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PubMedDate not supplied

[Injuries to laryngeal articulations in strangulation and throttling].

During the consecutive examination of the larynges of (81) deceased persons (strangulation by hand and/or ligature, blunt force against the neck, from other persons), the cricothyroid and cricoarytenoid-articulations were prepared and opened, and capsular or articular cavity hemorrhaging was found in 30% of all cases; a clear distinction being found between effect of manual strangulation (43%) or blunt trauma (44%) on the one hand and strangulation by ligature alone (9%) on the other. The greater the extent of injury to the cartilages the more articular lesions are found as an expression of the mechanical load on the entire laryngohyoid structure.

Homicide↗
PubMed1987

Strangulated femoral hernia containing acute gangrenous appendicitis: case report and review of the literature.

The author reports the case of a 69-year-old woman with acute gangrenous appendicitis in a strangulated right femoral hernia. The hernia was diagnosed preoperatively, but the gangrenous appendix was found in a strangulated loop of small bowel only at operation. The combination of gangrenous appendicitis and strangulated loop of small bowel in a femoral hernial sac is an unusual finding, but awareness of it will avoid delay in treatment and lead to the patient's full recovery.

Aged↗
PubMedDate not supplied

[The importance of postmortem influences on the visibility of strangulation marks].

A 44 year old male alcoholic was throttled by his wife. The visible white furrow after strangulation was massaged with unguentum; afterwards, the corpse was transported with a scooter by the sons of the victim into a lake. Here, the man was found 24 hours later without any external signs of strangulation. Experimentally produced strangulation furrows (at lower legs of human deceased and at neck of shaved and deeply narcotized guinea-pigs) disappeared when exposed to water or treated with ointments.

Adult↗
PubMed1994

[Strangulated laparoceles. Our experience].

The authors present their own experience of emergency in strangulated laparoceles. Between January 1984 and June 1992 they treated at the Division of Emergency Surgery of the Hospital "A. Cardarelli" in Naples 133 cases of laparocele, 63 of which were strangulated. 48 of the 63 cases were treated by simply vertical or transversal laparoplasty ("waistcoat"); in 4 cases a direct plastic surgery; was executed in 11 cases a synthetic patch was used: in 2 cases a Teflon prosthesis was used; in one case a double prosthesis: a reabsorbable Vicryl patch internally and an external Marlex reticulated; in 8 cases a Marlex prosthesis. Moreover in most cases, before the laparoplasty of the abdominal wall operations of viscerolysis, were carried out intestinal and/or epiploon resection because of ischemia, colostomy, a Hartmann (one case). Of the 11 patients treated with synthetic patches, only 4 presented local complications: a seroma, two suppurations of the wound and a skin necrosis. These complications were treated with a medical therapy. In no case it was necessary to remove the prosthesis, as there were no general complications or deaths. We have to underline that notwithstanding the great advances both in surgery and in prosthesis' materials, the problem of the strangulated laparocele still represent a great engagement for the surgeon. The main reasons are: concomitant pathologies ("eventration disease"') and complications. The complications may be local (infection of the wound) or general (cardiocirculatory and respiratory problems due the viscus reduction in the original abdominal cavity).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Strangulated hernia and eventration].

Incarcerated hernia or wound dehiscence are responsible for more than 10% of small bowel obstructions. The complication is easily recognized when hernia or wound dehiscence was previously diagnosed. Difficulties occur when mass is deeply located in a thick abdominal wall or inside the inguinal canal. Femoral hernias and direct inguinal hernias are those which strangulate the most. Strangulation in wound dehiscence is the most severe. Strangulated hernia should be routinely excluded in patient with intestinal obstruction, to avoid inappropriate surgical approach.

Hernia↗
PubMed1993

Testicular infarction complicating strangulated inguinal herniae in Nigerian children.

Between 1985 and 1990 30 children were operated on for strangulated inguinal herniae in the University of Benin Teaching Hospital, Benin City, Nigeria. Six of the children (20%) had testicular infarction secondary to the strangulated hernia. Half of the children with infarcted testes had viable bowel at operation. The surgeon dealing with African children with strangulated herniae needs to be sensitised to this condition and the possibility that the testis may well be infarcted before the intestines.

Child↗
PubMed1996

Outpatient treatment of isolated strangulated haemorrhoids with single dose injection sclerotherapy and oral Daflon.

OBJECTIVE: To assess the efficacy of single, large dose injection sclerotherapy together with oral Daflon 500 mg in the management of isolated strangulated haemorrhoids. DESIGN: Prospective non randomised study. SETTING: Private hospital, Sri Lanka. SUBJECTS: 15 patients (9 men and 6 women, median age 28 years, range 19-54) with isolated strangulated haemorrhoids. MAIN OUTCOME MEASURES: Resolution of symptoms at 12 weeks, residual haemorrhoids, and side effects of Daflon. RESULTS: 14 patients were evaluated at 12 weeks, and symptoms had resolved completely in 13. In all of these patients, the prolapsed haemorrhoid was restored within the anal canal. The remaining patient developed circumferential prolapsed haemorrhoids which were treated by surgical excision. No side effects of Daflon were reported. CONCLUSION: Single, large dose injection sclerotherapy combined with Daflon 500 mg was beneficial in the short term in patients with isolated strangulated haemorrhoids.

