Preoperative Abdominal Computed Tomography at Rest and During Valsalva's Maneuver to Evaluate Incisional Hernias.
CONCLUSIONS: The preoperative CT scan both at rest and during Valsalva's maneuver seemed useful to estimate the risk of difficult IH repairs. Moreover, it could allow surgeons to decide if the patient should be addressed to more specialized centers. PMID: 31096865 [PubMed - as supplied by publisher]
Publication date: Available online 19 July 2019Source: International Journal of Surgery Case ReportsAuthor(s): Dario Iadicola, Massimo Branca, Massimo Lupo, Eugenia Maria Grutta, Stefano Mandalà, Gianfranco Cocorullo, Antonino MirabellaAbstractIntroductionTraumatic diaphragmatic injuries are rare complications resulting from a thoracic-abdominal blunt or penetrating trauma. Left-sided diaphragmatic injuries are more commonly reported in literature. Bilateral injuries are extremely rare, occurring in about 3% of the patients and just few cases reported in literature. Traumatic diaphragmatic hernias are definitely a m...
ConclusionThe introduction of a liquid material which solidifies after injection in a short time (hydrogel) using a needle is feasible. The combined CT-scan and US image guidance allows for the percutaneous placement of the needle in the required location. The introduced hydrogel remains in this space, corresponding to the inguinal region, without moving. The placed hydrogel compresses the posterior wall composed of the transversalis fascia, supporting the potential use of hydrogel for hernia defects.
ConclusionThe clinicians should consider this rare condition in the differential diagnosis of patients presenting with large paraumbilical hernias associated with classical symptoms of acute pancreatitis, particularly in the absence of typical risk factors for pancreatitis. An intravenous contrast-enhanced abdominal CT scan should be performed immediately in these patients. We recommend the patients and the surgeons to consider prompt surgical repair for paraumbilical hernias to avoid further complications and the higher incidence of morbidity and mortality associated with emergency surgeries.
ConclusionGradual postoperative closure of a traumatic abdominal wall hernia with an ostomy in place may result in stomal stenosis. Stomal patency must be carefully evaluated during this process.
Conclusion: Modified placement of composite mesh is safe and helps in minimising mesh-related complications of the Sugarbaker technique for parastomal hernias.
ConclusionsPDH are not usually associated with specific symptoms and signs; thus, they constitute a diagnostic challenge, requiring a high level of knowledge and clinical suspicion. Undoubtedly, CT scan of the abdomen is the gold standard diagnostic tool. Their operative repair is mandatory, with the laparoscopic approach demonstrating significant advantages over the open repair, seeming to be the optimum treatment strategy.
Authors: Filosso PL, Guerrera F, Sandri A, Lausi PO, Lyberis P, Bora G, Roffinella M, Ruffini E Abstract Chronic diaphragmatic hernia (CDH) is an uncommon disease which may be associated with significant morbidity and mortality. Antecedent (even many months or years before CDH development) blunt or penetrating thoracic/thoraco-abdominal trauma is generally recognized. A wide spectrum of different mechanisms of injury, timing in presentation, size of the diaphragmatic defect, types and amount of abdominal viscera herniated into the chest cavity, clinical symptoms are observed in CDHs. Thoracic and abdominal CT scan ...
Authors: Ramkumar J, Lu D, Scott T Abstract Abdominal wall hernias are prevalent in patients undergoing peritoneal dialysis (PD). Obturator hernias, first described by Arnaud de Ronsil in 1724, are an uncommon type of hernia where intra-abdominal contents protrude through the obturator foramen. The following case highlights a rare presentation of bilateral obturator hernias with right femoral and inguinal hernia in an 82-year-old woman post-PD. This patient presented with 5 months of bilateral thigh pain and swelling and was found to only have a right-sided obturator hernia on computer tomography (CT) scan. Intraop...
CASE SUMMARY: A 63-year-old woman with history of stage II rectal adenocarcinoma status postneoadjuvant chemoradiation and subsequent abdominoperineal resection presented with worsening bulge and inability to pouch stoma. CT scan revealed a 4-cm parastomal hernia. After discussion with the patient regarding management options, she elected to undergo repair of hernia defect. A robot-assisted laparoscopic parastomal hernia repair with synthetic mesh via the Sugarbaker technique was performed. After a short stay in the hospital, the patient recovered well and reported no recurrent symptoms.
ConclusionFor gastric outlet obstruction caused by parastomal herniation, surgeons should consider non-operative management with nasogastric decompression when the patient in question is frail and a poor surgical candidate.