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

Lumbar hernias are rare (2% of abdominal wall hernias). Symptomatology consists frequently only of an arch formation seen best with the patient sitting and when coughing. In adults it is twice as frequent in women and on the left side. Acute events, dominated by incarceration of a digestive segment, particularly colic, often suggest the diagnosis (10% of cases). Diagnosis is simple when confronted with a large hernia, but difficulties arise with those less than 5 cm in diameter, often diagnosed as a lipoma or parietal tumor. Conventional radiographs and ultrasound images are usually sufficient to establish the correct diagnosis and to determine the content of the hernial sac, but computed tomography scans can provide data on the exact limits of the defect and allow evaluation of possible problems during surgical repair. Rarely congenital (10%), these hernias occur either secondary to a violent lumbo-abdomino-pelvic injury (25%) or following surgical intervention to the lumbar region (50% of cases). Small hernias can be repaired using the direct approach but larger deficits require the insertion of a reinforcing non absorbable prosthesis. Long term results, both for the 4 cases reported and those published in the literature, were assessed as satisfactory.
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PMID:[Lumbar hernias in adults. Apropos of 4 cases and review of the literature]. 827 8

A 7-year-old castrated male llama was admitted for evaluation of mild colic. Exploratory celiotomy revealed a diaphragmatic hernia that was entrapping the proximal portion of the ascending colon. The hernia was reduced, and the devitalized ileum, cecum, and 45 cm of the proximal portion of the ascending colon were resected. Surgical repair of the defect in the diaphragm could not be accomplished from the ventral celiotomy, and the owners declined definitive repair via left thoracotomy. The llama recovered and did well until 9 months after surgery, when the hernia recurred. Necropsy revealed a defect, with characteristics consistent with a congenital origin, in the dorsal part of the left hemidiaphragm. On the basis of the findings in this llama, repair of such defects is strongly advocated.
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PMID:Diaphragmatic hernia in a llama. 844 Jun 32

A 12-year old 573-kg (1,261-lb) Quarter Horse gelding was referred with colic of 12 hours' duration and with poor response to medical treatment. On the basis of physical and laboratory findings, a pelvic flexure impaction was suspected. The horse was treated medically. Because signs of mild abdominal pain persisted and the heart rate had increased, an exploratory celiotomy was performed 30 hours after signs of colic were first noticed. At surgery, the ileum was found partially entrapped within the epiploic foramen, in a left-to-right direction, to form a parietal hernia. The entrapped intestinal segment was reduced but not resected, and the horse recovered fully. In retrospect, the delay before surgery in this horse was tolerated because this was a parietal hernia and, therefore, did not cause complete ileal obstruction. This horse had an unusual form of small-intestinal strangulation in the epiploic foramen that might not cause sufficient obstruction initially to allow early detection.
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PMID:Parietal hernia of the small intestine into the epiploic foramen of a horse. 1031 78

This article evaluates the results of single vessel bypass surgery for symptomatic chronic mesenteric ischaemia (CMI) in 6 patients undergoing a total of 8 superior mesenteric artery (SMA) bypass operations, all with good post-operative symptom relief. Post-prandial pain and weight loss was present in 5 out of 6 patients. Epigastric bruit was present in only two patients and 4 out of 6 patients had diarrhoea. The patients had varying degrees of peripheral vascular disease, ischaemic heart disease and hypertension. All patients had occlusion of the SMA on angiography and bypassing the occluded segment resulted in disappearance of the symptoms and weight gain. The vascular graft was sutured end to side to the front of the infra-renal aorta and end to side to the SMA, distal to the origin of the middle colic artery. Two patients had recurrence of symptoms due to graft occlusion at 3 and 4 years, respectively; they were successfully treated with repeat SMA bypass. There were no major complications or deaths related to the procedure in this study; one patient developed an incisional hernia requiring elective repair. Thus, early restoration of SMA circulation by bypass grafting in patients with CMI is sufficient to alleviate symptoms and prevent intestinal infarction with its high mortality rate.
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PMID:Superior mesenteric artery bypass for chronic mesenteric ischaemia: a DGH experience. 1107 74

Meckel's diverticulum is the congenital anomaly of the gastrointestinal tract affecting about 2% of the population. It is a true diverticulum containing all layers of the ileum wall. Heterotopic tissue is frequently present (25%): gastric mucosa, duodenal mucosa, jejunal mucosa and pancreatic tissue. Meckel's diverticulum is localized about 50 cm from the ileo-colic valve on the external border of the ileum. Most of Meckel's diverticula are clinically silent; clinical symptoms (19%) are in cases of complications such as: strangulation of the bowel in a ring formed by the diverticulum, intussusception of the diverticulum into the ileum, volvulus, incarceration of the diverticulum in hernia, tumour originating in the diverticulum. The diagnosis of Meckel's diverticulum is very difficult. The most useful in the diagnosis are plain abdominal radiographs, barium studies, CT, sonography and scintigraphy Abdominal sonography shows a tubular fluid structure localized far from the coecum. The wall of the diverticulum is swollen and in the lumen are chyme or fat.
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PMID:[Ultrasonographic diagnosis of Meckel's diverticulum--case report]. 1120 10

