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Sample records for strangulated obturator hernia

  1. Difficult diagnosis: strangulated obturator hernia in an 88-year-old woman.

    PubMed

    Leitch, Megan Kathleen; Yunaev, Michael

    2016-01-01

    The obturator hernia is a rare type of hernia that can present a diagnostic challenge for the clinician. We report a case of an 88-year-old woman who presented with a history of right iliac fossa pain, bilious vomiting and diarrhoea. Non-specific findings on examination and blood tests made the diagnosis difficult, however, a CT scan of her abdomen revealed the site of the obstruction and the patient was taken to theatre for emergency surgery. We review the literature with focus on the diagnosis of obturator hernias and the different surgical approaches used. The authors believe that this case is of educational value to healthcare professionals, particularly those working in general practice, emergency departments and on surgical teams. It highlights to doctors that patients with incarcerated obturator hernias can present with or without overt signs of intestinal obstruction and emphasises the fact that an obturator hernia can be an important cause of intestinal obstruction in a thin, elderly woman. PMID:27358098

  2. Appendicitis in an obturator hernia.

    PubMed

    Camerlinck, Michael; Vanhoenacker, Filip; De Vuyst, Dimitri; Quanten, Inge

    2011-04-01

    We present a case of a 79-year-old female with a history of pain at the right groin for 9 days. Computer tomography of the pelvis showed herniation of the appendix through the obturator canal with a huge abscess surrounding the right hip joint. Laparotomy was performed and histopathology confirmed a perforated necrotic tip of the herniated appendix. An obturator hernia is a rare hernia of the pelvic floor. It is most common in old, emaciated, multiparous women and can cause groin pain with extension to the medial aspect of the thigh. In case of incarceration of bowel, patients also present with obstruction. Isolated incarceration of the appendix, however, does not cause obstruction. The diagnosis of an obturator hernia is often delayed, due to a non-specific clinical presentation. CT scan may offer the clue to the correct diagnosis and should be performed in case of a possible obturator hernia.

  3. Obturator hernia. Embryology, anatomy, and surgical applications.

    PubMed

    Skandalakis, L J; Androulakis, J; Colborn, G L; Skandalakis, J E

    2000-02-01

    Obturator hernia is a rare clinical entity. In most cases, it produces small bowel obstruction with high morbidity and mortality. The embryology, anatomy, clinical picture, diagnosis, and surgery are presented in detail.

  4. Obturator hernia revisited: surgical anatomy, embryology, diagnosis, and technique of repair.

    PubMed

    Stamatiou, Dimitrios; Skandalakis, Lee J; Zoras, Odysseas; Mirilas, Petros

    2011-09-01

    Obturator hernia is the protrusion of intraperitoneal or extraperitoneal organs or tissues through the obturator canal. The first case was published by de Ronsil in 1724. Obturator hernia is more common in older malnourished women due to loss of supporting connective tissue and the wider female pelvis. The hernia sac usually contains small bowel, especially ileum. It may follow the anterior or posterior division of the obturator nerve. In most cases, obturator hernia presents with intestinal obstruction of unknown cause. It may present with obturator neuralgia, as a palpable mass or, in cases of bowel necrosis, as ecchymosis of the thigh. A correct diagnosis is made in 20 to 30 per cent of cases. CT scan is considered the gold standard for diagnosis, whereas ultrasonography, contrast studies, herniography and plain films are less specific. Surgery is the only treatment option for obturator hernia. Hesitancy to intervene surgically for chronically ill patients results in high mortality. Transabdominal approach is indicated in cases of complete bowel obstruction or suspected peritonitis. The extra-abdominal approach is used in preoperatively diagnosed cases and in absence of bowel strangulation. The laparoscopic approach is minimally invasive and effectively reduces morbidity. The defect is closed using sutures, tissue flaps, or prosthetic mesh.

  5. Richter type of incarcerated obturator hernia; misery still continues.

    PubMed

    Jayant, Kumar; Agarwal, Rajendra; Agarwal, Swati

    2015-02-03

    Obturator hernia is a rare type of hernia which accounts for only 0.07-1.4% of all intra-abdominal hernias and 0.2-5.8% of small-intestinal obstructions. It develops predominantly in elderly underweight women. It has nonspecific early symptoms, so these hernias are usually discovered only after they have become incarcerated. Incarcerated obturator hernias are usually discovered on abdominal computed tomography scan or emergency surgery due to bowel obstruction. Here we present a case of a 65-year-old female who presented with intermittent abdominal pain, distension and nausea for last 3 days. She was a known case of hypothyroidism, taking Levothyroxine in inadequate dose. Her intial abdominal Xray was showing few air-fluid level with air present in rectum. She was initially managed conservatively but later developed features of peritonitis for which she was operated. In laparotomy, Richter type of right-sided incarcerated obturator hernia was discovered with a small necrotic area and perforation of small bowel. Bowel resection was performed and obturator hernia was closed with interrupted sutures. The patient recovered without complications. Obturator hernia, due to its rarity and nonspecific early symptoms, can still be misleading even to the most experienced clinicians. Delay in diagnosis of obturator hernia can lead to bowel necrosis and perforation with significant postoperative morbidity and mortality.

  6. Sudden unexpected death due to strangulated inguinal hernia.

    PubMed

    Menezes, Ritesh G; Padubidri, Jagadish Rao; Raghavendra Babu, Y P; Naik, Ramadas; Kanchan, Tanuj; Senthilkumaran, Subramanian; Chawla, Khushboo

    2016-06-01

    Sudden unwitnessed, unexpected deaths when the bodies are found in public places require a complete and meticulous medicolegal autopsy to ascertain the cause and manner of death to avoid further unnecessary investigations by the legal authorities. Such deaths attributed to gastrointestinal causes at autopsy are relatively uncommon. We report a case of sudden unexpected death due to strangulated inguinal hernia in a 60-year-old man. The body was discovered in a public area near a place of worship. The present case illustrates a potentially preventable sudden unexpected death due to a surgically correctable gastrointestinal condition. In the present case, the individual feared being hospitalised for treatment of his scrotal swelling with potential surgery and the eventual loss of daily income. In our opinion, such apprehensions may have delayed the potentially life-saving hospital surgical intervention in the individual. PMID:26837567

  7. Bilateral obturator hernia with intestinal obstruction: repair with a cigar roll technique.

    PubMed

    Tchanque, C N; Virmani, S; Teklehaimanot, N; Malamet, M D; McFarlane, K N; Lincoln, D; Jacobs, M J; Silapaswan, S

    2010-10-01

    Obturator hernia is an exceedingly rare pelvic hernia that occurs primarily in multiparous, elderly thin (>70 years of age) females. Here, we report a case of bilateral obturator hernia in an elderly female with high-grade small bowel obstruction repaired with a novel "cigar roll" technique.

  8. [Possibilities of ultrasonography in the differential diagnosis of strangulation and obturation forms of commissural small intestine ileus].

    PubMed

    Legostaeva, T B; Kirillova, N Iu

    2001-01-01

    The main aim of this paper, by the authors' intention, was to attempt to study and provide evidence for that routine transabdominal sonography has great capacities in diagnosing small intestinal strangulation and obstruction ileus caused by commissures or tumors. The data of 48 cases of small intestinal ileus (27 of its strangulation form and 21 of its obturation one) were analyzed. The paper details guidelines on ultrasonographic techniques and the ultrasound semiotics of this pathology. It is the first time that the authors give individual methodological and semiotic approaches at sonography in this group of papers. They present a particularly clinical picture in combination with ultrasonographic data by providing their constant comparison, which serves as an additional support of the results of this paper. In the authors' opinion, the findings suggest that transabdominal sonography may be a successful basic diagnostic technique for strangulation and obturation forms of small intestinal ileus.

  9. Rare case of a strangulated intercostal flank hernia following open nephrectomy: A case report and review of literature

    PubMed Central

    Akinduro, Oluwaseun O.; Jones, Frank; Turner, Jacquelyn; Cason, Frederick; Clark, Clarence

    2015-01-01

    Introduction Flank incisions may be associated with incisional flank hernias, which may progress to incarceration and strangulation. Compromised integrity of the abdominal and intercostal musculature due to previous surgery may be associated with herniation of abdominal contents into the intercostal space. There have been six previously reported cases of herniation into the intercostal space after a flank incision for a surgical procedure. This case highlights the clinical picture associated with an emergent strangulated hernia and highlights the critical steps in its management. Presentation of case We present a case of a 79-year-old adult man with multiple comorbidities presenting with a strangulated flank hernia secondary to an intercostal incision for a right-sided open nephrectomy. The strangulated hernia required emergent intervention including right-sided hemi-colectomy with ileostomy and mucous fistula. Discussion Abdominal incisional hernias are rare and therefore easily overlooked, but may result in significant morbidity or even death in the patient.. The diagnosis can be made with a thorough clinical examination and ultrasound or computed topographical investigation. Once a hernia has become incarcerated, emergent surgical management is necessary to avoid strangulation and small bowel obstruction. Conclusion Urgent diagnosis and treatment of this extremely rare hernia is paramount especially in the setting of strangulation. PMID:26629848

  10. Gastric necrosis secondary to strangulated giant paraesophic hiatal hernia.

    PubMed

    Díez Ares, José Ángel; Peris Tomás, Nuria; Estellés Vidagany, Nuria; Periáñez Gómez, Dolores

    2016-08-01

    Asymptomatic giant hiatal hernia comprises a relatively common disease, mostly presented in women with 50 years onwards. The therapeutic approach remains controversial in recent years. Under the latest SAGES`revision, all the symptomatic hernias must be repaired, but the symptomatic hiatal hernia definition isn`t even now established. We present the case os a A 67 - year old woman with an asymptomatic hiatal hernia, that is admitted to our hospital owing to toracic and abdominal pain. This pain was related with food intake for 6 months. The patient presents a clear worsening in the last 24 hours, with no other asociated symptomatology. Suspecting an incarcerated hiatal hernia with stomach perforation, the patient is taken to theatre for a laparotomy during the early hours. An atypic gastrectomy of the greater curvature with a gastropexy is performed with fixation to the anterior abdominal wall. The surgery is completed with a feeding jejunostomy. The Manegement of giant paraesophagic hernias, still remains as one of the challenge of the esophageal surgeons. PMID:27554384

  11. [Strangulated umbilical hernia in children (Burkina Faso): differences with developed countries].

    PubMed

    Bandré, E; Kaboré, R A F; Sanou, A; Ouédraogo, I; Soré, O; Tapsoba, T; Nébié, B; Wandaogo, A; Bachy, B

    2010-05-01

    Umbilical hernias occur frequently in children but complications are rarely reported. This study assesses the incidence of complicated umbilical hernias in our patients, evaluates data for risk factors, and shows dissimilarities with those encountered in developed countries. This study reports all children operated for complications due to strangulated umbilical hernia over a period of 3 years. On the whole, 162 children had umbilical hernias treated during this period. Thirty (18.5%) of these had complicated hernias. The average age of the complicated group was 3(1/2) years. Twenty-nine cases had a painful irreducible umbilical mass. Twenty-four children had bowel obstruction, while stercoral fistula occurred in one child. The average diameter of the hernia ranged between 1 and 1.5 cm. Five patients had ischemic intestine that required resection. One patient died. When active observation and follow-up after 1 year is difficult or not feasible when the wall defect diameter is 1.5 cm or less, and in suspicion of incarceration (unexplained abdominal pain, and irreducibility), umbilical hernia should be operated. PMID:20182838

  12. Laparoscopic management of a strangulated internal hernia underneath the left external iliac artery☆

    PubMed Central

    Dumont, Karl-Andreas; Wexels, Jan Cyril

    2013-01-01

    INTRODUCTION Internal herniation of a small bowel behind pelvic vessels is a rare complication seen after pelvic lymphadenectomy. PRESENTATION OF CASE A 56-year-old woman was operated due to a gynecological cancer. 4 years thereafter she presented with a 2 days history of abdominal pain and vomiting. Clinical and radiological findings indicated a small bowel obstruction. A loop of small bowel had herniated behind the left external iliac artery. Using laparoscopic technique the herniated bowel was reduced. Due to limited peritoneum around the area and skeletonized vessel, we decided not to do any repair of the hernia orifice. The postoperative recovery was uneventful, bowel activity returned to normal and she was discharged the next day. Follow-up was done at 1 month and the latest at 10 months. She didn’t experience pain or discomfort after the operation. DISCUSSION Due to limited peritoneum around the skeletonized vessel, we decided to leave the hernia orifice unrepaired. We found it hazardous to do any direct suture of the orifice or use a free peritoneal graft to repair the defect as the fibrosis and inflammatory process might have compromised the artery or the vein. A longer follow-up of the patient is needed to clearly conclude if this simple procedure has been sufficient. We agreed that if the patient would experience any sign of recurrence and need another operation we would close the defect at that time. CONCLUSION 4 years after pelvic lymphadenectomy a small bowel herniation behind an external iliac artery occurred. The patient was successfully treated with reduction of the small bowel using laparoscopic technique. A quick recovery with minimal discomfort and no sign of recurrence after 10 months made our approach an acceptable surgical option. PMID:24121051

  13. Strangulated epigastric hernia in a 90-year-old man: Point-of-Care Ultrasound (POCUS) as a saving kit: Case report

    PubMed Central

    Abu-Zidan, Fikri M.; Idris, Kamal; Khalifa, Mohammed

    2016-01-01

    Introduction The physiological reserve of extreme elderly patients is very limited and has major impact on clinical decisions on their management. Hereby we report a 90-year-old man who presented with a strangulated epigastric hernia and who developed postoperative intra-abdominal bleeding, and highlight the value of Point-of-Care Ultrasound (POCUS) in critical decisions made during the management of this patient. Presentation of case A 90-year-old man presented with a tender irreducible epigastric mass. Surgeon-performed POCUS using colour Doppler showed small bowel in the hernia with no flow in the mesentery. Resection anastomosis of an ischaemic small bowel and suture repair of the hernia was performed. Twenty four hours after surgery, in a routine follow up using POCUS, significant intra-peritoneal fluid was detected although the patient was haemodynamically stable. The fluid was tapped under bedside ultrasound guidance and it was frank blood. During induction of anaesthesia for a laparotomy, the patient became hypotensive. Resuscitation under inferior vena cava sonographic measurement, followed by successful damage control surgery with packing, was performed. 36 h later, the packs were removed, no active bleeding could be seen and the abdomen was closed without tension. The patient was discharged home 50 days after surgery with good general condition. Conclusion POCUS has a central role in the management of critically-ill elderly patients for making quick critical decisions. PMID:27017275

  14. Hernia

    MedlinePlus

    ... surrounds the muscle. This layer is called the fascia. Which type of hernia you have depends on ... problems. Surgery repairs the weakened abdominal wall tissue (fascia) and closes any holes. Most hernias are closed ...

  15. Hernia

    MedlinePlus

    ... in the abdomen. There are several types of hernias, including Inguinal, in the groin. This is the the most common type. Umbilical, around the belly button Incisional, through a scar Hiatal, a small opening in the diaphragm that allows ...

  16. Spontaneous Transomental Hernia

    PubMed Central

    Lee, Seung Hun

    2016-01-01

    A transomental hernia through the greater or lesser omentum is rare, accounting for approximately 4% of internal hernias. Transomental hernias are generally reported in patients aged over fifty. In such instances, acquired transomental hernias are usual, are commonly iatrogenic, and result from surgical interventions or from trauma or peritoneal inflammation. In rare cases, such as the one described in this study, internal hernias through the greater or lesser omentum occur spontaneously as the result of senile atrophy without history of surgery, trauma, or inflammation. A transomental hernia has a high postoperative mortality rate of 30%, and emergency diagnosis and treatment are critical. We report a case of a spontaneous transomental hernia of the small intestine causing intestinal obstruction. An internal hernia with strangulation of the small bowel in the lesser sac was suspected from the image study. After an emergency laparotomy, a transomental hernia was diagnosed. PMID:26962535

  17. Acute hernial strangulation following Wii Fit exercises.

    PubMed

    Khan, O A; Parvaiz, A C; Vassallo, D J

    2013-01-01

    The Wii Fit is one the most popular fitness games on the market. Although this device has been linked to a number of injuries, the vast majority of these have been relatively minor musculo-skeletal complaints. We present a case of a patient who presented with an acute strangulation of a pre-existing asymptomatic paraumbilical hernia after completing a series of aerobic exercises on her Wii Fit. She required laparotomy and small bowel resection for infarcted bowel. Although a number of minor mechanical and orthopaedic injurieshave been reported with the Wii Fit, this represents the first case of a life-threatening complication associated with the use of this device.

  18. Richter hernia: surgical anatomy and technique of repair.

    PubMed

    Skandalakis, Panagiotis N; Zoras, Odyseas; Skandalakis, John E; Mirilas, Petros

    2006-02-01

    Richter hernia (partial enterocele) is the protrusion and/or strangulation of only part of the circumference of the intestine's antimesenteric border through a rigid small defect of the abdominal wall. The first case was reported in 1606 by Fabricius Hildanus. The first definition of partial enterocele was given by August Gottlieb Richter in 1785. Sir Frederick Treves discriminated it from Littre hernia (hernia of the Meckel diverticulum). More often these hernias are diagnosed in the sixth and seventh decades of life. They comprise 10 per cent of strangulated hernias. Their common sites are the femoral ring, inguinal ring, and at incisional trauma. The most-often entrapped part of the bowel is the distal ileum, but any part of the intestinal tube may be incarcerated. These hernias progress more rapidly to gangrene than other strangulated hernias, and obstruction is less frequent. The gold standard technique for repair is the preperitoneal approach, followed by laparotomy and resection if perforation is suspected.

  19. Late presenting Bochdalek hernia with gastric perforation.

    PubMed

    Ozkan, Aybars; Bozkurter Cil, Asudan Tugce; Kaya, Murat; Etcioglu, Inci; Okur, Mesut

    2015-01-01

    Late-onset congenital diaphragmatic hernias that give symptoms beyond the neonatal period are rare and are difficult to diagnose. The diagnosis is usually made in case of complications such as intestinal obstruction, strangulation, and perforation, which further necessitate immediate surgical repair. The case of a 5-year-old child presenting with acute respiratory distress with gastric strangulation and perforation secondary to Bochdalek hernia is reported here. Although presentation in the latter ages is less common, congenital diaphragmatic hernia should be included in the differential diagnosis of respiratory distress in children. Symptoms and diagnostic tools should truly be interpreted. Gastrointestinal complications must urgently be recognized, and early surgical intervention must be performed.

  20. Variation in the Obturator Vasculature During Routine Anatomy Dissection of a Cadaver.

    PubMed

    Deshmukh, Vishwajit; Singh, Seema; Sirohi, Neerja; Baruhee, Divya

    2016-08-01

    The obturator artery normally originates from the internal iliac artery while the obturator vein drains into the internal iliac vein. During a routine gross anatomy dissection class for undergraduate students at the All India Institute of Medical Sciences, New Delhi, India, in 2016, a rare unilateral variation in the obturator vasculature was found in a female cadaver of approximately 55 years of age. In this case, the left obturator artery originated from the superior gluteal artery and the left obturator vein drained into the external iliac vein. Knowledge of such variations is necessary during hernia procedures, ligation of the internal iliac artery and muscle graft surgeries. PMID:27606118

  1. Variation in the Obturator Vasculature During Routine Anatomy Dissection of a Cadaver

    PubMed Central

    Deshmukh, Vishwajit; Singh, Seema; Sirohi, Neerja; Baruhee, Divya

    2016-01-01

    The obturator artery normally originates from the internal iliac artery while the obturator vein drains into the internal iliac vein. During a routine gross anatomy dissection class for undergraduate students at the All India Institute of Medical Sciences, New Delhi, India, in 2016, a rare unilateral variation in the obturator vasculature was found in a female cadaver of approximately 55 years of age. In this case, the left obturator artery originated from the superior gluteal artery and the left obturator vein drained into the external iliac vein. Knowledge of such variations is necessary during hernia procedures, ligation of the internal iliac artery and muscle graft surgeries. PMID:27606118

  2. Variation in the Obturator Vasculature During Routine Anatomy Dissection of a Cadaver

    PubMed Central

    Deshmukh, Vishwajit; Singh, Seema; Sirohi, Neerja; Baruhee, Divya

    2016-01-01

    The obturator artery normally originates from the internal iliac artery while the obturator vein drains into the internal iliac vein. During a routine gross anatomy dissection class for undergraduate students at the All India Institute of Medical Sciences, New Delhi, India, in 2016, a rare unilateral variation in the obturator vasculature was found in a female cadaver of approximately 55 years of age. In this case, the left obturator artery originated from the superior gluteal artery and the left obturator vein drained into the external iliac vein. Knowledge of such variations is necessary during hernia procedures, ligation of the internal iliac artery and muscle graft surgeries.

  3. Understanding noninguinal abdominal hernias in the athlete.

    PubMed

    Cabry, Robert J; Thorell, Erik; Heck, Keith; Hong, Eugene; Berkson, David

    2014-01-01

    Abdominal hernias are common with over 20 million hernia repairs performed worldwide. Inguinal hernias are the most common type of hernia. Inguinal and sports hernia have been discussed at length in recent literature, and therefore, they will not be addressed in this article. The noninguinal hernias are much less common but do occur, and knowledge of these hernias is important when assessing the athlete with abdominal pain. Approximately 25% of abdominal wall hernias are noninguinal, and new data show the order of frequency as umbilical, epigastric, incisional, femoral, and all others (i.e., Spigelian, obturator, traumatic). Return-to-play guidelines need to be tailored to the athlete and the needs of their sport. Using guidelines similar to abdominal strain injuries can be a starting point for the treatment plan. Laparoscopic repair is becoming more popular because of safety and efficacy, and it may lead to a more rapid return to play. PMID:24614421

  4. Congenital mesenteric hernia in neonates: Still a dilemma

    PubMed Central

    Mandhan, Parkash; Alshahwani, Noora; Al-Balushi, Zainab; Arain, Anwar

    2015-01-01

    Congenital transmesenteric hernia in neonates is a rare cause of intestinal obstruction with devastating outcomes and still remains a challenge to diagnose pre-operatively. Patients are often managed with emergency surgical exploration and may need bowel resection. We present 2 neonates with small bowel obstruction secondary to strangulated transmesenteric hernia through a congenital defect in the small bowel mesentery, which were managed successfully. We have also reviewed the literature about congenital transmesenteric hernia in neonates. PMID:26612129

  5. De Garengeot's hernia: our experience of three cases and literature review

    PubMed Central

    Akbari, Khalid; Wood, Claire; Hammad, Ahmed; Middleton, Simon

    2014-01-01

    Groin hernia is a common surgical presentation and nearly half of the femoral hernias present acutely with strangulation. The hernia sac usually contains omentum or small bowel. Rarely, the appendix can herniate into the femoral canal. De Garengeot's hernia is the term used to describe the presence of appendicitis in the femoral hernia. Hernia explorations are performed by surgical trainees and encountering a De Garengeot's hernia can be challenging to manage. We report our experience of three cases of this rare entity and a literature review to improve our understanding for optimum management. PMID:25080546

  6. Pediatric inguinal hernias, hydroceles, and undescended testicles.

    PubMed

    Lao, Oliver B; Fitzgibbons, Robert J; Cusick, Robert A

    2012-06-01

    Pediatric inguinal hernias are extremely common, and can usually be diagnosed by simple history taking and physical examination. Repair is elective, unless there is incarceration or strangulation. Hydroceles are also quite common, and in infancy many will resolve without operative intervention. Undescended testicles harbor an increased risk of infertility and malignancy, and require orchiopexy in early childhood.

  7. Management of voluminous abdominal incisional hernia.

    PubMed

    Bouillot, J-L; Poghosyan, T; Pogoshian, T; Corigliano, N; Canard, G; Veyrie, N

    2012-10-01

    Incisional hernia is one of the classic complications after abdominal surgery. The chronic, gradual increase in size of some of these hernias is such that the hernia ring widens to a point where there is a loss of substance in the abdominal wall, herniated organs can become incarcerated or strangulated while poor abdominal motility can alter respiratory function. The surgical treatment of small (<5 cm) incisional hernias is safe and straightforward, by either laparotomy or laparoscopy. For large hernias, surgical repair is often difficult. After reintegration of herniated viscera into the abdominal cavity, the abdominal wall defect must be closed anatomically in order to restore the function to the abdominal wall. Prosthetic reinforcement of the abdominal wall is mandatory for long-term successful repair. There are multiple techniques for prosthetic hernia repair, but placement of Dacron mesh in the retromuscular plane is our preference. PMID:23137643

  8. Case report of chylous ascites with strangulated ileus and review of the literature.

    PubMed

    Harino, Yukari; Kamo, Hitomi; Yoshioka, Yuki; Yamaguchi, Takeshi; Sumise, Yuko; Okitsu, Natsu; Yoshioka, Kazuo; Tashiro, Seiki

    2015-08-01

    We describe a case of chylous ascites with strangulated ileus, and review all 22 cases (including our case) of chylous ascites with strangulated ileus reported in the English and Japanese literature. The patient we describe was a 51-year-old woman with medical history of radiotherapy for cervical cancer of the uterus 15 months prior to being admitted to our hospital with abdominal pain after consuming a meal. A computed tomography (CT) scan revealed ascites, expansion of the small intestine, and whirl sign. Laparotomy revealed chylous ascites with an incarcerated internal hernia of the small intestine, which was released without intestinal resection. In our case the postoperative phase was uneventful, and as in the other 21 literature cases reviewed, treatment by either detorsion, release of the incarcerated internal hernia, or incision of the adhesion band without intestinal resection resulted in rapid improvement in the color of the intestine. It is considered that minimally invasive laparoscopic laparotomy should be selected as the treatment of first choice, because the degree of strangulation is slight in cases where chylous ascites is associated with strangulated ileus. PMID:26026475

  9. An unusual outcome of a giant ventral hernia

    PubMed Central

    Waheed, Muhammad; Alsenani, Mohammad; Al-Akeely, Muhammad; Al-Qahtani, Hamad

    2015-01-01

    Hernias are routine general surgical problems that may present in any age group, regardless of the patient’s socioeconomic status. We present a rare case of a complicated ventral hernia leading to short bowel. This is an unusual case and is very rarely reported in the literature. This current case report describes a 54-year-old gentleman who presented to the hospital with a giant strangulated ventral hernia causing massive bowel ischemia and resulting in a short bowel. The literature on large abdominal wall hernias leading to short bowel is reviewed, and a discussion on short bowel syndrome is also presented. PMID:26219451

  10. [Current Management of Congenital Diaphragmatic Hernia].

    PubMed

    Sakoda, Akiko; Matsufuji, Hiroshi

    2015-07-01

    Three types of congenital diaphragmatic hernias( Bochdalek hernia, Morgagni hernia, and esophageal hiatus hernia) are described with case presentation. In the Bochdalek hernia, the most common type of congenital diaphragmatic hernia, abdominal contents pass into the thorac bia diaphragmatic defect, limiting the space available for the developing lungs. Resulting lung hypoplasia, many infants experience severe respiratory distress within minutes of birth and may require resuscitation and stabilization of cardio-pulmonary function prior to surgery. The Morgagni hernia is rare and often incidentally diagnosed on routine chest x-ray in asymptomatic patients. Repair is still advisable due to risk of strangulated bowel and respiratory distress. Esophageal hiatal hernias usually produce symptoms of gastroesophageal reflux( GERD) and rarely result in incarceration of stomach or other organs. Surgical interventions for GERD, such as Nissen fundoplication, usually target neurologically impaired children in order to prevent aspiration pneumonia and improve quality of life. Laparoscopic surgery is beneficial for all types of diaphragmatic hernia, especially in older children, but careful consideration should be made based on individual patient background. PMID:26197915

  11. Suicidal ligature strangulation using gymnastics bands.

    PubMed

    Tzimas, Iliana; Bajanowski, Thomas; Pollak, Stefan; Trübner, Kurt; Thierauf, Annette

    2014-03-01

    Suicidal ligature strangulation is a rare event. The most important issue to solve in the investigation is whether it is a case of homicide or suicide. The characteristics of suicidal ligature strangulation are summarized by Koops and Brinkmann with the emphasis on the nature of the ligature instrument(s). In this article, we present two cases of self-strangulation with an almost identical modus operandi using gymnastics bands. The autopsy findings and the nature of the ligature in these cases are depicted and in good accordance with the described typical observations in suicidal cases. The importance of a broad medico-legal investigation is demonstrated. PMID:24429766

  12. Traumatic lumbar hernia: can't afford to miss.

    PubMed

    Saboo, Sachin S; Khurana, Bharti; Desai, Naman; Juan, Yu-Hsiang; Landman, Wendy; Sodickson, Aaron; Gates, Jonathan

    2014-06-01

    We describe the radiological and surgical correlation of an uncommon case of a traumatic lumbar hernia in a 22-year-old man presenting to the emergency department following a motor vehicle accident. Computed tomography (CT) of the abdomen revealed a right-sided traumatic inferior lumbar hernia containing a small amount of fat through the posterior lateral internal oblique muscle with hematoma in the subcutaneous fat and adjacent abdominal wall musculature, which was repaired surgically via primary closure on emergent basis. The purpose of this article is to emphasize the importance of diagnosing traumatic lumbar hernia on CT and need for urgent repair to avoid potential complications of bowel incarceration and strangulation.

  13. Laparoscopic Repair of Internal Transmesocolic Hernia of Transverse Colon

    PubMed Central

    Kishiki, Tomokazu; Mori, Toshiyuki; Hashimoto, Yoshikazu; Matsuoka, Hiroyoshi; Abe, Nobutsugu; Masaki, Tadahiko; Sugiyama, Masanori

    2015-01-01

    Introduction. Internal hernias are often misdiagnosed because of their rarity, with subsequent significant morbidity. Case Presentation. A 61-year-old Japanese man with no history of surgery was referred for intermittent abdominal pain. CT suggested the presence of a transmesocolic internal hernia. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We found internal herniation of the small intestine loop through a defect in the transverse mesocolon, without any strangulation of the small intestine. We were able to complete the operation laparoscopically. The patient's postoperative course was uneventful and the patient was discharged on postoperative day 6. Discussion. Transmesocolic hernia of the transverse colon is very rare. Transmesocolic hernia of the sigmoid colon accounts for 60% of all other mesocolic hernias. Paraduodenal hernias are difficult to distinguish from internal mesocolic transverse hernias. We can rule out paraduodenal hernias with CT. Conclusion. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We report a case of a transmesocolic hernia of the transverse colon with intestinal obstruction that was diagnosed preoperatively and for which laparoscopic surgery was performed. PMID:26246930

  14. Female homicidal strangulation in urban South Africa

    PubMed Central

    Suffla, Shahnaaz; Van Niekerk, Ashley; Arendse, Najuwa

    2008-01-01

    Background Female strangulation in South Africa occurs in a context of pervasive and often extreme violence perpetrated against women, and therefore represents a major public health, social and human rights concern. South African studies that provide accurate descriptions of the occurrence of strangulation incidents among female homicide victims are limited. The current study describes the extent, distribution and patterns of homicidal strangulation of women in the four largest South African metropolitan centres, Tshwane/Pretoria, Johannesburg, Cape Town and Ethekwini/Durban. Methods The study is a register-based cross sectional investigation of female homicidal strangulation, as reported in the National Injury Mortality Surveillance System for the four cities, for the period 2001 to 2005. Crude, unadjusted female strangulation rates for age and population group, and proportions of strangulation across specific circumstances of occurrence were compiled for each year and aggregated in some cases. Results This study reports that female homicidal strangulation in urban South Africa ranges from 1.71/100 000 to 0.70/100 000. Rates have generally declined in all the cities, except Cape Town. The highest rates were reported in the over 60 and the 20 to 39 year old populations, and amongst women of mixed descent. Most strangulations occurred from the early morning hours and across typical working hours in Johannesburg and Durban, and to a lesser extent in Cape Town. Occurrences across Johannesburg, Durban and Pretoria were distributed across the days of the week; an exception was Cape Town, which reported the highest rates over the weekend. Cape Town also reported distinctly high blood alcohol content levels of strangulation victims. The seasonal variation in strangulation deaths suggested a pattern of occurrence generally spanning the period from end-winter to summer. Across cities, the predominant crime scene was linked to the domestic context, suggesting that

  15. Complicated acute appendicitis within a right inguinal hernia sac (Amyand’s hernia): report of a case

    PubMed Central

    Kouskos, E; Komaitis, S; Kouskou, M; Despotellis, M; Sanidas, G

    2014-01-01

    Background: The term Amyand’s hernia refers to a rare clinical situation characterized by the presence of a normal or inflammed appendix within the sac of an inguinal hernia. The situation may be asymptomatic or may present as an incarcerated hernia in case of strangulation or acute appendicitis occurring inside the hernia sac. Description of the case: We present the case of a right Amyand’s hernia on a 88-years-old male that presented to our emergency department with a severely tender and swollen inguinal mass that was diagnosed as a strangulated inguinal hernia – inguinal abcess and underwent emergency operation. The intraoperative findings included a severely inflamed and perforated appendix along with healthy part of the caecum inside the sac. Appendectomy with subsequent primary hernia repair without mesh was performed with excellent outcome. Conclusion: Because of the fact that most of such rare cases are managed by urgent surgery with no preoperative diagnosis, every surgeon should be prepared for the possibility of coping with such an unexpected situation. PMID:25125958

  16. Internal abdominal hernia: Intestinal obstruction due to trans-mesenteric hernia containing transverse colon

    PubMed Central

    Crispín-Trebejo, Brenda; Robles-Cuadros, María Cristina; Orendo-Velásquez, Edwin; Andrade, Felipe P.

    2014-01-01

    INTRODUCTION Internal abdominal hernias are infrequent but an increasing cause of bowel obstruction still often underdiagnosed. Among adults its usual causes are congenital anomalies of intestinal rotation, postsurgical iatrogenic, trauma or infection diseases. PRESENTATION OF CASE We report the case of a 63-year-old woman with history of chronic constipation. The patient was hospitalized for two days with acute abdominal pain, abdominal distension and inability to eliminate flatus. The X-ray and abdominal computerized tomography scan (CT scan) showed signs of intestinal obstruction. Exploratory laparotomy performed revealed a trans-mesenteric hernia containing part of the transverse colon. The intestine was viable and resection was not necessary. Only the hernia was repaired. DISCUSSION Internal trans-mesenteric hernia constitutes a rare type of internal abdominal hernia, corresponding from 0.2 to 0.9% of bowel obstructions. This type carries a high risk of strangulation and even small hernias can be fatal. This complication is specially related to trans-mesenteric hernias as it tends to volvulize. Unfortunately, the clinical diagnosis is rather difficult. CONCLUSION Trans-mesenteric internal abdominal hernia may be asymptomatic for many years because of its nonspecific symptoms. The role of imaging test is relevant but still does not avoid the necessity of exploratory surgery when clinical features are uncertain. PMID:24880799

  17. Strangulation in childhood: epidemiology and clinical course.

    PubMed

    Feldman, K W; Simms, R J

    1980-06-01

    A review of 233 cases of childhood strangulation was made to determine injury epidemiology. Consistent patterns of injury were observed. Crib and playground equipment strangulations are already the subject of Consumer Product Safety Commission (CPSC) preventative regulations. High chair-, playpen mesh-, pacifier cord-, and clothing-related injuries would be amenable to prevention by improved product safety regulation. The CPSC has been petitioned to remedy the first two of these hazards. Many crib and rope strangulations can only be prevented by direct patient counseling. Although Congress empowered and required the CPSC to recognize and correct unsafe products, its surveillance systems may obscure the very design defects that cause injury. Likewise, political considerations may slow enactment of new design regulations. Physicians who treat childhood accident victims are in a position to recognize hazardous products and lobby for their improvement. Of the 233 cases 38 were further evaluated to delineate the clinical course of childhood strangulation. Victims who fail to resume normal cardiopulmonary function by the time of hospitalization have a poor prognosis for neurologic recovery with current modes of therapy. Improved treatment of hypoxic and ischemic cerebral injury might prevent some of the deaths and handicaps resulting from strangulation. PMID:7375230

  18. Penile strangulation: report of a fatal case.

    PubMed

    Morentin, Benito; Biritxinaga, Begoña; Crespo, Lourdes

    2011-12-01

    Penile strangulation or entrapment is an unusual entity that requires urgent treatment due to its potential complications. Several cases have been reported in the medical literature, some of them describing serious injuries such as necrosis, gangrene, and amputation of the penis. However, as far as we know, no fatal cases have been described before. We present the death of an adult male secondary to the complications due to penile strangulation with a plastic bottle neck. The time of incarceration was unknown, but according to a witness it could be about 10 to 14 days. The findings of autopsy were penile strangulation, necrosis of the penis, acute pyelonephritis, and bronchopneumonia. The subject's refusal to ask for medical help was the cause of this atypical evolution. PMID:22101437

  19. Hiatal Hernia

    MedlinePlus

    A hiatal hernia is a condition in which the upper part of the stomach bulges through an opening in the ... up into the esophagus. When you have a hiatal hernia, it's easier for the acid to come up. ...

  20. Strangulation--Suicide at the wheel.

    PubMed

    Madea, Burkhard; Schmidt, Peter; Kernbach-Wighton, Gerhard; Doberentz, Elke

    2015-11-01

    In cases of suicide at the wheel mostly velocity is used to cause death by a single occupant vehicle crash against a fixed roadside object or collision with other vehicles. A further well known mode of death is e.g. carbon monoxide poisoning. In the recent years several cases of vehicle assisted ligature strangulation resulting even in decapitation have been reported. However, cars are also used in rare cases just as places for a suicide by hanging or ligature strangulation. Not only forensic pathologists but also police officers have to be aware of this rare type of suicide to avoid unnecessary investigations.

  1. Dental obturation materials

    NASA Astrophysics Data System (ADS)

    Stockton, Elizabeth; Chudej, Lauren; Bilyeu, Brian; Brostow, Witold

    2006-10-01

    During the last decades, people have tried to develop a better material for use in dental obturation materials. This new material should meet the following requirements: durability, wear resistance, biocompatibility and chemical adhesion to dentin enamel. Wear resistance is very important and it is related with the service life of dental replacements. We have obtained aesthetically promising novel nano composites that can be used as dental replacements. The main objective of this work is to study the scratch and wear resistance of these nano composites. To meet this goal, scratch tests are performed using a micro scratch tester machine (CSEM), where a diamond indenter is used to make the scratch and the penetration of this indenter is measured with high resolution (7nm). We will be looking at the penetration depth (Rp) and the residual (or healing) depth (Rh) to calculate the percent recovery. These measurements represent the scratch resistance of the material.

  2. [Lumbar hernia].

    PubMed

    Teiblum, Sandra Sofie; Hjørne, Flemming Pii; Bisgaard, Thue

    2010-03-22

    Lumbar hernia is a rare condition. Lumbar hernia should be considered a rare differential diagnosis to unexplained back pain. Symptoms are scarce and diffuse and can vary with the size and content of the hernia. As there is a 25% risk of incarceration, operation is indicated even in asymptomatic hernias. We report a case of lumbar hernia in a woman with a slow growing mass in the lumbar region. She presented with pain and a computed tomography confirmed the diagnosis. She underwent open surgery and fully recovered with recurrence within the first half year.

  3. Subperiosteal orbital hemorrhage following self-strangulation.

    PubMed

    Knox Cartwright, Nathaniel E; Hussin, Hussin M; Biswas, Suman; Majid, Mohammed A; Potts, Mike J; Kabala, Julian; Mayer, Eric J

    2007-01-01

    Subperiosteal orbital hematomas are uncommon. The delayed presentation of such an event is described in an anticoagulated patient who attempted self-strangulation. Despite the initial presence of a relative afferent pupillary defect, excellent visual recovery occurred, demonstrating the importance of prompt recognition and treatment. The causes, mechanism of visual loss, radiographic diagnosis, and treatment of subperiosteal hemorrhages are discussed.

  4. Ultrasound-guided steroid injection for obturator neuralgia.

    PubMed

    Shankar, Hariharan

    2008-01-01

    Obturator neuralgia (ON) presents with pain in the groin, medial thigh, and sometimes the medial aspect of the knee. The causes include trauma, obturator hernia, pelvic cancer, pelvic surgery, hip surgery, following pelvic fractures, endometriosis, retroperitoneal hematoma, pregnancy, and delivery. Ultrasound (US) guidance facilitates real-time imaging, identification of vascular structures, and improves patient comfort in situations where nerve stimulation can be unpleasant. This is a case report of ON successfully treated with US-guided steroid injection. A 55-year-old man was referred to the pain clinic with groin pain and allodynia in the medial thigh and knee following a fall. He had tried multiple other therapies and none of them provided significant relief. Using a 10-5-MHz multi-frequency, 38-mm linear array transducer, the obturator nerve was scanned in both longitudinal and transverse directions. Under real-time imaging 10 mg of medroxy-progesterone in a volume of 1 mL was injected. Following the injection, a small area of the medial side of knee was still tender to light touch. A second injection was placed inferiorly and provided pain relief for more than 5 months. This successful demonstration of US guidance in ON may further encourage US guidance in pain clinic interventions.

  5. Twin pregnancy complicated with bowel strangulation

    PubMed Central

    Wong, Tze Fang; Imai, Shunichi; Tomita, Masato

    2014-01-01

    A 31-year-old primigravida at 35 weeks of gestation with twins who had no prior abdominal surgical history presented with worsening nausea, vomiting and abdominal pain. Initial screening ruled out obstetrical causes that may threaten the pregnancy. Twelve hours after the onset of symptoms, a transabdominal ultrasound revealed abdominal free fluid. A CT scan confirmed strangulated ileus involving the small bowels. Owing to non-reassuring fetal status in one of the twins, an emergency caesarean section and subsequent laparotomy were performed. The first twin presenting with fetal distress had to be resuscitated postdelivery but recovered uneventfully and met all developmental milestones by 3 months of age. The mother had a strangulated small bowel that had to be resected. She had an uncomplicated postsurgical course and gained full bowel function prior to discharge from the hospital. PMID:25199197

  6. Lumbar hernia: surgical anatomy, embryology, and technique of repair.

    PubMed

    Stamatiou, Dimitrios; Skandalakis, John E; Skandalakis, Lee J; Mirilas, Petros

    2009-03-01

    Lumbar hernia is the protrusion of intraperitoneal or extraperitoneal contents through a defect of the posterolateral abdominal wall. Barbette was the first, in 1672, to suggest the existence of lumbar hernias. The first case was reported by Garangeot in 1731. Petit and Grynfeltt delineated the boundaries of the inferior and superior lumbar triangles in 1783 and 1866, respectively. These two anatomical sites account for about 95 per cent of lumbar hernias. Approximately 20 per cent of lumbar hernias are congenital. The rest are either primarily or secondarily acquired. The most common cause of primarily acquired lumbar hernias is increased intra-abdominal pressure. Secondarily acquired lumbar hernias are associated with prior surgical incisions, trauma, and abscess formation. During embryologic development, weakening of the area of the aponeuroses of the layered abdominal muscles that derive from somitic mesoderm, which invades the somatopleure, may potentially lead to lumbar hernias. Repair of lumbar hernias should be performed as early as possible to avoid incarceration and strangulation. The classic repair technique uses the open approach, where closure of the defect is performed either directly or using prosthetic mesh. The laparoscopic approach, either transabdominal or extraperitoneal, is an alternative.

  7. Incisional Hernia Following Ventriculoperitoneal Shunt Positioning

    PubMed Central

    Bonatti, Matteo; Vezzali, Norberto; Frena, Antonio; Bonatti, Giampietro

    2016-01-01

    Incisional hernia represents a rare complication after ventriculoperitoneal shunt positioning due to failure of the fascial suture in the site of abdominal entrance of ventriculoperitoneal catheter. Clinical presentation can be extremely variable, according to patient’s performance status, herniated material constitution (i.e. mesenteric fat, bowel loops or both) and complication occurrence (e.g. strangulation or intestinal obstruction). Early diagnosis is fundamental in order to surgically repair the defect and prevent further complications. We present the case of a paucisymptomatic incisional hernia following ventriculoperitoneal shunt positioning. Diagnosis was made by means of ultrasound and confirmed by means of computed tomography. The patient was successfully managed by means of surgical repositioning of herniated loop and re-suture. PMID:27761180

  8. Three nonlethal ligature strangulations filmed by an autoerotic practitioner: comparison of early agonal responses in strangulation by ligature, hanging, and manual strangulation.

    PubMed

    Sauvageau, Anny; Ambrosi, Corinne; Kelly, Sean

    2012-12-01

    Despite great advances in forensic sciences in the last decades, our knowledge of the pathophysiology of ligature strangulation is still largely based on old writings from the 19th and beginning of the 20th century. The study of filmed hangings by the Working Group on Human Asphyxia has contributed to a better understanding of the agonal responses to strangulation by hanging, and judo-related studies have given some insight into the pathophysiology of manual strangulation, but the pathophysiology of ligature strangulation has remained largely unexplored so far. Three nonlethal strangulations filmed by an autoerotic practitioner are here presented. In these 3 ligature strangulations, the 35-year-old man is sitting on a chair. A pair of pajama pants is rolled once around his neck, with the extremities of the pants falling down on each side of his chest. The man is pulling the extremities of the pants with both hands to apply compression on his neck. After losing consciousness, he ceases to pull on the ligature, and the pants slowly loosen around the neck. A few seconds later, he regains consciousness and gets up from the chair. In the 3 nonlethal ligature strangulations presented in this study, the loss of consciousness occurred in 11 seconds. The loss of consciousness was closely followed by the onset of convulsions (7-11 seconds). These results are compared with the early agonal responses documented in filmed hangings and judo studies. PMID:22922552

  9. Epigastric Hernia.

    PubMed

    Suarez Acosta, Carlos Enrique; Romero Fernandez, Esperanza; Calvo Manuel, Elpidio

    2015-08-01

    Epigastric hernia is a common condition, mostly asymptomatic although sometimes their unusual clinical presentation still represents a diagnostic dilemma for clinician. The theory of extra tension in the epigastric region by the diaphragm is the most likely theory of epigastric hernia formation. A detailed history and clinical examination in our thin, elderly male patient who presented with abdominal pain and constipation of 5 days of evolution was crucial in establishing a diagnosis. Noninvasive radiologic modalities such as ultrasonographic studies in the case of our patient can reliably confirm the diagnosis of epigastric hernia. PMID:26702244

  10. Laparoscopic lumbar hernia repair.

    PubMed

    Madan, Atul K; Ternovits, Craig A; Speck, Karen E; Pritchard, F Elizabeth; Tichansky, David S

    2006-04-01

    Lumbar hernias are rare clinical entities that often pose a challenge for repair. Because of the surrounding anatomy, adequate surgical herniorraphy is often difficult. Minimally invasive surgery has become an option for these hernias. Herein, we describe two patients with lumbar hernias (one with a recurrent traumatic hernia and one with an incisional hernia). Both of these hernias were successfully repaired laparoscopically.

  11. [Lumbar hernia].

    PubMed

    Bednarek, Marcin; Bolt, Leszek; Biesiada, Zbigniew; Zub-Pokrowiecka, Anna

    2012-01-01

    Lumbar region constitutes one of the least common localizations for hernia formation. There are only slightly more than 300 cases found in English literature till the end of the 20th century, while there are only 8 cases presented in Polish literature. Exceptionally rare incidence together with diagnostic dilemma related to it made us to present cases of 2 patients operated on in the 2nd Chair of Surgery of Jagiellonian University Medical College due to lumbar hernia.

  12. Hiatal Hernia as a Total Gastrectomy Complication

    PubMed Central

    Santos, Bruna do Nascimento; de Oliveira, Marcos Belotto; Peixoto, Renata D'Alpino

    2016-01-01

    Introduction According to the Brazilian National Institute of Cancer, gastric cancer is the third leading cause of death among men and the fifth among women in Brazil. Surgical resection is the only potentially curative treatment. The most serious complications associated with surgery are fistulas and dehiscence of the jejunal-esophageal anastomosis. Hiatal hernia refers to herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm, though this occurrence is rarely reported as a complication in gastrectomy. Case Report A 76-year-old man was diagnosed with intestinal-type gastric adenocarcinoma. He underwent a total laparoscopic-assisted gastrectomy and D2 lymphadenectomy on May 19, 2015. The pathology revealed a pT4pN3 gastric adenocarcinoma. The patient became clinically stable and was discharged 10 days after surgery. He was subsequently started on adjuvant FOLFOX chemotherapy; however, 9 days after the second cycle, he was brought to the emergency room with nausea and severe epigastric pain. A CT scan revealed a hiatal hernia with signs of strangulation. The patient underwent emergent repair of the hernia and suffered no postoperative complications. He was discharged from the hospital 9 days after surgery. Conclusion Hiatal hernia is not well documented, and its occurrence in the context of gastrectomy is an infrequent complication. PMID:27293395

  13. [Examination reports on survived strangulation cases].

    PubMed

    Jänisch, Stefanie; Heine, Josephin; Günther, Detlef; Germerott, Tanja

    2010-01-01

    Clinical-forensic examination of strangulation victims is an increasing part of the routine of many forensic pathology institutes. The cases examined between 2004 and 2008 at the Institute of Legal Medicine of the Hanover Medical School were retrospectively analysed. In total, the study material comprised 218 victims (175 females and 43 males). In 80.7 %, the clinical-forensic examination was performed within 24 hours after the incident. In the overwhelming number of cases, the alleged perpetrator was no stranger. 128 victims (58.7 %) had strangulation marks, 32 victims (14.7 %) ligature marks and 65 victims (29.8 %) nail marks. Four victims showed injuries of the laryngeal and pharyngeal structures (reddening, hematomas, swelling and in one case a fracture of the cricoid cartilage on both sides). Extensive petechiae were predominantly seen in the conjunctivae, the buccal mucosa and the skin of the face in cases where the victims suffered a loss of consciousness. 87 cases (39.9% were classified as potentially life-threatening and 30 cases (13.8 %) as acute life-threatening events. This classification is of legal relevance for the penalty. In addition, 60 victims experienced sexual violence. These results suggest that early clinical-forensic examination is crucial for documenting forensic evidence in support of police investigations and may deliver significant details relevant in court.

  14. [Examination reports on survived strangulation cases].

    PubMed

    Jänisch, Stefanie; Heine, Josephin; Günther, Detlef; Germerott, Tanja

    2010-01-01

    Clinical-forensic examination of strangulation victims is an increasing part of the routine of many forensic pathology institutes. The cases examined between 2004 and 2008 at the Institute of Legal Medicine of the Hanover Medical School were retrospectively analysed. In total, the study material comprised 218 victims (175 females and 43 males). In 80.7 %, the clinical-forensic examination was performed within 24 hours after the incident. In the overwhelming number of cases, the alleged perpetrator was no stranger. 128 victims (58.7 %) had strangulation marks, 32 victims (14.7 %) ligature marks and 65 victims (29.8 %) nail marks. Four victims showed injuries of the laryngeal and pharyngeal structures (reddening, hematomas, swelling and in one case a fracture of the cricoid cartilage on both sides). Extensive petechiae were predominantly seen in the conjunctivae, the buccal mucosa and the skin of the face in cases where the victims suffered a loss of consciousness. 87 cases (39.9% were classified as potentially life-threatening and 30 cases (13.8 %) as acute life-threatening events. This classification is of legal relevance for the penalty. In addition, 60 victims experienced sexual violence. These results suggest that early clinical-forensic examination is crucial for documenting forensic evidence in support of police investigations and may deliver significant details relevant in court. PMID:21121118

  15. [Obturator nerve block in transurethral surgery].

    PubMed

    Rubial Alvarez, M; Molins Gauna, N; Rubio Pascual, P; Martín Bermejo, P; Pamplona Casamayor, M

    1989-01-01

    The obturator nerve passes in close proximity to the bladder as it courses through the pelvis. During transurethral operations, resection may result in stimulation of the obturator nerve, causing violent adductor contraction. Bladder perforation and incomplete tumor resection are the most important complications. All techniques proposed since transurethral surgery began, until nowadays are reviewed: neuromuscular blockade, electric circuit modifications, transparietal endoscopic blockade, periprostatic and subvesical infiltration, obturator nerve blockade and the "3 in 1 block" described by Winnie. Practical advices are proposed finally.

  16. Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

    PubMed Central

    Tatar, Cihad; Tüzün, İshak Sefa; Karşıdağ, Tamer; Kızılkaya, Mehmet Celal; Yılmaz, Erdem

    2016-01-01

    Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of non-complicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3), and the other consisting of patients not undergoing bowel resection (Group 4). Results: In Group 1, it was observed that eight (7.14%) of the patients had wound infections, while two (1.78%) had hematomas, four (3.57%) had seromas, and one (0.89%) had relapse. In Group 2, one (2.56%) of the patients had a wound infection, while three (7.69%) had hematomas, one (2.56%) had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection, seroma

  17. Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

    PubMed Central

    Tatar, Cihad; Tüzün, İshak Sefa; Karşıdağ, Tamer; Kızılkaya, Mehmet Celal; Yılmaz, Erdem

    2016-01-01

    Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of non-complicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3), and the other consisting of patients not undergoing bowel resection (Group 4). Results: In Group 1, it was observed that eight (7.14%) of the patients had wound infections, while two (1.78%) had hematomas, four (3.57%) had seromas, and one (0.89%) had relapse. In Group 2, one (2.56%) of the patients had a wound infection, while three (7.69%) had hematomas, one (2.56%) had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection, seroma

  18. Will safety release cords on children's cameras prevent strangulation?

    PubMed

    Ridenour, Marcella V

    2003-12-01

    This study investigated the automatic safety release mechanisms on neck cords for children's cameras. The purpose of the safety release mechanism is to reduce accidental strangulation associated with children's toys that have neck cords. The horizontal pull forces that activate the automatic safety release mechanism were measured for two different styles of release mechanisms for neck cords. When these forces were compared to forces associated with child strangulation, the automatic safety mechanisms released at higher forces than the forces associated with accidental strangulation or death, which is contrary to what was intended and creates a false sense of security for parents who select a toy camera with such a device. PMID:14738371

  19. Will safety release cords on children's cameras prevent strangulation?

    PubMed

    Ridenour, Marcella V

    2003-12-01

    This study investigated the automatic safety release mechanisms on neck cords for children's cameras. The purpose of the safety release mechanism is to reduce accidental strangulation associated with children's toys that have neck cords. The horizontal pull forces that activate the automatic safety release mechanism were measured for two different styles of release mechanisms for neck cords. When these forces were compared to forces associated with child strangulation, the automatic safety mechanisms released at higher forces than the forces associated with accidental strangulation or death, which is contrary to what was intended and creates a false sense of security for parents who select a toy camera with such a device.

  20. Angiolipoma located inside the obturator canal and supplied by the umbilical artery.

    PubMed

    Sarikcioglu, Levent; Demirel, Bahadir Murat; Ozsoy, Umut; Gurer, Elif Inanc; Oguz, Nurettin; Ucar, Yasar

    2007-01-01

    During dissection of the retropubic region of a 55-year-old female cadaver, we encountered an angiolipoma located inside the obturator canal which was connected to the wall of the urinary bladder by a fibrous cord. The angiolipoma was supplied by a branch originating from the umbilical artery. Microscopically the benign soft tissue tumor was characterized by lobules of mature adipocytes and densely distributed networks of small and larger blood vessels, thus resembling typical histological features of an angiolipoma. Both the uncommon location of the angiolipoma and the abnormal branch of the umbilical artery entering the obturator canal should be taken into account during surgical procedures in this region, such as for orthopedic pelvic procedures, hernia repair or bladder/urethra-related interventions (e.g. transobturator tape, tension-free vaginal tape, colposuspension).

  1. Littre hernia: surgical anatomy, embryology, and technique of repair.

    PubMed

    Skandalakis, Panagiotis N; Zoras, Odyseas; Skandalakis, John E; Mirilas, Petros

    2006-03-01

    Littre hernia is the protrusion of a Meckel diverticulum through a potential abdominal opening. Alexis de Littre (1700) reported ileal diverticula and attributed them to traction. August Gottlieb Richter (1785) defined them as preformed, and Johann Friedrich Meckel (1809) postulated their embryologic origin. Sir Frederic Treves (1897) distinguished between Littre and Richter hernia (partial enterocele). Embryologically, Meckel diverticulum is the persistent intestinal part of the omphaloenteric duct through which the midgut communicates with the umbilical vesicle until the fifth week. It is found at the antimesenteric border of the ileum, usually located 30 to 90 cm from the ileocecal valve, measuring 3 to 6 cm in length and 2 cm in diameter. Usual sites of Littre hernia are: inguinal (50%), umbilical (20%), and femoral (20%). Meckel diverticulum may be accompanied in the sac by the ileal loop to which it is attached; rarely, it may undergo incarceration or strangulation, necrosis, and perforation. In children, it is mostly found in umbilical hernias, and the diverticulum is more prone to adhere to the sac. Repair of Littre hernia consists of resection of the diverticulum and herniorraphy; in perforated cases, care must be taken to not contaminate the hernia field.

  2. A Morphometric Study of the Obturator Nerve around the Obturator Foramen

    PubMed Central

    Jo, Se Yeong; Chang, Jae Chil; Bae, Hack Gun; Oh, Jae-Sang; Heo, Juneyoung

    2016-01-01

    Objective Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. Methods Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. Results The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. Conclusion The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications. PMID:27226861

  3. Strangulation forensic examination: best practice for health care providers.

    PubMed

    Faugno, Diana; Waszak, Daria; Strack, Gael B; Brooks, Melodie Ann; Gwinn, Casey G

    2013-01-01

    Strangulation is one of the most dangerous forms of interpersonal violence (IVP), yet it is often not reported and missed by the health care provider because of lack of visible injury. The victim of strangulation can have critical injuries and a late onset symptoms. Victims of IVP should be directly asked whether they were choked or whether during the assault they felt like they could not breathe because of pressure on their neck. The objective of this article is to summarize "best practice" for health care providers so that they are better prepared to care for victims who report a history of strangulation. A summary of how to perform a forensic examination of the strangled patient is provided along with important documentation takeaways and useful forms to ensure that the severity of the strangulation is assessed, that critical injuries are identified, and that all injuries and findings are accurately documented for legal proceedings. PMID:24176831

  4. Perforated carcinoma of the sigmoid colon in an incarcerated inguinal hernia: report of a case.

    PubMed

    Kouraklis, Gregory; Kouskos, Efstratios; Glinavou, Andromachi; Raftopoulos, John; Karatzas, Gabriel

    2003-01-01

    Perforation of the large bowel due to benign or malignant disease in an inguinal hernia is very rare, but should be considered as a potential cause of strangulated hernias. A 79-year-old man with a 2-day history of scrotal swelling and pain in the left side associated with fever and chills was brought to our Emergency Department, where he was classified as American Society of Anesthesiologists IVE. A large left incarcerated scrotal hernia was diagnosed and surgical exploration was performed using local infiltration anesthesia. A standard oblique inguinal incision was made, revealing perforation of the sigmoid colon due to cancer. A 40-cm segmental resection of the sigmoid colon was done, and a double-barrel colostomy was made through the inguinal incision. This surgical strategy involving construction of a double-barrel colostomy through the inguinal hernia incision could be an alternative method of managing such critically ill patients.

  5. Fracture resistance of roots obturated with novel hydrophilic obturation systems

    PubMed Central

    Hegde, Vibha; Arora, Shashank

    2015-01-01

    Aim: Comparative assessment of fracture resistance of roots obturated with three hydrophilic systems — novel CPoint system, Resilon/Epiphany system, and EndoSequence BC sealer; and one hydrophobic gold standard gutta-percha/AHPlus system. Materials and Methods: Ninety freshly extracted, human, single-rooted mandibular premolars were selected. The specimens were decoronated and standardized to a working length of 13 mm. The teeth were randomly divided into six groups (n = 15). In Group A, teeth were left unprepared and unfilled (negative control). Rest of the groups were prepared by using ProTaper system up to a master apical file F3; followed by which Group B was left unobturated (positive control); Group C, novel CPoint System; group D, Resilon/Epiphany system, Group E EndoSequence BC sealer, and Group F gutta-percha and AH Plus. Specimens were stored for 2 weeks at 100% humidity. Each group was then subjected to fracture testing by using a universal testing machine. The force required to fracture each specimen was recorded and the data was analyzed statistically using analysis of variance (ANOVA) test and Tukey's post-hoc test. Results: The hydrophilic obturation systems have shown to exhibit significantly higher fracture resistance as shown by the values in Groups C, D, and E (P < 0.05) when compared with Group F. Within hydrophilic groups there was significant difference between Group D and Groups C and E (P < 0.05), while Groups C and E had no significant difference (P > 0.05). Conclusion: In contrast to hydrophobic systems, hydrophilic systems showed higher fracture resistance in a single-rooted premolar. PMID:26069417

  6. Palatal obturators in patients after maxillectomy

    PubMed Central

    CARDELLI, P.; BIGELLI, E.; VERTUCCI, V.; BALESTRA, F.; MONTANI, M.; DE CARLI, S.; ARCURI, C.

    2014-01-01

    SUMMARY Prosthodontic management of palatal defects is fundamental to improve patient’s life undergoing to a maxillary surgical treatment. A lot of maxillary defects are a direct consequence of surgical treatment of malformations, neoplasms or trauma. The obturators are prosthesis used to close palatal defects after maxillectomy, to restore masticatory function and to improve speech. The primary goals of the obturator prosthesis are to preserve the remaining teeth and tissue and to provide comfort, function, and aesthetics to the patients. Different materials and retention methods are a characteristic of new types of obturators. PMID:25992263

  7. Laparoscopic repair of a lumbar hernia: report of a case and extensive review of the literature.

    PubMed

    Suarez, Sebastian; Hernandez, Juan D

    2013-09-01

    Lumbar hernias are a protrusion of intra-abdominal contents through a weakness or rupture in the posterior abdominal wall. They are considered to be a rare entity with approximately 300 cases reported in the literature since it was first described by Barbette in 1672. Petit described the inferior lumbar triangle in 1783 and Grynfeltt described the superior lumbar triangle in 1866; both are anatomical boundaries where 95% of lumbar hernias occur, whereas the other 5% are considered to be diffuse. Twenty percent of lumbar hernias are congenital and the other 80% are acquired; the acquired lumbar hernias can be further classified into either primary (spontaneous) or secondary. The typical presentation of lumbar hernias is a patient with a protruding semispherical bulge in the back with a slow growth. However, they may present with an incarcerated or strangulated bowel, so it is recommended that all lumbar hernias must be repaired as soon as they are diagnosed. The "gold standard" for diagnosing a lumbar hernia is a CT scan, because it is able to delineate muscular and fascial layers, detect a defect in one or more of these layers, evaluate the presence of herniated contents, differentiate muscle atrophy from a real hernia, and serve as a useful tool in the differential diagnosis, such as tumors. Recent studies have demonstrated the advantages of a laparoscopic repair instead of the classic open approach as the ideal treatment option for lumbar hernias. We report a case of a spontaneous lumbar hernia initially diagnosed as a lipoma and corrected with the open approach, but after relapsing 2 years later it was corrected using a laparoscopic approach. It is followed by an extensive review of lumbar hernias literature regarding history, anatomy, and surgical techniques.

