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At least 19 recordsLinked to original sources
PubMed1991

Association of hiatus hernia with postero-lateral diaphragmatic hernia (Bochdalek's hernia).

A boy with hiatus hernia following the repair of the left postero-lateral diaphragmatic hernia (Bochdalek's hernia) was reported. At the age of one month, the repair of Bochdalek hernia was performed with transabdominal approach. At that time the stomach was located in the normal position. Eight days after the repair he developed vomiting and hiatus hernia was revealed by barium esophagram. Antireflux surgery was required because there was no response to the conservative management for two months. Esophageal pH study and manometric study were very useful for the diagnosis of hiatus hernia or GER and the evaluation of antireflux surgery.

Abnormalities, Multiple↗
PubMed1975

External herniae: ventral herniae and summary.

1. In three articles, inguinal, femoral, and ventral herniae have been discussed, one of the aims being to draw the attention of those who are new to surgery in the tropics to some of the things the author thought were peculiar to these herniae. Experiences in the 1,100-bed Korle Bu Hospital, Accra, where a retrospective survey showed that 609 external herniaw were mended in 15 months, formed the basis of the discussions. 2. The applied anatomy of the inguinal canal of adult Ghanaians was described. Three things were pointed out: the infantile type of inguinal hernia was the rule not the exception; the floor and the conjoint tendon were well developed and useful for repair; the pubic branch of the inferior epigastric artery was normal not aberrant. 3. IN Accra inguinal herniae are big and a man's disease. The differential diagnosis of scrotal hernia includes vaginal hydrocele, scrotal elephantiasis, testicular tumours, and tuberculous epididymoorchitis. A case was made in favour of differentiating between direct and indirect inguinal herniae preoperatively. 4. Elective herniorrhaphy was recommended as the treatment of choice and operative techniques were described. The suture material to employ for the Bassini repair must be non-absorbable, e.g. silk or nylon. Whereas herniotomy is adequate in children, in women herniorrhaphy is combined with clearance and obliteration of the inguinal canal. 5. The author did not recommend a truss for an inguinal let alone a femoral hernia. There is suggestive evidence that even in the tropics a man's hernia could be safely repaired on an out-patient basis. 6. Since femoral hernia is rare, it was recommended that in the interest of the patients, skillful surgeons should repair them. 7. The surgical anatomy of the femoral canal, and clinical features of femoral hernia were described. The differential diagnosis included inguinal hernia, abscesses in the groin, hydrocele of the femoral canal, saphena varix, lymphadenopathy, simple tumours and aneurysm of the femoral artery. 8. The treatment of choic is a surgical operation of which three were named and one described ("the low" operation of Lockwood). Recurrence is rare...

Cesarean Section↗
PubMed1990

[Lotheissen-McVay repair of hernia. Late follow-up analysis after 1202 operations for inguinal and femoral hernias].

Of 1202 hernia repairs performed according to the modified Lotheissen-McVay technique 1020 (84.9%) were followed up. The frequency of hernia increases with increasing age. The total recurrence rate after an average follow-up of 9 years was 9.2% for primary hernias and 11.5% for recurrences. The recurrence rate depends on the follow-up time and on sex. For primary hernias the recurrence rate was 0.7% after 1 year, 5% after 5 years, 9.1% after 10 years and 11.5% after 15 years. After 1 year the recurrence rate was 0.6% for women and 0.8% for men; after 5 years the corresponding figures were 3.9% and 5.2% and after 10 years, 6.6% and 9.5%. The results after repair of recurrent hernias are not much worse than those obtained in the case of primary hernias. The recurrence rate depends on the surgeon's experience. We found a recurrence rate of 3.6% in 319 operations performed by our most experienced surgeon, as against 16.3% among those performed by inexperienced surgeons. Therefore, careful assistance is paramount for the inexperienced surgeon, because training is indispensable. The most frequent complications of primary operations were hematoma and seroma (4.4%), wound infections (1.7%), pulmonary embolism (0.9%), deep vein thrombosis (0.7%) and testicular atrophy (0.4%). The traditional Lotheissen-McVay technique for hernia repair still has a place in the surgical treatment of hernia. This technique can be used as the standard treatment for all kinds of inguinal or femoral hernias, without higher complication rates, and it yields especially good results in recurrent hernias.

