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

Bupivacaine was utilized for postoperative analgesia in patients undergoing orchiopexy and hernia repair. In a study of 75 pediatric patients, ranging in ages from twelve months to twelve years, who had undergone orchiopexy and hernia repair during a three-year period, 42 received bupivacaine hydrochloride as a local infiltration block anesthesia to relieve postoperative pain; 33 patients did not receive bupivacaine. Patients receiving bupivacaine had less postoperative pain and were more comfortable when leaving the hospital within a few hours after surgery.
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PMID:Use of bupivacaine as block to relieve postoperative pain in pediatric orchiopexy and hernia repair. 287 45

In instances in which wide upper lateral abdominal exposure is required, standard midline incisions are occasionally inadequate. The typical invered "U" incision violates the nerve and blood supply to the abdominal wall. An interneural and intervascular incision which is used either as an extension of the midline incision or bilaterally as the primary incision is described herein. The interneural and intervascular extension begins at the costal margin and curves medially with severance of the full thickness abdominal wall to join the vertical midline incision. This extension raises a triangular flap of abdominal wall with a base on the costal cartilage and apex at the junction of the two incisions. In a series of seven patients, no interneural and intervascular incision resulted in wound hernia or delayed wound healing postoperatively. This approach provides superior lateral abdominal exposure and by paralleling nerve and vascular distribution, follows sound anatomic principles for minimizing pain and promoting subsequent wound healing.
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PMID:Interneural and intervascular extension for increased exposure in midline vertical incisions. 294 31

Nineteen patients with direct diverticular inguinal hernia (DDIH) were examined with herniography and surgically explored. A lump medially in the groin and pain were the prominent clinical manifestations in 18 patients. Physical examination indicated the presence of a DDIH in 6 patients. In 16 patients herniography revealed hernial sacs protruding from the supravesical fossa in 5 and from the medial inguinal fossa in 11. At operation a circumscribed defect was found in the transverse fascia laterally and cranially to the pubic tubercle in all patients. In 16 patients peritoneal hernial sacs were demonstrated at surgery while in 3 only lipomas (fatty hernia) were contained within the defect. In our opinion DDIH is a specific variety of inguinal hernia with a fairly typical clinical presentation and radiographic appearance but probably often overlooked at surgery.
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PMID:Direct diverticular inguinal hernia. 296 46

A rare case of Richter's hernia after laparoscopy, the 2nd such hernia reported among a total of 4 cases of small bowel hernia, is presented. This patient was a 32-year old woman who had Hulka clip sterilization without any difficulties, using a 10 mm trocar and a Wolff laparoscope, with 3 liter carbon dioxide for induction of pneumoperitoneum. Her symptoms were only severe pain and vomiting starting on the 5th postoperative day, and a hematoma-like swelling. Since her pain was so intense, the area was explored under general anesthesia the same day. A plum-sized, strangulated loop of the jejunum was apparent, with serous fluid but no blood, incarcerated between the skin and the abdominal muscles. A small serosal laceration in the bowel was corrected with 2 interrupted Dexon sutures. Symptoms of hernia have occurred 3-15 days after laparoscopy in previously reported cases. It is fortunate that this patient was not treated as though she had a hematoma, since serious perforation of the bowel and peritonitis would have resulted. It is important to insure that all gas has flowed out of the abdomen before removing the laparoscope or the trocar sheath, and advisable to shake the abdomen wall carefully while removing the instruments, to prevent this complication.
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PMID:Incarcerated Richter's hernia after laparoscopy: a case report. 296 30

Patients' postoperative pain experience during 5 days after hernia repairs or upper abdominal procedures was compared when skin closure was achieved by either full thickness interrupted sutures or subcuticular interrupted inversion sutures. Quantitative pain assessments were made using linear analogue charts and standardised analgesic requirements. Clinical advantage for the subcuticular technique was confirmed for the hernia group and possible advantage in the upper abdominal closure, suggested by lesser analgesic requirement. Statistical analysis has lent support to the hernia group findings but is less clear in the upper abdominal group. A comparison of wound healing, sepsis and cosmetic outcome showed no apparent advantage to either method. Economies and patient preference favoured the subcuticular method.
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PMID:Pain quantum and wound healing: a comparison of interrupted inversion PDS and standard nylon sutures in abdominal skin closure. 297 94