  8. Penile strangulation due to plastic bottle neck: a surgical emergency.

    PubMed

    Agarwal, Akshay Anand; Singh, Kul Ranjan; Kushwaha, Jitendra Kumar; Sonkar, Abhinav Arun

    2014-01-01

    Use of various metallic and non-metallic constricting objects on the external male genitalia for increasing sexual performance or because of autoerotic intentions is an unusual practice that can potentially lead to penile strangulation with severe consequences. Depending on the type of constricting material, emergency removal of such an object is a challenge. We report a case of a 45-year-old man who presented to our hospital with a hard plastic bottle neck at the base of his penis that led to penile strangulation. The constricting agent was successfully removed. The patient had an uneventful recovery. PMID:25427935

  9. Penile strangulation due to plastic bottle neck: a surgical emergency.

    PubMed

    Agarwal, Akshay Anand; Singh, Kul Ranjan; Kushwaha, Jitendra Kumar; Sonkar, Abhinav Arun

    2014-11-26

    Use of various metallic and non-metallic constricting objects on the external male genitalia for increasing sexual performance or because of autoerotic intentions is an unusual practice that can potentially lead to penile strangulation with severe consequences. Depending on the type of constricting material, emergency removal of such an object is a challenge. We report a case of a 45-year-old man who presented to our hospital with a hard plastic bottle neck at the base of his penis that led to penile strangulation. The constricting agent was successfully removed. The patient had an uneventful recovery.

  10. Laparoscopic Hernia Repair and Bladder Injury

    PubMed Central

    Bhoyrul, Sunil; Mulvihill, Sean J.

    2001-01-01

    Background: Bladder injury is a complication of laparoscopic surgery with a reported incidence in the general surgery literature of 0.5% and in the gynecology literature of 2%. We describe how to recognize and treat the injury and how to avoid the problem. Case Reports: We report two cases of bladder injury repaired with a General Surgical Interventions (GSI) trocar and a balloon device used for laparoscopic extraperitoneal inguinal hernia repair. One patient had a prior appendectomy; the other had a prior midline incision from a suprapubic prostatectomy. We repaired the bladder injury, and the patients made a good recovery. Conclusion: When using the obturator and balloon device, it is important to stay anterior to the preperitoneal space and bladder. Prior lower abdominal surgery can be considered a relative contraindication to extraperitoneal laparoscopic hernia repair. Signs of gas in the Foley bag or hematuria should alert the surgeon to a bladder injury. A one- or two-layer repair of the bladder injury can be performed either laparoscopically or openly and is recommended for a visible injury. Mesh repair of the hernia can be completed provided no evidence exists of urinary tract infection. A Foley catheter is placed until healing occurs. PMID:11394432

  11. Laparoscopic repair for a previously unreported form of ventral hernia on the right iliac fossa in an elderly emaciated woman.

    PubMed

    Yokoyama, T; Kobayashi, A; Shimizu, A; Motoyama, H; Miyagawa, S

    2015-10-01

    An 81-year-old emaciated woman was admitted to our hospital with a one-year history of recurrent bilateral inguinal swellings. Palpable lumps were observed not only in bilateral groin areas, but also on the right iliac fossa (RIF) of her abdomen. During a planned transabdominal preperitoneal laparoscopic herniorrhaphy, a previously unreported form of ventral hernia was observed at a position lateral and cranial to the right internal inguinal ring, which probably corresponded to the palpable lump on the RIF. The hernia orifice was 2 cm in diameter, and a vascular structure ran through the orifice. The contents of the hernia consisted of fatty tissue arising from the retroperitoneal tissue. Routine exploration revealed orifices of the following hernias: left indirect, right direct, bilateral femoral, bilateral obturator, and right Spigelian hernia. Her postoperative course was uneventful and a mass on the right lower quadrant disappeared after operation.

  12. Laparoscopic Ventral Hernia Repair

    MedlinePlus

    ... the likelihood of a hernia including persistent coughing, difficulty with bowel movements or urination, or frequent need for straining. What are the Advantages of Laparoscopic Ventral Hernia Repair? Keep reading... Page 1 of 2 1 2 » Brought to ...

  13. Pediatric hernias and hydroceles.

    PubMed

    Kapur, P; Caty, M G; Glick, P L

    1998-08-01

    Hernias and hydroceles are common conditions of infancy and childhood, and inguinal hernia repair is one of the most frequently performed pediatric surgical operations. As a result of improved neonatal intensive care, more and more premature babies are being delivered, and consequently the incidence of neonatal inguinal hernia is increasing. The most important aspect of the management of neonatal inguinal hernias relate to its risk on incarceration, and emphasis is placed on this point. This article covers the embryology, incidence, clinical presentation, and treatment of groin hernias and hydroceles, as well as dealing with abdominal wall hernias other than umbilical hernias. This article places special emphasis on when a patient with a hernia or hydrocele should be referred to a pediatric surgeon.

  14. Robotic inguinal hernia repair.

    PubMed

    Escobar Dominguez, Jose E; Gonzalez, Anthony; Donkor, Charan

    2015-09-01

    Inguinal hernias have been described throughout the history of medicine with many efforts to achieve the cure. Currently, with the advantages of minimally invasive surgery, new questions arise: what is going to be the best approach for inguinal hernia repair? Is there a real benefit with the robotic approach? Should minimally invasive hernia surgery be the standard of care? In this report we address these questions by describing our experience with robotic inguinal hernia repair. PMID:26153353

  15. 21 CFR 868.5650 - Esophageal obturator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Esophageal obturator. 868.5650 Section 868.5650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... patient during emergency resuscitation by occluding (blocking) the esophagus, thereby permitting...

  16. 21 CFR 868.5650 - Esophageal obturator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Esophageal obturator. 868.5650 Section 868.5650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... patient during emergency resuscitation by occluding (blocking) the esophagus, thereby permitting...

  17. [Obturator neuralgia (Howship-Romberg phenomenon)].

    PubMed

    Saurenmann, P; Brand, S

    1984-10-20

    A 73-year-old patient with obturator neuropathy presenting as disabling thigh pain is described. The clinical diagnosis was verified by electromyography. No indication for surgery could be found. The patient's discomfort was not influenced by common pain-killers, but was relieved by the antipsychotic drug Melleril.

  18. Planned complex suicide: self-strangulation and fall from height.

    PubMed

    Nor, Faridah Mohd; Das, Srijit

    2011-10-01

    We hereby present a case of planned complex suicide. In this case study, we report a teen-aged girl who committed suicide by strangulating herself, and subsequently fell from the 13th floor of a housing apartment. The planned complex suicide was substantiated by the presence of a suicide note and a photograph captured in a mobile handset. To the best of our knowledge, it is the first case involving self-strangulation and fall from height, in which the photograph was stored in the handset. This is to further emphasize that objects like mobile handsets can be important in determining the cause and manner of death. The available evidence at the site of incident should be explored meticulously in order to arrive at a proper conclusion. PMID:21907941

  19. Unintentional strangulation in children: a professional approach to the problem.

    PubMed

    Drew, C S

    2001-01-01

    Unintentional strangulation in children is a preventable cause of injury. Health care providers caring for injured children may not always consider the positive impact that they can have after such an incident. After caring for a child who had experienced a life-threatening accident involving a cable tie, the author explored the options available to health care providers in preventing similar incidences in other children.

  20. Retrospective analysis of 319 hanging and strangulation cases between 2001 and 2014 in Shanghai.

    PubMed

    Ma, Jianlong; Jing, Haojia; Zeng, Yan; Tao, Li; Yang, Yulei; Ma, Kaijun; Chen, Long

    2016-08-01

    In this study, we retrospectively analyzed 141 cases of hanging and 178 cases of ligature strangulation recorded in the Shanghai Municipal Public Security Bureau between January 2001 and December 2014 to explore the characteristics of hanging and ligature strangulation and to supply a scientific reference for forensic pathology. Several significant differences between hanging and ligature strangulation were found. Hanging cases were mostly suicide, with some accidental cases. Strangulation cases were mostly homicide, with a few cases of suicide or sexual asphyxia. Male hanging was more common than female hanging, with a ratio of 5:2. However, there were more female than male strangulation cases, with a ratio of 13:5. The ligature marks in hanging cases were almost all of a "U" type and above the hyoid bone. The ligature marks in strangulation cases were almost always a closed circle, but the position varied. The most common vital reactions were subcutaneous hemorrhage, exfoliation and blister, which are strong evidence of antemortem injury. Hemorrhagic spots were found on the temporalis, scalp, chest and back in strangulation cases, but were rare in hanging cases. Hemorrhagic manifestations were most common in the sternocleidomastoid muscle in hanging cases, and in the sternohyoid and sternothyroid muscles in strangulation cases. Fractures occurred in only ∼17% of victims. There are notable differences between hanging and ligature strangulation, which can help distinguish between these causes of death. These characteristics should be considered in forensic practice. PMID:27219113

  1. Parastomal hernias after radical cystectomy and ileal conduit diversion

    PubMed Central

    Donahue, Timothy F.

    2016-01-01

    Parastomal hernia, defined as an "incisional hernia related to an abdominal wall stoma", is a frequent complication after conduit urinary diversion that can negatively impact quality of life and present a clinically significant problem for many patients. Parastomal hernia (PH) rates may be as high as 65% and while many patients are asymptomatic, in some series up to 30% of patients require surgical intervention due to pain, leakage, ostomy appliance problems, urinary obstruction, and rarely bowel obstruction or strangulation. Local tissue repair, stoma relocation, and mesh repairs have been performed to correct PH, however, long-term results have been disappointing with recurrence rates of 30%–76% reported after these techniques. Due to high recurrence rates and the potential morbidity of PH repair, efforts have been made to prevent PH development at the time of the initial surgery. Randomized trials of circumstomal prophylactic mesh placement at the time of colostomy and ileostomy stoma formation have shown significant reductions in PH rates with acceptably low complication profiles. We have placed prophylactic mesh at the time of ileal conduit creation in patients at high risk for PH development and found it to be safe and effective in reducing the PH rates over the short-term. In this review, we describe the clinical and radiographic definitions of PH, the clinical impact and risk factors associated with its development, and the use of prophylactic mesh placement for patients undergoing ileal conduit urinary diversion with the intent of reducing PH rates. PMID:27437533

  2. Modern Endodontic Principles. Part 5: Obturation.

    PubMed

    Darcey, James; Roudsari, Reza Vahid; Jawad, Sarra; Taylor, Carly; Hunter, Mark

    2016-03-01

    Once cleaning and shaping is complete the clinician must obturate the canal. There are many different materials and techniques available each with their own discrete advantages and disadvantages. Whichever technique is used, the goal is to seal the entire prepared length of the root canal. This paper describes how best this may be achieved. CPD/Clinical Relevance: It is incumbent on the clinician to ensure that once the canal has been prepared it is sealed from bacterial re-entry. PMID:27188127

  3. [Spontaneous bilateral Petit hernia].

    PubMed

    Fontoura, Rodrigo Dias; Araújo, Emerson Silveira de; Oliveira, Gustavo Alves de; Sarmenghi Filho, Deolindo; Kalil, Mitre

    2011-01-01

    Petit's lumbar hernia is an uncommon defect of the posterior abdominal wall that represents less than 1% of all abdominal wall hernias. It is more often unilateral and founded in young females, rarely containing a real herniated sac. There are two different approaches to repair: laparoscopy and open surgery. The goal of this article is to report one case of spontaneous bilateral lumbar Petit's hernia treated with open surgery.

  4. Diaphragmatic hernia of Morgagni.

    PubMed

    LaRosa, D V; Esham, R H; Morgan, S L; Wing, S W

    1999-04-01

    Most cases of Morgagni hernia are asymptomatic and diagnosed incidentally on routine chest x-ray film, but they may occasionally become symptomatic. Symptomatic Morgagni hernias may present in many different ways, making the diagnosis challenging. We describe a patient with a Morgagni hernia, resulting in intractable nausea and vomiting, give a brief review of symptoms, note the different types of abdominal contents herniated, and describe the methods used to make the diagnosis.

  5. Richter’s Hernia and Sir Frederick Treves: An Original Clinical Experience, Review, and Historical Overview

    PubMed Central

    Steinke, Wolfgang; Zellweger, René

    2000-01-01

    Objective To describe the clinical recognition, pathology, and management of Richter’s hernia and to review the relevant literature of the past 400 years. Summary Background Data The earliest known reported case of Richter’s hernia occurred in 1598 and was described by Fabricius Hildanus. The first scientific description of this particular hernia was given by August Gottlob Richter in 1778, who presented it as “the small rupture.” In 1887, Sir Frederick Treves gave an excellent overview on the topic and proposed the title “Richter’s hernia.” To his work—a cornerstone to modern understanding—hardly any new aspects can be added today. Since then, only occasional case reports or small series of retrospectively collected Richter’s hernias have been published. Methods The authors draw on their experience with 18 prospectively collected cases treated in the ICRC Lopiding Hospital for War Surgery in northern Kenya between February and December 1998 and review the relevant literature of the past 400 years. Results The classic features of Richter’s hernia were confirmed in all case studies of patients: only part of the circumference of the bowel is entrapped and strangulated in the hernial orifice. The involved segment may rapidly pass into gangrene, yet signs of intestinal obstruction are often absent. The death rate in the authors’ collective was 17%. Conclusion Richter’s hernia is a deceptive entity whose high death rate can be reduced by accurate diagnosis and early surgery. Considering the increasing incidence at laparoscope insertion sites, awareness of this special type of hernia with its misleading clinical appearance is important and of general interest. PMID:11066144

  6. The nance obturator, a new fixed obturator for patients with cleft palate and fistula.

    PubMed

    Borzabadi-Farahani, Ali; Groper, John N; Tanner, Aaron M; Urata, Mark M; Panossian, Andre; Yen, Stephen L-K

    2012-07-01

    In patients with fistulas that impair function (e.g., feeding, resonance, intelligibility), obturators are used to improve feeding and reduce nasal air emission by occluding the abnormal opening between the oral and nasal cavities. This report describes a novel method for occluding an anterior palatal fistula in patients with cleft palates. The new design for a fixed obturator is based on the Nance appliance, which was originally used as a space maintainer, but has been redesigned for closing an anterior palatal fistula in a patient with cleft lip and palate. The Nance obturator may be used when the surgical closure of the fistula is not feasible and a removable device is not successful. As it is a fixed device, it does not require remaking with maxillary growth. The new design may also function as a fixed space maintainer to preserve molar anchorage and maxillary transverse width.

  7. A Peterson's hernia and subsequent small bowel volvulus: surgical reconstruction utilizing transverse colon as a new Roux-en-Y limb - 1 case.

    PubMed

    Jang, Jae Seong; Shin, Dong Gue

    2013-12-01

    Peterson's hernia is an internal hernia that can occur after Roux-en-Y anastomosis. It often accompanies small bowel volvulus and is prone to strangulation. Reconstruction of intestinal continuity after massive small bowel resection in a patient who undergoes near total gastrectomy and Roux-en-Y anastomosis can be difficult. A 74-year-old man who had undergone a near total gastrectomy and Roux-en-Y gastrojejunostomy for stomach cancer presented with abdominal pain. The preoperative computed tomography showed strangulated small bowel volvulus. During the emergent laparotomy, we found a strangulated Peterson's hernia with small bowel volvulus. After resection of the necrotized intestine, we made a new Roux-en-Y anastomosis connecting the remnant stomach and the jejunum with a transverse colon segment. We were safely able to connect the remnant stomach and the jejunum by making a new Roux-en-Y anastomosis utilizing a transverse colon segment as a new Roux-limb by two stage operation.

  8. Femoral hernia repair

    MedlinePlus

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  9. [Incidence of inguinal hernias].

    PubMed

    Michalský, R

    2001-04-01

    Groin hernia operation is the third most frequent operation in the Czech republic. Early recurrence of the hernia after prime operation is a medical failure. The recurrences can arise after all types of operation. Incidence of recurrences, time factors of its genesis and treatment are discussed there.

  10. Omentum in the pediatric umbilical hernia: is it a potential alarm for the appearance of complications?

    PubMed

    Sinopidis, Xenophon; Panagidis, Antonios; Alexopoulos, Vasileios; Karatza, Ageliki; Mitropoulou, Konstantina; Varvarigou, Anastasia; Georgiou, George

    2012-01-01

    Umbilical hernia is a common benign condition which resolves spontaneously during the first five years of life. However, in certain cases there are some characteristics which may be indicative of a different prognostic approach, as they increase the possibility of complications. The two cases of umbilical hernia that we describe here were treated operatively and revealed the presence of strangulated and adhered omentum, respectively. Reflecting on the adhesive properties of the omentum, we hypothesized that this may occur more often than it is believed, especially in those cases that are described as recurrent symptomatic herniations. In such cases, there should be increased alert for the possibility of complications during the period of the conservative expectance for resolution.

  11. Omentum in the Pediatric Umbilical Hernia: Is It a Potential Alarm for the Appearance of Complications?

    PubMed Central

    Sinopidis, Xenophon; Panagidis, Antonios; Alexopoulos, Vasileios; Karatza, Ageliki; Mitropoulou, Konstantina; Varvarigou, Anastasia; Georgiou, George

    2012-01-01

    Umbilical hernia is a common benign condition which resolves spontaneously during the first five years of life. However, in certain cases there are some characteristics which may be indicative of a different prognostic approach, as they increase the possibility of complications. The two cases of umbilical hernia that we describe here were treated operatively and revealed the presence of strangulated and adhered omentum, respectively. Reflecting on the adhesive properties of the omentum, we hypothesized that this may occur more often than it is believed, especially in those cases that are described as recurrent symptomatic herniations. In such cases, there should be increased alert for the possibility of complications during the period of the conservative expectance for resolution. PMID:23213589

  12. Rare cause of paraparesis: bilateral obturator neuropathy after hysterosalpingectomy.

    PubMed

    López-Blanco, Roberto; Mejía-Jiménez, Inmaculada; de Fuenmayor-Fernández de la Hoz, Carlos Pablo; Ruiz-Morales, Juan

    2015-01-01

    Bilateral obturator nerve injury during pelvic surgery is an infrequent cause of lower limb paraparesis. We report the case of a 45-year-old woman with a large uterine leiomyoma who underwent simple total hysterectomy and bilateral salpingectomy. At 24 h after the surgery, the patient noticed loss of muscle strength when adducting both legs. She had no problem with other movements and no sensory or sphincter abnormalities. Neurological examination confirmed that there was loss of strength only in the adductor muscles, with preserved sensory function and reflexes, suggesting bilateral obturator nerve involvement. Pelvic MRI showed a small postsurgical haematoma in the Douglas recess, but far from the obturator nerves. 2 weeks later, electromyography showed positive sharp waves and low motor unit recruitment in the adductor magnus muscles, confirming acute, bilateral obturator nerve neuropathy. The few cases of bilateral obturator neuropathy that have been reported were mostly related to abdominopelvic interventions. PMID:26689250

  13. Hernias and hydroceles.

    PubMed

    Palmer, Lane S

    2013-10-01

    Inguinoscrotal abnormalities in children are best understood by understanding the embryology of testicular descent and the failure of the processus vaginalis to properly obliterate. The inguinal hernia, communicating hydrocele, hydrocele of the spermatic cord, and scrotal hydrocele should be differentiated based on a history and physical examination in most cases, with selective use of ultrasonography. The urgency to surgically correct these entities depends on the nature of the hernia or hydrocele and the likelihood of incarceration or spontaneous resolution. Open standard herniorrhaphy remains the most common surgical approach, and concurrent transinguinal laparoscopy allows quick and accurate inspection of the contralateral internal inguinal ring and the need for bilateral repair of an inguinal hernia.

  14. Laparoscopic Inguinal Hernia Repair

    MedlinePlus

    ... Some hernia repairs are performed using a small telescope known as a laparoscope. If your surgeon has ... in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). Laparoscopic repair offers a ...

  15. Gastric femoral hernia in a male cadaver with gastroptosis: case report and review of the literature.

    PubMed

    Natsis, K; Apostolidis, S; Papadopoulou, A L; Vlasis, K; Totlis, T; Skandalakis, P

    2008-04-01

    The shape and the position of the stomach and its anatomic relations to the round viscera vary from individual to individual, but they also vary in the same subject depending on many factors. The downward displacement of the stomach is called gastroptosis. In the literature, there are only five case reports where the stomach constituted the content of a femoral hernia. The current study presents a case of a gastric femoral hernia in a cadaver along with a review of the relevant literature. During routine dissection of a 67-year-old male cadaver with a very large stomach and gastroptosis, a femoral hernia containing a part of the great curvature of the stomach was found. The length of the hernia sac was 5 cm, and its width was 3.5 cm. There was a disposition of the intestinal coils to the posterior wall and the lesser pelvis. The cadaver's former medical history and skin observation before dissection excluded any previous abdominal surgery. This is the second case of stomach herniation through the femoral ring in a male subject ever reported. The symptoms in this pathology vary from complete absence to symptoms due to high stenosis of the digestive tract, stomach strangulation and stomach wall necrosis.

  16. Dentinal defects before and after rotary root canal instrumentation with three different obturation techniques and two obturating materials

    PubMed Central

    Kumaran, Ponnuswamy; Sivapriya, Elangovan; Indhramohan, Jamuna; Gopikrishna, Velayutham; Savadamoorthi, K Subramani; Pradeepkumar, Angambakkam Rajasekharan

    2013-01-01

    Aim: To evaluate the role of rotary root canal instrumentation followed by obturation with three different techniques and two different materials on the incidence of dentinal defects. Materials and Methods: One hundred and sixty mandibular premolars were divided into eight groups (n = 20). Group I was left untreated and served as control. The other seven groups were prepared with profile rotary instruments till #40.06 taper. After preparation, group II was left unfilled, groups III, IV, and V were obturated with Gutta-percha and AH Plus sealer using passive technique, lateral compaction and warm vertical compaction, respectively. Groups VI, VII, and VIII were obturated with Resilon and Realseal sealer using passive technique, lateral compaction, and warm vertical compaction, respectively. Roots were then sectioned at 3, 6, and 9 mm from the apex and inspected under a stereomicroscope (50×) for dentinal defects. Chi-square test was performed to compare the incidence of dentinal defects between the groups (P < 0.05). Results: The unprepared control group had no dentinal defects. The instrumentation group (group II) and the obturation group (groups III-VIII) showed significantly more defects than the uninstrumented control group (group I) (P < 0.001). There was no significant difference between the root canal obturating techniques (group III-VIII) when compared with the instrumentation group (group II). On inter group comparison among the obturation groups the number of defects after lateral compaction with Gutta-percha (group IV) was significantly larger than passive Gutta-percha obturation (group III) (P < 0.05). Conclusions: The results suggest that root canal instrumentation significantly influenced the incidence of dentinal defects or fracture. Dentinal defects were more significantly attributed to the role of root canal instrumentation rather than the type of obturation technique or material. Lateral compaction with Gutta-percha significantly produces more

  17. Handlebar Hernia: A Rare Type of Abdominal Wall Hernia

    PubMed Central

    Hassan, Khairi A. F.; Elsharawy, Mohamed A.; Moghazy, Khaled; AlQurain, Abdulaziz

    2008-01-01

    Handlebar hernias are abdominal wall hernias resulting from direct trauma to the anterior abdominal wall. They usually result at weak anatomic locations of the abdominal wall. Such traumatic hernias are rare, requiring a high index of suspicion for a clinical diagnosis. We report the case of a handlebar hernia resulting from an injury sustained during a vehicular injury, and discuss the management of such injuries. PMID:19568493

  18. Non-fatal strangulation is an important risk factor for homicide of women

    PubMed Central

    Glass, Nancy; Laughon, Kathryn; Campbell, Jacquelyn; Wolf Chair, Anna D.; Block, Carolyn Rebecca; Hanson, Ginger; Sharps, Phyllis W.; Taliaferro, Ellen

    2008-01-01

    The purpose of the study is to examine non-fatal strangulation by an intimate partner as a risk factor for major assault, or attempted or completed homicide of women. A case control design was used to describe non-fatal strangulation among complete homicides and attempted homicides (n =506) and abused controls (n = 427). Interviews of proxy respondents and survivors of attempted homicides were compared with data from abused controls. Data were derived using the Danger Assessment. Non-fatal strangulation was reported in 10% of abused controls, 45% of attempted homicides and 43% of homicides. Prior non-fatal strangulation was associated with greater than six-fold odds (OR 6.70, 95% CI 3.91–11.49) of becoming an attempted homicide, and over seven-fold odds (OR 7.48, 95% CI 4.53–12.35) of becoming a completed homicide. These results show non-fatal strangulation as an important risk factor for homicide of women, underscoring the need to screen for non-fatal strangulation when assessing abused women in emergency department settings. PMID:17961956

  19. A titanium and visible light-polymerized resin obturator.

    PubMed

    Rilo, Benito; da Silva, José Luis; Martinez-Insua, Arturo; Santana, Urbano

    2002-04-01

    Obturator prostheses are typically large, and their weight and size are often important design factors. This article describes the fabrication of an obturator prosthesis with a titanium framework and visible light-polymerized denture base resin. It is speculated that these low-density materials may produce prostheses lighter than similar ones made with conventional materials. An added advantage is that visible light-polymerizing resins facilitate relining. PMID:12011852

  20. Obturator neuropathy: a cause of exercise-related groin pain.

    PubMed

    Brukner, P; Bradshaw, C; McCrory, P

    1999-05-01

    Obturator neuropathy is a cause of exercise-related groin pain, particularly in those who play sports that involve much running, twisting and turning, and kicking. Symptoms include pain that begins insidiously at the adductor origin on the pubic bone and worsens with exercise. Diagnostic measures include reproduction of pain by stretching the pectineus muscle after exercise, electromyography, and a local anesthetic block of the obturator nerve. Surgery allows most patients to resume previous levels of activity.

  1. A titanium and visible light-polymerized resin obturator.

    PubMed

    Rilo, Benito; da Silva, José Luis; Martinez-Insua, Arturo; Santana, Urbano

    2002-04-01

    Obturator prostheses are typically large, and their weight and size are often important design factors. This article describes the fabrication of an obturator prosthesis with a titanium framework and visible light-polymerized denture base resin. It is speculated that these low-density materials may produce prostheses lighter than similar ones made with conventional materials. An added advantage is that visible light-polymerizing resins facilitate relining.

  2. Vibration analysis of obturator prostheses with different bulb height designs.

    PubMed

    Kobayashi, Makio; Oki, Meiko; Ozawa, Shogo; Inoue, Takaaki; Mukohyama, Hitoshi; Takato, Tsuyoshi; Ohyama, Takashi; Taniguchi, Hisashi

    2002-12-01

    The purpose of this study was to investigate the effect on the vibratory characteristics of a cast hollow obturator prosthesis retainer when varying its bulb height. Bulb parts with high (H), middle (M), and low (L) lateral walls were prepared. A Vibration Generator was used to excite the three obturators, while a Laser-Doppler Vibrometer was employed to detect the vibrations at specified measurement points. The frequency response functions of each obturator were recorded on an FFT analyzer to enable their modal shapes to be identified. In addition, transient response simulations were carried out and the decay rate (DR) and the maximum amplitude (MA) of the rest and clasp parts of each obturator were obtained. These were statistically analyzed by ANOVA and Fisher's PLSD test (p < 0.01). The modal shapes were almost the same in all obturators. Significant differences were found in DR in all pairs among the three obturator prostheses, with the DR of the L type being the highest. On the other hand, there were no significant differences in MA. We conclude that the L type is preferable from the standpoint of its vibratory characteristics.

  3. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  4. Laparoscopic Repair of Bochdalek Diaphragmatic Hernia in Adults

    PubMed Central

    Machado, Norman Oneil

    2016-01-01

    Bochdalek hernia (BH) is an uncommon form of diaphragmatic hernia. The rarity of this hernia and its nonspecific presentation leads to delay in the diagnosis, with the potential risk of complications. This review summarizes the relevant aspects of its presentation and management, based on the present evidence in the literature. A literature search was performed on PubMed, Google Scholar, and EMBASE for articles in English on BH in adults. All case reports and series from the period after 1955 till January 2015 were included. A total of 180 articles comprising 368 cases were studied. The mean age of these patients was 51 years (range 15-90 years) with a male preponderance of 57% (211/368). Significantly, 6.5% of patients were above 70 years, with 3.5% of these being above 80 years. The majority of the hernias were on the left side (63%), with right-sided hernias and bilateral occurring in 27% and 10%, respectively. Precipitating factors were noted in 24%, with 5.3% of them being pregnant. Congenital anomalies were seen in 11%. The presenting symptoms included abdominal (62%), respiratory (40%), obstructive (vomiting/abdominal distension; 36%), strangulation (26%); 14% of them were asymptomatic (detected incidentally). In the 184 patients who underwent surgical intervention, the surgical approach involved laparotomy in 74 (40.27%), thoracotomy in 50 (27.7%), combined thoracoabdominal approach in 27 (14.6%), laparoscopy in 23 (12.5%), and thoracoscopic repair in 9 (4.89%). An overall recurrence rate of 1.6% was noted. Among these patients who underwent laparoscopic repair, 82% underwent elective procedure; 66% underwent primary repair, with 61% requiring interposition of mesh or reenforcement with or without primary repair. The overall mortality was 2.7%. Therefore, BH should form one of the differential diagnoses in patients who present with simultaneous abdominal and chest symptoms. Minimal access surgery offers a good alternative with short hospital stay and is

  5. SUCCESSFUL DIAGNOSIS AND TREATMENT OF BILATERAL PERINEAL HERNIAS IN A SKUNK (MEPHITIS MEPHITIS).

    PubMed

    Summa, Noémie; Eshar, David; Reynolds, Debbie; Caines, Deanne; Singh, Ameet

    2015-09-01

    This brief communication describes the diagnosis and surgical treatment of bilateral perineal hernias in a 1-yr-old, intact female, striped skunk (Mephitis mephitis) that was evaluated for chronic intermittent constipation, following early age, bilateral anal sacculectomy for descenting. Complete blood count and biochemistry results were within the reference ranges. Diagnosis was based on history, physical exam, clinical signs, and diagnostic imaging. A two-stage surgical approach for treatment was performed. First, colopexy and cystopexy were performed via celiotomy, which was followed by unilateral perineal herniorrhaphy by using an internal obturator muscle flap augmented with porcine small intestinal submucosa biomaterial. Long-term resolution of clinical signs was achieved without evidence of recurrence. This is the first description of bilateral perineal hernia in a skunk following routine anal sacculectomy for descenting. PMID:26352963

  6. SUCCESSFUL DIAGNOSIS AND TREATMENT OF BILATERAL PERINEAL HERNIAS IN A SKUNK (MEPHITIS MEPHITIS).

    PubMed

    Summa, Noémie; Eshar, David; Reynolds, Debbie; Caines, Deanne; Singh, Ameet

    2015-09-01

    This brief communication describes the diagnosis and surgical treatment of bilateral perineal hernias in a 1-yr-old, intact female, striped skunk (Mephitis mephitis) that was evaluated for chronic intermittent constipation, following early age, bilateral anal sacculectomy for descenting. Complete blood count and biochemistry results were within the reference ranges. Diagnosis was based on history, physical exam, clinical signs, and diagnostic imaging. A two-stage surgical approach for treatment was performed. First, colopexy and cystopexy were performed via celiotomy, which was followed by unilateral perineal herniorrhaphy by using an internal obturator muscle flap augmented with porcine small intestinal submucosa biomaterial. Long-term resolution of clinical signs was achieved without evidence of recurrence. This is the first description of bilateral perineal hernia in a skunk following routine anal sacculectomy for descenting.

  7. A Systematic Review of the Epidemiology of Nonfatal Strangulation, a Human Rights and Health Concern

    PubMed Central

    Joshi, Manisha; Sivitz, Elizabeth

    2014-01-01

    We reviewed the literature on the epidemiology of nonfatal strangulation (also, albeit incorrectly, called choking) by an intimate partner. We searched 6 electronic databases to identify cross-sectional, primary research studies from 1960 to 2014 that reported national prevalence estimates of nonfatal strangulation by an intimate partner among community-residing adults. Of 7260 identified references, 23 articles based on 11 self-reported surveys in 9 countries met the inclusion criteria. The percentage of women who reported ever having been strangled by an intimate partner ranged from 3.0% to 9.7%; past-year prevalence ranged from 0.4% to 2.4%, with 1.0% being typical. Although many epidemiological surveys inquire about strangulation, evidence regarding its prevalence is scarce. Modifying or adding a question to ongoing national surveys, particularly the Demographic and Health Surveys, would remedy the lack of data for low- and middle-income countries. In addition, when questions about strangulation are asked, findings should be reported rather than only combined with other questions to form broader categories (e.g., severe violence). Such action is merited because of the multiple negative short- and long-term sequelae of strangulation. PMID:25211747

  8. A systematic review of the epidemiology of nonfatal strangulation, a human rights and health concern.

    PubMed

    Sorenson, Susan B; Joshi, Manisha; Sivitz, Elizabeth

    2014-11-01

    We reviewed the literature on the epidemiology of nonfatal strangulation (also, albeit incorrectly, called choking) by an intimate partner. We searched 6 electronic databases to identify cross-sectional, primary research studies from 1960 to 2014 that reported national prevalence estimates of nonfatal strangulation by an intimate partner among community-residing adults. Of 7260 identified references, 23 articles based on 11 self-reported surveys in 9 countries met the inclusion criteria. The percentage of women who reported ever having been strangled by an intimate partner ranged from 3.0% to 9.7%; past-year prevalence ranged from 0.4% to 2.4%, with 1.0% being typical. Although many epidemiological surveys inquire about strangulation, evidence regarding its prevalence is scarce. Modifying or adding a question to ongoing national surveys, particularly the Demographic and Health Surveys, would remedy the lack of data for low- and middle-income countries. In addition, when questions about strangulation are asked, findings should be reported rather than only combined with other questions to form broader categories (e.g., severe violence). Such action is merited because of the multiple negative short- and long-term sequelae of strangulation. PMID:25211747

  9. CT imaging features of obturator prostheses in patients following palatectomy or maxillectomy.

    PubMed

    Kumar, V A; Hofstede, T M; Ginsberg, L E

    2011-01-01

    Palatal tumors are often treated with palatectomy or maxillectomy. The resulting surgical defect produces an oroantral communication. An obturator is a removable prosthesis used to close the palatal or maxillectomy defect. Fifteen patients who had undergone palatectomy or maxillectomy for carcinoma and subsequent obturator prosthesis placement were retrospectively studied. Obturators were characterized by Hounsfield units and were subdivided into 3 CT imaging groups: either hyperattenuated, hollow (air-containing), or heterogeneous (isoattenuated to hyperattenuated with internal foci of air). Eight patients had hyperattenuated obturators either representing acrylic resin or Trusoft. Four patients had hollow obturators also composed of acrylic resin or Trusoft. Three patients had heterogeneous obturators, which were composed of only Trusoft. The postoperative imaging of patients treated for palatal or maxillary tumors can be complicated by the presence of obturator prostheses. The intent of this article was to familiarize the reader with the CT imaging features of obturator prostheses. PMID:21799037

  10. Resistance to fracture of dental roots obturated with different materials.

    PubMed

    Celikten, Berkan; Uzuntas, Ceren Feriha; Gulsahi, Kamran

    2015-01-01

    The aim of this study was to compare the vertical fracture resistance of roots obturated with different root canal filling materials and sealers. Crowns of 55 extracted mandibular premolar teeth were removed to provide root lengths of 13 mm. Five roots were saved as negative control group (canals unprepared and unfilled). Fifty root canals were instrumented and then five roots were saved as positive control group (canals prepared but unfilled). The remaining 45 roots were randomly divided into three experimental groups (n = 15 root/group) and obturated with the following procedures: in group 1, glass ionomer-based sealer and cone (ActiV GP obturation system); in group 2, bioceramic sealer and cone (EndoSequence BC obturation system); and in group 3, roots were filled with bioceramic sealer and cone (Smartpaste bio obturation system). All specimens were tested in a universal testing machine for measuring fracture resistance. For each root, the force at the time of fracture was recorded in Newtons. The statistical analysis was performed by using Kruskal-Wallis and post hoc test. There were no significant differences between the three experimental groups. The fracture values of three experimental and negative control groups were significantly higher than the positive control group. Within the limitations of this study, all materials increased the fracture resistance of instrumented roots. PMID:25756048

  11. Resistance to Fracture of Dental Roots Obturated with Different Materials

    PubMed Central

    Uzuntas, Ceren Feriha; Gulsahi, Kamran

    2015-01-01

    The aim of this study was to compare the vertical fracture resistance of roots obturated with different root canal filling materials and sealers. Crowns of 55 extracted mandibular premolar teeth were removed to provide root lengths of 13 mm. Five roots were saved as negative control group (canals unprepared and unfilled). Fifty root canals were instrumented and then five roots were saved as positive control group (canals prepared but unfilled). The remaining 45 roots were randomly divided into three experimental groups (n = 15 root/group) and obturated with the following procedures: in group 1, glass ionomer-based sealer and cone (ActiV GP obturation system); in group 2, bioceramic sealer and cone (EndoSequence BC obturation system); and in group 3, roots were filled with bioceramic sealer and cone (Smartpaste bio obturation system). All specimens were tested in a universal testing machine for measuring fracture resistance. For each root, the force at the time of fracture was recorded in Newtons. The statistical analysis was performed by using Kruskal-Wallis and post hoc test. There were no significant differences between the three experimental groups. The fracture values of three experimental and negative control groups were significantly higher than the positive control group. Within the limitations of this study, all materials increased the fracture resistance of instrumented roots. PMID:25756048

  12. Ventral hernia repair

    MedlinePlus

    You will probably receive general anesthesia (asleep and pain-free) for this surgery. If your hernia is small, you may receive a spinal or epidural block and medicine to relax you. You will be awake, but pain-free. Your surgeon will make a surgical cut in ...

  13. Laparoscopic management of inferior lumbar hernia (Petit triangle hernia).

    PubMed

    Ipek, T; Eyuboglu, E; Aydingoz, O

    2005-05-01

    Lumbar hernias are rare defects in the posterolateral abdominal wall that may be congenital or acquired. We present a case of laparoscopic approach to repair an acquired inferior triangle (Petit) lumbar hernia in a woman by using polytetrafluoroethylene mesh. The size of the hernia was 8 x 10 cm. The length of her hospital stay was 2 days. The patient resumed normal activities in less than 2 weeks. The main advantage of this approach is excellent operative visualization, thus avoiding injury to structures near the hernia during repair. Patients benefit from a minimally invasive approach with less pain, shortened hospital course, less analgesic requirements, better cosmetic result, and minimal life-style interference.

  14. Thermographic assessment of root canal obturation using thermomechanical compaction.

    PubMed

    McCullagh, J J; Biagioni, P A; Lamey, P J; Hussey, D L

    1997-05-01

    The temperature changes on the root surface of 30 extracted human premolar teeth during thermomechanical root canal obturation with gutta-percha were determined using an infrared thermal imaging camera. Three handpiece rotational speeds of 8, 12 and 16 x 10(3) r.p.m. were used, in conjunction with a Gutta Condensor. On completion of the procedure, the quality of tooth canal obturation was examined radiographically. Under the conditions of this experiment, surface root temperature rises of > 97 degrees C were recorded during all three speed settings. The radiographic quality of obturation between the groups appeared not to be significantly different. The clinical relevance of these findings is uncertain, but the temperatures reported are of a magnitude to be of biological importance.

  15. Congenital Defect in Lesser Omentum Leading to Internal Hernia in Adult: A Rare Case Report.

    PubMed

    Rathnakar, Surag Kajoor; Muniyappa, Shridhar; Vishnu, Vikram Hubbanageri; Kagali, Nagaraj

    2016-08-01

    Intestinal obstruction is one of the common clinical condition which is encountered in emergency room. Internal hernia is one of the rare causes of small bowel obstruction accounting for less than 1% of cases. A congenital omental defect is very rare, but can potentially cause internal hernia leading to obstruction or strangulation of the bowel. We present a case of a 54-year-old man who was brought to the emergency department with sudden onset of lower abdominal pain. He had no history of abdominal surgeries or history of trauma. An emergency laparotomy was performed. On exploring the abdominal cavity, the lesser omental defect was detected, 3cm in size. Loops of jejunum had gone through the defect. Congested bowel loop was pulled back and defect was approximated. An adult congenital omental defect is rare; however, it should be considered as one of the differential diagnoses in a relatively young patient with bowel obstruction without external hernia, previous abdominal surgery or trauma. PMID:27656502

  16. [Forensic medical diagnostics of intra-vitality of the strangulation mark by morphological methods].

    PubMed

    Bogomolov, D V; Zbrueva, Yu V; Putintsev, V A; Denisova, O P

    2016-01-01

    The objective of the present study WaS to overview the current domestic and foreign literature concerning the up-to-date methods employed for the expert evaluation of intra-vitality of the strangulation mark. The secondary objective was to propose the new approaches for addressing this problem. The methods of expert diagnostics with a view to determining the time of infliction of injuries as exemplified by mechanical asphyxia are discussed. It is concluded that immunohistochemical and morphometric studies provide the most promising tools for the evaluation of intra-vitality of the strangulation mark for the purpose of forensic medical expertise.

  17. [Gangrene of the penis due to strangulation by a rubber band: a case report].

    PubMed

    Sasaki, Yutaro; Oda, Shinpei; Fujikata, Shiro; Tanimoto, Shuji; Kan, Masaharu

    2014-03-01

    We report a case of strangulation of the penis by a rubber band. A 79-year-old man placed a rubber band tightly around the corona of his glans penis in order to prevent urinary incontinence. After five days, he was taken to our hospital in an ambulance for high temperature and general malaise. We found the rubber band and removed it immediately. Gangrene of the penis continued and he did not recover from sepsis, so we performed partial penectomy. After the operation, he completely recovered. Penile strangulation using a soft constricting object such as a rubber band might result in severe complications and we should be careful.

  18. [Forensic medical diagnostics of intra-vitality of the strangulation mark by morphological methods].

    PubMed

    Bogomolov, D V; Zbrueva, Yu V; Putintsev, V A; Denisova, O P

    2016-01-01

    The objective of the present study WaS to overview the current domestic and foreign literature concerning the up-to-date methods employed for the expert evaluation of intra-vitality of the strangulation mark. The secondary objective was to propose the new approaches for addressing this problem. The methods of expert diagnostics with a view to determining the time of infliction of injuries as exemplified by mechanical asphyxia are discussed. It is concluded that immunohistochemical and morphometric studies provide the most promising tools for the evaluation of intra-vitality of the strangulation mark for the purpose of forensic medical expertise. PMID:27358932

  19. Surgical management of inguinal hernias at Bugando Medical Centre in northwestern Tanzania: our experiences in a resource-limited setting

    PubMed Central

    2012-01-01

    Background Inguinal hernia repair remains the commonest operation performed by general surgeons all over the world. There is paucity of published data on surgical management of inguinal hernias in our environment. This study is intended to describe our own experiences in the surgical management of inguinal hernias and compare our results with that reported in literature. Methods A descriptive prospective study was conducted at Bugando Medical Centre in northwestern Tanzania. Ethical approval to conduct the study was obtained from relevant authorities before the commencement of the study. Statistical data analysis was done using SPSS software version 17.0. Results A total of 452 patients with inguinal hernias were enrolled in the study. The median age of patients was 36 years (range 3 months to 78 years). Males outnumbered females by a ratio of 36.7:1. This gender deference was statistically significant (P = 0.003). Most patients (44.7%) presented late (more than five years of onset of hernia). Inguinoscrotal hernia (66.8%) was the commonest presentation. At presentation, 208 (46.0%) patients had reducible hernia, 110 (24.3%) had irreducible hernia, 84 (18.6%) and 50(11.1%) patients had obstructed and strangulated hernias respectively. The majority of patients (53.1%) had right sided inguinal hernia with a right-to-left ratio of 2.1: 1. Ninety-two (20.4%) patients had bilateral inguinal hernias. 296 (65.5%) patients had indirect hernia, 102 (22.6%) had direct hernia and 54 (11.9%) had both indirect and direct types (pantaloon hernia). All patients in this study underwent open herniorrhaphy. The majority of patients (61.5%) underwent elective herniorrhaphy under spinal anaesthesia (69.2%). Local anaesthesia was used in only 1.1% of cases. Bowel resection was required in 15.9% of patients. Modified Bassini’s repair (79.9%) was the most common technique of posterior wall repair of the inguinal canal. Lichtenstein mesh repair was used in only one (0.2%) patient

  20. [Congenital lumbar hernia].

    PubMed

    Peláez Mata, D J; Alvarez Muñoz, V; Fernández Jiménez, I; García Crespo, J M; Teixidor de Otto, J L

    1998-07-01

    Hernias in the lumbar region are abdominal wall defects that appear in two possible locations: the superior lumbar triangle of Grynfelt-Lesshaft and the inferior lumbar triangle of Petit. There are 40 cases reported in the pediatric literature, and only 16 are considered congenital, associated with the lumbocostovertebral syndrome and/or meningomyelocele. A new case is presented. A premature newborn with a mass in the left flank that increases when the patient cries and reduces easily. The complementary studies confirm the diagnosis of lumbar hernia and reveal the presence of lumbocostovertebral syndrome associated. At the time of operation a well defined fascial defect at the superior lumbar triangle of Grynfelt-Lesshaft is primarily closed. The diagnosis of lumbar hernia is not difficult to establish but it is necessary the screening of the lumbocostovertebral syndrome. We recommend the surgical treatment before 12 months of age; the objective is to close the defect primarily or to use prosthetic material if necessary. PMID:12602034

  1. Delayed traumatic diaphragmatic hernia

    PubMed Central

    Lu, Jing; Wang, Bo; Che, Xiangming; Li, Xuqi; Qiu, Guanglin; He, Shicai; Fan, Lin

    2016-01-01

    Abstract Background: Traumatic diaphragmatic hernias (TDHs) are sometimes difficult to identify at an early stage and can consequently result in diagnostic delays with life-threatening outcomes. It is the aim of this case study to highlight the difficulties encountered with the earlier detection of traumatic diaphragmatic hernias. Methods: Clinical data of patients who received treatment for delayed traumatic diaphragmatic hernias in registers of the First Affiliated Hospital of Xi’an Jiaotong University from 1998 to 2014 were analyzed retrospectively. Results: Six patients were included in this study. Left hemidiaphragm was affected in all of them. Most of the patients had a history of traffic accident and 1 a stab-penetrating injury. The interval from injury to developing symptoms ranged from 2 to 11 years (median 5 years). The hernial contents included the stomach, omentum, small intestine, and colon. Diaphragmatic injury was missed in all of them during the initial managements. All patients received operations once the diagnosis of delayed TDH was confirmed, and no postoperative mortality was detected. Conclusions: Delayed TDHs are not common, but can lead to serious consequences once occurred. Early detection of diaphragmatic injuries is crucial. Surgeons should maintain a high suspicion for injuries of the diaphragm in cases with abdominal or lower chest traumas, especially in the initial surgical explorations. We emphasize the need for radiographical follow-up to detect diaphragmatic injuries at an earlier stage. PMID:27512848

  2. Biliscrotum and Retroperitoneal Biloma: Spontaneous Rupture of the Biliary System presenting as an Incarcerated Inguinal Hernia

    PubMed Central

    Brady, RRW; McAteer, E; Weir, CD

    2006-01-01

    Spontaneous rupture of the biliary system is a well documented condition in infants1 but is rare in adults.2 We report the case of a 73-year-old gentleman who presented with clinical signs and symptoms mimicking that of a strangulated right inguinal hernia. At emergency operation the scrotum was found to contain bile. Following radiological imaging and exploratory surgery, a large retroperitoneal biloma was found. We discuss the clinical signs associated with biliscrotum and retroperitoneal biloma and describe our operative management of this patient. We review the previously reported cases of these rare clinical entities. We found that our case exhibited similarities in terms of the age of presentation and presence of distal common bile duct stones. This is, to our knowledge, the only reported case of a patient presenting with biliscrotum secondary to the assumed spontaneous rupture of the common bile duct and development of a retroperitoneal biloma. PMID:16457410

  3. Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material.

    PubMed

    Shrestha, Bidhan; Hughes, E Richard; Kumar Singh, Raj; Suwal, Pramita; Parajuli, Prakash Kumar; Shrestha, Pragya; Sharma, Arati; Adhikari, Galav

    2015-01-01

    Purpose. Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator. Method. After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally. Conclusion. This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration.

  4. Stress analysis in oral obturator prostheses: imaging photoelastic.

    PubMed

    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; dos Santos, Daniela Micheline; Haddad, Marcela Filié; Andreotti, Agda Marobo; Moreno, Amália

    2013-06-01

    Maxillary defects resulting from cancer, trauma, and congenital malformation affect the chewing efficiency and retention of dentures in these patients. The use of implant-retained palatal obturator dentures has improved the self-esteem and quality of life of several subjects. We evaluate the stress distribution of implant-retained palatal obturator dentures with different attachment systems by using the photoelastic analysis images. Two photoelastic models of the maxilla with oral-sinus-nasal communication were fabricated. One model received three implants on the left side of the alveolar ridge (incisive, canine, and first molar regions) and the other did not receive implants. Afterwards, a conventional palatal obturator denture (control) and two implant-retained palatal obturator dentures with different attachment systems (O-ring; bar-clip) were constructed. Models were placed in a circular polariscope and a 100-N axial load was applied in three different regions (incisive, canine, and first molar regions) by using a universal testing machine. The results were photographed and analyzed qualitatively using a software (Adobe Photoshop). The bar-clip system exhibited the highest stress concentration followed by the O-ring system and conventional denture (control). Images generated by the photoelastic method help in the oral rehabilitator planning. PMID:23143194

  5. Stress analysis in oral obturator prostheses: imaging photoelastic

    NASA Astrophysics Data System (ADS)

    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; dos Santos, Daniela Micheline; Haddad, Marcela Filié; Andreotti, Agda Marobo; Moreno, Amália

    2013-06-01

    Maxillary defects resulting from cancer, trauma, and congenital malformation affect the chewing efficiency and retention of dentures in these patients. The use of implant-retained palatal obturator dentures has improved the self-esteem and quality of life of several subjects. We evaluate the stress distribution of implant-retained palatal obturator dentures with different attachment systems by using the photoelastic analysis images. Two photoelastic models of the maxilla with oral-sinus-nasal communication were fabricated. One model received three implants on the left side of the alveolar ridge (incisive, canine, and first molar regions) and the other did not receive implants. Afterwards, a conventional palatal obturator denture (control) and two implant-retained palatal obturator dentures with different attachment systems (O-ring; bar-clip) were constructed. Models were placed in a circular polariscope and a 100-N axial load was applied in three different regions (incisive, canine, and first molar regions) by using a universal testing machine. The results were photographed and analyzed qualitatively using a software (Adobe Photoshop). The bar-clip system exhibited the highest stress concentration followed by the O-ring system and conventional denture (control). Images generated by the photoelastic method help in the oral rehabilitator planning.

  6. Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material

    PubMed Central

    Shrestha, Bidhan; Hughes, E. Richard; Kumar Singh, Raj; Suwal, Pramita; Parajuli, Prakash Kumar; Shrestha, Pragya; Sharma, Arati; Adhikari, Galav

    2015-01-01

    Purpose. Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator. Method. After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally. Conclusion. This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration. PMID:26491575

  7. Laparoscopic paracolostomy hernia mesh repair.

    PubMed

    Virzí, Giuseppe; Giuseppe, Virzí; Scaravilli, Francesco; Francesco, Scaravilli; Ragazzi, Salvatore; Salvatore, Ragazzi; Piazza, Diego; Diego, Piazza

    2007-12-01

    Paracolostomy hernia is a common occurrence, representing a late complication of stoma surgery. Different surgical techniques have been proposed to repair the wall defect, but the lowest recurrence rates are associated with the use of mesh. We present the case report of a patient in which laparoscopic paracolostomy hernia mesh repair has been successfully performed. PMID:18097321

  8. Incarcerated inferior lumbar (Petit's) hernia.

    PubMed

    Astarcioğlu, H; Sökmen, S; Atila, K; Karademir, S

    2003-09-01

    Petit's hernia is an uncommon abdominal wall defect in the inferior lumbar triangle. Colonic incarceration through the inferior lumbar triangle, which causes mechanical obstructive symptoms, necessitates particular diagnostic and management strategy. We present a rare case of inferior lumbar hernia, leading to mechanical bowel obstruction, successfully treated with prosthetic mesh reinforcement repair.

  9. Laparoscopic hernioplasty of hiatal hernia

    PubMed Central

    Yang, Xuefei; Hua, Rong; He, Kai; Shen, Qiwei

    2016-01-01

    Laparoscopic surgery is a good choice for surgical treatment of hiatal hernia because of its mini-invasive nature and intraperitoneal view and operating angle. This article will talk about the surgical procedures, technical details, precautions and complications about laparoscopic hernioplasty of hiatal hernia. PMID:27761447

  10. Current management of hernias and hydroceles.

    PubMed

    Lau, Stanley T; Lee, Yi-Horng; Caty, Michael G

    2007-02-01

    The repair of inguinal hernia and hydrocele is one of the most common operations in a pediatric surgery practice. This work reviews current concepts in the management of the inguinal hernia and hydrocele. The authors describe current concepts of anesthetic management of children undergoing repair of inguinal hernia. The authors also discuss current management of the contralateral hernia, hernias in premature infants, and the management of an incarcerated hernia. In addition, the authors discuss the role of laparoscopy in the surgical treatment of an inguinal hernia and its application for investigation of the contralateral inguinal canal.

  11. Abdominal Lipomatosis with Secondary Self-Strangulation of Masses in an Adult Rhesus Macaque (Macaca mulatta)

    PubMed Central

    Chum, Helen H; Long, C Tyler; McKeon, Gabriel P; Chang, Angela G; Luong, Richard H; Albertelli, Megan A

    2014-01-01

    An 10-y-old, intact male rhesus macaque (Macaca mulatta) presented for bilateral scrotal swelling and a distended abdomen. A soft mass in the left upper quadrant of the abdomen was palpated. A barium study did not reveal any gastrointestinal abnormalities. Exploratory laparotomy revealed a large (1.25 kg, 15.0 × 13.0 × 9.5 cm), red and tan, soft, circumscribed, spherical mass within the greater omentum and 10 to 20 smaller (diameter, 1 to 4 cm), soft to firm masses in the mesentery and greater omentum. The resected mass was a self-strangulating abdominal lipoma, a pedunculated neoplasm composed of white adipocytes arising from peritoneal adipose tissue undergoing secondary coagulation necrosis after strangulation of the blood supply due to twisting of the mass around the peduncle. The smaller masses were histologically consistent with simple or self-strangulating pedunculated abdominal lipomas. The macaque presented again 9 mo later with a firm, 5.0-cm mass in the midabdomen, with intestinal displacement visible on radiographs. Given this animal's medical history and questionable prognosis, euthanasia was elected. Necropsy revealed numerous, multifocal to coalescing, 1.0- to 15.0-cm, pale tan to yellow, circumscribed, soft to firm, spherical to ellipsoid, pedunculated masses that were scattered throughout the mesentery, greater omentum, lesser omentum, and serosal surfaces of the gastrointestinal tract. All of the masses were pedunculated abdominal lipomas, and most demonstrated coagulation necrosis due to self-strangulation of the blood supply. To our knowledge, this report is the first to describe abdominal lipomatosis with secondary self-strangulation of masses in a rhesus macaque. PMID:25402181

  12. Abdominal lipomatosis with secondary self-strangulation of masses in an adult rhesus macaque (Macaca mulatta).

    PubMed

    Chum, Helen H; Long, C Tyler; McKeon, Gabriel P; Chang, Angela G; Luong, Richard H; Albertelli, Megan A

    2014-10-01

    An 10-y-old, intact male rhesus macaque (Macaca mulatta) presented for bilateral scrotal swelling and a distended abdomen. A soft mass in the left upper quadrant of the abdomen was palpated. A barium study did not reveal any gastrointestinal abnormalities. Exploratory laparotomy revealed a large (1.25 kg, 15.0 × 13.0 × 9.5 cm), red and tan, soft, circumscribed, spherical mass within the greater omentum and 10 to 20 smaller (diameter, 1 to 4 cm), soft to firm masses in the mesentery and greater omentum. The resected mass was a self-strangulating abdominal lipoma, a pedunculated neoplasm composed of white adipocytes arising from peritoneal adipose tissue undergoing secondary coagulation necrosis after strangulation of the blood supply due to twisting of the mass around the peduncle. The smaller masses were histologically consistent with simple or self-strangulating pedunculated abdominal lipomas. The macaque presented again 9 mo later with a firm, 5.0-cm mass in the midabdomen, with intestinal displacement visible on radiographs. Given this animal's medical history and questionable prognosis, euthanasia was elected. Necropsy revealed numerous, multifocal to coalescing, 1.0- to 15.0-cm, pale tan to yellow, circumscribed, soft to firm, spherical to ellipsoid, pedunculated masses that were scattered throughout the mesentery, greater omentum, lesser omentum, and serosal surfaces of the gastrointestinal tract. All of the masses were pedunculated abdominal lipomas, and most demonstrated coagulation necrosis due to self-strangulation of the blood supply. To our knowledge, this report is the first to describe abdominal lipomatosis with secondary self-strangulation of masses in a rhesus macaque.

  13. Lumbar hernia: a diagnostic dilemma.

    PubMed

    Ahmed, Syed Tausif; Ranjan, Rajeeva; Saha, Subhendu Bikas; Singh, Balbodh

    2014-04-15

    Lumbar hernia is one of the rare cases that most surgeons are not exposed to. Hence the diagnosis can be easily missed. This leads to delay in the treatment causing increased morbidity. We report a case of lumbar hernia in a middle-aged woman. It was misdiagnosed as lipoma by another surgeon. It was a case of primary acquired lumbar hernia in the superior lumbar triangle. Clinical and MRI findings were correlated to reach the diagnosis. We also highlight the types, the process of diagnosis and the surgical repair of lumbar hernias. We wish to alert our fellow surgeons to keep the differential diagnosis of the lumbar hernia in mind before diagnosing any lumbar swelling as lipoma.

  14. Fiber-post bond strength in canals obturated with a cross-linked gutta-percha core obturator.

    PubMed

    Scotti, Nicola; Coero Borga, Francesco A; Alovisi, Mario; Bergantin, Emanuele; Marchionni, Silvia; Pasqualini, Damiano; Berutti, Elio

    2014-04-01

    The aim of this in-vitro study was to evaluate the bond strength of fiber posts cemented in a root canal filled using various root-canal obturation techniques. A total of 33 monoradicular samples, treated endodontically, were randomly assigned to three groups according to the root-canal obturation technique: group 1, continuous-wave technique; group 2, plastic-obturator-core technique; and group 3, cross-linked gutta-percha obturator-core technique. Fiber posts were luted in each sample and each was sectioned perpendicular to the post axis. The push-out test was performed using a universal machine and the maximum failure load was recorded in MPa mm(-2) . Several samples were randomly chosen for scanning electron microscopy evaluation. The mean debris and dentinal tubule-opening scores were calculated separately in the coronal and apical portions. Bond strength was significantly higher in group 1 than in groups 2 and 3. Debris scores were significantly higher in the apical portion of groups 2 and 3 than in group 1. Within the limitations of this study it can be affirmed that thermoplasticized alpha gutta-percha seemed to worsen the cleaning of post-space walls and hence reduced fiber-post bond strength.

  15. Vesicocutaneous fistula after sliding hernia repair

    PubMed Central

    Mittal, Varun; Kapoor, Rakesh; Sureka, Sanjoy

    2016-01-01

    Sliding inguinal hernias are usually direct inguinal hernias containing various abdominal viscera. The incidence of bladder forming a part of an inguinal hernia, called as “scrotal cystocele,” is 1–4%. The risk of bladder injury is as high as 12% when repairing this type of hernia. This case report emphasizes this aspect in a 65-year-old man who presented with urinary leak through the scrotal wound following right inguinal hernia repair. PMID:26941501

  16. An Unusual Trocar Site Hernia after Prostatectomy

    PubMed Central

    2016-01-01

    Trocar site hernias are rare complications after laparoscopic surgery but most commonly occur at larger trocar sites placed at the umbilicus. With increased utilization of the laparoscopic approach the incidence of trocar site hernia is increasing. We report a case of a trocar site hernia following an otherwise uncomplicated robotic prostatectomy at a 12 mm right lower quadrant port. The vermiform appendix was incarcerated within the trocar site hernia. Subsequent appendectomy and primary repair of the hernia were performed without complication.

  17. Comparative Evaluation of Obturating Techniques in Primary Teeth: An in vivo Study

    PubMed Central

    Vashista, Kriti; Sachdev, Vinod

    2015-01-01

    ABSTRACT Aim: The present study was undertaken to compare two methods of obturation in primary teeth by using lentulospirals and pressure syringe, radiographically. Materials and methods: Sixty teeth in subjects with mean age of 5.88 ± 1.58 years were obturated randomly using two different obturating techniques, i.e. group I: Thirty teeth obturated with pressure syringe, and group II: Thirty teeth obturated with lentulospiral. Quality of obturation and presence or absence of voids were assessed by taking radiographs after obturation was done using both the techniques. Results of quality of obturation were statistically analyzed using Chi-square test and Mann-Whitney’s test, whereas voids were analyzed using Chi-square test. Results: No statistically significant difference between the quality of obturation using pressure syringe or lentulospiral (p > 0.05) was observed. However, significantly higher number of voids were found for lentulospiral technique as compared to pressure syringe (p < 0.01). Conclusion: Both the techniques were found to be equally efficient statistically, though lentulospiral produced more voids. How to cite this article: Vashista K, Sandhu M, Sachdev V. Comparative Evaluation of Obturating Techniques in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2015;8(3): 176-180. PMID:26628851

  18. Rare inguinal hernia forms in children.

    PubMed

    Schier, F; Klizaite, J

    2004-10-01

    Rare inguinal hernia forms are encountered more frequently in the laparoscopic technique than in the open approach. The reasons are subject to speculation. The incidence of unusual inguinal hernia forms was studied in a series of inguinal hernias corrected laparoscopically in 452 children (334 boys and 118 girls aged 4 days--14 years, median age 1.6 years). The videos were retrospectively evaluated. Direct hernias were found in 10 children (2.2%), femoral hernias in five (1.1%), hernias en pantalon in three (0.7%), and a combination of indirect and femoral hernia and a combination of indirect, direct, and femoral hernia in one child each (0.2%). Routine videorecording during laparoscopy provides for the first time an objective and absolute picture of the true incidence of these unusual hernia forms. PMID:15503064

  19. Management of maxillectomy defect with a hybrid hollow bulb obturator.

    PubMed

    Singh, Kamleshwar; Singh, Saumyendra V; Mishra, Niraj; Agrawal, Kaushal Kishor

    2013-01-01

    A woman having already undergone maxillectomy came to the department complaining of difficulty in eating and speech. During the construction of an obturator, the bulb area should be hollowed to reduce weight so that the teeth and supporting tissues are not stressed unnecessarily. The conventional open design drains fluid from the adjacent mucosa, possibly increasing the weight of the prosthesis, and is difficult to clean. The closed bulb design does not drain secretions and may cause obstruction and susceptibility to infection in the paranasal and pharyngeal regions, though it is easier to maintain. An alternative to the two designs, combining their advantages, is presented in this report. As the open hollow part of the obturator was shallow, it was easy to clean. Making the inferior part of the bulb hollow and closed led to a reduction in the overall weight of the prosthesis while increasing its resonance. PMID:23436886

  20. Creating a digitized database of maxillofacial prostheses (obturators): A pilot study

    PubMed Central

    Sumita, Yuka; Aswehlee, Amel; Yoshi, Shigen; Taniguchi, Hisashi

    2016-01-01

    PURPOSE This study aimed to create a digitized database of fabricated obturators to be kept for patients' potential emergency needs. MATERIALS AND METHODS A chairside intraoral scanner was used to scan the surfaces of an acrylic resin obturator. The scanned data was recorded and saved as a single standard tessellation language file using a three-dimensional modeling software. A simulated obturator model was manufactured using fused deposition modeling technique in a three-dimensional printer. RESULTS The entire obturator was successfully scanned regardless of its structural complexity, modeled as three-dimensional data, and stored in the digital system of our clinic at a relatively small size (19.6 MB). A simulated obturator model was then accurately manufactured from these data. CONCLUSION This study provides a proof-of-concept for the use of digital technology to create a digitized database of obturators for edentulous maxillectomy patients. PMID:27350857

  1. Strangulation of the duodenum by the uterus during late pregnancy in two cows.

    PubMed

    Koller, U; Lischer, C; Geyer, H; Dressel, C; Braun, U

    2001-07-01

    Two Swiss Braunvieh cows in late pregnancy underwent surgery because of a rare form of ileus due to strangulation of the duodenum at its caudal flexure by the gravid uterus. The whole uterus had passed through a gap between the mesoduodenum and duodenum and with increasing weight had led to strangulation of the duodenum. This was possible since the mesoduodenum and both walls of the greater omentum adjacent to its caudal edge were not connected with the duodenum, probably due to a congenital inhibitory malformation. A transsection and an end-to-end anastomosis of the duodenum were necessary in both cases since it was impossible to retract the gravid uterus through the defect. Postoperative recovering was uneventful in both cows, which were discharged after seven and five days respectively and calved normally about two months later.

