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

There are two schools of thought concerning the aetiology of rectal prolapse. On the one hand it was conceived to be a sliding hernia through a defect in the pelvic fascia, while on the other hand radiological studies have demonstrated prolapse to be represented by an intussusception of the rectum. Various operative procedures have been proposed for the treatment of rectal prolapse based on the belief in one or the other of these concepts. The anatomic defects which have been described with prolapse include a defect in the pelvic floor with diastasis of the levatores ani, loss of the normal horizontal position of the rectum, an abnormally deep cul-de-sac of Douglas, a redundant rectosigmoid, and a patulous anal sphincter. The popularly used procedure in Great Britain is that in which a sheet of Ivalon sponge is sutured to the sacrum and wrapped around the rectum thus anchoring it in place. Various authors have reported good results using this technique. The mortality and morbidity rate appear to be acceptable. In the U.S.A. a popular procedure is the Ripstein technique where a sheet of Teflon is wrapped around the rectum anteriorly anchoring the rectum to the sacrum. This technique also has its proponents who rport satisfactory results. Abdominal proctopexy and sigmoid resection, although not in common general use, has been found to be effective with an acceptable morbidity and mortality rate. These three procedures have some drawbacks but the one problem common to all the repairs so far developed for prolapse is their inability to guarantee to restore continence. Probably half the patients operated upon continue to be incontinent. Faradic stimulation of the sphincter has not proved to be as helpful as initially hoped.
Clin Gastroenterol 1975 Sep
PMID:Treatment of rectal prolapse. 118 58

The case is reported of a 26-year-old man who had several episodes of subileus which responded to spasmolytics. Mesenteric angiography revealed a paraduodenal hernia, with displacement of several jejunal arteries towards the mesenteric root and compression of intestinal vessels at about the level of Treitz' ligament. The angiographic findings were confirmed at operation, which consisted of repositioning the jejunal loop and closing the hernial orifice. The patient has since been free of complaints.
Dtsch Med Wochenschr 1975 Sep 19
PMID:[Angiographic diagnosis of paraduodenal hernia (author's transl)]. 119 53

The significant increase in the number of people older than seventy forces the physician to be acquainted with both psychological and physical alterations induced by aging and to devote an ever increasing proportion of time for recognition and treatment os such alterations. In the medical sense, the biological and physiological age is more important than the chronological age. With increasing age there is--especially concerning the digestive tract and its accessory organs--a rise in the incidence of organic affections and a decline in the frequency of functional disorders. Besides it is wise to know, that the increasing age there is often a coexistence of multiple degenerative disorders and disease states, involving many body systems and organs. On the background of this recognition it is also important to know, that prognosis too varies with age because of the coexistence of individually prognosticated disease states and moreover to realize, that elderly patients do not tolerate invasive and prolonged surgical procedures. Structural or functional disturbances of the digestive organs by aging processes do not cause death per se, but can become one important factor; degenerative sclerotic vascular alterations bear relationship to the poorly contractile vasculature that brings up difficulties in the control of hemorrhagic gastroduodenal ulcers. Many gastrointestinal disorders in elderly patients occur with an equal frequency in younger patients, some are more common in the geriatric population; these include hiatal hernia, carcinoma of esophagus, stomach, pancreas, bile ducts and colon, intestinal obstruction (ileus) by neoplastic growth, gallstone ileus, external hernia and operative adhesions and especially diverticular diseases of the colon and its complications and ischemic colitis by mesenteric vascular occlusion. Cirrhosis of the liver is often diagnosed for the first time in the older age groups while acute viral hepatitis uses to run a cholestatic course and is therefore often misdiagnosed as mechanical obstruction. In general history is difficult to obtain, the response of the organism with temperature and white blood count to stress is often delayed and rigidity associated with an underlying inflammatory disease involving the peritoneum is often delayed and rigidity associated with an underlying inflammatory disease involving the peritoneum is often atypical. Because of this limited reaction to severe stress, early surgical intervention is imperative in the elderly patients.
Fortschr Med 1975 Sep 18
PMID:[Problems of the so-called geriatric gastrointestinal diseases]. 120 46

The increased number of automobile casualties increases the frequency of traumatic rupture of the diaphragm. Because of associated serious lesions, diagnosis is easily overlooked. The authors report on 11 cases and give an appraisal of the literature. In 6 patients, diagnosis was made late. The authors discuss the physiopathology, symptoms, clinical data and means of diagnosis. Roentgenography is very important. Surgical cure is always recommended because of the danger of delayed strangulation of the hernia.
Acta Chir Belg 1975 Sep
PMID:[Traumatic rupture of the diaphragm. Clinical experience (author's transl)]. 122 Apr 95

Case report of a congenital cervical lung hernia causing serious feeding and respiratory problems in a 5 1/2 months old baby. Surgical repair of the endothoracic fascia defect with a MARLEX mesh. As far as we know the first report of a surgical repair of a congenital cervical hernia in an infant. Review of frequency, signs and therapy of lung hernia in literature. Analysis of the anatomic situation of a lung hernia in the cervical region.
Acta Chir Belg 1975 Sep
PMID:[Surgical repair of a congenital cervical lung hernia in a baby (author's transl)]. 122 Apr 98

