Direct hernia

2021 ◽  
Author(s):  
◽  
Pradeep Chowbey ◽  
Rajesh Khullar ◽  
Anil Sharma ◽  
Manish Baijal ◽  
...  
Keyword(s):  
Direct Hernia

INGUINAL HERNIA REPAIR BY THE “MESH PLUG” TECHNIQUE

2014 ◽  
pp. 40-46
Author(s):  
Doan Van Phu Nguyen ◽  
Loc Le ◽  
Van Lieu Nguyen
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Operating Time ◽  
Life Assessment ◽  
Medium Size ◽  
Mesh Plug ◽  
Indirect Hernia ◽  
Postoperative Rehabilitation ◽  
Early Return ◽  
Direct Hernia

Background:In 1989, Lichtenstein I. L., Shulman A. G., Amid P. K., and Montlor M. M. presented an idea of using Mesh Plug to repair the defect inguinal canal. The new technique quickly became accepted by surgeons all over the world for several reasons: faster overall rehabilitation, less postoperative pain, less complication, shorter stay in the hospital and early return to normal activities and work. Materials and method:From December 2011 to October 2012, 97 patients with inguinal hernia were surgically treated with 110 Mesh Plugs applied at the Surgery Unit of Hue University of Medicine and Pharmacy. Result:The patients’ mean age was 48.96±23.19. There were 60 patients over 40 years old, accounting for 61.9%, and 93 of the group were males, accounting for 95.8%. 24 cases were direct hernia, accounting for 21.8%, 86 cases were indirect hernia accounting for 78.2% and 11cases were direct hernia associated with indirect hernia. Based on Nyhus’s classification, there were 76 cases of IIIA and IIIB (69.1%). Based on the position of protrusion, there were 66 cases of right inguinal hernia (60.0%), 44 cases of left inguinal hernia (40.0%), and 13 cases of hernia on both sides. The average size of the deep ring is 2.19±1.54cm. 65 cases used Mesh Plug of medium size (59.1%). The mean operating time was 37.26 minutes. The time of staying in the hospital was 3.58±1.17 days. Quality of life assessment after the surgery showed 93 very good and good cases 95.8% and 4 cases (4.2%) with satisfactory result. No case of bad outcome was recorded. Conclusion: Surgical treatment of inguinal hernia by the Mesh Plug technique is really effective, safe with faster postoperative rehabilitation, less postoperative pain, less complications, shorter hospital stay and early return to normal activities and work. Key words: Inguinal hernia, Mesh Plug.

A rare encounter of obstructed direct inguinal hernia

2019 ◽  
Vol 22 (2) ◽  
pp. 41-43
Author(s):  
Amit Kumar Singh ◽  
Nripesh Rajbhandari ◽  
Balaram Malla ◽  
Gakul Bhatta
Keyword(s):  
Emergency Department ◽  
Inguinal Hernia ◽  
Intestinal Obstruction ◽  
Intestinal Resection ◽  
Posterior Wall ◽  
Acute Intestinal Obstruction ◽  
University Hospital ◽  
Direct Inguinal Hernia ◽  
Direct Hernia ◽  
The Right

The direct inguinal hernia has a wider neck and thus usually doesn’t present as strangulation or incarceration in comparison to the indirect component. When direct inguinal hernias are untreated for a longer duration, they may get strangulated and incarcerated. Hence such long-standing direct hernias with features of intestinal obstruction and /or peritonism should be promptly seen and diagnosed to prevent massive and unwanted intestinal resection. We are reporting a case of 83-year-old male presented to Surgical Emergency Department of Dhulikhel Hospital, Kathmandu University hospital with complaints of swelling in the right inguinoscrotal region for 12 years and progressed to become irreducible and painful for 12 hours. Clinically he had an acute intestinal obstruction. Intra-operatively we found a direct hernia containing congested small bowel loops and toxic fluids. The toxic fluid was suctioned and after confirming viability, modified Bassini’s repair was done with reinforcement of the posterior wall. Even direct inguinal hernia of longer duration can cause acute or sub-acute intestinal obstruction with or without features of peritonism. This complication is more common in elderly patients.