  2. Strangulated adenoma of the liver: a unique cause of acute abdomen.

    PubMed

    Portinari, Mattia; Liboni, Alberto; Feo, Carlo V

    2014-03-20

    Hepatic adenomas are uncommon benign tumours of the liver which may eventually present with acute onset following rupture of the lesion and haemorrhage. We present here a unique case of strangulated adenoma of the liver presenting as acute abdomen. A 27-year-old woman taking oral contraceptives, presented to the emergency department with abdominal pain, palpable abdominal mass, fever, and neutrophilia. An abdominal ultrasound showed a 3-cm hepatic nodule and an 11-cm mesogastric mass. Computed tomography of the abdomen revealed a 2.3-cm liver adenoma and a 13-cm pedunculated mass of the liver showing no contrast enhancement suggestive of pedicle torsion with ischemia of the mass. The patient underwent an emergent open resection of the strangulated liver mass, she recovered without complications, and was discharged home after three days. Final pathology confirmed an hepatocellular adenoma with areas of necrosis and hemorrhage. The clinical significance of the disease is discussed.

  3. Sports Hernia: Misdiagnosed Muscle Strain

    MedlinePlus

    ... Manipulative Treatment Becoming a DO Video Library Misdiagnosed Muscle Strain Can Be A Pain Page Content If ... speeds, sports hernias are frequently confused with common muscle strain ,” says Michael Sampson, DO, who practices in ...

  4. Obturator Compartment Syndrome Secondary to Pelvic Hematoma After Robot-Assisted Laparoscopic Radical Prostatectomy

    PubMed Central

    Song, Jun H.; Abbott, Daniel; Gewirtz, Eric; Hauck, Ellen; Eun, Daniel D.

    2016-01-01

    Abstract Obturator nerve injury is a known injury after robot-assisted laparoscopic radical prostatectomy (RALP) and patients often present with motor and sensory deficits in the immediate postoperative period. We describe a 65-year-old male who presented with motor deficits, indicative of obturator neurapraxia after RALP upon waking from anesthesia. Work-up revealed an expansile hematoma possibly compressing the obturator nerve. After evacuation of the hematoma, the patient had immediate improvement of his neurologic deficits. Our patient's clinical vignette illustrates the importance of considering postsurgical hematoma in the differential diagnosis when patients present with signs and symptoms of obturator neurapraxia after RALP. PMID:27579444

  5. A hollow-bulb interim obturator for maxillary resection. A case report.

    PubMed

    Rilo, B; Dasilva, J L; Ferros, I; Mora, M J; Santana, U

    2005-03-01

    The treatment of hemimaxillectomy patients include the construction of an interim obturator in the wound healing period. With the aim of simplifying this process, we describe construction of an obturator in a short single visit, in the dental chair with no need for impressions or for laboratory services. The obturator comprises: (i) the surgical obturator and (ii) a hollow light-cured resin bulb built onto the base, and providing a large surface for bonding of the soft reline material. The advantages of this approach are rapid construction and ease of ongoing adjustment during the healing process. PMID:15707435

  6. Obturator Compartment Syndrome Secondary to Pelvic Hematoma After Robot-Assisted Laparoscopic Radical Prostatectomy.

    PubMed

    Song, Jun H; Kaplan, Joshua R; Abbott, Daniel; Gewirtz, Eric; Hauck, Ellen; Eun, Daniel D

    2016-01-01

    Obturator nerve injury is a known injury after robot-assisted laparoscopic radical prostatectomy (RALP) and patients often present with motor and sensory deficits in the immediate postoperative period. We describe a 65-year-old male who presented with motor deficits, indicative of obturator neurapraxia after RALP upon waking from anesthesia. Work-up revealed an expansile hematoma possibly compressing the obturator nerve. After evacuation of the hematoma, the patient had immediate improvement of his neurologic deficits. Our patient's clinical vignette illustrates the importance of considering postsurgical hematoma in the differential diagnosis when patients present with signs and symptoms of obturator neurapraxia after RALP. PMID:27579444

  7. A hollow-bulb interim obturator for maxillary resection. A case report.

    PubMed

    Rilo, B; Dasilva, J L; Ferros, I; Mora, M J; Santana, U

    2005-03-01

    The treatment of hemimaxillectomy patients include the construction of an interim obturator in the wound healing period. With the aim of simplifying this process, we describe construction of an obturator in a short single visit, in the dental chair with no need for impressions or for laboratory services. The obturator comprises: (i) the surgical obturator and (ii) a hollow light-cured resin bulb built onto the base, and providing a large surface for bonding of the soft reline material. The advantages of this approach are rapid construction and ease of ongoing adjustment during the healing process.

  8. In vitro evaluation of carrier based obturation technique: a CBCT study

    PubMed Central

    Gambarini, Gianluca; Piasecki, Lucila; Schianchi, Giovanni; Di Nardo, Dario; Miccoli, Gabriele; Al Sudani, Dina; Di Giorgio, Roberto; Testarelli, Luca

    2016-01-01

    Summary Aim The goal of the study was to compare the ability of two different carrier based obturation (CBO) techniques to reach working length and fill in three-dimensions root canal systems, by using CBCT. Materials and Methods Twenty-six extracted molars were scanned with CBCT and 40 curved canals were selected (between 30° and 90°) and divided in two similar groups (n=20). All canals were prepared up to size 25 taper .06 using nickel-titanium instrumentation. The canals in the Group SC were obturated using Soft-Core obturators (Kerr, Romulus, Mi, USA), while Group TH canals (n= 20) were obturated using Thermafil Endodontic Obturators (Tulsa Dental Products, Tulsa, OK, USA), strictly following manufacturers’ instructions for use. The obturations were analyzed by means of CBCT to measure the distance from the apical limit of obturation to the apical foramen and the presence of voids inside root canals. Results There was no significant difference between the two groups in the mean distance of the apical extent of the obturation (t test, p>0.05). Overfilling occurred in only 3 cases (2 in Group TH and 1 in Group SC). The percentages of voids in both groups were very low with no significant difference (Z test, p>0.05). Conclusions The two tested CBO techniques showed similar positive results in terms of performance, even if, after checking with verifiers, in most cases the size of the selected Soft-Core obturator was one size smaller than Thermafil. PMID:27486506

  9. A Case of Strangulated Urethral Prolapse in a Premenopausal Adult Female

    PubMed Central

    Jessop, Morris L.; Al-Omar, Osama

    2016-01-01

    Urethral prolapse in a premenopausal adult female is exceedingly rare. This paper describes a case of strangulated urethral prolapse presenting as a urethral mass in an unusual demographic and reviews the literature on etiology and management. Only a few cases have occurred in women of reproductive age. The etiology is likely multifactorial. Treatment with surgical excision provides good results in the majority of cases. PMID:27413572

  10. Strangulation as the primary mechanism for shutting down star formation in galaxies.

    PubMed

    Peng, Y; Maiolino, R; Cochrane, R

    2015-05-14

    Local galaxies are broadly divided into two main classes, star-forming (gas-rich) and quiescent (passive and gas-poor). The primary mechanism responsible for quenching star formation in galaxies and transforming them into quiescent and passive systems is still unclear. Sudden removal of gas through outflows or stripping is one of the mechanisms often proposed. An alternative mechanism is so-called "strangulation", in which the supply of cold gas to the galaxy is halted. Here we report an analysis of the stellar metallicity (the fraction of elements heavier than helium in stellar atmospheres) in local galaxies, from 26,000 spectra, that clearly reveals that strangulation is the primary mechanism responsible for quenching star formation, with a typical timescale of four billion years, at least for local galaxies with a stellar mass less than 10(11) solar masses. This result is further supported independently by the stellar age difference between quiescent and star-forming galaxies, which indicates that quiescent galaxies of less than 10(11) solar masses are on average observed four billion years after quenching due to strangulation.

  11. Strangulation as the primary mechanism for shutting down star formation in galaxies.

    PubMed

    Peng, Y; Maiolino, R; Cochrane, R

    2015-05-14

    Local galaxies are broadly divided into two main classes, star-forming (gas-rich) and quiescent (passive and gas-poor). The primary mechanism responsible for quenching star formation in galaxies and transforming them into quiescent and passive systems is still unclear. Sudden removal of gas through outflows or stripping is one of the mechanisms often proposed. An alternative mechanism is so-called "strangulation", in which the supply of cold gas to the galaxy is halted. Here we report an analysis of the stellar metallicity (the fraction of elements heavier than helium in stellar atmospheres) in local galaxies, from 26,000 spectra, that clearly reveals that strangulation is the primary mechanism responsible for quenching star formation, with a typical timescale of four billion years, at least for local galaxies with a stellar mass less than 10(11) solar masses. This result is further supported independently by the stellar age difference between quiescent and star-forming galaxies, which indicates that quiescent galaxies of less than 10(11) solar masses are on average observed four billion years after quenching due to strangulation. PMID:25971510

  12. Suffocation, choking, and strangulation in childhood in England and Wales: epidemiology and prevention.

    PubMed Central

    Nixon, J W; Kemp, A M; Levene, S; Sibert, J R

    1995-01-01

    The causes, classification, and prevention of mechanical asphyxial death in children were examined. The Office of Population Censuses and Surveys (OPCS) identified children, under 15 years of age, who had died as a result of choking, suffocation, or strangulation in England and Wales during the years 1990 and 1991. Cases in the International Classification of Diseases (ICD) codes of E911-3, E953, E963, and E983 were selected and case details from HM coroners' records and the death certificates were extracted. The OPCS identified 136 children (99 boys, 37 girls) in the two year period, 65% were under 3 years of age. The children were classified as dying from choking (21 cases), aspirating gastric contents (39 cases), suffocation (29 cases), strangulation (11 cases), and hanging (36 cases). The strangulation cases could be further subdivided into a group of 12 younger children who were suspended from ligatures around the home and a group of 21 boys (8-14 years) who died of self initiated hanging. Overall, 11 children were deliberately killed and 31 children died in beds or cots. Children whose deaths are classified as being due to aspiration of vomit appear to be cases of the sudden infant death syndrome or background medical conditions. This study suggests the need for advice on maintaining a safe sleeping environment. Only one child choked on a toy and European Standards for Toy Safety appear to have been successful. The prevention of hanging in the group of older boys needs further exploration. PMID:7717743

  13. Diaphragmatic hernia repair more than four years after severe trauma: Four case reports

    PubMed Central

    de Nadai, Tales Rubens; Lopes, José Carlos Paiva; Inaco Cirino, Caio César; Godinho, Maurício; Rodrigues, Alfredo José; Scarpelini, Sandro

    2015-01-01

    Introduction Diaphragmatic rupture is an infrequent complication of trauma, occurring in about 5% of those who suffer a severe closed thoracoabdominal injury and about half of the cases are diagnosed early. High morbidity and mortality from bowel strangulation and other sequelae make prompt surgical intervention mandatory. Case presentation Four Brazilian men with a delayed diagnosis of a rare occurrence of traumatic diaphragmatic hernia. Patient one had diaphragmatic rupture on the right side of thorax and the others three patients on the left thoracic side, all they had to approach by a laparotomy and some approach in the chest, either thoracotomy or VATS. This injuries required surgical repositioning of extensively herniated abdominal viscera and intensive postoperative medical management with a careful control of intra-abdominal pressure. Discussion The negative pressure of the thoracic cavity causes a gradually migration of abdominal contents into the chest; this sequestration reduces the abdomen’s ability to maintain the viscera in their normal anatomical position. When the hernia is diagnosed early, the repair is less complicated and requires less invasive surgery. Years after the initial trauma, the diaphragmatic rupture produces dense adhesions between the chest and the abdominal contents. Conclusions All cases demonstrated that surgical difficulty increases when diaphragmatic rupture is not diagnosed early. It should be noted that when trauma to the thoraco-abdominal transition area is blunt or penetrating, a thorough evaluation is required to rule out diaphragmatic rupture and a regular follow-up to monitor late development of this comorbidity. PMID:26241166

  14. Comparative Evaluation of Fracture Resistance of Endodontically Treated Teeth Obturated with Resin Based Adhesive Sealers with Conventional Obturation Technique: An In vitro Study

    PubMed Central

    Langalia, Akshay K; Dave, Bela; Patel, Neeta; Thakkar, Viral; Sheth, Sona; Parekh, Vaishali

    2015-01-01

    Background: To compare fracture resistance of endodontically treated teeth obturated with different resin-based adhesive sealers with a conventional obturation technique. Materials and Methods: A total of 60 Single canaled teeth were divided into five groups. The first group was taken as a negative control. The rest of the groups were shaped using ProFile rotary files (Dentsply Maillefer, Ballaigues, Switzerland). The second group was obturated with gutta-percha and a ZOE-based sealer Endoflas FS (Sanlor Dental Products, USA). The third group was obturated with gutta-percha and an epoxy-based sealer AH Plus (Dentsply, DeTrey, Germany). The fourth group was obturated with Resilon (Pentron Clinical Technologies, Wallingford, CT) and RealSeal sealer (Pentron Clinical Technologies). The fifth group was obturated with EndoREZ points and EndoREZ sealer (both from Ultradent, South Jordan, UT). Roots were then embedded into acrylic blocks and were then fixed into a material testing system and loaded with a stainless steel pin with a crosshead speed of 5 mm/min until fracture. The load at which the specimen fractured was recorded in Newtons. Results: It was found that forces at fracture were statistically significant for the newer resin systems, Resilon, and EndoREZ. Conclusion: It was concluded that roots obturated with newer resin systems (Resilon and EndoREZ) enhanced the root strength almost up to the level of the intact roots. PMID:25859099

  15. [Congenital lumbar hernia and bilateral renal agenesis].

    PubMed

    Barrero Candau, R; Garrido Morales, M

    2007-04-01

    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia. PMID:17650728

  16. Do large hiatal hernias affect esophageal peristalsis?

    PubMed Central

    Roman, Sabine; Kahrilas, Peter J; Kia, Leila; Luger, Daniel; Soper, Nathaniel; Pandolfino, John E

    2013-01-01

    Background & Aim Large hiatal hernias can be associated with a shortened or tortuous esophagus. We hypothesized that these anatomic changes may alter esophageal pressure topography (EPT) measurements made during high-resolution manometry (HRM). Our aim was to compare EPT measures of esophageal motility in patients with large hiatal hernias to those of patients without hernia. Methods Among 2000 consecutive clinical EPT, we identified 90 patients with large (>5 cm) hiatal hernias on endoscopy and at least 7 evaluable swallows on EPT. Within the same database a control group without hernia was selected. EPT was analyzed for lower esophageal sphincter (LES) pressure, Distal Contractile Integral (DCI), contraction amplitude, Contractile Front Velocity (CFV) and Distal Latency time (DL). Esophageal length was measured on EPT from the distal border of upper esophageal sphincter to the proximal border of the LES. EPT diagnosis was based on the Chicago Classification. Results The manometry catheter was coiled in the hernia and did not traverse the crural diaphragm in 44 patients (49%) with large hernia. Patients with large hernias had lower average LES pressures, lower DCI, slower CFV and shorter DL than patients without hernia. They also exhibited a shorter mean esophageal length. However, the distribution of peristaltic abnormalities was not different in patients with and without large hernia. Conclusions Patients with large hernias had an alteration of EPT measurements as a consequence of the associated shortened esophagus. However, the distribution of peristaltic disorders was unaffected by the presence of hernia. PMID:22508779

  17. [Congenital lumbar hernia and bilateral renal agenesis].

    PubMed

    Barrero Candau, R; Garrido Morales, M

    2007-04-01

    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.

  18. Successful obturator nerve repairing: Intraoperative sural nerve graft harvesting in endometrium cancer patient

    PubMed Central

    Harma, Müge; Sel, Görker; Açıkgöz, Bektaş; Harma, Mehmet İbrahim

    2014-01-01

    INTRODUCTION Intraoperative injury of obturator nerve is a rare complication of gynecologic surgeries, it has been reported especially in patients with endometriosis and genitourinary malignancies. Gynecologic patients undergoing open lymphadenectomy are at increased risk of obturator nerve injury. PRESENTATION OF CASE A 60-year-old woman with FIGO stage II Grade II endometrial adenocarcinoma underwent bilateral pelvic paraaortic lymphadenectomy. During right obturator lymph node dissection, the right obturator nerve was inadvertently transected with Harmonic scalpel sealing system. The graft was used to anastomose epyneurium of distal segment of obturator nerve to its counterpart in the proximal segment with 10–0 prolen suture. DISCUSSION In case of iatrogenic nerve transection, microsurgical end to end tension-free coaptation is advocated. In case of the obturator nerve is fixed and because of the thermal injury end to end alignment can not be achieved, nerve grafting is necessary. CONCLUSION According to our knowledge, successful immediate grafting of iatrogenically damaged obturator nerve during pelvic lymphadenectomy in our patient is the third report of such a case, but also it has a unique feature of being the first obturator nerve repairing case after dissected with tissue sealing system which causes large sealed area that does not make it possible to make end-to-end anastomosis without nerve harvesting. PMID:24814984

  19. Bacterial coronal leakage after obturation with three root canal sealers.

    PubMed

    Timpawat, S; Amornchat, C; Trisuwan, W R

    2001-01-01

    The purpose of this study was to compare the bacterial leakage of root canals obturated with three root canal sealers, using Endodontalis faecalis as a microbial tracer to determine the length of time for bacteria to penetrate through the obturated root canal to the root apex. Seventy-five, single-rooted teeth with straight root canals had the crown cut off at the cementoenamel junction. Root canals were instrumented by a step-back technique. The prepared teeth were randomly divided into 3 groups of 19 teeth each and another 2 groups as positive and negative controls (9 teeth each). The experimental groups were dependent on the sealer used: AH-Plus, Apexit, and Ketac-Endo. The root canals were obturated using a lateral condensation technique. After 24 h the teeth were attached to microcentrifuge tubes with 2 mm of the root apex submerged in Brain Heart Infusion broth in glass test tubes. The coronal portions of the root canal filling materials were placed in contact with E. faecalis. The teeth were observed for bacterial leakage daily for 30 and 60 days. With the chi2 test for comparing pairs of groups at the 0.05 level (p < 0.05), there was no statistical difference between Ketac-Endo and AH-Plus (p > 0.06), but Apexit had significantly higher leakage (p < 0.05) at 30 days. After 60 days there was no statistical difference between Ketac-Endo and Apexit (p > 0.05), but Apexit leaked more than AH-Plus. The conclusion drawn from this experiment was that epoxy resin root canal sealer was found to be more adaptable to the root canal wall and filling material than a calcium hydroxide sealer when bacterial coronal leakage was studied.

  20. Laparoscopic repair of abdominal incisional hernia

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Abdominal incisional hernia is a common complication after open abdominal operations. Laparoscopic procedures have obvious mini-invasive advantages for surgical treatment of abdominal incisional hernia, especially to cases with big hernia defect. Laparoscopic repair of incisional hernia has routine mode but the actual operations will be various according to the condition of every hernia. Key points of these operations include design of the position of trocars, closure of defects and fixation of meshes. The details of these issues and experiences of perioperative evaluation and treatment will be talked about in this article. PMID:27761446

  1. An Unusual Trocar Site Hernia after Prostatectomy.

    PubMed

    Schmocker, Ryan K; Greenberg, Jacob A

    2016-01-01

    Trocar site hernias are rare complications after laparoscopic surgery but most commonly occur at larger trocar sites placed at the umbilicus. With increased utilization of the laparoscopic approach the incidence of trocar site hernia is increasing. We report a case of a trocar site hernia following an otherwise uncomplicated robotic prostatectomy at a 12 mm right lower quadrant port. The vermiform appendix was incarcerated within the trocar site hernia. Subsequent appendectomy and primary repair of the hernia were performed without complication. PMID:27648335

  2. An Unusual Trocar Site Hernia after Prostatectomy

    PubMed Central

    2016-01-01

    Trocar site hernias are rare complications after laparoscopic surgery but most commonly occur at larger trocar sites placed at the umbilicus. With increased utilization of the laparoscopic approach the incidence of trocar site hernia is increasing. We report a case of a trocar site hernia following an otherwise uncomplicated robotic prostatectomy at a 12 mm right lower quadrant port. The vermiform appendix was incarcerated within the trocar site hernia. Subsequent appendectomy and primary repair of the hernia were performed without complication. PMID:27648335

  3. Measurement of the percentage of root filling in oval-shaped canals obturated with Thermafil Obturators and Beefill 2in1: In vitro study

    PubMed Central

    Collado-Castellanos, Nicolás; Alegre-Domingo, Teresa; Dolz-Solsona, María; Faus-Matoses, Vicente

    2015-01-01

    Background The aim of the study was to measure the percentage of root canal fillings in long oval canals obturated with thermoplasticized gutta-percha techniques, Beefill 2in1® and Thermafil Obturators®. Material and Methods Fifty four mandibular incisors were selected after bucco-lingual and mesio-distal radiographs showed at 5 mm from apex an internal long:short diameter ≥2. Teeth were instrumented with Protaper Universal and divided in two groups of 27. Group 1 was obturated with Thermafil Obturators® and group 2 with Beefill 2in1®. Two horizontal sections were cut at 5 and 7 mm from the apex and photographed in a stereo-microscope. The total area of the canal and filled canal in cross-sections were measured with AutoCad and the percentages of gutta-percha-sealer and voids in the canal were obtained. Results Both systems achieved high percentage of filled canal, Thermafil 96.8% and Beefill 2in1 98.9%. The percentages of voids in both groups were very low. No significant differences were found between the two groups . The percentage obtained at 5 and 7 mm from the apex in both groups showed no significant difference. Conclusions The percentages of filled canal (gutta-percha-sealer) were high and these two thermoplasticized techniques are suitable for long oval canals obturation. Key words:Long oval canal, oval canal, thermoplasticized obturation. PMID:26155350

  4. Case report: Sigmoid strangulation from evisceration through a perforated rectal prolapse ulcer – An unusual complication of rectal prolapse

    PubMed Central

    Li, Jennifer Z.; Kittmer, Tiffaney; Forbes, Shawn; Ruo, Leyo

    2015-01-01

    Introduction Rectal prolapse occurs particularly in elder females and presentation can sometimes lead to complications such as strangulation and evisceration of other organs through the necrotic mucosa. Presentation of case This is a case of a 61 year-old female with rectal prolapse complicated by rectal perforation through which a segment of sigmoid colon eviscerated and became strangulated. This patient initially presented with sepsis requiring ICU admission, but fully recovered following a Hartmann’s procedure with a sacral rectopexy. Discussion Complications of rectal prolapse include incarceration, strangulation, and rarely, perforation with evisceration of other viscera requiring urgent operation. This report provides a brief overview of complications associated with rectal prolapse, reviews similar cases of transrectal evisceration, and discusses the management of chronic rectal prolapse. Conclusion Prompt surgical consult is warranted if any signs or symptoms suggestive of complications from prolapse are present. PMID:25680532

  5. Bacterial penetration after obturation with four different root canal sealers.

    PubMed

    Yücel, Ali Cağin; Güler, Eda; Güler, Ahmet Umut; Ertaş, Ertan

    2006-09-01

    The aim of this study was to compare bacterial penetration after obturation with lateral compaction technique using four different root canal sealers. This study was performed on 100 teeth including negative control (n = 10), positive control (n = 10), and experimental groups (n = 80). 80 teeth were randomly divided into five groups of 20 teeth each and obturated with AH 26 (A), AH Plus (AP), Sealapex (S), Ketac-Endo (K) root canal sealers. Evaluation was carried out for 60 days. After 30 days of comparing the bacterial penetration values, total penetration was observed in 85% of the Group AP, and group K, 80% of the group S, and 75% of the group A. According to the results of chi(2) test, there was no statistically significant difference observed between any groups (p > 0.05). After 60 days of comparing the bacterial penetration values, total penetration was observed in 100% of the group AP, group K, and group S and 95% of the group A. It may be concluded that under the conditions of this study, there was no difference in the bacterial penetration of the four root canal sealers tested at 30 and 60 days.

  6. Ultrasound guided obturator nerve block: a single interfascial injection technique.

    PubMed

    Lee, Seong Heon; Jeong, Cheol Won; Lee, Hyun Jung; Yoon, Myung Ha; Kim, Woong Mo

    2011-12-01

    We describe a new technique of single interfascial injection for 25 patients scheduled for transurethral bladder tumor resection. An ultrasound probe was placed at the midline of inguinal crease and moved medially and caudally to visualize the fascial space between the adductor longus (or pectineus) and adductor brevis muscles. We injected 20 mL 1% lidocaine containing epinephrine into the interfascial space using a transverse plane approach to make an interfascial injection, not an intramuscular swelling pattern. And just distally, firm pressure was applied for 3 min. Afterwards, surgery was performed under spinal anesthesia. The time required for identification and location of the nerve was 20 ± 15 and 30 ± 15 s, respectively. Adductor muscle strength, which was measured with a sphygmomanometer, decreased in all patients, from 122 ± 26 mmHg before blockade to 63 ± 11 mmHg 5 min after blockade. No movement or palpable muscle twitching occurred in 23 cases, slight movement of the thigh not interfering with the surgical procedure was observed in 1 case, thus the obturator reflex was successfully inhibited in 96% of cases. Ultrasound-guided single interfascial injection is an easy and successful technique for obturator nerve block. PMID:21918855

  7. Strangulation du colon sigmoïdien par un testicule ectopique géant

    PubMed Central

    Sanogo, Zimogo; Koita, Adama; Camara, Moussa; Soumaré, Lamine; Kamaté, Bakarou; Doumbia, Dieneba; Ouattara, Zanafon; Tembely, Ali; Yena, Sadio; Coulibaly, Youssouf; Sangaré, Djibril

    2012-01-01

    Les causes de volvulus du colon sigmoïde sont variées et parmi elles la strangulation est des plus fréquentes dans notre contexte d’exercice. Les lésions vues tard permettent très rarement un traitement sans résection. La survenue d’un volvulus du colon sigmoïde autour d’un pédicule de testicule géant ectopique est une première que nous rapportons dans cette étude de cas. PMID:22593796

  8. [Diaphragmatic hernias, excluding hiatal hernias with gastroesophageal reflux].

    PubMed

    Ruer, V; Champault, G

    2007-01-01

    Large, mixed hiatal hernias are usually found between the ages of 60 and 70 years, with a female predominance (60%). The natural history is progression toward the appearance of symptoms, although 30%-40% of patients are initially asymptomatic. Symptoms develop quietly. The indication for surgical treatment of hiatal hernias amounts to considering the risks of leaving it in place. The literature reports a morbidity and mortality rate related to the complications of these hernias, leading to emergency interventions, which have an incidence of 1.16%.with a 27% mortality rate. Morbidity appears different depending on the approach used: laparoscopy or laparotomy (4.3% versus 16%). The debate continues on whether to monitor or treat these hernias, with a lack of consensus on the indications and the technique. However, the laparoscopic approach shows a gain in the length of the hospital stay, an easier approach to the hiatus in the diaphragm, and a lower morbidity and mortality rate. Fundoplication is advised, as well as placing prosthetic mesh if the orifice is larger than 8 cm. There is no indication for lengthening the esophagus (Collis-Nissen fundoplication).

  9. Comparison of vertical forces during root canal filling with three different obturation techniques.

    PubMed

    Katalinić, Ivan; Baraba, Anja; Glavicić, Snjezana; Segović, Sanja; Anić, Ivica; Miletić, Ivana

    2013-09-01

    The aim of this study was to examine and compare vertical forces exerted during root canal obturation with the cold lateral condensation technique, Thermafil technique and ProTaper guttapercha. Fourty-five single-rooted permanent teeth were used in the study. All specimens were instrumented using the ProTaper rotating technique and were randomly divided into three experimental groups (n = 15 per group). In the first group, root canals were obturated using the cold lateral condensation technique. In the second group, the Thermafil technique was used to obturate root canals. In the last group, a ProTaper gutta-percha of the same taper as the instrumented root canals was used for root canal obturation. Vertical forces were measured using the device developed for simulation of endodontic treatment. The results showed a statistically significant difference (p = 0.0001) for vertical forces when cold lateral condensation obturation technique was used in comparison to other techniques. No statistically significant difference was found for vertical forces during obturation with Thermafil and ProTaper gutta-percha (p = 0.16). The cold lateral condensation technique exerted higher vertical forces in comparison to the Thermafil and ProTaper obturation techniques.

  10. Intrathoracic Hernia after Total Gastrectomy.

    PubMed

    Tashiro, Yoshihiko; Murakami, Masahiko; Otsuka, Koji; Saito, Kazuhiko; Saito, Akira; Motegi, Kentaro; Date, Hiromi; Yamashita, Takeshi; Ariyoshi, Tomotake; Goto, Satoru; Yamazaki, Kimiyasu; Fujimori, Akira; Watanabe, Makoto; Aoki, Takeshi

    2016-01-01

    Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation. PMID:27403095

  11. Minilaparoscopy For Inguinal Hernia Repair

    PubMed Central

    Malcher, Flavio; Cavazzola, Leandro Totti; Araujo, Guilherme D. E.; Silva, José Antônio Da Cunha E.; Rao, Prashanth; Iglesias, Antonio Carlos

    2016-01-01

    Background and Objectives: Inguinal hernia repair is among the most common procedures performed worldwide and the laparoscopic totally extraperitoneal (TEP) approach is a recognized and effective surgical technique. Although technically advantageous because of the option of no mesh fixation and no need for creation of a peritoneal flap resulting, in less postoperative pain and faster recovery, TEP has not achieved the popularity it deserves, mainly because of its complexity and steep learning curve. Minilaparoscopy was first described in the 1990s and has recently gained significantly from better instrumentation that may increase TEP's effectiveness and acceptance. We performed a prospective study, to analyze the outcomes of minilaparoscopy in pain and operative time when compared to the conventional laparoscopic technique in hernia repair. Methods: Fifty-eight laparoscopic inguinal hernia repairs were performed: 36 by traditional laparoscopic technique and 22 by minilaparoscopic instruments (mini). A study protocol was applied prospectively for data collection. Variables analyzed were early postoperative pain (at hour 6 after procedure), pain at discharge, use of on-demand analgesics, and operative time. Results: The mini group presented reduced early postoperative pain and operative time. The present study also suggests less postoperative pain at discharge with mini procedures, although this difference was not statistically significant. No difference between the groups regarding on-demand use of analgesics was found. Conclusions: This study corroborates findings in previously published papers that have shown the feasibility of minilaparoscopy in laparoscopic TEP hernia repair and its benefits regarding postoperative pain, operative time, and aesthetic outcomes. PMID:27777499

  12. Intrathoracic Hernia after Total Gastrectomy

    PubMed Central

    Tashiro, Yoshihiko; Murakami, Masahiko; Otsuka, Koji; Saito, Kazuhiko; Saito, Akira; Motegi, Kentaro; Date, Hiromi; Yamashita, Takeshi; Ariyoshi, Tomotake; Goto, Satoru; Yamazaki, Kimiyasu; Fujimori, Akira; Watanabe, Makoto; Aoki, Takeshi

    2016-01-01

    Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation. PMID:27403095

  13. Nondrowning Asphyxia in Veterinary Forensic Pathology: Suffocation, Strangulation, and Mechanical Asphyxia.

    PubMed

    McEwen, B J

    2016-09-01

    Asphyxia in a forensic context refers to death by rapid cerebral anoxia or hypoxia due to accidental or nonaccidental injury. Death due to nondrowning asphyxia can occur with strangulation, suffocation, and mechanical asphyxia, each of which is categorized based on the mechanism of injury. Individuals dying due to various types of asphyxia may or may not have lesions, and even those lesions that are present may be due to other causes. The interpretation or opinion that death was due to asphyxia requires definitive and compelling evidence from the postmortem examination, death scene, and/or history. Beyond the postmortem examination, pathologists may be faced with questions of forensic importance that revolve around the behavioral and physiological responses in animals subjected to strangulation, suffocation, or mechanical asphyxia to determine if the animal suffered. While there is no prescriptive answer to these questions, it is apparent that, because of physiological and anatomical differences between humans and animals, for some mechanisms of asphyxia, consciousness is maintained for longer periods and the onset of death is later in animals than that described for people. Veterinary pathologists must be cognizant that direct extrapolation from the medical forensic literature to animals may be incorrect. This article reviews the terminology, classification, mechanisms, and lesions associated with asphyxial deaths in companion animals and highlights significant comparative differences of the response to various types of asphyxia in animals and people. PMID:27084399

  14. [Idiopathic Lumbar Hernia: A Case Report].

    PubMed

    Tsujino, Takuya; Inamoto, Teruo; Matsunaga, Tomohisa; Uchimoto, Taizo; Saito, Kenkichi; Takai, Tomoaki; Minami, Koichiro; Takahara, Kiyoshi; Nomi, Hayahito; Azuma, Haruhito

    2015-11-01

    A 68-year-old woman, complained of an indolent lump about 60 × 70 mm in size in the left lower back. We conducted a computed tomography scan, which exhibited a hernia of Gerota'sfascia-commonly called superior lumbar hernia. In the right lateral position, the hernia contents were observed to attenuate, hence only closure of the hernial orifice was conducted by using Kugel patch, without removal of the hernia sack. Six months after the surgery, she has had no relapse of the hernia. Superior lumbar hernia, which occurs in an anatomically brittle region in the lower back, is a rare and potentially serious disease. The urologic surgeon should bear in mind this rarely seen entity.

  15. Stress analysis in oral obturator prostheses, part II: photoelastic imaging.

    PubMed

    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; da Silva, Emily Vivianne Freitas; Haddad, Marcela Filié; Moreno, Amália; Zahoui, Abbas; dos Santos, Daniela Micheline

    2014-06-01

    In part I of the study, two attachment systems [O-ring; bar-clip (BC)] were used, and the system with three individualized O-rings provided the lowest stress on the implants and the support tissues. Therefore, the aim of this study was to assess the stress distribution, through the photoelastic method, on implant-retained palatal obturator prostheses associated with different attachment systems: BOC--splinted implants with a bar connected to two centrally placed O-rings, and BOD--splinted implants with a BC connected to two distally placed O-rings (cantilever). One photoelastic model of the maxilla with oral-sinus-nasal communication with three parallel implants was fabricated. Afterward, two implant-retained palatal obturator prostheses with the two attachment systems described above were constructed. Each assembly was positioned in a circular polariscope and a 100-N axial load was applied in three different regions with implants by using a universal testing machine. The results were obtained through photograph record analysis of stress. The BOD system exhibited the highest stress concentration, followed by the BOC system. The O-ring, centrally placed on the bar, allows higher mobility of the prostheses and homogeneously distributes the stress to the region of the alveolar ridge and implants. It can be concluded that the use of implants with O-rings, isolated or connected with a bar, to rehabilitate maxillectomized patients allows higher prosthesis mobility and homogeneously distributes the stress to the alveolar ridge region, which may result in greater chewing stress distribution to implants and bone tissue. The clinical implication of the augmented bone support loss after maxillectomy is the increase of stress in the attachment systems and, consequently, a higher tendency for displacement of the prosthesis. PMID:24972360

  16. Stress analysis in oral obturator prostheses, part II: photoelastic imaging

    NASA Astrophysics Data System (ADS)

    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; da Silva, Emily Vivianne Freitas; Haddad, Marcela Filié; Moreno, Amália; Zahoui, Abbas; dos Santos, Daniela Micheline

    2014-06-01

    In part I of the study, two attachment systems [O-ring; bar-clip (BC)] were used, and the system with three individualized O-rings provided the lowest stress on the implants and the support tissues. Therefore, the aim of this study was to assess the stress distribution, through the photoelastic method, on implant-retained palatal obturator prostheses associated with different attachment systems: BOC-splinted implants with a bar connected to two centrally placed O-rings, and BOD-splinted implants with a BC connected to two distally placed O-rings (cantilever). One photoelastic model of the maxilla with oral-sinus-nasal communication with three parallel implants was fabricated. Afterward, two implant-retained palatal obturator prostheses with the two attachment systems described above were constructed. Each assembly was positioned in a circular polariscope and a 100-N axial load was applied in three different regions with implants by using a universal testing machine. The results were obtained through photograph record analysis of stress. The BOD system exhibited the highest stress concentration, followed by the BOC system. The O-ring, centrally placed on the bar, allows higher mobility of the prostheses and homogeneously distributes the stress to the region of the alveolar ridge and implants. It can be concluded that the use of implants with O-rings, isolated or connected with a bar, to rehabilitate maxillectomized patients allows higher prosthesis mobility and homogeneously distributes the stress to the alveolar ridge region, which may result in greater chewing stress distribution to implants and bone tissue. The clinical implication of the augmented bone support loss after maxillectomy is the increase of stress in the attachment systems and, consequently, a higher tendency for displacement of the prosthesis.

  17. Current Trends in Laparoscopic Ventral Hernia Repair

    PubMed Central

    Patapis, Paul; Zavras, Nick; Tzanetis, Panagiotis; Machairas, Anastasios

    2015-01-01

    Background and Objectives: The purpose of this study was to analyze the surgical technique, postoperative complications, and possible recurrence after laparoscopic ventral hernia repair (LVHR) in comparison with open ventral hernia repair (OVHR), based on the international literature. Database: A Medline search of the current English literature was performed using the terms laparoscopic ventral hernia repair and incisional hernia repair. Conclusions: LVHR is a safe alternative to the open method, with the main advantages being minimal postoperative pain, shorter recovery, and decreased wound and mesh infections. Incidental enterotomy can be avoided by using a meticulous technique and sharp dissection to avoid thermal injury. PMID:26273186

  18. Massive hiatus hernia complicated by jaundice.

    PubMed

    Furtado, Ruelan V; D'Netto, Trevor J; Hook, Henry C; Falk, Gregory L; Vivian, SarahJayne

    2015-01-01

    Giant para-oesophageal hernia may include pancreas with pancreatic complication and rarely jaundice. Repair is feasible and durable by laparoscopy. Magnetic resonance cholangiopancreatography is diagnostic. PMID:26246452

  19. Split Hollow Bulb Obturator to Rehabilitate Maxillary Defect: A Case Report.

    PubMed

    Mohamed, Kasim; Mani, Umamaheswari; Saravanakumar, Prathibha; Kumar, S Prasanna; Arunachalam, Ravikumar

    2016-01-01

    The rehabilitation of a maxillectomy patient involves meticulous treatment planning and designing. Lack of retention and facial support and limited mouth opening are the major issues that lead to functional and psychological trauma in post-maxillectomy patients. The successful rehabilitation of a maxillary defect includes restoring the function, esthetics, and a complete obturation of the defect, enabling the patient to feed without nasal regurgitation. This case report describes the fabrication of an obturator with a modified design, namely a split-antral hollow bulb obturator and oral part that is retained with a ball attachment, for a patient with right-side acquired maxillary defect due to recurrent myxoma. The primary advantage of this modification is enhanced facial support and a self-retentive antral obturation that improved the quality of life of the patient after an extensive maxillectomy. PMID:27433414

  20. Split Hollow Bulb Obturator to Rehabilitate Maxillary Defect: A Case Report

    PubMed Central

    Mani, Umamaheswari; Saravanakumar, Prathibha; Kumar, S Prasanna; Arunachalam, Ravikumar

    2016-01-01

    The rehabilitation of a maxillectomy patient involves meticulous treatment planning and designing. Lack of retention and facial support and limited mouth opening are the major issues that lead to functional and psychological trauma in post-maxillectomy patients. The successful rehabilitation of a maxillary defect includes restoring the function, esthetics, and a complete obturation of the defect, enabling the patient to feed without nasal regurgitation. This case report describes the fabrication of an obturator with a modified design, namely a split-antral hollow bulb obturator and oral part that is retained with a ball attachment, for a patient with right-side acquired maxillary defect due to recurrent myxoma. The primary advantage of this modification is enhanced facial support and a self-retentive antral obturation that improved the quality of life of the patient after an extensive maxillectomy. PMID:27433414

  1. Analysis of the endogrammes developed during obturations on extracted teeth using system B.

    PubMed

    Blum, J Y; Cathala, C; Machtou, P; Micallef, J P

    2001-11-01

    The ability of an obturation technique to fill the root canal system tridimensionally depends partially on the timing and intensity of force applications. The aim of this study was to use the Endographe to analyze the forces and wedging effects developed in the root canal using a new obturation technique: System B. This system uses a heat plugger that simultaneously heats and pushes gutta-percha. The plugger was used to soften and move the gutta-percha apically during the down-pack stage. Two different methods, however, were used to withdraw the plugger from the compacted gutta-percha. One used the burst heat method, and the other was cold withdrawal. Five endodontists performed 50 obturations of prepared extracted teeth and 50 obturations of the "wedging effect" holder of the Endographe. The practitioner-obturation assignment was randomized. For each obturation the biggest plugger possible in relationship to the shape of the canal was chosen. For the obturation of the special holder the same tip was chosen. Endogrammes showed the force application and wedging effect sequences. The mean values for the vertical and horizontal forces and the wedging effect were, respectively, 16 +/- 2 N, 5 +/- 1 N, and 9 +/- 1 N. These results suggest that System B is one of the best techniques in terms of the developed vertical forces (low values) and the resulting wedging effect (high values) in relationship to the plasticity of the gutta-percha. The Endogrammes provide a new approach to the analysis of obturation techniques and a means to demonstrate correct and optimal manipulation of the new System B plugger. PMID:11716076

  2. Closed hollow bulb obturator--one-step fabrication: a clinical report.

    PubMed

    Buzayan, Muaiyed M; Ariffin, Yusnidar T; Yunus, Norsiah

    2013-10-01

    A method is described for the fabrication of a closed hollow bulb obturator prosthesis using a hard thermoforming splint material and heat-cured acrylic resin. The technique allowed the thickness of the thermoformed bulb to be optimized for weight reduction, while the autopolymerized seal area was covered in heat-cured acrylic resin, thus eliminating potential leakage and discoloration. This technique permits the obturator prosthesis to be processed to completion from the wax trial denture without additional laboratory investing, flasking, and processing.

  3. National results after ventral hernia repair.

    PubMed

    Helgstrand, Frederik

    2016-07-01

    Ventral hernia repairs are among the most frequently performed surgical procedures. The variations of repair techniques are multiple and outcome has been unacceptable. Despite the high volume, it has been difficult to obtain sufficient data to provide evidence for best practice. In order to monitor national surgical quality and provide the warranted high volume data, the first national ventral hernia register (The Danish Ventral Hernia Database) was established in 2007 in Denmark. The present study series show that data from a well-established database supported by clinical examinations, patient files, questionnaires, and administrative data makes it possible to obtain nationwide high volume data and to achieve evidence for better outcome in a complex surgical condition as ventral hernia. Due to the high volume and included variables on surgical technique, it is now possible to make analyses adjusting for a variety of surgical techniques and different hernia specifications. We documented high 30-day complications and recurrence rates for both primary and secondary ventral hernias in a nationwide cohort. Furthermore, recurrence found by clinical examination was shown to exceed the number of patients undergoing reoperation for recurrence by a factor 4-5. The nationwide adjusted analyses proved that open mesh and laparoscopic repair for umbilical and epigastric hernias does not differ in 30-day outcome or in risk of recurrence. There is a minor risk reduction in early complications after open sutured repairs. However, the risk for a later recurrence repair is significantly higher after sutured repairs compared with mesh repairs. The study series showed that large hernia defects and open re-pairs were independent predictors for 30-day complications after an incisional hernia repair. Open procedures and large hernia defects were independent risk factors for a later recurrence re-pair. However, patients with large defects (> 15 cm) seemed to benefit from an open mesh

  4. Sealing ability of a novel hydrophilic vs. conventional hydrophobic obturation systems: A bacterial leakage study

    PubMed Central

    Hegde, Vibha; Arora, Shashank

    2015-01-01

    Aim: Comparative assessment of apical sealing ability of a novel Smart-Seal System, Resilon, and conventional Gutta-Percha system using a bacterial leakage model. Materials and Methods: Seventy freshly extracted human single rooted teeth with fully formed apices were randomly divided into three groups (20 each) and two control groups (5 positive and 5 negative). Teeth were de-coronated, and roots were standardized to a working length of 16 mm. Root canal preparation was done with rotary pro-taper file system in all groups. Group A was obturated using Smart-Seal system (Hydrophilic), Group B using Resilon/Epiphany system (Hydrophilic), and Group C using Gutta-Percha (GP)/AH plus system (Hydrophobic) in a single cone technique. Using Enterococcus faecalis, a split chamber bacterial leakage model was developed to evaluate the sealing ability of three obturation systems. Samples will be monitored every 24 hours for 60 days. Results: All three groups have shown leakage. Novel Smart-Seal System and Resilon have shown similar results and relatively lesser samples leaked in comparison to GP obturations at the end of the observation period. There was no significant difference amongst Resilon and Smart-Seal System (P > 0.05) but there was a significant difference amongst them when compared to GP obturations (P < 0.05). Conclusion: Hydrophilic obturations of the root canal shows a better resistance to bacterial leakage as compared to hydrophobic obturations. PMID:25657530

  5. Congenital lateral abdominal wall hernia.

    PubMed

    Montes-Tapia, Fernando; Cura-Esquivel, Idalia; Gutiérrez, Susana; Rodríguez-Balderrama, Isaías; de la O-Cavazos, Manuel

    2016-08-01

    Congenital abdominal wall defects that are located outside of the anterior wall are extremely rare and difficult to classify because there are no well accepted guidelines. There are two regions outside of the anterior wall: the flank or lateral wall; and the lumbar region. We report the case of a patient with an oval 3 cm-diameter hernia defect located above the anterior axillary line, which affects all layers of the muscular wall. An anorectal malformation consisting of a recto-vestibular fistula was also identified, and chest X-ray showed dextrocardia. The suggested treatment is repair of the defect before 1 year of age. Given that the anomalies described may accompany lateral abdominal wall hernia, it is important to diagnose and treat the associated defects.

  6. Large hiatal hernia in infancy with right intrathoracic stomach along with left sided morgagni hernia.

    PubMed

    Saeed, Uzma; Mazhar, Naveed; Zameer, Shahla

    2014-11-01

    Congenital diaphragmatic hernia is a very common intrathoracic fetal anomaly with Morgagni hernia typically seen on right side anteriorly and Bochdalek hernia on left side posteriorly, because of the protective effects of liver and heart on either side respectively. Hiatal hernias range from herniation of a small portion of stomach into thoracic cavity to herniation of entire stomach into the left thoracic cavity. Very rarely the herniated stomach has been reported in the right thoracic cavity. Early diagnosis and treatment of all diaphragmatic hernias is essential to reduce the associated morbidity and mortality. We present a very rare and interesting case of an 18 months old baby girl with reverse scenarios. She had a large hiatal hernia with right intrathoracic stomach along with a left sided Morgagni hernia in combination.

  7. One surgeon experiences in childhood inguinal hernias

    PubMed Central

    2011-01-01

    Purpose In this manuscript we report one pediatric surgeon's experience in childhood inguinal hernia repair. Methods From 2005 to 2008, 402 children with inguinal hernias were operated on by one surgeon. A retrospective survey of their charts was carried out to evaluate the demographics and clinical aspects of these patients. Results The ages ranged from 20 days to 16 years with a male-to-female ratio of 2.5:1. 64.9% right, 27.1% left, and 7.9% bilateral hernias. Hydroceles were present in 6.2% assosiated hernias. Incarceration occurred in 8.7% of children. An opposite-side hernia developed in 5.7%. 5.3 percent of patients with a hernia repair on the right side later developed a hernia on the left side, and 8.2% of patients with a hernia repair on the left side later developed one on the right side. 4.5 percent of all male patients in this series and 8.6% of female patients developed an opposite-side hernia. While overall recurrence rate was 1.2%, our recurrence rate was 0.25%. There was a 0.24% wound infection rate, and 1 (0.24%) testicle was atrophic at follow-up. Conclusion In this study, in the recurrence of childhood hernia, the general surgeon's intervention was the prominent cause. It is suggested by the study that inguinal hernias on the contralateral side becomes symptomatic within the first six months following initial operation.Therefor, close observation is needed in that time. PMID:22066100

  8. Traumatic acute incarcerated scrotal hernia.

    PubMed

    Mucciolo, R L; Godec, C J

    1988-05-01

    A 23-year-old male presented to the ER with left scrotal pain and swelling after being struck with a knee in the left inguinoscrotal area during a basketball game. Upon examination, an incarcerated scrotal hernia with necrotic segment of small bowel was found. Bowel was resected and direct reanastomosis performed. This appears to be the first such case in the English-language literature.

  9. Rationale and early experience with prophylactic placement of mesh to prevent parastomal hernia formation after ileal conduit urinary diversion and cystectomy for bladder cancer

    PubMed Central

    Donahue, Timothy F.; Cha, Eugene K.; Bochner, Bernard H.

    2016-01-01

    Parastomal hernias represent a clinically significant problem for many patients after radical cystectomy and ileal conduit diversion. The prevalence may be as high as 60% and in some series, up to 30% of patients require surgical intervention due to the complications of pain, poor fit of an ostomy appliance, leakage, urinary obstruction, and bowel obstruction or strangulation. Due to the potential morbidity associated with PH repair, there have been efforts to prevent PH development at the time of the index surgery. Four randomized trials of prophylactic mesh placement at the time of colostomy and ileostomy stoma formation have demonstrated significant reductions in PH rates with acceptably low complication rates. In this review, we describe the clinical and radiographic definitions of PH, the clinical impact and risk factors behind its development, and the rationale behind prophylactic mesh placement for patients undergoing ileal conduit urinary diversion. Additionally, we report our experience with prophylactic mesh placed at radical cystectomy at our institution. PMID:26757903

  10. [The trocar hernia after laparoscopic operative interventions. classification, treatment, prophylaxis].

    PubMed

    Nychytaĭlo, M Iu; Bulyk, I I; Zahriĭchuk, M S; Korytko, I P; Homan, A V

    2014-11-01

    Own experience of treatment of patients, suffering trocar hernias, occurred after laparoscopic operative interventions, was analyzed. Classification of trocar hernias was proposed, the main factors of risk and prognostic criteria of a trocar hernias formation were analyzed. The main methods of the trocar hernias correction are adduced.

  11. Rehabilitation of Oncology Patients with Hard Palate Defects Part 3: Construction of an Acrylic Hollow Box Obturator.

    PubMed

    Ali, Rahat; Altaie, Asmaa; Nattress, Brian

    2015-09-01

    This article will discuss the clinical stages in the fabrication of a definitive acrylic hollow box obturator to restore a hard palate defect. The first two papers described the restorative/surgical planning phase and the principles of obturator design. CPD/CLINICAL RELEVANCE: Each of the clinical stages required to make a hollow box obturator must be performed to the highest possible standard to ensure than an optimal prosthesis.is fabricated.

  12. Initial experience of laparoscopic incisional hernia repair.

    PubMed

    Razman, J; Shaharin, S; Lukman, M R; Sukumar, N; Jasmi, A Y

    2006-06-01

    Laparoscopic repair of ventral and incisional hernia has become increasingly popular as compared to open repair. The procedure has the advantages of minimal access surgery, reduction of post operative pain and the recurrence rate. A prospective study of laparoscopic incisional hernia repair was performed in our center from August 2002 to April 2004. Eighteen cases (n: 18) were performed during the study period. Fifteen cases (n: 15) had open hernia repair previously. Sixteen patients (n: 16) had successful repair of the hernia with the laparoscopic approach and two cases were converted to open repair. The mean hernia defect size was 156cm2. There was no intraoperative or immediate postoperative complication. The mean operating time was 100 +/- 34 minutes (75 - 180 minutes). The postoperative pain was graded as mild to moderate according to visual analogue score. The mean day of discharge after surgery was two days (1 - 3 days). During follow up, three patients (16.7%) developed seroma at the hernia sac which was resolved with conservative management after three weeks. One (5.6%) patient developed recurrence six months after surgery. In conclusion, laparoscopic repair of incisional hernia particularly recurrent hernia has been shown to be safe and effective in our centre. However, careful patient selection and acquiring the necessary advanced laparoscopic surgical skills coupled with the proper use of equipment are mandatory before embarking on this procedure.

  13. [Neonatal occlusion due to a lumbar hernia].

    PubMed

    Hunald, F A; Ravololoniaina, T; Rajaonarivony, M F V; Rakotovao, M; Andriamanarivo, M L; Rakoto-Ratsimba, H

    2011-10-01

    A Petit lumbar hernia is an uncommon hernia. Congenital forms are seen in children. Incarceration may occur as an unreducible lumbar mass, associated with bilious vomiting and abdominal distention. Abdominal X-ray shows sided-wall bowel gas. In this case, reduction and primary closure must be performed as emergency repair.

  14. Inguinal hernia and a single strenuous event.

    PubMed Central

    Smith, G. D.; Crosby, D. L.; Lewis, P. A.

    1996-01-01

    A study of 129 consecutive patients, who had a total of 145 inguinal hernias, showed that in only 7% of the patients was the hernia subjectively attributable to a single muscular strain. Guidelines are suggested to assist in assessing 'cause' in claims for industrial injury in such patients. PMID:8712653

  15. [Trocar hernia: causes, treatment, methods of prevention].

    PubMed

    Ivan'ko, A V

    2012-01-01

    The paper presents the results of the study 41 patients with trocar hernias after various laparoscopic operations. It is established that the main reason is the expansion of trocar hernia injury when removing the drug without further suturing of the aponeurosis. Proposed closure of the aponeurosis, while the length of the wound more than 2 cm - alloplastica.

  16. 21 CFR 876.5970 - Hernia support.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hernia support. 876.5970 Section 876.5970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5970 Hernia support. (a) Identification. A...

  17. 21 CFR 876.5970 - Hernia support.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hernia support. 876.5970 Section 876.5970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5970 Hernia support. (a) Identification. A...

  18. 21 CFR 876.5970 - Hernia support.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hernia support. 876.5970 Section 876.5970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5970 Hernia support. (a) Identification. A...

  19. 21 CFR 876.5970 - Hernia support.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hernia support. 876.5970 Section 876.5970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5970 Hernia support. (a) Identification. A...

  20. 21 CFR 876.5970 - Hernia support.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hernia support. 876.5970 Section 876.5970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5970 Hernia support. (a) Identification. A...

  1. Current trends in laparoscopic groin hernia repair: A review.

    PubMed

    Pahwa, Harvinder Singh; Kumar, Awanish; Agarwal, Prerit; Agarwal, Akshay Anand

    2015-09-16

    Hernia is a common problem of the modern world with its incidence more in developing countries. Inguinal hernia is the most common groin hernia repaired worldwide. With advancement in technology operative techniques of repair have also evolved. A PubMed and COCHRANE database search was accomplished in this regard to establish the current status of laparoscopic inguinal hernia repair in view of recent published literature. Published literature support that laparoscopic hernia repair is best suited for recurrent and bilateral inguinal hernia although it may be offered for primary inguinal hernia if expertise is available.

  2. Diaphragmatic Hernia After Pediatric Liver Transplant.

    PubMed

    Kirnap, Mahir; Akdur, Aydincan; Ozcay, Figen; Soy, Ebru; Coskun, Mehmet; Moray, Gokhan; Haberal, Mehmet

    2015-10-01

    Diaphragmatic hernia is an unusual complication after pediatric liver transplant. Nearly half of bowel obstruction cases, which require surgical intervention in liver transplant patients, are caused by diaphragmatic hernia. The smaller patients are at risk for higher rates of diaphragmatic complication after pediatric liver transplant, but diaphragmatic hernia has not been reported as a unique occurrence. Here, we report 3 cases of diaphragmatic hernia after liver transplant and discuss the possible contributing factors. Diaphragmatic hernia should nevertheless be added to the list of potential complications after liver transplant in the pediatric population. Pediatric transplant physicians and surgeons should be aware of this complication so that it is recognized promptly in both acute and nonacute settings and appropriate action is taken.

  3. Preoperative progressive pneumoperitoneum for giant inguinal hernias.

    PubMed

    Piskin, Turgut; Aydin, Cemalettin; Barut, Bora; Dirican, Abuzer; Kayaalp, Cuneyt

    2010-01-01

    Reduction of giant hernia contents into the abdominal cavity may cause intraoperative and postoperative problems such as abdominal compartment syndrome. Preoperative progressive pneumoperitoneum expands the abdominal cavity, increases the patient's tolerability to operation, and can diminish intraoperative and postoperative complications. Preoperative progressive pneumoperitoneum is recommended for giant ventral hernias, but rarely for giant inguinal hernias. We present two giant inguinal hernia patients who were prepared for hernia repair with preoperative progressive pneumoperitoneum and then treated successfully by graft hernioplasty. We observed that abdominal expansion correlated with the inflated volume and pressure during the first four days of pneumperitoneum. Although insufflated gas volume can be different among patients, we observed that the duration of insufflation may be the same for similar patients.

  4. Laparoscopic repair of left lumbar hernia after laparoscopic left nephrectomy.

    PubMed

    Gagner, Michel; Milone, Luca; Gumbs, Andrew; Turner, Patricia

    2010-01-01

    Lumbar hernias, rarely seen in clinical practice, can be acquired after open or laparoscopic flank surgery. We describe a successful laparoscopic preperitoneal mesh repair of multiple trocar-site hernias after extraperitoneal nephrectomy. All the key steps including creating a peritoneal flap, reducing the hernia contents, and fixation of the mesh are described. A review of the literature on this infrequent operation is presented. Laparoscopic repair of lumbar hernias has all the advantages of laparoscopic ventral hernia repair.

  5. Traumatic lumbar hernias: do patient or hernia characteristics predict bowel or mesenteric injury?

    PubMed

    Mellnick, Vincent M; Raptis, Constantine; Lonsford, Chad; Lin, Michael; Schuerer, Douglas

    2014-06-01

    Traumatic lumbar hernias are rare but important injuries to diagnose in blunt abdominal trauma, both because of delayed complications of the hernia itself and because of well-documented association with bowel and mesenteric injuries. No study to our knowledge has determined whether specific features of the hernia-size of the wall defect, inferior or superior location, or the side of the hernia-bear any predictive value on the presence of underlying bowel and mesenteric injury. A retrospective query of the radiology information system yielded 21 patients with lumbar hernias which were diagnosed on CT. These were reviewed by three radiologists to confirm the presence of an acute lumbar hernia and to determine the size and location of the hernia. The patients' medical records were reviewed to determine the presence of operatively confirmed bowel and/or mesenteric injuries, which occurred in 52 % of patients. A significant (p < 0.001) difference was found in the frequency of bowel and/or mesenteric injury with hernia defects greater than 4.0 cm (100 %) and those less than 4.0 cm (17 %). Larger hernias also resulted in more procedures (p = 0.042) and a trend towards longer ICU stay, but no difference in injury severity score (ISS) or overall hospital stay. No significant difference was seen in the frequency of bowel and/or mesenteric injuries based on side or location of the hernia, though distal colonic injuries were more commonly seen with left-sided hernias (50 %) compared to right-sided hernias (18 %). Although based on a small patient population, these results suggest that larger traumatic lumbar hernias warrant particularly close evaluation for an underlying bowel and/or mesenteric injury.

  6. Dynamic intratubular biomineralization following root canal obturation with pozzolan‐based mineral trioxide aggregate sealer cement

    PubMed Central

    Yoo, Yeon‐Jee; Baek, Seung‐Ho; Kum, Kee‐Yeon; Shon, Won‐Jun; Woo, Kyung‐Mi

    2015-01-01

    Summary The application of mineral trioxide aggregates (MTA) cement during the root canal obturation is gaining concern due to its bioactive characteristic to form an apatite in dentinal tubules. In this regard, this study was to assess the biomineralization of dentinal tubules following root canal obturation by using pozzolan‐based (Pz‐) MTA sealer cement (EndoSeal MTA, Maruchi). Sixty curved roots (mesiobuccal, distobuccal) from human maxillary molars were instrumented and prepared for root canal obturation. The canals were obturated with gutta‐percha (GP) and Pz‐MTA sealer by using continuous wave of condensation technique. Canals obturated solely with ProRoot MTA (Dentsply Tulsa Dental) or Pz‐MTA sealer were used for comparison. In order to evaluate the biomineralization ability under different conditions, the PBS pretreatment before the root canal obturation was performed in each additional samples. At dentin‐material interfaces, the extension of intratubular biomineralization was analyzed using scanning electron microscopy (SEM) and energy dispersive spectroscopy. When the root canal was obturated with GP and Pz‐MTA sealer, enhanced biomineralization of the dentinal tubules beyond the penetrated sealer tag was confirmed under the SEM observation (p < 0.05). Mineralized apatite structures (calcium/phosphorous ratio, 1.45–1.89) connecting its way through the dentinal tubules were detected at 350–400 μm from the tubule orifice, and the pre‐crystallization seeds were also observed along the intra‐ and/or inter‐tubular collagen fiber. Intratubular biomineralization depth was significantly enhanced in all PBS pretreated canals (p < 0.05). Pz‐MTA cement can be used as a promising bioactive root canal sealer to enhance biomineralization of dentinal tubules under controlled environment. SCANNING 38:50–56, 2016. © 2015 The Authors. Scanning Published by Wiley Periodicals, Inc. PMID:26179659

  7. Dynamic intratubular biomineralization following root canal obturation with pozzolan-based mineral trioxide aggregate sealer cement.

