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

The surgical treatment of diaphragmatic hernia attempted on 19 lactating buffaloes is described. Thirteen cases recovered uneventfully, 1 recovered after developing brisket oedema and 5 died, 3 during surgery and 2 postoperatively. The desired depth of anaesthesia was achieved by the administration of 6% chloral hydrate followed by 5% thiopentone sodium. A postxiphoid approach and the use of a continuous lock stitch suture were preferred to repair the vent in the diaphragm. Pre- and post-operative use of hydrocortisones and fluids and sufficient tissue oxygenation by controlled positive pressure respiration are believed to be keys to the success of the treatment adopted.
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PMID:Treatment of diaphragmatic hernia in buffaloes. 61 19

Emergency equine abdominal surgery is easiest and most efficiently carried out with a team of surgeons. The surgical site should be as protected as possible by the use of sterile drapes and wound protectors. A ventral midline laparotomy incision has been found to be the most convenient approach to most equine intestinal obstructions. A standing laparotomy through the left paralumbar fossa gives adequate exposure for exploration of the abdomen and is, therefore, useful as a diagnostic tool. Horses tolerate having both ventral midline and left paralumbar laparotomy incisions well. If the cause of the intestinal obstruction is not readily apparent upon opening the abdominal cavity, a thorough systematic exploration of the abdominal cavity is necessary. If the problem cannot be found with the bowel in situ, intestine must be exteriorized for examination. The decision as to the extent of adequate bowel resection often depends on a subjective assessment of bowel function. In equivocal cases, the surgeon should choose to resect some normal bowel rather than taking a chance on leaving compromised bowel in place. Incarcerations are frequent causes of small intestinal obstructions. The small intestine may become incarcerated in the epiploic foramen, the inguinal canal or in an umbilical hernia. Thromboembolic compromise to intestinal vessels results in the longest lengths of embarrassed bowel requiring resection. Impactions are the most common obstructions associated with the caecum. Large colon torsions of 270 degrees or less may be corrected by surgical manipulation; with 360 degrees torsions of the large colon, however, vascular compromise is usually sufficient to devitalize this organ. Enterotomy of the large colon allows retrieval of most enteroliths from its lumen. Enterotomy of the right dorsal colon is also useful for removal of foreign bodies which cause obstruction of the most proximal portion of the small colon. In our Clinic a two-layer end to end anastomosis is usually utilized. Recently introduced automated stapling and ligating instruments have been useful in decreasing surgical time. Antibiotics, usually furacin and sodium or potassium penicillin in 2 litres of Normasol-R, are placed in the peritoneal cavity before closure of the abdomen. A Penrose drain is commonly placed into the abdominal cavity to provide drainage of the peritoneal cavity after surgery. The peritoneum is sutured with No 0 chromic gut in a simple continuous pattern. A second Penrose drain may be placed between peritoneum and ventral body wall, with its ends retracted through stab incisions in the skin. The linea alba is closed with simple interrupted sutures of stainless steel wire or No. 3 chromic gut. Employing the above described principles and techniques has increased the success of abdominal surgery in our Clinic.
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PMID:Surgical techniques in equine colic. 117 35

Haloperidol was administered intravenously at the dose rate of 0.87 mg/kg body weight five minutes prior to thiopental anaesthesia in 5 clinically healthy dogs, aged 10-12 months and weighing 11.5 +/- 0.96 kg. Animals required only 4.36 +/- 0.24 ml of the 5% thiopental sodium to achieve surgical anaesthesia which lasted for 37.5 +/- 4.3 minutes. There was adequate muscle relaxation and loss of pedal and palpebral reflexes during thiopental anaesthesia. Five minutes after administration of haloperidol, there was no appreciable change in the various cardiopulmonary dynamics with the exception of a hypocapnoea and a mild hypotension. During thiopentone anaesthesia, a mild hypotension and arterial hypoxemia was evident. This combination of anaesthesia was also employed in 14 clinical cases varying from fractures of long bones (4), mammary tumours (3), ear haematoma (4), venereal granuloma (2) and abdominal hernia (1). The combination proved extremely useful for orthopaedic surgery as the muscle relaxation was adequate and the reduction of the fractured ends was relatively easy.
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PMID:Haloperidol as a pre-medicant for thiopental anaesthesia in the dog. 211 11

