scholarly journals Diafragminių išvaržų diagnostikos ypatybės

2010 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Irena Bičkutė ◽  
Mindaugas Avižonis
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
General Surgery ◽  
Clinical Case ◽  
Surgical Care ◽  
Emergency Hospital ◽  
Vilnius University ◽  
Surgery Center

Irena Bičkutė1, Mindaugas Avižonis21Švenčionių rajono ligoninė,Partizanų g. 4, LT-18126 Švenčionys2Mykolo Marcinkevičiaus ligoninė,Kauno g. 7/2, LT-03215 VilniusEl paštas: [email protected] Nepaisant diagnostikos ir chirurgijos pažangos, kartais sunku diagnozuoti diafragminę išvaržą, pasitaiko ir mirties atvejų. Pateikiame klinikinį atvejį, kai stemplės žiočių išvarža buvo diagnozuota tik atlikus kompiuterinę tomografiją su peroraliniu kontrastavimu. Aptariame kitų autorių aprašytas klinikines situacijas. Specific features of diaphragmatic hernia diagnostics Irena Bičkutė1, Mindaugas Avižonis2Vilnius University, General Surgery Center of Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Despite the progres in medical and surgical care, sometimes it is difficult to diagnose diaphragmatic hernia, even death is possible. We present a clinical case when visualisation with computed tomography with per os contrasting helped to diagnose hiatal diaphragmatic hernia. Discussed are also the clinical situations presented by other authors.

scholarly journals Blužnies pseudocista: trimačiai kompiuteriniai vaizdai

2006 ◽  
Vol 4 (4) ◽  
pp. 0-0
Author(s):  
Raimundas Lunevičius ◽  
Raminta Šydeikienė
Keyword(s):  
General Surgery ◽  
Three Dimensional ◽  
Emergency Hospital ◽  
Vilnius University ◽  
Surgery Center

Raimundas Lunevičius, Raminta ŠydeikienėVilniaus universiteto Bendrosios chirurgijos centras,Vilniaus greitosios pagalbos universitetinė ligoninė, Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Pateikiami blužnies potrauminės pseudocistos trimačiai kompiuteriniai vaizdai. Splenic pseudocyst: three-dimensional computer imaging Raimundas Lunevičius, Raminta Šydeikienė.Vilnius University, General Surgery Center, Vilnius University Emergency Hospital,Šiltnamių 29, Vilnius, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Three-dimentional computer imagings of splenic posttraumatic pseudocyst are demonstrated.

scholarly journals Įstrigusi obturatorinė išvarža 49-erių metų moteriai: atvejo aprašymas ir literatūros apžvalga

2010 ◽  
Vol 8 (4) ◽  
Author(s):  
Marius Markevičius ◽  
Raimundas Lunevičius ◽  
Vitalijus Markovas ◽  
Juozas Stanaitis
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Bowel Obstruction ◽  
General Surgery ◽  
Obturator Hernia ◽  
Cervix Uteri ◽  
Emergency Hospital ◽  
University Center ◽  
Vilnius University ◽  
Incarcerated Obturator Hernia

Marius Markevičius, Raimundas Lunevičius, Vitalijus Markovas, Juozas Stanaitis Vilnius University, Center of General Surgery, Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04139 Vilnius, LithuaniaEl. paštas: [email protected] Incarcerated obturator hernia in 49 year old women: a case report and review of the literature Marius Markevičius, Raimundas Lunevičius, Vitalijus Markovas, Juozas Stanaitis Vilnius University, Center of General Surgery, Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04139 Vilnius, LithuaniaE-mail: [email protected] Introduction Incarcerated obturator hernia is a rare cause of bowel obstruction. This case report aimed to review the diagnosis and management of obturator hernia by describing the anatomy, clinical presentation, diagnostic modalities, and predisposing factors. Case presentation A 49-year-old woman presented to emergency department with progressive spastic abdominal pain, vomiting, abdomen enlargement, and tenesmus. One month before this episode she was diagnosed a carcinoma of the cervix uteri which was defined as T1b N1 M0 G2. She has undergone a curative R0 type surgery and adjuvant chemoradiation. There were no pelvic abnormalities described in the operative protocol. She lost 20 kg in two years. Because of ineffective conservative treatment, progression of acute bowel obstruction and signs of local peritonitis, she underwent an urgent curative laparotomy. It was confirmed that a loop of ileum was incarcerated and irreducible in the canal of right side of pelvis that suited to obturatoric foramen. Conclusion Rarity of such a condition makes great difficulties in diagnosing it. CT is needed to recognize obturator hernia in early stages before its incarceration. Significant lost weight (> 20 kg), and adjuvant chemoradiotherapy were most possible predisposing risk factors for right obturator hernia in 49 years old female. Keywords: obturator hernia, strangulated hernia, risk factors, laparoscopy, laparotomy.

