scholarly journals Fasciitis Necroticans after Elective Hernia Inguinal Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
T. A. Sigterman ◽  
Kim J. Gorissen ◽  
Dennis E. J. G. J. Dolmans
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Surgical Intervention ◽  
Elective Surgery ◽  
Necrotising Fasciitis ◽  
Time Interval ◽  
Mortality And Morbidity ◽  
Hernia Inguinal ◽  
High Index Of Suspicion ◽  
Inguinal Surgery

Necrotising fasciitis is a rare but disastrous complication after elective surgery. We present two patients (both male, 58 and 18 years old) who developed necrotising fasciitis following elective inguinal hernia repair according to Lichtenstein. The importance of both recognition and time interval between symptom occurrence and surgical intervention is illustrated, emphasising the need for immediate action when necrotising fasciitis is suspected. A high index of suspicion of necrotising fasciitis should be maintained when a wound infection is accompanied by disproportional pain, lethargy, or sepsis. Epidermolysis and subcutaneous emphysema are often very late symptoms. Recognition and immediate intervention decrease mortality and morbidity.

scholarly journals Retained Surgical Items in Inguinal Canal: A Case Report and Literature Review

2018 ◽  
Vol 6 (11) ◽  
pp. 2165-2167
Author(s):  
Amer Hashim Al Ani ◽  
Mohammad Bakri Hammami ◽  
Obaidah M. Mukhles Adi
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Literature Review ◽  
Hernia Repair ◽  
Preventive Measures ◽  
Inguinal Canal ◽  
Elective Surgery ◽  
Clinical Findings ◽  
History Of ◽  
High Index Of Suspicion

BACKGROUND: Retained surgical items (RSI) are rare medical challenges with serious complications and medicolegal implications. Knowledge and preventive measures for these rare events are currently not sufficient to limit their increasing incidence. Gauzes and sponges constitute most of RSI. Forceps, needles and pins may be found too. Diagnosis of these events is challenging and often missed due to nonspecific clinical findings. PRESENTATION OF CASE: We present here a 49-year-old patient who presented to the clinic with a history of chronic scrotal sinus on the same side of a repeatedly repaired inguinal hernia 4 months before admission. He underwent exploration of the inguinal canal as elective surgery. Exploration of the inguinal canal revealed missed surgical gauze left during the previous hernia repair. The gauze was removed, and the inguinal canal was repaired. The postoperative period was uncomplicated. CONCLUSION: Retained surgical items are completely preventable near-events. Although they are rare entities, clinicians must have a high index of suspicion for any postoperative, in patients presenting with pain, sinus or palpable masses.

scholarly journals PFA-100 test in the detection of platelet dysfunction and monitoring DDAVP in a patient with liver cirrhosis undergoing inguinal hernia repair

2012 ◽  
Vol 140 (11-12) ◽  
pp. 782-785 ◽  
Author(s):  
Dragica Vucelic ◽  
Milka Golubovic ◽  
Milos Bjelovic
Keyword(s):  
Liver Cirrhosis ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Elective Surgery ◽  
Standard Dose ◽  
Bleeding Complications ◽  
Platelet Dysfunction ◽  
Primary Hemostasis ◽  
Perioperative Bleeding

