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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hernial strangulation of Meckel's diverticulum (Littre's hernia) is a rare anatomoclinical form. It represents 10% of all complications of Meckel's diverticulum (8.8% of our cases), and complications like hemorrhage, perforation and diverticulitis are fairly frequent. Four cases of Littre's hernia are presented: two males and two females, with an average age of 67 years (range 50-83 years), representing 0.08% of all the inguinal-crural hernias operated in the department. The clinical manifestations were those of intestinal obstruction because a mixed type Littre's hernia was involved, with compromise of the diverticulum and its intestinal loop. Preoperative diagnosis is unlikely in strangulation without disturbances in the intestinal transit and, in fact, is even less likely if it is accompanied by obstruction. The diagnosis is thus almost always intraoperative. The correct treatment is surgery after restoring the patient's hemodynamic equilibrium. Simple and/or loop diverticulectomy via herniotomy, herniolaparotomy or laparotomy are debated. We think that this disorder can generally be resolved using the inguinal approach, as in any strangled hernia, with the technical option of using a larger, more comfortable and safer approach in cases of important obesity and/or deterioration of the loop (necrosis, perforation). In elderly patients with uncomplicated Littre's hernia and Meckel's diverticulum, abstention from diverticular exeresis may be justifiable. Of the four patients, the first two died from cardiogenic shock and pulmonary embolism, respectively; the last two evolved well (except for a wound abscess).
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PMID:[Hernial strangulation of Meckel's diverticulum: Littre's hernia. Apropos of 4 cases]. 261 52

Over a 42-month period, 210 patients had a lower midline incision, usually extending around the umbilicus, that was closed with a continuous, running number 2 polypropylene suture. Patients in this study had various predisposing factors for wound disruption. Over 60% were operated upon because of gynecologic cancer. Additional high-risk factors included obesity in 56%, diabetes in 28%, previous irradiation or chemotherapy in 17%, and ascites in 8%. The operative procedures performed ranged from hysterectomies with node sampling to bowel resections and exenterations; wound complications were noted in seven patients. One patient had an incisional hernia. No eviscerations occurred. The closure is safe, expedient, and cost-efficient, and distributes tension equally over a continuous line.
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PMID:Primary mass closure of midline incisions with a continuous running monofilament suture in gynecologic patients. 264 26

Carpenter syndrome (ACPS type II) was first described by Carpenter in 1901. The syndrome consists of acrocephaly, soft tissue syndactyly, brachy- or agenesis mesophalangy of the hands and feet, preaxial polydactyly, congenital heart disease, mental retardation, hypogenitalism, obesity, and umbilical hernia. Here we review the literature on Carpenter syndrome and add 2 affected sibs with marked intrafamilial variability. This review showed that 2 reported variations of Carpenter syndrome, Goodman and Summitt syndromes, actually fall within the clinical spectrum of this disorder. This confirms earlier suggestions of Gorlin (personal communication 1982) and Hall et al [Am J Med Genet 5:423-434, 1980].
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PMID:Acrocephalopolysyndactyly type II--Carpenter syndrome: clinical spectrum and an attempt at unification with Goodman and Summit syndromes. 332 2

CT of the abdomen was performed on 14 adult patients 2-25 months after laparotomy in order to evaluate intraabdominal processes. Clinically unsuspected incisional hernias were detected in all cases. These herniations were not disclosed by previous physical examination because of the patients' obesity, abdominal pain, distension, or various other factors. However, CT scans showed the exact size, location, and content of each incisional hernia. The evaluation of postsurgical abdomen by CT should include a careful assessment of previous laparotomy sites in search of occult incisional hernias that may be the source of the patient's abdominal symptoms.
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PMID:CT diagnosis of occult incisional hernias. 349 3

In order to study the problems of surgery for incisional hernia and its prognosis, 657 patients who had undergone surgery for incisional hernia between January 1974 and December 1983 in 27 hospitals were analyzed statistically by questionnaire survey. These patients consisted of 571 in whom surgery was performed for the first time and 86 in whom surgery was carried out for recurrent hernia. The ratio of male to female patients with initial surgery was 1:2.4, showing a higher frequency in females than in males. Initial surgery was most frequently carried out in the patients' 50s and 60s. The most common procedure which caused hernia was a median incision in 299 (51.6%), followed by an incision of the right hypogastrium for appendectomy in 211 (36.4%). There were many patients with systemic complications such as obesity, diabetes and asthma. The recurrence rate after radical surgery for incisional hernia was 9.1%. There was a tendency for the recurrence rate to be high in elderly patients and those who had had systemic complications (obesity, diabetes and asthma) preoperatively. The rate was very high, 33.3%, in patients with postoperative wound infection. The recurrence rate in patients with surgery for recurrent hernia was about three times as high as the 7.3% for patients with initial surgery. When the rate was determined by procedure, it was 2.4% for patients treated by a mesh prosthesis, 9.4% for those treated by celiorrhaphy and closure, and 16.7% for those treated by the overlap method. Mesh prosthesis was considered the best procedure, particularly for recurrent hernia.
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PMID:[Surgery of incisional hernia and its prognosis--statistical analysis in 657 patients]. 352 14