The authors report the case of a female patient suffering from colic neoplasm and a vast peristomal laparocele, the long-term outcome of a rectal amputation that the patient underwent at a young age. After colic resection, a vast area of surgical mesh in dacron was modelled and positioned in a retromuscular scat, thus allowing the hernia pathology to be resolved relatively simply, owing to its particular location-in correspondence with a preternatural anus-until not long ago this would have represented an absolute contraindication to the use of prosthetic materials. A precise surgical approach, marked by a scrupulous respect for aseptic conditions, is essential in these circumstances owing to the persistent risk of septic complications.
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PMID:[Peristomal laparocele: particular indications for the use of prosthetic materials]. 1128 85

In laparoscopic surgery, a pneumoperitoneum is generally created either by direct puncture (Veress needle technique) or by the open (Hasson) technique. Some surgeons predominantly use direct access, reserving open access for selected patients; others consider the Veress needle as carrying an unacceptable risk of intestinal or vascular injury and consequently use only the Hasson technique. The database containing records of all abdominal laparoscopic operations performed in our institution was reviewed; over the period from June 1991 to December 2001 a total of 2,126 laparoscopic operations were performed, consisting in 1,457 (68.5%) cholecystectomies, 392 (18.4%) appendectomies, 177 (8.3%) varicocelectomies, 65 (3%) operations on the uterus and ovaries, 6 (0.2%) groin hernia repairs, 6 (0.2%) fundoplications, 3 (0.1%) ileo-colic resections for right colon cancer, and 20 (1.3%) diagnostic laparoscopies. The direct puncture technique was used in 100% of cases. The time needed up to connection of the video camera averaged 4-7 minutes. Twelve laparoscopic cholecystectomies were converted, with a conversion rate of 0.5%. Four patients were re-operated on, two for bleeding from the gallbladder fossa and two because of small bowel perforation caused by electrocautery. None of the patients sustained any clinically apparent vascular or bowel injury as a result of the blind access. There were no cases of preperitoneal or omental air insufflation. The mortality was nil. The authors describe their technique for gaining access to the abdominal cavity by direct puncture and conclude that properly performed Veress needle insertion is less invasive, safe and perfectly feasible in all patients.
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PMID:Periumbilical veress needle pneumoperitoneum: technique and results in 2.126 cases. 1263 38

The presence of ureter within an inguinal hernia is an uncommon occurrence. We report on the presentation of a patient with ureteral colic and subsequent discovery of a herniated ueter in the inguinal canal. Surgeons must be aware of this condition in order to carefully preserve ureteral integrity and avoid complications during hernia repair.
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PMID:Presentation of ureteral colic in a patient with a ureteroinguinal hernia. 1273 25

Spilled gallstones during laparoscopic cholecystectomy are associated with a number of complications such as infection, abscess, inflammation, adhesions, cutaneous sinuses, small bowel obstruction, incarcerated hernia, and generalized septicemia. We report a case of a patient with middle colic vessel erosion and thrombosis secondary to a retained gallstone following laparoscopic cholecystectomy 11 years ago. At operation, the patient was found to have a necrotic transverse colon with a large 2 cm gallstone compressing her middle colic vessels. An extended right hemicolectomy was performed with a primary anastomosis. The importance of stone retrieval during laparoscopic cholecystectomy is emphasized.
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PMID:Middle colic artery thrombosis as a result of retained intraperitoneal gallstone after laparoscopic cholecystectomy. 1528 6

Pelvic magnetic resonance (MR) imaging is useful for identification of postoperative changes, complications, and disease recurrence in patients who have undergone surgery for primary or recurrent anorectal disease. Commonly used interventions include treatment for anorectal carcinoma: anterior rectal resection with or without creation of different colic anastomoses and abdominoperineal excision with or without pelvic reconstruction (omentoplasty, placement of myocutaneous flaps). Other common interventions include treatment for inflammatory bowel disease (coloproctectomy with or without creation of an ileoanal anastomosis and ileal pouch) and treatment for fistulas (placement of flaps or setons). Postoperative anatomic changes and formation of scar tissue can usually be identified with consecutive MR imaging examinations. Pelvic MR imaging is an accurate technique for assessment of complications including anastomotic leakage, septic complications such as fistulas and abscesses, neoplastic recurrence, and other less common complications (perineal hernia, peritoneal pseudocyst). The sophisticated surgical procedures used in rectal surgery can alter normal anatomy and make image interpretation difficult. Thus, familiarity with the appearances of postoperative anatomic changes, complications, and tumor recurrence is essential for accurate MR imaging evaluation after surgery for anorectal disease.
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PMID:Anatomic and pathologic findings at external phased-array pelvic MR imaging after surgery for anorectal disease. 1697 71


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