Abdominal hernia

腹疝
  • 文章类型: Case Reports
    绞窄闭孔疝的表现很少见,它占所有疝气的不到0.04%。延迟出现和诊断会导致肠缺血等并发症,坏死,穿孔,和腹膜炎,从而增加发病率和死亡率。
    作者报告了一例85岁的多胎妇女,有3天的腹痛和呕吐病史。经检查,她表现出低血压,改变的感官,腹部扩张,蠕动可见。腹部盆腔CT扫描证实诊断为“继发于嵌顿闭孔疝的肠梗阻”。随后,进行了下中线剖腹手术,成功减少肠道和修复疝口。病人在术后第四天出院,在她3个月的随访中,没有疝气复发。
    绞窄性闭孔疝的表现可能难以捉摸。在临床检查中,Howship-Romberg标志和Hannington-Kiffs标志测试都可能是阴性。腹腔镜闭孔疝修补术已被证明可以减少住院时间和发病率。中线剖腹手术的优点是易于手动复位,减少肠道创伤,准确进入肠道,并促进肠切除。
    闭孔疝构成腹部疝的罕见亚型。它们通常发生在老年妇女身上,患者通常表现为功能状态差和多种合并症。临床诊断测试不确定,即使是怀疑指数高的患者。及时的诊断和适当的手术管理对于获得良好的结果至关重要。
    UNASSIGNED: The presentation of a strangulated obturator hernia is rare, with it accounting for less than 0.04% of all hernias. Delay in presentation and diagnosis results in complications like bowel ischemia, necrosis, perforation, and peritonitis, thereby increasing morbidity and mortality.
    UNASSIGNED: The authors report the case of an 85-year-old multiparous woman who presented with a 3-day history of abdominal pain and vomiting. Upon examination, she exhibited hypotension, altered sensorium, and a distended abdomen with visible peristalsis. An abdominal pelvic computed tomography scan confirmed the diagnosis of \'intestinal obstruction secondary to an incarcerated obturator hernia\'. Subsequently, a lower midline laparotomy was performed, successfully reducing the bowel and repairing the hernial orifice. The patient was discharged on the fourth postoperative day, and there has been no hernia recurrence as of her 3-month follow-up.
    UNASSIGNED: The presentation of a strangulated obturator hernia can be elusive. During clinical examination, both the Howship-Romberg sign and the Hannington-Kiffs sign tests may be negative. Laparoscopic obturator hernia repair has been shown to reduce hospital stay and morbidity. A midline laparotomy has the advantage of easy manual reduction, minimizing bowel trauma, accurately accessing the bowel, and facilitating bowel resection.
    UNASSIGNED: Obturator hernias constitute rare subtypes of abdominal hernias. They typically occur in older women, and patients often present with poor functional status and multiple comorbidities. The clinical diagnostic tests are uncertain, even in patients with a high index of suspicion. Timely diagnosis and appropriate surgical management are crucial for a favorable outcome.
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  • 文章类型: Case Reports
    套管针疝是一种罕见的,机器人妇科手术后严重的手术相关并发症。这里,我们介绍了2例三端口机器人子宫肌瘤切除术后的8毫米端口疝病例,并回顾了以前报道的病例。在第一种情况下,术后发现小肠梗阻,原因是在左腋下中线8毫米套管针部位出现疝。在第二例中发现了与第一例相同部位的小肠疝。在这两种情况下,都通过延长左套管针位置进行了紧急探查。没有肠缺血的迹象,并成功完成了肠道复位和疝修补。与以前报道的病例不同,这些病例发生在体重指数(BMI)正常的患者中(第一例20.28kg/m2,第二例BMI24.80kg/m2),为盆腔引流管插入部位.这些部位是腹部肌肉覆盖的弱点。因此,应考虑封闭8毫米套管针位置。
    Trocar site hernia is a rare, serious operation-related complication after robotic gynecologic surgery. Here, we present two 8-mm port-site hernia cases after three-port robotic myomectomy with a review of reported previous cases. In the first case, small bowel obstruction was found postoperatively due to herniation at the left mid-axillary line 8-mm trocar site. Small bowel herniation through the same site as the first case was found in the second case. Emergency exploration was performed in both cases by extending the left trocar site. There was no sign of bowel ischemia, and successful bowel reduction and hernia repair were done. Unlike previously reported cases, these cases occurred in a normal body mass index (BMI) patient (first case 20.28 kg/m2, second case BMI 24.80 kg/m2) and were pelvic drain insertion sites. These sites were the weak points of the abdominal muscle coverage. Therefore, the closure of 8-mm trocar sites should be considered.
