1/55. Ultrasonographic detection of herniation of stomach in paraumbilical hernia.A patient with a paraumbilical hernia containing the stomach is reported for its imaging curiosity. ultrasonography showed a cystic mass in the anterior abdominal wall in the epigastrium with a defect in the linea alba. Evaluation by barium meal study showed complete obstruction to contrast in distal part of the stomach. On exploration, the stomach was found in the hernial sac with constriction in the body of the stomach.- - - - - - - - - - ranking = 1keywords = herniation (Clic here for more details about this article) |
2/55. Dynamic reconstruction of the abdominal wall using a reinnervated free rectus femoris muscle transfer.Dynamic reconstruction of the abdominal wall using a free reinnervated rectus femoris muscle and an island tensor fascia lata transfer was performed for a large herniation with loss of the bilateral rectus abdominis muscles of the abdominal wall. The tensor fascia lata transfer was used to close an inner side of the abdominal defect, and the rectus femoris muscle replaced the rectus abdominis muscle deficit. The motor nerve of the rectus femoris muscle was sutured to the motor branch of the intercostal nerve. Postoperatively, the transferred rectus femoris muscle was reinnervated via electromyography, and there was no abdominal protrusion and no hernia recurrence.- - - - - - - - - - ranking = 0.25keywords = herniation (Clic here for more details about this article) |
3/55. hernia at 5-mm laparoscopic port site presenting as early postoperative small bowel obstruction.A decade has passed since laparoscopy became a popular tool in general surgery. New technologies continue to surface, and surgeons are still trying to expand the applications of this technique. Parallel to the development of new techniques, we are also measuring the presentation of new complications. Incisional hernias are not new complications. Although their avoidance has been one of the proposed benefits of laparoscopy, several cases of port-site hernias have been reported. Current surgical wisdom suggests closure of 10-mm or larger port sites to avoid herniation. Most surgeons do not routinely close 5-mm port sites, believing that such fascial defects are not large enough to create a significant risk of hernia formation, thus not justifying the extra time and effort needed to close them. Although this practice may be reasonable for most cases, it should be reconsidered in lengthy procedures, particularly if the port has been used for active operative instruments. Under these circumstances, the repetitive motions in different directions may cause the 5-mm defect to enlarge significantly, allowing a hernia of considerable size to develop, with the obvious clinical implications of such a complication. We present a case of a hernia through a 5-mm port site presenting as small-bowel obstruction in the early postoperative period after a laparoscopic paraesophageal hernia repair.- - - - - - - - - - ranking = 0.25keywords = herniation (Clic here for more details about this article) |
4/55. Endoscopically assisted "components separation" for closure of abdominal wall defects.The repair of ventral hernia defects of the abdominal wall challenges both general and plastic surgeons. Ventral herniation is a postoperative complication in 10 percent of abdominal surgeries; the repair of such defects has a recurrence rate as high as 50 percent. The "components separation" technique has successfully decreased the recurrence rates of ventral abdominal hernias. However, this technique has been associated with midline dehiscence and a prolonged postoperative stay at the authors' institutions. The purpose of this study was to determine whether endoscopically assisted components separation could minimize operative damage to the vasculature of the abdominal wall and decrease postoperative wound dehiscence. The study group consisted of seven patients who underwent endoscopically assisted components separation; the control group consisted of 30 patients who underwent open components separation. The two groups were similar regarding demographic data and defect size. The endoscopic group had a higher initial success rate than the open group (100 versus 77 percent). recurrence rates were not significantly different between the two groups. However, the endoscopically assisted components separation patients had fewer postoperative and long-term complications. In the authors' experience, endoscopically assisted components separation has proved to be a safe and effective method for the repair of complicated and recurrent midline ventral hernias.- - - - - - - - - - ranking = 0.25keywords = herniation (Clic here for more details about this article) |
5/55. Ventral hernia of the urinary bladder with mixed urinary incontinence: treatment with herniorrhaphy and allograft fascial sling.Abdominal hernias are not rare in women with urinary incontinence, but incisional bladder hernia is uncommon. The presenting symptoms in the rare cases reported included suprapubic discomfort, irritative voiding symptoms, and urinary incontinence. We present a patient with bladder herniation and severe mixed urinary incontinence. The pathophysiology of the urinary symptoms and the surgical alternatives for the correction of this condition are discussed.- - - - - - - - - - ranking = 0.25keywords = herniation (Clic here for more details about this article) |