    PubMed

    Yoo, Yeon-Jee; Baek, Seung-Ho; Kum, Kee-Yeon; Shon, Won-Jun; Woo, Kyung-Mi; Lee, WooCheol

    2016-01-01

    The application of mineral trioxide aggregates (MTA) cement during the root canal obturation is gaining concern due to its bioactive characteristic to form an apatite in dentinal tubules. In this regard, this study was to assess the biomineralization of dentinal tubules following root canal obturation by using pozzolan-based (Pz-) MTA sealer cement (EndoSeal MTA, Maruchi). Sixty curved roots (mesiobuccal, distobuccal) from human maxillary molars were instrumented and prepared for root canal obturation. The canals were obturated with gutta-percha (GP) and Pz-MTA sealer by using continuous wave of condensation technique. Canals obturated solely with ProRoot MTA (Dentsply Tulsa Dental) or Pz-MTA sealer were used for comparison. In order to evaluate the biomineralization ability under different conditions, the PBS pretreatment before the root canal obturation was performed in each additional samples. At dentin-material interfaces, the extension of intratubular biomineralization was analyzed using scanning electron microscopy (SEM) and energy dispersive spectroscopy. When the root canal was obturated with GP and Pz-MTA sealer, enhanced biomineralization of the dentinal tubules beyond the penetrated sealer tag was confirmed under the SEM observation (p < 0.05). Mineralized apatite structures (calcium/phosphorous ratio, 1.45-1.89) connecting its way through the dentinal tubules were detected at 350-400 μm from the tubule orifice, and the pre-crystallization seeds were also observed along the intra- and/or inter-tubular collagen fiber. Intratubular biomineralization depth was significantly enhanced in all PBS pretreated canals (p < 0.05). Pz-MTA cement can be used as a promising bioactive root canal sealer to enhance biomineralization of dentinal tubules under controlled environment.

  8. Effect of masticatory cycles on apical leakage of obturated teeth.

    PubMed

    Esber, S; Blum, J Y; Chazel, J C; Parahy, E

    1998-05-01

    This study investigated the effect of apical leakage due to masticatory cycles on root canal treatment. Twenty upper maxillary molars were first obturated using the warm vertical compaction technique. Four maxillary casts were then built, with each holding four of the sample molars. The molars were embedded in resin with the roots separated from the resin by means of a light silicon. The four remaining teeth served as controls and were not submitted to occlusal forces. A mechanical device to simulate masticatory cycles subjected the teeth to 0.5 x 10(6) cycles (group A), 10(6) cycles (group B), 2 x 10(6) cycles (group C), and 3 x 10(6) cycles (group D); the control was group E. The roots were placed in 2% methylene blue dye solution for 72 h and then sectioned longitudinally so that dye penetration could be measured. The mean values of dye penetration were: 3.70 +/- 0.69 mm, group A; 5.00 +/- 1.14 mm, group B; 6.00 +/- 1.01 mm, group C; 7.23 +/- 0.66 mm, group D; and 2.74 +/- 0.75 mm, group E. The value of dye penetration increased in correlation with the number of masticatory cycles. This in vitro study suggests the significant effect of masticatory loads on apical leakage. PMID:9641106

  9. Rare variant of inguinal hernia, interparietal hernia and ipsilateral abdominal ectopic testis, mimicking a spiegelian hernia. Case report.

    PubMed

    Hirabayashi, Takeshi; Ueno, Shigeru

    2013-07-20

    We report a case in which the combination of an interparietal inguinal hernia and ipsilateral ectopic testicle mimicked a spigelian hernia. The patient was a 22-day-old boy who presented with a reducible mass that extended from the right lumbar region to the iliac fossa region. The right testis was palpable in the right lumbar region. Ultrasonography and magnetic resonance imaging revealed that a small bowel had herniated through the inguinal region below the external oblique aponeurosis. Surgery was performed when the patient was 23 months old. Laparoscopic examination to identify the hernia orifice revealed that it was the deep inguinal ring, and the testicular vessels and the vas deferens passed beneath the hernia sac. An inguinal incision was made, and a hernia sac was observed passing through the deep inguinal ring and extending superiorly below the aponeurosis. The testis was found in the hernia sac. Traditional inguinal herniorrhaphy and traditional orchidopexy were performed, and the postoperative course was uneventful. It is difficult to understand the surgical anatomy of interparietal hernias, but once the surgical anatomy is understood, surgical repair is simple. We report the case with a review of the literature and also emphasize that laparoscopic exploration is helpful during surgery.

  10. [Forensic medical diagnostics of the impact of the ligatures made from different materials in the cases of strangulation asphyxia].

    PubMed

    Sashko, S Yu; Krut, M I; Zaraf'yants, G N; Lebedeva, T V

    2015-01-01

    The identification of the instruments of injury resulting from neck compression not infrequently encounters difficulties. We developed an experimental model allowing to evaluate the impact of ligatures made from different materials on non-biological objects. The use of spectral techniques including X-ray fluorescence spectrometry and emission spectral analysis made it possible to detect and identify the chemical elements transferred from the loop material onto the object's surface. Specifically, the transfer of the elements contained in the rubber of the electric cable braid was demonstrated. The presence of these elements together with microparticles of rubber at the surface of the study objects proved to be a diagnostic sign giving evidence of the impact of the rubber sheath of the electric cable leaving the strangulation mark on the object's surface.. The results of the present experiments confirm the possibility of using spectral methods along with other techniques for the identification of a ligature employed as the instrument of strangulation injury. PMID:26710507

  11. Efficacy of ultrasound-guided obturator nerve block in transurethral surgery

    PubMed Central

    Thallaj, Ahmed; Rabah, Dany

    2011-01-01

    Background: During transurethral resection surgery (TUR), accidental stimulation of the obturator nerve can cause violent adductor contraction, leading to serious intraoperative complications. General anesthesia with muscle relaxation is currently the preferred technique for TUR surgery. Spinal anesthesia combined with obturator nerve block has also been used for TUR surgery in geriatric population. Blind, anatomical methods for identifying the obturator nerve are often unsatisfactory. Therefore, we conducted this prospective study to validate the efficacy of ultrasound-guided obturator nerve block (USONB) during TUR procedures. Methods: Eighteen male patients undergoing TURP surgery under spinal anesthesia were included in the study. Bilateral USONB with maximum 20 ml of 1% lidocaine per patient was performed. An independent observer was present to monitor any adduction movements during the operation and to record patient and surgeon satisfactions. Results: In all patients, obturator nerve was visualized from the first attempt, requiring an average of 4.3 min for blocking of each side. USONB was successful (97.2%) in preventing an adductor spasm in all except one patient. Patient’s and surgeon’s satisfaction were appropriate. In all patients, adductor muscle strength recovered fully within 2 h following the surgical procedure. Conclusions: USONB is safe and effective during TUR surgery. It provides optimal intra-and postoperative conditions. PMID:21655015

  12. The role of hiatus hernia in GERD.

    PubMed Central

    Kahrilas, P. J.

    1999-01-01

    Increased esophageal acid exposure in gastroesophageal reflux disease has several potential causes, some related primarily to physiological dysfunction of the LES and others related to anatomic distortion of the gastroesophageal junction as occurs with hiatus hernia. One attractive feature of implicating hiatal hernias in the pathogenesis of reflux disease is that, like reflux disease, axial hernias become more common with age and obesity. However, the importance of hiatus hernia is obscured by imprecise definition and an all-or-none conceptualization that has led to wide variation in estimates of prevalence among normal or diseased populations. There are at least three potentially significant radiographic features of a hiatus hernia: axial length during distention, axial length at rest, and competence of the diaphragmatic hiatus. Although any or all of these features may be abnormal in a particular instance of hiatus hernia, each is of different functional significance. Grouping all abnormalities of the gastroesophageal junction as "hiatus hernia" without detailing the specifics of each case defies logic. Mechanistically, the gastroesophageal junction must protect against reflux both in static and dynamic conditions. During abrupt increases in intra-abdominal pressure, the crural diaphragm normally serves as a "second sphincter," and this mechanism is substantially impaired in individuals with a gaping hiatus. Large, non-reducing hernias also impair the process of esophageal emptying, thereby prolonging acid clearance time following a reflux event (especially while in the supine posture). These anatomically-determined functional impairments of the gastroesophageal junction lead to increased esophageal acid exposure. Thus, although hiatus hernia may or may not be an initiating factor at the inception of reflux disease, it clearly can act as a sustaining factor accounting for the frequently observed chronicity of the disease. PMID:10780571

  13. Diaphragmatic hernia in Denys-Drash syndrome

    SciTech Connect

    Devriendt, K.; Deloof, E.; Moerman, P.

    1995-05-22

    We report on a newborn infant with male pseudohermaphroditism and glomerular lesions (Denys-Drash syndrome) but without Wilms tumor. A constitutional heterozygous mutation in the WT1 gene ({sup 366} Arg to His) was identified. In addition the child had a large diaphragmatic hernia, so far not described in Denys-Drash syndrome. The expression of the WT1 gene in pleural and abdominal mesothelium and the occurrence of diaphragmatic hernia in transgenic mice with a homozygous WT1 deletion strongly suggests that the diphragmatic hernia in this patient is part of the malformation pattern caused by WT1 mutations. 21 refs., 4 figs.

  14. [Traumatic Spigelian hernia. Elective extraperitoneal laparoscopic repair].

    PubMed

    Moreno-Egea, Alfredo; Campillo-Soto, Alvaro; Girela-Baena, Enrique; Torralba-Martínez, José Antonio; Corral de la Calle, Miquel; Aguayo-Albasini, José Luis

    2006-01-01

    Traumatic Spigelian hernia is rare. These hernias are usually treated in the same admission through open surgery. We present a case of Spigelian hernia in a high anatomical location following injury, with a cutaneous lesion and preperitoneal hematoma. Delayed parietal repair was performed through extraperitoneal laparoscopy. Elective laparoscopic repair in this case avoided surgery in an injured area, providing clear cosmetic advantages to the patient. We describe a modification to the classical approach to facilitate access to high-lying Spigelian defects. PMID:16426535

  15. Lumbar hernia: a short historical survey.

    PubMed

    Cavallaro, Antonino; De Toma, Giorgio; Cavallaro, Giuseppe

    2012-01-01

    Lumbar hernia is a rare form of abdominal hernia, which has been recognized later along the early development of the modern surgery. it has been, on many occasions, the object of heavy debate regarding its anatomical background and as well its etiology. The authors reports the historical aspects of this rare pathology, focusing on the earliest descriptions of hernia arising in lumbar regions, on the first reports of surgical repair, and on the anatomical description of the lumbar weakness areas, that are currently named Petit's triangle and Grynfeltt and Lesshaft's triangle.

  16. Colocutaneous Fistula after Open Inguinal Hernia Repair

    PubMed Central

    Kallis, Panayiotis; Koronakis, Nikolaos; Hadjicostas, Panayiotis

    2016-01-01

    The plug-and-patch technique is frequently used for the open repair of inguinal hernias; however, serious complications may arise on rare occasions. We present the case of a 69-year-old patient who presented with a colocutaneous fistula with the sigmoid colon 9 years after the repair of a left sliding inguinal hernia with the plug-and-patch technique. The patient underwent sigmoidectomy and excision of the fistulous track. He was discharged on postoperative day 5 and had an uneventful recovery. Although such complications are reported rarely, the surgeon must be aware of them when deciding upon the method of hernia repair. PMID:27738544

  17. Comparison of obturator prosthesis fabricated using different techniques and its effect on the management of a hemipalatomaxillectomy patient

    PubMed Central

    Badadare, Mokshada M; Patil, Sanjayagouda B; Bhat, Sudhakara; Tambe, Abhijit

    2014-01-01

    Odontogenic tumours involving the maxilla or mandible are usually treated with surgical resection. To prevent recurrence, extensive surgical intervention might be carried out leaving the patient with anatomical defects. However, rehabilitation of such patients with an obturator can improve function, facial form and social acceptance. In this case, we have evaluated the different designs and techniques of fabrication of an obturator prosthesis used for the rehabilitation of a hemipalatomaxillectomy patient. A 40-year-old man presented with a loose fitting obturator prosthesis. He had undergone hemipalatomaxillectomy for the treatment of an ameloblastoma 2 years earlier and had been using an obturator prosthesis since then. Hollow-bulb obturator prostheses were fabricated using two different methods, the lost salt and open lid techniques. The obturator prosthesis fabricated with the lost salt technique weighed less than the patient's old obturator. But the obturator fabricated using the open lid technique did not only considerably reduce the weight of the prosthesis but also improved health, function, aesthetics, phonetics and quality of life in this hemipalatomaxillectomy patient. PMID:25188927

  18. Intrapelvic obturator internus muscle injections: a novel fluoroscopic technique.

    PubMed

    Valovska, Assia; Zaccagnino, Michael P; Weaver, Michael J; Valovski, Ivan; Kaye, Alan David; Urman, Richard D

    2015-01-01

    The obturator internus (OI) muscle is important in adult chronic noninfectious pelvic, perineal, gluteal, and retrotrochanteric pain syndromes. Evaluation and management of these patients' pain can be challenging because of the complex anatomy of this region, broad differential diagnosis, and lack of specific physical examination findings. Consequently, several clinicians have advocated the use of image guided injections to assist in the accurate diagnosis of OI-related symptoms and provide symptomatic relief to affected patients. We present 2 case series describing a novel fluoroscopically guided contrast controlled transpectineal approach to intrapelvic OI injections. Unlike prior fluoroscopically guided OI injection techniques, the approach described in the present 2 cases utilized multiple standard pelvic views, thus facilitating optimal needle positioning in three-dimensional space. This technique utilized standard fluoroscopic pelvic views to accurately measure needle depth within the pelvic cavity permitting the bulk of the OI to be injected in a controlled and safe fashion. The first patient underwent a left intrapelvic OI muscle injection with bupivacaine 0.25% and 40 mg methylprednisolone. The average pre- and postprocedural visual analog pain scale scores were 5 out of 10 and 2 out of 10, respectively, with a self-reported 75% pain reduction. The second patient underwent a right intrapelvic OI muscle injection with bupivacaine 0.25% and 40 mg methylprednisolone. The average pre- and postprocedural visual analog scale scores were 8 out of 10 and 1 out of 10, respectively, with a self-reported 90% pain reduction. Larger scale studies should be undertaken to evaluate the therapeutic efficacy and generalized accuracy of this technique.

  19. Infants With Bochdalek Diaphragmatic Hernia

    PubMed Central

    Pober, Barbara R.; Lin, Angela; Russell, Meaghan; Ackerman, Kate G.; Chakravorty, Sharmila; Strauss, Bernarda; Westgate, Marie Noel; Wilson, Jay; Donahoe, Patricia K.; Holmes, Lewis B.

    2010-01-01

    Congenital diaphragmatic hernia (CDH) is a common and often devastating birth defect. In order to learn more about possible genetic causes, we reviewed and classified 203 cases of the Bochdalek hernia type identified through the Brigham and Women’s Hospital (BWH) Active Malformation Surveillance Program over a 28-year period. Phenotypically, 55% of the cases had isolated CDH, and 45% had complex CDH defined as CDH in association with additional major malformations or as part of a syndrome. When classified according to likely etiology, 17% had a Recognized Genetic etiology for their CDH, while the remaining 83% had No Apparent Genetic etiology. Detailed analysis using this largest cohort of consecutively collected cases of CDH showed low precurrence among siblings. Additionally, there was no concordance for CDH among five monozygotic twin pairs. These findings, in conjunction with previous reports of de novo dominant mutations in patients with CDH, suggest that new mutations may be an important mechanism responsible for CDH. The twin data also raise the possibility that epigenetic abnormalities contribute to the development of CDH. PMID:16094667

  20. A Rare Metastatic Myositis Ossificans of Obturator Muscle Secondary to Urothelial Carcinoma

    PubMed Central

    Dell’Atti, Lucio

    2015-01-01

    The most frequent metastatic sites of the urothelial bladder cancers (UBCs) are bones, lungs, lymph nodes, liver, pleura, and brain. In the literature, skeletal muscle metastases from UBC have been rarely reported. We report a case of a 65-year-old male with metastatic myositis ossificans to obturator muscle 14 months after radical cystectomy performed for a muscle invasive transitional cell carcinoma. An abdomen computed tomography scan showed a lesion of about 8 cm in diameter in the left obturator muscle with myositis ossificans aspect. Ultrasound guided biopsy specimen of the left obturator muscle revealed poorly differentiated metastatic urothelial carcinoma with malignant myositis ossificans aspects. The patient refused additional surgery and received systemic chemotherapy and radiotherapy at the site of the lesion. The patient more than 6 months after treatment has a good performance status with a partial reduction of the mass and negative imaging for metastases in the follow-up. PMID:26500729

  1. A simplified technique of orthograde MTA obturation on the elected canals of posterior teeth: Two case reports.

    PubMed

    Wahengbam, Brucelee; Wahengbam, Pragya; Tikku, Aseem Prakash

    2014-01-01

    This article suggests a simplified technique of orthograde MTA obturation in less accessible canal(s) of posteriors teeth without using costly ultrasonics or specialised carrier. Essentially few finger pluggers, absorbent points and a simple canal projection method were used. The orifice(s) of the elected canal(s) to be obturated with MTA were projected onto the external occlusal surface for easy delivery and predictive instrumentation. The idea was based on 'easy access', 'working one canal with one mix at one time', 'thorough condensation' and 'removal of excess moisture'. In case I, palatal canal of tooth no. 2 with gross apical perforation and suspected VRF was obturated with MTA. And in Case II, tooth no. 19 presented with incomplete furcal fracture extending into the canal was obturated with MTA in all 3 canals unitarily. Dense homogenous MTA obturation was achieved and both cases healed uneventfully. PMID:24554868

  2. Amyand's hernia: Our experience in the laparoscopic era.

    PubMed

    Sahu, Diwakar; Swain, Sudeepta; Wani, Majid; Reddy, Prasanna Kumar

    2015-01-01

    Amyand's hernia is a rare presentation of inguinal hernia, in which the appendix is present within the hernia sac. This entity is a diagnostic challenge due to its rarity and vague clinical presentation. A laparoscopic approach can confirm the diagnosis as well as serve as a therapeutic tool. When the appendix is not inflamed within the inguinal hernia sac, then appendicectomy is not always necessary. Our case series emphasize the same presumption as three patient of Amyand's hernia underwent laparoscopic transabdominal preperitoneal hernioplasty without appendicectomy. The aim of this paper is to review the literature with regards to Amyand's hernia and provide new insight in its diagnosis and treatment. PMID:25883458

  3. Modified snap-on attachment with 'O-ring' for two piece hollow bulb obturator.

    PubMed

    Gunasekar, C; Nasser, K S Gamal Abdul; Sabarigirinathan, C; Kumar, K Ram

    2013-01-01

    Restoration of near normal functions in patients who have been treated with hemimaxillectomy is generally difficult, in view of the restriction in mouth opening following healing of large surgical wound. Further, the extent and nature of the surgical defect differ from patient to patient. Thus, design of an obturator needs to be patient oriented. In this report, we describe a novel snap-on attachment with O-ring in a conventional two piece hollow bulb obturator for a 70-year-old male treated for carcinoma of the left maxilla and sinus. PMID:24047848

  4. Rehabilitation of Oncology Patients with Hard Palate Defects Part 2: Principles of Obturator Design.

    PubMed

    Ali, Rahat; Altaie, Asmaa; Nattress, Brian

    2015-06-01

    The first part of this series on the conventional rehabilitation of oncology patients with hard palate defects discussed the dental challenges posed by oncology patients and the surgical/restorative planning interface for conventional dental rehabilitation. This article will describe Aramany's classification of hard palate defects, Brown's classification of palatal defects and focus on the basic principles of obturator design which need to be appreciated when prosthetically rehabilitating a patient with a hard palate defect. CPD/CLINICAL RELEVANCE: A good understanding of basic removable prosthodontic theory relating to denture design, dental materials science and head and neck anatomy is a prerequisite when designing an obturator for a patient. PMID:26964444

  5. Closed hollow bulb obturator--one-step fabrication: a clinical report.

    PubMed

    Buzayan, Muaiyed M; Ariffin, Yusnidar T; Yunus, Norsiah

    2013-10-01

    A method is described for the fabrication of a closed hollow bulb obturator prosthesis using a hard thermoforming splint material and heat-cured acrylic resin. The technique allowed the thickness of the thermoformed bulb to be optimized for weight reduction, while the autopolymerized seal area was covered in heat-cured acrylic resin, thus eliminating potential leakage and discoloration. This technique permits the obturator prosthesis to be processed to completion from the wax trial denture without additional laboratory investing, flasking, and processing. PMID:23551843

  6. Repair of parastomal hernias using polypropylene mesh.

    PubMed

    Byers, J M; Steinberg, J B; Postier, R G

    1992-10-01

    Parastomal hernias are a common complication of ostomy construction. We have developed a method of repair that uses two strips of polypropylene prosthetic mesh through a midline incision. The medical records of 19 patients who underwent parastomal hernia repair were retrospectively reviewed. All nine patients operated on for this condition by the senior author (R.G.P.) (group 1) underwent repairs with this technique. All ten patients operated on by other surgeons in our center (group 2) underwent repairs in which the stoma was moved, the fascia was directly repaired through a parastomal incision, or the fascia was repaired via a midline incision. No patients in group 1 had recurrences while five patients in group 2 had recurrences. Neither group developed strictures or stomal prolapse. Our method of repair is technically easy and has excellent results. It is especially suitable in very large hernias in which incisional hernia is likely in the original stoma site if the stoma is moved. PMID:1417494

  7. [Lung hernia provoked by a cough fit].

    PubMed

    Aguir, S; Boddaert, G; Weber, G; Hornez, E; Pons, F

    2015-02-01

    Lung hernias are rare and their pathogenesis is few described. They are defined as the protrusion of lung parenchyma through the chest wall: intercostal space, inter-costo-clavicular, supra-clavicular or diaphragmatic hiatus. Lung hernias are classically divided into congenital and acquired hernias. Those are usually post-traumatic or post-surgical but can be provoked by cough. Clinical diagnosis is often evident but is confirmed by chest radiograph and especially computed tomography. Major risks are lung incarceration and necrosis but also ventilatory distress due to paradoxical respiration, in case of large defect. Treatment is first and foremost surgical but debated and should consider the localization, the size, the length of evolution and the possible infectious context. We report the case of a right basi-thoracic lung hernia induced by a cough fit, in a patient with chronic bronchitis. PMID:25687819

  8. Groin hernia: anatomical and surgical history.

    PubMed

    McClusky, David A; Mirilas, Petros; Zoras, Odysseas; Skandalakis, Panagiotis N; Skandalakis, John E

    2006-10-01

    The history of surgical repair of groin hernia is a lengthy record of assorted techniques in search of a cure for an ailment that comes in many sizes and shapes and that has plagued humanity for thousands of years. Although improvements are still being sought and found, for several decades surgeons have had the means to relieve most hernia sufferers. A remaining issue is whether the wide array of surgical procedures can or should be whittled down to a few "standard" operations that are safe, effective, and cost-efficient. The history of the anatomy of groin hernia shows how much there was to learn and how much remains to be learned. It also shows how important it is for the surgeon to know and understand both the anatomy of the area and the formation of groin hernia.

  9. Single incision endoscopic surgery for lumbar hernia.

    PubMed

    Kawaguchi, Masahiko; Ishikawa, Norihiko; Shimizu, Satsuki; Shin, Hisato; Matsunoki, Aika; Watanabe, Go

    2011-01-01

    Single Incision Endoscopic Surgery (SIES) has emerged as a less invasive surgery among laparoscopic surgeries, and this approach for incisional hernia was reported recently. This is the first report of SIES for an incisional lumbar hernia. A 66-year-old Japanese woman was referred to our institution because of a left flank hernia that developed after left iliac crest bone harvesting. A 20-mm incision was created on the left side of the umbilicus and all three trocars (12, 5, and 5 mm) were inserted into the incision. The hernial defect was 14 × 9 cm and was repaired with intraperitoneal onlay mesh and a prosthetic graft. The postoperative course was uneventful. SIES for lumbar hernia offers a safe and effective outcome equivalent compared to laparoscopic surgery. In addition, SIES is less invasive and has a cosmetic benefit.

  10. Lumbar hernia repaired using a new technique.

    PubMed

    Di Carlo, Isidoro; Toro, Adriana; Sparatore, Francesca; Corsale, Giuseppe

    2007-01-01

    Lumbar hernia is uncommon and occurs in Grynfeltt's triangle on the left side, more frequently in men than in women. Acquired lumbar hernias are the result of iliac crest bone harvest or blunt trauma and seat belt injuries in road accidents. Many surgical options have been reported for repairing this hernia through primary closure of the defect or through use of aponeurotic or prosthetic materials. The Dowd technique is the technique most often used. The authors describe a patient with posttraumatic inferior triangle lumbar hernia who underwent laparoscopy and, 10 days later, laparotomy. Both procedures failed. Finally, a novel lumbotomic surgical approach was used, involving the Dowd technique and prosthetic mesh. The patient was free of recurrence 3 months after the procedure.

  11. Hiatal hernia squeezing the heart to flutter.

    PubMed

    Patel, Arpan; Shah, Rushikesh; Nadavaram, Sravanthi; Aggarwal, Aakash

    2014-04-01

    An 80-year-old woman presented to the emergency department with failure to thrive and weakness for 14 days. Medical history was significant for polio. On admission her electrocardiogram showed atrial flutter, and cardiac enzymes were elevated. Echocardiogram revealed a high pulmonary artery pressure, but no other wall motion abnormalities or valvulopathies. Chest x-ray showed a large lucency likely representing a diaphragmatic hernia. Computed tomographic scan confirmed the hernia. Our patient remained in atrial flutter despite rate control, and thereafter surgery was consulted to evaluate the patient. She underwent hernia repair. After surgery, the patient was taken off rate control and monitored for 72 hours; she did not have any episode of atrial flutter and was discharged with follow up in a week showing no arrhythmia. Her flutter was caused directly by the mechanical effect of the large hiatal hernia pressing against her heart, as the flutter resolved after the operation.

  12. Genetics Home Reference: congenital diaphragmatic hernia

    MedlinePlus

    ... Center: Congenital Diaphragmatic Hernia University of Michigan Health System These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: Diagnostic Tests Drug Therapy ...

  13. Antonio Gimbernat y Arbós: an anatomist-surgeon of the Enlightenment (in the 220th anniversary of his "A new method of operating the crural hernia").

    PubMed

    Arráez-Aybar, Luis-Alfonso; Bueno-López, José-Luis

    2013-10-01

    This article focuses on Antonio de Gimbernat y Arbós (1734-1816), with particular attention paid to his famous publication "Nuevo método de operar en la hernia crural" (2013 marking its 220 anniversary), which was translated into English by Thomas Beddoe two years later (A new method of operating for the femoral hernia Translated from the Spanish of Don Antonio de Gimbernat, To which are added, with plates by the translator, queries respecting a safer method of performing inoculation). Antonio de Gimbernat y Arbós, a Spanish anatomist and surgeon, was one of the pioneers during the "Age of Dissection" (late 18th Century). He was a man of great willpower, bright, thorough, and unique. From his careful anatomical study in the inguinal region, he made a detailed description of the lacunar ligament, which John Hunter called the Gimbernat's ligament in his honor. Antonio de Gimbernat y Arbós also proposed an advanced treatment for strangulated femoral hernias. He acquired extraordinarily broad surgical skills with therapeutic orientation, conservative, not aggressive, based on the knowledge he had gained through dissection. Furthermore, though this is less well known nowadays, Antonio de Gimbernat y Arbós was also relevant organizer of education and health-services - as it was the custom of the great physician of this time. Consequently, Antonio de Gimbernat y Arbós is truly representative of the great figures of the anatomists-surgeons of the Enlightenment.

  14. Antonio Gimbernat y Arbós: an anatomist-surgeon of the Enlightenment (in the 220th anniversary of his "A new method of operating the crural hernia").

    PubMed

    Arráez-Aybar, Luis-Alfonso; Bueno-López, José-Luis

    2013-10-01

    This article focuses on Antonio de Gimbernat y Arbós (1734-1816), with particular attention paid to his famous publication "Nuevo método de operar en la hernia crural" (2013 marking its 220 anniversary), which was translated into English by Thomas Beddoe two years later (A new method of operating for the femoral hernia Translated from the Spanish of Don Antonio de Gimbernat, To which are added, with plates by the translator, queries respecting a safer method of performing inoculation). Antonio de Gimbernat y Arbós, a Spanish anatomist and surgeon, was one of the pioneers during the "Age of Dissection" (late 18th Century). He was a man of great willpower, bright, thorough, and unique. From his careful anatomical study in the inguinal region, he made a detailed description of the lacunar ligament, which John Hunter called the Gimbernat's ligament in his honor. Antonio de Gimbernat y Arbós also proposed an advanced treatment for strangulated femoral hernias. He acquired extraordinarily broad surgical skills with therapeutic orientation, conservative, not aggressive, based on the knowledge he had gained through dissection. Furthermore, though this is less well known nowadays, Antonio de Gimbernat y Arbós was also relevant organizer of education and health-services - as it was the custom of the great physician of this time. Consequently, Antonio de Gimbernat y Arbós is truly representative of the great figures of the anatomists-surgeons of the Enlightenment. PMID:23255248

  15. Esophagogastric junction distensibility in hiatus hernia.

    PubMed

    Lottrup, C; McMahon, B P; Ejstrud, P; Ostapiuk, M A; Funch-Jensen, P; Drewes, A M

    2016-07-01

    Hiatus hernia is known to be an important risk factor for developing gastroesophageal reflux disease. We aimed to use the endoscopic functional lumen imaging probe (EndoFLIP) to evaluate the functional properties of the esophagogastric junction. EndoFLIP assessments were made in 30 patients with hiatus hernia and Barrett's esophagus, and in 14 healthy controls. The EndoFLIP was placed straddling the esophagogastric junction and the bag distended stepwise to 50 mL. Cross-sectional areas of the bag and intra-bag pressures were recorded continuously. Measurements were made in the separate sphincter components and hiatus hernia cavity. EndoFLIP measured functional aspects such as sphincter distensibility and pressure of all esophagogastric junction components and visualized all hiatus hernia present at endoscopy. The lower esophageal sphincter in hiatus hernia patients had a lower pressure (e.g. 47.7 ± 13.0 vs. 61.4 ± 19.2 mm Hg at 50-mL distension volume) and was more distensible (all P < 0.001) than the common esophagogastric junction in controls. In hiatus hernia patients, the crural diaphragm had a lower pressure (e.g. 29.6 ± 10.1 vs. 47.7 ± 13.0 mm Hg at 50-mL distension volume) and was more distensible (all P < 0.001) than the lower esophageal sphincter. There was a significant association between symptom scores in patients and EndoFLIP assessment. Conclusively, EndoFLIP was a useful tool. To evaluate the presence of a hiatus hernia and to measure the functional properties of the esophagogastric junction. Furthermore, EndoFLIP distinguished the separate esophagogastric junction components in hiatus hernia patients, and may help us understand the biomechanics of the esophagogastric junction and the mechanisms behind hiatal herniation. PMID:25789842

  16. [FUNCTIONAL PLASTIC OF ANTERIOR ABDOMINAL WALL HERNIAS].

    PubMed

    Grubnik, V V; Parfentyeva, N D; Parfentyev, R S

    2015-07-01

    In order to improve the treatment efficacy of postoperative anterior abdominal wall hernias the method of plastic with restoration of anatomical and physiological properties of the muscles of the anterior abdominal wall was used. After the intervention by the improved method, regardless of the location of the hernia defect yielded promising results for the conservation of anterior abdominal wall muscle function in 75% of cases completely restored functional ability of muscles recti abdomini. PMID:26591212

  17. Inguinal hernia repair: toward Asian guidelines.

    PubMed

    Lomanto, Davide; Cheah, Wei-Keat; Faylona, Jose Macario; Huang, Ching Shui; Lohsiriwat, Darin; Maleachi, Andy; Yang, George Pei Cheung; Li, Michael Ka-Wai; Tumtavitikul, Sathien; Sharma, Anil; Hartung, Rolf Ulrich; Choi, Young Bai; Sutedja, Barlian

    2015-02-01

    Groin hernias are very common, and surgical treatment is usually recommended. In fact, hernia repair is the most common surgical procedure performed worldwide. In countries such as the USA, China, and India, there may easily be over 1 million repairs every year. The need for this surgery has become an important socioeconomic problem and may affect health-care providers, especially in aging societies. Surgical repair using mesh is recommended and widely employed in Western countries, but in many developing countries, tissue-to-tissue repair is still the preferred surgical procedure due to economic constraints. For these reason, the development and implementation of guidelines, consensus, or recommendations may aim to clarify issues related to best practices in inguinal hernia repair in Asia. A group of Asian experts in hernia repair gathered together to debate inguinal hernia treatments in Asia in an attempt to reach some consensus or develop recommendations on best practices in the region. The need for recommendations or guidelines was unanimously confirmed to help overcome the discrepancy in clinical practice between countries; the experts decided to focus mainly on the technical aspects of open repair, which is the most common surgery for hernia in our region. After the identification of 12 main topics for discussion (indication, age, and sex; symptomatic and asymptomatic hernia: type of hernia; type of treatment; hospital admission; preoperative care; anesthesia; surgical technique; perioperative care; postoperative care; early complications; and long-term complications), a search of the literature was carried out according to the five levels of the Oxford Classification of Evidence and the four grades of recommendation.

  18. Pediatric hernias and hydroceles. The urologist's perspective.

    PubMed

    Skoog, S J; Conlin, M J

    1995-02-01

    Pediatric inguinal hernias and hydroceles are due to incomplete or abnormal obliteration of the processus vaginalis. Surgical correction of these conditions is the most common surgical procedure performed on young children. The embryology, anatomy, evaluation, and management of pediatric inguinal hernias and hydroceles are reviewed. A thorough understanding of these topics will aid with the sometimes difficult decisions encountered in the care of these patients.

  19. Umbilical Hernia Repair: Analysis After 934 Procedures.

    PubMed

    Porrero, José L; Cano-Valderrama, Oscar; Marcos, Alberto; Bonachia, Oscar; Ramos, Beatriz; Alcaide, Benito; Villar, Sol; Sánchez-Cabezudo, Carlos; Quirós, Esther; Alonso, María T; Castillo, María J

    2015-09-01

    There is a lack of consensus about the surgical management of umbilical hernias. The aim of this study is to analyze the medium-term results of 934 umbilical hernia repairs. In this study, 934 patients with an umbilical hernia underwent surgery between 2004 and 2010, 599 (64.1%) of which were evaluated at least one year after the surgery. Complications, recurrence, and the reoperation rate were analyzed. Complications were observed in 5.7 per cent of the patients. With a mean follow-up time of 35.5 months, recurrence and reoperation rates were 3.8 per cent and 4.7 per cent, respectively. A higher percentage of female patients (60.9 % vs 29 %, P = 0.001) and a longer follow-up time (47.4 vs 35 months, P = 0.037) were observed in patients who developed a recurrence. No significant differences were observed between complications and the reoperation rate in patients who underwent Ventralex(®) preperitoneal mesh reinforcement and suture repair; however, a trend toward a higher recurrence rate was observed in patients with suture repair (6.5 % vs 3.2 %, P = 0.082). Suture repair had lower recurrence and reoperation rates in patients with umbilical hernias less than 1 cm. Suture repair is an appropriate procedure for small umbilical hernias; however, for larger umbilical hernias, mesh reinforcement should be considered.

  20. Hiatal hernia repair with biologic mesh reinforcement reduces recurrence rate in small hiatal hernias.

    PubMed

    Schmidt, E; Shaligram, A; Reynoso, J F; Kothari, V; Oleynikov, D

    2014-01-01

    The utility of mesh reinforcement for small hiatal hernia found especially during antireflux surgery is unknown. Initial reports for the use of biological mesh for crural reinforcement during repair for defects greater than 5 cm have been shown to decrease recurrence rates. This study compares patients with small hiatal hernias who underwent onlay biologic mesh buttress repair versus those with suture cruroplasty alone. This is a single-institution retrospective review of all patients undergoing repair of hiatal hernia measuring 1-5 cm between 2002 and 2009. The patients were evaluated based on surgical repair: one group undergoing crural reinforcement with onlay biologic mesh and other group with suture cruroplasty only. Seventy patients with hiatal hernia measuring 1-5 cm were identified. Thirty-eight patients had hernia repair with biologic mesh, and 32 patients had repair with suture cruroplasty only. Recurrence rate at 1 year was 16% (5/32) in patients who had suture cruroplasty only and 0% (0/38) in the group with crural reinforcement with absorbable mesh (statistically significant, P = 0.017). Suture cruroplasty alone appears to be inadequate for hiatal hernias measuring 1-5 cm with significant recurrence rate and failure of antireflux surgery. Crural reinforcement with absorbable mesh may reduce hiatal hernia recurrence rate in small hiatal hernias.

  1. Micro-computed tomographic assessment of quality of obturation in the apical third with continuous wave vertical compaction and single match taper sized cone obturation techniques.

    PubMed

    Alshehri, Mohammed; Alamri, Hadi M; Alshwaimi, Emad; Kujan, Omar

    2016-07-01

    The aim of the present micro-computed tomography (Micro-CT) analysis was to compare the quality of obturation in the apical third of the root with the warm vertical compaction (WVC) and single matching taper sized cone (SMTSC) techniques. Mesial roots of 16 freshly extracted mandibular first molar teeth (with a total of 32 canals) were used. Canals in each mesial root were shaped to a size F3 Protaper and were randomly assigned to either continuous wave vertical compaction or single match tapered size cone technique. Volume of voids and gaps in the obturated roots were measured using micro-CT scanning at 1, 3, and 5 mm from the apex of the root. There was no statistically significant difference in the volume of voids measured at 1 mm (p > 0.05), 3 mm (p > 0.05) and 5 mm (p > 0.05) filled with either WVC and SMTSC techniques. The quality of obturation in the apical third of the root with the WVC and SMTSC techniques is comparable. SCANNING 38:352-356, 2016. © 2015 Wiley Periodicals, Inc.

  2. Which mesh for hernia repair?

    PubMed Central

    Brown, CN; Finch, JG

    2010-01-01

    INTRODUCTION The concept of using a mesh to repair hernias was introduced over 50 years ago. Mesh repair is now standard in most countries and widely accepted as superior to primary suture repair. As a result, there has been a rapid growth in the variety of meshes available and choosing the appropriate one can be difficult. This article outlines the general properties of meshes and factors to be considered when selecting one. MATERIALS AND METHODS We performed a search of the medical literature from 1950 to 1 May 2009, as indexed by Medline, using the PubMed search engine (). To capture all potentially relevant articles with the highest degree of sensitivity, the search terms were intentionally broad. We used the following terms: ‘mesh, pore size, strength, recurrence, complications, lightweight, properties’. We also hand-searched the bibliographies of relevant articles and product literature to identify additional pertinent reports. RESULTS AND CONCLUSIONS The most important properties of meshes were found to be the type of filament, tensile strength and porosity. These determine the weight of the mesh and its biocompatibility. The tensile strength required is much less than originally presumed and light-weight meshes are thought to be superior due to their increased flexibility and reduction in discomfort. Large pores are also associated with a reduced risk of infection and shrinkage. For meshes placed in the peritoneal cavity, consideration should also be given to the risk of adhesion formation. A variety of composite meshes have been promoted to address this, but none appears superior to the others. Finally, biomaterials such as acellular dermis have a place for use in infected fields but have yet to prove their worth in routine hernia repair. PMID:20501011

  3. Stress analysis in oral obturator prostheses over parallel and tilted implants: photoelastic imaging.

    PubMed

    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; dos Santos, Daniela Micheline; Nobrega, Adhara Smith; Haddad, Marcela Filié; Andreotti, Agda Marobo; Moreno, Amália

    2013-10-01

    This study aimed to evaluate the stress distribution through the photoelastic method in implant-retained palatal obturators prostheses. Two photoelastic models with bucco-sinusal communication were fabricated, one model without implants and another with two parallel implants and one tilted in the molar region. A conventional obturator prosthesis and five implant-retained obturators dentures with different attachment systems were fabricated: OR, three individualized O-rings; BC, bar clip; BOC, implants splinted by bars associated with two O-rings positioned at the center of the bar; OD, implants splinted by bars associated with two O-rings positioned in distal cantilever; and BOD, implants splinted by bars with clips associated with two O-rings positioned in distal cantilever. Each assembly (model/attachment system/prosthesis) was positioned in a circular polariscope and a load of 100 N was applied on each implant. The results were obtained by observing the photographic record of the tensions in the photoelastic models resulting from the application of load. It can be observed that a larger amount of stress fringes on BC system. It was concluded that the attachment system has a direct influence on the stress distribution of implant-retained obturator prostheses, with the three individualized O-rings exhibiting the lowest stress values, and tilted implants presented a biomechanical behavior similar to parallel implants. PMID:24129983

  4. A South Indian cadaveric study on obturator neurovascular bundle with a special emphasis on high prevalence of 'venous corona mortis'.

    PubMed

    Nayak, Satheesha B; Deepthinath, R; Prasad, A M; Shetty, Surekha D; Aithal, Ashwini P

    2016-07-01

    Surgical procedures in the pelvic region are very challenging because of the complex anatomy of this region. "Corona mortis" is a term used to describe retro-pubic anastomosis between the obturator and external iliac vessels. It is considered as a key structure as significant haemorrhage may occur if the vessels are cut accidentally during pelvic surgeries. Earlier studies have documented a high frequency of venous anastomosis compared to its arterial counterpart. The objective of our study was to document the prevalence of venous corona mortis in South Indian human adult cadaveric pelvises. We conducted this study on 73 cadaveric pelvic halves. Out of the 73 hemi pelvises, 36 were normal without any variations of the obturator vessels while 37 hemi pelvises (51%) showed the presence of abnormal obturator vessels which proves to be a very high incidence in terms of variations. Out of the 37 hemi pelvises, 25 (68%) showed the presence of 2 obturator veins, out of which 1 was normal and the other was an abnormal obturator vein. 8 hemi pelvises (22%) had only abnormal obturator vein. Most of the abnormal obturator veins drained into the external iliac vein, while two veins drained into inferior epigastric veins. Venous corona mortis is said to be frequently encountered during surgery and is considered to be as important as arterial corona mortis in its clinical implications. Individual evaluation of this risky anatomical structure should be done prior to any surgical interventions.

  5. Relationship between cup position and obturator externus muscle in total hip arthroplasty

    PubMed Central

    2010-01-01

    Background It is often challenging to find the causes for postoperative pain syndromes after total hip replacement, since they can be very allotropic. One possible cause is the muscular impingement syndrome. The most commonly known impingement syndrome is the psoas impingement. Another recently described impingement syndrome is the obturator externus muscle impingement. The aim of this study is to analyze pathological conditions of the Obturator externus and to show possible causes. Methods 40 patients who had undergone a total hip replacement were subjected to clinical and MRI examinations 12 months after the surgery. The Harris Hip Score (HHS) was used to analyze pain and function. Additionally, a satisfaction score and a pain score (VAS) were determined. The MRI allowed for the assessment of the spatial relation between the obturator externus muscle and the acetabulum. Also measured were the acetabular inclination angle as well as the volume and cross-sectional area of the obturator externus muscle. Results The patients were assigned to 3 groups in accordance with their MRI results. Group 1 patients (n = 18) showed no contact between the obturator externus and the acetabulum. Group 2 (n = 13) showed contact, and group 3 (n = 9) an additional clear displacement of the muscle in its course. It was not possible to establish a connection between the imaging findings, the HHS, the VAS, and patient satisfaction. What was striking, however, was a significant difference between the median inclination angle in group 1 (40° ± 5.4°) and group 3 (49° ± 4.7°) (p < 0.05), and the corresponding image-morphological pathology. The average inclination angle in group 2 was 43.3° ± 3.8° Conclusion Contact between the obturator externus muscle and the caudal acetabula border occurs frequently, but is only rarely accompanied by a painful muscular impingement. The position of the acetabula must be seen as one of the main risk factors for contact between the acetabula border

  6. Meckel's diverticulum incarcerated in an umbilical hernia--case report.

    PubMed

    Kurnicki, Jacek; Wrzesińska, Natalia; Kabala, Przemysław

    2011-07-01

    Hernias containing incarcerated Meckel's diverticulum are rare and often asymptomatic. The proper preoperative diagnosis is difficult to establish. The presence of a Meckel's diverticulum incarcerated in a hernia should be consider in a differential diagnosis of abdominal disease that is not sufficiently apparent. We present a case of a 22 years old male patient with a Meckel's diverticulum incarcerated in an umbilical hernia.

  7. Laparoscopic lumbar hernia repair in a child with lumbocostovertebral syndrome.

    PubMed

    Jones, Sarah L; Thomas, Iona; Hamill, James

    2010-02-01

    Lumbocostovertebral syndrome is the association of a congenital lumbar hernia with rib and vertebral anomalies. We report the first case of a laparoscopic repair of a lumbar hernia in a child with lumbocostovertebral syndrome. Laparoscopic lumbar hernia repair appears to be safe and feasible in children.

  8. Hernias

    MedlinePlus

    ... Fitness Diseases & Conditions Infections Q&A School & Jobs Drugs & Alcohol Staying Safe Recipes En Español Making a Change – Your Personal Plan Hot Topics Meningitis Choosing Your Mood Prescription Drug Abuse Healthy School Lunch Planner How Can I ...

  9. Maternal and infant characteristics associated with accidental suffocation and strangulation in bed in US infants.

    PubMed

    Carlberg, Michelle M; Shapiro-Mendoza, Carrie K; Goodman, Michael

    2012-11-01

    To identify maternal and infant characteristics associated with accidental suffocation and strangulation in bed (ASSB) in US infants. Using 2000-2002 US linked infant birth and death certificate cohort files, we compared ASSB deaths to survivors. Adjusted odds ratios (aOR) from logistic regression were used to analyze associations between selected maternal and infant characteristics and ASSB mortality. During 2000-2002, 1,064 infants died from ASSB, resulting in an ASSB mortality rate of 9.2 per 100,000 live births. Most ASSB deaths (71%) occurred before an infant reached 4 months old. Maternal factors associated with an increased risk of ASSB were younger age (using maternal age of 25-29 years as reference aOR 2.6 for mothers <20 years old and 1.6 for mothers 20-24 years old), lower educational attainment (aOR 4.3 for <12 years and 3.3 for 12 years compared to ≥16 years), multiparity (aOR 1.7, 2.2, and 3.5 for parity 2, 3, and 4 or higher, respectively) and smoking during pregnancy (aOR 2.8). Compared to non-Hispanic whites, non-Hispanic blacks (aOR 1.8) and American Indians (aOR 1.8) were more likely to have an ASSB death. Being male and born preterm were also associated with a higher ASSB mortality risk. Younger, less educated, mulitparous, non-Hispanic black or American Indian women and their families who smoke during their pregnancy and deliver male or preterm infants, may need more intense safe sleeping education during the infant's first year of life, especially during the first 4 months of age.

  10. Maternal and infant characteristics associated with accidental suffocation and strangulation in bed in US infants.

    PubMed

    Carlberg, Michelle M; Shapiro-Mendoza, Carrie K; Goodman, Michael

    2012-11-01

    To identify maternal and infant characteristics associated with accidental suffocation and strangulation in bed (ASSB) in US infants. Using 2000-2002 US linked infant birth and death certificate cohort files, we compared ASSB deaths to survivors. Adjusted odds ratios (aOR) from logistic regression were used to analyze associations between selected maternal and infant characteristics and ASSB mortality. During 2000-2002, 1,064 infants died from ASSB, resulting in an ASSB mortality rate of 9.2 per 100,000 live births. Most ASSB deaths (71%) occurred before an infant reached 4 months old. Maternal factors associated with an increased risk of ASSB were younger age (using maternal age of 25-29 years as reference aOR 2.6 for mothers <20 years old and 1.6 for mothers 20-24 years old), lower educational attainment (aOR 4.3 for <12 years and 3.3 for 12 years compared to ≥16 years), multiparity (aOR 1.7, 2.2, and 3.5 for parity 2, 3, and 4 or higher, respectively) and smoking during pregnancy (aOR 2.8). Compared to non-Hispanic whites, non-Hispanic blacks (aOR 1.8) and American Indians (aOR 1.8) were more likely to have an ASSB death. Being male and born preterm were also associated with a higher ASSB mortality risk. Younger, less educated, mulitparous, non-Hispanic black or American Indian women and their families who smoke during their pregnancy and deliver male or preterm infants, may need more intense safe sleeping education during the infant's first year of life, especially during the first 4 months of age. PMID:21769585

  11. Influence of root canal instrumentation and obturation techniques on intra-operative pain during endodontic therapy

    PubMed Central

    Martín-González, Jenifer; Echevarría-Pérez, Marta; Sánchez-Domínguez, Benito; Tarilonte-Delgado, Maria L.; Castellanos-Cosano, Lizett; López-Frías, Francisco J.

    2012-01-01

    Objective: To analyse the influence of root canal instrumentation and obturation techniques on intra-operative pain experienced by patients during endodontic therapy. Method and Materials: A descriptive cross-sectional study was carried out in Ponferrada and Sevilla, Spain, including 80 patients (46 men and 34 women), with ages ranged from 10 to 74 years, randomly recruited. Patient gender and age, affected tooth, pulpal diagnosis, periapical status, previous NSAID or antibiotic (AB) treatment, and root canal instrumentation and obturation techniques were recorded. After root canal treatment (RCT), patients completed a 10-cm visual analogue scale (VAS) that ranked the level of pain. Results were analysed statistically using the Chi-square and ANOVA tests and logistic regression analysis. Results: The mean pain level during root canal treatment was 2.9 ± 3.0 (median = 2) in a VAS between 0 and 10. Forty percent of patients experienced no pain. Gender, age, arch, previous NSAIDs or AB treatment and anaesthetic type did not influence significantly the pain level (p > 0.05). Pain during root canal treatment was significantly greater in molar teeth (OR = 10.1; 95% C.I. = 1.6 - 63.5; p = 0.013). Root canal instrumentation and obturation techniques did not affect significantly patient’s pain during root canal treatment (p > 0.05). Conclusion: Patients feel more pain when RCT is carried out on molar teeth. The root canal instrumentation and obturation techniques do not affect significantly the patients’ pain during RCT. Key words:Anaesthesia, endodontic pain, pulpitis, root canal instrumentation, root canal obturation, rotary files. PMID:22549694

  12. Incidence of post obturation pain following single and multi visit root canal treatment in a teaching hospital of Bangladesh.

    PubMed

    Jabeen, S; Khurshiduzzaman, M

    2014-04-01

    Post obturation pain is the pain of any degree after endodontic treatment. There are different opinions regarding incidence of post obturation pain related to single and multi visit root canal treatment. This prospective study was conducted to evaluate the incidence of post obturation pain in single visit and multi visit root canal treatment and to compare the incidence of pain between the two treatment groups. A total of 120 cases of endodontically involved asymptomatic non vital single rooted teeth were selected for this study. The patients were assigned and divided in to two treatment groups, sixty patients each. In single visit group, all teeth were prepared and filled using the standardized preparation and lateral condensation filling technique. In the multi visit treatment group, at the first appointment, the teeth were prepared, and dressed with calcium hydroxide paste for 7 days. At the second appointment, the teeth were prepared and obturated by using lateral condensation technique. The frequency of post obturation pain was recorded as no pain, slight, moderate and severe pain and evaluated at the day 1 and at the day 7 after obturation. The data were analyzed statistically by using SPSS version-12. P value <0.05 was taken as significant. The study showed that the post obturation pain in the single visit treatment group was more than multi visit treatment group, which is significant (p value <0.044). Out of the 120 patients, 86(71.7%) patients had no pain, 19(15.8%) had slight pain and 15(12.5%) patients had moderate pain at the day 1 after obturation. At the day 7 after obturation, 108(90%) patients had no pain, 9(7.5%) had slight pain and 3(2.5%) patients had moderate pain. No patient noticed severe pain during the follow up period. Older patient had significantly more post obturation pain than the younger patient. There was higher incidence of post obturation pain following the single visit root canal treatment. In multi visit root canal treatment with

  13. The inferior epigastric artery arising from the internal iliac artery via a common trunk with the obturator artery.

    PubMed

    Won, Hyung-Sun; Won, Hyung-Jin; Oh, Chang-Seok; Han, Seung-Ho; Chung, In-Hyuk; Kim, Dong-Hoan

    2012-12-01

    We report a rare case of a left inferior epigastric artery arising from the internal iliac artery via a common trunk with the obturator artery in an 84-year-old female cadaver. A common trunk for the inferior epigastric and obturator arteries firstly originated from the left internal iliac artery, at 3.0 mm below the bifurcation of the left common iliac artery. This trunk ran straight between the left external iliac artery and left external iliac vein, and was finally divided into the left inferior epigastric and left obturator arteries just superior to the inguinal ligament. PMID:23301197

  14. Detection and comparison of nitric oxide in clinically normal horses and those with naturally acquired small intestinal strangulation obstruction.

    PubMed Central

    Mirza, M H; Oliver, J L; Seahorn, T L; Hosgood, G; Moore, R M

    1999-01-01

    The purpose of this study was to determine whether nitric oxide (NO) is present in clinically normal horses under basal conditions and if it increases secondary to naturally acquired small intestinal strangulation obstruction. Thirty-one horses were used; 20 horses with naturally acquired small intestinal strangulation obstruction and 11 clinically normal horses with no signs of gastrointestinal tract disease. Jugular venous blood, abdominal fluid, and urine were collected for NO quantification. Plasma, abdominal fluid, and urine were stored at -70 degrees C until analyzed for NO using a chemiluminescent method. Biopsy specimens collected from the affected jejunal segment, during anesthesia or after immediately after euthanasia, or from the midjejunum of control horses, were divided into subsections for fixation in zinc formalin and cryopreservation in OCT gel. Nicotinamide adenine dinucleotide phosphate (reduced) (NADPH) diaphorase histochemical stains were performed on cryopreserved tissues and inducible nitric oxide synthase (iNOS) and nitrotyrosine immunohistochemical stains were performed on formalin-fixed, paraffin-embedded tissues. There were significantly greater plasma and abdominal fluid NO concentrations in affected horses as compared with controls, but there were no significant differences between horses for urine NO concentrations. There was a significant decrease in NADPH diaphorase stain in mucosal epithelium, vasculature, and leukocytes, and in submucosal plexi in affected horses compared with control horses. There was a significant increase in iNOS staining in mucosal and submucosal leukocytes and in mucosal leukocyte nitrotyrosine staining of the affected compared with control horses. Endothelial NOS and neuronal NOS are present under basal conditions in the jejunum of horses and probably mediate physiologic or cytoprotective effects. Plasma and abdominal fluid, but not urine, NO concentrations increase subsequent to small intestinal strangulation

  15. Grynfelt hernia: case report and literature review.

    PubMed

    Cesar, D; Valadão, M; Murrahe, R J

    2012-02-01

    Back lumbar hernia is a rare abdominal wall defect that usually presents spontaneously after trauma or lumbar surgery or, less frequently, during infancy (congenital). Few reports have been published in the literature describing primary lumbar hernia. A general surgeon will have the opportunity to repair only one or a few lumbar hernia cases in his/her lifetime. We report a case of a healthy 50-year-old man, with no previous surgeries or history of trauma, who presented to the outpatient department with abdominal discomfort, pain, and a sensation of a growing mass on his lower left back for 4 years. CT scan of the abdomen showed a mass in the left posterolateral abdominal wall. Specifically, a herniation of retroperitoneal fat between the erector spinae muscle group and internal oblique muscles through aponeurosis of the transversalis muscle (Grynfeltt hernia). The patient underwent a small lumbotomy, polypropylene mesh was placed and he recovered well. Although many techniques have been described for the surgical management of such hernias, none of them can be recommended as the preferred method. Our impression, however, is that the open approach, with a small lumbotomy, seems to be easy, safe and presents good postoperative recovery.

  16. Comparison of Coskun and Lichteinstein hernia repair methods for groin hernia

    PubMed Central

    Cete, Hayri Mükerrem; Saylam, Barış; Özer, Mehmet Vasfi; Düzgün, Arife Polat; Coşkun, Faruk

    2015-01-01

    Purpose Coskun hernia repair technique has been reported to be an effective new fascia transversalis repair with its short-term follow-up results. Our aim is to determine the results of Coskun hernia repair technique and to compare it with Lichtenstein technique. Methods At this comparative retrospective study a total of 493 patients, who had groin hernia repair procedure using Coskun or Lichtenstein technique, between January 1999 and March 2010 were enrolled into the study. Patients were reached by telephone and invited to get a physical examination. Results Out of 493 groin hernia repairs, 436 (88.5%) were carried out by residents and 57 (11.5%) by attending surgeons. Lichtenstein technique was the choice in 241 patients and 252 patients underwent Coskun hernia repair technique. Groin hernia recurrence was detected in 8 patients (3.1%) in Coskun hernia repair group and 7 patients (2.9%) in Lichtenstein group. Comparison of early complication rates in Coskun group (3.9%) and Lichtenstein group (4.5%) showed no significant difference. Late complication rates were significantly higher in Lichtenstein group (1.2% vs. 4.9%). The operation time was shorter in Coskun group (44 minutes) than in Lichtenstein group (60 minutes). Subgroup of patients, whose hernia repair operations were carried out by attending surgeons, had a recurrence rate of 0% and 3.8%, in Coskun group and Lichtenstein group, respectively. Conclusion This study showed that Coskun hernia repair technique has a similar efficacy with Lichtenstein repair, on follow-up. PMID:26366383

  17. Choice of imaging modality in the diagnosis of sciatic hernia

    PubMed Central

    Labib, Peter L. Z.; Malik, Sohail N.

    2013-01-01

    Sciatic hernias are one of the rarest types of hernia and often pose diagnostic difficulty to clinicians. We report a case of an 80-year-old lady with a sciatic hernia who had a falsely negative computed tomography (CT) but was found to have a colonic hernia on ultrasonography. The authors recommend that for patients in which there is a high degree of clinical suspicion for a sciatic hernia and a negative CT, ultrasonography may be considered as a useful imaging modality to confirm the diagnosis. PMID:24968433

  18. Transfascial suture in laparoscopic ventral hernia repair; friend or foe?

    PubMed

    Sahu, Diwakar; Das, Somak; Wani, Majid Rasool; Reddy, Prasanna Kumar

    2015-01-01

    'Suture hernia' is fairly a new and rare type of ventral hernia. It occurs at the site of transfascial suture, following laparoscopic ventral hernia repair (LVHR). Employment of transfascial sutures in LVHR is still debatable in contrast to tackers. Prevention of mesh migration and significant post-operative pain are the pros and cons with the use of transfascial sutures, respectively. We report an unusual case of suture hernia or transfascial hernia, which can further intensify this dispute, but at the same time will provide insight for future consensus. PMID:25883460

  19. Congenital Paraesophageal Hernia in a Cat.

    PubMed

    Tong, Kim; Guillou, Reunan; Vét, Doc

    2015-01-01

    A 3 mo old male domestic shorthair weighing 2 kg was presented for acute onset of anorexia, lethargy, paradoxical breathing, and a palpable mass effect in the cranial abdomen. Initial diagnostics and imaging suggested a pleuroperitoneal or hiatal hernia. Emergency abdominal exploration was performed, and a complex type II paraesophageal hiatal hernia was identified. The entire stomach, greater and lesser omenta, spleen, left limb of the pancreas, and the proximal segment of the descending duodenum were herniated through a discrete defect in the phrenicoesophageal ligament. After reduction of the herniated organs back into the abdomen, a phrenicoplasty, esophagopexy, and left-sided fundic gastropexy were performed. The cat recovered uneventfully from the procedure and was free of any signs of disease for at least 30 mo postoperatively. This is the first detailed report of the findings and successful surgical treatment of a complex congenital, type II paraesophageal hiatal hernia with complete herniation of the stomach, omenta, and spleen in a cat.

  20. An unusual inguinoscrotal hernia with renal involvement.

    PubMed

    Osmani, Humza Tariq; Boulton, Richard; Wyatt, Harry; Saunders, Stephen Michael

    2015-01-01

    We present a case of a 74-year-old man who, while in intensive treatment unit for an upper gastrointestinal bleed, decompensated cardiac failure and concurrent pneumonia, was found to have a large right hydronephrotic pelvic kidney and bladder within the hernia. After discharge, he was medically optimised for 7 months before undergoing an elective open mesh repair of his hernia. During the procedure, drainage of a large hydrocoele was performed to facilitate reduction of the hernia. Postoperatively, he underwent ureteric stenting due to a persistent hydronephrosis with impairment of his renal function. He subsequently made a good recovery and was discharged home with outpatient follow-up planned. PMID:26443094

  1. Traumatic lumbar hernia: report of a case.

    PubMed

    Torer, Nurkan; Yildirim, Sedat; Tarim, Akin; Colakoglu, Tamer; Moray, Gokhan

    2008-12-01

    Traumatic lumbar hernias are very rare. Here, we present a case of secondary lumbar hernia. A 44-year-old man sustained a crushing injury. On admission, ecchymotic, fluctuating swelling was present on his left flank with normal vital signs. Subcutaneous intestinal segments were revealed at his left flank on abdominal CT. Emergency laparotomy revealed a 10-cm defect on the left postero-lateral abdominal wall. The splenic flexure was herniated through the defect. Herniated segments was reduced, the defect was repaired with a polypropylene mesh graft. There was also a serosal tear and an ischemic area 3mm wide on the splenic flexure and was repaired primarily. The patient had an uneventful recovery. Most traumatic lumbar hernias are caused by blunt trauma. Trauma that causes abdominal wall disruption also may cause intraabdominal organ injury. Abdominal CT is useful in the diagnosis and allows for diagnosis of coexisting organ injury. Emergency laparotomy should be performed to repair possible coexisting injuries.

  2. [Diagnosis and surgical therapy of hiatal hernia].

    PubMed

    Koch, O O; Köhler, G; Antoniou, S A; Pointner, R

    2014-08-01

    Using the usual diagnostic tools like barium swallow examination, endoscopy, and manometry, we are able to diagnose a hiatal hernia, but it is not possible to predict the size of the hernia opening or, respectively, the size of the hiatal defect. At least a correlation can be expected if the gastroesophageal junction is endoscopically assessed in a retroflexed position, and graded according to Hill. So far, it is not possible to come to a clear conclusion how the hiatal closure during hiatal hernia repair should be performed. There is no consensus on using a mesh, and when using a mesh which type or shape should be used. Further studies including long-term results on this issue are necessary. However, it seems obvious to make the decision depending on certain conditions found during operation, and not on preoperative findings.