Many factors seem to influence the recurrence rate after adult inguinal hernia repair. A statistical analysis of data derived from 726 transversalis fascia repairs examined by the authors (with a follow-up rate of 82.5% and a mean follow-up time of 5.5 years) revealed a significantly higher recurrence rate in patients with chronic bronchitis (p less than 0.05) or with postoperative complications (p less than 0.001). Lower recurrence rates were found after resection of lipomas of the cord (p less than 0.01) or cremasteric muscle resection (p less than 0.05). No significant difference of recurrence rate could be established for following parameters: Sex, side, age distribution, profession, prostatism, obesity, type of hernia (direct, indirect, combined, sliding), suture material (silk, polyglycolic acid), surgeon, anesthesia (local, spinal, full), elective or emergency operation, and whether the repair was unilateral or simultaneously bilateral. Recurrent repairs showed no significantly higher recurrence rate than primary repairs.
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PMID:[10 years' experience using a modified Shouldice surgical technic for inguinal hernia in adults. II. Which factors modify the recurrence of inguinal hernia?]. 355 81

Physical examinations were performed and personal histories were obtained for 496 12-14-year-old inner city, middle school students participating in extracurricular activities. Health problems were identified in 47 (9.5%) students. The most common health problems were hypertension (5 students), cardiac arrhythmia (8), hernia (5), genital abnormality (6), and obesity (8). Of those students with a medical problem, 72% were male and 28% were female. A subset of 276 students, with a mean age of 13 years, was questioned about sexual activity. 21% of these students (36% of the males and 12% of the females) reported having experienced sexual intercourse. 47% of these students reported using condoms, 12% relied on oral contraception, and 32% used no method of birth control. Parents were cited as the source of knowledge about sex by 53%. 21% of the females sampled had not reached menarche. Self-injurious behavior such as cigarette smoking and alcohol use was reported by only 1% of students. Overall, these findings suggest that inner city, middle school students have general and reproductive health care needs that require early intervention so preventive practices can be established. The data further indicate a need for early sex education in the schools; only 9% of students stated they had received information on sex from a teacher or clergy.
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PMID:Health problems and sexual activity of selected inner city, middle school students. 364 Jan 25

This retrospective analysis of 140 continuous ambulatory peritoneal dialysis patients followed during a 4 year period revealed a 5 percent incidence of abdominal wall hernias. Inguinal hernias were frequently manifested as unilateral scrotal swelling. Hernias too small to be appreciated by physical examination were easily demonstrable with intraperitoneal instillation of technetium 99m sulfur colloid through the continuous ambulatory peritoneal dialysis catheter. This procedure was also useful when differentiating dialysate leaks from inguinal hernia in the early and late postoperative periods. Recurrences developed in 27 percent of the herniorrhaphies. Factors contributing to the development of abdominal wall hernias in continuous ambulatory peritoneal dialysis patients include uremia, obesity, anemia, and chronically elevated intraperitoneal pressures.
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PMID:Abdominal wall and inguinal hernias in continuous ambulatory peritoneal dialysis patients. 403 96

Details of the techniques and technical problems encountered in over 1000 tubal ligations in Milne Bay Province, Papua New Guinea are described. Discussed are patient selection, preparation and anesthesia, opening the abdomen, finding and ligating the tubes and wound closure. Problems addressed include inadequate anesthsia, difficulty finding the fallopian tubes, adhesions, obesity, a full bladder, the possibility of a tiny umbilical hernia adjacent to the incision and unexpected early ectopic pregnancies. As many grand multiparas from remote villages find it difficult to leave their large families and go to a faraway hospital, they will gladly have the operation done at a nearby health center. Details of techniques and problems that may be encountered when operating at rural health centers are described. It is stressed that tubal ligations must be safe, as painless as possible, and that the patient must not be kept waiting too long for surgery, or she may become frightened and change her mind. It is argued that laparascopy offers no real advantage to an experienced operator in a rural hospital. Tubal ligation can be done more simply and safely by an experienced surgeon under direct vision, using local anesthesia. The methods outlined in this paper have been successful. In the 1st year the method was adopted, 80 patients came for tubal ligation, 139 in the 2nd, 193 in the 3rd and 282 in the 4th year. There were no deaths or serious complications. It seems likely that many maternal and neonatal deaths were prevented by admitting numerous grand multiparas to hospital for delivery and tubal ligations. Tubal ligation used in an appropriate and safe way is preventive surgery. It is often the cheapest and most effective family planning method for women from remote villages.
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PMID:Tubal ligation with local anaesthesia. 404 7

During the last 18 years we have treated few hundreds of patients with large incisional hernias. In more than the half of the cases our surgical procedure followed 3, 4 or even 5 previous surgical operations. In about 160 patients the hernia was connected with obesity, and in 25 females with pendulous abdomen. Our results were good due to anatomic and plastic reconstruction of the abdominal wall, and in case of the tension in the suture line--the application of decompression sutures or the implantation of knitted nets.
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PMID:Reconstructive operation of large incisional hernias. 622 Feb 66


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