Multiple Ipsilateral Inguinal Hernias Comprising One Direct Hernia and One External Supravesical Hernia: Two Case Reports

2019 ◽  
Vol 1 (9) ◽  
pp. 726-729
Author(s):  
Masahiko Kawaguchi ◽  
Kazunori Koyama ◽  
Karin Kimura ◽  
Yoshitaka Iwaki ◽  
Hideaki Kato ◽  
...  
Keyword(s):  
Case Reports ◽  
Inguinal Hernias ◽  
Direct Hernia

scholarly journals Strangulated direct inguinal hernia with intraperitoneal perforation

2017 ◽  
Vol 4 (12) ◽  
pp. 4093 ◽  
Author(s):  
Md Asjad Karim Bakhteyar ◽  
Binod Kumar ◽  
Sushil Kumar
Keyword(s):  
Small Intestine ◽  
Inguinal Hernia ◽  
Posterior Wall ◽  
Indirect Inguinal Hernia ◽  
Direct Inguinal Hernia ◽  
Peritoneal Perforation ◽  
Direct Hernia

Usually direct inguinal hernia doesn’t present as strangulation or incarceration as compared to indirect inguinal hernia because of earlier has wider neck. A patient of recurrent direct inguinal hernia presents as intra-scrotal gangrene and intra-peritoneal perforation. We reported a case of 65 years old male presented with septicemia and right sided strangulated direct hernia. On exploration through inguino scrotal incision and mid line laparotomy, gangrenous loop was found in scrotum and perforation was found in intra-peritoneal part of small intestine. Resection-anastomosis was done for both the parts of intestine. Inguinal Incision was closed by posterior wall closure and modified Bassini’s herniorraphy. Abdomen was closed in layers with brain. Long standing direct hernia may present as strangulation or incarceration specially in elderly but perforation and gangrene of intra-peritoneal part of small intestine is very rare.

scholarly journals A clinical study of complicated inguinal hernias

2019 ◽  
Vol 6 (5) ◽  
pp. 1608
Author(s):  
Vijaykumar Kappikeri ◽  
Nitinkumar N. N. Kalaskar
Keyword(s):  
Urban Areas ◽  
Postoperative Outcome ◽  
Medical College ◽  
Modes Of Presentation ◽  
Inguinal Hernias ◽  
Life Threatening ◽  
Direct Hernia ◽  
Resection And Anastomosis ◽  
Complications And Mortality ◽  
Treatable Condition

Background: Hernia is a common, treatable condition, if ignored can lead to life- threatening complications. Lack of health awareness, poverty, and lack of surgical facilities will lead to devastating complications. This study aims at illustrating the various modes of presentation, management and postoperative outcome in complicated inguinal hernias.Methods: 50 patients of complicated inguinal hernia admitted in Basaveshwar Teaching and General Hospital attached to M.R. Medical College, Kalaburagi from September 2016 to August 2018 was studied.Results: 12 cases (24%) presented within 24 hrs of onset of symptoms, while 38 cases (76%) after 24 hrs. 32 cases (64%) were right sided and 16 cases (32%) were left sided hernias. 2 cases (4%) were bilateral hernias but had complication on only 1 side. 44% cases were irreducible, 36% were obstructed and 20% were strangulated. 96% cases were indirect while only 4% were direct hernia. 82% cases were from rural and 18% cases were from urban areas. Most common age of presentation was 4th and 5th decade. Most common mode of presentation was an irreducible swelling (100%), followed by pain in 48% and vomiting in 46% cases. The content was small bowel in 54% cases, omentum in 18% cases and both in 16% cases. Herniorrhaphy was performed in 74% cases and hernioplasty in 14%. 6 cases of strangulated hernia with non-viable bowel underwent resection and anastomosis. 3 deaths (6%) were reported.Conclusions: Patients who presented within 24 hours of onset of symptoms had shorter hospital stay, lesser complications and no mortality. Whereas cases presented after (>24 hrs) had higher rate of complications and mortality. Most of the complicated cases were from rural area and were right sided indirect inguinal hernias.

scholarly journals Umbilical hernia in children

2003 ◽  
Vol 56 (5-6) ◽  
pp. 291-294 ◽  
Author(s):  
Smiljana Marinkovic ◽  
Svetlana Bukarica
Keyword(s):  
Umbilical Hernia ◽  
Pain Treatment ◽  
Pediatric Population ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Great Majority ◽  
Common Condition ◽  
Direct Hernia ◽  
Incomplete Closure

