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

Sportsman's hernia is an increasingly recognized cause of chronic groin pain in athletes. Although the definition is controversial, it is a condition of chronic inguinal/pubic exertional pain caused by rectus abdominal wall weakness or injury without a palpable hernia, usually affecting high-performance male athletes. Diagnosis is made after careful history and physical examination. Some radiographic studies such as ultrasound or MRI may be helpful in evaluating these patients and ruling out other pathology, although no radiographic study can rule out sportsman's hernias. Because sports hernias are not true hernias but an injury in the rectus insertion, unilateral or bilateral rectus reattachment is the most appropriate surgical treatment. This reattachment may be done in combination with adductor release in the setting of adductor pain or weakness on physical examination. Other surgical repairs (eg, Lichtenstein, Shouldice, Kugel, laparoscopic) do not stabilize the pelvis and tend not to be as successful. In the motivated patient, after surgical repair and physical rehabilitation, 95% are free of pain and able to return to competitive sports.
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PMID:Sports hernias. 1797 64

We present a case of an 81-year-old woman, without medical history, with a swelling in the right lateral abdominal wall. Ultrasound and multislice CT were sufficient to confirm the diagnosis of a herniated gall bladder through the abdominal wall. This is the first case in which MRI proved to be a useful modality to exclude malignant characteristics and revealed an accurate differentiation between the gall bladder and the different layers of the abdominal wall. The gall bladder, including three stones, was removed laparoscopically. Histopathological research revealed signs of a chronic cholecystitis. Herniation of the gall bladder through the abdominal wall is rare. It was previously described in a few cases, but they were associated with the presence of an incisional hernia or carcinoma infiltration.
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PMID:Herniation of the gall bladder through the abdominal wall. 1799 Oct 89

This case report concerns a previously healthy thirty-five-year-old female with complaints of inguinal hernia that ultimately proved to be a retroperitoneal haematoma. The patient suffered from a car accident 5 months before admission and was hospitalized. During her prior hospitalization, explorative laparotomy revealed a haematoma of the mesentery. The haematoma was treated conservatively, with fluid resuscitation and rest. During her second admission, MRI of the inguinal region revealed localized haematoma. During inguinal exploration, a fluid-filled bluish indirect hernia sac was identified and found to be contoured by free-flowing, non-clotting blood. The postoperative course was uneventful, and the patient was discharged six days following surgery.
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PMID:Groin swelling, the anatomic way out of abdominal haematomas: a case report and explicative literature review. 1855 54

This review summarises the existing knowledge about pathogenesis, differential diagnosis, conservative treatment, surgery and post-surgical rehabilitation of sports hernias. Sports hernias occur more often in men, usually during athletic activities that involve cutting, pivoting, kicking and sharp turns, such as those that occur during soccer, ice hockey or football. Sports hernias generally present an insidious onset, but with focused questioning a specific inciting incident may be identified. The likely causative factor is posterior inguinal wall weakening from excessive or high repetition shear forces applied through the pelvic attachments of poorly balanced hip adductor and abdominal muscle activation. There is currently no consensus as to what specifically constitutes this diagnosis. As it can be difficult to make a definitive diagnosis based on conventional physical examination, other methods, such as MRI and diagnostic ultrasonography are often used, primarily to exclude other conditions. Surgery seems to be more effective than conservative treatment, and laparoscopic techniques generally enable a quicker recovery time than open repair. However, in addition to better descriptions of surgical anatomy and procedures and conservative and post-surgical rehabilitation, well-designed research studies are needed, which include more detailed serial patient outcome measurements in addition to basing success solely on return to sports activity timing. Only with this information will we better understand sports hernia pathogenesis, verify superior surgical approaches, develop evidence-based screening and prevention strategies, and more effectively direct both conservative and post-surgical rehabilitation.
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PMID:Sports hernias: a systematic literature review. 1860 84

Intrathoracic renal ectopia as a result of a congenital diaphragmatic hernia (CDH) is a rare congenital anomaly. We present a case in which the prenatal diagnosis of an ectopic intrathoracic kidney was made on routine anatomical survey at 28 weeks' gestation. Color doppler sonography imaging revealed the renal artery coursing into the infant's thorax and was consistent with CDH, but fetal MRI suggested an intact diaphragm. However, neonatal evaluation confirmed the diagnosis of intrathoracic kidney with posterior CDH, which was repaired without complication. In contrast to diaphragmatic hernia with liver or bowel herniation, infants with intrathoracic ectopic kidneys generally do well.
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PMID:Prenatal diagnosis of ectopic intrathoracic kidney in a fetus with a left diaphragmatic hernia. 1861 74