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  • 文章类型: Case Reports
    水痘-带状疱疹病毒重新激活导致带状疱疹,通常称为带状疱疹。带状疱疹传统上表现为皮肤组织分布中的瘙痒囊泡,在有免疫能力的患者中伴有相关的体质症状。通常,皮疹在七到十天内完全消退。疱疹性神经痛是最典型的带状疱疹后果。大约1%到5%的人有运动障碍,Ramsay-Hunt综合征是最常见的疾病.其他问题包括腹部假疝,麻痹性肠梗阻/结肠假性梗阻,半膈麻痹,膀胱功能障碍,局限性轻瘫,便秘,和内脏神经病。带状疱疹感染通常涉及后根神经节,大部分的症状都是感觉的.运动受累可以发生在相同的分布中,但相对罕见。节段性带状疱疹麻痹是带状疱疹的一种罕见运动并发症,模仿腹部疝气,发病率约为0.7%,但它不需要手术不同于真正的腹壁疝。在这个案例报告中,我们描述一个病人,出现带状疱疹皮疹三周后,获得了腹部突出,即,疱疹诱发的假疝.
    The varicella-zoster virus reactivates to cause herpes zoster, commonly referred to as shingles. Shingles traditionally manifest as itchy vesicles in a dermatomal distribution, accompanied by related constitutional symptoms in immunocompetent patients. Usually, the rash resolves completely in seven to ten days. Herpetic neuralgia is the most typical herpes zoster consequence. Around 1% to 5% of individuals have motor impairments, with Ramsay-Hunt syndrome being the most prevalent ailment. Additional problems encompass abdominal pseudohernia, paralytic ileus/colonic pseudo-obstruction, hemidiaphragm paralysis, bladder dysfunction, localized paresis, constipation, and visceral neuropathy. Herpes zoster infection typically involves the posterior root ganglia, and most of the symptoms are sensory. Motor involvement can occur in the same distribution but is relatively uncommon. Segmental zoster paresis is a rare motor complication of herpes zoster, mimicking an abdominal hernia, which has an incidence of approximately 0.7%, but it needs no surgery different from the real abdominal wall hernia. In this case report, we describe a patient who, three weeks after developing a herpes zoster rash, acquired an abdominal protrusion, i.e., herpes-induced pseudohernia.
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  • 文章类型: Case Reports
    一个15岁的孩子,Spyed女性,没有任何创伤史的苏格兰直猫表现为腹部肿胀,并被诊断为腹壁疝。腹部超声显示增厚,不规则,缺损附近腹壁肌肉低回声改变。在疝修补术期间,在缺损周围的皮下组织中发现多个结节.对结节组织进行组织学检查,证实为乳腺肿瘤。手术后,发现了胰腺的转移性变化,胸腔积液和腹水也得到证实。患者在手术后78天迅速恶化并死亡。这是兽医中首例由恶性肿瘤引起的腹壁疝。
    A 15-year-old, spayed female, Scottish Straight cat without any traumatic history was presented with swollen abdomen and diagnosed as an abdominal wall hernia. Abdominal ultrasound revealed thickened, irregular, and hypoechoic change of abdominal wall muscle adjacent to defect. During the herniorrhaphy, multiple nodules were identified in the subcutaneous tissue around the defect. Histological examination of the nodular tissue was performed, and it was confirmed as mammary gland tumor. After the surgery, metastatic changes of the pancreas were identified, and pleural effusion and ascites were also confirmed. The patient deteriorated rapidly and died 78 days after the surgery. This is the first case presenting abdominal wall hernia induced by malignant tumor in veterinary medicine.
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  • 文章类型: Case Reports
    Spigelian疝是一种罕见的腹壁疝,占所有腹侧疝的0.1%至2%。临床上,症状和体征是非特异性的且不明确.
    方法:这里,我们介绍了一位69岁的女性患者,两个髂窝腹部鼓胀。影像学检查提示为Spigelian疝和右腹股沟疝。治疗是手术,随着聚丙烯网的放置,患者术后进展顺利。
    本案的特点印证了目前的文献,这表明年龄在40至70岁之间的成年人参与更大。选择的治疗方法是手术,可以是开放式或视频腹腔镜,放置网状物或初级缝线。
    结论:Spigelian疝的临床表现不是特征性的,在腹部肿块的研究中应怀疑其诊断。
    UNASSIGNED: Spigelian hernia is a rare abdominal wall hernia, representing 0.1 to 2 % of all ventral hernias. Clinically, the signs and symptoms are nonspecific and unclear.
    METHODS: Here, we present a 69-year-old female patient, with abdominal bulging in both iliac fossae. Imaging exams suggested Spigelian hernia and right inguinal hernia. The treatment was surgical, with placement of polypropylene meshes and the patient had an uneventful postoperative evolution.
    UNASSIGNED: The characteristics of this case corroborate the current literature, which points to a greater involvement of adults aged between 40 and 70 years. The treatment of choice is surgery, which can be open or videolaparoscopic, with placement of a mesh or primary suture.
