Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings.
Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings. Acta Biomed. 2019 Apr 24;90(5-S):20-37 Authors: Lanzetta MM, Masserelli A, Addeo G, Cozzi D, Maggialetti N, Danti G, Bartolini L, Pradella S, Giovagnoni A, Miele V Abstract Although internal hernias are uncommon, they must be beared in mind in the differential diagnosis in cases of intestinal obstruction, especially in patients with no history of previous surgery or trauma. Because of the high possibility of strangulation and ischemia of the affected loops, internal hernias represent a potentially life-threatening condition and surgical emergency that needs to be quickly recognized and managed promptly. Imaging plays a leading role in the diagnosis and in particular multidetector computed tomography (MDCT), with its thin-section and high-resolution multiplanar reformatted (MPR) images, represents the first line image technique in these patients. The purpose of the present paper is to illustrate the characteristic anatomic location, the clinical findings and the CT appearance associated with main types of internal hernia, including paraduodenal, foramen of Winslow, pericecal, sigmoid-mesocolon- and trans-mesenteric- related, transomental, supravesical and pelvic hernias. PMID: 31085971 [PubMed - in process]
CONCLUSIONS: Ovarian inguinal hernias should be considered among the differential diagnoses of a groin mass or swelling. In women of reproductive age, repair of the hernia with the intent to preserve fertility is of critical importance. PMID: 31696731 [PubMed - as supplied by publisher]
Conclusions: Using a novel approach, we provide details of the esophageal hiatus in patients with various kinds of hiatal hernia. Impaired LES relaxation in paraesophageal hernia may play a role in its pathophysiology and genesis of symptoms. PMID: 31677612 [PubMed - as supplied by publisher]
DEAR MAYO CLINIC: After a recent CT scan, endoscopy and colonoscopy, I learned that I have a hiatal hernia containing both stomach and colon, and extrinsic stenosis at the splenic flexure. My understanding is that this is rare and that I will need surgery. Will I need to find a surgeon who has seen this [...]
Conclusion: A combination of laparoscopic reduction and nonsutured PEG gastropexy is a safe and effective alternative treatment for high-risk patients (with significant morbidity and mortality) with symptomatic PHs. Most patients (80%) returned to normal oral intake postprocedure and were discharged home within 3 d. PMID: 31624456 [PubMed - in process]
ConclusionAs PDH can lead to major and life threatening complications, it must remain in our minds as a possible cause of intestinal obstruction.
Abstract Lumbar hernias are from weakened areas in the posterior lateral abdominal wall. Minimally invasive techniques are recommended for nonmidline abdominal wall hernias. Endoscopic methods utilizing the subcutaneous space only are rarely reported. A 66-year-old man presented with abdominal pain and a computed tomography (CT) scan revealing a lumbar hernia. The procedure was done utilizing the subcutaneous space to open the hernia sac and repair the defect in layers. A sublay mesh and an onlay mesh were used within the subcutaneous pocket. The patient had an uneventful postoperative course and was discharged ho...
CONCLUSIONWe believe that careful preoperative diagnosis and strategy can lead to a good outcome and that the significance of emergency laparoscopic approach without sufficient decompression will keep increasing.
CONCLUSIONThe presence of the reported accessory spleen inside the thoracic cavity is only a possible variation within the possibilities in cases of diaphragmatic hernias, which does not modify the surgical procedure in a relevant way.
We present a case of a 60-year-old male patient presented with bilateral inguinal swelling associated with urinary hesitancy and intermittency. He had undergone transabdominal preperitoneal (TAPP) repair for a left inguinal hernia 8 years ago. CT scan confirmed the presence of a bilateral hernia with the bladder herniating bilaterally. He underwent an elective bilateral open Lichtenstein tension-free mesh repair.
AbstractForamen of Winslow hernia (FWH) is an extremely rare entity accounting for up to 8% of internal hernias and 0.08% of all hernias. Only 150 cases of FWH have been described in the literature to date with a peak incidence between the third and sixth decades of life. Three main mechanisms seem to be implicated in the FWH pathogenesis: (a) excessive viscera mobility, (b) abnormal enlargement of the foramen of Winslow, and (c) changes in the intra-abdominal pressure. The presence of an abnormally long bowel, enlargement of the right liver lobe or cholecystectomy, a “wandering cecum,” and defects of the gastr...