One goat anesthetized with thiamylal sodium, xylazine, and halothane for repair of an abominal hernia, and 7 of 29 goats similarly anesthetized for an experiment unrelated to considerations of anesthesia, developed signs of hepatic failure within 24 hours of anesthesia. Affected goats had high values for serum aspartate transaminase and serum total bilirubin by 12 to 24 hours after induction of anesthesia. Necropsy of the 8 affected goats revealed centrilobular to massive hepatic necrosis (8 of 8), brain lesions consistent with hepatic encephalopathy (3 of 4), and acute renal tubular necrosis (6 of 6). Two unaffected goats had no hepatic necrosis. Causes of hepatic necrosis other than those related to anesthesia (eg, infectious agents, toxins) were ruled out by lack of supporting necropsy findings or were considered unlikely because of lack of opportunity for exposure. Hepatic lesions in these goats closely resembled those described in human beings with halothane-associated hepatic injury, although in both species these lesions are nonspecific at the gross and light microscopic levels. The pathogenesis of halothane-associated hepatic injury in goats, as in human beings, remains to be determined.
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PMID:Hepatic necrosis following halothane anesthesia in goats. 379 99

The effect of topical ampicillin sodium and polyglycolic acid and silk sutures on the recurrence of an existing hernia or an incisional hernia and on infection rates in clean abdominal wounds (herniotomies and simple cholecystectomies) was studied in a triple-blind, randomized trial with 398 consecutive patients. One infection, three suture sinuses, and two incisional hernias occurred among 113 patients with cholecystectomies, while the corresponding rates in 285 patients with hernia repairs were 11 infections, no suture sinuses, and three recurrent hernias. No effect of ampicillin could be demonstrated, nor was any difference between polyglycolic acid and silk sutures shown. No interaction between the antibiotic and suture material was found, and no side effects were observed. Wound infection was significantly more frequent in patients with postoperative seromas or hematomas.
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PMID:Polyglycolic acid, silk, and topical ampicillin. Their use in hernia repair and cholecystectomy. 624 16

This randomized prospective study examines the efficacy of intravenously administered heparin as prophylaxis against deep-vein thrombosis, detected isotopically with iodine 125, in 37 patients scheduled to undergo major abdominal procedures. Twenty patients were given 5000 units of sodium heparin on opening the abdominal cavity, while 17 patients who did not receive heparin acted as controls. The effect of heparin was reversed at the end of the operative procedure by protamine. Three control patients had deep-vein thrombosis postoperatively but only one heparin-treated patient did. Complications in the treated group included excessive blood loss intraoperatively in one patient and an incisional hernia postoperatively in another. Although the results are not statistically significant, this study suggests that a single dose of heparin given intravenously during operation is a safe and effective means of prophylaxis against deep-vein thrombosis in patients who undergo general surgical procedures. Studies are now being carried out to determine the optimal dose of heparin, time of administration and duration of anticoagulation.
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PMID:Intraoperative single-dose heparin prophylaxis against deep-vein thrombosis. 638 Jun 92

Traumatic diaphragmatic hernia, whether of blunt or penetrating etiology, is difficult to diagnose in the acute phase. The lesion is presently best diagnosed by chest X-ray, but only occasionally. Chest X-ray appears normal or nonspecific 25 to 50% of the time. For this reason, simple diagnostic technique using radiographic methodology available in emergency rooms was studied in animals in order to devise a way to diagnose this injury. Eight per cent diatrizoate meglumine and diatrizoate sodium (Renografin, Squibb) was placed into the chest or abdomen of animals with either 8-cm simulated blunt or 5-mm simulated penetrating injuries. The Renografin was infused by either a peritoneal lavage or thoracostomy catheter. Serial X-rays showed diagnostic rate of transdiaphragmatic leakage in 24 of 26 animals with blunt injury and seven of 16 animals with penetrating injury. There was no evidence of pleural, peritoneal, or pulmonary injury from the Renografin itself. It was concluded that the experimental technique may prove useful in screening or confirming traumatic diaphragmatic hernia during the acute or latent phases.
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PMID:Diaphragmatic injury: a method for early diagnosis. 709 13

