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

Pneumatocele and haemato-pneumatocele are air or air/fluid cavitary lesions which develop in the lung parenchyma after thoracic trauma. The formation of this lesion requires a direct violent impact on the pliable lung wall which explains its frequency in young adults. They are preferentially localised in the lung bases. The importance of associated lesions often marks the pneumatocele. Though rarely described, its frequency is certainly underestimated. If haemoptysis is the most frequent clinical sign it is the chest x-ray which demonstrates the early abnormality in the form of a rounded translucent image with a fine contour and variable diameter. The existence of a fluid level suggests the presence of blood (haemato-pneumatocele). The differential diagnosis with a localised pneumothorax, a diaphragmatic hernia and a pre-existing cystic lesion is easy as a rule but an evacuated pulmonary haematoma may lead to the discussion, especially as the mechanism of their formation may be the same. In isolation their clinical implications are minimal, their evolution favourable and after several weeks with a restitution of the integrity of the pulmonary parenchyma the absence of therapeutic intervention is justified.
Rev Mal Respir 1988
PMID:[Post-traumatic pneumatocele and hemato-pneumatocele of the lung. Apropos of 3 cases]. 336 37

Discal L4 crural neuralgia is conventionally considered secondary to a hernia of the L3-L4 disc. Now, another source of discoradicular conflict exists on the path of the L4 root: hernia of the link canal of the L4-L5 canal through which the root leaves the rachidian canal. Of 27 discal neuralgias operated upon, 9 were linked to a hernia of the L3-L4 disc, while 18 were secondary to a hernia of the L4-L5 foramen, that is 2 foramina hernias for 1 "intrarachidian" hernia. The diagnostic difficulties resulting from foramina hernias probably reflect a rarity that is more apparent than real. The etiology of crural neuralgia is conventionally sought at the L3-L4 disc. This search is often unsuccessful: one speaks of "essential crural neuralgia". The scanner provides the only certain way of revealing foramina hernias, and will probably detect increasing numbers and thus reduce the number of "idiopathic crural neuralgias".
Rev Rhum Mal Osteoartic 1986 Mar
PMID:[L4 crural neuralgia and disc hernia of the L4-L5 intervertebral foramen]. 370 29

Out of a total of 435 cases of nucleolysis, 400 case-reports of which could be used, secondary surgery was performed in 48 cases or 12% of the total. Surgery was most frequently required following L4/L5 than L5/S1 nucleolysis. The most frequent causes of failure of nucleolysis were lateral osseous stenosis (19 cases) and sub-ligamentous hernia (17 cases), apparently due to the ineffectiveness of the enzyme. Excluded hernia was rare (4 cases). Hernias at another level (4 cases) required surgery since it was not possible to repeat the injection of chymopapain. Three of these explorations were of the linea alba and one failure was due to spondylolisthesis due to isthmic lysis. Some failures occurred after some delay. The sciatic relapses after a period of complete clinical cure. In some cases, the relapse was in fact at another level or involved sub-ligamentous or excluded hernia. Surgery following nucleolysis is the same as that of an uninjected hernia; there are no adherences. The results are generally the same as those obtained by primitive surgery (two thirds favorable outcome). However, this depends mainly on what has been detected. The results are very good for hernias at another level and for excluded hernias. Fair results are obtained for stenosis and for sub-ligamentous hernias but only poor results in explorations of the linea alba.
Rev Rhum Mal Osteoartic 1986 Jun
PMID:[Cause of failure of nucleolysis and results of surgery]. 376 25

Conal twisting seems to result from dissociation between the cardiac jelly and the deep myocardial interface like the lining in the sleeve of a jacket. The conal ridges are the natural markers of the jelly and endocardium. They are responsible for septation of the conus and enable the twisting to be observed and measured. The myocardium is marked artificially by cauterisation. This marks the armature of the wall and leaves behind a zone of reduced resistance in the form of a hernia or false diverticulum. The conal ridges and marked myocardium dissociate. In the mid segment the myocardium does not play any role in twisting. In the proximal and distal segments it is only partially involved. This dissociation is observed even in the structure of the conal wall; the jelly, which is dense near the endocardium, is loose near the myocardium and adheres to the deep surface by dispersed fibres. Perfusion under pressure of the investigated specimens induces a detachment between the jelly and the myocardium and there only. This fragility only lasts during the twisting period. It is not found at the end of cardiac embryogenesis. This zone would allow not only a sliding--due to its fragility--but also a controlled sliding--by its fibres. In addition to twisting there is also conal migration. This takes place in the same direction as proximal twisting and determines myocardial rotation, which is less marked however, than that of the corresponding ridges. Experimentation may exaggerate this dissociation by preventing migration. It may also reduce or even suppress it by the formation of adhesions between the two layers. Although this mechanism is not univocal, a myocardial-jelly adhesion could stop distal twisting for example and explain malposition or transposition of the great vessels. This dissociation is no unique to superior vertebrates as it has also been found in the first living animals in whom conal twisting occurs, the dipneustes.
Arch Mal Coeur Vaiss 1983 May
PMID:[Myocardium-cardiac jelly dissociation and conal torsion. A study on the chick embryo heart]. 641 Oct 23