Administration, Oral↗
PubMed1996

[Ileal occlusion with strangulation: importance of ultrasonography findings of the dilated loop with intraluminal fluid-fluid resulting from sedimentation].

To identify some dynamic or morphological patterns for the diagnosis of small bowel obstruction by hernia, adhesions or volvulus, we submitted to ultrasonography (US) 61 patients with clinical and radiographic syndromes of mechanical small bowel obstruction. The cause of obstruction was demonstrated in 58 patients-namely, with surgery in 56 patients and further instrumental examinations in 2. Three patients died before surgery. In our series, small bowel obstruction with strangulation was demonstrated at surgery in 31/56 patients. In 27/31 patients, US showed the coexistence of dilated loops with different kinetic behavior in the abdominal cavity-i.e., the simultaneous presence of akinetic loops with an intraluminal fluid-fluid level by sediment and peristaltic loops with solid particles in suspension. In 4/31 patients with strangulating small bowel obstruction. US provided no useful elements to explain the mechanism of obstruction. The US pattern of fluid-fluid levels due to intraluminal sediment in all the intestinal mass above the occluded segment was observed in 6/6 patients with uncompensated mechanical intestinal obstruction. This sign is due to the absence of intestinal muscular activity in the late stages of mechanical intestinal obstruction; its value is purely prognostic. To conclude, the US pattern of fluid-fluid levels by sediment diffused in the whole intestinal mass provides no useful elements to explain the cause of obstruction: on the contrary, the US pattern characterized by isolated intraluminal fluid-fluid levels or by the association of akinetic and peristaltic loops in the abdominal cavity appears pathognomonic of strangulating obstruction caused by volvulus, adhesion or hernia, with 87% sensitivity and 100% specificity.

Female↗
PubMed1997

Use of a preperitoneal prosthesis for strangulated groin hernia.

BACKGROUND: Prostheses are widely used in the elective treatment of adult groin hernias. Their use for strangulated hernias remains controversial because of the potential risk of sepsis. METHODS: Thirty-five patients with a strangulated groin hernia were treated by insertion of a prosthetic mesh via a midline preperitoneal approach. Nine patients needed an intestinal resection for irreversible necrosis without peritonitis, and an appendicectomy was carried out in three others. RESULTS: There were two postoperative wound infections, neither in patients who had an intestinal resection. No mesh had to be removed. The recurrence rate was one of 35 after mean follow-up of 4.2 years. CONCLUSION: A strangulated groin hernia can be repaired safely with prosthetic mesh. When an intestinal resection is carried out with sufficient care to minimize infective complications, the use of mesh is not contraindicated.

Adult↗
PubMed1998

[A strangulated perineal hernia. A rare case of intestinal obstruction].

A rare case of intestinal obstruction due to strangulated perineal hernia, observed among 533 small bowel obstructions operated since January 1982 until December 1994 (0.2%) is described. Less than 100 cases are reported in literature. The etiologic, anatomical and clinical aspects of perineal hernia are examined. The reported case is of the primitive, congenital type caused by defect of the rectovaginal fascia fusion, in correspondence of the Douglas. Preoperative diagnosis is very difficult. Strangulation of this type of hernia is rare, the hernial sac surrounding tissue being elastic. In case of strangulation, symptoms of intestinal obstruction appear. In the reported case the preoperative diagnosis was "acute abdomen", because there was defence in hypogastrium and in the right iliac fossa. A straight abdominal radiography has not been performed. In the reported case the patient, a 22-year-old woman, was promptly operated and the incarcerated intestinal loop released. A regular postoperative period followed. The importance of a complete clinical examination, of a straight abdominal radiography and of a promptly performed operation is underlined.

Abdomen, Acute↗
PubMed1991

Delayed postanoxic encephalopathy after strangulation. Serial neuroradiological and neurochemical studies.

A 13-year-old boy was the victim of attempted strangulation. His condition had returned to normal by the sixth day after the assault; however, from the seventh day, choreoathetosis, dystonia, and marked pseudobulbar paralysis developed in the boy. The computed tomographic scans and T2-weighted magnetic resonance images that were obtained at this time revealed low-density and high-signal intensities in the region of the bilateral putamen and caudate nucleus. These symptoms and the changes in his computed tomographic scans and magnetic resonance images subsided gradually during a 2-month period. Sequential analysis of the cerebrospinal fluid for gamma-aminobutyric acid and dopamine concentrations during his illness revealed reciprocal changes with normal recovery. Because of the delayed onset of neurological changes and the cerebrospinal fluid showing reversible symptoms, the delayed encephalopathy after strangulation had been related to the biochemical alterations that followed anoxia in the vulnerable basal ganglia.

