scholarly journals A case of colon necrosis resulting from a delayed traumatic diaphragmatic hernia

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Héloïse Tessely ◽  
Stéphane Journé ◽  
Alexis Therasse ◽  
Didier Hossey ◽  
Jean Lemaitre
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Diaphragmatic Hernia ◽  
Emergency Surgery ◽  
Past History ◽  
Traumatic Diaphragmatic Hernia ◽  
Abdominal Symptoms ◽  
History Of ◽  
Diaphragmatic Hernias

Abstract We present the case of a 71 years old woman who came at the emergency room for abdominal pain and symptoms of occlusion. The scanner demonstrated a colonic occlusion resulting from an incarceration, diagnosed as a hernia of Bochdalek. But two old rib fractures and a past history of a fall directed us to the diagnostic of delayed diaphragmatic rupture. The patient was operated in emergency and post-operative follow-up was simple. Traumatic diaphragmatic hernias are rarely diagnosed directly after trauma. Complications such as pneumonia, occlusion, enteric ischemia, visceral perforation and twisting of splenic hilium can occur many years after the trauma. This is why, for patients with intestinal obstruction or association of pulmonary abdominal symptoms and history of thoraco-abdominal injury, the diagnostic of diaphragmatic hernia should be considered. When patients present complications, there is a higher rate of morbidity and mortality (31%) reason why, emergency surgery is mandatory.

scholarly journals HOW TO MANAGE SUDDEN IVC DECOMPRESSION IN CASE OF A LARGE RETROPERITONEAL MYELOLIPOMA.

2021 ◽  
pp. 12-14
Author(s):  
Nina M. Shah ◽  
Priyanka Warde ◽  
Hiral C. Chauhan
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Cesarean Section ◽  
Past History ◽  
Incidental Finding ◽  
Large Mass ◽  
Normal Vaginal Delivery ◽  
Suprarenal Mass ◽  
History Of

31 year female patient presented to surgical OPD to take consult about incidental finding of large mass originating th from liver in routine antennal checkup at 5 month of pregnancy. We have done ultrasound which is suggestive of suprarenal mass patient was kept under regular follow up and checked for any increase in size of mass but there is no changes in mass .patient deliver baby with normal vaginal delivery ,after postpartum 7 months patient came back with right sided abdominal lump. No complaint of abdominal pain ,vomiting ,headache ,palpitation ,diarrhea ,constipation ,fever ,generalized weakness and weight loss. Past history of cesarean section before 8 years .

scholarly journals Acute Large Bowel Obstruction Following Late Sequelae of Traumatic Diaphragmatic Hernia

2020 ◽  
Vol 15 (1) ◽  
pp. 119-120
Author(s):  
Md Mahboob Hasan ◽  
MA Baqui ◽  
Farzana Rahman ◽  
Merajul Hasan
Keyword(s):  
Diaphragmatic Hernia ◽  
Transverse Colon ◽  
Proper Time ◽  
Past History ◽  
Armed Forces ◽  
Military Hospital ◽  
Diagnostic Dilemma ◽  
Left Chest ◽  
Traumatic Diaphragmatic Hernia ◽  
History Of

A 33 years old patient was admitted in a Military Hospital with the features of acute large gut obstruction. Exploratory laparotomy was done and peroperatively the obstruction was seen in the transverse colon and obstruction seemed to be carcinoma of transverse colon with involvement of left hemidiaphragm which was not negotiable. Transverse loop colostomy with decompression of bowel was done. Subsequently the patient was transferred to tertiary level hospital in Dhaka. In the tertiary hospital, the patient developed left sided massive pleural effusion. With relevant investigation the condition was diagnosed as left sided diaphragmatic hernia. Thoracotomy was done and herniorrhophy was performed after reduction of the content. Post-operative management was stormy and eventful but the condition improved gradually and the patient was discharged in proper time. The patient had history of chest trauma due to RTA he met 4 years back and he received hospital indoor management for 3½ months. The patient was asymptomatic and leading normal active military life before 2nd time admission for acute intestinal obstruction. The patient had past history of trauma to left chest wall 4 years back, presented with acute large gut obstruction and there was diagnostic dilemma. There were management difficulties and post operative events were stormy. The aim of this reporting is to highlight all of these. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 119-120

scholarly journals Faecopneumothorax due to missing diaphragmatic hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Resul Nusretoğlu ◽  
Yunus Dönder
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Colon Resection ◽  
Emergency Laparotomy ◽  
Hernia Sac ◽  
Case Presentation ◽  
Abdominal Tenderness ◽  
History Of ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

Rare cause of chronic abdominal pain: left paraduodenal hernia and its surgical management