Use of Synthetic Protetic Materials in Surgical Abdominal Defects. Analysis of the Advantages and Lack of the Liechtenstein Method

2018 ◽  
Vol 69 (7) ◽  
pp. 1740-1743
Author(s):  
Vlad Dumitru Baleanu ◽  
Denis Vlad Constantin ◽  
Anca Pascal ◽  
Dragos Ovidiu Alexandru ◽  
Simona Bobic ◽  
...  
Keyword(s):  
Relative Risk ◽  
Recurrence Rate ◽  
General Surgery ◽  
Prosthetic Material ◽  
Emergency Hospital ◽  
Rural And Urban ◽  
Abdominal Interventions ◽  
Defects Analysis ◽  
Surgery Department

Liechtenstein procedure represents the most frequent technique used for surgical abdominal interventions. Although, it is a modern and inovative procedure, it still has a relative risk for complications. A number of 93 subjects were included in our research. We develop our study in General Surgery Department of County Emergency Hospital of Craiova, Romania between 1st July 2017-31th March 2018. From the total of 93 patients, 88% were men. Most of subjects had ages between 70 and 79 years old, were operated by Liechtenstein technique and they were coming from quite equal percent from rural and urban areas.The incidence for complications(seroma, hematoma, infection, abscess) was generally lower for the patients diagnosticated with Liechtenstein procedure comparing with the subjects operated by other technique. Liechtenstein procedureis recommended especially for its simplicity and efficiency, reproducibility and safety. It is very important to choose the perfect synthetic prosthetic material to have a good evolution of the disorder and a small recurrence rate.

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.

scholarly journals 892 Emergency General Surgical Practice at a District General Hospital during COVID-19 Pandemic: Implementing Royal College of Surgeons Guidance

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K Hashmi ◽  
S Khalid ◽  
K Raja ◽  
A Zaka ◽  
J Easterbrook
Keyword(s):  
Informed Consent ◽  
Royal College ◽  
Mortality Risk ◽  
General Surgery ◽  
Surgical Care ◽  
District General Hospital ◽  
Emergency General Surgery ◽  
Surgical Practice ◽  
Full Compliance ◽  
Type Of Surgery

Abstract Introduction COVID-19 pandemic had a significant impact on surgical practice across NHS. RCS released guidance on altering surgical practise during the pandemic to deliver safe surgical care in March, 2020. We present an audit conducted at a DGH comparing practice of emergency general surgery (EGS) with RCS guidance at the peak of COVID-19 pandemic. Method Consecutive patients undergoing EGS from 1st April to 15th May,2020. Data of demographics, ASA grade, comorbidities, type of surgery, hospital stay, informed COVID-19 pneumonia consent, complications and 30-day mortality were collected. Pre- and post-operative COVID-19 status was determined. Results Forty-four (n = 44) patients, mean age 47.5 and IQR (26-69). Male (55.8%) and females (44.2%). Preoperative COVID19 status was confirmed in around 79.1% patients. All (100%) patients who underwent CT imaging preoperatively had CT chest performed. Informed consent for COVID19 pneumonia was taken in 4.7% patients. 30-day mortality risk was 7% and complications risk was 4.7%. RR of 30-day mortality in preoperative COVID19 status positive patients was RR = 0.92 (CI 0.85-1.01) and for complications was RR = 0.95 (CI 0.88-1.02). Conclusions RCS guidance on managing and altering practice in EGS during COVID-19 pandemic is reliable, implementable, and measurable in a DGH setting. Simple improvements in consent process can achieve full compliance with RCS guidelines.

