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

Sixteen cases of traumatic disruption of the right hemidiaphragm are presented. Six tears were treated in the acute post-trauma phase and ten were detected from late manifestations. The causal trauma was penetrating in 11 cases and blunt in five. Rupture of the right hemidiaphragm not uncommonly occurs without serious associated injuries. Bowel often herniates through such tears, unhindered by the liver, though the liver is the most commonly herniating organ. No recurrence of hernia was found after standard repair techniques (mean follow-up 5.2 years). Three of the 16 patients died, one from associated injury, one from strangulation of herniated bowel and one from postoperative myocardial infarction. To demonstrate diaphragmatic tearing and subsequent organ herniation, serial chest radiographs and computed tomography are useful, and exploratory laporotomy should be done without delay after penetrating injury to the trunk. The treatment of diaphragmatic tear is surgical, with better results from early than from late repair.
Scand J Thorac Cardiovasc Surg 1986
PMID:Traumatic rupture of the right hemidiaphragm. 373 39

Herniation through a "cribriform" diaphragm was incidentally detected in a 65-year-old woman. Liver tissue protruding into the right hemithorax showed signs of strangulation. The defects were surgically corrected. The condition presumably was an extremely rare variant of congenital diaphragmatic hernia.
Scand J Thorac Cardiovasc Surg 1986
PMID:Cribriform diaphragm: a variant of congenital diaphragmatic herniation. A case report. 373 52

Fifty-three neonates and seven pediatric patients were treated with extracorporeal membrane oxygenation from September 1983 until April 1986. Venoarterial bypass was achieved by cannulating the right atrium via the right internal jugular vein and the aortic arch via the right common carotid artery. In the neonatal group, 40 infants with acute respiratory failure were treated, and 36 (90%) survived. Five infants with congenital heart disease were treated and three (60%) survived. Among the eight patients with congenital diaphragmatic hernia, there were three (38%) survivors. In the pediatric group, four patients were treated for ventricular failure after cardiac operations. Two were weaned from bypass, with one long-term survivor. Three patients with acute respiratory failure were treated, with one survivor. salvaging high-risk neonates with minimal morbidity and mortality. It has also been useful in the support of infants with congenital heart disease and congenital diaphragmatic hernia. In pediatric patients one cannot expect to get results that are comparable to those found in neonates. Still, this modality can be useful in salvaging some moribund patients with pulmonary or cardiac failure, or both.
J Thorac Cardiovasc Surg 1987 Feb
PMID:Extracorporeal membrane oxygenation for respiratory and cardiac failure in infants and children. 380 95

The first two cases of intrapericardial diaphragmatic hernia following a subxiphoid epicardial pacemaker insertion are reported. Factors deemed responsible for this rare complication in one case were previous gastrectomy with a resulting paucity of omentum, and entrance into the peritoneal cavity during the pacemaker procedure.
J Thorac Cardiovasc Surg 1984 Oct
PMID:Intrapericardial diaphragmatic hernia after subxiphoid epicardial pacemaker insertion: case reports. 648 96

Since 1979 our policy for management of esophageal perforation has included correction of underlying esophageal disorder as part of the initial treatment in selected cases. A series of 23 patients is presented, of whom 3 were managed conservatively and 20 surgically. The overall mortality rate was 8.7%. Concomitant operation of underlying esophageal disease and perforation was done in eight cases within 12 hours of the perforation. These operations included emergency resection and esophagogastrostomy in five patients (4 with stenosis and 1 with cancer). A Heller myotomy was done in addition to suture repair in two patients with achalasia, and a Belsey Mark IV hernia repair was added to the esophageal suture closure in a patient with gastroesophageal reflux and hiatal hernia. A postoperative fistula healed spontaneously in one of the eight patients, and the early postoperative course was uncomplicated in the other seven. Simultaneous correction of underlying esophageal disease in patients with iatrogenic perforation of the esophagus seems to be safe when perforation is diagnosed at an early stage. Such a radical approach is clearly beneficial.
Scand J Thorac Cardiovasc Surg 1984
PMID:Advisability of concomitant immediate surgery for perforation and underlying disease of the esophagus. 652 78

Four neonates (three having undergone repair of a congenital diaphragmatic hernia and developing a persistent fetal circulatory pattern and one having severe infant respiratory distress syndrome) have been supported with prolonged extracorporeal membrane oxygenation (ECMO) at Children's Hospital of Pittsburgh between December of 1979 and April of 1980. Three have survived. This encouraging experience indicates that the pattern of persistent fetal circulation in the newborn infant who has undergone repair of a diaphragmatic hernia can be successfully managed with ECMO even when efforts to lower pulmonary hypertension and improve oxygenation with vasodilators (tolazoline, phenothiazine, acetylcholine, or prostaglandin E1) and have been ineffective. The effectiveness and safety of ECMO is convincing enough to warrant its consideration as therapy for congenital diaphragmatic hernia and persistent fetal circulation prior to the use of vasodilators.
J Thorac Cardiovasc Surg 1981 Apr
PMID:Extracorporeal membrane oxygenation. Successful treatment of persistent fetal circulation following repair of congenital diaphragmatic hernia. 720 62