Over a period of six years, the authors have seen sixteen cases of foraminal sciatica with an L5 topography which possesses the following unusual clinical features: long history of back pain with a grumbling course and without any acute episodes, progressive sciatica without any predisposing factors, paresthesiae particularly on standing with normal amipaque saccoradiculography and unresponsive to medical treatment. The operative finding in all of these patients was a disc compression in the intervertebral foramen (hernia, disc residue or softened disc), which was frequently associated with factors reducing the calibre of the foramen: abnormal position of the root and lowering of the pedicular roof caused by lumbosacral disc degeneration. This multi-factorial compression therefore required, depending on the case, curettage of the disc or a localized annulectomy combined with a facettectomy. The long term results of the operation can be considered to be favourable, in view of the long history of root pain (an average of 4 years) which largely explains the incomplete nature of the post-operative success.
Rev Rhum Mal Osteoartic
PMID:[Sciatic foramina radiculalgia. Apropos of 16 cases]. 663 14

120 cases of the Williams-Beuren syndrome were collected by 11 cardiological centres in France, to determine the incidence of the various clinical signs and to obtain information on its aetiology, outcome and treatment. The selection criteria for inclusion in the series was typical facies. No particular complications were reported during pregnancy. Boys were a little more affected than girls. The birth weight was low and problems, especially digestive, often occurred in the first months. Cardiac signs were usually detected from the first year, although the exact diagnosis was usually made later on. 3/4 patients had subaortic stenosis, which was severe in 1/3 cases. Involvement of the branches of the aorta was not looked for systematically: the incidence (1/5 cases) found was lower than the true figure. Half the patients also had stenoses on branches of the pulmonary artery, but only rarely were they severe. These vascular malformations often seem to be progressive and, over a 10 year period, half the patients deteriorated. Many extracardiac abnormalities were reported. The most frequently encountered were inguinal and/or umbilical hernia. Surgery on the subvalvular stenosis gave good results in over 80 p. 100 cases; operative mortality was about 10 p. 100. Surgery should be performed before irreversible coronary or myocardial lesions develop. The study of the previous history did not give any new information on the cause of the syndrome, whose association with idiopathic hypercalcaemia of infancy is emphasised once again.
Arch Mal Coeur Vaiss 1980 Jun
PMID:[120 cases of the Williams and Beuren syndrome]. 677 59

The authors present 46 cases studies of herniated lumbar discs treated by chemonucleolysis in the previous 2 to 9 months. One patient suffered from recurrent acute lumbago; the other 45 patients suffered from lumbar root pain. The diagnosis of herniated disc was confirmed by radiography of the lumbar roots. Chemonucleolysis was performed under neuroleptanalgesia in the majority of cases, after failure of medical treatment and as an alternative to surgery. The patient treated for recurrent lumbago obtained a good result. After one month, 20 patients no longer suffered from sciatica and two had only a mild and intermittent sciatic pain. The results are lasting. Overall, chemonucleolysis is successful in 69% of cases. The success rate decreases with the age of the patient and the age of the symptoms. The results appear to be unchanged by the number of discs treated, their level or their discographic features. The results appear to be unchanged by the number of discs treated, their level or their discographic features. The results seem to be better when the disc being treated has not collapsed and when the hernia is not too large. Seven failed cases went to operation when, in each case, a non ruptured herniated disc was found. In 4 cases there was minimal tissue and in 2 cases the hernia was soft. The tolerance was excellent. Chemonucleolysis is effective in the treatment of herniated lumbar discs, but should be reserved for selected patients. Used with care, the treatment is safe. In cases where the treatment fails, the surgical procedure is not interefered with.
Rev Rhum Mal Osteoartic
PMID:[Treatment of lumbar disk hernias using chemonucleolysis]. 718 28

We recall a certain number of cases in our experience after cure of a hernia. Cases include damage to the iliac arteries and veins after appendicectomy (the case is still in court 25 years after the accident), hemorrhage after hysterectomy, damage to the iliac artery due to a Pfannensteel incision, lesion of the axillary artery during lymph node curettage, and hemorrhage during attempted appendicectomy.
J Mal Vasc 1996 Nov
PMID:[Forensic medical implications of vascular injuries and accidents related to the practice of conventional general surgery]. 900 40

Bochdalek hernias are the result of a congenital defect of the postero-lateral part of the diaphragm, usually discovered in the neonatal period. The diagnosis is rare in adult life and usually follows an acute gastro-intestinal complication. We report the case of a 63 year old man presenting with positional hypoxaemia that could have been related to a left sided Bochdalek hernia.
Rev Mal Respir 2002 Apr
PMID:[Positional hypoxaemia complicating a Bochdalek hernia in an adult]. 1204 Mar 25

Lumbar puncture is the best way to prove bacterial meningitis. It should be performed without any delay if the diagnosis is suspected. Herniation is a rare complication of LP. CT is normal in most cases of purulent meningitis, including those complicated by a subsequent herniation; normal CT results does not mean that performing a LP is safe. Three main clinical features can help determine which patient is at risk of herniation and should have a CT before LP. This risk has to be determined rapidly in the emergency ward while assessing anamnestic data, localization signs or symptoms, and level of consciousness. Cranial imaging (mainly MRI) is useful in the course of bacterial meningitis. Patients who do not respond well to treatment or with atypical presentation, persistence of fever, or new neurological signs should undergo brain imaging; MRI and CT may identify subdural effusions, brain abscesses, empyemas, hydrocephaly, or brain parenchymal changes (cerebritis, infarction, hemorrhage). CT and MRI are useful to screen for an ENT cause of bacterial meningitis, and mandatory in case of pneumococcal meningitis. Numerous MRI sequences are useful to identify bacterial meningitis complications: SE T1 without and with gadolinium injection, SE T2, FLAIR, gradient-echo T2, diffusion weighted imaging, MR angiography.
Med Mal Infect
PMID:[Indication of neuro-imaging for the initial management and the follow-up of acute community-acquired bacterial meningitis]. 1939 88


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