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

The unusual association of a giant extracranial vertebral artery pseudoaneurysm, intracranial aneurysms, and extracranial carotid occlusion in a woman with neurofibromatosis is presented. Pain as a result of expansion of the mass in the soft tissue of the neck led to her seeking evaluation. Herniation of the mass intraspinally between the occiput and C-1 resulted in myelopathy. Following balloon occlusion of the vertebral artery, the mass and associated symptoms resolved without the need for direct resection. The salient features of these unusually associated problems are discussed.
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PMID:Pseudoaneurysm of the extracranial vertebral artery. Case report. 368 35

The morbidity and image quality after administration of three different contrast media were compared in 229 patients referred for herniography. Sixty patients received metrizoate 150 mg I/ml, 92 received metrizoate 200 mg I/ml, and 77 patients, ioxaglate 200 mg I/ml. Patient discomfort was single-blindedly assessed based on an arbitrary verbal rating scale. The number of patients with pain increased with the osmolality of the contrast media. Metrizoate 200 induced pain in 57% of the patients, metrizoate caused pain in 39%, and ioxaglate 200 in 18%. Hernia patients who received metrizoate 200 had pain significantly more often (72%) than patients without hernia (45%). Seven patients, predominantly young men, had a vasovagal reaction associated with the administration of contrast media. The image quality was sufficient after all injections of 200 mg I/ml. The results indicate that low osmolality contrast media with an iodine concentration of about 200 mg I/ml are well suited for herniography.
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PMID:Herniography: comparison of morbidity and image quality after use of high and low osmolality contrast media. 371 Jul 42

Ventral herniation of the bladder occurred in 2 patients following Marshall-Marchetti-Krantz procedures for stress incontinence. Symptoms included suprapubic pain, urgency, incontinence, and a ventral abdominal hernia. The diagnosis was easily established by cystography in both patients. Possible etiologic factors included postoperative wound infection in 1 patient and possibly suspension of the anterior bladder to the pubis in the other.
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PMID:Ventral bladder hernia following Marshall-Marchetti-Krantz procedure for stress urinary incontinence. 373 13

Abdominal wall hernia was detected in 4 pregnant mares. Antemortem diagnosis of the specific abdominal wall lesion was difficult. Ventral deviation of the abdomen, associated abdominal wall edema, and pain indicated rupture of the prepubic tendon. Three mares examined at necropsy did not have a rupture of the prepubic tendon but did have herniation of the abdominal wall. Abdominal pain was severe and was compounded by incarceration or entrapment of viscus.
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PMID:Herniation of the abdominal wall in pregnant mares. 377 41

The authors report a case of intradural disc hernia at L2-L3 in a woman aged 72 years. It presented clinically as chronic lumbar pain associated from the beginning with referred pain in the thighs, later with severe paraparesis and disturbance of bladder function. The myelogram showed a partial block suggestive of an intradural neoplasm. With a view to obtaining a more precise diagnosis, a CT lumbar scan was advised, but surgical intervention could not be deferred. Despite the gravity of the symptoms, the case reports in the literature showed that surgery carried out immediately offers a more than average chance of neurological recovery or improvement. This was in fact the outcome in the present case.
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PMID:Intradural lumbar disc hernia. Case report. 379 65

Two hundred and thirty three patients with major laparotomy wounds, either midline or transverse, were randomly allocated to mass closure using No 1 (BPC) polyamide (Nylon) or polydioxanone suture (PDS). Wounds were assessed during the hospital stay and postoperatively in outpatients, at six weeks and six months, for evidence of wound failure or wound infection. Two wound failures occurred in the PDS group (one burst abdomen and one incisional hernia) although neither was directly attributable to suture failure. The overall wound infection rate was 13.3%; 2.9% being major infections and the majority (two thirds) occurring in the PDS group. There were no reported wound sinuses or wound pain in either group at six months. Polydioxanone suture may be an alternative to polyamide for laparotomy closure but is associated with a higher, though not statistically significant, incidence of wound failure and infection.
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PMID:Abdominal wound closure: a controlled trial of polyamide (nylon) and polydioxanone suture (PDS). 393 36

