scholarly journals Strangled gravidic uterus, an exceptional complication of umbilical hernia during pregnancy, a case report

2021 ◽  
Vol 72 ◽  
pp. 103143
Author(s):  
Rachid Jabi ◽  
Siham Elmir ◽  
Karam Saoud ◽  
Houda Mir Ali ◽  
Siham Nasri ◽  
...  
Keyword(s):  
2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 263-265
Author(s):  
A LAGROTTERIA ◽  
A Aruljothy ◽  
K Tsoi

Abstract Background Patients with decompensated liver cirrhosis with ascites frequently have umbilical hernias with a prevalence of 20% and are managed with large volume paracentesis (LVP). Common complications of LVP include hemorrhage, infection, and bowel perforation that occur infrequently with a frequency of less than 1%. However, incarceration of umbilical hernias has been reported as a rare complication of LVP and is speculated to be from ascitic fluid decompression that reduces the umbilical hernia ring diameter resulting in entrapment of the hernia sac. It is unclear whether the quantity or the fluid removal rate increases the herniation risk. Based on case series, this rare complication occurs within 48 hours of the LVP and requires emergent surgical repair and involves a high risk of morbidity and mortality due to potential infection, bleeding, and poor wound healing. Aims We describe a case report of an incarcerated umbilical hernia following a bedside large-volume paracentesis. Methods Case report Results A 59-year-old Caucasian male presented to the emergency department with a 24-hour history of acute abdominal pain following his outpatient LVP. His medical history included Child-Pugh class C alcoholic liver cirrhosis with refractory ascites managed with biweekly outpatient LVP and a reducible umbilical hernia. He reported the onset of his abdominal pain 2-hours after his LVP with an inability to reduce his umbilical hernia. Seven liters of clear, straw-coloured asitic fluid was drained. Laboratory values at presentation revealed a hemoglobin of 139 g/L, leukocyte count of 4.9 x109 /L, platelet count of 110 xo 109 /L, and a lactate of 2.7 mmol/L His physical exam demonstrated an irreducible 4 cm umbilical hernia and bulging flanks with a positive fluid wave test. Abdominal computed tomography showed a small bowel obstruction due to herniation of a proximal ileal loop into the anterior abdominal wall hernia, with afferent loop dilation measuring up to 3.4 cm. He was evaluated by the General Surgery consultation service and underwent an emergent laparoscopic hernia repair. There was 5 cm of small bowel noted to be ecchymotic but viable, with no devitalized tissue. He tolerated the surgical intervention with no post-operative complications and was discharged home. Conclusions Ultrasound-guided bedside paracentesis is a common procedure used in the management of refractory ascites and abdominal wall hernia incarceration should be recognized as a potential rare complication. To prevent hernia incarceration, patients with liver cirrhosis should be examined closely for hernias and an attempt should be made for external reduction prior to LVP. A high index of suspicion for this potential life-threatening condition should be had in patients who present with symptoms of bowel obstruction following a LVP. Funding Agencies None


Author(s):  
Saunri Hansadah ◽  
Jasmina Begum ◽  
Pankaj Kumar ◽  
Sweta Singh ◽  
Deepthy Balakrishnan ◽  
...  

2021 ◽  
Author(s):  
Anna Marija Lescinska ◽  
Igors Ivanovs

Abstract Aim. The case report demonstrates a successful laparoscopic treatment of early postoperative small bowel obstruction after open strangulated umbilical hernia repair with mesh.Case report. An 86-year-old female was admitted to the hospital due to abdominal pain for 2 days localised in the umbilical region. A diagnosis of strangulated umbilical hernia was set, and emergency operative therapy was performed. On the third postoperative day the patient showed symptoms of bowel obstruction, confirmed on CT. An emergency laparoscopy proceeded. It revealed small intestine loop fixation to the mesh through the peritoneal defect. While separating the intestine a defect in bowel wall was found and sutured laparoscopically. Patient was discharged from the hospital on the 8th postoperative day.Conclusion. Laparoscopic treatment after open hernia surgery is an alternative access for redo surgery in early postoperative period. It provides acceptable results even in contaminated area without needs to reopen surgical wound.


2017 ◽  
Vol 9 (1) ◽  
pp. 34
Author(s):  
C. Bhuyan ◽  
S. Sathapathy ◽  
S.K. Joshi ◽  
S. Mishra ◽  
S.S. Beura

2011 ◽  
Vol 83 (7) ◽  
Author(s):  
Jacek Kurnicki ◽  
Natalia Wrzesińska ◽  
Przemysław Kabala

2021 ◽  
Vol 8 ◽  
Author(s):  
Imke Hennink ◽  
Pia Düver ◽  
Ulrich Rytz ◽  
Felix Meneses ◽  
Melania Moioli ◽  
...  

Objective: This study aims to describe an unusual peritoneopericardial diaphragmatic hernia (PPDH) in an 8-month-old German shepherd dog, associated with a pericardial pseudocyst and coexisting severe pericardial effusion resulting in right-sided heart failure.Case Summary: An 8-month-old, male, intact, German shepherd dog, was referred for ascites. Echocardiography revealed a severe pericardial effusion with a cyst-like structure within the pericardium and consequently decompensated right-sided heart failure. The ascites was secondary to right-sided heart failure (cardiac tamponade). Computed tomography (CT) of the thorax and abdomen was performed and showed PPDH with severe pericardial effusion and presence of a pericardial cyst-like structure; xyphoid cleft and Y-shaped seventh sternebra; and mild thickening along the cranioventral abdominal wall consistent with scar tissue from the previous umbilical hernia surgical repair. During surgery, the PPDH was corrected, and it was revealed that the remnant of the umbilical cord passed through it, into the pericardium. The cyst-like structure was successfully resected and sent for pathology. Histopathology showed signs of a chronic suppurative inflammation, with absence of a mesothelial or endothelial wall layer, thus consistent with a pseudocyst. Based on tomographic and surgical findings, it is suspected that the pseudocyst, together with the pericardial effusion, evolved by an inflammation of the remnant of the umbilical cord during the umbilical hernia surgical repair 1 month prior to presentation. The underlying PPDH most likely favored the development of the pericardial pseudocyst. However, due to prior antibiotic therapy initiated by the private vet, an infectious origin cannot be ruled out completely.New or Unique Information Provided: There are a few case reports describing PPDH and/or pericardial pseudocysts in veterinary patients, but the current case report is unique, since it describes PPDH associated with a pericardial pseudocyst and coexisting severe pericardial effusion resulting in cardiac tamponade. As far as the authors know, such a case has not been described in veterinary medicine before.


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