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

To determine whether intra-abdominal pressure may have a role in the process of testicular descent in man, we reviewed retrospectively the records of all male infants who presented during a 10-year period with severe abdominal wall defects, such as gastroschisis (28), omphalocele (29) and umbilical hernia (53), and calculated the incidence of cryptorchidism in these patients. The incidence of cryptorchidism at birth and at 1 year after birth was 18 and 15 per cent, respectively, in patients with gastroschisis, 52 and 33 per cent, respectively, in those with omphalocele, and 6 and 6 per cent, respectively, in those with umbilical hernia. For all 3 disorders the incidence of cryptorchidism was higher than in documented historical controls. From these data we conclude that in male infants there is an association between these 3 abdominal wall defects and cryptorchidism. The demonstration that intra-abdominal pressure is lowered significantly by these abdominal wall defects would suggest a possible role for intra-abdominal pressure in the process of testicular descent in man.
J Urol 1986 Sep
PMID:Association between abdominal wall defects and cryptorchidism. 287 39

Syringomyelia management is showing some progressive improvements following surgical methods of investigation and treatment. Investigation of simultaneous pressure changes in the cerebrospinal fluid pathways has illustrated the importance of craniospinal pressure dissociation in impacting the cerebellar and medullary tissues in the foramen magnum in hindbrain related syringomyelia. Such pressure differences may be referred to as 'suck' and similar changes are to be found in non-hindbrain related forms of syringomyelia such as those associated with spinal arachnoiditis. When cavities have formed then impulsive movements may occur with them and enlargement of the cavities may be continued by sloshing of the fluid within them. Investigations have been improved following the widespread use of water soluble contrast media and CT scanning with reconstructions after myelography. A definite relationship between birth injury and hindbrain related syringomyelia has been established especially with cases showing arachnoiditis. The nature of the relationship to hindbrain hernia and basilar invagination remains unclear. Magnetic resonance imaging holds great promise particularly in showing hindbrain deformation in new-born babies, showing whether or not a communication commonly exists between the fourth ventricle and the cavities within the spinal cord in early childhood and also in outlining the changes in the spinal cord in the presence of acute traumatic paraplegia. Treatment still relies upon valved ventricular to extrathecal shunts for hydrocephalus, cranio-vertebral decompression to prevent suck and drainage of the syrinx in appropriate cases. Syrinx to extrathecal shunting may be preferred to shunts to the subarachnoid space. The peritoneum and the pleura are favoured sites and a valve is not necessary. The advances for the future may depend on earlier diagnosis and greater understanding of the mechanisms of pathogenesis in which MRI seems likely to play an increasingly important part.
Neurol Res 1986 Sep
PMID:Progress in syringomyelia. 287 6

Using this technique of anatomic fascial staple closure, we have not seen a single wound disruption in nearly 800 patients. In the seven patients who had incisional hernias develop, all but one hernia occurred just above the umbilicus where the degree of fascial fiber dicussation was attenuated. In properly selected patients, our method of staple closure results in substantially decreased operating time and yields a dependable closure associated with minimal morbidity.
Surg Gynecol Obstet 1986 Sep
PMID:Anatomic staple closure of midline incision of the upper part of the abdomen. 294 37

A simplified technique for the repair of gastroschisis without the need to excise the umbilicus or make a fascial incision has been developed. First, the abdominal wall is stretched and the viscera are reduced. Next, the skin and subcutaneous tissue are elevated from the fascia for 1.5 cm around the defect and the fascia is closed transversely with interrupted sutures. The skin is also closed transversely. The umbilical stump is left intact. Eight of nine consecutive patients with gastroschisis were able to undergo repair by this technique. The average hospital stay was 35.6 days. There were no cases of omphalitis or cellulitis of the abdominal wall, but one child has a small umbilical hernia. All have a near normal-appearing umbilicus. This simpler technique for the repair of gastroschisis is quicker and less traumatic, and gives a better cosmetic result than the conventional method.
J Pediatr Surg 1986 Sep
PMID:Repair of gastroschisis with preservation of the umbilicus. 294 20