Adolescent↗
PubMed2026

Genetic Susceptibility to Incisional Hernia Evaluation of Hernia Polygenic Risk Scores.

OBJECTIVES: Incisional hernia (IH) affects 13-30% of people after abdominal surgery, resulting in substantial morbidity and costs. While clinical risk factors have been studied extensively, genomic risk for IH is incompletely understood. We aimed to evaluate the impact of polygenic risk scores (PRS) on IH risk prediction. METHODS: We created and evaluated three PRS for abdominal hernia, ventral hernia and latent hernia susceptibility for prediction of IH in an institutional biobank. The primary outcome was defined as the diagnosis or repair of an IH based on ICD-9/10-CM/PCS and CPT codes. Clinical covariates included age, sex, body mass index (BMI), smoking status, index procedure type, and perioperative surgical site infection. A phenome-wide association study (PheWAS) was performed to assess clinical associations with increased PRS. We then tested the ability of the PRS to improve prediction for IH by modeling clinical covariates with and without PRS in patients who underwent abdominal surgery. Model performance was assessed using 10 iterations of 5-fold cross-validation to estimate Brier scores and area under the receiver operating characteristic curve (AUROC), which were compared using cross-model Bayesian analysis of variance. RESULTS: In 55,809 subjects, assessed PRS was significantly associated with incisional, umbilical, and ventral hernia on PheWAS, with 1.19 greater odds of developing IH per 1-SD increase in PRS (95% CI: 1.13-1.25, P < 0.001). Of 9,909 subjects who underwent qualifying abdominal surgery, 706 developed IH. In this cohort, the latent hernia susceptibility PRS was associated with a 16% increased hazard of developing IH per 1-SD increase (HR 1.16; 95% CI: 1.07-1.26; P < 0.001). Compared to a predictive model using clinical covariates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC = 0.660, 95% CI: 0.653-0.666), addition of the PRS showed similar Brier score and AUROC estimates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC: 0.667, 95% CI: 0.661-0.673) at five years. Cross-model Bayesian analysis demonstrated >99% probability of practical equivalence when trying to detect a difference of &#x2265; 0.02. CONCLUSION: All three PRS for hernia were independently associated with IH, suggesting that genomic factors contribute significantly to IH development. However, none of the three PRS meaningfully improved clinical IH risk prediction in patients who underwent abdominal surgery. This suggests that clinical comorbidities and surgical techniques may be equally as important as genomic architecture.

Bayesian analysis↗
PubMedDate not supplied

The inguinal hernia: not always straightforward, not always a hernia.

Swelling in the groin may represent much more than an inguinal hernia and an inguinal hernia may be much more complicated than it seems upon superficial consideration. Intraperitoneal or retroperitoneal hemorrhage as well as many other congenital, inflammatory, infectious, or neoplastic processes occurring either locally or at distance from the groin may present in the groin, simulating a hernia, or within an inguinal hernia sac itself. Delayed and spontaneous rupture of the spleen are not rare occurrences. The case discussed, an episode of delayed rupture of the spleen presenting as blood within an inguinal hernia sac, serves to emphasize that following a complete clinical evaluation many entities other than simple inguinal hernia must be considered if a thorough differential diagnosis of a groin mass is to be developed.

Adult↗
PubMed1992

Anatomical laparoscopic hernia repair of direct or indirect inguinal hernias using the transversalis fascia and iliopubic tract.

