scholarly journals Laparoscopic repair of a Bochdalek hernia in an elderly patient: a case report with a review from 1999 to 2019 in Japan

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Toshimitsu Miyasaka ◽  
Takeshi Matsutani ◽  
Tsutomu Nomura ◽  
Nobutoshi Hagiwara ◽  
Naoto Chihara ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Abdominal Cavity ◽  
Suture Technique ◽  
Uneventful Recovery ◽  
Bochdalek Hernia ◽  
Direct Closure ◽  
Hernia Sac ◽  
Ischemic Change ◽  
Life Threatening ◽  
Laparoscopic Evaluation

Abstract Background A Bochdalek hernia (BH) is a congenital defect of the diaphragm that generally presents in the newborn as life-threatening cardiorespiratory distress. In contrast, the diagnosis of a BH in adults is rare. Surgical repair for adult BH is recommended, but the optimal surgical method remains unclear. Case presentation A 75-year-old woman presented with progressive dyspnea and back pain, and a diagnosis of BH was made based on chest X-ray and computed tomography. Laparoscopic evaluation revealed a defect in the left posterior attachment of the diaphragm, and a left-sided BH without hernia sac was diagnosed. Parts of the stomach, small intestine, colon, pancreas, and spleen had prolapsed into the left thoracic cavity, without ischemic change, and these herniated organs were reduced to the abdominal cavity. A direct closure of the hernia orifice was possible by the laparoscopic suture technique using a mesh reinforcement. The patient made an uneventful recovery, and no recurrence was found in the 2-year follow-up. Conclusion A recently published study reviewing detailed cases of repair of adult BH from 1999 to 2019 identified 96 cases, including the present case. The number of reports on laparoscopic and/or thoracoscopic surgery for BH in adults has recently increased, and the approach for repairing BH should be selected carefully on a case-by-case basis.

A SCROTAL ABDOMEN IN AN ELDERLY PATIENT MANAGED BY HERNIOPLASTY WITHOUT DEBULKING OF THE HERNIA CONTENTS: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
pp. 15-17
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Piyas Sengupta ◽  
Tuhinsubhra Manda
Keyword(s):  
Elderly Patient ◽  
Abdominal Cavity ◽  
Wound Dehiscence ◽  
Uneventful Recovery ◽  
General Surgeon ◽  
Respiratory Compromise ◽  
Hernia Sac ◽  
Long Duration ◽  
Giant Inguinoscrotal Hernia ◽  
Mesh Hernioplasty

Background: Scrotal abdomen is not a common today, but most challenging case even in experienced general surgeon, as there is no standard surgical procedure. They present as a huge inguinoscrotal swelling for a longstanding, neglected to treatment, because fear of operative intervention and remote places where medical service is inadequate. The morbidity and mortality also high because of forced reduction of the herniated viscera to the abdominal cavity, which is accustomed to being relatively empty for long duration, may cause alteration in the intra-abdominal and intra-thoracic pressures, leading to complications such as ACS, precipitation of cardiovascular or respiratory compromise, hernia recurrence and wound dehiscence . We present this ca Case presentation: se of giant inguinoscrotal hernia of a 72 years old male who had difculty in performing his daily activities. Patient underwent emergency mesh repair after reduction of content through inguinal approach. Giant inguinal hernia containing almost whole abdomen with terminal 50 cm ileum, caecum, appendix, ascending colon, hepatic exure of colon and transverse colon with omentum in the hernia sac and the patient had an uneventful recovery with eventual discharge on postoperative day 8. The giant inguinal hernias are uncommon in today's surgical Conclusion: practice. Management of which is challenging with grave complications but early intervention and postoperative monitoring to raised IAP and its complications which can save the patient. We report this case of an elderly patient with an acute presentation of scrotal abdomen with contents as both direct and indirect component which has been managed successfully with tension free open mesh hernioplasty and biological repair without debulking of the hernia contents and this case supported by a review of the literature.

scholarly journals Combined laparoscopic and thoracoscopic surgical repair of Bochdalek hernia in an adult: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sho Nambara ◽  
Yoshihisa Sakaguchi ◽  
Fumihiro Shoji ◽  
Yasuo Tsuda ◽  
Kensuke Kudou ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Abdominal Cavity ◽  
First Year ◽  
Thoracic Cavity ◽  
Bochdalek Hernia ◽  
Simple Closure ◽  
Post Surgery ◽  
Left Diaphragm ◽  
Combined Use ◽  
Hernial Repair