Introduction. Hemostatic abnormalities in liver cirrhosis are complex and multifactorial and may predispose to prolonged hemorrhage following invasive procedures. Due to increased perioperative bleeding risks, patients with cirrhosis should undergo elective surgery after making medical preparations. It has been shown that 1-deamino-8-D-arginine vasopressin (DDAVP), desmopressin, can be used as a safe and effective remedy in preventing and treating bleeding in cirrhotics. However, there is still scarce information of adequate test(s) for assessing effects of DDAVP in platelet dysfunction. The use of platelet function analyzer-100 (PFA-100) allows more reliable assessment of impaired primary hemostasis as well as follow-up of hemostatic changes induced by DDAVP effects. Case Outline. In a 49-year-old male with ethylic liver cirrhosis and prolonged bleeding time scheduled for elective left side inguinal hernia repair, we carried out PFA-100 testing to investigate the patient?s platelet functional status. Results were affirmative for the presence of platelet functional problems. By standard coagulation tests the patient was also identified as having secondary hemostasis. Preoperatively, PFA-100 was used to test the patient?s response to a standard dose of DDAVP, which was favorable. The patient was operated after medical preparations with DDAVP and vitamin K. Neither bleeding complications nor side effects of DDAVP were recorded in the perioperative period. Conclusion. The PFA-100 is a simple and reliable test for the assessment of primary hemostasis as well as in monitoring of DDAVP therapy.

scholarly journals Extradural Haematoma in Children: Surgical Experiences and Prospective Analysis of 138 Cases

2014 ◽  
Vol 1 (1) ◽  
pp. 19-24
Author(s):  
Sharif Md. Noman Khaled Chowdhury ◽  
Abdul Hanif ◽  
K M Tarikul Islam ◽  
Ehsan Mahmud ◽  
Sk. Sader Hossain
Keyword(s):  
Traffic Accident ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Time Interval ◽  
Extradural Haematoma ◽  
Age Group ◽  
Mortality And Morbidity ◽  
Common Clinical Presentation ◽  
Operative Measures

Objective: The authors present their experiences in the management of xtradural haematoma in children which involved an aggressive diagnostic approach, prompt surgical evacuation of the haematoma results in an excellent outcome.Subjects and methods: 138 consecutive patients with cranial extradural haematoma who underwent surgery in department of Neurosurgery from 1st January 2006 to 31st July 2009 were included in this prospective study. Each of the patients were evaluated in term of age, sex, mode of injury, localization of haematoma, clinical presentation, CT findings, operative measures and outcome.Results: Out of 138 cases 72.47 % were boys and 13.78 % were girls. The boys and girls ratio was 2.64: 1. Age ranges from 1.8 to 15 years with a mean age of 9.49 years. Most of the victims are in first half of second decade of life and closely followed by the 5-10 years age group. The most common mode of injury was fall 40.58 %, (n = 56) followed by Road traffic Accident (RTA) 31.89 %, (n = 44) .The Most common clinical presentation was altered sensorium 59.43 %, (n = 82), followed by Headache / Vomiting 56.53 %, (n = 78).Conclusion: Extradural haematoma in children is a recognized and one of the most rewarding neurosurgical emergencies. It must be recognized and evacuate early to prevent potential mortality and morbidity. Many factors affect the outcome of extradural haematoma surgery. In addition to influence of presence cranial fractures, associated brain lesions and pre-operative neurological condition of patient, duration of time interval between onset of coma and surgical intervention, morbidity and mortality have also been shown to be affected by age – with better prognosis in patients under 10 years of age.DOI: http://dx.doi.org/10.3329/jpsb.v1i1.19450

scholarly journals P163 ROLE OF THE LAPAROSCOPIC APPROACH IN EMERGENT INGUINAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Joan Ricard Soler Frias ◽  
Anabel García León ◽  
Luis Tallon-Aguilar ◽  
Jose Tinoco González ◽  
Alejandro Sánchez Arteaga ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Elective Surgery ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Reoperation Rate ◽  
Open Group ◽  
Open Approach