The effect of intraperitoneal sodium carboxymethylcellulose (SCMC) administration on clinical outcome and survival was evaluated in horses undergoing exploratory celiotomy for acute gastrointestinal disease. Comparison of variables was made retrospectively between 44 horses that had SCMC and 92 horses (controls) not treated with SCMC. Mean age, body weight, heart rate, packed cell volume and plasma total protein of horses at admission, and convalescent period were not significantly different between control and SCMC groups. No significant differences were noted between control horses and SCMC horses with respect to incisional infection, hernia formation, recurrent episodes of colic, clinical outcome, and long-term survival (> 6 months). Seventy-six (83%) control horses and 34 (77%) SCMC horses survived long-term. Seventy (76%) control horses and 30 (68%) SCMC horses survived without complications and returned to their previous use. These results suggest that intraperitoneal use of SCMC does not adversely affect abdominal incisional wound healing, clinical outcome or long-term survival, however, the efficacy of SCMC in prevention of postoperative intestinal adhesions in horses requires further investigation.
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PMID:Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing exploratory celiotomy. 777 49

Hyperglycemia and hypokalemia caused by catecholamine discharge have been reported to occur in patients after severe head trauma. The aim of this prospective study was to evaluate whether a similar neuroendocrine and metabolic response is found in children after minor head trauma such as brain concussion (Glasgow Coma Scale (GCS) > or = 13). One hundred fifty patients aged 2 to 14 years (average, 6 years) were divided into three groups (n = 50 in each group). Group 1 included patients admitted to the emergency department for brain concussion (Glasgow Coma Scale (GCS) > or = 13); group 2 included patients admitted for fractures of long bones without head injury; and group 3 were control patients electively admitted for hernia repair. All patients had complete physical and neurological examinations. Complete blood count and blood chemistry were obtained on admission. All blood tests were repeated at 6, 12, and 24 hours in patients belonging to group 1. An electrocardiogram was obtained in selected patients and catecholamine levels were measured in some patients. Statistical analysis was performed using analysis of variance (ANOVA). Serum potassium and sodium levels in patients with brain concussion (group 1) were 3.6 +/- 0.6 and 136 +/- 3 mEq/L, respectively and were significantly lower (P < 0.01) than those in patients belonging to group 2, 4 +/- 0.4 and 138 +/- 3, respectively, and the controls (group 3), 4.2 +/- 0.5 and 140 +/- 2, respectively. Serum glucose level was 124 +/- 34 and 118 +/- 32 mg% in groups 1 and 2 and was significantly higher than that of the controls (group 3), 90 +/- 23 mg%. There was no correlation between serum electrolytes and GCS. No electrocardiogram changes or elevation of serum catecholamines were found. Hypokalemia resolved spontaneously within 24 hours. All patients recovered without neurological sequalae. Transient hypokalemia frequently occurs in children even with minor head trauma. This hypokalemia resolves spontaneously, without treatment and within 24 hours.
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PMID:Brain concussion produces transient hypokalemia in children. 902 78

Paraduodenal hernia is a rare condition in which the small bowel loops are herniated into an unusual fossa in the periduodenal area. We treated a patient with paraduodenal hernia diagnosed preoperatively. A 28-year-old woman was admitted to our hospital because of intermittent abdominal pain. Abdominal ultrasonography revealed a large tumor adjacent to the pancreas. Provisional diagnosis made according to computed tomography (CT) findings was tumor of the pancreas tail. However, on a CT scan performed after the administration of diatrizoate meglumine/diatrizoate sodium (Gastrografin, Schering, Berlin, Germany) the mass was shown as a jejunum loop located between the stomach and the pancreas body. Subsequent laparotomy revealed that the jejunum loop was herniated into an unusually large mesocolic fossa and that the hernial orifice was covered by the adhesion between the transverse and descending colons. It seemed that the small intestine within the mesocolic fossa was strangulated by this adhesion. The patient's abdominal pain resolved postoperatively. These observations suggest that paraduodenal hernia should be suspected in patients with chronic, atypical abdominal pain, regardless of the findings for small bowel obstruction.
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PMID:Unusual variant of left paraduodenal hernia herniated into the mesocolic fossa leading to jejunal strangulation. 977 41


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