6/55. Richter's hernia: an unusual presentation.Richter's hernia is an unusual form of herniation. The incarceration accompanying the hernia invariably leads to bowel ischemia. Chronic incarceration of the antimesenteric border of the intestine, presenting with a long-standing history of signs and symptoms with no dire consequences is unusual. We present a case with a typical acute presentation, and the only case we are aware of with a chronic incarceration leading to a true diverticulum of the hepatic flexure.- - - - - - - - - - ranking = 0.25keywords = herniation (Clic here for more details about this article) |
7/55. Recurrent ventral herniation in ehlers-danlos syndrome.ehlers-danlos syndrome is an inherited collagen disorder characterized by skin hyperextensibility, joint laxity, and tissue friability. In this study, it was hypothesized that ehlers-danlos syndrome is frequently undiagnosed in patients who present for repair of ventral abdominal wall hernias. A retrospective chart review was conducted, and patients who had presented for elective repair of recurrent abdominal wall herniation were identified. In all patients, one or more prior attempts at repair with either mesh or autologous tissues had failed. patients in whom abdominal wall components were lost secondary to extirpation or trauma, patients who had required acute closure, and patients with less than 2 months of follow-up were excluded. Twenty patients met these criteria. Twenty cases of recurrent ventral hernia repairs were reviewed, with special attention to identification of the preoperative diagnosis of ehlers-danlos syndrome. patients ranged in age from 29 to 75 years, with a mean age of 54 years. Five patients were male (25 percent), and 15 were female (75 percent). The majority (95 percent) were Caucasian. The most common initial procedures were gynecologic in origin (35 percent). A precise closure technique that minimizes recurrence after ventral hernia repairs was used. With use of this technique, there was only one recurrence over a follow-up period that ranged from 2 to 60 months (mean follow-up duration, 25.7 months). Two patients with ehlers-danlos syndrome were identified, and their cases are presented in this article. The "components separation" technique with primary component approximation and mesh overlay was used for defect closure in the two cases presented. The identification of these two patients suggests the possibility of underdiagnosis of ehlers-danlos syndrome among patients who undergo repeated ventral hernia repair and who have had previous adverse postoperative outcomes. There are no previous reports in the literature that address recurrent ventral abdominal herniation in patients with ehlers-danlos syndrome.- - - - - - - - - - ranking = 1.5keywords = herniation (Clic here for more details about this article) |
8/55. Left paraduodenal hernia presenting as intestinal obstruction: report of one case.We report a case of internal hernia of the small intestine in a 13-year-old boy with presentation of partial intestinal obstruction. The patient suffered from recurrent abdominal pain and chronic constipation over the past few years. An abdominal mass was suspected from clinical manifestations and images derived from abdominal echography. Upper gastrointestinal contrast study revealed poor motility at the distal jejunum with barium stasis. Follow-up film on the next day delineated medially and downwardly displaced splenic flexure and proximal descending colon. At operation, total herniation of small intestine into a retroperitoneal space through a defect on left mesocolon was noted. A left paraduodenal (mesocolic) hernia was diagnosed. The patient made an uneventful recovery after the hernia was repaired. This report provides unusual image clues of internal hernias of the small intestine presenting as ileus. Though rare, paraduodenal hernia should be taken into account in a differential diagnosis of intestinal obstruction. Early surgical intervention allows uneventful recovery to occur and also prevents the possible complication of gangrenous bowels.- - - - - - - - - - ranking = 0.25keywords = herniation (Clic here for more details about this article) |
9/55. Complication of the retroperitoneal approach: intercostal abdominal hernia.The left thoracoabdominal incision with retroperitoneal dissection offers excellent exposure of the abdominal and thoracic aorta. Disadvantages to this approach include inadequate access to the right ileofemoral arterial segments and the right renal artery. Additional difficulties with this approach include flank bulges, hernias, and neuropathy. We present a case of an incisional hernia at the tenth interspace with subsequent herniation of the left colon through this defect. CT defined the extent of this defect and ruled out other significant pathology. The patient underwent an uneventful herniorrhaphy. Abdominal-intercostal hernias have not been previously reported in association with the retroperitoneal aortic repair.- - - - - - - - - - ranking = 0.25keywords = herniation (Clic here for more details about this article) |
10/55. Incisional hernia of a normal gallbladder: sonographic and CT demonstration.The subcutaneous herniation of gallbladder through the abdominal wall is very rare, and to our knowledge, only two cases were reported previously in the literature [Clin. Radiol. 42 (1990) 283; J. Clin. Ultrasound 25 (1997) 398]. In both of these cases, the gallbladders were found to be distended. To our knowledge, the present case is the first case report in the literature in which a morphologically normal gallbladder herniated into the subcutaneous tissue.- - - - - - - - - - ranking = 0.25keywords = herniation (Clic here for more details about this article) |
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