Abstract Aim Analyze the evolution of the laparoscopic approach in emergent inguinal hernia repair at our center. Material and Methods Retrospective review of patients with emergent inguinal hernia repair in our center from January 2011 to June 2020. Demographic, clinical and postoperative data were analyzed as well as the evolution of the laparoscopic approach. Results 385 patients with incarcerated/strangulated inguinal hernia were registered. 58.96% were men, with a median age of 71. Of those, 22 patients (5.71%) were treated by laparoscopic approach and 363 (94.29%) by open approach. The open approach had a longer median hospitalization (4.82 vs 1.66 days), higher rate of surgical wound infection (5.51% vs. 0%), higher reoperation rate (3.31% vs 0%) and higher incidence of respiratory complications (1.97% vs 0%). 1 patient (4.54%) with laparoscopic approach required intestinal resection vs 48 patients (13.22%) of the open group, with a dehiscence rate of 0% vs 4.76% respectively. Mortality rate was 0% for the laparoscopic group and 2.75% in the open group. In the last 18 months, 28.98% of urgent hernias repaired have been performed laparoscopically, while previously from 2011 to 2017 only 0.95%, due to the learning curve obtained in elective surgery where the laparoscopic approach has had a major development in the last 3 years. Conclusions Despite the evident patient selection bias because the approach choice by the surgeon in emergent inguinal hernia repair, laparoscopic approach is feasible and has lower morbidity-mortality compared to open approach in our center. In specialized centers this may be a treatment option for selected patient groups.

P16 Relation of timing of surgery to outcome from traumatic acute subdural haematoma

2019 ◽  
Vol 90 (3) ◽  
pp. e30.1-e30
Author(s):  
M Paranathala ◽  
S Quake ◽  
M Prasad
Keyword(s):  
Mortality Rate ◽  
Patient Outcomes ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Rank Correlation ◽  
Time Interval ◽  
Acute Subdural Haematoma ◽  
Mortality And Morbidity ◽  
Spearman Rank Correlation Test ◽  
Overall Mortality

ObjectivesAcute subdural haemorrhage (ASDH) is a neurosurgical emergency with high mortality and morbidity rates. Time to surgical intervention is implicated as an important factor affecting patient outcomes, however, more recent studies do not support this. We aimed to determine the correlation between time interval to surgery and outcome of patients with traumatic ASDH.MethodsWe retrospectively reviewed consecutive ASDH patients who underwent haematoma evacuation in the period between 2010 and 2016 at this tertiary neurosurgical centre. 49 patients were included for the analysis. Patient data was extracted from theatre records, patient notes and electronic records.ResultsThe median time interval from injury to surgery was 403 min (6 hours 43 min) with road traffic accident being the commonest mechanism of injury. 20 of 49 (34.7%) patients underwent evacuation within five hours from time of injury. Of these, 12 (41.4%) had good recovery (GOS 5), versus 15 (51.7%) amongst the 29 patients who underwent operation after five hours. Spearman rank correlation test (rs=0.07375) showed no statistically significant correlation between time interval to surgery and patient outcomes as measured by GOS. The overall mortality rate of evacuated patients at JCUH was 8.16% and the majority had good functional status, 55.1% with GOS 5.ConclusionsLonger time interval of more than four hours from injury to surgical intervention was not associated with higher mortality rate, or worse functional outcome.

scholarly journals Risk factors for perioperative complications in inguinal hernia repair – a systematic review

2017 ◽  
Vol 2 (2) ◽  
pp. 47-52 ◽  
Author(s):  
Dirk Weyhe ◽  
Navid Tabriz ◽  
Bianca Sahlmann ◽  
Verena-Nicole Uslar
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Potential Risk ◽  
Elective Surgery ◽  
Perioperative Complications ◽  
Cardiovascular Complications ◽  
Medical Intervention ◽  
Potential Risk Factors

AbstractThe current literature suggests that perioperative complications occur in 8%–10% of all inguinal hernia repairs. However, the clinical relevance of these complications is currently unknown. In our review, based on 571,445 hernia repairs reported in 39 publications, we identified the following potential risk factors: patient age, ASA score, diabetes, smoking, mode of admission (emergency vs. elective surgery), surgery in low resource settings, type of anesthesia, and (in men) bilateral and sliding hernias. The most commonly reported complications are bleeding (0.9%), wound infection (0.5%), and pulmonary and cardiovascular complications (0.2%). In 3.9% of the included publications, a reliable grading of the reported complications according to Clavien-Dindo classification was possible. Using this classification retrospectively, we could show that, in patients with complications, these are clinically relevant for about 22% of these patients (Clavien-Dindo grade ≥IIIa). About 78% of all patients suffered from complications needing only minor (meaning mostly medical) intervention (Clavien-Dindo grade <III). Especially with regard to the low incidence of complications in inguinal hernia repair, future studies should use the Clavien-Dindo classification to achieve better comparability between studies, thus enabling better correlation with potential risk factors.