Introduction Umbilical hernia is a common condition in the pediatric population. Embryology Umbilical hernia is a consequence of incomplete closure or weakness at the umbilical ring, where protrusion of intraabdominal contents may occur. Anatomy Fascia posterior to the canal is thinner creating an area of weakness. Congenital or direct hernia occurs in this area, while herniation in the umbilical canal leads to indirect or acquired hernia. Incidence The incidence of umbilical hernia is 1.9% to l8.5% in white population. Clinical manifestations The great majority of pediatric umbilical hernias are asymptomatic. Incarceration and strangulation are uncommon Rupture of umbilical hernia with resultant evisceration is extremely rare Umbilical hernia may also be the source of intermittent umbilical or abdominal pain. Treatment Treatment options for umbilical hernias range from simple observation to surgical repair. The great majority close spontaneously and observation with periodic follow-up is appropriate in most cases. There are no available data to suggest that strapping improves or accelerates closure. Operation would be recommended for defects greater than 1cm, by the age 3 to 4. Persistence or enlargement of fascial defect during the period of observation are reasons to consider repair, whatever the age. Complications Complications of operative repair of umbilical hernias include those related to anesthesia and local wound infections. Conclusion Umbilical hernia is a common condition among infants and children. In the great majority of cases the natural history is one of eventual closure without treatment. If spontaneous closure does not occur until the age of 3-4 years, operative correction is recommended.

TEM and SEM Studies on Alteration of Collagen Fibrils in the Inguinal Herniation

1980 ◽  
Vol 38 ◽  
pp. 472-473
Author(s):  
C. N. Sun ◽  
H. J. White ◽  
R. C Read ◽  
J. H. L. Watson
Keyword(s):  
Rectus Sheath ◽  
Dry Weight ◽  
Conclusive Evidence ◽  
Indirect Hernia ◽  
Anterior Rectus Sheath ◽  
Inguinal Herniorrhaphy ◽  
Constant Area ◽  
Direct Hernia ◽  
Lower Ratio ◽  
Inguinal Herniation

Although a large number of conditions in man and animals has been designated as collagen diseases, there is as yet no conclusive evidence to prove collagen involvement in most of these conditions. In a study of patients undergoing inguinal herniorrhaphy, the anterior rectus sheath some inches above the defect was noted to be thinner than normal, especially in those with the direct type. This observation was confirmed by weighing samples of constant area. Further study revealed that the lighter weight of rectus sheath biopsies from adults with inguinal herniation could be accounted for by a striking decrease in hydroxyproline. The content of hydroxyproline in the direct inguinal herniation as measured in terms of tissue dry weight was lower and the amount of proline in the direct hernia specimens was significantly higher, thus accounting for a significantly lower ratio of hydroxyproline:proline compared to control or indirect hernia samples.

scholarly journals PROFILE OF THE PATIENTS WHO UNDERWENT PROLENE HERNIA SYSTEM EXTENDED FOR INGUINAL HERNIA IN A TEACHING INSTITUTE IN SUBHIMALAYAN REGION

2020 ◽  
pp. 1-2
Author(s):  
Rohit Kumar ◽  
Arvind Bhatia ◽  
Shelja Rawat ◽  
Ritu Rawat ◽  
Shikha Rawat ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Repair ◽  
Previous History ◽  
Controlled Study ◽  
History Of Surgery ◽  
Indirect Hernia ◽  
Prolene Hernia System ◽  
Direct Hernia ◽  
History Of ◽  
Scrotal Swelling

Introduction: Worldwide, inguinal hernia repair is probably the most commonly performed general surgical procedure. Hence, a slight refinement of surgical repair of inguinal hernia would mean a substantial benefit to the patient. Aim: The study aimed to study profile of the patients who underwent Prolene Hernia System Extended (PHSE) for Inguinal Hernia in a teaching institute in Sub-Himalayan region. Materials and Methods: This was a controlled study conducted over 30 adult patients of both genders admitted at Dr RPGMC Tanda at Kangra from September 2016 to September 2017. Patients clinically diagnosed with inguinal hernias both direct and indirect on examination were enrolled in the trial after their informed consent. Results: Mean age of the patients was 54.9±13.66 years (range 30 to 80 years). 33% of the patients were elderly. All the patients were males. 43% of the patients were smokers and 53% were consuming alcohol. 20% of the patients had associated co-morbidities. 7% patients had previous history of surgery. Fifty percent of the patients had direct hernia while 33% had indirect hernia. Among 10% patients, it was bubonocele type. Seven patients had complications. Scrotal swelling was the most common welling (n=3) followed by inguinodynia (n=2), and seroma formation and urinary retention in one patient each. Conclusion: PHSE for management of inguinal hernia is associated with better outcomes.

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