    CONCLUSIONS: The clinical presentation of Spigelian hernia is not characteristic and its diagnosis should be suspected during the investigation of an abdominal mass.
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  • 文章类型: Case Reports
    Spigelian疝是罕见的腹壁缺损,发生在腹直肌外侧的半月线。它们位于腹壁的肌肉层之间,由于腹部肥胖而容易被忽略。由于它们的位置和模糊的症状,它们很难诊断。超声检查和计算机断层扫描的引入极大地帮助了诊断。
    方法:我们报告一例60岁男性,表现为右下腹部肿胀和模糊的腹部不适,并在俯卧位CT扫描的帮助下诊断。患者在腹腔镜下接受了经腹腹膜前修补。他的康复顺利。
    Spigelian疝约占所有腹部疝的0.12%至0.2%。它通常发生在semilunaris线,“Spigelian疝”带的Spigelian膜缺损。在疑似病例中,建议使用超声扫描作为一线影像学检查。建议对斯皮氏疝进行及时的手术修复,以防止随后的绞窄。
    结论:由于Spigelian疝是一种罕见的实体,因此需要高度怀疑才能准确诊断。一旦做出诊断,需要手术管理来防止监禁。
    UNASSIGNED: Spigelian hernias are rare abdominal wall defects that occur at the semilunar line lateral to the rectus abdominis muscle. They are located between the muscular layers of the abdominal wall and can be easily overlooked because of abdominal obesity. They are difficult to diagnose because of their location and vague symptoms. The diagnosis has been considerably aided by the introduction of ultrasonography and Computed Tomography.
    METHODS: We report a case of 60 years old male who presented with swelling and vague abdominal discomfort in the right lower abdomen and was diagnosed with the help of CT scan in prone position. The patient underwent transabdominal preperitoneal repair laparoscopically. His recovery was uneventful.
    UNASSIGNED: Spigelian hernia constitutes about 0.12 to 0.2 % of all abdominal hernias. It commonly occurs in semilunaris line, well-defined defect in the Spigelian aponeurosis at the \"Spigelian hernia\" belt. Ultrasound scanning is recommended as first line imaging investigation in suspected case. Prompt surgical repair is recommended for spigelian hernia to prevent subsequent strangulation.
    CONCLUSIONS: Since spigelian hernia is a rare entity a high index of suspicion is required for accurate diagnosis. Once diagnosis is made, operative management is required to prevent incarceration.
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  • 文章类型: Case Reports
    未经证实:疝形成是一种众所周知的小牛腹壁疾病,最常见于脐部。此外,它发生在脐带区域以外的腹壁。据报道,它涉及后天因素,例如对下部或外侧腹壁的外力,创伤,肌肉无力,and,虽然罕见,先天或遗传因素。虽然已有关于肌肉形成异常引起的腹壁疝修复的报道,没有关于牛或其他反刍动物的椎骨和肋骨异常形成引起的腹壁疝的治疗报告。在这项研究中,第一次,我们描述了一例成功闭合由椎骨和肋骨畸形引起的左侧疝的病例。修复是通过使用手术线使肋骨变窄并用游离的网膜移植物覆盖缺损来进行的。
    UASSIGNED:一名男性日本黑小腿在出生后立即显示左腹壁轻度隆起和左肋骨形态异常。在3个月大的时候,计算机断层扫描显示9号融合,第十,和第11个胸椎以及在胸椎融合部位的第10和第11个左肋骨的缺失形成。此外,腹壁形成了15.2×24.4cm的腹疝。手术期间,形成疝气的肋骨用手术线变窄,疝用大型自体游离网膜移植物覆盖,以防止腹内器官脱垂。在每月随访时(手术后11个月),小牛的发育与农场上其他同龄小牛相似,没有发现并发症。
    UNASSIGNED:目前的案例表明,使用手术线进行肋骨矫正与游离的自体大网膜移植相结合,被证明是一种可能的治疗选择,可以手术修复由肋骨畸形引起的大腹壁疝。
    UNASSIGNED: Hernia formation is a well-known abdominal wall disorder in calves and most often occurs in the umbilical region. In addition, it occurs in the abdominal wall outside the umbilical region. It has been reported to involve acquired factors, such as external force to the lower or lateral abdominal wall, trauma, muscle weakness, and, although rare, congenital or hereditary factors. Although there have been reports on the repair of abdominal wall hernias caused by abnormal muscle formation, there have been no reports on the treatment of abdominal wall hernias caused by abnormal vertebral and rib formation in cattle or other ruminants. In this study, for the first time, we describe a case of successful closure of a hernia in the left flank caused by malformation of the vertebrae and ribs. The repair was performed by narrowing the ribs using a surgical wire and covering the defect with a free omental graft.