  3. Laparoscopic tension-free hernioplasty for lumbar hernia.

    PubMed

    Maeda, K; Kanehira, E; Shinno, H; Yamamura, K

    2003-09-01

    Lumbar hernia, a defect of the posterior abdominal wall, is a very rare condition. The repair of a posterior abdominal wall hernia by simply closing the hernia port with sutures may not be adequate, especially when the herniation is due to a weakness in the abdominal wall. Recently, a simple, logical method of tension-free repair has become a popular means for the treatment of various abdominal wall hernias. Previous studies have advocated the use of tension-free repair for lumbar hernia; the technique uses a mesh replacement and requires an extensive incision. Herein we present a case of superior lumbar hernia. Our technique consisted of a laparoscopic tension-free hernioplasty with the application of a Prolene mesh. This technique, which provides an excellent operative view, is safe, feasible, and minimally invasive. We conclude that laparoscopic tension-free repair should be the preferred option for the treatment of lumbar hernia.

  4. Chronic pain after open inguinal hernia repair.

    PubMed

    Nikkolo, Ceith; Lepner, Urmas

    2016-01-01

    Following the widespread use of mesh repairs, recurrence rates after inguinal hernia surgery have become acceptable and focus has shifted from recurrence to chronic pain. Although pain can be controlled with analgesics, chronic postsurgical pain is a major clinical problem, which can significantly influence the patient's quality of life. The rate of chronic pain after inguinal hernia mesh repair can reach 51.6%. The reasons for posthernioplasty chronic pain are often unclear. It has been linked to nerve injury and nerve entrapment, but there is also association between the rate of chronic pain and the type of mesh used for hernia repair. As there are >160 meshes available in the market, it is difficult to choose a mesh whose usage would result in the best outcome. Different mesh characteristics have been studied, among them weight of mesh has probably gained the most attention. The choice of adequate therapy for chronic groin pain after inguinal hernia repair is controversial. The European Hernia Society recommends that a multidisciplinary approach at a pain clinic should be considered for the treatment of chronic postoperative pain. Although surgical treatment of chronic posthernioplasty pain is limited because of the lack of relevant research data, resection of entrapped nerves, mesh removal in the case of mesh related pain or removal of fixation sutures can be beneficial for the patient with severe pain after inguinal hernia surgery. One drawback of published studies is the lack of consensus over definition of chronic pain, which makes it complicated to compare the results of different studies and to conduct meta-analyses and systematic reviews. Therefore, a uniform definition of chronic pain and its best assessment methods should be developed in order to conduct top quality multicenter randomized trials. Further research to develop meshes with optimal parameters is of vital importance and should be encouraged. PMID:26567717

  5. Durability of laparoscopic repair of paraesophageal hernia.

    PubMed Central

    Edye, M B; Canin-Endres, J; Gattorno, F; Salky, B A

    1998-01-01

    OBJECTIVES: To define a method of primary repair that would minimize hernia recurrence and to report medium-term follow-up of patients who underwent laparoscopic repair of paraesophageal hernia to verify durability of the repair and to assess the effect of inclusion of an antireflux procedure. SUMMARY BACKGROUND DATA: Primary paraesophageal hernia repair was completed laparoscopically in 55 patients. There were five recurrences within 6 months when the sac was not excised (20%). After institution of a technique of total sac excision in 30 subsequent repairs, no early recurrences were observed. METHODS: Inclusion of an antireflux procedure, incidence of subsequent hernia recurrence, dysphagia, and gastroesophageal reflux symptoms were recorded in clinical follow-up of patients who underwent a laparoscopic procedure. RESULTS: Mean length of follow-up was 29 months. Forty-nine patients were available for follow-up, and one patient had died of lung cancer. Mean age at surgery was 68 years. The surgical morbidity rate in elderly patients was no greater than in younger patients. Eleven patients (22%) had symptoms of mild to moderate reflux, and 15 were taking acid-reduction medication for a variety of dyspeptic complaints. All but 2 of these 15 had undergone 360 degrees fundoplication at initial repair. Two patients (4%) had late recurrent hernia, each small, demonstrated by esophagram or endoscopy. CONCLUSIONS: Laparoscopic repair in the medium term appeared durable. The incidence of postsurgical reflux symptoms was unrelated to inclusion of an antireflux procedure. In the absence of motility data, partial fundoplication was preferred, although dysphagia after floppy 360 degrees wrap was rare. With the low morbidity rate of this procedure, correction of symptomatic paraesophageal hernia appears indicated in patients regardless of age. Images Figure 1. PMID:9790342

  6. Chronic pain after open inguinal hernia repair.

    PubMed

    Nikkolo, Ceith; Lepner, Urmas

    2016-01-01

    Following the widespread use of mesh repairs, recurrence rates after inguinal hernia surgery have become acceptable and focus has shifted from recurrence to chronic pain. Although pain can be controlled with analgesics, chronic postsurgical pain is a major clinical problem, which can significantly influence the patient's quality of life. The rate of chronic pain after inguinal hernia mesh repair can reach 51.6%. The reasons for posthernioplasty chronic pain are often unclear. It has been linked to nerve injury and nerve entrapment, but there is also association between the rate of chronic pain and the type of mesh used for hernia repair. As there are >160 meshes available in the market, it is difficult to choose a mesh whose usage would result in the best outcome. Different mesh characteristics have been studied, among them weight of mesh has probably gained the most attention. The choice of adequate therapy for chronic groin pain after inguinal hernia repair is controversial. The European Hernia Society recommends that a multidisciplinary approach at a pain clinic should be considered for the treatment of chronic postoperative pain. Although surgical treatment of chronic posthernioplasty pain is limited because of the lack of relevant research data, resection of entrapped nerves, mesh removal in the case of mesh related pain or removal of fixation sutures can be beneficial for the patient with severe pain after inguinal hernia surgery. One drawback of published studies is the lack of consensus over definition of chronic pain, which makes it complicated to compare the results of different studies and to conduct meta-analyses and systematic reviews. Therefore, a uniform definition of chronic pain and its best assessment methods should be developed in order to conduct top quality multicenter randomized trials. Further research to develop meshes with optimal parameters is of vital importance and should be encouraged.

  7. Congenital diaphragmatic Bochdaleck hernia: case report

    PubMed Central

    2012-01-01

    Congenital diaphragmatic Bochdaleck hernia is an anatomical defect of the diaphragm, which allows protrusion of abdominal viscera into the chest, causing serious pulmonary and cardiac complications in the neonate. In this study we aimed to present a case of congenital Bochdaleck hernia. We investigated a 40 weeks old child, with a pregnancy carried out in a public hospital in Passo Fundo, Rio Grande do Sul, Brazil. We suggest that if diagnosis occurs in the prenatal period, the prognosis of this disease improves. As a consequence, it allows the parity of the fetus to occur in a higher complexity center, optimizing the chances of survival. PMID:23110948

  8. Effect of 95% Ethanol as a Final Irrigant before Root Canal Obturation in Primary Teeth: An in vitro Study

    PubMed Central

    Thiruvenkadam, G; John, Baby; Priya, PR Geetha

    2016-01-01

    ABSTRACT Background: Successful obturation in the primary teeth demands complete dryness of the root canal system. Aim: The purpose of this study was to determine the effect of 95% ethanol as the final irrigant before root canal obturation in primary teeth. Materials and methods: A total of 20 extracted primary mandibular canines were biomechanically prepared and pre-obturated volume of each tooth was assessed using spiral computed tomography (CT). The specimens were divided into two groups (n = 10): group 1, Metapex group; group 2, zinc oxide eugenol group. Each group was further divided randomly into two subgroups (n = 5): subgroup 1, canals were dried with 95% ethanol; subgroup 2, canals were blot dried with paper points with the last one appearing dry. All canals were obturated and the postobturated volume of each tooth was measured. The percentage of obturated volume (POV) was calculated using the formula: (postobturated volume/preobturated volume) × 100. The POV between the groups was statistically analyzed using Mann-Whitney test and Wilcoxon Signed rank test appropriately. Results: Root canals that were dried with ethanol showed better obturation than using paper points alone and the difference was statistically significant in both group 1 (p < 0.001) and group 2 (p < 0.002). Conclusion: Drying of the root canal system with 95% ethanol can result in better obturation in the primary teeth. How to cite this article: Thiruvenkadam G, Asokan S, John B, Geetha Priya PR. Effect of 95% Ethanol as a Final Irrigant before Root Canal Obturation in Primary Teeth: An in vitro Study. Int J Clin Pediatr Dent 2016;9(1):21-24. PMID:27274150

  9. Manual strangulation: experimental approach to the genesis of hyoid bone fractures.

    PubMed

    Lebreton-Chakour, Catherine; Godio-Raboutet, Yves; Torrents, Romain; Chaumoitre, Kathia; Boval, Catherine; Bartoli, Christophe; Adalian, Pascal; Piercecchi-Marti, Marie-Dominique; Thollon, Lionel

    2013-05-10

    Discovery of a fracture of the hyoid bone during forensic autopsy is a feature that raises suspicions of constriction of the neck. Studies have shown the influence of gender and build of the individual on the morphology of this bone. Our aims were to confirm these findings and to develop an experimental protocol for simulating manual strangulation in order to determine the force required to fracture the hyoid bone and the influence of anthropometric parameters on this force. A total of 77 intact hyoid bones were obtained, scanned, modeled, measured and embedded in resin. Using a hydraulic press, we applied force to the distal extremity of the greater horn. The relationships between the parameters of sex, weight and height of the subject, anteroposterior length of the hyoid, width between the greater horns, angle, fusion of the greater horns and force applied were analyzed. Our study confirmed sexual dimorphism, shown by greater length in males (>37.8 mm) than in females, and a larger angle in females (a shorter bone with a width>43.7 mm and an angle>31°01). The study confirmed the positive correlation between the length of the hyoid and the weight and height of the subject (p<0.05). Sixty-seven of the 77 hyoid bones fractured during the experiment (87% fracture rate). Of the fractures, 48% occurred at the junction between the body and the greater horns, 49% in the greater horns (mean distance from the distal extremity of the horn 17.33±4.37 mm), and 3% in the median part of the body. No significant association was found between gender and type of fracture, or between fusion or non-fusion of the horn (p>0.05). Fused bones were not more susceptible to fracture than non-fused bones. Fracture occurred at a mean force of 30.55 N (±18.189). Multiple linear regression showed a significant negative correlation between force required for fracture and age, weight and height of the subject, anteroposterior length and angle. The younger the individual, the slighter their

  10. Manual strangulation: experimental approach to the genesis of hyoid bone fractures.

    PubMed

    Lebreton-Chakour, Catherine; Godio-Raboutet, Yves; Torrents, Romain; Chaumoitre, Kathia; Boval, Catherine; Bartoli, Christophe; Adalian, Pascal; Piercecchi-Marti, Marie-Dominique; Thollon, Lionel

    2013-05-10

    Discovery of a fracture of the hyoid bone during forensic autopsy is a feature that raises suspicions of constriction of the neck. Studies have shown the influence of gender and build of the individual on the morphology of this bone. Our aims were to confirm these findings and to develop an experimental protocol for simulating manual strangulation in order to determine the force required to fracture the hyoid bone and the influence of anthropometric parameters on this force. A total of 77 intact hyoid bones were obtained, scanned, modeled, measured and embedded in resin. Using a hydraulic press, we applied force to the distal extremity of the greater horn. The relationships between the parameters of sex, weight and height of the subject, anteroposterior length of the hyoid, width between the greater horns, angle, fusion of the greater horns and force applied were analyzed. Our study confirmed sexual dimorphism, shown by greater length in males (>37.8 mm) than in females, and a larger angle in females (a shorter bone with a width>43.7 mm and an angle>31°01). The study confirmed the positive correlation between the length of the hyoid and the weight and height of the subject (p<0.05). Sixty-seven of the 77 hyoid bones fractured during the experiment (87% fracture rate). Of the fractures, 48% occurred at the junction between the body and the greater horns, 49% in the greater horns (mean distance from the distal extremity of the horn 17.33±4.37 mm), and 3% in the median part of the body. No significant association was found between gender and type of fracture, or between fusion or non-fusion of the horn (p>0.05). Fused bones were not more susceptible to fracture than non-fused bones. Fracture occurred at a mean force of 30.55 N (±18.189). Multiple linear regression showed a significant negative correlation between force required for fracture and age, weight and height of the subject, anteroposterior length and angle. The younger the individual, the slighter their

  11. Umbilical hernia, inguinal hernias, and hydroceles in children: diagnostic clues for optimal patient management.

    PubMed

    Gill, F T

    1998-01-01

    The assessment of pediatric patients with a possible umbilical hernia, inguinal hernias, or hydroceles can often be problematic for the pediatric nurse practitioner. Understanding the embryologic processes related to these conditions may increase the diagnostic capabilities of the practitioner. Clues to assist in the differential diagnosis and current treatment modalities will be offered. Tips for parental guidance related to these conditions will enhance the team approach to effective referrals and optimal treatment of the children in this clinical population.

  12. An Alternative Approach to Combine Orbital Prosthesis and Obturator: A Case Report

    PubMed Central

    Soganci, Gokce; Yalug, Suat; Kocacikli, Mustafa

    2011-01-01

    This report describes a different approach for diminishing the movements of orbital prosthesis during mimic movements and chewing function. Mechanical devices such as magnets are used to enhance the retention in case lack of the implants. However rigid fixation of obturator and orbital prosthesis can result in movements of the orbital prosthesis during mastication. In this case obturator and orbital prosthesis are combined by magnets. However this combination is not rigid because of an active part which provides movement. This active part allows movements in a space constructed in the acrylic base of orbital prosthesis. Thus, the movements that may occur on orbital prosthesis during chewing can be diminished by this simple mechanism. Due to the fact that designing such a mechanism that minimizes the movements of the orbital prosthesis contributes patient’s comfort. PMID:21912502

  13. Aortobifemoral Reconstruction with Right Extra-Anatomic Obturator Foramen Bypass due to a Septic Groin

    PubMed Central

    Hinojosa, Carlos A.; Anaya-Ayala, Javier E.; Laparra-Escareno, Hugo; Lizola, Rene; Torres-Machorro, Adriana

    2016-01-01

    The aortic bifurcation and iliac vessels are common sites of atherosclerotic occlusive disease causing the clinical expression known as “Leriche’s syndrome”. An aortobifemoral bypass grafting in the setting of a septic groin remains a significant challenge to vascular surgeons. We present a 65-year-old male with complete occlusion of the distal aorta and iliac arteries; he had undergone a left axillo-femoral and femoral-femoral artery bypass 2 years prior to our evaluation. Owing to a complex graft infection in the right groin and worsening lower extremity ischemia, we performed an aortobifemoral reconstruction through the right obturator membrane. This report highlights the safety and efficacy of the obturator bypass for avoiding infected groins while preserving vascular continuity and durability with 78 months of secondary patency rate. PMID:27386453

  14. Avulsed Immature Permanent Central Incisors Obturated With Mineral Trioxide Aggregate: A Case Report

    PubMed Central

    Al-Kahtani, Ahmed

    2013-01-01

    The endodontic management of immature permanent incisors in young children can be challenging. This case reported an avulsed immature maxillary central incisors that underwent complete endodontic obturation using mineral trioxide aggregate. A 10-year-old male who suffered a fall injury avulsed both his central incisors. The revascularization process was not possible due to patient compliance and geographic reasons. Mineral trioxide aggregate was utilized as a novel endodontic treatment. After one year post-injury, the teeth remained symptom-free, the clinical and radiographic follow-up showed evidence of healthy periodontium. How to cite this article: Al-Kahtani A. Avulsed Immature Permanent Central Incisors Obturated With Mineral Trioxide Aggregate: A Case Report. J Int Oral Health 2013; 5(3):88-96. PMID:24155609

  15. Hiatal hernia on thoracic computed tomography in pulmonary fibrosis.

    PubMed

    Tossier, Céline; Dupin, Clairelyne; Plantier, Laurent; Leger, Julie; Flament, Thomas; Favelle, Olivier; Lecomte, Thierry; Diot, Patrice; Marchand-Adam, Sylvain

    2016-09-01

    Gastro-oesophageal reflux has long been suspected of implication in the genesis and progression of idiopathic pulmonary fibrosis (IPF). We hypothesised that hiatal hernia may be more frequent in IPF than in other interstitial lung disease (ILD), and that hiatal hernia may be associated with more severe clinical characteristics in IPF.We retrospectively compared the prevalence of hiatal hernia on computed tomographic (CT) scans in 79 patients with IPF and 103 patients with other ILD (17 scleroderma, 54 other connective tissue diseases and 32 chronic hypersensitivity pneumonitis). In the IPF group, we compared the clinical, biological, functional, CT scan characteristics and mortality of patients with hiatal hernia (n=42) and without hiatal hernia (n=37).The prevalence of hiatal hernia on CT scan at IPF diagnosis was 53%, similar to ILD associated with scleroderma, but significantly higher than in the two other ILD groups. The size of the hiatal hernia was not linked to either fibrosis CT scan scores, or reduction in lung function in any group. Mortality from respiratory causes was significantly higher among IPF patients with hiatal hernia than among those without hiatal hernia (p=0.009).Hiatal hernia might have a specific role in IPF genesis, possibly due to pathological gastro-oesophageal reflux.

  16. Two Ports Laparoscopic Inguinal Hernia Repair in Children

    PubMed Central

    Ibrahim, Medhat M.

    2015-01-01

    Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7%) cases were suffering unilateral hernia and 20 (22.2%) patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%). The patients' median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus. Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment. PMID:25785196

  17. Hiatus Hernia Repair with Bilateral Oesophageal Fixation.

    PubMed

    Mendis, Rajith; Cheung, Caran; Martin, David

    2015-01-01

    Background. Despite advances in surgical repair of hiatus hernias, there remains a high radiological recurrence rate. We performed a novel technique incorporating bilateral oesophageal fixation and evaluated outcomes, principally symptom improvement and hernia recurrence. Methods. A retrospective study was performed on a prospective database of patients undergoing hiatus hernia repair with bilateral oesophageal fixation. Retrospective and prospective quality of life (QOL), PPI usage, and patient satisfaction data were obtained. Hernia recurrence was assessed by either barium swallow or gastroscopy. Results. 87 patients were identified in the database with a minimum of 3 months followup. There were significant improvements in QOL scores including GERD HRQL (29.13 to 4.38, P < 0.01), Visick (3 to 1), and RSI (17.45 to 5, P < 0.01). PPI usage decreased from a median of daily to none, and there was high patient satisfaction (94%). 57 patients were assessed for recurrence with either gastroscopy or barium swallow, and one patient had evidence of recurrence on barium swallow at 45 months postoperatively. There was an 8% complication rate and no mortality or oesophageal perforation. Conclusions. This study demonstrates that our technique is both safe and effective in symptom control, and our recurrence investigations demonstrate at least short term durability. PMID:26065030

  18. Diaphragmatic hernia simulating a left pleural effusion.

    PubMed

    Wooldridge, Jamie L; Partrick, David A; Bensard, Denis D; Deterding, Robin R

    2003-12-01

    We review a case of a diaphragmatic hernia simulating on chest radiograph left lower lobe pneumonia and associated pleural effusion. We also characterize the atypical chest radiographic findings of this patient and recommend further imaging with computed tomography in unusual patient presentations.

  19. Intestinal obstruction from diaphragmatic hernia following colonoscopy.

    PubMed

    Rustagi, Tarun

    2011-05-01

    Diaphragmatic hernias caused or exacerbated by colonoscopy are rare with only few cases reported. The author reports here an unusual case of herniation and incarceration of the colon into the left thoracic cavity without bowel perforation after an uneventful screening colonoscopy, through an occult focal diaphragmatic weakness from the patient's prior trauma.

  20. Root surface temperature rises in vitro during root canal obturation using hybrid and microseal techniques.

    PubMed

    Lipski, Mariusz

    2005-04-01

    The aim of this in vitro study was to measure the temperature rise on the outer surface of roots during filling with hybrid technique and Microseal. Twenty extracted human maxillary and mandibular premolars with a single canal were randomly divided into two groups of 10 teeth each. In the first group, the teeth were filled with hybrid technique (thermomechanical compaction with Engine Plugger used following lateral condensation of the apical part of the canal), the second group was filled using Microseal. After root canal obturation the filling material was removed and the obturation procedure was repeated. A total of 20 obturations in each group were performed. Temperature changes were measured using a thermal imaging camera. The temperature of certain regions of the mesial surface was analyzed and the highest temperature values were recorded. Statistical analysis was performed using the Mann-Whitney U test. The mean increase of temperature during the hybrid technique with Engine Plugger was 23.8 degrees C, while during Microseal it was significantly lower (p = 0.000001) at 5.5 degrees C. The temperature rise generated by Microseal was below the critical level and should not damage supporting structures, however, the hybrid technique generated a relatively high temperature rise that may cause periodontal tissue damage.

  1. Sabots, Obturator and Gas-In-Launch Tube Techniques for Heat Flux Models in Ballistic Ranges

    NASA Technical Reports Server (NTRS)

    Bogdanoff, David W.; Wilder, Michael C.

    2013-01-01

    For thermal protection system (heat shield) design for space vehicle entry into earth and other planetary atmospheres, it is essential to know the augmentation of the heat flux due to vehicle surface roughness. At the NASA Ames Hypervelocity Free Flight Aerodynamic Facility (HFFAF) ballistic range, a campaign of heat flux studies on rough models, using infrared camera techniques, has been initiated. Several phenomena can interfere with obtaining good heat flux data when using this measuring technique. These include leakage of the hot drive gas in the gun barrel through joints in the sabot (model carrier) to create spurious thermal imprints on the model forebody, deposition of sabot material on the model forebody, thereby changing the thermal properties of the model surface and unknown in-barrel heating of the model. This report presents developments in launch techniques to greatly reduce or eliminate these problems. The techniques include the use of obturator cups behind the launch package, enclosed versus open front sabot designs and the use of hydrogen gas in the launch tube. Attention also had to be paid to the problem of the obturator drafting behind the model and impacting the model. Of the techniques presented, the obturator cups and hydrogen in the launch tube were successful when properly implemented

  2. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study

    PubMed Central

    Hiremath, Mallayya C.; Srivastava, Pooja

    2016-01-01

    Purpose: The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. Materials and Methods: A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test. Results: The results showed significant differences between the four groups for the length of obturation (P < 0.05). The endodontic pressure syringe showed the best results (98.5% optimal fillings) and jiffy tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used. Conclusions: Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods. PMID:27433062

  3. A Rare Case of Laparoscopic Repair of Simultaneously Occurring Morgagni and Paraesophageal Hernias

    PubMed Central

    Zhou, Zu-Li; Li, Hao; Li, Jian-Feng; Liu, Yan-Guo; Wang, Chong

    2015-01-01

    Simultaneously occurring Morgagni hernia and paraesophageal hernia is an extremely rare clinical condition with only six case reports in the English-language literature and only two laparoscopic repair reports. We report a 73-year-old woman with both Morgagni hernia and paraesophageal hernia who underwent successful laparoscopic repair of the hernia defects using transabdominal wall suturing. The laparoscopic operation can provide excellent exposure and repair the hernia defect easily with minimal invasiveness and fewer complications. This case report reported the concurring Morgagni and paraesophageal hernias and validated the feasibility of laparoscopic repair both hernias simultaneously. PMID:26289630

  4. What is a Certified Hernia Center? The Example of the German Hernia Society and German Society of General and Visceral Surgery.

    PubMed

    Köckerling, Ferdinand; Berger, Dieter; Jost, Johannes O

    2014-01-01

    To date, the scientific definition "hernia center" does not exist and this term is being used by hospitals and private institutions as a marketing instrument. Hernia surgery has become increasingly more complex over the past 25 years. Differentiated use of the various techniques in hernia surgery has been adopted as a "tailored approach" program and requires intensive engagement with, and extensive experience of, the entire field of hernia surgery. Therefore, there is a need for hernia centers. A basic requirement for a credible certification process for hernia centers involves definition of requirements and its verification by hernia societies and/or non-profit organizations that are interested in assuring the best possible quality of hernia surgery. At present, there are two processes for certification of hernia centers by hernia societies or non-profit organizations.

  5. [Elimination of the obturator reflex with prilocaine in transurethral resection of bladder tumors in combination with spinal and general anesthesia].

    PubMed

    Schwilick, R; Steinhoff, H

    1987-04-01

    During transurethral resection of bladder tumors under either spinal or general anesthesia without muscular relaxation, direct stimulation of the obturator nerve by the electroresectoscope is possible. The resulting obturator reflex may lead to severe complications, at the worst to a perforation of the bladder. Therefore, if resection in lateral bladder regions is necessary, blockade of the obturator nerve is often required to provide optimal conditions for transurethral resection of bladder tumors. To interrupt the obturator reflex are, we blocked the inguinal lumbar plexus using the "3-in-1-block" as described by Winnie because of its advantages compared to isolated blockade of the obturator nerve. Prilocaine 1% was the chosen local anesthetic because of its low tendency towards cardiac and cerebral side effects. Spinal anesthesia was induced with 3-4 ml hyperbaric bupivacaine 0.5%. After the onset of analgesia, making use of a nerve stimulator, a "3-in-1-block" was completed with 30-35 ml prilocaine 1%. The study included over 90 patients. Firstly we observed the efficiency of the obturator motor block by the "3-in-1-block"; secondly clinical side effects of prilocaine were evaluated; and finally in 20 cases methemoglobin levels were measured before and 90 min after injection of prilocaine. A "3-in-1-block" with prilocaine 1% provided a good motor block of the obturator nerve. Neither clinical side effects nor relevant methemoglobinemia occurred. In 3 cases methemoglobin levels were elevated by 1%, whereas in the remaining 17 cases methemoglobin values were normal.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Simultaneous sleeve gastrectomy and hiatus hernia repair: a systematic review.

    PubMed

    Mahawar, Kamal K; Carr, William R J; Jennings, Neil; Balupuri, Shlok; Small, Peter K

    2015-01-01

    Sleeve gastrectomy can exacerbate gastro-oesophageal reflux disease in some patients and cause de novo reflux in others. Some surgeons believe Roux-en-Y gastric bypass is the best bariatric surgical procedure for obese patients with hiatus hernia. Others believe that even patients with hiatus hernia can also be safely offered sleeve gastrectomy if combined with a simultaneous hiatus hernia repair. Still, others will offer these patients sleeve gastrectomy without any attempt to diagnose or repair hiatus hernia repair. The effectiveness of concurrent hiatal hernia repair in reducing the incidence of postoperative reflux after sleeve gastrectomy is unclear. This review systematically investigates the results and techniques of simultaneous sleeve gastrectomy and hiatus hernia repair for the treatment of obesity in accordance with PRISMA guidelines. PMID:25348434

  7. Bochdalek Hernia With Gastric Volvulus in an Adult

    PubMed Central

    Atef, Mejri; Emna, Trigui

    2015-01-01

    Abstract Bochdalek hernias in adulthood are rare. Symptomatic Bochdalek hernias in adults are rarer, but may lead to fatal complications. Patients with acute gastric volvulus on diaphragmatic hernia are a diagnostic and therapeutic emergency. Here, we report a case of a 56-year-old woman diagnosed with epigastric pain, cough, vomiting since 2 weeks and shortness of breath. Complicated Bochdalek hernia was an incidental finding, diagnosed by chest radiograph, computed tomography (CT), and barium swallow study. Stomach was within the thorax in the left side due to left diaphragmatic hernia of a nontraumatic cause. The patient was prepared for the laparoscopic surgical repair, to close the defect. The patient recovered with accepted general condition and was discharged 9 days later. Diagnoses of Bochdalek hernias in adulthood are challenging. However, although rare, this possibility should be kept in mind to avoid fatal complications. PMID:26705205

  8. Bochdalek Congenital Diaphragmatic Hernia in an Adult Sheep

    PubMed Central

    Williams, R. D.; Katz, M. G.; Fargnoli, A. S.; Kendle, A. P.; Mihalko, K. L.; Bridges, C. R.

    2016-01-01

    Summary Congenital diaphragmatic hernia (CDH) is a rare condition. The aetiology of CDH is often unclear. In our case, a hollow mass was noted on MRI. Cardiac ejection fraction was diminished (47.0%) compared to 60.5% (average of 10 other normal animals, P < 0.05). The final diagnosis of congenital diaphragmatic hernia (Bochdalek type) was made when the sheep underwent surgery. The hernia was right-sided and contained the abomasum. Lung biopsy demonstrated incomplete development with a low number of bronchopulmonary segments and vessels. The likely cause of this hernia was genetic malformation. PMID:26293994

  9. Perineal hernia: surgical anatomy, embryology, and technique of repair.

    PubMed

    Stamatiou, Dimitrios; Skandalakis, John E; Skandalakis, Lee J; Mirilas, Petros

    2010-05-01

    Perineal hernia is the protrusion into the perineum of intraperitoneal or extraperitoneal contents through a congenital or acquired defect of the pelvic diaphragm. The first case was reported by de Garangeot in 1743. Perineal hernias may occur anteriorly or posteriorly to the superficial transverse perineal muscles. Congenital perineal hernia is a rare entity. Failure of regression of the peritoneal cul de sac of the embryo is considered a predisposing factor for hernia formation. Acquired perineal hernias are primary or secondary. Primarily acquired perineal hernias are caused by factors associated with increased intra-abdominal pressure. They are more common in females as a result of the broader female pelvis and the attenuation of the pelvic floor during pregnancy and childbirth. Secondarily acquired perineal hernias are incisional hernias associated with extensive pelvic operations such as abdominoperineal resection of the anorectum and pelvic exenteration. Pain in the perineal area, intestinal obstruction, topical skin erosion, and difficulty with urination necessitate the surgical repair of a perineal hernia. This can be accomplished through transabdominal, perineal, or combined abdominoperineal approaches. The defect in the muscles of the pelvic diaphragm may be closed either with direct suturing or by using autogenous tissues or synthetic mesh.

  10. [The systematization and the etiopathogenicity of diaphragmatic hernias].

    PubMed

    Alecu, L

    2001-01-01

    The author, based on up to date published dates, intends to present the classification and ethiopathogeny of the diaphragmatic hernias, except the aesophagic hiatus oms. This is an interesting chapter of the borderline surgery (abdominal and thorax). They are placed on the second position in frequency (after the hiatal hernias) in the diaphragmatic pathology; they are internal hernias, through congenital or obtained holes which allow to abdominal viscera to pass into thorax. They are--in the most cases, even elderly ones-congenital, result of the abnormalities in the embrionary growth of the diaphragm. A special place' is represented by the traumatic hernias.

  11. Inguinal hernia repair: anaesthesia, pain and convalescence.

    PubMed

    Callesen, Torben

    2003-08-01

    Elective surgical repair of an inguinal or femoral hernia is one of the most common surgical procedures. The treatment, however, presents several challenges regarding anaesthesia for the procedure, the postoperative analgesic therapy and convalescence, as well as planning of the procedure. Local, general, and regional anaesthesia are all used for hernia repair, but to different degrees, primarily depending on traditions and whether the institution has specific interest in hernia surgery. Thus, the use of local anaesthesia varies from a few percent in Sweden, 18% in Denmark and up to almost 100% in specialised institutions, dedicated to hernia surgery. The feasibility of local anaesthesia is high, as judged by the rate of conversion to general anaesthesia (< 1%), although intraoperative pain is quite common. The generally low rate of serious complications does not allow firm conclusions, but the rate of less serious complications is lower by local anaesthesia, compared to other anaesthetic techniques. Of special interest is, that the rate of urinary retention can be eliminated by the use of local anaesthesia. Local anaesthesia results, in comparative studies, in a higher degree of patient satisfaction than other anaesthetic techniques. Local anaesthesia also facilitates faster mobilisation and earlier discharge/fulfilment of discharge criteria from post anaesthetic care units than other anaesthetic techniques. Pain after hernia repair is more pronounced at mobilisation or coughing than during rest, and younger patients seem to have more pain than older patients. The pain ceases over time, and it is most pronounced the day after surgery, where two thirds have moderate or severe pain during activity, while one third still have moderate or severe pain after one week, and approximately 10% after 4 weeks. Pain after laparoscopic surgery is less pronounced than after open surgery, while different open repair techniques do not exhibit significant differences. Postoperative

  12. What is inside the hernia sac?

    PubMed Central

    Virgínia, Ana Araújo; Santos, Cláudia; Contente, Helena; Branco, Cláudia

    2016-01-01

    Most ovarian inguinal hernias occur in children and are frequently associated with congenital genitalia defects. The authors present the case of a multiparous 89-year-old woman, without any genitalia defect, who was brought to the emergency department with an irreducible inguinal hernia. The patient was proposed for emergency surgery during which we encountered an ovary and a fallopian tube inside the hernial sac. An oophorosalpingectomy and a Lichtenstein procedure were carried out and the postoperative period was uneventful. This case shows that, even though it is rare, a hernial sac may contain almost any intra-abdominal organ, including those least frequent such as the appendix, an ovary or the fallopian tubes. PMID:27511751

  13. Congenital diaphragmatic hernia in the older child.

    PubMed Central

    Booker, P D; Meerstadt, P W; Bush, G H

    1981-01-01

    Five children aged between 9 months and 7 years were admitted to hospital each with an unsuspected congenital diaphragmatic hernia. In 4 the diagnosis was pneumonia with a secondary pleural effusion or lung abscess. Initial investigations were unhelpful to the admitting physician; two of the children had had a previous chest x-ray which was normal. For 3 children the correct diagnosis was only made at necropsy. It is suggested that the possibility of a congenital diaphragmatic hernia be considered in any patient who has an indefinable diaphragm and cystic lesion on his chest x-ray film. Barium studies with the patient in Trendelenburg's position are of value in excluding the presence of bowel in the chest. Images Fig. 1 Fig. 2 PMID:7247437

  14. Sports hernia and femoroacetabular impingement in athletes: A systematic review

    PubMed Central

    Munegato, Daniele; Bigoni, Marco; Gridavilla, Giulia; Olmi, Stefano; Cesana, Giovanni; Zatti, Giovanni

    2015-01-01

    AIM: To investigate the association between sports hernias and femoroacetabular impingement (FAI) in athletes. METHODS: PubMed, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review. Finally, 24 studies were reviewed to evaluate the prevalence of FAI in cases of sports hernia and examine treatment outcomes and evidence for a common underlying pathogenic mechanism. RESULTS: FAI has been reported in as few as 12% to as high as 94% of patients with sports hernias, athletic pubalgia or adductor-related groin pain. Cam-type impingement is proposed to lead to increased symphyseal motion with overload on the surrounding extra-articular structures and muscle, which can result in the development of sports hernia and athletic pubalgia. Laparoscopic repair of sports hernias, via either the transabdominal preperitoneal or extraperitoneal approach, has a high success rate and earlier recovery of full sports activity compared to open surgery or conservative treatment. For patients with FAI and sports hernia, the surgical management of both pathologies is more effective than sports pubalgia treatment or hip arthroscopy alone (89% vs 33% of cases). As sports hernias and FAI are typically treated by general and orthopedic surgeons, respectively, a multidisciplinary approach for diagnosis and treatment is recommended for optimal treatment of patients with these injuries. CONCLUSION: The restriction in range of motion due to FAI likely contributes to sports hernias; therefore, surgical treatment of both pathologies represents an optimal therapy. PMID:26380829

  15. [Median incisional hernias and coexisting parastomal hernias : new surgical strategies and an algorithm for simultaneous repair].

    PubMed

    Köhler, G

    2014-08-01

    The co-occurrence of incisional and parastomal hernias (PSH) remains a surgical challenge. Standardized treatment guidelines are missing, and the patients concerned require an individualized surgical approach. The laparoscopic techniques can be performed with incised and/or stoma-lateralizing flat meshes with intraperitoneal onlay placement. The purely laparoscopic and laparoscopic-assisted approaches with 3-D meshes offer advantages regarding the complete coverage of the edges of the stomal areas and the option of equilateral or contralateral stoma relocation in cases of PSH, which are difficult to handle due to scarring, adhesions, and large fascial defects > 5 cm with intestinal hernia sac contents. A relevant stoma prolapse can be relocated by tunnel-like preformed 3-D meshes and shortening the stoma bowel. The positive effect on prolapse prevention arises from the dome of the 3-D mesh, which is directed toward the abdominal cavity and tightly fits to the bowel. In cases of large incisional hernias (> 8-10 cm in width) or young patients with higher physical demands, an open abdominal wall reconstruction in sublay technique is required. Component separation techniques that enable tension-free ventral fascial closure should be preferred to mesh-supported defect bridging methods. The modified posterior component separation with transversus abdominis release (TAR) and the minimally invasive anterior component separation are superior to the original Ramirez technique with respect to wound morbidity. By using 3-D textile implants, which were specially designed for parastomal hernia prevention, the stoma can be brought out through the lateral abdominal wall without increased risk of parastomal hernia or prolapse development. An algorithm for surgical treatment, in consideration of the complexity of combined hernias, is introduced for the first time.

  16. Laparoscopic Total Extraperitoneal Hernia Repair Outcomes

    PubMed Central

    Bresnahan, Erin R.

    2016-01-01

    Background and Objectives: Laparoscopic inguinal hernia repair has become increasingly popular as an alternative to open surgery. The purpose of this study was to evaluate the safety and effectiveness of the laparoscopic total extraperitoneal procedure with the use of staple fixation and polypropylene mesh. Methods: A retrospective chart review examined outcomes of 1240 laparoscopic hernia operations in 783 patients, focusing on intraoperative and early postoperative complications, pain, and time until return to work and normal physical activities. Results: There were no intraoperative complications in this series; 106 patients experienced early postoperative complications across 8 evaluated categories: urinary retention (4.1%), seroma (3.0%), testicular/hemiscrotal swelling (1.9%), testicular atrophy (0%), hydrocele (0.6%), mesh infection (0.1%), and neurological symptoms (transient, 1.0%; persistent, 0.2%). Patients used an average of 5.6 Percocet pills after the procedure, and mean times until return to work and normal activities, including their routine exercise regimen, were 3.0 and 3.8 days, respectively. Conclusion: Complication rates and convalescence times were considered equivalent or superior to those found in other studies assessing both laparoscopic and open techniques. The usage of multiple Endostaples did not result in increased neurologic complications in the early postoperative period when compared with findings in the literature. In the hands of an experienced surgeon, total extraperitoneal repair is a safe, effective alternative to open inguinal hernia repair. PMID:27493471

  17. Comparing the Apical Microleakage of Lateral Condensation and Chloroform Dip Techniques with a New Obturation Method

    PubMed Central

    Saatchi, Masoud; Barekatain, Behnaz; Behzadian, Masoumeh

    2011-01-01

    Background: The final objective of root canal therapy is to create a hermetic seal along the length of the root canal system. For this purpose, many methods and materials have been introduced. The purpose of this study was to compare the apical microleakage in a new obturation technique (true-tug-back) with two other obturation techniques (lateral condensation and chloroform dip technique). Methods: In this in vitro study 102 single canal teeth were selected. The crowns were removed, and the canals were prepared using step-back technique. The master apical file was K-file #40. The teeth were divided into 3 experimental groups of 32 teeth. First group were obturated with lateral condensation technique and second group with chloroform dip technique and the third group with true-tug-back technique. Six teeth were used as control group. The teeth were placed in incubator at 100% humidity and 37°c for three days. The roots of the teeth were coated with two layers of nail varnish except for the apical 2 millimeter. Teeth were placed in Methylene blue 2% for one week. The teeth were sectioned vertically and the depth of maximum dye penetration for each tooth was recorded by stereomicroscope. Data were analyzed using ANOVA and Dunkan test. Results: The mean liner dye penetration differences between lateral condensation group (6.88 ± 4.06 mm) and chloroform dip technique group (7.16 ± 3.37 mm) were not statistically significant (P = 0.719). The differences between true-tug-back group (3.15 ± 0.52 mm) and two other groups were statistically significant (P < 0.001). Conclusion: The results of this study showed that the true-tug-back technique can improve apical seal. Further studies are needed for this purpose. PMID:22132011

  18. Modified functional obturator for the consideration of facial growth in the mucoepidermoid carcinoma pediatric patient.

    PubMed

    Kim, Soung Min; Park, Min Woo; Cho, Young Ah; Myoung, Hoon; Lee, Jong Ho; Lee, Suk Keun

    2015-10-01

    Mucoepidermoid carcinoma (MEC) is a common salivary gland tumor in a adults but is very rare in pediatric patients. The standard treatment of MEC is en bloc resection with wide safety margins and subsequent reconstruction of the jaw, but few surgeons or pediatric specialists have experience with this procedure. An 11-year-old boy received a hemi-maxillectomy with subsequent application of the modified functional obturator (MFO) by the functional matrix concept of Moss. And the patient's face showed normal growth pattern. The purpose of this report is to demonstrate the novel concept of pediatric maxillary reconstruction using MFO for the consideration of facial growth.

  19. Obturating teeth with wide open apices using mineral trioxide aggregate: a case report.

    PubMed

    Levenstein, H

    2002-07-01

    The conventional approach in handling a tooth with a wide open apex requiring endodontic treatment is by means of a procedure called apexification. The objective of treatment is to introduce calcium hydroxide mixed with sterile water or local anaesthetic into the root canal to create a hard-tissue-like formation or an apical plug to prevent extrusion of filling materials during obturation of teeth with wide open apices. This procedure may take anything from 6 months to 2 years. In 1999 a new material called mineral trioxide aggregate (MTA) was introduced to the dental profession for clinical use which has the ability to create an apical plug within a few weeks.

  20. Interim obturator in an infant with Treacher Collins syndrome: Review and chairside modification in impression making.

    PubMed

    Bhandari, Sudhir; Aras, Meena; Bakshi, Sonika

    2011-10-01

    Treacher Collins syndrome has been described as a syndrome involving 1st and 2nd branchial arches, affecting various organs in the craniofacial region. Affected infants report with nasal regurgitation and minimal dietary intake due to cleft palate, consequently show delayed and retarded growth. The situation is further complicated when the repair of the palatal defect is postponed due to delayed milestones. At this juncture, it is of paramount importance to intervene prosthetically and close the defect with the aid of an interim obturator. Herein we describe a simple, yet successful, chairside approach to make an impression of an infant without the aid of any kind of anesthesia.

  1. Transdiaphragmatic intercostal hernia: imaging aspects in three cases*

    PubMed Central

    Macedo, Ana Carolina Sandoval; Kay, Fernando Uliana; Terra, Ricardo Mingarini; de Campos, José Ribas Milanez; Aranha, André Galante Alencar; Funari, Marcelo Buarque de Gusmão

    2013-01-01

    Transdiaphragmatic intercostal hernia is uncommon and mostly related to blunt or penetrating trauma. We report three similar cases of cough-induced transdiaphragmatic intercostal hernia, highlighting the anatomic findings obtained with different imaging modalities (radiography, ultrasonography, CT, and magnetic resonance) in each of the cases. PMID:24068274

  2. Incidence of Ostomy Site Incisional Hernias after Stoma Closure.

    PubMed

    Sharp, Stephen P; Francis, Jacquelyn K; Valerian, Brian T; Canete, Jonathan J; Chismark, A David; Lee, Edward C

    2015-12-01

    This study sought to evaluate the incidence of ostomy site incisional hernias after stoma reversal at a single institution. This is a retrospective analysis from 2001 to 2011 evaluating the following demographics: age, gender, indication for stoma, urgent versus elective operation, time to closure, total follow-up time, the incidence of and reoperation for stoma incisional hernia, diabetes, postoperative wound infection, smoking status within six months of surgery, body mass index, and any immunosuppressive medications. A total of 365 patients were evaluated. The median follow-up time was 30 months. The clinical hernia rate was 19 percent. Significant risk factors for hernia development were age, diabetes, end colostomies, loop colostomies, body mass index >30, and undergoing an urgent operation. The median time to clinical hernia detection was 32 months. Sixty-four percent of patients required surgical repair of their stoma incisional hernia. A significant number of patients undergoing stoma closure developed an incisional hernia at the prior stoma site with the majority requiring definitive repair. These hernias are a late complication after stoma closure and likely why they are under-reported in the literature. PMID:26736162

  3. Diaphragmatic Hernia after Transhiatal Esophagectomy for Esophageal Cancer.

    PubMed

    Kim, Dohun; Kim, Si-Wook; Hong, Jong-Myeon

    2016-08-01

    Diaphragmatic hernia was found in a patient who had undergone transhiatal esophagectomy for early esophageal cancer. Chest X-ray was not helpful, but abdominal or chest computed tomography was useful for accurate diagnosis. Primary repair through thoracotomy was performed and was found to be feasible and effective. However, long-term follow-up is required because hernia recurrence is common. PMID:27525243

  4. Laparoscopic repair of diaphragmatic hernia after left ventricular assist device.

    PubMed

    Farma, Jeffrey; Leeser, David; Furukawa, Satoshi; Dempsey, Daniel T

    2003-06-01

    This case report describes a patient with a symptomatic diaphragmatic hernia that developed after orthotopic heart transplantation and explantation of a left ventricular assist device. The hernia was repaired laparoscopically, and at 6-month follow-up, she is without evidence of recurrence.

  5. Incidence of Ostomy Site Incisional Hernias after Stoma Closure.

    PubMed

    Sharp, Stephen P; Francis, Jacquelyn K; Valerian, Brian T; Canete, Jonathan J; Chismark, A David; Lee, Edward C

    2015-12-01

    This study sought to evaluate the incidence of ostomy site incisional hernias after stoma reversal at a single institution. This is a retrospective analysis from 2001 to 2011 evaluating the following demographics: age, gender, indication for stoma, urgent versus elective operation, time to closure, total follow-up time, the incidence of and reoperation for stoma incisional hernia, diabetes, postoperative wound infection, smoking status within six months of surgery, body mass index, and any immunosuppressive medications. A total of 365 patients were evaluated. The median follow-up time was 30 months. The clinical hernia rate was 19 percent. Significant risk factors for hernia development were age, diabetes, end colostomies, loop colostomies, body mass index >30, and undergoing an urgent operation. The median time to clinical hernia detection was 32 months. Sixty-four percent of patients required surgical repair of their stoma incisional hernia. A significant number of patients undergoing stoma closure developed an incisional hernia at the prior stoma site with the majority requiring definitive repair. These hernias are a late complication after stoma closure and likely why they are under-reported in the literature.

  6. Diaphragmatic Hernia after Transhiatal Esophagectomy for Esophageal Cancer

    PubMed Central

    Kim, Dohun; Kim, Si-Wook; Hong, Jong-Myeon

    2016-01-01

    Diaphragmatic hernia was found in a patient who had undergone transhiatal esophagectomy for early esophageal cancer. Chest X-ray was not helpful, but abdominal or chest computed tomography was useful for accurate diagnosis. Primary repair through thoracotomy was performed and was found to be feasible and effective. However, long-term follow-up is required because hernia recurrence is common. PMID:27525243

  7. Inguinal bladder hernia associated with vesico-ureteric reflux.

    PubMed

    Noble, J G; Christmas, T J; Chapple, C R; Rickards, D

    1992-04-01

    The urinary bladder is frequently found as a component of inguinal herniae. This report describes a case of 'bladder hernia' associated with vesico-ureteric reflux. The current methods of investigation and subsequent treatment for this condition are reviewed along with the possible underlying cause of vesico-ureteric reflux in this case.

  8. Evolution and advances in laparoscopic ventral and incisional hernia repair

    PubMed Central

    Vorst, Alan L; Kaoutzanis, Christodoulos; Carbonell, Alfredo M; Franz, Michael G

    2015-01-01

    Primary ventral hernias and ventral incisional hernias have been a challenge for surgeons throughout the ages. In the current era, incisional hernias have increased in prevalence due to the very high number of laparotomies performed in the 20th century. Even though minimally invasive surgery and hernia repair have evolved rapidly, general surgeons have yet to develop the ideal, standardized method that adequately decreases common postoperative complications, such as wound failure, hernia recurrence and pain. The evolution of laparoscopy and ventral hernia repair will be reviewed, from the rectoscopy of the 4th century to the advent of laparoscopy, from suture repair to the evolution of mesh reinforcement. The nuances of minimally invasive ventral and incisional hernia repair will be summarized, from preoperative considerations to variations in intraoperative practice. New techniques have become increasingly popular, such as primary defect closure, retrorectus mesh placement, and concomitant component separation. The advent of robotics has made some of these repairs more feasible, but only time and well-designed clinical studies will tell if this will be a durable modality for ventral and incisional hernia repair. PMID:26649152

  9. Hiatal hernia in a harbor seal (Phoca vitulina) pup.

    PubMed

    Biancani, Barbara; Field, Cara L; Dennison, Sophie; Pulver, Robert; Tuttle, Allison D

    2012-06-01

    A 2-wk-old stranded harbor seal (Phoca vitulina) rescued by Mystic Aquarium showed signs of the presence of a hiatal hernia during rehabilitation. Contrast radiographs of esophagus and stomach revealed an intrathoracic radiodensity that contains filling defects typical of stomach, consistent with gastric rugal folds. Mural thickening was observed at the level of the cardia consistent with a diagnosis of a hiatal hernia. Although clinical improvement was noted with medical therapy and tube feeding, surgical correction of the hiatal hernia was considered necessary for full resolution. However, owing to the animal's low body weight, the corrective hernia surgery was postponed until the body condition improved. The seal needed to be surgically treated for a corneal ulcer, and while anesthetized with isoflurane, the seal became dyspneic and developed cardiac arrhythmias; ultimately cardiac arrest ensued. Resuscitation was unsuccessfully attempted and the seal was euthanized. Necropsy confirmed the radiographic diagnosis and further characterized a paraesophageal hiatal hernia.

  10. Ultrasound Prenatal Diagnosis of Inguinal Scrotal Hernia and Contralateral Hydrocele

    PubMed Central

    Massaro, G.; Sglavo, G.; Cavallaro, A.; Pastore, G.; Nappi, C.; Di Carlo, C.

    2013-01-01

    Fetal inguinal scrotal hernia is a rare condition resulting in an abnormal embryonic process of the tunica vaginalis. We report a case of ultrasound prenatal diagnosis of inguinal scrotal hernia associated with contralateral hydrocele in a woman at 37 weeks of gestation, referred to our clinic for a scrotal mass. Differential diagnosis includes hydrocele, teratoma, hemangiomas, solid tumours of testis, bowel herniation, and testicular torsion. Bowel peristalsis is an important ultrasound sign and it allowed us to make diagnosis of inguinal scrotal hernia. Diagnosis was confirmed at birth and a laparoscopic hernia repair was performed without complications on day 10. During surgery, a bilateral defect of canal inguinal was seen and considered as the cause of scrotal inguinal hernia and contralateral hydrocele observed in utero. PMID:24455356

  11. [Orbital hernias: new views of the pathogenesis, possibilities of correction].

    PubMed

    Lutsevich, E E

    2006-01-01

    The paper deals with the basic pathogenetic aspects of development of orbital hernias--the factors of a tarsoorbital fascial change in the presence of the hereditary syndrome of connective tissue hyperplasticity and elevated intraorbital pressure, which affects the volume of orbital fat. The possibilities of a differential diagnosis of orbital hernias and eyelid edemas are considered. There is a biomechanical association of orbital hernias with acquired age-related enophthalmos. The examples of impairments in the tolerance of the optic nerve and in the development of optic neuropathy in enophthalmos are considered. The fact that there may be tarsoorbital fascial lesions, followed by the development of orbital hernias after parabulbar injections is indicated. The author proposes an operation dealing with the reposition of orbital hernias instead of their resection during blepharoplastic interventions. PMID:17217192

  12. Association Between Thoracic Aortic Disease and Inguinal Hernia

    PubMed Central

    Olsson, Christian; Eriksson, Per; Franco‐Cereceda, Anders

    2014-01-01

    Background The study hypothesis was that thoracic aortic disease (TAD) is associated with a higher‐than‐expected prevalence of inguinal hernia. Such an association has been reported for abdominal aortic aneurysm (AAA) and hernia. Unlike AAA, TAD is not necessarily detectable with clinical examination or ultrasound, and there are no population‐based screening programs for TAD. Therefore, conditions associated with TAD, such as inguinal hernia, are of particular clinical relevance. Methods and Results The prevalence of inguinal hernia in subjects with TAD was determined from nation‐wide register data and compared to a non‐TAD group (patients with isolated aortic stenosis). Groups were balanced using propensity score matching. Multivariable statistical analysis (logistic regression) was performed to identify variables independently associated with hernia. Hernia prevalence was 110 of 750 (15%) in subjects with TAD versus 29 of 301 (9.6%) in non‐TAD, P=0.03. This statistically significant difference remained after propensity score matching: 21 of 159 (13%) in TAD versus 14 of 159 (8.9%) in non‐TAD, P<0.001. Variables independently associated with hernia in multivariable analysis were male sex (odds ratio [OR] with 95% confidence interval [95% CI]) 3.4 (2.1 to 5.4), P<0.001; increased age, OR 1.02/year (1.004 to 1.04), P=0.014; and TAD, OR 1.8 (1.1 to 2.8), P=0.015. Conclusions The prevalence of inguinal hernia (15%) in TAD is higher than expected in a general population and higher in TAD, compared to non‐TAD. TAD is independently associated with hernia in multivariable analysis. Presence or history of hernia may be of importance in detecting TAD, and the association warrants further study. PMID:25146705

  13. Spigelian hernia: surgical anatomy, embryology, and technique of repair.

    PubMed

    Skandalakis, Panagiotis N; Zoras, Odyseas; Skandalakis, John E; Mirilas, Petros

    2006-01-01

    Spigelian hernia (1-2% of all hernias) is the protrusion of preperitoneal fat, peritoneal sac, or organ(s) through a congenital or acquired defect in the spigelian aponeurosis (i.e., the aponeurosis of the transverse abdominal muscle limited by the linea semilunaris laterally and the lateral edge of the rectus muscle medially). Mostly, these hernias lie in the "spigelian hernia belt," a transverse 6-cm-wide zone above the interspinal plane; lower hernias are rare and should be differentiated from direct inguinal or supravescical hernias. Although named after Adriaan van der Spieghel, he only described the semilunar line (linea Spigeli) in 1645. Josef Klinkosch in 1764 first defined the spigelian hernia as a defect in the semilunar line. Defects in the aponeurosis of transverse abdominal muscle (mainly under the arcuate line and more often in obese individuals) have been considered as the principal etiologic factor. Pediatric cases, especially neonates and infants, are mostly congenital. Embryologically, spigelian hernias may represent the clinical outcome of weak areas in the continuation of aponeuroses of layered abdominal muscles as they develop separately in the mesenchyme of the somatopleura, originating from the invading and fusing myotomes. Traditionally, repair consists of open anterior herniorraphy, using direct muscle approximation, mesh, and prostheses. Laparoscopy, preferably a totally extraperitoneal procedure, or intraperitoneal when other surgical repairs are planned within the same procedure, is currently employed as an adjunct to diagnosis and treatment of spigelian hernias. Care must be taken not to create iatrogenic spigelian hernias when using laparoscopy trocars or classic drains in the spigelian aponeurosis.

  14. Photoelastic analysis to compare implant-retained and conventional obturator dentures.

    PubMed

    Goiato, Marcelo Coelho; Ribeiro, Paula do Prado; Pellizzer, Eduardo Piza; Pesqueira, Aldiéris Alves; Haddad, Marcela Filiè; dos Santos, Daniela Micheline; Moreno, Amália

    2012-06-01

    The use of photoelastic analysis contributes to the rehabilitation of patients with oral-sinus-nasal sequelae, which in turn affect important functions such as chewing, swallowing, and speech. The prosthetic rehabilitation with implant-retained dentures is a suitable treatment option. The purpose of this study was to verify, by using a photoelastic analysis, the stress distribution in implant-retained palatal obturator dentures (relined or not) associated with different attachment systems (O-ring, bar-clip, and bar-clip associated with distally placed O-rings). Two photoelastic models were obtained from an experimental maxillary cast presenting an oral-nasal communication. One model had two 13-mm length implants placed on the left region. A total of eight colorless maxillary obturators were fabricated and subsequently four of them were relined with soft silicone soft, and three had attachment systems associated. The assembly (model/attachment system/prosthesis) was positioned in a circular polariscope and a 100-N load was applied at 10 mm/s. The results showed that the denture relining influenced the distribution and amount of stress on the models. The O-ring group displayed the lowest stress levels, followed by bar-clip system associated with distally placed O-rings and bar-clip groups. PMID:22734733

  15. Photoelastic analysis to compare implant-retained and conventional obturator dentures

    NASA Astrophysics Data System (ADS)

    Goiato, Marcelo Coelho; Prado Ribeiro, Paula do; Pellizzer, Eduardo Piza; Pesqueira, Aldiéris Alves; Haddad, Marcela Filiè; dos Santos, Daniela Micheline; Moreno, Amália

    2012-06-01

    The use of photoelastic analysis contributes to the rehabilitation of patients with oral-sinus-nasal sequelae, which in turn affect important functions such as chewing, swallowing, and speech. The prosthetic rehabilitation with implant-retained dentures is a suitable treatment option. The purpose of this study was to verify, by using a photoelastic analysis, the stress distribution in implant-retained palatal obturator dentures (relined or not) associated with different attachment systems (O-ring, bar-clip, and bar-clip associated with distally placed O-rings). Two photoelastic models were obtained from an experimental maxillary cast presenting an oral-nasal communication. One model had two 13-mm length implants placed on the left region. A total of eight colorless maxillary obturators were fabricated and subsequently four of them were relined with soft silicone soft, and three had attachment systems associated. The assembly (model/attachment system/prosthesis) was positioned in a circular polariscope and a 100-N load was applied at 10 mm/s. The results showed that the denture relining influenced the distribution and amount of stress on the models. The O-ring group displayed the lowest stress levels, followed by bar-clip system associated with distally placed O-rings and bar-clip groups.

  16. Penetration of a resin-based filling material into lateral root canals and quality of obturation by different techniques.

    PubMed

    Michelotto, André Luiz da Costa; Moura-Netto, Cacio; Araki, Angela Toshie; Akisue, Eduardo; Sydney, Gilson Blitzkow

    2015-01-01

    The aim of this study was to evaluate the penetration of a resin/polyester polymer-based material (Resilon Real Seal; SybronEndo Corp., Orange, USA) into simulated lateral canals, and the quality of obturations by different techniques. A total of 30 standardized simulated canals were divided into three groups according to the technique of obturation used: MS (McSpadden), SB (SystemB/Obtura II), and LC (Lateral Condensation). To analyze the penetration of the filling material, the simulated canals were digitalized and the images were analyzed using the Leica QWIN Pro v2.3 software. The data of the middle and apical thirds were separately submitted to analysis of variance (ANOVA), followed by the Tukey's test for the comparison of the techniques. Results showed a significant difference (p < 0.05) between groups (LC < SB) in the middle third, and a significant difference (p < 0.05) between groups (LC < SB and MS < SB) in the apical third. To analyze the quality of the obturations, the canals were radiographed and evaluated by three examiners. The Kappa test on interexaminer agreement and the nonparametric Kruskal-Wallis test indicated no significant difference between filling techniques. It was concluded that Resilon achieves greater levels of penetration when associated with thermoplastic obturation techniques.

  17. Penetration of a resin-based filling material into lateral root canals and quality of obturation by different techniques.

    PubMed

    Michelotto, André Luiz da Costa; Moura-Netto, Cacio; Araki, Angela Toshie; Akisue, Eduardo; Sydney, Gilson Blitzkow

    2015-01-01

    The aim of this study was to evaluate the penetration of a resin/polyester polymer-based material (Resilon Real Seal; SybronEndo Corp., Orange, USA) into simulated lateral canals, and the quality of obturations by different techniques. A total of 30 standardized simulated canals were divided into three groups according to the technique of obturation used: MS (McSpadden), SB (SystemB/Obtura II), and LC (Lateral Condensation). To analyze the penetration of the filling material, the simulated canals were digitalized and the images were analyzed using the Leica QWIN Pro v2.3 software. The data of the middle and apical thirds were separately submitted to analysis of variance (ANOVA), followed by the Tukey's test for the comparison of the techniques. Results showed a significant difference (p < 0.05) between groups (LC < SB) in the middle third, and a significant difference (p < 0.05) between groups (LC < SB and MS < SB) in the apical third. To analyze the quality of the obturations, the canals were radiographed and evaluated by three examiners. The Kappa test on interexaminer agreement and the nonparametric Kruskal-Wallis test indicated no significant difference between filling techniques. It was concluded that Resilon achieves greater levels of penetration when associated with thermoplastic obturation techniques. PMID:25466332

  18. Coronal Microleakage of the Resilon and Gutta-Percha Obturation Materials with Epiphany SE Sealer: An in-vitro Study

    PubMed Central

    Al-Maswary, Arwa Ahmed; Alhadainy, Hatem Abdel-Hameed

    2016-01-01

    Introduction The coronal leakage of bacteria and other irritants to the root canal system is one of the main factors that may result in clinical failure and affect the long term success of endodontic treatment. The Resilon/Epiphany obturation system has been developed as an alternative to gutta-percha and traditional sealers. Aim This study aimed to evaluate and compare the coronal leakage between Resilon obturation material and gutta-percha using the same sealer. Materials and Methods In this in-vitro study, 72 freshly extracted single-rooted human teeth were used, and were sectioned at CEJ with 13mm length. The roots were randomly divided into four groups. In Group I, 30 roots were obturated using Resilon and Epiphany SE sealer, Group II, 30 roots were obturated using gutta-percha and Epiphany SE. Group III and Group IV, 12 roots were used as control groups (positive and negative). The coronal leakage was measured using the dye penetration technique. Data were statistically analysed by a One-Way ANOVA test. Results There was a significant difference between the two experimental groups where Resilon revealed less microleakage than gutta-percha group (p <0.05). Conclusion Resilon is a suitable replacement for gutta-percha on the basis of its increased resistance to microleakage, but it failed to provide complete hermetic coronal sealing. PMID:27437358

  19. Ability of New Obturation Materials to Improve the Seal of the Root Canal System – A Review

    PubMed Central

    Zhang, Wei; Olsen, Mark; De-Deus, Gustavo; Eid, Ashraf A.; Chen, Ji-hua; Pashley, David H.; Tay, Franklin R.

