Cases reported "Hernia, Inguinal"

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1/155. Preoperative sonographic diagnosis of sliding appendiceal inguinal hernia.

    Rarely, the appendix forms the sliding component of an inguinal hernia. We report the case of a 2-month-old boy who was preoperatively diagnosed with sliding appendiceal inguinal hernia by sonographic examination. To our knowledge, this is the first report in the literature of the preoperative sonographic diagnosis of a sliding appendiceal inguinal hernia.
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2/155. Parietal mesh abscess as an original presentation of cancer of the caecum.

    We report a case of cancer of the caecum in a 71-year-old male who presented with parietal mesh abscess. Two years before, he was treated for a right inguinal hernia by insertion of a Dacron mesh. CT scan then colonoscopy determined the existence of a voluminous caecal tumor perforated in the abdominal wall with an important abscess around the mesh. Right colectomy and parietal muscles excision were performed completed with postoperative radiochemotherapy. At 2 years, there is no evidence of recurrence. Atypical features with a hernia mesh repair associated with a sudden change in the patient's condition should alert the clinician to the possibility of a further subjacent pathological process.
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3/155. Spinal anaesthesia and meningitis in former preterm infants: cause-effect?

    meningitis associated with spinal anaesthesia is a rare but well-known complication. We report on a case of fatal bacterial meningitis following spinal anaesthesia in a former preterm infant. The aetiology of this meningitis could not be established. Former preterm infants represent a high-risk population because of their susceptibility to group B streptococcal meningitis at this age as documented in a second case. Therefore we discuss whether meningitis was consequential or coincidental with spinal anaesthesia and could have been prevented by more comprehensive preoperative laboratory screening or prophylactic antibiotics.
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4/155. Fatal carbon dioxide embolism as an unreported complication of retroperitoneoscopy.

    Retroperitoneoscopy has gained popularity because it offers a safe alternative to the more debilitating open approach and avoids postoperative ileus. However, this type of procedure carries certain disadvantages in terms of intraperitoneal effusions and hemodynamic changes. Major complications are exceptional. We describe the case of a 52-year-old man who died of carbon dioxide embolism during elective totally extraperitoneal (TEP) inguinal hernioplasty for symptomatic left indirect inguinal hernia. With the patient under general anesthesia, the retroperitoneal space was gained through a 1. 5-cm incision made below the umbilicus. During the dissection, the patient collapsed and could not be resuscitated. At autopsy, air bubbles were admixed with blood in the epicardial veins, but no injury to vessels was demonstrated. We conclude that carbon dioxide embolism usually is caused by direct puncture of major vessels during intra-abdominal procedures. However, when this complication occurs during retroperitoneoscopy, it seems related to pressure-forced entry of carbon dioxide into the venous plexus.
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5/155. Mesh plug migration into scrotum: a new complication of hernia repair.

    hernia repair is one of the most frequent operative procedures performed throughout the world. The technique has continued to evolve and we now are performing these repairs utilizing mesh as a patch and also as a plug. The mesh plug concept has been advocated by Rutkow and others. With this change in technique, we have seen a new complication of hernia repair - the migration of the mesh plug from the original hernia repair site into the scrotum. It presented as a large tender mass in the scrotum of a 45-year-old male who had had previous recurrent surgery. In addition, he again had a recurrent incarcerated hernia. Correction of the hernia and resection of the migrated mesh plug from the scrotum were carried out. It is recommended that both the patch and the plug be into position to avoid or reduce the risk of such a recurrence and plug migration.
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6/155. Necrotizing fasciitis in infancy: an uncommon setting and a prognostic disadvantage.

    Necrotizing fasciitis is a potentially fatal, progressive soft tissue infection that typically occurs in adults, and only rarely occurs in infants. Although adults in whom necrotizing fasciitis develops are commonly diabetic, malnourished, or otherwise immunocompromised, infants in whom the disease develops are typically healthy and without clear predisposing factors. Herein, however, the authors report the case of an infant with compromised immunity secondary to the manifestations and treatment of panhypopituitarism, in whom postoperative necrotizing fasciitis developed after bilateral inguinal herniorrhaphy. The diagnosis, pathological mechanism, and treatment of necrotizing fasciitis are reviewed and the distinguishing features in infants are highlighted. The combination of a low incidence and very high mortality rate associated with necrotizing fasciitis in this subgroup strengthens the need for hypercritical suspicion. early diagnosis and the prompt initiation of surgical treatment are the most essential means to improve on the prognosis for necrotizing fasciitis in infants.
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7/155. The role of ultrasound in the diagnosis of stitch granulomas following paediatric herniotomy.

    OBJECTIVE: To study the role of US in the diagnosis of stitch granulomas following paediatric herniotomy. MATERIALS AND methods: A retrospective 10-year study of herniotomies performed by a paediatric surgical service. RESULTS: Twenty children developed stitch granulomas following herniotomy. In all cases, silk sutures had been used in the repair. Masses appeared 1-10 years following surgery and were demonstrated by preoperative US in 17 patients, by CT alone in 1 patient and by both CT and US in 2 patients. CONCLUSIONS: US is an accurate and cost-effective method for evaluating stitch granulomas following herniotomy in children. The procedure is also valuable in marking the position of these foreign bodies prior to removal.
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8/155. Large abdominal wall herniae: an easy method of repair without prosthetic material, with the induction of pneumoperitoneum.

    Large abdominal wall herniae may pose problems of management, particularly in the presence of obstructive airway and cardiovascular disease. Preoperative induction of pneumoperitoneum usually permits the anatomical repair of large herniae without complications and without the use of prosthetic materials to close the defect.
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9/155. Synchronically performed laparoscopic cholecystectomy and hernioplasty.

    Cholecystectomies and hernioplasties are the two most frequently performed surgical interventions. The laparoscopic technique can be offered for the simultaneous treatment with both operating indications. The synchronical operation can give all the advantages of the minimally invasive technique. Authors had performed laparoscopic cholecystectomy with laparoscopic hernioplasty in five cases. Two inguinal and three postoperative hernias were reconstructed. The cholecystectomy was performed with a "three punction method", and the hernioplasty by using the same approach, completed by inserting a fourth assisting trocar as required. The hernial ring was covered with an intraperitoneally placed mesh, which was fixed by staplers (the so-called "IPOM-method": intraperitoneal on-lay mesh). There was no intra-, nor postoperative complication. The hernioplasty combined with laparoscopic cholecystectomy did not have effect on postoperative pain and nursing time. The return to the normal physical activity was short, similar to laparoscopic hernioplasty (in 1-2 weeks). Authors conclude that the simultaneous, synchronous laparoscopic cholecystectomy and hernioplasty is recommended and should be the method of choice because it is more advantageous for patients.
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10/155. Bladder rupture after inguinal herniotomy.

    An 18-month-old male sustained an extensive bladder injury during a routine right inguinal herniotomy. Primary closure of the remaining detrusor was performed. Three months postoperatively he could void spontaneously, but with a small, contracted bladder and bilateral vesicoureteral reflux. He was stable throughout a 6-month follow-up period. Further surgical options will depend upon the bladder capacity and the grade of reflux.
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keywords = operative
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