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

In patients about to have hernia repair, preoperative screening studies for early colorectal cancer using the rigid proctosigmoidoscope and barium enema have previously shown minimal cost effectiveness and poor patient acceptance. Flexible sigmoidoscopy may be more acceptable to patients and of greater diagnostic value. Between October 1980 and December 1983, 100 consecutive asymptomatic male surgical patients were examined using the Olympus 60 flexible proctosigmoidoscope. All patients were admitted for elective hernia repair. Age ranged from 21 to 88 years (mean 59.7). All patients with stool positive for occult blood on admission were excluded from this study. In addition, patients with any gastrointestinal symptoms, history of colorectal disease, or family history of colorectal polyps or carcinoma were excluded. Examinations were done under direct supervision of an attending surgeon (W.W. or C.S.C.). Of the 22 patients who had one or more benign polyps, three had villous adenomas. Two additional patients had carcinoma. Results of examination were completely normal in 63, while 13 patients were found to have hemorrhoids or diverticular disease. There were no complications and the procedure was well tolerated by all patients.
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PMID:Flexible sigmoidoscopy as a screening procedure for asymptomatic colorectal carcinoma in patients with inguinal hernia. 407 Nov 66

Seventy-one patients presenting for elective hernia repair without gastrointestinal symptoms were screened for occult blood in their stools. All patients had stools negative for occult blood and were studied with proctosigmoidoscopy and barium enema. Polyps were found in 10% of the study population. The potential for missing polyps definitely exists if patients are selected for further studies only on the basis of tests for occult stool blood.
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PMID:Screening for occult blood in selected patients. The potential for false-negatives. 648 47

We studied the anatomy of the esophageal hiatus using axial CT scans in 320 patients. Normally, the diaphragmatic crura are tightly opposed and closely related to the esophagus. Widening of the esophageal hiatus is readily demonstrated by CT as a separation of the diaphragmatic crura and an increased distance between the crura and esophageal wall. The incidence of widening increases with age, lending support to the hypothesis that the abnormality is acquired. In 100 patients who also had barium studies of the upper gastrointestinal tract, a sliding hiatus hernia was found in 37/43 (86.4%) patients who had a widened esophageal hiatus shown by CT. In 26 of 37 (70.2%) patients, the hernia was demonstrated on CT as a pseudomass usually filled with contrast material lying within and/or above the esophageal hiatus. Small hiatus hernias were shown without a widened esophageal hiatus in only two patients.
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PMID:Incidence and significance of a widened esophageal hiatus at CT scan. 650 34

Oesophageal emptying was studied with scintigraphy, radiography, and the acid clearing test (ACT) in 18 patients reporting dysphagia and previously operated on with fundoplication. Radiography with contrast medium, isodense with water, revealed abnormalities in either motility or emptying capacity in 39% (7/18). A A barium meal showed abnormalities--that is, a tight repair, disruption of the fundoplication, or recurrence of the hernia--in 56% (10/18). The ACT was prolonged in 40% (6/15) of the patients. Pathological findings at scintigraphy with a solid bolus were found in 67% (12/18). Even if scintigraphy with a solid bolus is the method that identifies the highest number of patients with impaired oesophageal function among the tests used, it cannot differentiate between functional and anatomical disorders. A barium meal examination is the method of choice when an anatomical disorder is suspected.
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PMID:Scintigraphy, radiography, and acid clearing in dysphagia patients after anti-reflux surgery. 653 75

The author presents the results of a new surgical technique for the reconstruction of the gastrointestinal tract after gastrectomy. It was utilized in 36 patients (ten with total, 16 with subtotal and seven with minimal radical gastrectomy and also three cases of post-gastrectomy syndrome). The initial methodology, using the lost tie (group striction (GST)) to the duodenojejunal reservoir was not successful since it showed recanalization and consequent refluxing esophagitis (55,5%). For that reason, we changed to a complete section of the intestinal loop (group section (GS)). The follow up period ranged from one to 49 months. The following complications were observed: incisional hernia, one case (GST); early postoperative period death (19th day), one case (GS); dumping syndrome, one case (GST); bilious vomiting, two cases (GS); diarrhea, four cases (one GST and three GS). Clinically, in the late follow up of patients without recurrency of neoplasia, 17 of them have gained weight, four have lost weight and two were unaltered. Laboratory tests such as amilasemia, hematologic, proteins and glycemia were favorable to the method. Postoperative function, studied roentgenologically, showed that the average time emptying of the remmant stomach was 115 minutes in the subtotal resections and 82 minutes in total resections. The filling of the reservoir by the barium solution ranged from 40 to 60%; this variation depended on whether the duodenum was in peristalsis or antiperistalsis. Late death occurred in 13 patients, none because of the proposed technique.
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PMID:[An antiperistaltic duodenojejunal pouch in the reconstruction of digestive transit after subtotal and total gastrectomy and in the postgastrectomy syndrome. Results]. 653 56