A series of 250 patients with oesophageal reflux and hiatus hernia were treated at North Middlesex Hospital, London, the Regional Cardiothoracic Centre, between 1968-72. These patients received surgical treatment by the "Belsey Mark IV technique" and there were no significant complications. The 7--10 year follow-up showed in 8.4% actual recurrence which was of a combined functional and anatomical nature. In 2% of the cases hernia was demonstrated only by radiology, but there was no evidence of recurrent reflux. The majority of recurrences occurred within two years of initial operation. The patients with recurrences, who underwent the second Mark IV repair, had excellent results. The improving quality of the life in the successful cases was dramatic. This series indicates that the Belsey Mark IV repair is a safe and reliable procedure and gives excellent results with relief of all symptoms.
Scand J Thorac Cardiovasc Surg 1980
PMID:Surgery for oesophageal reflux and hiatus hernia. Long-term results in 250 patients. 722 7

Nineteen patients undergoing aortic surgery during which 5,000 units of heparin were given intravenously were compared with 39 patients undergoing laparotomy or herniorrhaphy. There was an expected significant reduction in coagulability as measured by thrombelastography in those patients undergoing aortic surgery. Moreover, the early post-operative deep vein thrombosis (DVT) rate was significantly less. This implies that a reduction in coagulability by I.V. heparin during surgery is associated with a lower incidence of early post-operative deep vein thrombosis. Among the laparotomy and hernia group who developed a DVT, coagulability was significantly greater both before and during the operation and on the first post-operative day.
J Cardiovasc Surg (Torino)
PMID:Coagulation changes during major surgery and relationship to post-operative deep vein thrombosis. 727 77

One hundred two patients referred to our Esophageal Function Laboratory without endoscopic evidence of esophagitis were divided into two groups on the basis of the presence of a hiatal hernia on endoscopic examination. Fifty-three patients had a hiatal hernia and 49 did not. Both groups and 30 normal volunteer subjects had esophageal manometry and 24 hour esophageal pH monitoring. The incompetency of the cardia in patients with a hiatal hernia was dependent upon loss of components responsible for the antireflux mechanism, mainly a decrease in distal esophageal sphincter pressure and a decrease in the length of the sphincter exposed to the positive-pressure environment of the abdomen. These deficiencies were not related to the presence of a hiatal hernia and were similar to those of patients with an incompetent cardia without a hiatal hernia. Patients with a hiatal hernia and an incompetent cardia had significantly more esophageal exposure to refluxed acid than without a hiatal hernia. On the basis of the number of reflux episodes that lasted 5 minutes or longer and radioisotope transit studies, this increased acid exposure was due to both a loss of competency of the cardia and poor esophageal clearance secondary to the presence of a hiatal hernia. Reduction of the hernia and anchoring the distal esophagus into the abdomen not only may improve the antireflux mechanism, but corrects the clearance abnormality as well. The presence of a hiatal hernia has a detrimental effect on the clearance function of the body of the esophagus and may aggravate the effects of gastroesophageal reflux due to an incompetent cardia.
J Thorac Cardiovasc Surg 1981 Oct
PMID:Relationship of a hiatal hernia to the function of the body of the esophagus and the gastroesophageal junction. 727 46

Ninety-seven consecutive patients with hiatal hernia were operated upon with a modified Husfeldt hernia repair during a ten-year period. Thirty-two of the patients had severe reflux complications, such as ulcerative oesophagitis, oesophageal stricture and shortened oesophagus. Ninety patients were carefully followed up postoperatively. The mean duration of follow-up was 5 years. Analysis of the postoperative results in relation to the type of hernia showed no difference between sliding and combined hernia. Recurrence of hernia, unsatisfactory clinical results and gastro-oesophageal reflux were recorded more often in patients with severe reflux complications. The main cause of unsatisfactory results in these patients was found to be a shortened oesophagus. The method proved to be a reliable procedure for surgical treatment of not only uncomplicated hernias, but also cases complicated by oesophageal stricture if the stricture was not associated with shortened oesophagus. It is considered that a shortened oesophagus is a contra-indication for employment of the Husfeldt method.
Scand J Thorac Cardiovasc Surg 1980
PMID:Husfeldt hernia repair: indications and results. A follow-up study. 737 86


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