    2014-01-01

    Objectives New obturation biomaterials have been introduced over the past decade to improve the seal of the root canal system. However, it is not clear whether they have really produced a three-dimensional impervious seal that is important for reducing diseases associated with root canal treatment. Methods A review of the literature was performed to identify models that have been employed for evaluating the seal of the root canal system. Results and Significance In-vitro and in-vivo models are not totally adept at quantifying the seal of root canals obturated with classic materials. Thus, one has to resort to clinical outcomes to examine whether there are real benefits associated with the use of recently-introduced materials for obturating root canals. However, there is no facile answer because endodontic treatment outcomes are influenced by a host of other predictors that are more likely to take precedence over the influence of obturation materials. From the perspective of clinical performance, classic root filling materials have stood the test of time. Because many of the recently-introduced materials are so new, there is not enough evidence yet to support their ability to improve clinical performance. This emphasizes the need to translate anecdotal information into clinically relevant research data on new biomaterials. PMID:24321349

  20. Comparative Evaluation of Three Different Obturating Techniques Lateral Compaction, Thermafil and Calamus for Filling Area and Voids Using Cone Beam Computed Tomography: An Invitro study

    PubMed Central

    Dhingra, Anil; Panwar, Nidhi R

    2015-01-01

    Introduction The success of root canal treatment depends upon the proper sealing of root canal system. Improper apical seal leads to the microleakage which can be prevented by proper obturation technique. Aim To compare the quality of three different root canal obturation techniques: lateral compaction, Thermafil and Calamus by using cone beam computed tomography. Materials and Methods A total of 30 central incisors were selected. Biomechanical preparation was done by Reciproc file no 25. Teeth were divided into 3 groups of 10 teeth each according to the obturation technique i.e. Calamus, Thermafil and lateral compaction. Cone beam computed tomography was used to measure filling area and voids at coronal, middle and apical third of the root canal after obturation by different techniques. Data was statistically analysed by One-Way Anova and multiple comparison of Tukey HSD tests. Result The maximum amount of obturating material was observed in Calamus group followed by Thermafil and lateral compaction. Minimum voids were seen in obturation by Calamus technique. Conclusion Within the limitations of this study, it can be concluded that Calamus may be a good obturation technique. PMID:26436038

  1. Return to Play After Sports Hernia Surgery.

    PubMed

    Choi, Ho-Rim; Elattar, Osama; Dills, Vickie D; Busconi, Brian

    2016-10-01

    Sports hernia is a condition that causes acute/chronic pain of low abdominal, groin, or adductor area in athletes. It is considered a weakness in the rectus abdominis insertion or posterior inguinal wall of lower abdomen caused by acute or repetitive injury of the structure. It is most commonly seen in soccer, ice hockey, and martial arts players who require acute cutting, pivoting, or kicking. A variety of surgical options have been reported with successful outcome and with high rates of return to the sports in a majority of cases. PMID:27543403

  2. Genetic aspects of human congenital diaphragmatic hernia

    PubMed Central

    Pober, BR

    2010-01-01

    Congenital diaphragmatic hernia (CDH) is a common major malformation affecting 1/3000–1/4000 births, which continues to be associated with significant perinatal mortality. Much current research is focused on elucidating the genetics and pathophysiology contributing to CDH to develop more effective therapies. The latest data suggest that many cases of CDH are genetically determined and also indicate that CDH is etiologically heterogeneous. The present review will provide a brief summary of diaphragm development and model organism work most relevant to human CDH and will primarily describe important human phenotypes associated with CDH and also provide recommendations for diagnostic evaluation of a fetus or infant with CDH. PMID:18510546

  3. Coexistent Congenital Diaphragmatic Hernia with Extrapulmonary Sequestration

    PubMed Central

    Kawamura, Nao; Bhandal, Samarjeet

    2016-01-01

    Bronchopulmonary foregut malformations are a heterogeneous but interrelated group of abnormalities that may contain more than one histologic feature. It is helpful to be familiar with the presentation and imaging features of bronchopulmonary foregut malformations presenting as a congenital mass or mass-like lesion, as imaging plays a central role in the evaluation of these lesions since, when symptomatic, clinical features are usually nonspecific. With imaging, the presence of other associated lesions can be determined, facilitating appropriate management to prevent the potential complications. We report a case of coexisting extralobar pulmonary sequestration and ipsilateral diaphragmatic hernia in a term neonate. PMID:27445516

  4. Sportsman’s hernia? An ambiguous term

    PubMed Central

    Dimitrakopoulou, Alexandra; Schilders, Ernest

    2016-01-01

    Groin pain is common in athletes. Yet, there is disagreement on aetiology, pathomechanics and terminology. A plethora of terms have been employed to explain inguinal-related groin pain in athletes. Recently, at the British Hernia Society in Manchester 2012, a consensus was reached to use the term inguinal disruption based on the pathophysiology while lately the Doha agreement in 2014 defined it as inguinal-related groin pain, a clinically based taxonomy. This review article emphasizes the anatomy, pathogenesis, standard clinical assessment and imaging, and highlights the treatment options for inguinal disruption. PMID:27026822

  5. Hernia of Morgagni--case report.

    PubMed

    Zadro, Zvonko; Frketić, Ivan; Boban, Zdenko; Zadro, Ana Sostarić; Fudurić, Jurica; Veir, Zoran; Jurjević, Zoran

    2012-12-01

    Morgagni's hernia is result of penetration of the abdominal contents into the chest through an anterior retrocostoxiphoid defect in the anterior midline of the diaphragm. It can be manifested with symptoms since birth as a bloated feeling, nausea and belching after meals. We present a patient with symptomatic herniation of the torqued antral part of stomach and loops of the transverse colon. In our case, chest and abdominal radiography after oral intake of contrast are used to diagnose this condition. Herniation was reduced surgically by a transabdominal approach. At the control examination one year after surgery in our patient all symptoms have disappeared, and was given 15 kg of body weight. PMID:23390852

  6. Umbilical hernia in patients with liver cirrhosis: A surgical challenge

    PubMed Central

    Coelho, Julio C U; Claus, Christiano M P; Campos, Antonio C L; Costa, Marco A R; Blum, Caroline

    2016-01-01

    Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites. Hernia repair is indicated in patients in whom medical treatment is effective in controlling ascites. Patients who have a good perspective to be transplanted within 3-6 mo, herniorrhaphy should be performed during transplantation. Hernia repair with mesh is associated with lower recurrence rate, but with higher surgical site infection when compared to hernia correction with conventional fascial suture. There is no consensus on the best abdominal wall layer in which the mesh should be placed: Onlay, sublay, or underlay. Many studies have demonstrated several advantages of the laparoscopic umbilical herniorrhaphy in cirrhotic patients compared with open surgical treatment. PMID:27462389

  7. Management of inguinal hernia in premature infants: 10-year experience

    PubMed Central

    Crankson, Stanley John; Al Tawil, Khalil; Al Namshan, Mohammad; Al Jadaan, Saud; Baylon, Beverly Jane; Gieballa, Mutaz; Ahmed, Ibrahim Hakim

    2015-01-01

    Aim: Debatable issues in the management of inguinal hernia in premature infants remain unresolved. This study reviews our experience in the management of inguinal hernia in premature infants. Materials and Methods: Retrospective chart review of premature infants with inguinal hernia from 1999 to 2009. Infants were grouped into 2: Group 1 had repair (HR) just before discharge from the neonatal intensive care unit (NICU) and Group 2 after discharge. Results: Eighty four premature infants were identified. None of 23 infants in Group 1 developed incarcerated hernia while waiting for repair. Of the 61 infants in Group 2, 47 (77%) underwent day surgery repair and 14 were admitted for repair. At repair mean postconceptional age (PCA) in Group1 was 39.5 ± 3.05 weeks. Mean PCA in Group 2 was 66.5 ± 42.73 weeks for day surgery infants and 47.03 ± 8.87 weeks for admitted infants. None of the 84 infants had an episode of postoperative apnea. Five (5.9%) infants presented subsequently with metachronous contralateral hernia and the same number of infants had hernia recurrence. Conclusions: Delaying HR in premature infants until ready for discharge from the NICU allows for repair closer to term without increasing the risk of incarceration. Because of low occurrence of metachronous hernia contralateral inguinal exploration is not justified. Day surgery HR can be performed in former premature infant if PCA is >47 weeks without increasing postoperative complications. PMID:25552826

  8. Quality of Obturation Achieved by an Endodontic Core-carrier System with Crosslinked Gutta-percha Carrier in Single-rooted Canals

    PubMed Central

    Li, Guo-hua; Niu, Li-na; Selem, Lisa C.; Eid, Ashraf A.; Bergeron, Brian E.; Chen, Ji-hua; Pashley, David H.; Tay, Franklin R.

    2014-01-01

    Objectives The present study examined the quality of obturation in root canals obturated by GuttaCore, a gutta-percha-based core-carrier system with a cross-linked thermoset gutta-percha carrier, by comparing the incidence of gaps and voids identified from similar canals obturated by cold lateral compaction or warm vertical compaction. Methods Thirty single-rooted premolars with oval-shaped canals were shaped and cleaned, and obturated with one of the three obturation techniques (N=10): GuttaCore, warm vertical compaction or cold lateral compaction. Filled canals were scanned with micro-computed tomography (micro-CT); reconstructed images were analysed for the volumetric percentage of gaps and voids at 3 canal levels (0-4 mm, 4-8 mm and 8-12 mm from working length). The roots were subsequently sectioned at the 4-mm, 8-mm and 12-mm levels for analyses of the percentage of interfacial gaps, and area percentage of interfacial and intracanal voids, using scanning electron microscopy (SEM) to examine negative replicas of root sections. Data were analysed with parametric or non-parametric statistical methods at α=0.05. Results Both micro-CT and SEM data indicated that canals obturated with GuttaCore core-carriers had the lowest incidence of interfacial gaps and voids, although the results were not significantly different from canals obturated by warm vertical compaction. Both the GuttaCore and the warm vertical compaction groups, in turn, had significantly lower incidences of gaps and voids than the cold lateral compaction group. Conclusions Because of the similarity in obturation quality between GuttaCore and warm vertical compaction, practitioners may find the GuttaCore core-carrier technique a valuable alternative for obturation of oval-shaped canals. PMID:24769108

  9. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era.

    PubMed

    Esposito, Ciro; Escolino, Maria; Turrà, Francesco; Roberti, Agnese; Cerulo, Mariapina; Farina, Alessandra; Caiazzo, Simona; Cortese, Giuseppe; Servillo, Giuseppe; Settimi, Alessandro

    2016-08-01

    The surgical repair of inguinal hernia and hydrocele is one of the most common operations performed in pediatric surgery practice. This article reviews current concepts in the management of inguinal hernia and hydrocele based on the recent literature and the authors׳ experience. We describe the principles of clinical assessment and anesthetic management of children undergoing repair of inguinal hernia, underlining the differences between an inguinal approach and minimally invasive surgery (MIS). Other points discussed include the current management of particular aspects of these pathologies such as bilateral hernias; contralateral patency of the peritoneal processus vaginalis; hernias in premature infants; direct, femoral, and other rare hernias; and the management of incarcerated or recurrent hernias. In addition, the authors discuss the role of laparoscopy in the surgical treatment of an inguinal hernia and hydrocele, emphasizing that the current use of MIS in pediatric patients has completely changed the management of pediatric inguinal hernias. PMID:27521714

  10. [Basic principles of surgical treatment of recurrent inguinal hernias].

    PubMed

    Michalský, R

    2001-04-01

    The incidence of the recurrences after groin hernia operation can be surprisingly high. Both basic principles of the surgical treatment (tension on, tension free) of this disease are known more than 30 years. It seems, that the latest endoscopic-laparoscopic proceedings have smaller recurrences. However long-term results are absent for more than 10 years from the prime surgery. In the report the basic principles of prime groin hernia surgery are mentioned, both classical transinguinal operation and endoscopic surgery. In the end the fundamental scheme is introduced--how to proceed in surgical treatment of groin hernia recurrences.

  11. Congenital spigelian hernia and cryptorchidism: another case of new syndrome.

    PubMed

    Parihar, Dhiraj; Kadian, Yogender Singh; Raikwar, Preeti; Rattan, Kamal Nain

    2013-01-01

    Spigelian hernia (SH) is rarely seen in pediatric age group and is usually associated with cryptorchidism on the same side; termed as a syndromic association of the defect in the Spigelian fascia and absence of gubernaculum and inguinal canal. The absence of the inguinal canal has surgical implication as to placement of the undescended testis into the scrotum. A 3-month-old baby presented with spigelian hernia and ipsilateral impalpable testis. The spigelian hernia was repaired and undescended testis which was present in abdominal wall layers was brought to scrotum with cord structures anterior to external oblique muscle.

  12. Sportsman hernia; the review of current diagnosis and treatment modalities

    PubMed Central

    Paksoy, Melih; Sekmen, Ümit

    2016-01-01

    Groin pain is an important clinical entity that may affect a sportsman’s active sports life. Sportsman’s hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman’s hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman’s hernia at our hospital between 2011–2014, in light of current literature. PMID:27436937

  13. Chest wall reconstruction after resection using hernia repair piece.

    PubMed

    Wu, Yimin; Zhang, Guofei; Zhu, Zhouyu; Chai, Ying

    2016-06-01

    Reconstruction of chest wall tumor is very important link of chest wall tumor resection. Many implants have been reported to be used to reconstruct the chest wall, such as steelwire, titanium mesh and polypropylene mesh. It is really hard for clinicians to decide which implant is the best one to replace the chest wall. We herein report a 68-year-old man who had underwent a chest wall reconstruction with a hernia repair piece and a Dacron hernia repair piece. The patient has maintained an excellent cosmetic and functional outcome since surgery, which proves that the hernia piece still has its place in reconstruction of chest wall. PMID:27293859

  14. [CLINICO-EXPERIMENTAL SUBSTANTIATION OF INTRAABDOMINAL PLASTY FOR UMBILICAL HERNIAS].

    PubMed

    Joffe, O Yu; Shvets, I M; Tarasyuk, T V; Stetsenko, O P; Tsyura, Yu P

    2015-04-01

    The impact of various methods of plasty, using net implants, on results of umbilical hernias treatment was studied in experimental and clinical investigation. The umbilical hernias plasty was performed in accordance to the IPOM (intraperitoneal on lay mesh) method, application of which have permitted to reduce a hospital stay of the patients as well as their period of social rehabilitation, and to guarantee the best cosmetic effect in comparison with such while making umbilical hernias plasty in accordance to a sub lay method. PMID:26263641

  15. Incarcerated small bowel within a spontaneous lumbar hernia.

    PubMed

    Teo, K A T; Burns, E; Garcea, G; Abela, J E; McKay, C J

    2010-10-01

    Lumbar hernias are rare, resulting from protrusion through the posterior abdominal wall that may be congenital, acquired or spontaneous. They very rarely present with acute bowel obstruction. We present a case of incarcerated small bowel within a spontaneous inferior (Petit's) lumbar hernia, treated by early open repair with mesh insertion. This case highlights the importance of thorough clinical examination and a high index of suspicion, even in the absence of previous surgery around the anatomical site of the suspected hernia, in order to effect an early repair before the onset of ischaemia in incarcerated contents.

  16. Chest wall reconstruction after resection using hernia repair piece

    PubMed Central

    Wu, Yimin; Zhang, Guofei; Zhu, Zhouyu

    2016-01-01

    Reconstruction of chest wall tumor is very important link of chest wall tumor resection. Many implants have been reported to be used to reconstruct the chest wall, such as steelwire, titanium mesh and polypropylene mesh. It is really hard for clinicians to decide which implant is the best one to replace the chest wall. We herein report a 68-year-old man who had underwent a chest wall reconstruction with a hernia repair piece and a Dacron hernia repair piece. The patient has maintained an excellent cosmetic and functional outcome since surgery, which proves that the hernia piece still has its place in reconstruction of chest wall. PMID:27293859

  17. Scratch and abrasion properties of polyurethane-based micro- and nano-hybrid obturation materials.

    PubMed

    Estevez, Miriam; Rodriguez, J Rogelio; Vargas, Susana; Guerra, J A; Brostow, Witold; Lobland, Haley E Hagg

    2013-06-01

    Polyurethane-based micro- and nano-hybrid composites were produced with controlled porosity to be used as obturation materials. In addition to hydroxyapatite (HAp) micro-particles in the composites, two different ceramics particle types were also added: alumina micro-particles and silica nano-particles. Particles of different sizes provide the materials with improved mechanical properties: the use of micro- and nano-particles produces a better packing because the nano-particles fill the interstitial space left by the micro-particles, rendering an improvement in the mechanical properties. The silica and alumina particles provide the materials with appropriate abrasion and scratching properties, while the HAp provides the required bio-acceptance. The polymeric matrix was a mono-component solvent-free polyurethane. The porosity was selected by controlling the chemical reaction.

  18. EVALUATION OF THE APICAL INFILTRATION AFTER ROOT CANAL DISRUPTION AND OBTURATION

    PubMed Central

    Gomes, João Eduardo; Hopp, Renato Nicolás; Bernabé, Pedro Felício Estrada; Nery, Mauro Juvenal; Otoboni, José Arlindo; Dezan, Elói

    2008-01-01

    The aim of this study was to evaluate two root canal filling techniques used in teeth that had their apical foramen disrupted and compare the apical infiltration with an ideal clinical situation. Twenty-seven freshly extracted single-rooted teeth were selected and radiographed to confirm the existence of a single and straight root canal. The crowns were removed at a mean distance of 11 mm from the apex. The teeth had the root canals instrumented and were randomly assigned to 3 groups (n=9): ND group - root canals were filled using the lateral compaction technique and no disruption was performed; DRF group - the apical constriction was disrupted by advancing a #40 K-file 1 mm beyond the original working length, the canals were reinstrumented to create an apical ledge at 1 mm from the apical foramen and were obturated with a master gutta-percha cone with same size as the last file used for reinstrumentation; DF group - the teeth had the apical constriction disrupted and the canals were obturated with a master gutta-percha cone that fit at 1 mm from the apex. The teeth were submitted to dye leakage test with Rhodamine B for 7 days, using vaccum on the initial 5 min. The teeth were sectioned longitudinally and the leakage was measured in a linear fashion from apex to crown. There was no statistically significant difference (p>0.05) between the groups that had the apical foramen disrupted (DF, DRF), but significant difference was found between the disrupted groups and the non-disrupted one (p<0.01). In conclusion, none of the evaluated techniques was able to prevent apical infiltration, so working length so the working length determination has to be established and maintained carefully. PMID:19089232

  19. [Pleural hernia of an esophageal graft--late postoperative complication].

    PubMed

    Grabowski, K; Lewandowski, A; Moroń, K; Strutyńska-Karpińska, M; Błaszczuk, J; Machała, R

    1997-01-01

    Pleural hernia of the oesophageal substitute from pedicled intestinal segment is one of the late postoperative complications. 13 cases of patients with oesophagus reconstructed because of lye ingestion stenosis are presented. Problems concerning diagnosis and treatment of pleural hernia are analysed. Eight patients with minor symptoms were treated conservatively. Five patients were operated, two of them from acute necrosis of the substitute. Necrosis was caused by incarceration of the bowel and torsion of the mesentery. Elective operative treatment consisted of reduction of hernia sac contents, closing of the hernia orifice, chest drainage and temporary gastronomy. In patient operated as an emergency cases necrotic part of substitute was removed. This resulted in oesophageal exclusion in the neck, creating gastronomy. Chest drainage was also performed.

  20. The management of hernias, hydroceles and undescended testes.

    PubMed

    Nuss, D

    1976-03-27

    The management of hernias, hydroceles and undescended testicles is reviewed on the basis of current practice as reported in recent literature and of the author's experience at Addington Hospital, Durban.

  1. Parastomal hernia: a growing problem with new solutions.

    PubMed

    Aquina, Christopher T; Iannuzzi, James C; Probst, Christian P; Kelly, Kristin N; Noyes, Katia; Fleming, Fergal J; Monson, John R T

    2014-01-01

    Parastomal hernia is one of the most common complications following stoma creation and its prevalence is only expected to increase. It often leads to a decrease in the quality of life for patients due to discomfort, pain, frequent ostomy appliance leakage, or peristomal skin irritation and can result in significantly increased healthcare costs. Surgical technique for parastomal hernia repair has evolved significantly over the past two decades with the introduction of new types of mesh and laparoscopic procedures. The use of prophylactic mesh in high-risk patients at the time of stoma creation has gained attention in lieu of several promising studies that have emerged in the recent days. This review will attempt to demonstrate the burden that parastomal hernias present to patients, surgeons, and the healthcare system and also provide an overview of the current management and surgical techniques at both preventing and treating parastomal hernias. PMID:25531238

  2. Pantaloon Hernia: Obstructed Indirect Component and Direct Component with Cryptorchidism.

    PubMed

    Kariappa, Mohan Kumar; Harihar, Vivek; Kothudum, Ashwini Rajareddy; Hiremath, Vivekanand Kedarlingayya

    2016-01-01

    Cryptorchidism is a condition in which one or both testes have not passed down into the scrotal sac. It is categorized as true undescended testis in which testes are present in the normal path of descent, and as ectopic testis, in which testes are present at abnormal site. Common complications of cryptorchidism are testicular torsion, subfertility, inguinal hernia, and testicular cancer. Here we present a rare case of pantaloon hernia of obstructed indirect component and direct component with cryptorchidism. PMID:27579208

  3. WSES guidelines for emergency repair of complicated abdominal wall hernias

    PubMed Central

    2013-01-01

    Emergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of Emergency Surgery with the goal of defining recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. PMID:24289453

  4. Laparoscopic Hiatal Hernia Repair in 221 Patients: Outcomes and Experience

    PubMed Central

    Thackeray, Lisa

    2016-01-01

    Background and Objectives: Hiatal hernia is a common condition often associated with symptomatic gastroesophageal reflux disease (GERD). The objectives of this study were to examine the efficacy and safety of laparoscopic hiatal hernia repair (LHHR) with biologic mesh to reduce and/or alleviate GERD symptoms and associated hiatal hernia recurrence. Methods: We retrospectively reviewed consecutive LHHR procedures with biologic mesh performed by a single surgeon from July 2009 to October 2014. The primary efficacy outcome measures were relief from GERD symptoms, as measured according to the GERD–health-related quality-of-life (GERD-HRQL) scale and hiatal hernia recurrence. A secondary outcome measure was overall safety of the procedure. Results: A total of 221 patients underwent LHHR with biologic mesh during the study period, and pre- and postoperative GERD-HRQL studies were available for 172 of them. At baseline (preoperative), the mean GERD-HRQL score for all procedures was 18.5 ± 14.4. At follow-up (mean, 14.5 ± 11.0 months [range, 2.0–56.0]), the score showed a statistically significant decline to a mean of 4.4 ± 7.5 (P < .0001). To date, 8 patients (3.6%, 8/221) have had a documented anatomic hiatal hernia recurrence. However, a secondary hiatal hernia repair reoperation was necessary in only 1 patient. Most complications were minor (dysphagia, nausea and vomiting). However, there was 1 death caused by a hemorrhage that occurred 1 week after surgery. Conclusions: Laparoscopic hiatal hernia repair using biologic mesh, both with and without a simultaneous bariatric or antireflux procedure, is an efficacious and safe therapeutic option for management of hiatal hernia, prevention of recurrence, and relief of symptomatic GERD. PMID:26884676

  5. Pantaloon Hernia: Obstructed Indirect Component and Direct Component with Cryptorchidism

    PubMed Central

    Kariappa, Mohan Kumar; Hiremath, Vivekanand Kedarlingayya

    2016-01-01

    Cryptorchidism is a condition in which one or both testes have not passed down into the scrotal sac. It is categorized as true undescended testis in which testes are present in the normal path of descent, and as ectopic testis, in which testes are present at abnormal site. Common complications of cryptorchidism are testicular torsion, subfertility, inguinal hernia, and testicular cancer. Here we present a rare case of pantaloon hernia of obstructed indirect component and direct component with cryptorchidism. PMID:27579208

  6. Tissue Expanders in Skin Deficient Ventral Hernias Utilizing Component Separation

    PubMed Central

    Molinar, Vanessa E.; Molinar, Alonso; Palladino, Humberto

    2015-01-01

    Summary: Skin deficient complex ventral hernias are complicated surgical cases that have multimodal approaches. There is no current consensus on the management of those patients who also have concomitant stomas or enterocutaneous fistula. We present 2 cases in which the senior authors were able to apply tissue expanders above and between the abdominal wall in patients with an enterocutaneous fistula or stoma. After expansion and final closure, the patients did not experience recurrent hernias. PMID:26893988

  7. Tissue Expanders in Skin Deficient Ventral Hernias Utilizing Component Separation.

    PubMed

    Agullo, Francisco J; Molinar, Vanessa E; Molinar, Alonso; Palladino, Humberto

    2015-11-01

    Skin deficient complex ventral hernias are complicated surgical cases that have multimodal approaches. There is no current consensus on the management of those patients who also have concomitant stomas or enterocutaneous fistula. We present 2 cases in which the senior authors were able to apply tissue expanders above and between the abdominal wall in patients with an enterocutaneous fistula or stoma. After expansion and final closure, the patients did not experience recurrent hernias. PMID:26893988

  8. Robotic repair of scrotal bladder hernia during robotic prostatectomy.

    PubMed

    Sung, Ee-Rah; Park, Sung Yul; Ham, Won Sik; Jeong, Wooju; Lee, Woo Jung; Rha, Koon Ho

    2008-09-01

    We report a case of scrotal bladder hernia in a 68-year-old man who was also diagnosed with prostate cancer. We fixed the herniated portion of the bladder using robotics after having successfully accomplished robotic prostatectomy. To the best of our knowledge, this is the first case report on simultaneous repair of scrotal bladder hernia and prostate cancer where both pathological findings have been treated with the assistance of robotics at a single operation. PMID:27628264

  9. [Unusual case of pericecal internal hernia of the retrocecal fossa].

    PubMed

    Mascia, G; Scaglione, R; Pessina, R

    1979-12-01

    Prompted by actual observation of one case, the authors call attention to this rare form of pericecal hernia. After a brief recall of pertinent anatomical features, they emphasize the rarity of this of hernia and the difficulty of diagnosing it preoperatively on the basis of clinical semiotics and radiological findings. In the last part of their paper the authors review the possible complications of this disorders and discuss therapeutic methods for its correction.

  10. CLASH-VLT: Strangulation of cluster galaxies in MACS J0416.1-2403 as seen from their chemical enrichment

    NASA Astrophysics Data System (ADS)

    Maier, C.; Kuchner, U.; Ziegler, B. L.; Verdugo, M.; Balestra, I.; Girardi, M.; Mercurio, A.; Rosati, P.; Fritz, A.; Grillo, C.; Nonino, M.; Sartoris, B.

    2016-05-01

    find on average metallicities higher than predicted by the models. This trend is intensified for accreted cluster galaxies of the lowest mass bin (log (M/M⊙) < 9.2), that display metallicities two to three times higher than predicted by models with primordial gas inflow. Environmental effects therefore strongly influence gas regulations and control gas metallicities of log (M/M⊙) < 10.2 cluster galaxies. We also investigate chemical evolutionary paths of model galaxies with and without inflow of gas showing that strangulation is needed to explain the higher metallicities of accreted cluster galaxies. Our results favor a strangulation scenario in which gas inflow stops for galaxies with log (M/M⊙) < 10.2 when accreted by the cluster. Based on observations obtained at the European Southern Observatory (ESO) Very Large Telescope (VLT), Paranal, Chile; ESO large program 186.A-0798.

  11. [Changes of micellarity and lithogenicity of bile under conditions of transcutaneous electrostimulation and enterosorption in patients with obturation jaundice of nontumoral genesis].

    PubMed

    Dronov, O I; Prylutskyĭ, O I

    2010-05-01

    The conduction of pathogenetically substantiated treatment--enterosorption together with procedures of electrostimulation--in patients, suffering obturation jaundice of nontumoral genesis, secures favorable course of postoperative period, the hepatorenal insufficiency prophylaxis, and postcholecystectomy syndrome occurrence as well.

  12. Detection and comparison of nitric oxide in clinically healthy horses and those with naturally acquired strangulating large colon volvulus

    PubMed Central

    2005-01-01

    Abstract The objective of the study was to determine whether nitric oxide (NO) is present in clinically healthy horses (control) under basal conditions, and if it increases secondary to naturally acquired strangulating large colon volvulus (affected). Eleven affected horses and 10 controls were studied. Jugular venous blood, abdominal fluid, and urine were collected. The NO concentrations were standardized to the creatinine concentration in the respective samples. A biopsy specimen collected from the large colon pelvic flexure at surgery was divided into subsections for processing for inducible nitric synthase (iNOS) and nitrotyrosine (NT) immunohistochemical staining and reduced nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase histochemical staining. There were no significant differences in plasma, abdominal fluid, or urine NO concentrations between affected and control horses. There was a significant decrease in submucosal arteriolar and venular endothelium, submucosal plexus, mucosal leukocyte, mucosal and musclaris vasculature, and myenteric plexus NADPH diaphorase staining in affected versus control horses. There was a significant increase in iNOS staining in mucosal leukocytes and vasculature in affected versus control horses. Other than a greater number of positively stained mucosal leukocytes in affected horses, there were no significant differences between affected and control horses for NT staining. The presence of NADPH diaphorase staining in the endothelium and submucosal neurons suggests endothelial and neuronal NOS are present under basal conditions in the large colon of horses. Increased iNOS and NT staining in mucosal leukocytes of affected horses suggests involvement of the NO pathway in large colon volvulus. The reasons for the lack of a significant difference in plasma, abdominal fluid, and urine NO concentrations between affected and control horses are unknown. PMID:15971674

  13. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    PubMed Central

    Nomura, Tsutomu; Matsuda, Akihisa; Takao, Yoshimune

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain. PMID:27635414

  14. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    PubMed Central

    Nomura, Tsutomu; Matsuda, Akihisa; Takao, Yoshimune

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

  15. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study.

    PubMed

    Matsutani, Takeshi; Nomura, Tsutomu; Hagiwara, Nobutoshi; Matsuda, Akihisa; Takao, Yoshimune; Uchida, Eiji

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40-132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain. PMID:27635414

  16. Supraesophageal complications of reflux disease and hiatal hernia.

    PubMed

    Kahrilas, P J

    2001-12-01

    A unifying theme of gastroesophageal reflux disease (GERD) is increased acid exposure on vulnerable epithelia. In most cases, the vulnerable epithelium is the esophagus, but alternatively it may be that of the supraesophageal terrain, which includes the larynx, pharynx, and airways. In 50% to 94% of patients with GERD, hiatal hernia is a significant pathophysiologic factor. The esophagogastric junction (EGJ) is anatomically and physiologically complex, making it vulnerable to dysfunction by several mechanisms, including transient relaxations of the lower esophageal sphincter (LES), hypotensive LES, and anatomic disruption. The importance of hiatal hernia is obscured by imprecise use of the term and by the misconception that it is an all-or-none, one-dimensional phenomenon. Rather, hiatal hernia can be viewed as a continuum of progressive disruption of the EGJ, with larger hernias being of greater significance and invoking several pathogenetic mechanisms. The dynamic anatomy of the EGJ highlights the difficulty of defining hiatal hernia and of elucidating the relation between hiatal hernia, the diaphragmatic hiatus, the LES, and GERD, including supraesophageal reflux.

  17. [Abdominal wall closure by incisional hernia and herniation after laparostoma].

    PubMed

    Mischinger, H-J; Kornprat, P; Werkgartner, G; El Shabrawi, A; Spendel, S

    2010-03-01

    As hernias and abdominal wall defects have a variety of etiologies each with its own complications and comorbidities in various constellations, efficient treatment requires patient-oriented management. There is no recommended standard treatment and the very different clinical pictures demand an individualized interdisciplinary approach. Particularly in the case of complicated hernias, the planning of the operation should focus on the problems posed by the individual patient. Treatment mainly depends on the etiology of the hernia, immediate or long-term complications and the efficiency of individual repair techniques. Abdominal wall repair for recurrent herniation requires direct closure of the fascia generally using the sublay technique with a lightweight mesh. It is still unclear whether persistent inflammation, mesh dislocation, fistula formation or other long-term complications are due to certain materials or to the surgical technique. With mesh infections it has been shown to be advantageous to remove a polytetrafluoroethylene (PTFE) mesh, while the combination of systemic and local treatment appears to suffice for a polypropylene or polyester mesh. Heavier meshes in the sublay position or plastic reconstruction with autologous tissue are indicated as substitutes for the abdominal wall for giant hernias, repeated recurrences and large abdominal wall defects. A laparostoma is increasingly more often created to treat septic intra-abdominal processes but is very often responsible for a complicated hernia. If primary repair of the abdominal wall is not an option, resorbable material or split skin is used for coverage under the auspices of a planned hernia repair.

  18. Hybrid technique for postoperative ventral hernias – own experience

    PubMed Central

    Okniński, Tomasz; Pawlak, Jacek

    2015-01-01

    Introduction There are many techniques which may be involved in abdominal hernia repair, from classical to tension-free. Treatment of complicated hernias has undergone evolution. Many surgeons consider the laparoscopic method as a method of choice for incisional hernia repair. Sometimes miniinvasive repair of complicated hernia is not so easy to perform. We are convinced that selected patients may benefit from combined open and laparoscopic techniques. Aim To present the operating technique and early results of treatment of 15 patients operated on using the 3 hybrid technique. Material and methods Fifteen patients suffering from recurrent incisional hernias underwent the hybrid technique for their repair between June 2012 and April 2015. The hybrid technique was performed using synthetic meshes in 14 cases and a biological implant in 1 case. Results The early postoperative period was uncomplicated in all cases. Within a maximum follow-up period of 32 months, two deep wound infections were observed. Conclusions The hybrid technique may be used in patients with recurrent incisional hernias. PMID:26865889

  19. Insight into the function of the obturator internus muscle in humans: observations with development and validation of an electromyography recording technique.

    PubMed

    Hodges, Paul W; McLean, Linda; Hodder, Joanne

    2014-08-01

    There are no direct recordings of obturator internus muscle activity in humans because of difficult access for electromyography (EMG) electrodes. Functions attributed to this muscle are based on speculation and include hip external rotation/abduction, and a role in stabilization as an "adjustable ligament" of the hip. Here we present (1) a technique to insert intramuscular EMG electrodes into obturator internus plus (2) the results of an investigation of obturator internus activity relative to that of nearby hip muscles during voluntary hip efforts in two hip positions and a weight-bearing task. Fine-wire electrodes were inserted with ultrasound guidance into obturator internus, gluteus maximus, piriformis and quadratus femoris in ten participants. Participants performed ramped and maximal isometric hip efforts (open kinetic chain) into flexion/extension, abduction/adduction, and internal/external rotation, and hip rotation to end range in standing. Analysis of the relationship between activity of the obturator internus and the other hip muscles provided evidence of limited contamination of the recordings with crosstalk. Obturator internus EMG amplitude was greatest during hip extension, then external rotation then abduction, with minimal to no activation in other directions. Obturator internus EMG was more commonly the first muscle active during abduction and external rotation than other muscles. This study describes a viable and valid technique to record obturator internus EMG and provides the first evidence of its activation during simple functions. The observation of specificity of activation to certain force directions questions the hypothesis of a general role in hip stabilisation regardless of force direction.

  20. Insight into the function of the obturator internus muscle in humans: observations with development and validation of an electromyography recording technique.

    PubMed

    Hodges, Paul W; McLean, Linda; Hodder, Joanne

    2014-08-01

    There are no direct recordings of obturator internus muscle activity in humans because of difficult access for electromyography (EMG) electrodes. Functions attributed to this muscle are based on speculation and include hip external rotation/abduction, and a role in stabilization as an "adjustable ligament" of the hip. Here we present (1) a technique to insert intramuscular EMG electrodes into obturator internus plus (2) the results of an investigation of obturator internus activity relative to that of nearby hip muscles during voluntary hip efforts in two hip positions and a weight-bearing task. Fine-wire electrodes were inserted with ultrasound guidance into obturator internus, gluteus maximus, piriformis and quadratus femoris in ten participants. Participants performed ramped and maximal isometric hip efforts (open kinetic chain) into flexion/extension, abduction/adduction, and internal/external rotation, and hip rotation to end range in standing. Analysis of the relationship between activity of the obturator internus and the other hip muscles provided evidence of limited contamination of the recordings with crosstalk. Obturator internus EMG amplitude was greatest during hip extension, then external rotation then abduction, with minimal to no activation in other directions. Obturator internus EMG was more commonly the first muscle active during abduction and external rotation than other muscles. This study describes a viable and valid technique to record obturator internus EMG and provides the first evidence of its activation during simple functions. The observation of specificity of activation to certain force directions questions the hypothesis of a general role in hip stabilisation regardless of force direction. PMID:24788026

  1. Genetic Factors in Congenital Diaphragmatic Hernia

    PubMed Central

    Holder, A. M.; Klaassens, M.; Tibboel, D.; de Klein, A.; Lee, B.; Scott, D. A.

    2007-01-01

    Congenital diaphragmatic hernia (CDH) is a relatively common birth defect associated with high mortality and morbidity. Although the exact etiology of most cases of CDH remains unknown, there is a growing body of evidence that genetic factors play an important role in the development of CDH. In this review, we examine key findings that are likely to form the basis for future research in this field. Specific topics include a short overview of normal and abnormal diaphragm development, a discussion of syndromic forms of CDH, a detailed review of chromosomal regions recurrently altered in CDH, a description of the retinoid hypothesis of CDH, and evidence of the roles of specific genes in the development of CDH. PMID:17436238

  2. Genetics Home Reference: short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething ...

    MedlinePlus

    ... Conditions SHORT syndrome short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething delay Enable Javascript to ... Close All Description Short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething delay , commonly known by ...

  3. Gallstone ileus obstructing within an incarcerated lumbar hernia: an unusual presentation of a rare diagnosis.

    PubMed

    Ziesmann, Markus Tyler; Alotaiby, Nouf; Al Abbasi, Thamer; Rezende-Neto, Joao B

    2014-12-03

    We describe an unusual case of a 74-year-old woman who presented with signs and symptoms of small-bowel obstruction and a clinically appreciable, irreducible, left-sided lumbar hernia associated with previous iliac crest bone graft harvesting. Palpation of the hernia demonstrated a small, firm mass within the loops of herniated bowel. CT scanning recognised an intraluminal gallstone at the transition point, establishing the diagnosis of gallstone ileus within an incarcerated lumbar hernia. The proposed explanatory mechanism is that of a gallstone migrating into an easily reducible hernia containing small bowel causing obstruction at the hernia neck by a ball-valve mechanism, resulting in proximal bowel dilation and thus hernia incarceration; it remains unclear when the stone entered the hernia, and whether it enlarged in situ or prior to entering the enteral tract. This is only the second reported instance in the literature of an intraluminal gallstone causing hernia incarceration.

  4. Plummer-Vinson syndrome associated with chronic blood loss anemia and large diaphragmatic hernia.

    PubMed

    Maleki, Dordaneh; Cameron, Alan J

    2002-01-01

    The coexistence of large diaphragmatic hernia and Plummer-Vinson syndrome in two patients is described. It is proposed that the hernias caused chronic blood loss anemia, and that iron deficiency then resulted in postcricoid web formation.

  5. Obturator internus pyomyositis manifested as sciatica in a patient with subacute bacterial endocarditis: A rare case report.

    PubMed

    Hsu, Wei-Ching; Hsu, Jin-Yi; Chen, Michael Yu-Chih; Liang, Chung-Chao

    2016-07-01

    Pyomyositis is a pyogenic infection of the skeletal muscles causing myalgia and fever in patients. Hematogenous seeding engendered by persistent bacteremia and septic embolism is usually the underlying cause of the disease. Trauma, intravenous drug use, and immunodeficiency are the main predisposing factors.Obturator internus pyomyositis with sciatica has not previously been reported. We report a rare case of a patient with subacute bacterial endocarditis presenting with left buttock pain and sciatica.Computed tomography confirmed the diagnosis of obturator internus pyomyositis. The patient was discharged uneventfully after successful antibiotic treatment.The mortality rate of patients who have pyomyositis comorbid with another condition or disease is extremely high. Early diagnosis and aggressive management are imperative. PMID:27472717

  6. A simple method of enhancing retention in interim hollow bulb obturator in a case of an acquired palatal defect

    PubMed Central

    Karthikeyan, S.; Balu, K.; Devaki, V.; Ajay, R.

    2015-01-01

    Maxillary defects occur either as a result of surgical resection of malignant tumors of the nasal cavity and paranasal sinuses or of the congenital causes. Rehabilitation of the patients with maxillectomy defects presents a challenge in restoring the lost form, function and speech. Maxillary interim obturators in prosthetic reconstruction of the defects are often complicated with lack of adequate retention, stability, and support. This case report presents the simplified approach, to rehabilitate a case of sub-total maxillectomy due to squamous cell carcinoma of maxillary sinus, using a closed hollow bulb obturator prosthesis fabricated with a “U” loop and a modified buccal flange for enhanced retention of the prosthesis. PMID:26538969

  7. Discal hernia in children and teenagers: medical, surgical and recovery treatment.

    PubMed

    Burnei, G; Gavriliu, S; Vlad, C; Georgescu, Ileana; Hurmuz, Lucia; Hodorogea, D

    2006-01-01

    Lumbar disc hernia represents a rare situation for the physician. The first intervention in disc hernia was performed during the '40. The rate of surgery needing lumbar hernia is about 1-2%. Lumbar disc hernia in children and teenagers has 4 main causes: familial history, trauma, congenital malformation of the spine and disc degeneration. The symptoms in young patients are dominated by local or ischiadic irradiated pain, but neurological discrepancies rarely occur. PMID:18386625

  8. Softening of the gutta-percha by laser irradiation and its thermal impact in the canal obturation

    NASA Astrophysics Data System (ADS)

    Ortega-Martínez, Roberto; Rodríguez-Rosales, Antonio; Calzada-Nova, Manuel; Copin-Tovar, Antonio

    1998-08-01

    An Argon Laser was employed as a thermal source for the softening of the guttapercha, which is used in the root canal obturation; the preliminary results showed this technique can be superior when compared with other techniques. The tests of sealing with methylene blue with an average penetration of 0.76 mm is obtained on the walls of the channel, with almost a zero risk on the surrounding tissues by effect of the temperature on the surface of the dental pieces.

  9. Pyomyositis of the obturator internus muscle extending to septic arthritis of the hip in a child: a case report.

    PubMed

    Amari, Rui; Yokoi, Hiromichi

    2014-01-01

    We report a case of primary pyomyositis in the obturator internus muscle. Pyomyositis involving muscles around the hip needs to be differentiated from septic arthritis because these infections show similar symptoms. Management with antibiotics can avoid the need for surgical intervention. Uncontrolled pyomyosistis can cause sequelae such as septic shock, osteomyelitis of adjacent bone, and septic arthritis. Awareness of this condition will facilitate correct diagnosis and early treatment.

  10. Evaluation of the Quality of Obturation with Obtura at Different Sizes of Apical Preparation Through Microleakage Testing

    PubMed Central

    Tanikonda, Rambabu; Sajjan, Girija S.; Lakshmi, B.H. Vijaya; Varma, K. Madhu; Satish, R. Kalyan

    2016-01-01

    Introduction Obturation of the root canal system is required to prevent recontamination of the root canal after cleaning and shaping procedures and to seal the root canal completely, both the apical and coronal avenues of potential leakage and to maintain the disinfected status. Aim The aim of this study was to determine the microleakage by dye leakage method at 1mm, 3mm and 5mm short of the apex with different sizes of apical preparation, obturated by Obtura. Materials and Methods Sixty freshly extracted human single rooted teeth were randomly distributed into six equal groups. Group I (control group) was obturated by lateral compaction technique. Group II to VI were experimental groups (apical preparations done upto ISO sizes 20, 30, 40, 50 and 60 respectively), obturated by Obtura technique. After storing the samples at 100% humidity for seven days and one day in 2% methylene blue, the roots of the teeth were sectioned at 3mm short of the apex. They were observed under stereomicroscope at 20X magnification and the images were analysed for microleakage using the scoring criteria. The data obtained were analysed by One-way ANOVA followed by Tukey pair-wise multiple comparison test and p ≤ 0.05 was considered as the level of significance. Results The lowest mean microleakage score was seen in Group VI (0) and the highest mean leakage score was seen in Group II (1.5). There was statistically significant difference between Group II and Group V (p = 0.044), Group II and Group VI (p = 0.013). There was no significant difference between all the other groups (p> 0.05). Conclusion Comparison of microleakage between different groups from ISO sizes 20-60 recommends a minimum apical preparation of ISO size 30. PMID:27190948

  11. Biomechanical 3-Dimensional Finite Element Analysis of Obturator Protheses Retained with Zygomatic and Dental Implants in Maxillary Defects

    PubMed Central

    Akay, Canan; Yaluğ, Suat

    2015-01-01

    Background The objective of this study was to investigate the stress distribution in the bone around zygomatic and dental implants for 3 different implant-retained obturator prostheses designs in a Aramany class IV maxillary defect using 3-dimensional finite element analysis (FEA). Material\\Methods A 3-dimensional finite element model of an Aramany class IV defect was created. Three different implant-retained obturator prostheses were modeled: model 1 with 1 zygomatic implant and 1 dental implant, model 2 with 1 zygomatic implant and 2 dental implants, and model 3 with 2 zygomatic implants. Locator attachments were used as a superstructure. A 150-N load was applied 3 different ways. Qualitative analysis was based on the scale of maximum principal stress; values obtained through quantitative analysis are expressed in MPa. Results In all loading conditions, model 3 (when compared models 1 and 2) showed the lowest maximum principal stress value. Model 3 is the most appropirate reconstruction in Aramany class IV maxillary defects. Two zygomatic implants can reduce the stresses in model 3. The distribution of stresses on prostheses were more rational with the help of zygoma implants, which can distribute the stresses on each part of the maxilla. Conclusions Aramany class IV obturator prosthesis placement of 2 zygomatic implants in each side of the maxilla is more advantageous than placement of dental implants. In the non-defective side, increasing the number of dental implants is not as suitable as zygomatic implants. PMID:25714086

  12. [A Case of Abdominal Wall Hernia Rupture during Bevacizumab Treatment].

    PubMed

    Sugimoto, Satoshi; Miyazaki, Yasuaki; Hirose, Sou; Michiura, Toshiya; Fujita, Shigeo; Yamabe, Kazuo; Miyazaki, Satoru; Nagaoka, Makio

    2015-11-01

    A 78 -year-old man with rectal cancer underwent abdominoperineal resection of the rectum. In the postoperative period, the patient experienced wound infection, leading to an abdominal wall hernia. Two years following surgery, a rise in the serum CEA level was seen. A metastatic tumor was detected in the right lung on chest CT. VATS right lung inferior lobe segmental resection was performed. After lobectomy, the serum CEA level continued to increase. Another metastatic tumor was detected in the right lung on chest CT. Chemotherapy with capecitabine, oxaliplatin, and bevacizumab was commenced. The erosive part of the abdominal wall scar hernia extended during the nine weeks of chemotherapy. The chemotherapy was then discontinued. In the follow-up CT scan, a right pleural recurrence, local recurrence in the pelvis, and a liver metastasis were detected. Chemotherapy was re-introduced 3 years after surgery. The erosive part of the abdominal wall hernia again began to spread with chemotherapy recommencement. Four months after restarting chemotherapy, the hernia ruptured, with a loop of the small intestine protruding out of it. The patient covered this with a sheet of vinyl and was taken by the ambulance to our hospital. The erosive part of the abdominal wall hernia had split by 10 cm, and a loop of the small intestine was protruding. As ischemia of the small intestine was not observed, we replaced it into the abdominal cavity, and performed a temporary suture repair of the hernia sac. Following this, bevacizumab was discontinued, and the erosive part reduced. We performed a radical operation for abdominal wall scar hernia repair 11 weeks after the discontinuation of bevacizumab. PMID:26805294

  13. Open tension free repair of inguinal hernias; the Lichtenstein technique

    PubMed Central

    Sakorafas, George H; Halikias, Ioannis; Nissotakis, Christos; Kotsifopoulos, Nikolaos; Stavrou, Alexios; Antonopoulos, Constantinos; Kassaras, George A

    2001-01-01

    Background Recurrences have been a significant problem following hernia repair. Prosthetic materials have been increasingly used in hernia repair to prevent recurrences. Their use has been associated with several advantages, such as less postoperative pain, rapid recovery, low recurrence rates. Methods In this retrospective study, 540 tension-free inguinal hernia repairs were performed between August 1994 and December 1999 in 510 patients, using a polypropylene mesh (Lichtenstein technique). The main outcome measure was early and late morbidity and especially recurrence. Results Inguinal hernia was indirect in 55 % of cases (297 patients), direct in 30 % (162 patients) and of the pantaloon (mixed) type in 15 % (81 patients). Mean patient age was 53.7 years (range, 18 – 85). Follow-up was completed in 407 patients (80 %) by clinical examination or phone call. The median follow-up period was 3.8 years (range, 1 – 6 years). Seroma and hematoma formation requiring drainage was observed in 6 and 2 patients, respectively, while transient testicular swelling occurred in 5 patients. We have not observed acute infection or abscess formation related to the presence of the foreign body (mesh). In two patients, however, a delayed rejection of the mesh occurred 10 months and 4 years following surgery. There was one recurrence of the hernia (in one of these patients with late mesh rejection) (recurrence rate = 0.2 %). Postoperative neuralgia was observed in 5 patients (1 %). Conclusion Lichtenstein tension-free mesh inguinal hernia repair is a simple, safe, comfortable, effective method, with extremely low early and late morbidity and remarkably low recurrence rate and therefore it is our preferred method for hernia repair since 1994. PMID:11696246

  14. Management of a giant inguinoscrotal hernia with an ulcerated base in a patient with cardiac disease

    PubMed Central

    Turner, E Jane H; Malhas, Amar; Chisti, Imran; Oke, Tayo

    2010-01-01

    Giant inguinal herniae pose a surgical challenge, though not uncommon in the developing world they are a rare presentation in the UK. We present a patient with cardiac disease who presented with a giant inguino-scrotal hernia complicated by a bleeding scrotal ulcer. We describe his medical management and the surgical repair of the hernia and refashioning of his scrotum. PMID:24946352

  15. An Atypical Case of Right-Sided Bochdalek Hernia in an Adult

    PubMed Central

    Safdar, Syed A.; Jawad, Sami Abdul; Dieguez, Javier; Doraiswamy, Vikram; Kam, Jennifer; Shaaban, Hamid; Miller, Richard A.

    2014-01-01

    Bochdalek hernias are usually congenital in nature and normally present after birth. However, in rare cases, these hernias are present in adulthood. We report an unusual case of a posttraumatic right-sided Bochdalek hernia found incidentally in an adult and treated successfully with conservative management. PMID:25657968

  16. Open reconstruction of sizeable ventral hernias in the laparoscopic era.

    PubMed

    Pavlakis, Emmanouil; Avgerinos, Efthimios; Filippou, Dimitrios; Pikoulis, Emmanouil; Tsatsoulis, Panagiotis; Skandalakis, Panagiotis

    2006-02-01

    The purpose of this study was to review our 15 years of experience in the repair of sizeable ventral hernias with a standardized open surgery technique, to evaluate the clinical outcome, and to assess the decreasing role of traditional surgical techniques in the laparoscopic era. A retrospective study has been conducted, including 200 patients operated for ventral hernia defects with a standardized underlay mesh implantation technique between 1990 and 2004. Their mean age was 62.6 (range 21-88) years and their mean BMI (body mass index) was 33.4 (range 22-69). Out of them, 56 per cent presented one to four major risk factors and 31.5 per cent had previously undergone ventral hernia repair surgery. The mean size of hernial defect was 135.2 (range 24-684) cm2. The mean follow-up was 43 (range 3-174) months. The overall major complication rate was 3.8 per cent and overall recurrence rate was 9.6 per cent. Our retrospective study confirms the safety and efficacy of open reconstruction in complex hernias. Prospective randomized homogenous trials with long-term follow-up are needed to provide us a better evidence-based approach. Minimal invasive surgery is favored but open reconstruction should still be considered as an alternative for sizeable ventral hernias management. A careful selection among patients for selecting the optimal technique is necessary.

  17. Clinical presentation and operative repair of Morgagni hernia

    PubMed Central

    Aghajanzadeh, Manouchehr; Khadem, Shahram; Khajeh Jahromi, Sina; Gorabi, Hamed Esmaili; Ebrahimi, Hannan; Maafi, Alireza Amir

    2012-01-01

    OBJECTIVES Morgagni hernia (MH) is an uncommon type of diaphragmatic hernia. This study aimed to summarize clinically relevant data with respect to MHs in adults. METHODS We performed a retrospective chart review of patients who underwent surgical repair of foramen due to MH at our hospitals between 1996 and 2010. Data were collected on patient demographics, presenting symptoms, modes of diagnosis, surgical procedures, surgery outcomes, recurrence of hernia and follow-up of the patients. RESULTS We included 36 patients with the mean age of 50.2 years. Of these 66.7% (n = 24) were female. Thirty-one patients had MH on the right side and 1 patient had bilateral MH. Most of the patients experienced abdominal symptoms. 72.2% of patients underwent laparotomy (n = 26, 72.2%), (n = 6, 16.7%) thoracotomy (n = 6, 16.7%), and a thoraco-abdominal approach (n = 4, 11.1%). Resection of the hernia sac and insertion of a mesh were not done in any patients. No recurrence occurred. CONCLUSIONS We conclude that preoperative diagnosis and early diagnosis of MH by using laparotomy and thoracotomy is useful for safe and effective repair. Also we suggest that resection of the hernia sac and insertion of a mesh are not necessary. PMID:22778140

  18. Initial outcomes of laparoscopic paraesophageal hiatal hernia repair with mesh.

    PubMed

    Gebhart, Alana; Vu, Steven; Armstrong, Chris; Smith, Brian R; Nguyen, Ninh T

    2013-10-01

    The use of mesh in laparoscopic paraesophageal hiatal hernia repair (LHR) may reduce the risk of late hernia recurrence. The aim of this study was to evaluate initial outcomes and recurrence rate of 92 patients who underwent LHR reinforced with a synthetic bioabsorbable mesh. Surgical approaches included LHR and Nissen fundoplication (n = 64), LHR without fundoplication (n = 10), reoperative LHR (n = 9), LHR with a bariatric operation (n = 6), and emergent LHR (n = 3). The mean length of hospital stay was 2 ± 3 days (range, 1 to 30 days). There were no conversions to open laparotomy and no intraoperative complications. One of 92 patients (1.1%) required intensive care unit stay. The 90-day mortality was zero. Minor complications occurred in 3.3 per cent, major complications in 2.2 per cent, and late complications in 5.5 per cent of patients. There were no perforations or early hernia recurrence. The 30-day reoperation rate was 1.1 per cent. For patients with available 1-year follow-up, the overall recurrence rate was 18.5 per cent with a mean follow-up of 30 months (range, 12 to 51 months). LHR repair with mesh is associated with low perioperative morbidity and no mortality. The use of bioabsorbable mesh appears to be safe with no early hiatal hernia recurrence or late mesh erosion. Longer follow-up is needed to determine the long-term rate of hernia recurrence associated with LHR with mesh.

  19. Amyand's Hernia: Rare Presentation of a Common Ailment

    PubMed Central

    Singhal, Sanjeev; Singhal, Anu; Negi, Sanjay Singh; Tugnait, Rahul; Arora, Pankaj Kumar; Tiwari, Bishwanath; Malik, Pawan; Gupta, Lav; Bimal, Amit; Gupta, Abhishek; Gupta, Rahul; Chouhan, Pushkar; Singh, ChandraKant

    2015-01-01

    Inguinal hernia with vermiform appendix as content is known as Amyand's hernia. It is a rare entity but we encountered four cases within six months. A 52-year-old female had high grade fever and evidence of inflammatory pathology involving the ileocaecal region. She was initially managed conservatively and subsequently underwent exploratory laparatomy. The appendix was perforated and herniating in the inguinal canal. Appendectomy was done with herniorrhaphy without mesh placement. A 74-year-old male with bilateral inguinal hernia, of which, the right side was more symptomatic, underwent open exploration. Operative findings revealed a lipoma of the sac and a normal appearing appendix as content. Contents were reduced without appendectomy and mesh hernioplasty was performed. A 63-year-old male with an obstructed right sided hernia underwent emergency inguinal exploration which revealed edematous caecum and appendix as content without any inflammation. Contents were reduced without any resection. Herniorrhaphy was performed without mesh placement. A 66-year-old male with an uncomplicated right inguinal hernia underwent elective surgery. The sac revealed an appendix with adhesions at the neck. Contents were reduced after adhesiolysis and hernioplasty was performed with mesh placement. Emphasis is made to the rarity of disease, variation in presentation, and difference in treatment modalities depending upon the state of appendix. PMID:26576304

  20. The influence of obturation technique on sealer thickness and depth of sealer penetration into dentinal tubules evaluated by computer-aided digital analysis.

    PubMed

    Ravindranath, Mithun; Neelakantan, Prasanna; Karpagavinayagam, Kumaraguru; Subba Rao, C V

    2011-01-01

    The aim of this study was to determine sealer penetration into dentinal tubules and sealer thickness with different obturation materials and techniques, with the null hypothesis that sealer cement thickness and dentinal tubule penetration was not affected by obturation technique. This study used 180 freshly extracted human mandibular premolars. Samples were obturated using the lateral condensation technique with either gutta-percha (Group 1) or Resilon (Group 2), using AH Plus (subgroup A) or Epiphany (subgroup B) as a sealer. Other samples were obturated with One-Step Obturator (Group 3) using AH Plus or Epiphany sealer. The sealer thickness and sealer penetration into dentinal tubules was evaluated using stereomicroscopy and analysis of digital images using AutoCAD software at 5.0 mm, 3.0 mm, and 1.0 mm from the apex. The mean value of sealer thickness for Group 3 was significantly lower than the mean values of the other groups. There was no significant difference in the mean values between subgroups A and B for Group 1 or Group 3, whereas for Group 2, the mean value in subgroup A was significantly higher than the mean value in subgroup B. The greatest average frequency of the penetration of sealer cement was found at the 5.0 mm level, followed by the 3.0 mm level, which, in turn, was greater than at the 1.0 mm level. The thickness of the sealer cement is dependent on the obturation technique employed, while the penetration of the sealer into the dentinal tubules is independent of the obturation technique. PMID:22313823

  1. Sealing ability of three hydrophilic single-cone obturation systems: An in vitro glucose leakage study

    PubMed Central

    Hegde, Vibha; Arora, Shashank

    2015-01-01

    Aim: The aim of this study is to compare the corono-apical sealing ability of three single-cone obturation systems using a glucose leakage model. Materials and Methods: A total of 90 freshly extracted human maxillary single-rooted teeth was selected, and their crowns were cut. The root canal of each sample was instrumented using a rotary crown down technique and then divided into four experimental (n = 20 each) and two control groups (n = 5 each). Samples in the experimental groups were filled as follows: Group 1, cold lateral condensation using gutta-percha/AH Plus; group 2, single-cone C-points/smart-paste bio-sealer; group 3, single-cone bio-ceramic (BC) impregnated gutta-percha/endo-sequence BC sealer; group 4, single-cone Resilon/RealSeal SE after 7 days, the sealing ability of root canal fillings was tested at different time intervals using glucose leakage model. Glucose leakage values were measured using a spectrophotometer and statistically analyzed. Results: The four experimental groups presented significantly different glucose leakage values at all test periods (P < 0.05). At the end of the observation period, the cumulative glucose leakage values of groups 2 and 3 were significantly lower than those of groups 1 and 4 (P < 0.05). Conclusion: C-points/smart-paste Bio and BC impregnated gutta-percha/endo-sequence BC sealer combinations provided the superior sealing ability over the lateral condensation technique. PMID:25821383

  2. Emergency repair of Morgagni hernia with partial gastric volvulus: our approach.

    PubMed

    Razi, Kasra; Light, Duncan; Horgan, Liam

    2016-01-01

    Morgagni hernias are a rare form of congenital diaphragmatic hernias, thus there is paucity in literature about the diagnosis and management of the condition. We report an 83-year-old woman who presented with vomiting and a metabolic acidosis with a previous computed tomography diagnosis of Bochdalek's hernia. Diagnostic laparoscopy revealed a Morgagni hernia containing transverse colon, greater curvature of the stomach and a partial gastric volvulus. The hernia was reduced with the sac untouched, and the defect was closed with a composite mesh using tac fixation. The operation was done successfully in 45 minutes with no complications. PMID:27605660

  3. Recurrent Congenital Diaphragmatic Hernia in Ehlers-Danlos Syndrome

    SciTech Connect

    Lin, I.C.; Ko, S.F.; Shieh, C.S.; Huang, C.F.; Chien, S.J.; Liang, C.D.

    2006-10-15

    Ehlers-Danlos syndrome (EDS) includes a group of connective tissue disorders with abnormal collagen metabolism and a diverse clinical spectrum. We report two siblings with EDS who both presented with congenital diaphragmatic hernia (CDH). The elder sister suffered from recurrent diaphragmatic hernia twice and EDS was overlooked initially. Echocardiography as well as contrast-enhanced magnetic resonance angiography (MRA) showed dilatation of the pulmonary artery, and marked elongation and tortuosity of the aorta and its branches. A diagnosis of EDS was eventually established when these findings were coupled with the clinical features of hyperelastic skin. Her younger brother also had similar features. This report emphasizes that EDS may present as CDH in a small child which could easily be overlooked. Without appropriate surgery, diaphragmatic hernia might occur. Echocardiographic screening is recommended in patients with CDH. Contrast-enhanced MRA can be helpful in delineation of abnormally tortuous aortic great vessels that are an important clue to the early diagnosis of EDS.

  4. Hiatus Hernia: A Rare Cause of Acute Pancreatitis

    PubMed Central

    Patel, Shruti; Jawairia, Mahreema; Subramani, Krishnaiyer; Mustacchia, Paul

    2016-01-01

    Hiatal hernia (HH) is the herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm. A giant HH with pancreatic prolapse is very rare and its causing pancreatitis is an even more extraordinary condition. We describe a case of a 65-year-old man diagnosed with acute pancreatitis secondary to pancreatic herniation. In these cases, acute pancreatitis may be caused by the diaphragmatic crura impinging upon the pancreas and leading to repetitive trauma as it crosses the hernia; intermittent folding of the main pancreatic duct; ischemia associated with stretching at its vascular pedicle; or total pancreatic incarceration. Asymptomatic hernia may not require any treatment, while multiple studies have supported the recommendation of early elective repair as a safer route in symptomatic patients. In summary, though rare, pancreatic herniation should be considered as a cause of acute pancreatitis. A high index of suspicion for complications is warranted in cases like these. PMID:27066077

  5. [Controversies in the current management of traumatic abdominal wall hernias].

    PubMed

    Moreno-Egea, Alfredo; Girela, Enrique; Parlorio, Elena; Aguayo-Albasini, José Luis

    2007-11-01

    The management of traumatic abdominal wall hernias is controversial. We performed a MEDLINE search and report a personal series of 10 patients. Cases were classified according to the cause of injury. Fifty-six percent were caused by car accidents and 14% by bicycle accidents. Diagnosis was clinical in 22% and surgical in 13% and intra-abdominal lesions were found in 67%. Treatment was delayed in 12%. In our series, 55% were lumbar hernias due to traffic accidents and all were associated with pelvic fracture. Treatment was delayed in 50%, including laparoscopic surgery with good results. In conclusion, traumatic hernias due to road traffic accidents are frequently associated with intra-abdominal lesions. The diagnostic technique of choice is computed tomography and delayed surgery (laparoscopy) is an effective option. PMID:18021624

  6. Hiatus Hernia: A Rare Cause of Acute Pancreatitis.

    PubMed

    Patel, Shruti; Shahzad, Ghulamullah; Jawairia, Mahreema; Subramani, Krishnaiyer; Viswanathan, Prakash; Mustacchia, Paul

    2016-01-01

    Hiatal hernia (HH) is the herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm. A giant HH with pancreatic prolapse is very rare and its causing pancreatitis is an even more extraordinary condition. We describe a case of a 65-year-old man diagnosed with acute pancreatitis secondary to pancreatic herniation. In these cases, acute pancreatitis may be caused by the diaphragmatic crura impinging upon the pancreas and leading to repetitive trauma as it crosses the hernia; intermittent folding of the main pancreatic duct; ischemia associated with stretching at its vascular pedicle; or total pancreatic incarceration. Asymptomatic hernia may not require any treatment, while multiple studies have supported the recommendation of early elective repair as a safer route in symptomatic patients. In summary, though rare, pancreatic herniation should be considered as a cause of acute pancreatitis. A high index of suspicion for complications is warranted in cases like these. PMID:27066077

  7. A trial of suction drainage in inguinal hernia repair.

    PubMed

    Beacon, J; Hoile, R W; Ellis, H

    1980-08-01

    A prospective randomized trial was conducted on 301 adult males undergoing inguinal herniorrhaphy to assess the value of postoperative suction drainage. Hernias were classified into 'complicated' and 'simple'. In the 'complicated' group suction drainage for 24 h significantly reduced the incidence of wound haematoma, seroma or infection from 48.7 per cent to 17.6 per cent (P < 0.01); there was also a noticeable effect on the postoperative morbidity in the 'simple' hernias, although this just failed to achieve significance (4.5 per cent in the suction group compared with 9.8 per cent in the controls). It is concluded that suction drainage should be employed postoperatively following repair of hernias where dissection may be difficult or where other complicating factors are present.