Fifty-five operations for paraesophageal hiatus hernia were performed at the Lahey Clinic, Burlington, Mass, between January 1970 and October 1985. Pain was present in 35 of 51 patients. Other less common symptoms were anemia and vomiting. Reflux symptoms were rare. Esophageal manometry disclosed a mean lower esophageal sphincter pressure of 18.2 mm Hg and a length of 3.5 cm. An anterior crural repair (Collis procedure) was employed in all patients. In 22 patients Stamm gastrostomies were also performed. In two patients, a Nissen fundoplication was also carried out because of coexisting gastroesophageal reflux. One patient died postoperatively of a pulmonary embolus. Of the patients, 88.4% benefited from the operation. Of the five poor results, four were due to hernial recurrence and only one was due to severe reflux symptoms. Gastroesophageal reflux is rare in patients with paraesophageal hiatus hernia. An antireflux procedure should be added to surgical correction of the anatomic defect only if evidence of a hypotensive lower esophageal sphincter is clearly present preoperatively or intraoperatively. The addition of gastrostomy to the procedure protects against recurrence of hernia.
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PMID:Paraesophageal hiatus hernia. 395 87

In the years 1974 to 1981, herniography was performed in 78 athletes with groin pain. The investigation comprised 101 painful groin sides in 23 athletes with bilateral symptoms. Before herniography, a hernia was palpated in only eight (7.9 percent) groins with pain. Hernias were found at herniography in 84.2 percent of the symptomatic groin sides and in 49.1 percent of the asymptomatic groin sides. Sixty-three hernia operations were performed. The herniographic and operative diagnoses corresponded well. Direct hernias dominated among the operated athletes, and were found in 55.6 percent of those below 30 years of age. Altogether 69.8 percent of the operated patients were cured by hernia repair and another 20.6 percent were improved. Tenoperiostitis of the adductor muscles was the most frequent diagnosis in those not cured by operation and among the nonoperated patients. Herniography was of great value in selecting those patients who needed a repair. A broad differential diagnostic approach when examining these patients is of the utmost importance.
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PMID:Herniography in athletes with groin pain. 397 96

Spigelian hernia may be a more common clinical entity than previously recognized or reported. We report seven cases, four diagnosed and treated in the past 12 months at a large military hospital. Diagnosis can be difficult because of failure to consider it, incomplete understanding of the anatomy, and the nonpalpable intraparietal nature of the hernia. A careful history and physical examination are essential. Any patient with persistent localized pain in the proper anatomic location--just lateral to the outer border of the rectus muscle and usually below the umbilicus--warrants surgical exploration.
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PMID:Spigelian hernia: uncommon or unrecognized? 398 62

The analgesic requirement and some factors influencing the respiratory capacity after upper abdominal surgery were studied during the first 2 days postoperatively in 417 patients, aged 17 to 84 years, undergoing surgery in the upper part of the abdomen. The operations were cholecystectomy or choledocholithotomy through a subcostal incision, partial gastric resection, repair of a diaphragmatic hernia or vagotomy through a midline incision. Pain relief was achieved in a random order either by intercostal block (i.c.b.) and centrally acting analgesics on demand, or by centrally acting analgesics alone. The analgesic demand was recorded, and the respiratory capacity was monitored by the peak expiratory flow rate (PEF). A smaller analgesic requirement and a smaller change in PEF were found after cholecystectomy than after any other kind of surgery. The demand for analgesics was age-dependent, and patients under 60 years of age demanded more than those aged 60 years and older. Bilateral i.c.b. given after surgery through a midline incision had few advantages, but unilateral i.c.b. following cholecystectomy and choledocholithotomy with a subcostal incision had positive effects. Thus it decreased the demand for centrally acting analgesics and resulted in higher PEF values than without i.c.b. for cholecystectomy during the period of effective nerve block and for choledocholithotomy for 2 whole days postoperatively. Smokers seemed to benefit from i.c.b. for 2 postoperative days. The reduction of PEF after cholecystectomy also seemed to be related to the duration of treatment with centrally acting analgesics.
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PMID:Factors influencing the respiratory capacity after upper abdominal surgery. 401 28


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