Abstract Background Bochdalek hernia is a rare disease in adults. Diaphragmatic hernia in adults has been repaired using minimally invasive surgery through laparoscopy or thoracoscopy. However, the literature regarding the combined use of laparoscopy and thoracoscopy for the repair of Bochdalek hernia is limited. Case presentation A 26-year-old man diagnosed with Bochdalek hernia was managed through combined abdominal and thoracic endoscopic surgery. On laparoscopy, the omentum prolapsed into the left thoracic cavity through the posterolateral area of the left diaphragm. On thoracoscopy, no adhesions of the omentum were seen in the thoracic cavity. The omentum was drawn back to the abdominal cavity, and a 4 × 3-cm hernial orifice was identified. The hernia orifice was repaired through simple closure with sutures laparoscopically. The patient’s postoperative course was uneventful with no recurrences within the first year post-surgery. Conclusion Combined laparoscopic and thoracoscopic surgery is a safe and effective method for Bochdalek hernial repair in adults.

scholarly journals Bochdalek hernia in adults: A case report

2018 ◽  
Vol 75 (6) ◽  
pp. 628-631
Author(s):  
Anita Ivosevic ◽  
Ivana Meta-Jevtovic ◽  
Vojislav Cupurdija ◽  
Ivan Cekerevac ◽  
Aleksandar Radunovic ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Imaging Techniques ◽  
Main Bronchus ◽  
Abdominal Cavity ◽  
Proximal Part ◽  
Bochdalek Hernia ◽  
Hernia Sac ◽  
Hernial Sac ◽  
The Right

Introduction. Asymptomatic Bochdalek hernia in adults is a rarity. The aim of this paper is to present a rare case of Bochdalek hernia among adults and to point out to significance of clinical suspicion and important role of imaging techniques in reaching the exact diagnosis of this abnormality. Case report. A patient, aged 68 years, came to the Clinic of Pulmonology complaining of constant dyspnea, coughing and fatigue. Computed tomography (CT) findings were dominated by the large rear right diaphragmatic hernia with the hernial sac that reached the carina trachea and urged the principal bronchi. The stomach, duodenum and proximal part of jejunal winds, as well as a greater amount of omental and mesenteric adipose tissue were localized in hernial sac. Radiography of gastroduodenum showed: entry of the esophagus into the cardia was in the level of the right main bronchus. Stomach was mainly located in the chest (cardia, upper corpus half - to the level of the right main bronchus). Operation was indicated. First, we made right thoracotomy and the hernia sac was separated from the right lung and then we performed median laparotomy and the contents of the hernia sac were returned to the abdominal cavity; diaphragm defect was reconstructed with prolen mesh. Conclusion. We presented a rare case of right sided Bochdalek hernia which was discovered at late age and surgically treated with success.

scholarly journals Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoki Enomoto ◽  
Kazuhiko Yamada ◽  
Daiki Kato ◽  
Shusuke Yagi ◽  
Hitomi Wake ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Abdominal Cavity ◽  
Three Dimensional ◽  
Simulation Software ◽  
3D Simulation ◽  
Diaphragmatic Defect ◽  
Intestinal Malrotation ◽  
Intestinal Loop ◽  
Bochdalek Hernia ◽  
The Right

Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.

Laparoscopic evaluation of the reproductive organs and abdominal cavity content of the lowland gorilla

1982 ◽  
Vol 2 (1) ◽  
pp. 29-42 ◽  
Author(s):  
D. E. Wildt ◽  
P. K. Chakraborty ◽  
R. C. Cambre ◽  
J. G. Howard ◽  
M. Bush
Keyword(s):  
Abdominal Cavity ◽  
Reproductive Organs ◽  
Laparoscopic Evaluation

Fournier gangrene: what’s new in treatment?

Nowa Medycyna ◽  
2018 ◽  
Vol 25 (3) ◽  
Author(s):  
Zbigniew Tański ◽  
Zbigniew Jarząbek ◽  
Bartosz Konowalski ◽  
Maciej Truszkowski ◽  
Jakub Biedrzycki ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Medical Literature ◽  
Abdominal Cavity ◽  
Tissue Necrosis ◽  
Improve Treatment ◽  
Fournier Gangrene ◽  
Soft Tissue Necrosis ◽  
Life Threatening ◽  
Perineal Region ◽  
Balanced Crystalloid