  8. [Amyand hernia--a rare anatomic and clinical entity diagnosed intraoperatively].

    PubMed

    Grecu, F; Filip, B; Moţoc, I; Andriescu, Nadia; Lăpuşneanu, A; Ursaru, Manuela

    2010-01-01

    The Amyand hernia is an uncommon variant of the inguinal hernia, rarely recognised before the surgical treatment because of the confusion with a strangled hernia. In spite of this, the clinical presentation seems to follow a well determined pathway, so it is possible to state that the uncorrect diagnosis is to be attributed to the ignorance of this variant of hernia. We present two consecutive case reports of acute appendicitis founded in an inguinal hernia sac. The clinical presentation depended on the inflammation extension inside the hernia sac and the presence or not of peritoneal contamination. The patients were admitted for a painful pseudotumor in the inguinal region with irreducibility, mimicking strangled inguinal hernia with acute inflammatory syndrome. Intraoperatively we have found a hernia sac with a phlegmonous/gangrenous appendix inside. Appendectomy was performed, followed by hernioplasty (retrofunicular technique) without prosthetic material). The operation followings were favorable. We conclude that amyand hernia must be considered as differential diagnosis of apparently strangled inguinal hernias. Technical precautions and antibioprophylaxy applied during surgery may prevent septic complications after hernioplasty. The hernia repair must be performed without prosthetic material and using exclusively resorbable sutures.

  9. Familial hiatal hernia in a large five generation family confirming true autosomal dominant inheritance

    PubMed Central

    Carre, I; Johnston, B; Thomas, P; Morrison, P

    1999-01-01

    BACKGROUND—Familial hiatal hernia has only rarely been documented.
AIMS—To describe the pattern of inheritance of familial hiatal hernia within an affected family.
SUBJECTS—Thirty eight members of a family pedigree across five generations.
METHODS—All family members were interviewed and investigated by barium meal for evidence of a hiatal hernia.
RESULTS—Twenty three of 38 family members had radiological evidence of a hiatal hernia. No individual with a hiatal hernia was born to unaffected parents. In one case direct male to male transmission was shown.
CONCLUSIONS—Familial inheritance of hiatal hernia does occur. Evidence of direct male to male transmission points to an autosomal dominant mode of inheritance.


Keywords: familial hiatal hernia; Barrett's oesophagus; autosomal dominant genetics PMID:10517898

  10. Proficiency of Surgeons in Inguinal Hernia Repair

    PubMed Central

    Neumayer, Leigh A.; Gawande, Atul A.; Wang, Jia; Giobbie-Hurder, Anita; Itani, Kamal M. F.; Fitzgibbons, Robert J.; Reda, Domenic; Jonasson, Olga

    2005-01-01

    Objectives: We examined the influence of surgeon age and other factors on proficiency in laparoscopic or open hernia repair. Summary Background Data: In a multicenter, randomized trial comparing open and laparoscopic herniorrhaphies, conducted in Veterans Administration hospitals (CSP 456), we reported significant differences in recurrence rates (RR) for the laparoscopic procedure as a result of surgeons’ experience. We have also reported significant differences in RR for the open procedure related to resident postgraduate year (PGY) level. Methods: We analyzed data from unilateral laparoscopic and open herniorrhaphies from CSP 456 (n = 1629). Surgeon's experience (experienced ≥250 procedures; inexperienced <250), surgeon's age, median PGY level of the participating resident, operation time, and hospital observed-to-expected (O/E) ratios for mortality were potential independent predictors of RR. Results: Age was dichotomized into older (≥45 years) and younger (<45 years). Surgeon's inexperience and older age were significant predictors of recurrence in laparoscopic herniorrhaphy. The odds of recurrence for an inexperienced surgeon aged 45 years or older was 1.72 times that of a younger inexperienced surgeon. For open repairs, although surgeon's age and operation time appeared to be related to recurrence, only median PGY level of <3 was a significant independent predictor. Conclusion: This analysis demonstrates that surgeon's age of 45 years and older, when combined with inexperience in laparoscopic inguinal herniorrhaphies, increases risk of recurrence. For open repairs, only a median PGY level of <3 was a significant risk factor. PMID:16135920

  11. Broad Ligament Hernia-Associated Bowel Obstruction

    PubMed Central

    López-Loredo, A.; León, J. F. García

    2007-01-01

    Background and Objective: We present the case of a female patient 29 years of age with antecedents of laparoscopic laser ablation for endometriosis, laparoscopic appendectomy, and umbilical hernioplasty. Methods: The patient was admitted to the hospital's emergency room for abdominal pain in the epigastrium, transfixing, irradiating to both upper quadrants and to the lumbar region, accompanied by nausea and gastrobiliary vomiting. Lipase determination was 170 mg/dL. Other laboratory findings were normal. Plain abdominal films on the patient's admission were normal, and computed tomography (CT) showed data compatible with acute pancreatitis. Without improvement during the patient's hospital stay, pain and vomiting increased in intensity and frequency. Results: New abdominal x-rays revealed dilatation of small bowel loops. Management was begun for intestinal obstruction, with intravenous hydration and placement of a nasogastric tube without a good response. At 48 hours, a diagnostic laparoscopy was performed, revealing a 3-cm internal hernia in the left broad ligament in which a 20-cm segment of terminal ileum was encased. We performed liberation of the ileal segment and closed the hernial orifice by using the laparoscopic approach. Conclusion: The patient's evolution was excellent. PMID:17651574

  12. Hiatal Hernia Repair with Novel Biological Graft Reinforcement

    PubMed Central

    Sasse, Kent C.; Ackerman, Ellen; Brandt, Jared

    2016-01-01

    Background and Objectives: Hiatal hernias are repaired laparoscopically with increasing use of reinforcement material. Both synthetic and biologically derived materials reduce the recurrence rate compared to primary crural repair. Synthetic mesh introduces complications, such as mesh erosion, fibrosis, and infection. Urinary bladder matrix (UBM) represents a biologically derived material for use in hiatal hernia repair reinforcement with the potential to improve durability of repair without incurring the risks of other reinforcement materials. Methods: The 15 cases presented involved hiatal hernia repair with primary crural repair with UBM reinforcement and fundoplication. Patients were followed for an average of 3 years, and were assessed with upper gastrointestinal (GI) series, endoscopy, and assessments of subjective symptoms of gastroesophageal reflux disease (GERD). Results: Hernia diameters averaged 6 cm. Each repair was successful and completed laparoscopically. UBM exhibited favorable handling characteristics when placed as a horseshoe-type graft sutured to the crura. One patient underwent endoscopic balloon dilatation of a mild postoperative stenosis that resolved. No other complications occurred. In more than 3 years of follow-up, there have been no recurrences or long-term complications. GERD-health-related quality of life (HRQL) scores averaged 6 (range, 0–12, of a possible 50), indicating little reflux symptomatology. Follow-up upper GI series were obtained in 9 cases and showed intact repairs. An upper endoscopy was performed in 8 patients and showed no recurrences. Conclusion: Surgeons may safely use laparoscopic fundoplication with UBM reinforcement for successful repair of hiatal hernias. In this series, repairs with UBM grafts have been durable at 3 years of follow-up and may serve as an alternative to synthetic mesh reinforcement of hiatal hernia repairs. PMID:27186066

  13. Resorbable biosynthetic mesh for crural reinforcement during hiatal hernia repair.

    PubMed

    Alicuben, Evan T; Worrell, Stephanie G; DeMeester, Steven R

    2014-10-01

    The use of mesh to reinforce crural closure during hiatal hernia repair is controversial. Although some studies suggest that using synthetic mesh can reduce recurrence, synthetic mesh can erode into the esophagus and in our opinion should be avoided. Studies with absorbable or biologic mesh have not proven to be of benefit for recurrence. The aim of this study was to evaluate the outcome of hiatal hernia repair with modern resorbable biosynthetic mesh in combination with adjunct tension reduction techniques. We retrospectively analyzed all patients who had crural reinforcement during repair of a sliding or paraesophageal hiatal hernia with Gore BioA resorbable mesh. Objective follow-up was by videoesophagram and/or esophagogastroduodenoscopy. There were 114 patients. The majority of operations (72%) were laparoscopic primary repairs with all patients receiving a fundoplication. The crura were closed primarily in all patients and reinforced with a BioA mesh patch. Excessive tension prompted a crural relaxing incision in four per cent and a Collis gastroplasty in 39 per cent of patients. Perioperative morbidity was minor and unrelated to the mesh. Median objective follow-up was one year, but 18 patients have objective follow-up at two or more years. A recurrent hernia was found in one patient (0.9%) three years after repair. The use of crural relaxing incisions and Collis gastroplasty in combination with crural reinforcement with resorbable biosynthetic mesh is associated with a low early hernia recurrence rate and no mesh-related complications. Long-term follow-up will define the role of these techniques for hiatal hernia repair.

  14. Paraesophageal Hernia Repair With Partial Longitudinal Gastrectomy in Obese Patients

    PubMed Central

    Rodriguez, John; El-Hayek, Kevin; Brethauer, Stacy; Schauer, Philip; Zelisko, Andrea; Chand, Bipan; O'Rourke, Colin; Kroh, Matthew

    2015-01-01

    Background and Objectives: Treatment of gastroesophageal reflux disease (GERD) with hiatal hernia in obese patients has proven difficult, as studies demonstrate poor symptom control and high failure rates in this patient population. Recent data have shown that incorporating weight loss procedures into the treatment of reflux may improve overall outcomes. Methods: We retrospectively reviewed 28 obese and morbidly obese patients who presented from December 2007 through July 2013 with large or recurrent type 3 or 4 paraesophageal hernia. All of the patients underwent combined paraesophageal hernia repair and partial longitudinal gastrectomy. Charts were retrospectively reviewed, and the patients were contacted to determine symptomatic relief. Results: Mean preoperative body mass index was 38.1 ± 4.9 kg/m2. Anatomic failure of prior fundoplication occurred in 7 patients (25%). The remaining 21 had primary paraesophageal hernia, 3 of which were type 4. Postoperative complications included pulmonary embolism (n = 1), pulmonary decompensation (n = 2), and wound infection (n = 1). Mean hospital stay was 5 ± 3 days. Upper gastrointestinal esophagogram was performed in 21 patients with no immediate recurrence or staple line dehiscence. Mean excess weight loss was 44 ± 25%. All of the patients surveyed experienced near to total resolution of their preoperative symptoms within the first month. At 1 year, symptom scores decreased significantly. At 27 months, however, there was a mild increase in the scores. Return of severe symptoms occurred in 2 patients, both of whom underwent conversion to gastric bypass. Conclusions: Combined laparoscopic paraesophageal hernia repair with longitudinal partial gastrectomy offers a safe, feasible approach to the management of large or recurrent paraesophageal hernia in well-selected obese and morbidly obese patients. Short-term results were promising; however, intermediate results showed increasing rates of reflux symptoms that required

  15. Efficacy of ProTaper Retreatment System in Root Canals Obturated with Gutta-Percha Using Two Different Sealers and GuttaFlow.

    PubMed

    Siotia, Jaya; Acharya, Shashi Rashmi; Gupta, Sunil Kumar

    2011-01-01

    Objective. To compare the efficacy of ProTaper retreatment files in removing three different obturating materials. Study Design. Forty-five human, single-rooted premolars were divided into three experimental groups. Group 1 was obturated with gutta-percha and AH Plus sealer, Group 2 was obturated with gutta-percha and zinc oxide eugenol sealer, and Group 3 was obturated with GuttaFlow. Retreatment was done using the ProTaper universal rotary retreatment files. Root halves were visualized using magnifying loops at 3X magnification and optical stereomicroscope at 10X magnification. Images were analyzed using AutoCAD 2004 software to calculate area of the remaining debris in the canal. For statistical analysis were used variance test and ANOVA. Results. Total debris/canal area ratio between the three groups showed a statistically significant difference (P < 0.001). Conclusion. ProTaper retreatment system did not produce completely clean canals in any of the groups. However, it had the best efficacy towards removing silicon based obturating material GuttaFlow. PMID:22114598

  16. Root surface temperature rises in vitro during root canal obturation with thermoplasticized gutta-percha on a carrier or by injection.

    PubMed

    Lipski, Mariusz

    2004-06-01

    The aim of this in vitro study was to measure the temperature rise on the outer root surfaces of teeth during four different root canal obturation techniques. Sixty extracted human maxillary and mandibular premolars with a single canal were used. After root canal cleaning and shaping, the teeth were randomly divided into four groups of 15 teeth each and obturated with Thermafil obturators or Soft-Core obturators using Ultrafil or Trifecta low-temperature thermoplasticized gutta-percha techniques. Temperature changes on the external mesial root surfaces were measured using a thermal imaging camera. Lower temperature rises were found for Ultrafil and Trifecta techniques (2.14 degrees C and 2.03 degrees C, respectively) than for Thermafil and Soft-Core techniques (3.87 degrees C and 3.67 degrees C, respectively). These findings suggest that solid core gutta-percha combined with low-temperature injectable gutta-percha obturation techniques may impose less risk for thermal damage to the surrounding periradicular tissues.

  17. [Vena cava agenesia presented as incarcerated groin hernia].

    PubMed

    Safir-Hansen, Kristina; Achiam, Michael Patrick

    2014-12-15

    The case describes a 45-year-old man with a rare finding of vena cava agenesia presented as incarcerated groin hernia. From childhood the patient had developed dilatation of subcutaneous veins with establishment of aneurismal dilatation in the lower right side of the abdomen and groin. The patient was submitted with severe abdominal pain in the lower right side. The case describes the difficulties of an initially incorrect radiological diagnosis of incarcerated groin hernia and the discrepancy of the clinical findings. The case stresses the importance of a thorough evaluation of each patient. PMID:25497657

  18. Congenital diaphragmatic hernia in a patient with tetrasomy 9p.

    PubMed

    Henriques-Coelho, Tiago; Oliva-Teles, Natália; Fonseca-Silva, M Luz; Tibboel, Dick; Guimarães, Hercília; Correia-Pinto, Jorge

    2005-10-01

    Tetrasomy of the short arm of chromosome 9 constitutes a rare condition resulting in a well clinically recognized syndrome. In our case, in addition to the characteristic phenotype at birth, the existence of a hernia-type Bochdalek diaphragmatic defect was found. Cytogenetic analysis revealed a nonmosaic case of an isochromosome of the entire short arm of chromosome 9 with no involvement of the heterochromatic region of the long arm: 47, XX, +i (9p). Because chromosome 9 contains several gene locus for enzymes and receptors of the retinoid pathway, this case potentially contributes to retinoid hypothesis in the etiology of congenital diaphragmatic hernia. PMID:16226972

  19. Laparoscopy for perforated Richter hernia with incarcerated foreign body.

    PubMed

    Hartin, Charles W; Caty, Michael G; Bass, Kathryn D

    2011-07-01

    Children often place nonedible objects into their mouths. Occasionally, these objects are inadvertently swallowed, and fortunately, the majority passes spontaneously without intervention. We present the case of a 10-month-old girl who presented with an incarcerated Richter hernia through an indirect inguinal defect containing a wall of sigmoid colon perforated by a swallowed lollipop stick. Although this is a rare case, we conclude that prompt laparoscopic abdominal exploration is an extremely valuable tool in making an accurate diagnosis in difficult-to-reduce or incarcerated hernia cases.

  20. Sealing Ability of Mineral Trioxide Aggregate and Calcium-Enriched Mixture Cement as Apical Barriers with Different Obturation Techniques

    PubMed Central

    Tabrizizade, Mahdi; Asadi, Yasin; Sooratgar, Aidin; Moradi, Saeed; Sooratgar, Hossein; Ayatollahi, Fatemeh

    2014-01-01

    Introduction: Endodontic treatment in pulpless immature teeth is challenging due to the lack of an apical stop. Insertion of an apical plug is an alternative to conventional long-term apexification with calcium hydroxide. The aim of this study was to compare the apical microleakage of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement as apical plugs with three different obturation techniques. Methods and Materials: This experimental study was conducted on 130 single rooted human teeth with one canal. Samples were randomly divided into 2 experimental groups (n=60) and two negative and positive control groups containing 5 samples each. After cleaning and shaping, an open apex configuration was prepared in all samples. MTA or CEM cement apical plugs with 5 mm thicknesses were placed. Then, each group was divided to 4 subgroups and the remaining space of root canals were filled with either lateral compaction or thermoplasticized injectable gutta-percha or was obturated by filling the entire canal with apical plug material. In one remaining subgroup the canal space was left unfilled. Microleakage was measured by the fluid filtration method and results were analyzed by means of the two-way ANOVA test. Results: There were no significant differences between microleakage of MTA and CEM cement apical plugs (P=0.92). The difference between three obturation methods was not significant, either (P=0.39). Conclusion: MTA and CEM cement have similar sealing ability as apical plugs and no significant difference was found in microleakage of the three groups. PMID:25386206

  1. Comparative evaluation of a novel smart-seal obturating system and its homogeneity of using cone beam computed tomography: In vitro simulated lateral canal study

    PubMed Central

    Arora, Shashank; Hegde, Vibha

    2014-01-01

    Aim: The aim was to evaluate and compare a novel polyamide polymer based obturating system and Gutta-percha and sealer in filling simulated lateral canals and their homogeneity when used for obturating the root canals. Materials and Methods: A total of 60 freshly extracted human single rooted teeth with fully formed apices were selected for this study. Teeth were de-coronated, and roots were standardized to a working length of 15 mm. Root canal preparation was carried out with rotary Protaper file system in all groups. The specimens were then randomly divided into three groups A, B, and C (n = 20). Ten samples from each group were decalcified and simulated lateral canals were made at 2, 4, and 6 mm from the root apex. Remaining ten samples from each group were maintained calcified. Group A was obturated with SmartSeal system (Prosmart-DRFP Ltd., Stamford, UK). Group B was obturated with sectional backfill method. Group C was obutrated with cold lateral compaction method (control). Decalcified samples from the respective groups were analyzed with digital radiography and photography and the measurement of the linear extension and area of lateral canal filling was done using UTHSCSA (UTHSCSA Image Tool for Windows version 3.0, San Antonio, TX, USA) software. Calcified samples were subjected to cone beam computed tomography image analysis sectioned axially. Results: Group A 92.46 ± 19.45 showed greatest extent of filling in lateral canals and denser homogeneity of oburation, followed by Group B 78.43 ± 26.45 and Group C 52.12 ± 36.67. Conclusions: Polyamide polymer obturation proved to have greater efficiency when compared with Gutta-percha system, when used for obturation with regards to adaptation of the sealer and penetration into the simulated lateral canals. PMID:25125851

  2. Effectiveness of Lichtenstein repairs in planned treatment of giant inguinal hernia – own experience

    PubMed Central

    Kosim, Anna; Kołodziejczak, Małgorzata; Zmora, Jan; Kultys, Ewa

    2012-01-01

    Introduction Occurrence of giant inguinal hernias is not frequent because of growing medical awareness in the community as well as progress in surgical treatment in this field. Aim To evaluate the effectiveness of repairs using the Lichtenstein technique in scheduled treatment of giant inguinal hernias. Material and methods Between 2006 and 2010 in the Department of Surgery with the Subdepartment of Proctology, Hospital at Solec in Warsaw, 909 repairs of inguinal hernia were performed, including 15 patients (1.65%) with the diagnosis of giant hernia. In 3 cases it was direct inguinal hernia and in 12 cases indirect inguinal hernia. All giant hernias occurred in male patients between 33 and 87 years of age (mean age 65 years old) and developed for many years, median of 14.2 years. All patients underwent scheduled repairs using the tension-free Lichtenstein technique. A non-absorbable polypropylene mesh was used for hernioplasty. Exact Fisher's test (p < 0.01) was used for statistical analysis. Results In all cases contents of the hernial sac consisted of loops of small intestine, colon and omentum. Early complications occurred in 11 patients (73%) in the group of patients with giant hernias, whereas in the remaining group of patients early complications occurred in 53 patients (5.9%). The difference was statistically significant. In the group of patients with giant hernias no recurrence was observed over the observation period ranging from 6 months to 4.5 years. In the remaining group of patients recurrences occurred in 23 patients (2.6%). Conclusions The Lichtenstein technique of repair is effective in management of giant inguinal hernias. A statistically significantly higher percentage of complications was observed in the group of patients with giant hernias as compared to the remaining group of patients with inguinal hernias. Patients with giant hernias require proper preparation for surgery, especially in relation to their respiratory efficiency. PMID:23630552

  3. Toxoplasma gondii infection and abdominal hernia: evidence of a new association

    PubMed Central

    2011-01-01

    Background We performed a retrospective, observational study in 1156 adult subjects from the general population of Durango City, Mexico, Fifty five subjects with a history of abdominal hernia repair and 1101 subjects without hernia were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and IgM antibodies. Results The seroprevalence of anti-Toxoplasma IgG antibodies and IgG titers was significantly higher in subjects with abdominal hernia repair than those without hernia. There was a tendency for subjects with hernia repair to have a higher seroprevalence of anti-Toxoplasma IgM antibodies than subjects without hernia. The seroprevalence of anti-Toxoplasma IgG antibodies in subjects with hernia repair was significantly higher in subjects ≥ 50 years old than those < 50 years old. Further analysis in subjects aged ≥ 50 years showed that the seroprevalence of anti-Toxoplasma IgG antibodies was also significantly higher in individuals with hernia repair than those without hernia (OR = 2.72; 95% CI: 1.10-6.57). Matching by age and sex further showed that the seroprevalence of Toxoplasma infection was significantly higher in patients with hernia repair than those without hernia (OR: 4.50; 95% CI: 1.22-17.33). Conclusions Results indicate that infection with Toxoplasma is associated with abdominal hernia. The contributing role of infection with Toxoplasma in abdominal hernia was observed mainly in subjects aged ≥ 50 years old. Our results might have clinical, prevention and treatment implications and warrant for further investigation. PMID:21682896

  4. Sampson's Artery Hemorrhage after Inguinal Hernia Repair: Second Case Reported

    PubMed Central

    Adjei Boachie, Joseph

    2016-01-01

    Sampson artery is normally obliterated in postembryonic development. In rare cases it can remain patent and complicate a routine outpatient herniorrhaphy when severed. This is the second reported case in the available English literature of hemoperitoneum due to bleeding from a patent Sampson's artery following an open inguinal hernia repair. PMID:27247822

  5. Sampson's Artery Hemorrhage after Inguinal Hernia Repair: Second Case Reported.

    PubMed

    Adjei Boachie, Joseph; Smith-Singares, Eduardo

    2016-01-01

    Sampson artery is normally obliterated in postembryonic development. In rare cases it can remain patent and complicate a routine outpatient herniorrhaphy when severed. This is the second reported case in the available English literature of hemoperitoneum due to bleeding from a patent Sampson's artery following an open inguinal hernia repair. PMID:27247822

  6. Solitary fibrous tumors arising in abdominal wall hernia sacs.

    PubMed

    Lee, J R; Hancock, S M; Martindale, R G

    2001-06-01

    Solitary fibrous tumor (SFT) of the peritoneum is an unusual spindle-cell neoplasm. SFT was originally described in the pleura; however it is now diagnosed in multiple extrathoracic sites. Most believe that the tumor is of mesenchymal origin and should be classified as a variant of fibroma. SFT of the pleura and peritoneum have also been called fibrous mesothelioma, and the cell of origin is felt to be a pluripotential submesothelial mesenchymal cell. Primary tumors arising in hernia sacs are rare, and we report on two patients with hernia SFT. The first is a 67-year-old man who had a diffusely thickened distal left inguinal hernia sac. Within the sac was copious myxoid material mimicking pseudomyxoma peritonei. Herniorrhaphy and orchiectomy were performed. The second is a 44-year-old woman with a midepigastric mass attached to a ventral hernia. Wide local excision was performed. Both tumors demonstrated plump spindle cells, one with myxoid background and the other with keloidal collagen. Calretinin immunostaining was positive in both tumors, whereas CD34 was negative. This suggests tumor origin from a submesothial pluripotential cell that maintains potential for mesothelial differentiation. Surgical excision is the treatment of choice with the degree of resectability being a powerful predictor of outcome.

  7. Congenital Diaphragmatic Hernia and Occupational Therapy: A Case Report

    ERIC Educational Resources Information Center

    Bates, Angela C.

    2011-01-01

    This case report describes occupational therapy (OT) intervention in an outpatient setting and outcomes for a child diagnosed with congenital diaphragmatic hernia (CDH) from 4 to 28 months of age. There is little information on therapy intervention and outcomes of children who have survived. The patient is a white male, born at 35 weeks gestation…

  8. Inguinal Hernia and Airport Scanners: An Emerging Indication for Repair?

    PubMed Central

    Cawich, Shamir O.; Maharaj, Ravi; Dan, Dilip

    2013-01-01

    The use of advanced imaging technology at international airports is increasing in popularity as a corollary to heightened security concerns across the globe. Operators of airport scanners should be educated about common medical disorders such as inguinal herniae in order to avoid unnecessary harassment of travelers since they will encounter these with increasing frequency. PMID:24368923

  9. Nutritional status and umbilical hernia in Nigerian school children of different ethnic groups.

    PubMed Central

    Ebomoyi, E.; Parakoyi, D. B.; Omonisi, M. K.

    1991-01-01

    The relationship between nutritional status and umbilical hernia was assessed among Hausa and Yoruba school children in rural areas of Kwara State, Nigeria. The prevalence of umbilical hernia in the rural school pupils was 19.4%. The Yoruba school children had a higher prevalence rate of 22.0%, while the prevalence rate for Hausa pupils was 16.9%. The association between umbilical hernia and primary school class was statistically significant. More school children suffering from protein energy malnutrition presented with umbilical hernia. The association between umbilical hernia and nutritional status was weak. The school health component of the national primary health program should be intensified to screen school children regularly for umbilical hernia. The school health environment of rural Nigerian schools should be improved through government efforts. Images Figure 1 Figure 2 PMID:1800766

  10. Thoracoscopic repair of a large neonatal congenital diaphragmatic hernia using Gerota's fascia.

    PubMed

    Fukuzawa, Hiroaki; Tamaki, Akihiko; Takemoto, Jyunkichi; Morita, Keiichi; Endo, Kosuke; Iwade, Tamaki; Yuichi, Okata; Bitoh, Yuko; Yokoi, Akiko; Maeda, Kosaku

    2015-05-01

    A large congenital diaphragmatic hernia needing patch repair has a high risk of recurrence. Thus, managing these large congenital diaphragmatic hernias under thoracoscopy has become a problem. Here, a large congenital diaphragmatic hernia that was repaired using Gerota's fascia under thoracoscopy is reported. In the present case, it was impossible to close the hernia directly under thoracoscopy because the hernia was too large. Gerota's fascia was raised up by the left kidney and used for the repair. The left colon adhering to Gerota's fascia was mobilized, and a large space was made under thoracoscopy. Gerota's fascia was fixed to the diaphragmatic defect. The patient's postoperative course was good, and there was no recurrence. This technique could be one option for repairing a large hernia under thoracoscopy.

  11. An in vitro comparative study of the adaptation and sealing ability of two carrier-based root canal obturators.

    PubMed

    Alkahtani, Ahmed; Al-Subait, Sara; Anil, Sukumaran

    2013-01-01

    The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability. PMID:23710141

  12. Fracture Resistance of Simulated Immature Teeth Obturated with Gutta-Percha or Resilon and Reinforced by Composite or Post

    PubMed Central

    Bolhari, Behnam; Mojazi Amiri, Elham; Kermanshah, Hamidreza; Ghabraei, Sholeh; Jamei, Azad

    2015-01-01

    Objectives: The purpose of this ex- vivo study was to evaluate the fracture resistance of simulated immature teeth, obturated with Gutta-percha or Resilon and reinforced by either composite resin or fiber post. Materials and Methods: Eighty-four human maxillary incisors were divided into seven groups (n=12). Teeth in all groups were prepared until Peeso #5 (1.5mm) could be passed through the apex. Root ends received 4mm of MTA plug as an apical barrier. Groups received the followings: 1.Gutta-percha, 2.Resilon, 3.Gutta-percha + composite resin, 4.Resilon + composite resin, 5.Gutta-percha + fiber post, 6.Resilon + fiber post and 7.No obturation (control group). Access openings were filled with composite resin. Specimens were then subjected to oblique load using Instron Testing Machine. The mean peak load at fracture was recorded and analyzed using ANOVA. Results: Experimental groups had a significantly more fracture resistance than the control group (P< 0.05). No significant difference was seen between experimental groups. Teeth reinforced by fiber post showed favorable fracture resistance. Conclusion: Treatment plans used in this study increase the fracture resistance of immature teeth. Use of fiber posts in immature teeth, may be the most favorable clinically applicable technique. PMID:26056522

  13. An in vitro comparative study of the adaptation and sealing ability of two carrier-based root canal obturators.

    PubMed

    Alkahtani, Ahmed; Al-Subait, Sara; Anil, Sukumaran

    2013-01-01

    The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability.

  14. Inguinal or inguino-iliac/obturator lymph node dissection after positive inguinal sentinel lymph node in patients with cutaneous melanoma

    PubMed Central

    Glumac, Nebojsa; Hocevar, Marko; Zadnik, Vesna; Snoj, Marko

    2012-01-01

    Background The aim of the study was to determine whether the presence of inguinal sentinel lymph node (SLN) metastases smaller than 2 mm (micrometastases) subdivided according to the number of micrometastases predicts additional, non-sentinel inguinal, iliac or obturator lymph node involvement in completion lymph node dissection (CLND). Patients and methods. Positive inguinal SLN was detected in 58 patients (32 female, 26 male, median age 55 years) from 743 consecutive and prospectively enrolled patients with primary cutaneous melanoma stage I and II who were treated with SLN biopsy between 2001 and 2007. Results Micrometastases in inguinal SLN were detected in 32 patients, 14 were single, 2 were double, and 16 were multiple. Twenty-six patients had macrometastases. Conclusions No patient with any micrometastases or a single SLN macrometastasis in the inguinal region had any iliac/obturator non-sentinel metastases after CLND in our series. Furthermore, no patient with single SLN micrometastasis in the inguinal region had any non-sentinel metastases at all after CLND in our series. In these cases respective CLND might be omitted. PMID:23077465

  15. Retreatability of Root Canals Obturated Using Gutta-Percha with Bioceramic, MTA and Resin-Based Sealers

    PubMed Central

    Uzunoglu, Emel; Yilmaz, Zeliha; Sungur, Derya Deniz; Altundasar, Emre

    2015-01-01

    Introduction: The aim of this study was to evaluate the retreatability of root canals obturated with gutta-percha (GP) and three different endodontic sealers [iRoot SP (bioceramic sealer), MTA Fillapex (MTA-based sealer) and AH-26 (epoxy resin-based sealer)] using the ProTaper Universal Retreatment (PTR) system. Methods and Materials: Forty extracted single-rooted human teeth were prepared with universal ProTaper files up to F4 (40/0.06). Specimens were randomly divided into four groups according to obturation technique/material: single-cone GP/AH-26, lateral compaction of GP/AH-26, single-cone GP/iRoot SP, and single-cone GP/MTA Fillapex. Root fillings were removed with PTR. The time taken to reach the working-length (TWL) was recorded. Roots were longitudinally sectioned and each half was evaluated using a stereomicroscope. Three observers scored each third of all specimen. Obtained data were analyzed using the Kruskal-Wallis, Mann-Whitney U, Welch and Games-Howell tests. The level of significance was set at 0.05. Results: In single-cone GP/MTA Fillapex group the TWL was significantly shorter. The remnant of filling material in the apical and middle thirds of groups was similar and higher than the coronal thirds. Conclusion: None of the tested sealers were completely removed from the root canal system. PMID:25834591

  16. An In Vitro Comparative Study of the Adaptation and Sealing Ability of Two Carrier-Based Root Canal Obturators

    PubMed Central

    Alkahtani, Ahmed; Al-Subait, Sara; Anil, Sukumaran

    2013-01-01

    The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability. PMID:23710141

  17. Contraction of Abdominal Wall Muscles Influences Incisional Hernia Occurrence and Size

    PubMed Central

    Lien, Samuel C.; Hu, Yaxi; Wollstein, Adi; Franz, Michael G.; Patel, Shaun P.; Kuzon, William M.; Urbanchek, Melanie G.

    2015-01-01

    Background Incisional hernias are a complication in 10% of all open abdominal operations and can result in significant morbidity. The purpose of this study is to determine if inhibiting abdominal muscle contraction influences incisional hernia formation during laparotomy healing. We hypothesize that reducing abdominal musculature deformation reduces incisional hernia occurrence and size. Study Design Using an established rat model for incisional hernia, a laparotomy through the linea alba was closed with one mid-incision, fast-absorbing suture. Three groups were compared: a SHAM group (SHAM; n = 6) received no laparotomies while the Saline Hernia (SH; n = 6) and Botox Hernia (BH; n = 6) groups were treated once with equal volume saline or Botulinum Toxin (Botox®, Allergan) before the incomplete laparotomy closure. On post-operative day 14, the abdominal wall was examined for herniation and adhesions and contractile forces were measured for abdominal wall muscles. Results No hernias developed in SHAM rats. Rostral hernias developed in all SH and BH rats. Caudal hernias developed in all SH rats, but in only 50% of the BH rats. Rostral hernias in the BH group were 35% shorter and 43% narrower compared to those in the SH group (p < 0.05). The BH group had weaker abdominal muscles compared to the SHAM and SH groups (p < 0.05). Conclusions In our rat model, partial paralysis of abdominal muscles reduces the number and size of incisional hernias. These results confirm abdominal wall muscle contractions play a significant role in the pathophysiology of incisional hernia formation. PMID:25817097

  18. [Laparoscopic repair of inguinal hernia--experience in 54 consecutive cases].

    PubMed

    Kyzer, S; Kristalni, I; Alis, M; Charuzi, I

    1999-02-15

    We describe our experience in 54 consecutive patients who underwent laparoscopic repair of 86 inguinal hernias. Laparoscopic repair of inguinal hernia is technically feasible, does not prolong the length of the procedure nor of hospitalization and is not accompanied by increased morbidity. Although there is not yet general agreement, in our experience and that of others, it appears that laparoscopic repair will be the preferred approach to the treatment of inguinal hernia. PMID:10914213

  19. The u and the sushi roll: a conceptual aid for lichtenstein hernia repair.

    PubMed

    Yu, Jessica A; Burlew, Clay Cothren

    2012-10-01

    For surgical trainees, perfecting a systematic approach to open inguinal herniorrhaphy can be complicated by the difficulty of conceptualizing hernias in relationship to the relatively complex anatomy of the inguinal canal. Open inguinal hernia repair is a common general surgery operation and a precise understanding of the operation is essential for residents. We present a systematic approach to this operation that uses the U and sushi roll technique as a conceptual aid to understand inguinal anatomy and a method of hernia repair.

  20. Laparoscopic repair of a morgagni hernia in a child: a case report.

    PubMed

    Ozmen, Vahit; Gün, Feryal; Polat, Coskun; Asoğlu, Oktar; Ozaçmak, I D; Salman, Tansu

    2003-04-01

    Morgagni hernias are anomalies of the sternal insertions of the diaphragmatic bundles and represent 1% to 4% of all surgically treated diaphragmatic hernias. We present a case of a laparoscopic repair of Morgagni hernia incidentally found in a 4-year-old boy. Primary laparoscopic closure of the defect with interrupted silk sutures was performed. The patient had uneventful recovery and is asymptomatic at 2 months of follow-up. We propose that the laparoscopic approach is feasible and effective treatment of this kind of hernia.

  1. [Amyand's hernia: a report of two cases and review of the bibliography].

    PubMed

    Manzanares-Campillo, Maria del Carmen; Muñoz-Atienza, Virginia; Sánchez-García, Susana; García-Santos, Esther; Ruescas-García, Francisco; Martín-Fernández, Jesús

    2014-01-01

    Antecedentes: encontrar el apéndice vermiforme en un saco herniario inguinal es un hallazgo infrecuente (1%), excepcionalmente raro si está inflamado (0.13%). Clínicamente simula una hernia inguinal incarcerada y el diagnóstico preoperatorio adecuado se establece en contadas excepciones. Se reportan dos casos excepcionales de hernias de Amyand y se revisa la bibliografía. Casos clínicos: 1. Paciente masculino de 78 años con una hernia inguinal derecha, incarcerada, en el que el diagnóstico de hernia de Amyand se estableció antes de la cirugía mediante tomografía computada abdominal. Caso clínico 2. Paciente femenina de 82 años de edad, con clínica de hernia crural derecha incarcerada con una hernia de Amyand a través de una hernia inguinal derecha. Conclusiones: la hernia de Amyand es una rara enfermedad cuyo diagnóstico preoperatorio es infrecuente y que siempre debe considerarse en el diagnóstico diferencial en los casos con signos clínicos de hernia inguinal derecha incarcerada.

  2. A Rare Cause of Haemorrhage in the Upper Gastrointestinal System: Bochdalek Hernia

    PubMed Central

    Cevizci, MN; Erdemir, G; Cayir, A

    2015-01-01

    ABSTRACT Diaphragmatic hernia originates from insufficient closure of the pericardioperitoneal canals and pleuroperitoneal membranes. It is seen in one in every 4000 births. The general finding in the newborn period is respiratory difficulty. Mortality is 40–50%. There may be other accompanying organ anomalies. Congenital diaphragmatic hernias diagnosed after the newborn period are known as late-presenting congenital diaphragmatic hernias. This group is seen at a level of 5–20% and poses difficulty in diagnosis. This report describes a case under observation and receiving treatment for gastrointestinal haemorrhage, diagnosed as Bochdalek hernia. PMID:26360672

  3. Incisional hernia after open resections for colorectal liver metastases – incidence and risk factors

    PubMed Central

    Nilsson, Jan H.; Strandberg Holka, Peter; Sturesson, Christian

    2016-01-01

    Background Incisional hernia is one of the most common complications after laparotomy. The aim of this retrospective study was to investigate incidence, location and risk factors for incisional hernia after open resection for colorectal liver metastases including the use of perioperative chemotherapy and targeted therapy evaluated by computed tomography. Methods Patients operated for colorectal liver metastases between 2010 and 2013 were included. Incisional hernia was defined as a discontinuity in the abdominal fascia observed on computed tomography. Results A total of 256 patients were analyzed in regard to incisional hernia. Seventy-eight patients (30.5%) developed incisional hernia. Hernia locations were midline alone in 66 patients (84.6%) and involving the midline in another 8 patients (10.3%). In multivariate analysis, preoperative chemotherapy >6 cycles (hazard ratio 2.12, 95% confidence interval 1.14–3.94), preoperative bevacizumab (hazard ratio 3.63, 95% confidence interval 1.86–7.08) and incisional hernia from previous surgery (hazard ratio 3.50, 95% confidence interval 1.98–6.18) were found to be independent risk factors. Conclusions Prolonged preoperative chemotherapy and also preoperative bevacizumab were strong predictors for developing an incisional hernia. After an extended right subcostal incision, the hernia location was almost exclusively in the midline. PMID:27154807

  4. Autopsy features in a newborn baby affected by a central congenital diaphragmatic hernia.

    PubMed

    Bolino, Giorgio; Gitto, Lorenzo; Serinelli, Serenella; Maiese, Aniello

    2015-03-01

    Congenital diaphragmatic hernia is a congenital malformation of the diaphragm, resulting in the herniation of the abdominal organs into the thoracic cavity. The most common types of congenital diaphragmatic hernia are Bochdalek hernia (postero-lateral hernia), Morgagni hernia (anterior defect), and diaphragm eventration (abnormal displacement of part or all of an otherwise intact diaphragm into the chest cavity). Congenital diaphragmatic hernia is a life-threatening pathology in infants, and a major cause of death due to pulmonary hypoplasia and pulmonary hypertension. We present a fatal case of congenital diaphragmatic hernia in a newborn. At the autopsy, a central defect of the diaphragm was found, 8 × 5 cm in size, that led to a herniation of the small intestine, the right lobe of the liver, and the right adrenal gland into the thorax. An esophageal atresia was associated with the congenital diaphragmatic hernia. The lungs showed severe hypoplasia and atelectasia. Physicians should pay attention to a prenatal diagnosis of congenital diaphragmatic hernia in order to prevent newborn fatalities. PMID:25573226

  5. A Comparative in Vitro Study of Apical Microleakage with Five Obturation Techniques: Lateral Condensation, Soft-Core®, Obtura II®, Guttaflow® and Resilon®

    PubMed Central

    Pallarés, Antonio; Cabanillas, Cristina; Zarzosa, Ignacio; Victoria, Alejandro

    2014-01-01

    Aim A comparison was made between the root canal lateral condensation technique and other condensation techniques in which physical (temperature: Soft-Core®, Obtura II®) or chemical changes (condensation: Guttaflow®, Resilon®) may affect the dimensional stability of obturation and thus favor apical microleakage. Materials and methods A total of 212 single-root teeth removed for orthodontic or periodontal reasons were randomized to 5 groups of 40 teeth each. Six samples were used as positive controls, and another 6 as negative controls. The teeth were worked with the Hero 642 system, and each group was obturated using a different technique: lateral condensation, Obtura II®, Soft-Core®, Guttaflow® or Resilon®. The samples were immersed in black ink, and after 72 hours the teeth were transparentized using the technique described by Robertson. Filtration of the ink was measured under the stereoscopic microscope. Analysis of variance and post-hoc testing were used for the statistical analysis. Results The Soft-Core® obturated group showed significantly greater microleakage than the other groups, with no differences among the rest of the groups. Conclusions Under the conditions of this study, the teeth obturated with the Soft-Core® technique showed greater apical microleakage than the other systems.

  6. Effect of advanced irrigation protocols on self-expanding Smart-Seal obturation system: A scanning electron microscopic push-out bond strength study

    PubMed Central

    Hegde, Vibha; Arora, Shashank

    2015-01-01

    Introduction: The aim of this study was to evaluate the effect of different final irrigation activation techniques affect the bond strength of self-expanding Smart-Seal obturation at the different thirds of root canal space. Materials and Methods: One hundred single-rooted human teeth were prepared using the Pro-Taper system to size F3, and a final irrigation regimen using 3% sodium hypochlorite and 17% EDTA was performed. The specimens were randomly divided into five groups (n = 20) according to the final irrigation activation technique used as follows: No activation (control), manual dynamic activation (MDA), CanalBrush activation, ultrasonic activation (UA) and EndoActivator. Five specimens from each group were subjected to scanning electron microscopic observation for assessment of the smear layer removal after the final irrigation procedures. All remaining roots were then obturated with Smart-Seal obturation system. A push-out test was used to measure the bond strength between the root canal dentin and Smart-Seal paste. The data obtained from the push-out test were analyzed using two-way analysis of variance and Tukey post-hoc tests. Conclusions: It was observed that UA improved the bond strength of Smart-Seal obturation in the coronal and middle third and MDA/EndoActivator in the apical third of the root canal space. PMID:25684907

  7. Clinical and radiological evaluation of zinc oxide-eugenol and Maisto's paste as obturating materials in infected primary teeth--nine months study.

    PubMed

    Reddy, V V; Fernandes

    1996-06-01

    The present study, performed in-vivo, included 30 infected primary teeth in 26 children in the age group of 3-8 years. The purpose of this study was to compare the efficacy of two obturating materials, zinc oxide-eugenol and Maisto's paste, in infected primary teeth. 30 teeth were divided into two groups of 15 teeth. Teeth in Group I were obturated using zinc oxide-eugenol and those in Group II were obturated using Maisto's paste. On clinical evaluation, teeth obturated with Maisto's paste showed 100% success. Five teeth that were overfilled with Maisto's paste showed complete resorption of excess material within 3 months while the two teeth overfilled with zinc oxide-eugenol showed incomplete resorption of the excess material even after 9 months. Zinc oxide-eugenol treated cases showed only 26.7% bone regeneration while in case of Maisto's paste, it was 93%. Complete healing of the inter-radicular pathology was seen with Maisto's paste. However, the pathology was present in 40% of the zinc oxide-eugenol treated teeth even after 9 months. Maisto's paste was thus seen to be superior to zinc oxide-eugenol both in clinical as well as radiological evaluation, done over a period of 9 months in relation to bone regeneration, healing of inter-radicular pathology and resorption of excess material.

  8. Postoperative pain after one-visit root-canal treatment on teeth with vital pulps: Comparison of three different obturation technique

    PubMed Central

    Alonso-Ezpeleta, Luis O.; Gasco-Garcia, Carmen; Castellanos-Cosano, Lizett; Martín-González, Jenifer; López-Frías, Francsico J.

    2012-01-01

    Objectives. To investigate and compare postoperative pain after one-visit root canal treatment (RCT) on teeth with vital pulps using three different obturation techniques. Study Design. Two hundred and four patients (105 men and 99 women) aged 12 to 77 years were randomly assigned into three treatments groups: cold lateral compaction of gutta-percha (LC), Thermafil technique (TT), and Backfill - Thermafil obturation technique (BT). Postoperative pain was recorded on a visual analogue scale (VAS) of 0 - 10 after 2 and 6 hours, and 1, 2, 3, 4, 5, 6 and 7 days. Data were statistically analyzed using multivariate logistic regression analysis. Results. In the total sample, 87% of patients experienced discomfort or pain in some moment between RCT and the seventh day. The discomfort experienced was weak, light, moderate and intense in 6%, 44%, 20% and 6% of the cases, respectively. Mean pain levels were 0.4 ± 0.4, 0.4 ± 0.3, and 1.4 ± 0.7 in LC, BT, and TT groups, respectively. Patients of TT group experienced a significantly higher mean pain level compared to other two groups (p < 0.0001). In TT group, all patients felt some level of pain at six hours after RCT. Conclusions. Postoperative pain was significantly associated with the obturation technique used during root canal treatment. Patients whose teeth were filled with Thermafil obturators (TT technique) showed significantly higher levels of discomfort than patients whose teeth were filled using any of the other two techniques. Key words:Postoperative pain, root-canal obturation, root-canal treatment, Thermafil. PMID:22322522

  9. Clinical presentation and operative repair of hernia of Morgagni

    PubMed Central

    Loong, T; Kocher, H

    2005-01-01

    A 77 year old woman who presented with an incarcerated hernia of Morgagni was successfully treated without complications. A Medline search (1996 to date) along with cross referencing was done to quantify the number of acute presentations in adults compared to children. Different investigating modalities—for example, lateral chest and abdominal radiography, contrast studies or, in difficult cases, computed tomography or magnetic resonance imaging—can be used to diagnose hernia of Morgagni. The favoured method of repair—laparotomy or laparoscopy—is also discussed. A total of 47 case reports on children and 93 case reports on adults were found. Fourteen percent of children (seven out of 47) presented acutely compared with 12% of adults (12 out of 93). Repair at laparotomy was the method of choice but if uncertain, laparoscopy would be a useful diagnostic tool before attempted repair. Laparoscopic repair was favoured in adults especially in non-acute cases. PMID:15640427

  10. Anesthesia for Traumatic Diaphragmatic Hernia Associated with Corneal Laceration.

    PubMed

    Safaeian, Reza; Hassani, Valiollah; Faiz, Hamid Reza

    2016-01-01

    BACKGROUND Diaphragmatic rupture can be seen in up to 5% of car accidents, and 80%-100% of diaphragmatic hernias are associated with other vital organ injuries. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic managements. CASE REPORT A 37-year-old male victim of a head-on collision who was suffering diaphragmatic rupture and corneal laceration was prepared for an emergency operation 11 hours after the car accident. Gastric decompression, pre-oxygenation, rapid sequence induction with succinylcholine, immediate use of non-depolarizing muscle relaxant, and mechanical ventilation with low tidal volume after intubation were used in anesthetic management of the patient. CONCLUSIONS Because of the high prevalence of coexisting pathologies with traumatic diaphragmatic hernia, anesthetic management must be tailored to the associated pathologies. PMID:27595907

  11. Endometriosis within a left-sided inguinal hernia sac

    PubMed Central

    Albutt, Katherine; Glass, Charity; Odom, Stephen; Gupta, Alok

    2014-01-01

    Endometriosis is a common gynecologic disorder wherein ectopic endometrial glands and stroma are found at extrauterine sites. Extrapelvic endometriosis is a well-documented, yet rare, disease entity that can affect almost any organ system. Inguinal endometriosis is an extremely rare disease entity characterized by tender inguinal swelling. Here we report a case of a sudden-onset and acutely painful left inguinal hernia with concordant endometriosis. A review of the literature is presented. The presence of isolated endometriosis contained within a left-sided inguinal hernia sac has, to our knowledge, never been reported. Often diagnosed incidentally or on histologic examination, general surgeons should consider inguinal endometriosis in the differential diagnosis of inguinal masses, even in the absence of catamenial symptoms. Surgical excision, with gynecologic follow-up, is locally curative and the treatment of choice for inguinal endometriosis. PMID:24876515

  12. Inguinal dermoid cyst presenting as an incarcerated inguinal hernia.

    PubMed

    Leeming, R; Olsen, M; Ponsky, J L

    1992-01-01

    A case of an inguinal dermoid cyst presenting as an incarcerated inguinal hernia in a 18-year-old boy is reported. A differential diagnosis of masses in the inguinal region is discussed and includes not only hernias but also gynecologic and vascular lesions. Dermoid cysts must be included in the differential diagnosis. Histologically, these cysts are characterized by an external lining composed of squamous epithelium with an underlying fibroconnective tissue containing hair follicles, sebaceous, eccrine, and apocrine glands. The presence of all the skin appendages in these cysts distinguishes them from epidermoid and sebaceous cysts. The lack of structures foreign to skin differentiates them from dermoids (benign cystic teratomas) in the ovarian, testicular, retroperitoneal, and sacrococcygeal region.

  13. [Potentialities of computed tomography in the diagnosis of hiatal hernia].

    PubMed

    Gorshkov, A N

    2003-01-01

    An analysis of the results of 98 studies has demonstrated the potentialities of X-ray computed tomography in the diagnosis of hiatal hernia (HH), provided the X-ray computed tomography (XCT) semiotics of HH. It has found that XCT may directly visualize and objectively evaluate anatomic structures, such as diagraphmatic crus and esophageal foremen. It has emphasized that when XCT of abdominal and thoracic organs is performed, it is necessary to include the areas of diagragmatic curs and esophageal foramen into the list of anatomic structures binding for visual assessment and characterization, which in combination with other studies will assist in the early diagnosis of hiatal hernia and eventually expand the potentialities of XCT to a greater extent.

  14. Abnormal collagen I to III distribution in the skin of patients with incisional hernia.

    PubMed

    Klinge, U; Si, Z Y; Zheng, H; Schumpelick, V; Bhardwaj, R S; Klosterhalfen, B

    2000-01-01

    The surgical mesh-free repair of incisional hernias has to face recurrence rates of up to 50%. Apart from technical faults this is probably due to collagen metabolic disorders, known to play an important role in the development of inguinal hernia. In particular an altered ratio of collagen types I and III with an increase in collagen type III has been claimed to reduce the mechanical strength of connective tissues. Therefore, we investigated the content of collagen types I and III in the skin of patients with incisional hernia (n = 7) and recurrent incisional hernia (n = 5) in comparison to controls with healthy skin (n = 7) and normal skin scar (n = 7) both by immunohistochemistry and Western blot analysis. Both immunohistochemistry and Western blot analysis revealed a decrease in the ratio of collagen I/III due to a concomitant increase in collagen III. The patients with incisional hernias and with recurrent incisional hernias showed a ratio of 1.0 +/- 0.1 and 0.8 +/- 0.1, respectively, whereas the controls exhibit a ratio of 2.1 +/- 0.2 in healthy skin and of 1.2 +/- 0.2 in normal skin scar, respectively. The decrease was highly significant (p < 0.01) between the patients with either primary or recurrent hernia and the controls or the normal scar, as well as between controls and normal scar, whereas there was not any significant difference between primary and recurrent hernia (p > 0.05). Our data for the first time confirmed that the presence of incisional hernia is accompanied by impaired collagen synthesis in the skin. The decreased tensile strength of collagen type III may play a key role in the development of incisional hernias. Furthermore, it might explain the high recurrence rates of hernia repair by simple closure, as a repetition of the primarily failing technique, and the improvement by the additional use of alloplastic material.

  15. Laparoscopic Repair of Morgagni Hernia Using Polyvinylidene Fluoride (PVDF) Mesh.

    PubMed

    Godazandeh, Gholamali; Mortazian, Meysam

    2012-10-01

    We report the cases of two patients diagnosed with Morgagni hernia who presented with nonspecific abdominal symptoms. Both underwent laparoscopic surgery that used a dual-sided mesh, polyvinylidene fluoride (PVDF; Dynamesh IPOM®). The procedures were successful and both patients were discharged with no complications. There was no recurrence in 18 months of follow up.Herein is the report of these cases and a literature review. PMID:24829663

  16. Congenital diaphragmatic hernia: where and what is the evidence?

    PubMed

    Losty, Paul D

    2014-10-01

    Congenital diaphragmatic hernia (CDH) retains high mortality and morbidity due to lung hypoplasia, pulmonary hypertension and severe co-existent anomalies. This article offers a comprehensive state-of-the-art review for the paediatric surgeon whilst also describing key contributions from the basic sciences in the search to uncover the cause of the birth defect together with efforts to develop new and better therapies for CDH. PMID:25459012

  17. FIXING JEJUNAL MANEUVER TO PREVENT PETERSEN HERNIA IN GASTRIC BYPASS

    PubMed Central

    MURAD-JUNIOR, Abdon José; SCHEIBE, Christian Lamar; CAMPELO, Giuliano Peixoto; de LIMA, Roclides Castro; MURAD, Lucianne Maria Moraes Rêgo Pereira; dos SANTOS, Eduardo Pachu Raia; RAMOS, Almino Cardoso; VALADÃO, José Aparecido

    2015-01-01

    Background : Among Roux-en-Y gastric bypass complications is the occurrence of intestinal obstruction by the appearance of internal hernias, which may occur in Petersen space or the opening in mesenteric enteroenteroanastomosis. Aim : To evaluate the efficiency and safety in performing a fixing jejunal maneuver in the transverse mesocolon to prevent internal hernia formation in Petersen space. Method : Two surgical points between the jejunum and the transverse mesocolon, being 5 cm and 10 cm from duodenojejunal angle are made. In all patients was left Petersen space open and closing the opening of the mesenteric enteroenteroanastomosis. Results : Among 52 operated patients, 35 were women (67.3%). The age ranged 18-63 years, mean 39.2 years. BMI ranged from 35 to 56 kg/m2 (mean 40.5 kg/m2). Mean follow-up was 15.1 months (12-18 months). The operative time ranged from 68-138 min. There were no intraoperative complications, and there were no major postoperative complications and no reoperations. The hospital stay ranged from 2-3 days. During the follow-up, no one patient developed suspect clinical presentation of internal hernia. Follow-up in nine patients (17.3%) showed asymptomatic cholelithiasis and underwent elective laparoscopic cholecystectomy. During these procedures were verified the Petersen space and jejunal fixation. In all nine, there was no herniation of the jejunum to the right side in Petersen space. Conclusion : The fixation of the first part of the jejunum to left side of the transverse mesocolon is safe and effective to prevent internal Petersen hernia in RYGB postoperatively in the short and medium term. It may be interesting alternative to closing the Petersen space. PMID:26537279

  18. Laparoscopic Repair of Morgagni Hernia Using Polyvinylidene Fluoride (PVDF) Mesh

    PubMed Central

    Godazandeh, Gholamali; Mortazian, Meysam

    2012-01-01

    We report the cases of two patients diagnosed with Morgagni hernia who presented with nonspecific abdominal symptoms. Both underwent laparoscopic surgery that used a dual-sided mesh, polyvinylidene fluoride (PVDF; Dynamesh IPOM®). The procedures were successful and both patients were discharged with no complications. There was no recurrence in 18 months of follow up.Herein is the report of these cases and a literature review. PMID:24829663

  19. Pubic inguinal pain syndrome: the so-called sports hernia.

    PubMed

    Cavalli, Marta; Bombini, Grazia; Campanelli, Giampiero

    2014-03-01

    The "sportsman's hernia" commonly presents as a painful groin in those sports that involve kicking and twisting movements while running, particularly in rugby, football, soccer, and ice hockey players. Moreover, sportsman's hernia can be encountered even in normally physically active people. The pain experienced is recognized at the common point of origin of the rectus abdominis muscle and the adductor longus tendon on the pubic bone and the insertion of the inguinal ligament on the pubic bone. It is accepted that this chronic pain caused by abdominal wall weakness or injury occurs without a palpable hernia. We proposed the new name "pubic inguinal pain syndrome." In the period between January 2006 and November 2013 all patients afferent in our ambulatory clinic for chronic groin pain without a clinically evident hernia were assessed with medical history, physical examination, dynamic ultrasound, and pelvic and lumbar MRI. All patients were proposed for a conservative treatment and then, if it was not effective, for a surgical treatment. Our etiopathogenetic theory is based on three factors: (1) the compression of the three nerves of the inguinal region, (2) the imbalance in strength of adductor and abdominal wall muscles caused by the hypertrophy and stiffness of the insertion of rectus muscle and adductor longus muscle, and (3) the partial weakness of the posterior wall. Our surgical procedure includes the release of all three nerves of the region, the correction of the imbalance in strength with the partial tenotomy of the rectus and adductor longus muscles, and the repair of the partial weakness of the posterior wall with a lightweight mesh. This treatment reported excellent results with complete relief of symptoms after resumption of physical activity in all cases. PMID:24526429

  20. A surprising content of congenital hernia: complete splenogonadal fusion band

    PubMed Central

    Lakshmanan, Prakash Manikka; Reddy, Ajit Kumar; Nutakki, Aditya

    2014-01-01

    Splenogonadal fusion is a rare congenital anomaly. We present the case of a 6-year-old boy who presented with a left inguinoscrotal swelling. With a clinical diagnosis of left congenital inguinal hernia the patient was taken up for explorative laparotomy where a transperitoneal band was noted adherent to the left testis. Biopsy revealed normal splenic tissue. Postoperatively the boy was imaged and a diagnosis of splenogonadal fusion was made. This article illustrates the imaging features of this rare anomaly. PMID:24671325

  1. Oral, intestinal, and skin bacteria in ventral hernia mesh implants

    PubMed Central

    Langbach, Odd; Kristoffersen, Anne Karin; Abesha-Belay, Emnet; Enersen, Morten; Røkke, Ola; Olsen, Ingar

    2016-01-01

    Background In ventral hernia surgery, mesh implants are used to reduce recurrence. Infection after mesh implantation can be a problem and rates around 6–10% have been reported. Bacterial colonization of mesh implants in patients without clinical signs of infection has not been thoroughly investigated. Molecular techniques have proven effective in demonstrating bacterial diversity in various environments and are able to identify bacteria on a gene-specific level. Objective The purpose of this study was to detect bacterial biofilm in mesh implants, analyze its bacterial diversity, and look for possible resemblance with bacterial biofilm from the periodontal pocket. Methods Thirty patients referred to our hospital for recurrence after former ventral hernia mesh repair, were examined for periodontitis in advance of new surgical hernia repair. Oral examination included periapical radiographs, periodontal probing, and subgingival plaque collection. A piece of mesh (1×1 cm) from the abdominal wall was harvested during the new surgical hernia repair and analyzed for bacteria by PCR and 16S rRNA gene sequencing. From patients with positive PCR mesh samples, subgingival plaque samples were analyzed with the same techniques. Results A great variety of taxa were detected in 20 (66.7%) mesh samples, including typical oral commensals and periodontopathogens, enterics, and skin bacteria. Mesh and periodontal bacteria were further analyzed for similarity in 16S rRNA gene sequences. In 17 sequences, the level of resemblance between mesh and subgingival bacterial colonization was 98–100% suggesting, but not proving, a transfer of oral bacteria to the mesh. Conclusion The results show great bacterial diversity on mesh implants from the anterior abdominal wall including oral commensals and periodontopathogens. Mesh can be reached by bacteria in several ways including hematogenous spread from an oral site. However, other sites such as gut and skin may also serve as sources for the

  2. Parastomal Hernia: Avoidance and Treatment in the 21st Century.

    PubMed

    Glasgow, Sean C; Dharmarajan, Sekhar

    2016-09-01

    Despite medical and surgical advances leading to increased ability to restore or preserve gastrointestinal continuity, creation of stomas remains a common surgical procedure. Every ostomy results in a risk for subsequent parastomal herniation, which in turn may reduce quality of life and increase health care expenditures. Recent evidence-supported practices such as utilization of prophylactic reinforcement, attention to stoma placement, and laparoscopic-based stoma repairs with mesh provide opportunities to both prevent and successfully treat parastomal hernias. PMID:27582655

  3. Quadrapod mesh for posterior wall reconstruction in adult inguinal hernias.

    PubMed

    Wu, Shih-Chung; Wang, Chih-Chi; Yong, Chee-Cheng

    2008-03-01

    Inguinal hernia repairs are the most frequently carried out operations worldwide, and open-mesh herniorrhaphies have gained wide acceptance for advantages of little tension, less pain and lower recurrence rates. Even so, potential drawbacks of original open-mesh repairs exist, and we accordingly make some modifications, suggesting a new 'quadrapod' marlex mesh as an alternative. From July 2002 to March 2004, we carried out 288 consecutive inguinal hernia repairs using quadrapod mesh in 273 patients, all of them were male and aged older than 35 years. Patient demographics, operative parameters, morbidity and outcomes were collected in detail. After surgery, patients were followed up every 6 months at one surgeon's clinic and any major abnormality was recorded. Mean age of the 273 patients was 58.7 years. Twenty-eight patients had recurrent hernias and 15 bilateral hernias. Mean surgical duration was 50.7 min. One patient suffered from major wound infection and needed prolonged hospitalization for parenteral antibiotics. Owing to old age and benign prostatic hyperplasia, 11 patients receiving spinal anaesthesia had temporary postoperative urine retention and needed short-term urinary catheter insertion. Most patients were discharged 1 day following surgery. Acute wound pain generally improved within days, and no patients complained of chronic pain or debility necessitating special interventions. With a mean follow up of 40.7 months, no case of recurrent herniation was detected to date. Open-mesh herniorrhaphy using quadrapod mesh provides a cheap, feasible and effective alternative choice in centres with limited resources. Preliminary results are encouraging, and a formal prospective study may be warranted.