2021 ◽  
Vol 14 (12) ◽  
pp. e245024
Author(s):  
Ajay Chikara ◽  
Sasidhar Reddy Karnati ◽  
Kailash Chand Kurdia ◽  
Yashwant Sakaray
Keyword(s):  
Abdominal Pain ◽  
Stable Condition ◽  
Paraduodenal Hernia ◽  
Inferior Mesenteric Vein ◽  
Anterior Border ◽  
Initial Reduction ◽  
Contrast Enhanced ◽  
History Of ◽  
Enhanced Computed Tomography

A 30-year-old man presented with colicky abdominal pain for 2 months, associated with occasional episodes of bilious vomiting. He had a history of similar complaints at the age of 16 and 26 years. Contrast-enhanced computed tomography abdomen was consistent with a diagnosis of left paraduodenal hernia. On laparoscopy a 3 × 3 cm hernial defect was identified in the left paraduodenal fossa (fossa of Landzert). Contents were jejunal, and proximal ileal loops which were dilated and edematous. Anterior border of the sac was formed by the inferior mesenteric vein and left branch of the left colic artery. Initial reduction of contents was easy. However, complete reduction proved to be difficult due to adhesions with the sac opening, the hernial sac instead laid open by dividing the Inferior Mesentric Vein (IMV) (anterior border of defect) using a vascular stapler. The patient was discharged on postoperative day 3 in a stable condition. On follow-up the patient is doing well.

scholarly journals P034 STRANGULATED DIAPHRAGMATIC HERNIA: TEN CASES REPORTS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Mehmet Gunay ◽  
gorkem uzunyolcu ◽  
yalın iscan ◽  
kaan gok ◽  
hakan yanar ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Diaphragmatic Hernia ◽  
Emergency Surgery ◽  
Penetrating Trauma ◽  
Abdominal Symptoms ◽  
Threatening Condition ◽  
Segmental Bowel Resection ◽  
Life Threatening ◽  
Surgery Department ◽  
Laparoscopic Techniques

Abstract Aim A diaphragmatic hernia (DH) is a protrusion of abdominal contents into the thoracic cavity as a result of a defect within diaphragm. It is most common as a congenital phenomenon; however, there have also been cases where it can be acquired. DH can be life-threatening, resulting in incarceration and strangulation. Material and Methods From June 2009 to April 2021, ten cases of strangulated diaphragmatic hernia were admitted to our Emergency Surgery Department of General Surgery with respiratory and abdominal symptoms. Patients' characteristics, operation details, and postoperative complications were retrospectively analyzed. Results There were 5 (50%) men and 5 (50%) women with a mean age of 66 years (range, 20–85 years). . Emergency surgery was performed by laparoscopic in 4(40%) patients and open in 6(60%) patients. Two patients had a history of penetrating trauma to the left thoracoabdominal region. Segmental bowel resection was performed in 3 patients and total gastrectomy in 1 patient. Reconstruction was not performed in the patient who underwent total gastrectomy due to ischemia and perforation. In the postoperative period, wound infection was observed in 2 patients. Anastomotic leakage was observed in 1 patient and treated with end enterostomy. Empyema was observed in one patient after discharge, the empyema was evacuated and thoracoscopic decortication was performed .The patient who underwent total gastrectomy died due to septic shock and comorbid diseases. Conclusions Strangulated diaphragmatic hernia is a life-threatening condition and requires emergency surgery. Laparoscopic techniques can also be used in treatment.

scholarly journals Oral Antithrombotic Use Among Myocardial Infarction Patients

2003 ◽  
Vol 37 (1) ◽  
pp. 143-146 ◽  
Author(s):  
Menno E van der Elst ◽  
Nelly Cisneros-Gonzalez ◽  
Cornelis J de Blaey ◽  
Henk Buurma ◽  
Anthonius de Boer
Keyword(s):  
Myocardial Infarction ◽  
Record Linkage ◽  
Antithrombotic Therapy ◽  
Past History ◽  
Oral Anticoagulants ◽  
Antiplatelet Agents ◽  
Antithrombotic Treatment ◽  
History Of ◽  
Using Data

OBJECTIVE To examine the use of oral antithrombotics (i.e., antiplatelet agents, oral anticoagulants) after myocardial infarction (MI) in the Netherlands from 1988 to 1998. METHODS Retrospective follow-up of 3800 patients with MI, using data from the PHARMO Record Linkage System. RESULTS From 1988 to 1998, oral antithrombotic treatment increased significantly from 54.0% to 88.9%. In 1998, only 75.8% of patients who experienced a MI in the late 1980s received oral antithrombotic treatment compared with 94.4% of those who experienced a recent MI. CONCLUSIONS Oral antithrombotics were considerably underused in patients with a past history of MI. Therefore, these patients should be reviewed for antithrombotic therapy to assess whether their failure to use oral antithrombotics was right or wrong, and whether treatment should be initiated if possible.

scholarly journals Audit of safety, efficacy, and cost-effectiveness of local anaesthetic cystodiathermy