    UNASSIGNED: A male Japanese Black calf showed a mild bulge of the left abdominal wall and abnormal morphology of the left ribs immediately after birth. At 3 months of age, computed tomography revealed fusion of the 9th, 10th, and 11th thoracic vertebrae and missing formation of the 10th and 11th left ribs at the thoracic vertebral fusion site. Additionally, a 15.2 × 24.4 cm abdominal hernia had formed in the abdominal wall. During surgery, the ribs forming the hernia were narrowed with a surgical wire, and the hernia was covered with a large autologous free omental graft to prevent intra-abdominal organ prolapse. At the monthly follow-up (11 months after surgery), the calf had developed similarly to other calves of the same age on the farm, and no complications were noted.
    UNASSIGNED: The current case shows that a combination of rib correction using a surgical wire combined with transplantation of a free autologous greater omentum graft was shown to be a possible treatment option for surgical repair of large abdominal wall hernias caused by rib malformation.
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  • 文章类型: Case Reports
    未经证实:切口疝是腹部手术最常见的并发症之一,发病率为4-10%的患者[1]。根据患者的需求及其合并症的多学科方法已被证明可以改善术后结局。本病例报告强调了包括心脏病学在内的多学科方法的重要性。普外科,整形外科麻醉和重症监护病房用于心力衰竭和射血分数降低的患者的腹壁重建。
    方法:我们介绍了一例61岁的长期切口疝患者,由于患者的病情和多种合并症,没有进行手术矫正,晚期心力衰竭,左射血分数降低(10-15%),通过心脏病学进行多学科治疗,整形手术,麻醉学,重症监护室,和普外科。
    结论:患者行腹壁重建术,无并发症。由于多种合并症,患者在术后即刻入住ICU.他在手术后9天出院。患者未报告长期并发症。
    结论:心力衰竭与手术住院期间心血管并发症风险增加相关。在有多种合并症的患者中,多学科方法是改善手术结果的重要策略,降低医疗保健系统的成本,提高患者的生活质量。
    UNASSIGNED: Incisional hernias are among the most frequent complications of abdominal surgery, with an incidence of 4-10 % of patients [1]. The multidisciplinary approach according to the patient\'s needs and their comorbidities has been shown to improve postoperative outcomes. This case report highlights the importance of a multidisciplinary approach including cardiology, general surgery, plastic surgery anesthesiology and intensive care unit for abdominal wall reconstruction in a patient with heart failure and reduced ejection fraction.
    METHODS: We present a case of a 61-year-old patient with long-standing incisional hernia, without surgical correction due to the patient\'s condition and multiple comorbidities, advanced heart failure with reduced left ejection fraction (10-15 %) who underwent a multidisciplinary approach by cardiology, plastic surgery, anesthesiology, intensive care unit, and general surgery.
    CONCLUSIONS: The patient underwent abdominal wall reconstruction without complications. Due to multiple comorbidities, the patient was admitted in the ICU in the immediate postoperative period. He was discharged 9 days after surgery. The patient did not report long-term complications.
    CONCLUSIONS: Heart failure is associated with an increased risk of cardiovascular complications during surgical hospitalization. In patients with multiple comorbidities, the multidisciplinary approach represents an essential strategy in order to improve the surgical outcome, reduce costs to the health care system, and improve the patient\'s quality of life.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    Spigelian疝是一种罕见的腹侧疝,发病率为0.1-2%。我们报告了一例非绞窄的左下腹Spigelian疝及其处理方法。一名74岁的女性表现为逐渐恶化的左侧腹疼痛,并伴有排尿困难和与肾盂肾炎有关的频率。顺便说一句,腹部和骨盆的CT显示左斯皮氏疝,包含中等大小的小肠,没有绞窄。此后,她开始在那个区域增加腹痛。在入院当天通过腹腔镜腹膜内覆盖网片加修补术修复了疝气。Spigelian疝具有难以捉摸的临床表现。虽然罕见,由于腹部疝急性并发症的高风险,在鉴别诊断时必须考虑它。
    Spigelian hernia is a rare type of ventral hernia with an incidence of 0.1-2%. We report a case of a non-strangulated left lower quadrant spigelian hernia and its management. A 74-year-old female presented with progressively worsening left flank pain along with dysuria and frequency related to pyelonephritis. Incidentally, CT of the abdomen and pelvis demonstrated a left spigelian hernia containing intermediate size small bowel without strangulation. Thereafter, she began developing increasing abdominal pain in that area. The hernia was repaired on the same day as admission via laparoscopic intraperitoneal onlay mesh-plus repair. Spigelian hernia possesses an elusive clinical presentation. Though rare, it must be considered in the differential diagnosis of abdominal hernia due to its high risk for acute complications.
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