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

We report the case of a 54-year-old woman who developed epigastralgia and vomit. Because of the abnormal gas in the epigastrium on abdominal X-ray, ileus due to foramen of Winslow hernia or left paraduodenal hernia was suspected. However, abdominal CT and barium study revealed the gas in the epigastrium to be the air in the transverse colon interposed between the stomach and pancreatic body. This anomalous interposition of the transverse colon is called retrogastric colon. The ileus was due to non-specific inflammatory duodenal stenosis. It is important to prevent misdiagnosis of retrogastric colon as lesser sac pathologic condition such as abscess, bowel perforation and internal hernia.
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PMID:[Retrogastric colon mimicking foramen of Winslow hernia or left paraduodenal hernia: case report]. 1096 51

This is a case report of an elderly woman who presented with a history of epigastric pain and persistent vomiting diagnosed initially as a duodenal ulcer, later as a pyloric stenosis and at laparotomy was found to have an anterior diaphragmatic hernia with gastric volvulus. Hernia of Morgagni occurs through a congenital defect in the diaphragm but usually presents in adulthood. It could be an incidental diagnosis or can present with obstructing symptoms of the herniated viscera. Treatment is surgical with reduction of hernia and repair of the diaphragmatic defect. If misdiagnosed, this can lead to considerable morbidity and occasionally mortality due to the obstructed/strangulated hernial contents.
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PMID:Morgagni hernia: case report. 1192 4

The diaphragmatic hernia usually appears in neonatal period. The late onset, due to diafragmatic tear after blunt trauma, is exceptional. We report the case of a boy aged 13, who was studied for epigastric pain since two months. Contrast gastrointestinal study showed bowel loops in left hemithorax. The patient had a blunt abdominal trauma due to a fallen from a horse, when he was 6 year old. It was performed a thoracotomy with reinsertion of intestinal structures into the abdomen and closure of the anterolateral tear of left hemidiaphragm. Postoperative progress was without event and the boy was discharged home well. We emphasize the lack of symptoms during seven years after trauma and we point out that diaphragm rupture may occur. Symptoms could be no specific, only light respiratory or digestive alterations.
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PMID:[Traumatic diaphragmatic hernia of late onset]. 1202 76

Gastric volvulus is an uncommon condition which is difficult to diagnose and treat. It designates abnormal rotation of the stomach along its longitudinal (organoaxial) or transverse (mesenteroaxial) axis. When the rotation exceeds 180 degrees, gastric obstruction or strangulation may occur. The classical presentation of acute gastric volvulus is the triad of severe epigastric pain, vomiting followed by retching without the ability to vomit, and difficulty or inability to pass a nasogastric tube. Delay in diagnosis and treatment of gastric volvulus can lead to fatal complications such as gastric ischemia, perforation, and hemorrhage. Gastric volvulus is a true emergency which should be treated immediately either surgically or by upper endoscopy. We report a case of an acute incarcerated gastric volvulus due to a left-sided diaphragmatic hernia in an adult male patient, which was treated successfully by operation.
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PMID:[Acute gastric volvulus due to diaphragmatic hernia]. 1469 13

In three patients, a woman aged 87 years who presented with signs indicating a myocardial infarction, a man aged 31 suffering from postprandial epigastric pain that suddenly worsened, and a woman aged 60 years with longstanding postprandial pain and recent fatigue due to anaemia, a para-oesophageal hernia was diagnosed. Para-oesophageal herniation is an uncommon disorder accounting for approximately 5% of all hernias at the oesophageal hiatus. They are distinguished from the more common sliding hiatal hernia by a relative preservation of the intra-abdominal fixation of the gastro-oesophageal junction. These patients show that the clinical presentation of para-oesophageal rolling hernias is different from that of sliding hernias. Pathological reflux may occur; though symptoms associated with a relative obstruction of the stomach within the hernia sac, such as dysphagia, are more common. Rare non-specific symptoms such as anaemia and loss of weight are also seen. Adequate therapy differs from that of a sliding hernia and should be individualized: surgical correction is indicated in a healthy patient with a symptomatic para-oesophageal hernia, such as in the last patient. However, when the hernia is incidentally diagnosed or when comorbidity is present, such as in the first patient, a wait-and-see policy is recommended. Only in case of a threatening incarceration, such as in the second patient, is an emergency operation indicated.
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PMID:[The para-esophageal hernia: a rare hiatal hernia requiring a specific approach]. 1522 26