Adolescent↗
PubMed1983

Manual strangulation injuries of the larynx.

Laryngeal injuries secondary to manual strangulation are seen more often by the forensic pathologist than by the otolaryngologist. Forces sufficient to cause thyroid and cricoid cartilage fractures are usually sufficient to cause acute asphyxia and death. However, due to the static nature of the compressive forces applied in strangulation, fractures of the cartilaginous framework may occur without obvious mucosal disruption or submucosal hematoma formation. If the victim survives the initial assault and the injuries go unrecognized and untreated, delayed life-threatening airway obstruction of long-term vocal dysfunction may result. Computed tomography seems to be an excellent noninvasive technique to evaluate and verify cartilaginous laryngeal fractures and soft-tissue injury. Recognition of the potential for such injuries is the key to management and treatment.

Aged↗
PubMed1981

Presentation and outcome of strangulated external hernia in a district general hospital.

Two hundred consecutive emergency hernia operations are reviewed. Mortality from this condition has not significantly altered in the past 30 years. Half of the patients presented 48 h or more from the onset of symptoms. Mortality and bowel resection were clearly linked with the duration of symptoms prior to admission. There were no reliable clinical signs to predict the likelihood of bowel strangulation. Recurrent incisional and femoral hernias were associated with high resection rates and mortality. Right-sided hernias appeared to strangulate more frequently than left-sided hernias.

Adolescent↗
PubMed2002

Ischemia-reperfusion injury following superior mesenteric artery occlusion and strangulation obstruction.

BACKGROUND: Intestinal ischemia-reperfusion injury (IRI) is a serious and common clinical entity resulting in severe tissue injury. This study was designed to compare IRI in superior mesenteric artery (SMA) occlusion and strangulation obstruction (SO). MATERIALS AND METHODS: Thirty Wistar-Albino rats were assigned randomly to three groups. In the control group, a sham operation was performed. In the SMA occlusion group, a vascular clamp was placed across the SMA to occlude arterial circulation. In the SO group, a 15-cm segment of small intestine was looped to prevent venous circulation. Sixty minutes of ischemia was followed by 60 min of reperfusion. Following reperfusion, biopsies of small intestine were taken to assess morphologic damage, tissue levels of malonyldialdehyde (MDA) as an index of lipid peroxidation reflecting oxygen free radicals (OFR) were determined, and serum biochemical analyses were performed. RESULTS: The levels of tissue MDA were significantly higher in the SO group than in the SMA occlusion group (P < 0.05). Biochemical parameters of SO and SMA occlusion groups were higher than those in the control group and there was a significant difference between the SMA occlusion and the SO models, except for ALP levels. Histopathologically, transmural intestinal damage were present in seven cases of SO and in six cases in the SMA occlusion group. CONCLUSIONS: Despite no significant difference between the two groups in terms of intestinal tissue damage, OFR-induced injury was higher in the strangulation obstruction group.

Animals↗
PubMed1994

Immunohistological investigations of autopsied carotid bodies and their application to diagnosing strangulation.

Using immunohistochemical staining, the histological changes and the presence of neuropeptides (enkephalin and VIP) in the carotid body have been investigated in medico-legal autopsy cases, especially asphyxia cases. Only in cases of manual and/or ligature strangulation cases that sustained a force near the carotid body, were the chief cells mainly lightly stained, indicating that they had been "active" cells. Furthermore, these cells and their nuclei were enlarged in comparison to the chief carotid body cells in other autopsy groups. It was thus felt that these changes had resulted from the force that had directly affected the carotid body. Based on these findings, it was concluded that immunohistochemical investigation of the carotid body offers a useful possibility for diagnosing manual asphyxia, especially in autopsy cases involving strangulation.

Adolescent↗
PubMed1991

CT diagnosis of strangulated diaphragmatic hernia.

Strangulated diaphragmatic hernia is a surgical emergency which on occasions can be a diagnostic dilemma. We report of a 2-year-old-male child with strangulated diaphragmatic hernia in whom a correct preoperative diagnosis was made with progression of illness. CT depicted a curvilinear fat stripe in a fluid filled hemithorax.

Child, Preschool↗
PubMedDate not supplied

Laparoscopic repair of a strangulated Bochdalek hernia.

BACKGROUND: Bochdalek herniae are rare. They are usually repaired by open abdominal surgery or by a thoracic video-assisted approach. When strangulated and in a compromised patient the options are fewer. AIM: To describe a case treated by a laparoscopic approach. RESULTS: The procedure was technically difficult, but the patient recovered without recurrence. CONCLUSION: Laparoscopic repair is possible even with strangulation.

Aged↗