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

Haemodynamic changes and plasma catecholamine concentrations were measured in 12 patients aged 24 to 87 years after performance of a field block for elective repair of inguinal or femoral hernia. The local anaesthetic used comprised a mixture of lignocaine 0.5% with adrenaline 1:200,000; the dose of lignocaine administered varied from 3.8 mg/kg to 4.9 mg/kg. Plasma adrenaline increased by 326% and plasma noradrenaline by 75% at 10 minutes after completion of the block. Mean heart rate increased from 75 to 94 beats/minute after 20 minutes, whilst there were no obvious changes in systolic and diastolic arterial pressures. Potentially serious arrhythmias developed in two patients, thought to be related to the peak plasma concentrations of adrenaline produced. It is recommended that the dose of adrenaline used as described for this block should be reduced.
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PMID:Changes in haemodynamics and plasma catecholamine concentrations after field block for inguinal herniorrhaphy using lignocaine with adrenaline. 231 57

A newborn with right diaphragmatic hernia suffered myocardial stunning and suprasystemic pulmonary hypertension secondary to postpartal asphyxia. In addition to conventional therapy, norepinephrine, enoximone, and inhalational nitric oxide were successfully used. Norepinephrine improved myocardial perfusion pressure; the addition of enoximone, a phosphodiesterase-inhibitor, to beta-adrenergic agents increased cardiac performance. with decreasing concentrations of inhalational nitric oxide, severe pulmonary hypertension resolved after a few days, suggesting that transient endothelial dysfunction was partially responsible for pulmonary vasoconstriction in the newborn with congenital diaphragmatic hernia.
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PMID:Norepinephrine, enoximone, and nitric oxide for treatment of myocardial stunning and pulmonary hypertension in a newborn with diaphragmatic hernia. 766 10

A female newborn was delivered by Caesarean section in 36/37 week of pregnancy, due to prenatally diagnosed congenital diaphragmatic hernia. She was admitted to the intensive care unit in the first minutes of life. It was the first uneventful pregnancy of a 25 year old woman. The newborn's Apgar score was 0, at both 1(st) and 5(th) minute of life. She was immediately intubated, given adrenaline and 4.2% NaHCO(3). High frequency oscillatory ventilation, with high ventilation parameters was initiated. Right-sided pneumothorax was found by auscultation and pleural drainage was installed. On X-ray a left-sided congenital diaphragmatic hernia was noted with presence of the stomach, spleen, small intestine and left lobe of the liver in the thorax. Because of deteriorating clinical condition fluid resuscitation and continuous noradrenaline infusion were used. Despite implemented treatment, severe bradycardia and hypotension developed. Patient died 1.5 hours after birth. On autopsy left-sided diaphragmatic hernia, bilateral pneumothorax, pneumoperitoneum, severe lung hypoplasia and transposition of the great arteries were found. Prenatal diagnosis of cardiac defects by routine ultrasonography may be difficult in a neonate with diaphragmatic hernia, due to altered anatomical conditions. Postnatal echocardiographic examination of the heart is suggested in such infants to exclude the presence of cardiovascular anomalies.
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PMID:[Transposition of great arteries in a newborn with congenital diaphragmatic hernia - case report]. 1930 30

Systolic anterior motion describes the anterior displacement of one or both mitral valve leaflets, obstructing the outflow tract of the left ventricle. It can be a cause of severe hypotension during the intraoperative and postoperative period of non-cardiac surgery. The diagnosis is made with echocardiography. We report two patients with this problem. The first was a 74-year-old male subjected to an incisional hernia repair who presented severe hypotension in the intraoperative period. A transesophageal echocardiography revealed an anterior displacement of the mitral valve anterior leaflet. Epinephrine was discontinued and Norepinephrine and a volume expander were administered, with good response. The second patient was a 64-year-old male undergoing a right liver lobectomy. In the postoperative period, he suffered severe hypotension. A transesophageal echocardiography revealed an anterior displacement of the mitral valve anterior leaflet. Dobutamine was discontinued, volume was administered, and a Norepinephrine infusion was started with good response.
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PMID:[Systolic anterior motion: a report of two cases]. 2328 79

We report a case of awake intubation in a patient with a difficult airway combined with severe hemorrhagic shock using the Pentax-AWS Airwayscope (AWS). A 65-year-old man experienced severe hemorrhagic shock due to diaphragmatic hernia after extrapleural pneumonectomy and was scheduled for emergent exploratory thoracotomy under general anesthesia. Blood pressure was maintained with dopamine-noradrenaline support, and rapid transfusion. We anticipated difficult ventilation due to a swollen face and tongue. The patient underwent awake intubation with the AWS under dexmedetomidine sedation and lidocaine spray for laryngotracheal anesthesia. The patient did not buck during intubation and hemodynamic changes were minimal.
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PMID:[A case of awake intubation using the Pentax-AWS airwayscope in a patient with a difficult airway combined with severe hemorrhagic shock]. 2347 24

Postoperative diaphragmatic hernia following transhiatal oesophagectomy is a rare but potentially life threatening complication. We describe a case of a 65 year old patient who developed diaphragmatic hernia following oesophagectomy and presented with cardio pulmonary compromise. During surgery, haemodynamic instability continued despite fluid resuscitation and noradrenaline infusion. An immediate improvement in the haemodynamics and reduction in airway pressure occurred on reduction of the herniated colon from the thoracic cavity. This can be explained by tension colothorax causing collapse of the underlying lung and cardiac tamponade. It is a surgical emergency requiring urgent decompression for resuscitation. The etiology, clinical presentation, pathophysiology and preventive measures are discussed.
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PMID:Tension colothorax causing cardiac tamponade: A life-threatening complication following transhiatal oesophagectomy. 2382 22