Three patients who presented with left congenital posterolateral diaphragmatic hernia at the ages of six months, two years and six years and who had a normal chest x-ray earlier in life are reported. In two children the late onset of symptoms and previously normal radiographic appearance might be explained by the spleen acting as a plug in the diaphragmatic defect. A normal chest x-ray in early infancy does not exclude the diagnosis of congenital posterolateral diaphragmatic hernia.
Pediatr Radiol 1975 Sep 15
PMID:Congenital left posterolateral diaphragmatic hernia with previously normal chest x-ray. 123 38

A series of 30 incisional hernia repairs with knitted monofilament polypropylene is presented. The recurrence rate was 3.3% (one patient). No patch has sloughed or required removal. There was one postoperative death. Synthetic mesh allows defects of any size to be repaired without tension with a low recurrence rate.
Ceylon Med J 1992 Sep
PMID:Synthetic mesh in the repair of incisional hernia. 129 Nov 40

With the development of laparoscopic cholecystectomy, surgeons have been stimulated to develop techniques that allow many open surgical procedures to be performed laparoscopically. Appendectomy, hernia repair, and vagotomy have already been introduced clinically. Laparoscopic bowel resection, however, is somewhat more complicated. Bowel transection, mass tissue removal, and reanastomosis in the proper geometric fashion are critical to the success of this type of operation. The introduction of the Endo-GIA stapler (United States Surgical Corp., Norwalk, CT) will make this procedure feasible on a large-scale basis. The major problem with bowel resection is not transection or tissue removal, but, rather, reanastomosis. With intracorporeal anastomosis, manipulation of the bowel with proper orientation becomes difficult. This is less of a problem when performing low-anterior resection, however, because one of the bowel limbs is fixed. The purpose of this study was to develop a technique in the laboratory that would ensure proper orientation of the two bowel limbs, with minimal manipulation prior to performance of the anastomosis. The technique that we developed and describe herein does not require manual orientation during anastomosis. Improper bowel alignment with kinking and twisting is thereby avoided. The technique appears to be useful for small- and large-bowel resections, but not for low-anterior resection. For this technique to become a reality clinically, longer endoscopic staplers with taller staple height will be required.
Surg Laparosc Endosc 1992 Sep
PMID:An experimental technique of laparoscopic bowel resection and reanastomosis. 134 32

The basic cause of paracolostomy hernia is enlargement of the trephine opening in the abdominal wall, due to tangential forces working on the circumference of the opening. Our attempts of hernia repair with polypropylene mesh were not successful, as the diameter of the hole in the mesh tended to enlarge with time. For this reason we developed a new device, which secures the desired diameter of the opening. The prosthesis consists of a polypropylene ring with an internal diameter of 20, 25 or 30 mm, mounted in the centre of a polypropylene mesh. In 14 patients with a parastomal hernia, complicating an end colostomy, this prosthesis has been used. In one patient the implant had to be removed owing to infection. In the remaining 13 patients no recurrence or other complications have been noted after a median follow-up of 18 months (range 5-35 months). We conclude that the presented prosthetic device seems to be a useful adjunct for the local repair of a paracolostomy hernia.
Int J Colorectal Dis 1992 Sep
PMID:Successful local repair of paracolostomy hernia with a newly developed prosthetic device. 824 77

In November 1987 we began to practice delayed repair of acutely symptomatic congenital diaphragmatic hernia (CDH) following medical and/or extracorporeal membrane oxygenation (ECMO) stabilization. We reviewed 23 consecutive patients with CDH symptomatic at birth treated over the ensuing 2 1/2 years. The mean age at admission, age at repair, and interval from admission to repair were 4.9, 37.0, and 32.6 hours, respectively. Overall survival was 52% (12/23). ECMO was used in 14 patients with 7 survivors (50%); 4 of these patients underwent repair prior to ECMO and 10 while on ECMO. The patients were retrospectively grouped into three classes based on postductal arterial blood gas (ABG) response to conventional medical management: class A (n = 8), able to achieve and sustain adequate oxygenation (PO2 greater than 60 mm Hg) and hyperventilation (PCO2 less than 40 mm Hg); class B (n = 10), unable to sustain adequate oxygenation (PO2 less than 60 mm Hg) but able to be hyperventilated (PCO2 less than 40 mm Hg); and class C (n = 5), unable to be oxygenated (PO2 less than 60 mm Hg) or hyperventilated (PCO2 greater than 40 mm Hg). The interval from admission to repair was 13.6, 53.5, and 25.4 hours for classes A, B, and C, respectively. Two class A (25%), nine class B (90%), and three class C patients (60%) were placed on ECMO. Survival rates were 88%, 50%, and 0% for classes A, B, and C, respectively. We propose the following management protocol. Class A patients are stable and can be repaired at any convenient point after admission without prerepair ECMO; few will need it afterward.(ABSTRACT TRUNCATED AT 250 WORDS)
J Pediatr Surg 1992 Sep
PMID:Congenital diaphragmatic hernia in an era of delayed repair after medical and/or extracorporeal membrane oxygenation stabilization: a prognostic and management classification. 143 27


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