Fourteen patients with symptomatic inguinal hernias underwent anatomic repair, which approximates the transversalis muscle and fascia to the iliopubic tract. Polyproprolene mesh was used to obliterate the canal space formerly occupied by the hernia sac. Nine patients were operated on for a direct inguinal hernia, four for an indirect hernia, and one recurrent direct hernia. Two patients required the laparoscopic approach to abandoned in favor of an open method. The remaining 12 patients underwent laparoscopic repair and were discharged within 23 h of the procedure.

Adult↗
PubMed1988

[Morgagni hernia. A rare form of diaphragmatic hernia].

The Morgagni hernia is the rarest form of diaphragmatic hernias. Knowledge has been accumulated over time of combinations with other congenital malformations, familial occurrence, and traumatic genesis. Morgagni hernia has been more often recordable from women, along with rising age and usually located on the right hand side. Embryonic disorder of diaphragmatic differentiation is believed to be the major aetiological factor. Vitamin deficit as well as some chemical substances, primarily active in the foetal period, have become known as additional factors of predisposition. Intensive diagnosis to rule out malignancy is absolutely essential because of the variability of symptoms of this type of hernia. Colon fragments and large omentum were found to be most often contained in the hernial sac. Contrast medium X-ray checks of the gastrointestinal tract and pneumoperitoneum are preferential methods of examination. Exploratory laparotomy is generally considered the optional therapeutic approach because of possible saving of liver veins, safe removal of the hernial sac, and the possibility of abdominal exploration. Preoperative wide-range sterile covering of the patient's body around the site of surgery is recommended to allow for possible thoractomy, as may be required.

Female↗
PubMed1978

"Paratransplant" hernia. Three patients with a new variant of internal hernia.

Three cases of bowel obstruction due to internal hernia caused by entrapment of bowel or omentum through a defect in the peritoneum covering the transplanted kidney are described. All three patients survived due to early surgical intervention and reduction of the hernia and/or resection of necrotic bowel or omentum. In view of the high mortality of peritonitis in transplant patients, early surgical treatment is indicated in all cases of intestinal obstruction to avoid the sequelae of bowel infarction. This "paratransplant" hernia represents the newest type of internal hernia described.

Adult↗
PubMed1987

Meckel's diverticulum in a femoral hernia: a Littre's hernia.

We have described a patient with strangulation of a Meckel's diverticulum in a femoral hernia. In the case of Littre's hernia, true diagnosis before surgical intervention is rare if not impossible. It is therefore important that the surgeon be well versed in the management of such cases, as well as in distinguishing a Littre's hernia from a Richter's hernia during the intraoperative period.

Aged↗
PubMed1977

Ventral hernia with a skin-covered Silastic sheet for newborn infants with a diaphragmatic hernia.

The persistently high mortality rate for newborn infants with a congenital diaphragmatic hernia, which is symptomatic and treated in the first 24 hours of life, is due to multiple pulmonary and vascular factors. This demands the exclusion of any additional compromising elements. The effects of increased intra-abdominal pressure due to replacement of the intestine into the abdomen can be avoided by the formation of a ventral hernia. A large hernia can be produced best by suturing a sheet of Dacron reinforced Silastic to the fascia of a midline abdominal incision and covering it with skin flaps. This nonreactive prosthesis will remain in place for several months and later can be removed simply. This technique was used successfully in three infants and should improve the survival rate of precariously balanced newborn infants operated upon during the first few hours of life.

Female↗
PubMed1979

[Posterior gastro-esophago-phreno-plasty (PGEPP) in the treatment of hiatal hernia and of esophagogastric reflux. Experience in over 500 cases. Anterior gastro-esophago-phreno-plasty (AGEPP) in the prevention of sliding hiatal hernia and of esophagogastric reflux. Experience in over 300 cases].

