Strangulated umbilical hernia with external fecal fistula. Management by delayed definitive surgery.
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Biomedical subjects
Publications and source records attributed to I H Friedman.
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Cystadenomas of the appendix are an unusual clinical entity. Despite a recognized constellation of findings, the diagnosis is not usually made prior to surgical exploration. A 65-year-old man is reported in whom preoperative evaluation, including sonography and angiography, resulted in the correct diagnosis confirmed at surgery. The appropriate use of newer diagnostic modalities will establish the preoperative diagnosis and facilitate surgical intervention. Appendectomy is curative for this condition, as neither regional nor distant lymph node metastases or hematogenous spread have been reported. When symptoms due to pseudomyxoma peritoneai occur, a continued aggressive surgical approach is justified.
Pericecal hernia is a rare type of internal hernia and, though congenital in origin, may occur at any age, usually with symptoms of acute intestinal obstruction. The pathophysiology and character of these defects are described, and the management of this situation in an 80-year-old patient is reported. Prompt operative intervention to avoid the associated high mortality secondary to strangulation is urged. It is suggested that closure of these defects be performed if incidentally found at laparotomy.