The authors describe the clinical and imagiologic challenges faced at the Emergency Room while observing a 48-year-old woman, submitted to a Nissen fundoplication 16 months earlier. She presented herself with a one-month total progressive dysphagia, epigastric pain and regurgitation. Intraoperative findings demonstrated an intraabdominal fundoplication, closure of diaphragmatic crura and part of the gastric greater curvature and body herniated through a small posterior defect on the diaphragm, with a gigantic serosal cystic mass and associated perforation. Data from posterior clinical investigation shows a traffic accident 34 years ago. Although described before, the association of late traumatic diaphragmatic hernia and gastric intrathoracic perforation is rare (< 2.5%) and difficult to diagnose. A revision of the literature is performed concerning the pathophysiologic mechanisms of late diaphragmatic rupture, its clinical presentation and diagnosis, as for Nissen fundoplication complications, its prevention and management.
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PMID:[Late traumatic diaphragmatic hernia complicated by intrathoracic perforation and haemorrhagic gastric cyst: a rare combination]. 1658 62

A paraesophageal hernia was diagnosed in a 67-year-old female patient suffering from epigastric pain and gastroesophageal reflux disease. The patient underwent laparoscopy. Beside the paraesophageal hernia, a Morgagni hernia was also observed, with a significant part of the omentum herniated in the sac. A 360-degree Nissen fundoplication was performed, the Morgagni hernia sac was not resected, and its closure was performed with interrupted sutures. No complications were observed in the postoperative period and on one-year follow-up the patient was free of symptoms.
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PMID:Laparoscopic treatment of simultaneously occurring Morgagni and paraesophageal hernias. 1724 84

We describe seven patients who suffered chronic gastric torsion, seen during a 28-month period. Four were children, of which three were infants. The infants had projectile vomiting and two also had failure to thrive. The adults presented with epigastric pain and vomiting. Upper gastrointestinal series clinched the diagnosis in all patients. The classic radiographic presentation of a stomach lying across the epigastrium with the cardia and fundus in a dependent position to the body of the stomach and pylorus may be overlooked in some cases. Choice of surgical procedure in its management has been discussed. There was no associated abnormality in four of the six operated cases. One infant had an atretic bowel, vascular anomalies, umbilical hernia, and previous meconium peritonitis; a second infant had jejunojejunal intussusception. A high index of suspicion is warranted in patients presenting with recurrent abdominal pain or in infants with unexplained vomiting and failure to thrive. Upper gastrointestinal series in adults should preferably be performed while the pain is present.
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PMID:Gastric torsion: Not such a rare entity. 1758 77

We present a successful laparoscopic treatment of paraesophageal hiatal hernia with an incarceration of the pancreas and jejunum. The patient was a 75-year-old woman who had complaints of epigastric pain and dysphasia. A chest x-ray revealed a mediastinal air-fluid level. Chest computed tomography showed intestinal contents, body and tail of the pancreas, and the splenic artery within the mediastinum. At laparoscopy, jejunum was incarcerated into the mediastinal cavity through the internal hernia of transverse mesocolon. Body and tail of the pancreas and the splenic artery were also dislocated within the hernia sac. The operation time took 115 minutes. The patient tolerated a regular diet on the first postoperative day and was discharged uneventfully. There were no recurrence or abdominal symptoms during the 29-month follow-up period. In the case of asymptomatic paraesophageal hiatal hernia with incarcerating pancreas on diagnostic imagings, elective surgical treatment is required to prevent a critical outcome.
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PMID:Laparoscopic treatment of paraesophageal hiatal hernia with incarceration of the pancreas and jejunum. 1771 57

The advantages of minimally invasive therapy can be utilised in the surgical disorders of pregnant patients. To our knowledge, there has not been a previous report describing laparoscopic management of diaphragmatic hernia (with mesh) in pregnancy. A 23-year-old pregnant (second trimester) woman was admitted with vomiting, epigastric pain, oliguria and dyspnoea of one month duration. Investigations revealed posterolateral diaphragmatic hernia of Bochdalek with gastric volvulus. Successful laparoscopic mesh-plasty of the diaphragmatic hernia was performed without mortality or morbidity to both mother and child. Principles of laparoscopic surgery for diaphragmatic hernias remain the same. Pregnancy poses challenges to both surgeon and anaesthetist due to changes in the physiology. Acute diseases that threaten the life of mother and child have to be dealt with urgently. We conclude that even complex laparoscopic surgery during pregnancy is feasible.
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PMID:Laparoscopic mesh repair of a Bochdalek diaphragmatic hernia with acute gastric volvulus in a pregnant patient. 1820 56


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