  4. EXPERIENCE OF TREATMENT OF CONGENITAL DIAPHRAGMATIC HERNIA AMONG BABIES.

    PubMed

    Savvina, V A; Tarasov, A Yu; Varfolomeyev, A R; Nikolaev, V N; Petrova, N e; Emeliynova, Z E; Grigoriev, V A; Sleptsov, A A

    2015-01-01

    The article presents our experience of treatment of congenital diaphrogmatic hernia at newborns and hernia of an esophageal opening of a diaphragm among children of early age. Since 2010 surgical tactics has been changed: the prolonged preoperative preparation with use of the device of high-frequency ventilation of lungs, correction of symptoms of pulmonary hypertensia is carried out, operation is carried out according to plan after stabilization of the patient in parameters of oxygenation and an acid-base state, operative treatment is executed by method of low-invasive endosurgery. Over the last 5 years 25 children with good functional and cosmetic results have been operated. The lethality in the case of congenital diaphragmatic hernia at newborns decreased to 12%, it was noted generally among patients with the expressed hypoplasia of lungs which died during preoperative preparation. In recent years we place emphasis on antenatal diagnosis of pathology and prenatal diagnostics of degree of a hypoplasia of a lung on indicators of a pulmonary and head index at a fetus. It wasn't noted a postoperative lethality. PMID:26887143

  5. Bochdalek hernia: A rare case report of adult age

    PubMed Central

    Yagmur, Yusuf; Yiğit, Ebral; Babur, Mehmet; Gumuş, Serdar

    2015-01-01

    Introduction Bochdalek hernia is the most common type of congenital diaphragmatic hernia and constitutes 85% of cases. Bochdalek hernia (BH) in adults is extremely rare. We present a BH case in an adult patient and discuss the literature. Presentation 22-year-old female patient with abdominal pain, occasional cramps, dysphagic problems, constipation, shortness of breath and choking for about 2 years applied to our clinic. Diagnosis A defect about 5 cm in the left hemidiaphragm posterior area and herniation of intra-abdominal fat plan in the left hemithorax was seen in intravenous and oral whole abdominal CT. Treatment Patient was operated laparoscopically. Transverse colon and a large portion of the omentum entering into hemidiaphragm were pulled in to intraperitoneal area carefully. Approximately 10 × 8 cm intraabdominal mesh was fixed to the defect area with the help of laparoscopic tacker. Conclusion Adult BH is very rare and when confronted laparoscopic treatment with mesh fixation can be performed safely. PMID:26865978

  6. Anesthesia for Traumatic Diaphragmatic Hernia Associated with Corneal Laceration

    PubMed Central

    Safaeian, Reza; Hassani, Valiollah; Faiz, Hamid Reza

    2016-01-01

    Patient: Male, 37 Final Diagnosis: Diaphragmatic hernia Symptoms: Dyspnea Medication: — Clinical Procedure: CT-scan Specialty: Anesthesiology Objective: Rare co-existance of disease or pathology Background: Diaphragmatic rupture can be seen in up to 5% of car accidents, and 80%–100% of diaphragmatic hernias are associated with other vital organ injuries. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic managements. Case Report: A 37-year-old male victim of a head-on collision who was suffering diaphragmatic rupture and corneal laceration was prepared for an emergency operation 11 hours after the car accident. Gastric decompression, preoxygenation, rapid sequence induction with succinylcholine, immediate use of non-depolarizing muscle relaxant, and mechanical ventilation with low tidal volume after intubation were used in anesthetic management of the patient. Conclusions: Because of the high prevalence of coexisting pathologies with traumatic diaphragmatic hernia, anesthetic management must be tailored to the associated pathologies. PMID:27595907

  7. Morgagni hernia: A rare case report and review of literature.

    PubMed

    Pattnaik, Manoj Kumar; Sahoo, Sarada Prasanna; Panigrahy, Sameer Kumar; Nayak, Kalyani Bala

    2016-01-01

    Morgagni hernias (MHs) are rare and constitute about 2% of all diaphragmatic hernias. Although uncommon, it has potential for considerable morbidity if the diagnosis is missed. An elderly woman with known history of chronic asthma and constipation presented to us with vague right-sided chest pain. General physical examination was unremarkable and coincidentally diagnosed to have diabetes mellitus. Chest roentgenogram posteroanterior view revealed a right paracardiac opacity and right lateral view showed the opacity in the peridiaphragmatic area of anterior mediastinum. Computed tomographic scan of the chest and abdomen revealed a right-sided MH containing omental fat. Standard right posterolateral thoracotomy was done, and there was a rent at the medial end of the xiphoid process with hernia sac containing the omentum, which was compressing adjacent lungs and heart. The sac was opened; redundant omentum was resected, and rent closed with intercostal muscle with prolene. MH being rare must be addressed with appropriate investigation to prevent unnecessary morbidity and mortality. PMID:27578938

  8. Increased nuchal translucency and diaphragmatic hernia. A case report.

    PubMed

    Daniilidis, A; Balaouras, D; Psarra, N; Chitzios, D; Tzafettas, M; Balaouras, G; Vrachnis, N

    2015-01-01

    Increased nuchal translucency (NT) thickness is present in 40% of fetuses with diaphragmatic hernia, including 80% of those that result in neonatal death and in 20% of the survivors. A 33-year-old nulliparous woman had first trimester scan at 12 weeks. The fetus had a NT of 2.3 mm, normal ductus venosus (DV), and tricuspid doppler and present nasal bone. Pregnancy-associated plasma protein A (PAPP-A) was 0.59 MoM and beta-human chorionic gonadotropin (b-hCG) 2.56 MoM. The couple did not opt for chorionic villous sampling (CVS) and repeat ultrasound examination was advised. At 18 weeks, ultrasound revealed left sided diaphragmatic hernia. The couple consented for termination of the pregnancy. The molecular test showed normal karyotype and male gender. In such cases with intrathoracic herniation of abdominal viscera, the increased NT may be the consequence of venous congestion due to mediastinal compression. The prolonged compression of the lungs causes pulmonary hypoplasia. Increased NT with normal fetal karyotype is associated with structural fetal anomalies like diaphragmatic hernia and screening at 16-18 weeks is imperative. PMID:26054128

  9. Morgagni hernia: A rare case report and review of literature

    PubMed Central

    Pattnaik, Manoj Kumar; Sahoo, Sarada Prasanna; Panigrahy, Sameer Kumar; Nayak, Kalyani Bala

    2016-01-01

    Morgagni hernias (MHs) are rare and constitute about 2% of all diaphragmatic hernias. Although uncommon, it has potential for considerable morbidity if the diagnosis is missed. An elderly woman with known history of chronic asthma and constipation presented to us with vague right-sided chest pain. General physical examination was unremarkable and coincidentally diagnosed to have diabetes mellitus. Chest roentgenogram posteroanterior view revealed a right paracardiac opacity and right lateral view showed the opacity in the peridiaphragmatic area of anterior mediastinum. Computed tomographic scan of the chest and abdomen revealed a right-sided MH containing omental fat. Standard right posterolateral thoracotomy was done, and there was a rent at the medial end of the xiphoid process with hernia sac containing the omentum, which was compressing adjacent lungs and heart. The sac was opened; redundant omentum was resected, and rent closed with intercostal muscle with prolene. MH being rare must be addressed with appropriate investigation to prevent unnecessary morbidity and mortality. PMID:27578938

  10. Pyometra in an inguinal hernia in a bitch.

    PubMed

    Gogny, A; Bruyas, J-F; Fiéni, F

    2010-12-01

    Pyometra in an inguinal hernia was diagnosed in a 10-year-old intact cross-bred bitch which had had dysorexia, depression and inguinal distension. The hernia contained caudal portions of the two uterine horns, uterine cervix and cranial part of the vagina. As the organs were enlarged and full of pus, manual attempt to push back the uterine horns and the vagina in the abdominal cavity through the inguinal canal was unsuccessful. Herniated uterine horns were ligated and cut in their median portion, so it became possible to remove the cervix and the caudal portion of the horns through the hernial orifice, and the ovaries and the cranial part of the horns through a peritoneal midline incision. This bitch was not intended for breeding purposes and, given the presence of a huge pyometra associated with an inguinal hernia, an ovario-hysterectomy was recommended. Uterine herniation should be considered as a differential diagnosis of a caudal lateral inguinal mass. When pushing the uterus back in the abdominal cavity is impossible, a surgical procedure should be performed to detect ischemia–reperfusion injury and/or a septic risk. PMID:20088851

  11. Early clinical outcomes following laparoscopic inguinal hernia repair.

    PubMed

    Tolver, Mette Astrup

    2013-07-01

    Laparoscopic inguinal hernia repair (TAPP) has gained increasing popularity because of less post-operative pain and a shorter duration of convalescence compared with open hernia repair technique (Lichtenstein). However, investigation of duration of convalescence with non-restrictive recommendations, and a procedure-specific characterization of the early clinical outcomes after TAPP was lacking. Furthermore, optimization of the post-operative period with fibrin sealant versus tacks for fixation of mesh, and the glucocorticoid dexamethasone versus placebo needed to be investigated in randomized clinical trials. The objective of this PhD thesis was to characterize the early clinical outcomes after TAPP and optimize the post-operative period. The four studies included in this thesis have investigated duration of convalescence and procedure-specific post-operative pain and other early clinical outcomes after TAPP. Furthermore, it has been shown that fibrin sealant can improve the early post-operative period compared with tacks, while dexamethasone showed no advantages apart from reduced use of antiemetics compared with placebo. Based on these findings, and the existing knowledge, 3-5 days of convalescence should be expected when 1 day of convalescence is recommended and future studies should focus on reducing intraabdominal pain after TAPP. Fibrin sealant can optimize the early clinical outcomes but the risk of hernia recurrence and chronic pain needs to be evaluated. Dexamethasone should be investigated in higher doses. PMID:23809977

  12. A case of congenital diaphragmatic hernia with a hernia sac attached to the liver: hints for an early embryological insult.

    PubMed

    Sharma, Shilpa; Jain, Rani; Singh, M K; Gupta, Devendra K

    2007-10-01

    We describe here the unusual operative findings in a case of congenital diaphragmatic hernia (CDH). A neonate antenatally diagnosed as having CDH was operated via a left subcostal incision. The operative findings included a large central diaphragmatic defect of 5 x 5 cm, lined by a thick sac. The contents of the hernia included the stomach, spleen, and loops of the small and large intestine. The left side of the liver was thinned out and forming a part of the dome of the sac of the CDH. Vessels of the hepatic tissue were in continuity with the sac. There were scattered liver tissues forming cords in the sac lining. These findings were confirmed by histopathologic examinations. These findings have not been reported earlier in humans and might help to elucidate the embryology of the development of the diaphragm. Our findings suggest that this kind of defect occurs early in development, and we hypothesize that it is associated with a poorer prognosis.

  13. Ipsilateral obturator type of hip dislocation with fracture shaft femur in a child: a case report and literature review.

    PubMed

    Arjun, R H H; Kumar, Vishal; Saibaba, Balaji; John, Rakesh; Guled, Uday; Aggarwal, Sameer

    2016-09-01

    The incidence of traumatic hip dislocations in children is rising in this fast developing world along with increasing numbers of high-velocity road traffic accidents. Anterior dislocation of the hip has a lower incidence compared with posterior dislocation of the hip. We encountered a rare case of the obturator type of anteriorly dislocated hip associated with ipsilateral fracture of the shaft femur in an 11-year-old child. This is a highly unusual injury combination and the mechanism of injury is obscure. Only two similar cases have been reported in the English literature to date. Closed reduction of the hip using a hitherto undescribed technique and an intramedullary interlocking nail was performed in this case. At 6 months of follow-up, the fracture shaft femur has united and the child is bearing full weight on the limb. PMID:27128394

  14. [Resection of a left obturator lymph node recurrence five years five months after surgery for rectal cancer].

    PubMed

    Takenoya, Takashi; Kobayashi, Yukari; Suda, Kouichi; Shimizu, Kazuki; Kikuichi, Masahiro

    2014-11-01

    A 62-year-old man with lower rectal cancer underwent abdominoperineal resection and dissection of the lateral pelvic lymph nodes. The cancer was staged at pT3pN0cM0, pStage II and did not show recurrence. Two years later, the patient had dysphagia and was diagnosed with esophageal cancer based on upper gastrointestinal endoscopy. Positron emission tomography-computed tomography (PET/CT) performed to detect distant metastasis revealed fluorodeoxyglucose (FDG) uptake in the left obturator lymph nodes, indicating rectal cancer recurrence. The patient received radiation therapy (60.4 Gy) for the recurrence. A PET/CT scan obtained 2 years 6 months after the initial rectal cancer resection revealed no FDG uptake. Uraciltegafur plus Leucovorin (UFT+LV) was started and continued for 6 months, but tumor enlargement was noted. Treatment was changed to LV, 5-fluorouracil, and irinotecan (FOLFIRI), but after 4 courses, the patient's carcinoembryonic antigen (CEA) levels rose. The patient then received 4 courses of bevacizumab plus FOLFIRI. A CT scan revealed tumor shrinkage, so the patient received 4 more courses of this regimen. Five years postoperatively, the patient's CEA levels rose again. A PET/CT scan 4 months later revealed FDG uptake in the left obturator lymph nodes, indicative of rectal cancer recurrence. One month later, the lymph nodes were resected. The patient was subsequently recurrence free. Tumor marker measurement and PET/CT helped to assess the patient's condition. When cancer recurs in the lateral pelvic lymph nodes with no involvement of the pelvis and R0 resection is possible, resection should be considered if the patient is capable of undergoing surgery.

  15. Evaluation of Coronal Leakage Following Different Obturation Techniques and in-vitro Evalution Using Methylene Blue Dye Preparation

    PubMed Central

    Mathur, Rachit; Sharma, Medhavi; Sharma, Deepak; Raisingani, Deepak; Vishnoi, Suchita; Singhal, Deepika

    2015-01-01

    Introduction Coronal and apical leakage still remains one of the most important cause for endodontic failure in spite of the presence of advanced endodontic materials. The cause may attribute to different filling techniques, physical and chemical properties of sealers and presence or absence of smear layer assessment of coronal or apical leakage is used as a research method to compare the sealing ability of different techniques and endodontic materials. Aim To compare the coronal bacterial leakage using methylene blue in four different obturation techniques after protaper hand instrumentation. Materials and Methods Ninety extracted single-rooted teeth were instrumented to an apical preparation size F3 Protaper hand files. Twenty teeth were randomly obturated with lateral compaction, 20 with vertical compaction, 20 with combination of vertical and lateral compaction and 20 with Thermafil. Ten teeth were used for positive and negative controls (five teeth in each group). Teeth were kept in 100% humidity for 90 days, and then subjected coronally to Proteus vulgaris for 21 days to assess bacterial leakage. After bacterial challenge, methylene blue was placed coronally for another 21 days, and then scoring was done according to depth of dye leakage. Chi-square test was done for statistical analysis. Results Leakage as observed with combination of vertical and lateral compaction was significantly less than vertical compaction, lateral compaction and thermafil carriers during bacterial challenge. However, when dye was used it also showed statistically significant results with thermafil carriers showing the least leakage in comparison to vertical condensation, lateral condensation and combined groups. Conclusion The study concludes that two different methods i.e. bacterial and dye leakage revealed considerable variation on the same substrate Thus, due to the presence of variability among the results obtained by two different analytical methods used in the present study

  16. A fatal case of complicated congenital peritoneopericardial diaphragmatic hernia in a Holstein calf.

    PubMed

    Hicks, Keltie A; Britton, Ann P

    2013-07-01

    Congenital peritoneopericardial diaphragmatic hernia is a rare condition most commonly reported in cats and dogs. A 6-week-old Holstein heifer calf with a congenital peritoneopericardial diaphragmatic hernia complicated by a perforated abomasal ulcer is described. The clinical signs and pathological findings are compared with those reported in other species.

  17. Surgical physiology of inguinal hernia repair - a study of 200 cases

    PubMed Central

    Desarda, Mohan P

    2003-01-01

    Background Current inguinal hernia operations are generally based on anatomical considerations. Failures of such operations are due to lack of consideration of physiological aspects. Many patients with inguinal hernia are cured as a result of current techniques of operation, though factors that are said to prevent hernia formation are not restored. Therefore, the surgical physiology of inguinal canal needs to be reconsidered. Methods A retrospective study is describer of 200 patients operated on for inguinal hernia under local anaesthesia by the author's technique of inguinal hernia repair. Results The posterior wall of the inguinal canal was weak and without dynamic movement in all patients. Strong aponeurotic extensions were absent in the posterior wall. The muscle arch movement was lost or diminished in all patients. The movement of the muscle arch improved after it was sutured to the upper border of a strip of the external oblique aponeurosis (EOA). The newly formed posterior wall was kept physiologically dynamic by the additional muscle strength provided by external oblique muscle to the weakened muscles of the muscle arch. Conclusions A physiologically dynamic and strong posterior inguinal wall, and the shielding and compression action of the muscles and aponeuroses around the inguinal canal are important factors that prevent hernia formation or hernia recurrence after repair. In addition, the squeezing and plugging action of the cremasteric muscle and binding effect of the strong cremasteric fascia, also play an important role in the prevention of hernia. PMID:12697071

  18. A new approach to primary strengthening of colostomy with Marlex mesh to prevent paracolostomy hernia.

    PubMed

    Bayer, I; Kyzer, S; Chaimoff, C

    1986-12-01

    A new procedure for preventing paracolostomy hernia is described. It has been used since 1979 in 43 patients and is effective in strengthening the colostomy outlet in its common location and affixing the intestine firmly to the aperture. Four years after operation, no hernia or prolapse has occurred in the patients who underwent this procedure. PMID:3787436

  19. Evaluation of the Splash Time Test as a Bedside Test for Hiatal Hernia

    PubMed Central

    Lindow, Thomas Akesson; Franzen, Thomas

    2014-01-01

    Background Hiatal hernias may present with heartburn, acid regurgitation, dysphagia, chest pain, pulmonary symptoms and globus jugularis. Due to the heterogeneous presentation, there is a need for a simple diagnostic instrument when hiatal hernia is suspected. Hiatal hernia may impair esophageal bolus transportation. The splash time test is a rough measurement of esophageal bolus transportation, where time is measured from the start of swallowing a liquid bolus to the appearance of a “splashing” sound at xiphoid level. We aimed to test the hypothesis that the splash time test is prolonged in patients with hiatal hernia compared to normal subjects. Methods In 30 patients with hiatal hernia, time was measured from swallow to splash using audiosignal recording. Thirty healthy subjects were used as controls. Results Median time from swallow to splash was 4.9 seconds in the patient group and 4.4 seconds in the control group. Five patients, but none of the controls, performed swallows with absence of splash. Using only absence of splash as a pathological result, sensitivity was 23% and specificity was 100%. Conclusion The splash time test is not a sensitive instrument in diagnosing hiatal hernias. The absence of splash, however, seems to be a specific marker of hiatal hernia. Further research is needed regarding which other conditions besides hiatal hernia may cause absence of splash. The splash time test can be replaced by the even simpler “splash test”.

  20. Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic.

    PubMed Central

    Lowham, A S; Filipi, C J; Fitzgibbons, R J; Stoppa, R; Wantz, G E; Felix, E L; Crafton, W B

    1997-01-01

    OBJECTIVE: The authors provide an assessment of mechanisms leading to hernia recurrence after laparoscopic and traditional preperitoneal herniorrhaphy to allow surgeons using either technique to achieve better results. SUMMARY BACKGROUND DATA: The laparoscopic and traditional preperitoneal approaches to hernia repair are analogous in principle and outcome and have experienced a similar evolution over different time frames. The recurrence rate after preperitoneal herniorrhaphy should be low (< 2%) to be considered a viable alternative to the most successful methods of conventional herniorrhaphy. METHODS: Experienced surgeons supply specifics regarding the mechanisms of recurrence and technical measures to avoid hernia recurrence when using the preperitoneal prosthetic repair. Videotapes of laparoscopic herniorrhaphy in 13 patients who subsequently experienced a recurrence also are used to determine technical causes of recurrence. RESULTS: Factors leading to recurrence include surgeon inexperience, inadequate dissection, insufficient prosthesis size, insufficient prosthesis overlap of hernia defects, improper fixation, prosthesis folding or twisting, missed hernias, or mesh lifting secondary to hematoma formation. CONCLUSIONS: The predominant factor in successful preperitoneal hernia repair is adequate dissection with complete exposure and coverage of all potential groin hernia sites. Hematoma mesh lifting and inadequate lateral inferior and medial inferior mesh fixation represent the most common causes of recurrence for surgeons experienced in traditional or laparoscopic preperitoneal hernia repair. PMID:9114802

  1. [Complex approach to the treatment of the diskal hernia of lumbosacral spine].

    PubMed

    Chekhonatskiĭ, A A; Chekhonatskaia, M L; Sharova, E V; Toma, A S

    2010-08-01

    21 patients with lumbosacral osteochondritis and diskal hernia were treated. Diagnosis was verified with the help of radiological method. The spinal motion segment after the hernia excision was fixed with the help of fixator with the shape memory for the prevention of post-operation instability. Thioctic acid showed the high effectiveness in complex treatment of radiculopathy.

  2. [Impaired lung function and anemia from large hiatal hernia: a case report].

    PubMed

    Suppa, Marianna; Colzi, Marina; Magnanelli, Elisa; Migliozzi, Elisa; Negri, Silvia; Millarelli, Federica; Coppola, Alessandro

    2013-05-01

    We present the clinical case of a 54 years old man who accessed for dyspnea and severe anemia. After being transfused, he underwent to gastroscopy, which showed an erosive gastritis with large hiatal hernia. The hernia was surgically reduced with laparoscopic hiatoplastic and Nissen-Rossetti fundoplication. In conclusion, dyspnea is not merely a medical competence but also a surgical one.

  3. An irreducible left scrotal hernia containing a sigmoid colon tumor (adenocarcinoma) – Case report

    PubMed Central

    Gnaś, Jarosław; Bulsa, Marek; Czaja-Bulsa, Grażyna

    2014-01-01

    INTRODUCTION In relation to all inguinal hernias, large irreducible scrotal hernias are quite rare, while such hernias containing colon tumors in the sac have so far been described in fewer than 30 cases. PRESENTATION OF CASE A 61-year-old patient was admitted for a planned surgery because of a large irreducible left-sided scrotal hernia. Intraoperatively, a large tumor of the sigmoid colon was found in the hernial sac. In a histopathological examination it was diagnosed as adenocarcinoma. A palliative operation was performed and he was referred to further systemic and palliative treatment (because of numerous coexisting liver metastases). DISCUSSION Until now, only about 30 cases of colon tumor in inguinal hernia sac have been reported. CONCLUSION It should be remembered that even the most obvious preoperative diagnosis may be verified intraoperatively. PMID:24988210

  4. 5-millimeter Trocar-site Hernias After Laparoscopy Requiring Surgical Repair.

    PubMed

    Pereira, Nigel; Hutchinson, Anne P; Irani, Mohamad; Chung, Eric R; Lekovich, Jovana P; Chung, Pak H; Zarnegar, Rasa; Rosenwaks, Zev

    2016-01-01

    Trocar-site hernias are rare complications of laparoscopic surgery. Although trocar-site hernias occur more often at >10-mm sites, hernias can still develop at 5-mm sites after laparoscopy and can lead to serious complications. The primary objective of this review is to summarize the current medical literature pertaining to the clinical presentation and predisposing risk factors of trocar-site hernias at 5-mm sites after laparoscopy. A total of 295 publications were identified, 17 (5.76%) of which met the inclusion criteria. Twenty-seven patients with trocar-site hernias were identified after laparoscopic cases. The median age (interquartile range) for all adult patients with trocar-site hernias was 63 years (interquartile range, 39.5-66.5 years). Eight of the 18 patients (44.4%) undergoing gynecologic laparoscopy were parous although details of parity were not reported in most publications. Simple manual reduction or laparoscopic reduction with fascial closure (21 patients [84%]) was used more often compared with exploratory laparotomy (4 patients [16%], p < .001) to manage trocar-site hernias. There was no statistical difference in the location of trocar-site hernias (i.e., umbilical [14 patients, 56%] vs nonumbilical/lateral [11 patients, 44%], p = .12). Findings of this review suggest that increased operative times and excessive manipulation can extend 5-mm fascial incisions, thereby increasing the risk of trocar-site hernias. Parous women older than 60 years may have unrecognized fascial defects, which confer a higher risk of trocar-site hernias after laparoscopic surgery, even in the absence of incision manipulation or prolonged surgical duration. Such patients may benefit from closure of 5-mm fascial incisions although prospective data are required to validate the overall generalizability of this management strategy.

  5. Fabricating a tooth- and implant-supported maxillary obturator for a patient after maxillectomy with computer-guided surgery and CAD/CAM technology: A clinical report.

    PubMed

    Noh, Kwantae; Pae, Ahran; Lee, Jung-Woo; Kwon, Yong-Dae

    2016-05-01

    An obturator prosthesis with insufficient retention and support may be improved with implant placement. However, implant surgery in patients after maxillary tumor resection can be complicated because of limited visibility and anatomic complexity. Therefore, computer-guided surgery can be advantageous even for experienced surgeons. In this clinical report, the use of computer-guided surgery is described for implant placement using a bone-supported surgical template for a patient with maxillary defects. The prosthetic procedure was facilitated and simplified by using computer-aided design/computer-aided manufacture (CAD/CAM) technology. Oral function and phonetics were restored using a tooth- and implant-supported obturator prosthesis. No clinical symptoms and no radiographic signs of significant bone loss around the implants were found at a 3-year follow-up. The treatment approach presented here can be a viable option for patients with insufficient remaining zygomatic bone after a hemimaxillectomy. PMID:26774316

  6. Inguinodynia following Lichtenstein tension-free hernia repair: a review.

    PubMed

    Hakeem, Abdul; Shanmugam, Venkatesh

    2011-04-14

    Chronic groin pain (Inguinodynia) following inguinal hernia repair is a significant, though under-reported problem. Mild pain lasting for a few days is common following mesh inguinal hernia repair. However, moderate to severe pain persisting more than 3 mo after inguinal herniorrhaphy should be considered as pathological. The major reasons for chronic groin pain have been identified as neuropathic cause due to inguinal nerve(s) damage or non-neuropathic cause due to mesh or other related factors. The symptom complex of chronic groin pain varies from a dull ache to sharp shooting pain along the distribution of inguinal nerves. Thorough history and meticulous clinical examination should be performed to identify the exact cause of chronic groin pain, as there is no single test to confirm the aetiology behind the pain or to point out the exact nerve involved. Various studies have been performed to look at the difference in chronic groin pain rates with the use of mesh vs non-mesh repair, use of heavyweight vs lightweight mesh and mesh fixation with sutures vs. glue. Though there is no convincing evidence favouring one over the other, lightweight meshes are generally preferred because of their lesser foreign body reaction and better tolerance by the patients. Identification of all three nerves has been shown to be an important factor in reducing chronic groin pain, though there are no well conducted randomised studies to recommend the benefits of nerve excision vs preservation. Both non-surgical and surgical options have been tried for chronic groin pain, with their consequent risks of analgesic side-effects, recurrent pain, recurrent hernia and significant sensory loss. By far the best treatment for chronic groin pain is to avoid bestowing this on the patient by careful intra-operative handling of inguinal structures and better patient counselling pre- and post-herniorraphy.

  7. Hypersplenism Associated With Late-Presenting Congenital Diaphragmatic Hernia

    PubMed Central

    Lu, Xue-Xin; Shen, Zhen; Dong, Kui-Ran; Zheng, Shan

    2016-01-01

    Abstract Congenital diaphragmatic hernia (CDH) is a rare developmental anomaly of the diaphragm that mainly presents mainly in newborns. Even less common is late-onset CDH associated with hypersplenism. We report a 10-year-old male who presented with coughing, blood-stained sputum, and fever. He was diagnosed with CDH complicating hypersplenism after computed tomography was done. The patient was treated by CDH repair and splenectomy, and remained asymptomatic at 6-month follow-up. Computed tomography can be an important diagnostic option in this rare combination of CDH and hypersplenism, and surgical intervention is strongly recommended. PMID:27227931

  8. Jarcho-Levin syndrome presenting with diaphragmatic hernia.

    PubMed

    Onay, O S; Kinik, S T; Otgün, Y; Arda, I S; Varan, B

    2008-08-01

    Jarcho-Levin syndrome (spondylothoracic or spondylocostal dysostosis) is an eponym that is used to define individuals with a short neck, short trunk, and short stature and multiple vertebral anomalies. The prognosis is directly related to respiratory complications. Reported findings associated with Jarcho-Levin syndrome include congenital heart defects, abdominal wall malformations, genitourinary malformations, upper limb anomalies, and neural tube defects. We report on a 6-day-old girl who presented with an incomplete form of Jarcho-Levin syndrome with late-presenting congenital diaphragmatic hernia and congenital heart disease. PMID:18629769

  9. Lower incidence of inguinal hernia after radical prostatectomy using open gasless endoscopic single-site surgery.

    PubMed

    Fukuhara, H; Nishimatsu, H; Suzuki, M; Fujimura, T; Enomoto, Y; Ishikawa, A; Kume, H; Homma, Y

    2011-06-01

    Inguinal hernia is one of the long-term complications requiring surgical interventions after retropubic radical prostatectomy (RRP), and its incidence has been reported to range from 12 to 21%. The number of open gasless laparoendoscopic single-site surgery, especially minimum incision endoscopic radical prostatectomy (MIES-RRP) is increasing in Japan. The incidence of post-operative inguinal hernia was compared between conventional RRP and MIES-RRP. The medical records of 333 patients who underwent conventional RRP (n=214) or MIES-RRP (n=119) with pelvic lymphadenectomy at our hospital were retrospectively evaluated. There were no significant differences between the two groups in age, pre-operative PSA levels, or previous major abdominal surgery (cholecystectomy, gastrectomy and colectomy), appendectomy or inguinal hernia repair. MIES-RRP was carried out with a 5-8-cm lower abdominal midline incision. Inguinal hernia developed postoperatively in 41 (19%) of the 214 men undergoing conventional RRP during mean follow-up of 58 months (range: 7-60 months). In contrast, 7 (5.9%) of the 119 men receiving MIES-RRP, developed inguinal hernia during mean follow-up of 21 months (range: 13-31 months). The hernia-free survival was significantly higher after MIES-RRP than after conventional RRP (P=0.037). Our results suggest that MIES-RRP is less associated with post-operative inguinal hernia than conventional RRP.

  10. A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia

    PubMed Central

    Jorgenson, Eric; Makki, Nadja; Shen, Ling; Chen, David C.; Tian, Chao; Eckalbar, Walter L.; Hinds, David; Ahituv, Nadav; Avins, Andrew

    2015-01-01

    Inguinal hernia repair is one of the most commonly performed operations in the world, yet little is known about the genetic mechanisms that predispose individuals to develop inguinal hernias. We perform a genome-wide association analysis of surgically confirmed inguinal hernias in 72,805 subjects (5,295 cases and 67,510 controls) and confirm top associations in an independent cohort of 92,444 subjects with self-reported hernia repair surgeries (9,701 cases and 82,743 controls). We identify four novel inguinal hernia susceptibility loci in the regions of EFEMP1, WT1, EBF2 and ADAMTS6. Moreover, we observe expression of all four genes in mouse connective tissue and network analyses show an important role for two of these genes (EFEMP1 and WT1) in connective tissue maintenance/homoeostasis. Our findings provide insight into the aetiology of hernia development and highlight genetic pathways for studies of hernia development and its treatment. PMID:26686553

  11. Lumbar hernia treated with lightweight partially absorbable mesh: report of a case.

    PubMed

    Yamaguchi, Shohei; Tsutsumi, Norifumi; Kusumoto, Eiji; Endo, Kazuya; Ikejiri, Koji; Yamashita, Yo-ichi; Uchiyama, Hideaki; Saeki, Hiroshi; Oki, Eiji; Kawanaka, Hirofumi; Morita, Masaru; Ikeda, Tetsuo; Maehara, Yoshihiko

    2013-12-01

    Superior lumbar hernia, also known as Grynfeltt-Lesshaft hernia, is an uncommon abdominal wall defect. We report a case of superior lumbar hernia, which was successfully treated with a lightweight partially absorbable mesh. A 73-year-old man visited our department with complaints of lumbar pain and a feeling of pressure associated with a right lumbar mass. A CT scan of the abdomen demonstrated a defect in the aponeurosis of the transversus abdominis muscle and a protrusion of the small intestine through the defect. The diagnosis of a right superior lumbar hernia was made. The lumbar hernia was surgically treated with a lightweight large-pore polypropylene mesh containing an absorbable component consisting of poliglecaprone (ULTRAPRO Plug). The patient had no evidence of recurrence after 4 years of follow-up without any sense of discomfort. This is the first case report of a lumbar hernia treated with a lightweight partially absorbable mesh. This partially absorbable mesh can be considered to be suitable for the treatment of a lumbar hernia.

  12. A novel technique of lumbar hernia repair using bone anchor fixation.

    PubMed

    Carbonell, A M; Kercher, K W; Sigmon, L; Matthews, B D; Sing, R F; Kneisl, J S; Heniford, B T

    2005-03-01

    Lumbar hernias are difficult to repair due to their proximity to bone and inadequate surrounding tissue to buttress the repair. We analyzed the outcome of patients undergoing a novel retromuscular lumbar hernia repair technique. The repair was performed in ten patients using a polypropylene or polytetrafluoroethylene mesh placed in an extraperitoneal, retromuscular position with at least 5 cm overlap of the hernia defect. The mesh was fixed with circumferential, transfascial, permanent sutures and inferiorly fixed to the iliac crest by suture bone anchors. Five hernias were recurrent, and five were incarcerated; seven were incisional hernias, and three were posttraumatic. Back and abdominal pain was the most common presenting symptom. Mean hernia size was 227 cm(2) (60-504) with a mesh size of 620 cm(2) (224-936). Mean operative time was 181 min (120-269), with a mean blood loss of 128 ml (50-200). Mean length of stay was 5.2 days (2-10), and morphine equivalent requirement was 200 mg (47-460). There were no postoperative complications or deaths. After a mean follow-up of 40 months (3-99) there have been no recurrences. Our sublay repair of lumbar hernias with permanent suture fixation is safe and to date has resulted in no recurrences. Suture bone anchors ensure secure fixation of the mesh to the iliac crest and may eliminate a common area of recurrence.

  13. A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia.

    PubMed

    Jorgenson, Eric; Makki, Nadja; Shen, Ling; Chen, David C; Tian, Chao; Eckalbar, Walter L; Hinds, David; Ahituv, Nadav; Avins, Andrew

    2015-01-01

    Inguinal hernia repair is one of the most commonly performed operations in the world, yet little is known about the genetic mechanisms that predispose individuals to develop inguinal hernias. We perform a genome-wide association analysis of surgically confirmed inguinal hernias in 72,805 subjects (5,295 cases and 67,510 controls) and confirm top associations in an independent cohort of 92,444 subjects with self-reported hernia repair surgeries (9,701 cases and 82,743 controls). We identify four novel inguinal hernia susceptibility loci in the regions of EFEMP1, WT1, EBF2 and ADAMTS6. Moreover, we observe expression of all four genes in mouse connective tissue and network analyses show an important role for two of these genes (EFEMP1 and WT1) in connective tissue maintenance/homoeostasis. Our findings provide insight into the aetiology of hernia development and highlight genetic pathways for studies of hernia development and its treatment. PMID:26686553

  14. Perineural Dexmedetomidine as an Adjuvant Reduces the Median Effective Concentration of Lidocaine for Obturator Nerve Blocking: A Double-Blinded Randomized Controlled Trial

    PubMed Central

    Lu, Yuechun; Sun, Jian; Zhuang, Xinqi; Lv, Guoyi; Li, Yize; Wang, Haiyun; Wang, Guolin

    2016-01-01

    Research suggests that the addition of dexmedetomidine to local anesthetics can prolong peripheral nerve blocks; however, it is not known whether dexmedetomidine can reduce the quantity of local anesthetic needed. We hypothesized that adding dexmedetomidine as an adjuvant to an obturator nerve block could reduce the median effective concentration of lidocaine. In this double-blinded randomized trial, 60 patients scheduled for elective transurethral resection of bladder tumors on the lateral wall were randomly divided into two groups: the control group (C group, n = 30) and the dexmedetomidine group (D group, n = 30). Two main branches of the obturator nerve (i.e., anterior and posterior) were identified using neural stimulation at the inguinal level, with only lidocaine used for the C group and 1 μg/kg dexmedetomidine combined with lidocaine used for the D group. The median effective concentration was determined by an up-and-down sequential trial. The ratio of two consecutive concentrations was 1.2. The median effective concentration (95% confidence interval) of lidocaine was 0.57% (0.54%-0.62%) in the C group and 0.29% (0.28%-0.38%) in the D group. The median effective concentration of lidocaine was significantly lower in the D group than in the C group (p < 0.05). These results indicate that dexmedetomidine (1 μg/kg) in combination with lidocaine for obturator nerve block decreases the median effective concentration of lidocaine. Trial Registration: ClinicalTrials.gov NCT02066727 PMID:27341450

  15. Comparative Evaluation of Fracture Resistance of Root Obturated with Resilon and Gutta-Percha Using Two Different Techniques: An in Vitro Study

    PubMed Central

    Shiraguppi, Vijayakumar L.; Shivalingappa, Chandu Giriyapur; Desai, Niranjan; Azad, Antriksh

    2015-01-01

    Introduction: Present study evaluated the fracture resistance of endodontically treated teeth filled with Gutta percha and a new resin based obturating material (Resilon). Materials and Methods: A total of 150 freshly extracted Mandibular premolar with fully formed apices were selected and decoronated at cemento-enamel junction (CEJ). Teeth were divided into Group A and Group B of 75 teeth each. In Group A canals were prepared up to # no 40 K file and Group B up to #no 80 K file. Both the groups were sub divided into five group of 15 teeth each as control group (unfilled canals), lateral condensation with Gutta-percha using AH 26 sealer, vertical condensation with Gutta-percha using AH 26 sealer, lateral condensation with Resilon using resilon sealer, vertical condensation with Resilon using resilon sealer. Each specimen was subjected to compressive load using Universal testing machine. The force required to fracture was recorded and data were analysed by ANOVA, Duncan’s test and student T test. Result: The result showed that there is statistically significant difference among experimental groups (p < 0.05). The groups with the Resilon material displayed higher mean fracture loads than the Gutta percha groups. No statistically significant differences were observed between different preparation techniques. Conclusion: Obturating the canals with the new resin-based obturation material increases the in vitro fracture resistance of endodontically treated teeth when compared with standard Gutta percha techniques. PMID:25954697

  16. Preperitoneal Surgery Using a Self-Adhesive Mesh for Inguinal Hernia Repair

    PubMed Central

    Oguntodu, Olakunle F.; Rodriguez, Francisco; Rassadi, Roozbeh; Haley, Michael; Shively, Cynthia J.; Dzandu, James K.

    2014-01-01

    Background and Objectives: Laparoscopic preperitoneal hernia repair with mesh has been reported to result in improved patient outcomes. However, there are few published data on the use of a totally extraperitoneal (TEP) approach. The purpose of this study was to present our experience and evaluate early outcomes of TEP inguinal hernia repair with self-adhesive mesh. Methods: This cohort study was a retrospective review of patients who underwent laparoscopic TEP inguinal hernial repair from April 4, 2010, through July 22, 2014. Data assessed were age, sex, body mass index (BMI), hernia repair indications, hernia type, pain, paresthesia, occurrence (bilateral or unilateral), recurrence, and patient satisfaction. Descriptive and regression analyses were performed. Results: Six hundred forty patients underwent laparoscopic preperitoneal hernia surgery with self-adhesive mesh. The average age was 56 years, nearly all were men (95.8%), and the mean BMI was 26.2 kg/m2. Cases involved primary hernia more frequently than recurrent hernia (94% vs 6%; P < .05). After surgery, 92% of the patients reported no more than minimal pain, <1% reported paresthesia, and 0.2% had early recurrence. There were 7 conversions to an open procedure. The patients had no adverse reactions to anesthesia and no bladder injury. Postoperative acute pain or recurrence was not explained by demographics, BMI, or preoperative pain. There were significant associations of hernia side, recurrence, occurrence, and sex with composite end points. Nearly all patients (98%) were satisfied with the outcome. Conclusion: The use of self-adhesive, Velcro-type mesh in laparoscopic TEP inguinal hernia repair is associated with reduced pain; low rates of early recurrence, infection, and hematoma; and improved patient satisfaction. PMID:25587212

  17. Similar symptom patterns in gastroesophageal reflux patients with and without hiatal hernia.

    PubMed

    Antoniou, S A; Koch, O O; Antoniou, G A; Asche, K U; Kaindlstorfer, A; Granderath, F A; Pointner, R

    2013-07-01

    Gastroesophageal reflux disease is a common clinical entity in Western societies. Its association with hiatal hernia has been well documented; however, the comparative clinical profile of patients in the presence or absence of hiatal hernia remains mostly unknown. The aim of the present study was to delineate and compare symptom, impedance, and manometric patterns of patients with and without hiatal hernia. A cumulative number of 120 patients with reflux disease were enrolled in the study. Quality of life score, demographic, symptom, manometric, and impedance data were prospectively collected. Data comparison was undertaken between patients with and without hiatal hernia. A P-value < 0.05 was considered statistically significant. Patients with hiatal hernia tended to be older than patients without hernia (52.3 vs. 48.6 years, P < 0.05), whereas quality of life scores were slightly better for the former (97.0 vs. 88.2, P= 0.005). Regurgitation occurred more frequently in patients without hiatal hernia (78.3% vs. 93.9%, P < 0.05). Otherwise, no differences were found with regard to esophageal and extraesophageal symptoms. However, lower esophageal sphincter pressures (7.7 vs. 10.0 mmHg, P= 0.007) and more frequent reflux episodes (upright, 170 vs. 134, P= 0.01; supine, 41 vs. 24, P < 0.03) were documented for patients with hiatal hernia on manometric and impedance studies. Distinct functional characteristics in patients with and without hiatal hernia may suggest a tailored therapeutic management for these diverse patient groups.

  18. The Earliest Presenting Umbilical Port Site Hernia Following Laparoscopic Cholecystectomy: A Case Report

    PubMed Central

    Sharma, Rajeev; Goyal, Manav; Gupta, Sanjay

    2016-01-01

    Port site hernia after laparoscopic surgery is a rare complication. Here we present a case of a 55-year-old female, diagnosed with an anterior abdominal wall hernia through the 10mm umbilical port, just two days after her laparoscopic cholecystectomy. The uniqueness of this case is its extremely early presentation. Patient presented with features of acute intestinal obstruction and due to prompt diagnosis and timely intervention, she underwent a successful reduction of hernia and an anatomical repair of the fascial and peritoneal defect through the midline laparotomy incision.

  19. [The role of connective tissue nonspecific dysplasia in postoperative and recurrent abdominal hernias formation].

    PubMed

    Akhmedov, N I

    2011-04-01

    There were studied the rate of clinical indices diagnosis concerning nondifferentiated form of connective tissue dysplasia (NFCTD) as well as their significance in postoperative and recurrent abdominal hernias formation in 61 patients, ageing 20 - 78 years. It was established, that in 77% of patients the hernia have had formated on a NFCTD background, including in 16.4%--with a mild degree, in 27.8%--moderate degree and in 32.8%--a severe one. The authors recommend while abdominal hernia is present to study a characteristic phenotypical signs of a connective tissue dysplasia and, if more than 4 signs are diagnosed, to prefer the application of alloplastic methods.

  20. Internal supravesical hernia - a rare cause of intestinal obstruction: report of two cases

    PubMed Central

    Bouassida, Mahdi; Sassi, Selim; Touinsi, Hassen; Kallel, Helmi; Mighri, Mohamed Mongi; Chebbi, Fathi; Ali, Mechaal Ben; Bouzeidi, Khaled; Sassi, Sadok

    2012-01-01

    Supravesical hernias develop at the supravesical fossa between the remnants of the urachus and the left or right umbilical artery. They are exceptional and are often the cause of intestinal obstruction. We report two cases of surgically proven internal supravesical hernias presenting with small bowel obstruction. Abdominal computed tomography showed, for our first case, the relation of the incarcerated intestine anterior to and compressing the urinary bladder. We believe that the preoperative diagnosis of supravesical hernia by abdominal computed tomography is possible, as shown in our first case. PMID:22368760

  1. [Retro-costo-xyphoid hernia in adults. Apropos of 3 cases].

    PubMed

    Daou, R; Serhal, S; Jureidini, F; Demian, P

    1992-01-01

    Three cases of retrosternal diaphragmatic hernia (Morgagni hernia) are reported. Diagnosis have been made by conventional radiology (Chest X-ray, Upper G-I series) in 2 cases: the third one was found incidentally during a laparotomy. Peritoneography, CT scan, NMR are recommended in the difficult cases. ONe case presented as acute gastric outlet obstruction secondary to an intra-thoracic volvulus of the herniated stomach. Surgical treatment is indicated in all cases of retrosternal diaphragmatic hernia because of the high-risk of complications (gastric volvulus, colonic obstruction). Surgery through an abdominal approach is preferred and post-operative course is benign.

  2. Round Ligament Leiomyoma Presenting as an Incarcerated Inguinal Hernia: Case Report and Review of the Literature

    PubMed Central

    Mandel, Marc

    2016-01-01

    Leiomyomas are common benign gynecologic tumors occurring in up to 30% of women. Round ligament leiomyomas however are very rare and, if symptomatic, can present as an inguinal hernia. We report the case of a 47-year-old woman who presented with an irreducible inguinal mass consistent with an incarcerated hernia. Intraoperatively, the mass was found to be a round ligament leiomyoma, a diagnosis that was confirmed by histopathology following excision of the mass. Although rare, round ligament leiomyomas should be part of the differential diagnosis of an inguinal hernia in females. PMID:27144048

  3. The Earliest Presenting Umbilical Port Site Hernia Following Laparoscopic Cholecystectomy: A Case Report

    PubMed Central

    Sharma, Rajeev; Goyal, Manav; Gupta, Sanjay

    2016-01-01

    Port site hernia after laparoscopic surgery is a rare complication. Here we present a case of a 55-year-old female, diagnosed with an anterior abdominal wall hernia through the 10mm umbilical port, just two days after her laparoscopic cholecystectomy. The uniqueness of this case is its extremely early presentation. Patient presented with features of acute intestinal obstruction and due to prompt diagnosis and timely intervention, she underwent a successful reduction of hernia and an anatomical repair of the fascial and peritoneal defect through the midline laparotomy incision. PMID:27630904

  4. [Giant hernias with loss of domain: what is the best way to prepare patients?].

    PubMed

    Balaphas, Alexandre; Morel, Philippe; Breguet, Romain; Assalino, Michela

    2016-06-15

    Giant hernias with loss of domain induce physiological modifications that impair quality of life and make more complex their surgical management. A good preparation of patients before surgery is the key to an eventless postoperative course. The progressive pre-operative pneumoperitoneum (PPP) is one of the described abdominal augmentation protocols which can help patients to tolerate hernia content reintegration and avoid components separation technique during hernia repair. This article describes the management of these complex patients. We also report the case of a patient who follows successfully a PPP protocol. PMID:27487621

  5. Is there a common basis between hiatal hernia and hemorrhoidal disease?

    PubMed

    Sahiner, Zeynep; Uzel, Mehmet; Filik, Levent

    2015-05-01

    In this letter-to-editor, we hypothesize that there is a link between hemorrhoidal disease and hiatal hernia. We underline common risk factors for both and present a cross-sectional patient data. Therefore, we emphasize the necessity of new studies to clarify this coincidence. Clinical benefit of establishment of this link is to delay or prevent development of hiatal hernia as a result of appropriate preventive measures. Accordingly, postoperative period of hiatal hernia operations may also be relieved or recurrence risk may also be decreased with this precautions.

  6. Indirect Inguinal Hernia Containing a Fallopian Tube and Ovary in a Reproductive Aged Woman

    PubMed Central

    Graul, Ashley; Ko, Emily

    2014-01-01

    An indirect inguinal hernia containing an incarcerated fallopian tube and ovary is extremely rare in adult females. The current report describes a woman of reproductive years presenting with an irreducible indirect hernia which required the surgical intervention of a general surgeon as well as counseling regarding future fertility by a gynecologist. The diagnosis was made by physical and sonographic examination and was confirmed by CT scan and surgical intervention. We suggest a multimodel and multidisciplinary approach in order to safely and efficiently preserve ovarian and fertility function in young women who present with an inguinal hernia containing reproductive organs. PMID:25028618

  7. The Earliest Presenting Umbilical Port Site Hernia Following Laparoscopic Cholecystectomy: A Case Report.

    PubMed

    Sharma, Rajeev; Mehta, Deeksha; Goyal, Manav; Gupta, Sanjay

    2016-07-01

    Port site hernia after laparoscopic surgery is a rare complication. Here we present a case of a 55-year-old female, diagnosed with an anterior abdominal wall hernia through the 10mm umbilical port, just two days after her laparoscopic cholecystectomy. The uniqueness of this case is its extremely early presentation. Patient presented with features of acute intestinal obstruction and due to prompt diagnosis and timely intervention, she underwent a successful reduction of hernia and an anatomical repair of the fascial and peritoneal defect through the midline laparotomy incision. PMID:27630904

  8. Mesh fixation alternatives in laparoscopic ventral hernia repair.

    PubMed

    Muysoms, Filip E; Novik, Bengt; Kyle-Leinhase, Iris; Berrevoet, Frederik

    2012-12-01

    Since the introduction of laparoscopic ventral hernia repair, there has been an ongoing dispute over the optimal method of fixating the mesh against the abdominal wall. In general, one could say that the more penetrating the fixation used, the stronger the fixation, but at the cost of increased acute postoperative pain. The occurrence of chronic pain in some patients has led to the search for less permanent penetrating fixation, but without risking a less stable mesh fixation and increased recurrences due to shift or shrinkage of the mesh. Avoiding transfascial sutures by using a double crown of staples has been proposed and recently absorbable fixation devices have been developed. Some surgeons have proposed fixation with glue to reduce the number of staples, or even eliminate them entirely. The continuously increasing multitude of marketed meshes and fixating devices leads to unlimited options in mesh fixation combination and geometry. Therefore, we will never be able to get a clear view on the benefits and pitfalls of every specific combination. Clearance of the anterior abdominal wall from peritoneal fatty tissue and correct positioning of the mesh with ample overlap of the hernia defect are possibly as important as the choice of mesh and fixation. Other topics that are involved in successful outcomes but not addressed in this article are adequate training in the procedure, appropriate selection of patients, and careful adhesiolysis to minimize accidental visceral injuries. PMID:23225589

  9. To evaluate the influence of smear layer with different instruments and obturation methods on microleakage of root canal filled teeth: In vitro study

    PubMed Central

    Likhitkar, Manoj S.; Kulkarni, Shantaram V.; Burande, Aravind; Solanke, Vishal; Kumar, C. Sushil; Kamble, Babasaheb

    2016-01-01

    Aims and Objectives: The success of root canal treatment depends on proper debridement, instrumentation, proper accessibility, and proper restoration. The presence of a smear layer is considered to be a significant factor. This in vitro study was conducted to assess the effect of the presence/absence of a smear layer on the microleakage of root canal filled teeth using different instruments and obturation methods. Materials and Methods: One hundred extracted mandibular premolars with closed apices and single roots were chosen and then divided into six groups, A to F, consisting of 15 teeth each. The control group included 10 teeth; 5 positive and 5 negative. The teeth were decoronated at the cementoenamel junction. Groups A, B, C, and D were instrumented with engine-driven rotary Protaper NiTi files. Groups E and F were instrumented with conventional stainless steel hand files. Groups A, C, and E were flushed with 3 ml of 17% EDTA to remove the smear layer prior to obturation. All teeth were flushed with 5.25% sodium hypochlorite solution and obturated with AH-Plus sealer with lateral condensation technique for Groups C, D, E, F and with thermoplasticized gutta-percha technique for Groups A and B. Using an electrochemical technique, leakages in the obturated canals were assessed for 45 days. The results were tabulated using Student's t-test (paired and unpaired t-test) with the Statistical Package for the Social Sciences Software Version 21 (IBM Company, New York, USA). Results: Group A showed the lowest mean value at intervals of 10, 20, 30, and 45 days. There was no current flow in the negative controls during the test period. There was leakage in the positive controls within a few minutes of immersion. Conclusion: The results showed that rotary instrumentation contributed toward an exceptional preparation of root canals compared to hand instrumentation. Elimination of the smear layer enhanced the resistance to microleakage; thermoplasticized gutta

  10. Re-establishing apical patency after obturation with Gutta-percha and two novel calcium silicate-based sealers

    PubMed Central

    Agrafioti, Anastasia; Koursoumis, Anastasios D.; Kontakiotis, Evangelos G.

    2015-01-01

    Objective: Aim of the present study was to evaluate the retreatability and reestablishment of apical patency of two calcium silicate-based sealers, TotalFill BC Sealer (BCS) and mineral trioxide aggregate Fillapex (MTA F), versus AH Plus, when used in combination with Gutta-percha (GP). Materials and Methods: The canals of 54 single-rooted anterior teeth were instrumented and filled with GP/AH Plus (Group A), GP/MTA F (Group B), or GP/BCS (Group C) using continuous wave obturation technique. The groups were subdivided into subgroups with the master-GP cone placed to the working length (WL) or intentionally 2 mm short. The retreatment procedures were performed using ultrasonics, chloroform, rotary, and hand files. The ability to establish the patency and reach WL was determined as well as the time taken to reach WL was calculated in minutes. Furthermore, the samples were observed under a dental, optical microscope, after vertically splitting them. Results: The WL and patency were reestablished in 100% of specimens in all groups. The Mann–Whitney U-test indicated that there was a significant difference in the amount of time required to reach WL between the groups (P < 0.05) with group GP/BCS short of the WL showing the most amount of time to be retreated. Conclusion: The novel calcium silicate-based sealers are negotiable under simple root canal anatomy. However, the conventional retreatment techniques are not able to fully remove them. PMID:26929681

  11. Inguinal hernia containing a kidney with a duplicated system: an exceptionally rare case.

    PubMed

    Farrell, Michael Ryan; Coogan, Christopher; Hibbeln, John; Millikan, Keith; Benson, Jonas

    2014-03-01

    An inguinal hernia is a commonly encountered surgical case, with multiple unusual contents being reported. We present an exceptionally rare case of an inguinal hernia. Computed tomography imaging of the 62-year-old male patient showed a large left inguinal hernia extending into the left scrotum that contained a duplicated left kidney. There was an associated large left hydrocele and incidental non-obstructive nephrolithiasis. Left nephropexy, left orchiectomy, and repair of the incarcerated left inguinal hernia with mesh placement via a preperitoneal (retroperitoneal) approach were performed. The patient was discharged to home on post-operative day 5 and the post-operative course was uneventful. We discuss a possible mechanism for this rare event.

  12. Modified tension-free mesh repair used in rare case of Littre’s hernia

    PubMed Central

    Duysenovich, Raimkhanov Aidar; Zhaksybekvich, Aimagambetov Meyirbek; Bakytbekovich, Omarov Nazarbek; Yermukhambetovichzhan, Zhagniyev Zhandos

    2015-01-01

    Introduction Meckel’s diverticulum is found at the antimesenteric border of the ileum, usually located from 30 to 90 cm from the ileocecal valve. Meckel’s diverticulum complications, such as bowel obstruction, diverticulitis, hemorrhage and rarely, hernias containing a Meckel’s diverticulum (Littre’s Hernia) required surgical intervention. Case presentation We introduce the case report of 77-year-old man with inguinal hernia containing Meckel’s diverticulum operated by the modified tension-free mesh repair. Discussion Although Meckel’s diverticulum is a relatively common anomaly, herniation of these embryological remnants is an exceedingly rare event. It can be difficult to diagnose Littre’s hernia before operation. Conclusion The important thing is not to hesitate to perform diverticulectomy, to avoid complications of the patient in the future. PMID:26036457

  13. Right Congenital Diaphragmatic Hernia Associated With Hepatic Pulmonary Fusion: A Case Report

    PubMed Central

    Laamiri, Rachida; Belhassen, Samia; Ksia, Amine; Ben Salem, Amina; Kechiche, Nahla; Mosbahi, Sana; Sahnoun, Lassaad; Mekki, Mongi; Belghith, Mohsen; Nouri, Abdellatif

    2016-01-01

    We present a case of male newborn presented with respiratory distress at 21 hours of life. The patient was operated for right congenital diaphragmatic hernia (CDH). Hepatic pulmonary fusion (HPF) was found at surgery. PMID:27433453

  14. A Data Mining and Survey Study on Diseases Associated with Paraesophageal Hernia

    PubMed Central

    Yang, Jianji; Logan, Judith

    2006-01-01

    Paraesophageal hernia is a severe form of hiatal hernia, characterized by the upward dislocation of the gastric fundus into the thoracic cavity. In this study, the 1999 National Inpatient Sample dataset of the Healthcare Cost and Utilization Project was analyzed using data mining techniques to explore disorders associated with paraesophageal hernia. The result of this data mining process was compared with a subsequent expert knowledge survey of 97 gastrointestinal tract surgeons. This two-step analysis showed that the results of data mining and expert knowledge are consistent in some factors that are highly associated with paraesophageal hernia: older age, other gastrointestinal tract disorders and obesity, for example. But the data mining approach revealed some other related disorders that were not known to the experts or reported in the literature, for example, hypertension, peritoneal adhesions and gall bladder/bile duct diseases. These findings lay a framework for subsequent hypothesis-driven research. PMID:17238457

  15. MANAGEMENT OF OMPHALOPHLEBITIS AND UMBILICAL HERNIA IN THREE NEONATAL GIRAFFE (GIRAFFA CAMELOPARDALIS).

    PubMed

    Selig, Michael; Lewandowski, Albert; Burton, Michael S; Ball, Ray L

    2015-12-01

    Umbilical disorders, including omphalophlebitis, omphaloarteritis, external umbilical abscesses, urachal abscesses, patent urachus, and umbilical hernias, represent a significant challenge to the health and well-being of a neonate. The three neonatal giraffe (Giraffa camelopardalis) in this report were evaluated for umbilical swellings. Two developed omphalophlebitis, and one had an uncomplicated umbilical hernia. Omphalophlebitis is an inflammation and/or infection of the umbilical vein. Giraffe calves with a failure of passive transfer may be predisposed and should be thoroughly evaluated for the condition. Umbilical hernias result from a failure of the umbilical ring to close after parturition or from malformation of the umbilical ring during embryogenesis. These problems were surgically corrected for all three individuals, although one died due to postsurgical complications. The risks involved include anesthetic complications, surgical dehiscence, and maternal rejection. Early detection and surgical intervention are recommended for the correction of omphalophlebitis and umbilical hernias in neonatal giraffe.

  16. [Amyand's hernia--case presentation and a discussion about diagnosis problems and surgical treatment].

    PubMed

    Suliman, E; Popa, D; Palade, R; Simion, G

    2012-01-01

    We present the case of a 62 years old patient, with multiple associated tares, which was operated in emergency for an Amyand's hernia. The appendix was perforated and generated a big pussy collection (aprox. 200 ml) in the hernia sac. The impossibility of mobilization of the appendix, which was just 2/3 in the hernia sac, made us perform a median laparotomy for safety reasons. The position and fixation of the cecum made impossible the exteriorization of the appendix in the hernia sac. The postoperative evolution, under a complex supervision, was favorable. Due to the rarity of the clinical entity, of the specific issues and of the literature review, we decided to communicate the clinical observation. PMID:22844840

  17. Parastomal hernia: an exploration of the risk factors and the implications.

    PubMed

    McGrath, Anthony; Porrett, Theresa; Heyman, Bob

    Risk may be defined as 'the chance that something may happen to cause loss or an adverse effect' (Concise Oxford Medical Dictionary, 2003). Patients undergoing stoma formation are at risk of developing a wide range of complications following surgery. A parastomal hernia is an adverse effect that can contribute to postoperative morbidity. The risk of developing a parastomal hernia is dependent upon a number of variables, and stoma care nurses need to be aware of these to plan the appropriate care for patients undergoing stoma formation. This article discusses the issues surrounding the development of parastomal hernias and also looks at ways in which the risk factors associated with the development of a parastomal hernia may be minimized. PMID:16628167

  18. Congenital Right Morgagni Hernia Presenting in an Adult-a Case Report.

    PubMed

    Pillai, Sastha Ahanatha; Chinnappan, Santhanakrishnan

    2016-06-01

    Patients with congenital diaphragmatic hernias (CDH) usually present in the neonatal period with respiratory distress. Delayed presentation of CDH in adults is rare and difficult to diagnose. We present a 42-year-old female patient who came with complaints of epigastric pain and breathlessness on exertion. X-ray and CT scan of the chest revealed a right-sided Morgagni hernia. The contents of the hernia were reduced and a primary tension free repair of the hernia defect was done through laparotomy. The postoperative course was uneventful. A strong clinical suspicion and good interpretation of radiological images help diagnose CDH which present late. Prompt surgical repair is mandatory and the outcomes are usually favorable. Primary repair is usually successful; however, mesh repair may be required for larger defects. PMID:27358522

  19. Parastomal hernia: an exploration of the risk factors and the implications.

    PubMed

    McGrath, Anthony; Porrett, Theresa; Heyman, Bob

    Risk may be defined as 'the chance that something may happen to cause loss or an adverse effect' (Concise Oxford Medical Dictionary, 2003). Patients undergoing stoma formation are at risk of developing a wide range of complications following surgery. A parastomal hernia is an adverse effect that can contribute to postoperative morbidity. The risk of developing a parastomal hernia is dependent upon a number of variables, and stoma care nurses need to be aware of these to plan the appropriate care for patients undergoing stoma formation. This article discusses the issues surrounding the development of parastomal hernias and also looks at ways in which the risk factors associated with the development of a parastomal hernia may be minimized.

  20. Treatment of a giant inguinal hernia using transabdominal pre-peritoneal repair.

    PubMed

    Momiyama, Masato; Mizutani, Fumitoshi; Yamamoto, Tatsuyoshi; Aoyama, Yoshinori; Hasegawa, Hiroshi; Yamamoto, Hideo

    2016-01-01

    We present the case of a male Japanese patient with a giant inguinal hernia that extended to his knees while standing. A transabdominal pre-peritoneal (TAPP) repair was performed under general anesthesia. Complete reduction of the contents of the hernia was achieved within 2 h 50 min. A blood loss of approximately 700 ml was noted. The patient was discharged from the hospital on post-operative Day 12, with no recurrence of the hernia 6 months post-surgery. Factors contributing to the successful outcomes included preparation of several reduction methods before surgery, use of a large size mesh and implementation of pre-operative measures to prevent abdominal compartment syndrome. Further studies are required to evaluate the feasibility of laparoscopic repair in the management of giant inguinal hernia. PMID:27672103