27 +/- 1 min) than were subjects receiving 0.15% bupivacaine (38 +/- 5 min; P = 0.05). Children receiving greater than or equal to 0.2% bupivacaine tended to complain more of leg weakness after surgery; however, the difference did not reach statistical significance (39 of 67 vs. 16 of 47; P = 0.057). The incidence of complaints of leg weakness and paresthesia was positively correlated with bupivacaine concentration (r = 0.706; P = 0.05). Subjects receiving 0.125% bupivacaine had higher pain scores on arrival to the PACU than did those receiving 0.2% bupivacaine (P = 0.05); there were no other differences in pain scores.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Optimum concentration of bupivacaine for combined caudal--general anesthesia in children. 206 61

In six women with a preoperative diagnosis of incarcerated hernia, surgical exploration of the groin revealed inguinal endometriosis and no hernia. The affected structure was always the extraperitoneal portion of the round ligament. Six of the seven lesions were on the right. Intraperitoneal endometriosis was demonstrated in all patients. Catamenial pain was the pathognomonic symptom in the differential diagnosis of the inguinal mass. Gynecologists and surgeons should bear in mind the possibility that endometriosis may be the cause of symptoms of a suspected incarcerated inguinal hernia. Should this disease be detected at inguinal exploration, a laparoscopy is indicated during the same operation.
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PMID:Inguinal endometriosis: pathogenetic and clinical implications. 206 61

This study describes a prospective randomized controlled trial to evaluate whether suture of the peritoneal layer is necessary as a separate step in the closure of midline abdominal surgical wounds. Consecutive patients undergoing abdominal operation--elective and emergency surgery--through a midline abdominal wound were randomized to have the peritoneal layer closed with continuous catgut, or to have this step omitted. The linea alba was closed with interrupted stainless steel sutures, and the skin approximated with staples. Patients were evaluated for wound sepsis, wound dehiscence, and subsequent incisional hernia development. Postoperative pain was assessed by a self-administered visual analogue score, and by measuring narcotic requirements. There was no significant difference in narcotic requirements, pain scores, or wound complications between the 2 groups. Single-layer closure of the abdominal wall is quicker, less costly, and theoretically safer than layered closure, and it is recommended that separate suture of the peritoneum be abandoned.
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PMID:Is closure of the peritoneal layer necessary in the repair of midline surgical abdominal wounds? 804 38

Treating ectopic pregnancy with laparoscopy requires special training, but it results in decreased morbidity, discomfort, and pain; reduced recuperative time; and lower cost to the patient and hospital. Many conditions mimic ectopic pregnancy. Therefore, to make the diagnosis, a complete history must be taken, a careful physical examination must be performed, and certain diagnostic tests must be made. Contraindications include bowel obstruction, ileus, abdominal hernia, peritonitis, brisk intraperitoneal bleeding, diaphragmatic hernia, severe cardiac disease, extremes of body weight, previous surgery, or presence of a large abdominal mass.
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PMID:Pelviscopy for ectopic pregnancy: a safer and quicker alternative. 214 37

Laser laparoscopic inguinal herniorraphy represents an extension of current technology. Based on the principles of preperitoneal inguinal herniorraphy, it is performed by internal incision of the peritoneum and identification of the musculofascial defect through a laparoscope. Polypropylene mesh is then passed down the laparoscope, placed into the defect to obliterate the space, and the edges of the peritoneum are then reapproximated. Results in 20 patients with an 11 month followup indicates success in nineteen exhibiting early resumption of activity (3.3 days) and minimal pain (2.1 Tylenol #3 tablets per patient). One early recurrence suggests that anatomic identification of a direct space hernia may be difficult and that routine support of this area with additional mesh may be a requirement of a complete inguinal hernia repair.
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PMID:Laser laparoscopic herniorraphy: a clinical trial preliminary results. 215 57

We have presented the case of an elderly woman with severe kyphoscoliosis, osteoarthritis and left knee effusion who had symptoms and signs of intermittent intestinal obstruction. Operation showed a left-sided obturator hernia. In any elderly, debilitated, chronically ill woman, symptoms and signs of recurrent small-bowel obstruction (without a history of abdominal surgery or external hernias) and pain along the ipsilateral thigh and knee (Howship-Romberg sign) should raise suspicion for an obturator hernia. If the hernia is not palpable by physical examination, a CT scan of the pelvis and upper aspect of the thigh would confirm the diagnosis before operation and allow prompt treatment and better chance of patient survival.
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PMID:Obturator hernia: a difficult diagnosis. 219 70

We report a rare case of Bochdalekhs hernia, congenital posterolateral diaphragmatic hernia with mesenterioaxia volvulus of the stomach, in an adult. A 23-year-old man suddenly felt severe pain in his left chest after drinking beer. Roentgenologic examination of the chest showed air above the left diaphragm, and the mediastinum was displaced to the right. Upper gastrointestinal series revealed mesenterioaxial volvulus of the stomach in which the pylorus was displaced to the left. Thoracotomy through the left seventh intercostal space was performed. The stomach, colon, spleen and greater omentum were displaced into the left thoracic cavity. After reduction of the herniated viscera, a defect measuring 10 X 4 cm, in the posterolateral part of the diaphragm, was closed with double interrupted Tevdek sutures. Three months later, he was asymptomatic and his chest roentgenogram was normal.
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PMID:[A case report of Bochdalek's hernia with volvulus of the stomach in an adult]. 224 36

A) Frequency of Far Lateral Lumbar Disc Herniation: The analysis of pre-operative computer-assisted tomograms and myelograms in a series of 694 operated lumbar disc herniations showed that a far lateral disc prolapse occured in 7% of the cases. Within the group of those far laterally herniated discs 3% of the herniations were predominantly located in the intervertebral foramen, whereas 4% of the protruded discs were mainly situated extraforaminally compressing the spinal nerve in its paravertebral course. B) Surgical Management of Extraforaminal Far Lateral Lumbar Disc Herniation: By March 1988 40 patients had been operated on for an extraforaminal disc protrusion making use of an external microsurgical exposure (in two cases by a transmuscular approach and in 38 cases via an enlarged midline approach). A medium-term follow-up of these 40 patients revealed a substantial clinical relief of pain in 34 cases (85%). Based on these gratifying results we regard the external exposure of the extraforaminally protruded disc as the treatment of choice.
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PMID:Frequency and specific surgical management of far lateral lumbar disc herniations. 227 23

The change in the relative size of lumbar disc hernias and its relation to sciatic symptoms was investigated in 30 consecutive patients after conservative treatment of CT verified lumbar disc herniations. CT and clinical examination were performed before the start of therapy (CT1), as well as 3 months (CT2) and 24 months (CT3) after institution of treatment. In each patient the size of the lumbar disc herniation in relation to the size of the spinal canal was measured on identical CT slices and expressed as an index. The disc herniation index decreased markedly from CT1 to CT2 (p less than 0.001). Between CT2 and CT3 the reduction of the hernias was less pronounced and not significant for hernias located centrally but still significant for intermediate (p = 0.03) and lateral (p = 0.04) hernias. The degree of sciatic symptoms also decreased markedly between CT1 and CT2 (p = 0.001) while no further improvement occurred from CT2 to CT3. There was a significant positive correlation between the improvement from sciatic pain and the reduction in the size of the individual hernia (CT1-CT2 p = 0.02, CT2-CT3 p less than 0.001). Thus, the disc herniation index provided a method to study the anatomic effect of conservative treatment as well as a method to evaluate sciatic symptoms in relation to anatomic changes.
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PMID:Size of lumbar disc hernias measured using computed tomography and related to sciatic symptoms. 227 76


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