Three cases of traumatic intrapericardial diaphragmatic hernia are reported. The defect was limited to the central tendon of the diaphragm in all 3 cases with herniation of the transverse colon (n = 2) or small bowel (n = 1) into the pericardial sac. A correct preoperative diagnosis was made in all 3, using a dilute barium meal in 2 patients, and from the chest X-ray examination alone in 1. Successful operative repair was performed. Previous reports suggest that barium studies of the gastrointestinal tract are the most accurate method of diagnosis but should be used with caution as they may precipitate cardiac tamponade through distension of herniated bowel.
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PMID:Traumatic pericardiophrenic hernia: a report of 3 cases. 682 96

Infants with congenital diaphragmatic hernia (CDH) die because their lungs are hypoplastic. If hypoplasia is a developmental consequence of compression by herniated viscera, decompression before birth may allow pulmonary development and survival at term. A conical silicone rubber balloon progressively inflated (60 to 150 ml) in the left hemithoraxi of fetal limbs (days 100 to 145) simulated compression by growing viscera ("CDH"). Six of six neonates delivered by cesarean section died of severe respiratory insufficiency, despite maximal resuscitation. Lungs were hypoplastic. Lung weight and air capacity were significantly reduced (P less than 0.01) as compared with controls. Pressure-volume curves revealed decreased compliance and barium gelatin injections revealed decreased cross-sectional area of the pulmonary vascular bed. Deflation of the balloon at day 120 (simulated "correction") allowed sufficient lung growth and development to alleviate respiratory insufficiency and to assure survival in five of five lambs delivered by cesarean section. Simulated correction produced a significant (P less than 0.01) increase in lung weight, air capacity, compliance, and area of the pulmonary vascular bed. Efficacy of in utero correction was confirmed by three twin studies in which simulated CDH in one twin was compared with simulated correction in the other. Infants with CDH may be salvaged by in utero correction.
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PMID:Correction of congenital diaphragmatic hernia in utero. II. Simulated correction permits fetal lung growth with survival at birth. 689 89

One case of a para-oesophageal hernia and ten cases of gasto-oesophageal reflux with or without hiatal hernia are reviewed. Vomiting commenced from the first week of life and in three children progressed to stricture formation. Pulmonary manifestations of gastro-oesophagela reflux were intractable asthma and attacks of bronchiolitis. A surgical operation performed through the abdomen was successful in controlling the reflux in all cases. Follow-up barium studies in all cases showed no hernia recurrences. A conservative approach to fibrous reflux strictures has been adopted and it is found that these can be cured by dilatations once the reflux has been controlled.
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PMID:Gastro-oesophageal reflux and hiatal hernia in children. 693 48

Experience with 42 cases of traumatic diaphragmatic hernia is reviewed. The correct diagnosis was most readily made when: (1) the injury was recent, (2) the tear was left sided and large with readily identifiable structures herniated, (3) appropriate diagnostic procedures were carried out (chest film, upper gastrointestinal examination, barium enema study, nuclear liver scan, computed tomography), and (4) a high index of suspicion was maintained. The diagnosis was likely to be missed when: (1) the history of trauma, usually remote, was not obtained or was disregarded, (2) the hernia was right sided with herniation of the liver or other solid (water density) organs, or (3) diagnostic tests were not properly correlated (i.e., abnormal barium enema and chest film) or were not obtained. The rather characteristic appearance of herniated liver on the nuclear liver/spleen scan is noted and its use rather than pneumoperitoneum is recommended.
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PMID:Traumatic diaphragmatic hernia: errors in diagnosis. 697 24

Right paraduodenal hernias are uncommon. Approximately 50 cases have been reported and 2 more are reported in this paper. The diagnosis of internal hernia should be considered in all patients with abdominal cramps and intermittent small bowel obstruction. The most valuable investigation is roentgenography of the small intestine after barium ingestion; this usually shows a clumping of the intestine, as in a bag, with incomplete rotation of the cecum and ascending colon. Duodenal hernias should be treated surgically even if they are asymptomatic, because they may cause potentially lethal complications such as obstruction. gangrene or bowel perforation.
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PMID:Right paraduodenal hernia. 705 68


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