On the basis of the anatomophysiological assumption that the abdominal oesophagus is kept in its seat by the meso-oesophagus and that the complex functional role of the gastro-oesophageal junction is conditioned essentially by the inferior oesophageal sphincter under the influence of intra-abdominal and endogastric pressure variables, posterior gastro-oesophagophreno-plasty (p.g.p.p.) is proposed to offset the destruction or severe insufficiency of the meso-oesophagus and hence for the treatment of hiatal hernia and of regurgitation. This retro-oesophageal tuberous valve involves simultaneous fixation of the stomach and oesophagus to the pillars of the diaphragm, first on the right and then on the left, and the fixation of the fundus to the left diaphragmatic dome. Anterior gastro-oesophago-phreno-plasty is proposed on the basis of the finding that damage of any kind to the meso-oesophagus can cause the oesophagus to rise in the chest and thus disturb inferior sphincter function and possibly lead to the onset of regurgitation and hernia. The pre-oesophageal tuberous valve employed involves simultaneous fixation of stomach and oesophagus to the pillars of the diaphragm, first left and then right, and the fixation of the fundus to the left diaphragmatic dome. Anterior plasty is almost always confined to patients who have undergone vagotomy of the trunk without complex isolation of the oesophagus.

Diaphragm↗
PubMed1977

Richter hernia in a sacral foramen: new site for richter hernia.

This is a report of the first case to my knowledge, of a Richter hernia occurring in a sacral foramen. A 60-year-old woman had gradual onset of postsacral pain and swelling. The area was drained and small intestinal contents found. Laparotomy showed that a Richter hernia had occurred in the third right sacral foramen. The bowel had incarcerated and perforated into the posterior sacral area, without leakage into the peritoneal cavity.

Colon↗
PubMed1987

[10 years' experience using a modified Shouldice surgical technic for inguinal hernia in adults. II. Which factors modify the recurrence of inguinal hernia?].

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.

Adult↗
PubMed1990

Pathophysiology of congenital diaphragmatic hernia: I. Renal enlargement suggests feedback modulation by pulmonary derived renotropins--a unifying hypothesis to explain pulmonary hypoplasia, polyhydramnios, and renal enlargement in the fetus/newborn with congenital diaphragmatic hernia.

Survival of newborns with congenital diaphragmatic hernia (CDH) is largely dependent on the severity of pulmonary hypoplasia (PH) present at birth. Intrathoracic compression by the herniated abdominal viscera is thought to be the primary factor involved in the pathogenesis of the PH in CDH. Humoral and/or amniotic pulmonary growth factors (PGF) have been hypothesized to play a role in normal fetal pulmonary development and may be involved in the pathogenesis of CDH as well. The hypothesis of this paper is that growth of the fetal lung is stimulated by a PGF produced by the kidneys, which is modulated by a feedback signal from the lungs, a pulmonary derived renotropin (PDR). In the fetus with CDH, the lungs may be unable to respond to PGF due to compression by the herniated abdominal viscera. Theoretically, PH associated with CDH would maximally stimulate this feedback loop to release more PDR, resulting in continual stimulation of the kidneys and renal enlargement. If such a scheme plays a role in the in utero pathophysiology of CDH, then newborns with CDH should have enlarged kidneys. To investigate this hypothesis, we reviewed 30 autopsy cases of newborns with CDH and analyzed their kidney weights versus body weights, using historical data as control. Kidney weights in CDH cases were greater than the control population in 77% of the cases; 57% of kidney weights were more than one standard deviation above control values. Adjusted group mean kidney weights were 29.8 g (+/- 1.0 SE) in CDH cases and 25.9 g (+/- 1.5 SE) in the control population (P less than .04). These data support our hypothesis and demonstrate that in newborns with CDH and morphologically normal kidneys, there is significant renal enlargement associated with CDH. The presumed mechanism of this renal enlargement, as well as its relationship to normal and aberrant pulmonary growth and regulation are discussed. If such a selective PGF exists, its therapeutic implications for fetuses and newborns with PH are considerable.

Analysis of Variance↗