scholarly journals A eficácia da antibioticoprofilaxia no reparo da hérnia inguinal / The effectiveness of antibiotic prophylaxis in inguinal hernia repair

2021 ◽  
Vol 4 (2) ◽  
pp. 7957-7964
Author(s):  
Matheus Kuffner ◽  
Ruan Martins Bonzi ◽  
Henrique Figueiredo Silva ◽  
Pedro Luiz Teodoro Dutra ◽  
Antônio Carlos Leon Dos Santos
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antibiotic Prophylaxis ◽  
Inguinal Hernia Repair ◽  
Hernia Inguinal

scholarly journals Small bowel obstruction secondary to obturator hernia in an elderly female

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Aneela Devarakonda ◽  
Aarav Gupta-Kaistha ◽  
Nikhil Kulkarni
Keyword(s):  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Delayed Diagnosis ◽  
Obturator Hernia ◽  
Computed Tomography Imaging ◽  
Rare Type ◽  
Midline Laparotomy ◽  
Mortality And Morbidity ◽  
Tomography Imaging ◽  
High Index Of Suspicion

Abstract Obturator hernia is an extremely rare type of pelvic hernia with relatively high mortality and morbidity due to delayed diagnosis. Most cases present with acute intestinal obstruction and typically affect elderly, emaciated females. A high index of suspicion is required for early diagnosis and timely surgical intervention. We present a rare case of an 81-year-old female who was initially discharged from the emergency department due to nonspecific symptoms. She represented with clinical features of bowel obstruction and was diagnosed preoperatively with computed tomography imaging identifying a left-sided obturator hernia with a loop of bowel extending through the obturator canal. She was taken to theater for lower midline laparotomy and repair of obturator hernia. Although many cases are identified intraoperatively, we will discuss preoperative means of diagnosis of obturator hernia from examination findings to imaging diagnosis.

scholarly journals Severe Necrotising Soft Tissue Infections in Orthopaedic Surgery

2002 ◽  
Vol 10 (2) ◽  
pp. 108-113 ◽  
Author(s):  
JC Theis ◽  
J Rietveld ◽  
T Danesh-Clough
Keyword(s):  
Orthopaedic Surgery ◽  
Surgical Intervention ◽  
Treatment Strategies ◽  
Predisposing Factors ◽  
Mortality And Morbidity ◽  
Presenting Symptoms ◽  
Group A ◽  
Inflammatory Drugs ◽  
The Mean ◽  
High Index Of Suspicion

Purpose. To review all cases of necrotising infection managed in the Department of Orthopaedic Surgery of Dunedin Hospital in New Zealand between 1989 and 1998. Methods. Hospital records were analysed for predisposing factors, clinical features, diagnostic results, treatment strategies, and outcomes. Results. 13 cases (9 males and 4 females) of necrotising infection were identified. The mean age was 48 years (range, 8–76 years). Presenting symptoms included painful swelling, erythema, and necrosis. Most patients had predisposing factors and had received non-steroidal anti-inflammatory drugs before presentation. 12 patients underwent surgical debridement including a total of 4 amputations. Septic shock developed in 9 patients who required dialysis for renal failure. Four patients died. The most common organisms identified were group A beta-haemolytic streptococci. Conclusion. Severe necrotising infections require a high index of suspicion and rapid medical and surgical intervention to reduce the mortality and morbidity.

Sign in / Sign up

Export Citation Format

Share Document