There is currently much concern over the morbidity and mortality of donors undergoing nephrectomy for living related renal transplants. Between April, 1970 and July, 1986, 247 cases of living related renal transplants were performed at the Second Department of Surgery, Kyoto Prefectural University of Medicine. The average age of the donors was 50.3 +/- 9.7 years, 81 per cent of the donors being parents of the recipients. Minor abnormalities which did not affect the donors suitability were found in 71 cases. Nephrectomies were performed extraperitoneally in all cases. Peri-operative complications, including wound complications in 13 cases, urinary infection in 12 cases and pulmonary complications and arrhythmia in 4 cases, were considered to be minor in nature. A variety of renal function tests, carried out two weeks after nephrectomy revealed normal levels, although they had become slightly worse than those estimated pre-operatively. Long-term sequelae in the follow-up period from 18 months to 16 years and 2 months, was studied on 124 donors who answered questionnaires. Currently, there are 5 late deaths, none of which are directly related to the nephrectomy. Of the 124 donors, 85.5 per cent stated that there had been no change in their physical states following surgery. Pain or a feeling of discomfort at the wound site was reported by 10 donors (8.1 per cent) and hypertension was observed only in 3 (2.4 per cent). No major complication directly related to the donor nephrectomy was found, except for one case of incisional hernia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Experience with 247 living related donor nephrectomy cases at a single institution in Japan. 304 68

Any thrombotic affection can involve the deep veins as well as the superficial veins of the calf. It is considered that venous thrombosis may be a result of low concentrations of the activator of plasminogen levels in the vein wall, which produces a mediocre fibrinolytic response. The concentrations of the activator of plasminogen in these veins are little knows. Immediately after amputation, for pain in the decubitus position, samples of the soleus vein (N = 9) and long saphenous vein (LSV; N = 9) were removed and frozen in liquid nitrogen. In 6 limbs operated for varicose veins, samples of the vein in the calf (VC; N = 6) were removed and frozen. As a control, we examined samples of normal veins removed from the groin of patients undergoing hernia repairs. The quantitative determination of the activator of plasminogen was achieved thanks to a homogenate technique, and the results were expressed in taps by the minute by a tissue microgram. The median activity and the range of results were: LSV 1675 (777-8119); soleus vein 6795 (2232-21 570); CV 2356 (676-4099); inguinal veins 11 221 (6717-13 410). The low concentration of activator of plasminogen in the calf veins may contribute to a mediocre fibrinolytic response in these veins. This is not likely to be the case in the soleus veins. The results may indicate a different thrombotic mechanism in the two types of veins.
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PMID:[Quantitative determination of tissue-type plasminogen activator in varicose soleus veins]. 312 2

Eight patients with a pyogenic infection of the sacroiliac joint are compared to 200 published cases. In all our patients the disease began with fever and immobilizing low back and buttock pain. All had bacterial growth in the blood cultures. Five out of 6 patients did not show inflammatory signs in the initial plain roentgenogram. Tc-99m scan was initially positive in 4 out of 6 patients. In 2 patients only the second scan, at 13 and 15 days respectively, was positive. All but one patient had a 4-6 week course of intravenous antibiotics. Three patients underwent surgery for abscesses or intraarticular sequestra. One patient with a small psoas abscess had only medical treatment under CT monitoring. All the patients recovered. From our observations and the literature we conclude that pyogenic sacroiliitis is often not recognized initially. Wrong diagnoses such as sepsis of unknown origin, appendicitis, discal hernia etc. can be avoided if pyogenic sacroiliitis is sought in a systematic fashion. The clinical diagnosis can be confirmed by bone scan, to be repeated at a later stage of disease (i.e. two weeks after onset) if the first examination is inconclusive.
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PMID:[Pyogenic sacroiliitis. Review of 8 personal cases and 200 cases from the literature]. 329 Nov 6

Four techniques to close the fascia after midline laparotomy were compared in a prospective randomized multicentre trial. The four techniques were: interrupted closure with polyglactin; continuous closure with polyglactin; continuous closure with polydioxanone-s, and continuous closure with nylon. The early postoperative results in 1491 patients revealed an incidence of wound infection of 8.6 per cent and of wound dehiscence of 2.3 per cent with no statistically significant differences between the four techniques. We reviewed 1156 patients after 1 year. Wound pain was present in 9.7 per cent of the patients, statistically significantly more in the group closed with nylon (16.7 per cent). Suture sinuses developed in 3.5 per cent of the patients, statistically significantly more frequently in the nylon group (7.7 per cent). The total number of incisional hernias detected 1 year postoperatively was high (15.2 per cent) (interrupted polyglactin 16.9 per cent, continuous polyglactin 20.6 per cent, continuous polydioxanone 13.2 per cent and continuous nylon 10.3 per cent). The difference between nylon and continuous polyglactin is statistically significant. The results of this trial indicate that although nylon has the lowest incidence of incisional hernia it also is associated with more wound pain and suture sinuses.
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PMID:Fascia closure after midline laparotomy: results of a randomized trial. 330 92

A 23-year-old male presented to the ER with left scrotal pain and swelling after being struck with a knee in the left inguinoscrotal area during a basketball game. Upon examination, an incarcerated scrotal hernia with necrotic segment of small bowel was found. Bowel was resected and direct reanastomosis performed. This appears to be the first such case in the English-language literature.
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PMID:Traumatic acute incarcerated scrotal hernia. 336 22


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