Tarlov cysts and nerve roots anomalies usually involve lumbosacral roots and are often asymptomatic. MRI has enabled recognition of many conditions that used to be missed by CT or myelography investigations performed for back and leg pain. However, even without additional compressive impingement (disc hernia, spondylolisthesis or lumbar canal stenosis) these anomalies can be responsible for sciatica, motor deficit and bladder sphincter dysfunction. Tarlov cysts are perinervous dilatations of the dorsal root ganglion. CT and especially MRI can reveal these cysts and their precise relations with the neighboring structures. Delayed filling of the cysts can be visualized on the myelogram. MRI is more sensitive than CT myelography for a positive diagnosis of nerve root anomalies, a differential diagnosis with disc hernia and classification of these anomalies. Surgical treatment is indicated for symptomatic Tarlov cysts and nerve root anomalies resistant to conservative treatment. Better outcome is observed in patients with an additional compressive impingement component. We report two cases of sciatica: one caused by Tarlov cysts diagnosed by MRI and the other by nerve root anomalies diagnosed by CT myelography. In both cases, conservative treatment was undertaken. The clinical, radiological and therapeutic aspects of these disorders are discussed.
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PMID:[Sciatica due to unusual causes: Tarlov cysts and nerve roots anomalies]. 1880 89

Symptoms and findings during physical examination of patients with a femoral hernia are notoriously aspecific. Signs in the inguinal region tend to be overlooked, particularly in obese patients. Three women aged 72, 83 and 68, presented with abdominal pain and ileus due to incarcerated femoral hernias. A correct diagnosis was not considered prior to emergency laparotomy. One progressively septic patient with disseminated breast cancer refused reintervention after successful correction of the femoral hernia, and succumbed. The other two recovered uneventfully. Any older female patient with recurrent abdominal complaints may harbour a femoral hernia. The inguinal region should be examined, if possible in the upright position. Ultrasound, CT or MRI scans should establish the diagnosis. Open or laparoscopic intervention is required in patients fit for surgery since incarceration of a femoral hernia is associated with considerable morbidity and even mortality.
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PMID:[Elderly women with abdominal pain due to an incarcerated 'femoral hernia']. 1899 63

Inguinal endometriosis is a rare manifestation of endometriosis. Four cases are presented. In three of these cases proper diagnosis was delayed due to differential diagnostic difficulties as the symptoms in these cases were interpreted as hernia. In two cases the patient underwent hernia surgery. In inguinal lump cases in fertile women, endometriosis should be considered if accompanied by dysmenorrhoea or deep dyspareunia. In such cases MRI (magnetic resonance imaging) scans often yield further diagnostic information. If surgery is needed, it should be performed in a gynaecological setting to facilitate full surgical intervention including abdominal laparoscopy and excision.
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PMID:[Inguinal endometriosis]. 1920 35

Interstitial deletions of 7q11.23 cause Williams-Beuren syndrome, one of the best characterized microdeletion syndromes. The clinical phenotype associated with the reciprocal duplication however is not well defined, though speech delay is often mentioned. We present 14 new 7q11.23 patients with the reciprocal duplication of the Williams-Beuren syndrome critical region, nine familial and five de novo. These were identified by either array-based MLPA or by array-CGH/oligonucleotide analysis in a series of patients with idiopathic mental retardation with an estimated population frequency of 1:13,000-1:20,000. Variable speech delay is a constant finding in our patient group, confirming previous reports. Cognitive abilities range from normal to moderate mental retardation. The association with autism is present in five patients and in one father who also carries the duplication. There is an increased incidence of hypotonia and congenital anomalies: heart defects (PDA), diaphragmatic hernia, cryptorchidism and non-specific brain abnormalities on MRI. Specific dysmorphic features were noted in our patients, including a short philtrum, thin lips and straight eyebrows. Our patient collection demonstrates that the 7q11.23 microduplication not only causes language delay, but is also associated with congenital anomalies and a recognizable face.
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PMID:Fourteen new cases contribute to the characterization of the 7q11.23 microduplication syndrome. 1924 92

Unilateral pulmonary anomalies are rare events of unknown etiology and large clinical variability. Neonatal history does not allow for a reliable prognosis. Interdisciplinary mangament includes prenatal diagnostics and obstetrics, genetics, neonatology, pediatric cardiology and surgery as well as pediatric orthopedics. Neonatal history and long-term follow-up in three patients are presented here including a discussion of prenatal diagnostics and the embryo-genetic basics of lung development. In three term neonates the diagnoses of unilateral pulmonary agenesis, aplasia and dysplasia, respectively, were based on angiography, MRI and bronchoscopy. Neonatal presentation and long-term consequences were studied in the context of the current literature. Neonatal complications ranged from mild repiratory distress to pulmonary failure requiring mechanical ventilation. One patient developed scoliosis on long-term follow-up. Cardiac failure or pulmonary hypertension did not occur during follow-up, in one case lung malformation was accompanied by VACTER-association. Unilateral lung malformation is frequently associated with other, singular or complex anomalies (e.g., renal and vascular). A possible relationship to disrupted regulation of embryo-genetic factors such as T-BOX genes, PITX2 and growth factors ( FGF10), which regulate ASYMMETRICAL pulmonary morphogenesis is discussed. Disruptive unilateral pulmonary malformations may serve as a model for embryological lung development and other anomalies (e.g., congenital diaphragmatic hernia, unilateral hypoplasia and CCAM). Prenatal diagnosis is characterized by unilateral hyperechogenicity of the affected lung. Neonatal presentation is determined by mediastinal shift which may be corrected by tissue-expander implantation. Associated anomalies require cytogenetic analysis and sequencing of currently known mutations. Long-term follow-up by echocardiography and pulmonary function testing is mandatory in these patients.
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PMID:[Unilateral pulmonary agenesis, aplasia and dysplasia]. 1931 94


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