2010 ◽  
Vol 92 (8) ◽  
pp. 706-709 ◽  
Author(s):  
Kim Davenport ◽  
Francis X Keeley ◽  
Anthony G Timoney
Keyword(s):  
Cost Effectiveness ◽  
Local Anaesthetic ◽  
Past History ◽  
Transitional Cell ◽  
General Anaesthetic ◽  
Patient Anxiety ◽  
Bladder Transitional Cell Carcinoma ◽  
Flexible Cystoscopy ◽  
History Of

INTRODUCTION The aim of this study was to audit our experience of cystodiathermy under local anaesthetic (LA) at the time of flexible cystoscopy for recurrent superficial bladder transitional cell carcinoma (TCC). PATIENTS AND METHODS A total of 264 flexible cystoscopies were performed on patients with a past history of TCC. The number and site of recurrences were recorded and selected patients were offered cystodiathermy. Patient tolerability was noted. At follow-up, any recurrence was recorded. RESULTS Eighty patients (30%) had 91 procedures showing one or more recurrences. Fifty-one of the 80 patients (64%) were treated with cystodiathermy under LA. All completed treatment. Forty-five (88%) tolerated the procedure well. Forty-seven (92%) treatments were completed within 5 min. At a median follow-up of 15 weeks, 30 (59%) treated patients had no recurrence and three (6%) had recurrence at the site of treatment. CONCLUSIONS LA cystodiathermy is an effective and well-tolerated alternative to general anaesthetic cystodiathermy that enables treatment at the time of detection and may, thereby, reduce patient anxiety.

scholarly journals A rare cause of small bowel diaphragm disease presenting with palpated abdominal mass

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Aghyad K Danial ◽  
Ahmad Al-Mouakeh ◽  
Yaman K Danial ◽  
Ahmad A Nawlo ◽  
Ahmad Khalil ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Medical History ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Past Medical History ◽  
Abdominal Symptoms ◽  
Diaphragm Disease ◽  
History Of ◽  
Specific Symptoms

Abstract Small bowel diaphragm disease is a rare complication related to non-steroidal anti-inflammatory drug (NSAID) use. It presents with non-specific symptoms such as vomiting, abdominal pain, subacute bowel obstruction and occasionally as an acute abdominal condition. We report a case of diaphragm disease in a 33-year-old female who presented with vomiting, constipation and abdominal pain started 5 days earlier. Physical examination revealed palpated abdominal mass. The patient’s past medical history was remarkable for NSAID use. The patient was managed by surgical resection of involved intestine and diagnosis was confirmed by histological examination. Although there are few published cases of diaphragm disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing patients presenting with non-specific abdominal symptoms with remarkable past medical history of NSAID use.

scholarly journals Incarcerated Lumbar Hernia Complicated by Retroperitoneal Pseudoaneurysm 50 Years after Resection and Radiation Therapy of a Sarcoma

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Oluwatobi Onafowokan ◽  
Dabanjan Bandyopadhyay ◽  
Dale Johnson ◽  
Hugo J. R. Bonatti
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Ct Scan ◽  
Late Complication ◽  
Abdominal Hernia ◽  
Emergency Laparotomy ◽  
Incisional Hernias ◽  
History Of ◽  
The Right

Background. Lumbar hernias are rare abdominal hernias. Surgery is the only treatment option but remains challenging. Posterior incisional hernias are even rarer especially with incarceration of intra-abdominal contents.Case Presentation. A 68-year old female presented with a 3-day history of worsening acute abdominal pain and distension, with multiple episodes of emesis. A CT scan indicated a large incarcerated posterolateral abdominal hernia. The patient had a history of resection of a sarcoma on her back as a child and also received chemotherapy and radiation. During emergency laparoscopy, a hemorrhagic small bowel segment incarcerated in the hernia was reduced and resected, and the distended small bowel was decompressed. An elective hernia repair was scheduled. After temporary clinical improvement, the patient again developed abdominal pain, distention, and emesis. During emergency laparotomy, a large hematoma in the right flank was found and partially evacuated. The right colon was mobilized out of the hernia and the duodenum was kocherized. A20×20cm BIO-A mesh was placed on top of the Gerota fascia and cranially tucked under liver segment VI. Anteriorly, the mesh was fixated with absorbable tacks. The duodenum and colon were placed into the mesh pocket. A postoperative CT scan identified a 2 cm pseudoaneurysm of a side branch of a lumbar artery, and the bleeding source was embolized. The postoperative course was complicated byClostridium difficile-associated colitis, but ultimately, the patient recovered fully. At 6-month follow-up, there was no evidence for a recurrent hernia.Discussion. There is a paucity of literature concerning lumbar incisional hernias. Repair with bioabsorbable mesh seems feasible, but longer follow-up is necessary as the mesh was placed in an unusual fashion due to the retroperitoneal hematoma. The exact cause of the hemorrhage is unclear and may have been caused during the initial incarceration, during surgery, or may be a late complication of her previous radiation.

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