We describe two patients with strangulated obturator hernia to enhance clinical awareness of the varied presentations of this uncommon hernia, which occurs especially in elderly women with either recurrent abdominal pain or partial intestinal obstruction, a positive Howship-Romberg sign, and an absent thigh adductor reflex. Early laparotomy for unexplained bowel obstruction is essential to avoid the complications associated with strangulated obturator hernia.
South Med J 1988 Sep
PMID:Strangulated obturator hernia: can mortality be reduced? 304 79

We report the case of a healthy one-month-old male infant who underwent an uneventful endotracheal anaesthetic for hernia repair. During transport to the recovery room (a less than 30 second trip), the endotracheal tube in the spontaneously breathing infant became obstructed, possibly due to impaction of the tip in the right main bronchus. Restoration of the airway was followed by fulminant pulmonary oedema. Several days of vigorous respiratory and pharmacologic therapy were required for resolution of the infant's respiratory distress. We review other reported cases of acute airway obstruction associated with pulmonary oedema in children and briefly describe the proposed mechanisms. The difficulties of gauging proper endotracheal tube depth in the infant are noted. This case report demonstrates the importance of continuous monitoring during patient transport to the recovery room.
Can J Anaesth 1988 Sep
PMID:Negative pressure pulmonary oedema secondary to airway obstruction in an intubated infant. 304 56

A case of internal Richter's hernia due to a congenital defect of the peritoneum in a 17-year-old girl is described.
Acta Chir Scand 1988 Sep
PMID:Internal Richter's hernia due to congenital peritoneal defect. Case report. 320 67

A rare case of postoperative starch granuloma in a 55-year-old woman, revealed as femoral herniation, is reported. A small, finger-tip-sized tumor showing femoral herniation was noticed 3 weeks after cholecystectomy for cholelithiasis, and no content in the hernia sac was noticed. Histologically, the granuloma situated in the wall of the hernia sac was diagnosed as a starch granuloma consisting of starch granules, which were clearly revealed by polarized light microscopy. These granules were detected in the cytoplasm of macrophages including multinucleated types, some showing a positive immune reaction with antibodies to the alpha-subunit of S-100 protein, vimentin and lysozyme. Starch granules from surgical gloves showed identical features by polarized light microscopy, thus proving the histogenesis of this granuloma. This is the first reported case in the Japanese literature of starch granuloma manifested as femoral herniation.
Acta Pathol Jpn 1988 Sep
PMID:Postoperative starch granuloma revealed as femoral herniation. A case report. 324 58

Authors with wide experience report that the Shouldice technique for repair of inguinal hernia is very effective. The technique has not gained widespread acceptance or notoriety. For example, the 13th edition of Textbook of Surgery, edited by Sabiston, devotes only one paragraph to this type of herniorrhaphy. Because of the excellent results reported by the Shouldice Clinic, this technique was adopted at the Augusta Veterans Administration Hospital, a teaching hospital of the Medical College of Georgia. Since 1976, a total of 604 Shouldice repairs have been performed by supervised house staff; 468 patients have been followed for up to 8 years and a recurrence rate of 1.3 per cent is reported. Although the follow-up is brief, the Shouldice hernia repair is widely applicable and good results are not dependent on wide experience alone.
Am Surg 1987 Sep
PMID:Shouldice hernia repair: results at a teaching institution. 330 78

One hundred and fifteen patients were entered into a prospective randomized trial to establish whether midline abdominal incisions through the umbilicus produced any differences in the incidence of wound infection or failure when compared with the more conventional midline incision skirting around the umbilicus. No significant difference was shown between wound infection rates in 58 transumbilical and 51 circumumbilical incisions. Follow-up of surviving patients for at least one year showed no difference in incisional hernia rate between the two groups of patients. No problems were encountered in making the incisions through the umbilicus, but skirting the umbilicus was felt to cause problems with slewing of the scalpel blade, and asymmetry of the scar in 13 circumumbilical incisions. This study has shown that the practice of avoiding the umbilicus in midline abdominal surgery serves no useful purpose.
Br J Surg 1987 Sep
PMID:Circumumbilical versus transumbilical abdominal incision. 331 Dec 85


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