Fournier gangrene is necrotic, life-threatening fasciitis occurring in the perineal region and within external sexual organs and anus. It may extend to the abdominal cavity, leading to soft tissue necrosis and sepsis. The article presents current methods of diagnosis and treatment of necrotising fasciitis (Fournier gangrene being a part of this disease) based on the medical literature and experience of two urological wards. The following methods are discussed: isotonic salt and balanced crystalloid fluids, antibiotics, steroids, immunoglobulin, hyperbaric oxygen therapy, surgical debridement and split-thickness mesh grafting. At the beginning broad spectrum antibiotics were administrated for the patients, according with local guidelines therapeutic committee and results of specimens for Gram’s staining and culture and laboratory tests. After receiving antibiogram prompt antibiotic treatment was continued. Cystostomy was done for everyone. Active dressing was applied rarely. Mortality was not observed in this group of patients. Fournier gangrene frequently ends with death due to sepsis, ARDS, or insufficiency of the kidneys, liver or other organs. Early diagnosis, careful debridement and application of a proper antibiotic are the basic factors that reduce mortality and improve treatment outcomes.

scholarly journals Diagnostic difficulties and features of endovideosurgical treatment of a patient with mucocele of the appendix

2020 ◽  
Vol 12 (2) ◽  
pp. 85-90
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Elguja L. Lataria ◽  
Alexey A. Kurkov ◽  
Vyacheslav A. Melnikov ◽  
...  
Keyword(s):  
Benign Tumor ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Vermiform Appendix ◽  
Diagnostic Methods ◽  
Number Of Patients ◽  
Mucocele Of The Appendix ◽  
Diagnostic Difficulties ◽  
Life Threatening ◽  
The Right

The mucocele of the appendix is the expansion of the appendix with the accumulation of a large amount of mucus. The mechanism and causes of mucocele are not fully understood. According to some authors, such changes in the appendix can occur due to cicatricial narrowing of the lumen of the appendix, compression or blockage of its base. Other authors believe that the mucocele of the appendix is a benign tumor that develops from the remnants of primitive mesenchyme and is sometimes prone to malignancy. Clinical manifestations of mucocele of the appendix are nonspecific. In a number of patients, this disease causes pain in the right abdomen, more often pulling, intermittent. However, the disease is often asymptomatic. In this regard, diagnosis is established only during performing an operation, most often, regarding acute appendicitis. Nevertheless, instrumental diagnostic methods such as ultrasound and computed tomography of the abdominal and pelvic organs make it possible to suspect mucocele. Despite the frequent asymptomatic, non-aggressive course, a number of life-threatening complications can become the outcome of the mucocele of the vermiform appendix. The most formidable complication is the rupture of the appendix with mucus entering free abdominal cavity, followed by the development of peritoneal pseudomyxoma due to implantation of mucus-forming cells. The only option for radical treatment of the mucocele of the appendix is a surgical intervention. A presented clinical case demonstrates the difficulties of diagnosis, as well as the features of surgical treatment of a patient with a mucocele of the appendix.

scholarly journals On the question of the treatment of uterine blood tumors

2020 ◽  
Vol 11 (4) ◽  
pp. 403-417
Author(s):  
Gr. N. Egorov
Keyword(s):  
Blood Vessel ◽  
Whole Blood ◽  
Total Mass ◽  
Lymphatic System ◽  
Blood Clot ◽  
Abdominal Cavity ◽  
The Body ◽  
Long Time ◽  
Life Threatening

The abdominal cavity is, in essence, an appendage of the lymphatic system, therefore, it cannot represent a completely foreign container for the blood poured out here. Indeed, the observations of Virchow, Wintrich and others show that whole blood can remain in this cavity for a long time (several days) without undergoing clotting (Pashutin). In view of this fact, it is natural to expect, as is confirmed by experiments, that most of the blood that has entered the abdominal cavity has time to be absorbed before it begins to coagulate. If a part of it, which failed to be absorbed in time, undergoes clotting, then this does not represent any particular disturbances in the overall economy of blood, the blood clot is completely absorbed after preliminary disintegration (fat). In this sense, hemorrhage into the abdominal cavity is not life-threatening, since the blood does not disappear for the body, but soon again, almost entirely, enters the total mass of the blood vessel.

scholarly journals Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

2020 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen ◽  
Jun Wang
Keyword(s):  
Inguinal Hernia ◽  
Doppler Ultrasound ◽  
Vas Deferens ◽  
Abdominal Cavity ◽  
Undescended Testes ◽  
Processus Vaginalis ◽  
Hernia Sac ◽  
Patent Processus Vaginalis ◽  
Contralateral Patent Processus Vaginalis ◽  
Laparoscopic Orchiopexy

Abstract Background Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination. Conclusion Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

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