scholarly journals Laparoscopic Repair of a Diaphragmatic Hernia Associated with Radiofrequency Ablation for Hepatocellular Carcinoma: Lessons from a Case and the Review of the Literature

2014 ◽  
Vol 99 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Ryohei Nomura ◽  
Hiromi Tokumura ◽  
Makoto Furihata
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Diaphragmatic Hernia ◽  
Laparoscopic Repair ◽  
Laparoscopic Approach ◽  
Review Of The Literature ◽  
Gastrografin Enema ◽  
History Of ◽  
Segment Viii

Abstract We describe the case of a patient with a diaphragmatic hernia associated with radiofrequency ablation for hepatocellular carcinoma who was successfully treated by laparoscopic surgery. A 62-year-old man with a long history of hepatitis C-induced liver cirrhosis was admitted to our institution because of recurrent postprandial periumbilical pain. Eight years earlier, he had undergone radiofrequency ablation for hepatocellular carcinoma at hepatic segment VIII. Computed tomography, gastrografin enema examination revealed transverse colon obstruction because of a diaphragmatic hernia. We diagnosed diaphragmatic hernia associated with the prior radiofrequency ablation treatment. The patient underwent laparoscopic repair of the diaphragmatic hernia. Though the patient experienced the recurrence once, relaparoscopic treatment has improved the patient's conditions. Thus, diaphragmatic hernia can develop as a complication of radiofrequency ablation treatment. A laparoscopic approach is safe, feasible, and minimally invasive, even in patients with cirrhosis who develop iatrogenic diaphragmatic hernia as a complication of radiofrequency ablation treatment.

scholarly journals Usefulness of Plain Computed Tomography with Swallowing of GastrografinTM for the Diagnosis of a Late-Onset Iatrogenic Diaphragmatic Hernia following Biopsy of a Diaphragmatic Tumor: Report of a Case

2018 ◽  
Vol 12 (2) ◽  
pp. 271-276
Author(s):  
Yoh Asahi ◽  
Shohei Honda ◽  
Tadao Okada ◽  
Hisayuki Miyagi ◽  
Makoto Kaneda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Late Onset ◽  
Epigastric Pain ◽  
Contrast Study ◽  
Mixed Germ Cell Tumor ◽  
Left Diaphragm ◽  
Granulomatous Lesions ◽  
Chest X Ray ◽  
Diaphragmatic Tumor

Although diaphragmatic hernia (DH) may be congenital, posttraumatic, or iatrogenic, DHs after diaphragmatic surgery are rarely reported in the literature. This report describes the rare case of a 14-year-old girl complicated by iatrogenic DH following the biopsy of granulomatous lesions of the left diaphragm, when a mediastinal mixed germ cell tumor was extirpated. Plain computed tomography (CT) with swallowing of GastrografinTM was useful for the diagnosis of this disorder. The patient presented to our hospital with frequent epigastric pain and vomiting 11 months after the original surgery. Chest X-ray, a gastrointestinal contrast study, and plain CT with swallowing of GastrografinTM revealed the left DH with gastric content. At laparotomy, the diaphragmatic defect, 3 × 3 cm in diameter, was repaired using nonabsorbable sutures after hernia reduction. The patient showed a rapid recovery with complete resolution of symptoms. We should consider the presence of iatrogenic DH in patients who develop epigastralgia after procedures involving the diaphragm, even at 11 months after the original surgery. Furthermore, plain CT with swallowing of GastrografinTM is useful for the diagnosis of this disorder.

scholarly journals SPLENIC CYST

2014 ◽  
Vol 2 (3) ◽  
Author(s):  
Larissa L. Garcia ◽  
Fernanda L. Lomanto ◽  
Felipe Simões da Rocha Mata ◽  
Dilton Mendonça
Keyword(s):  
Computed Tomography ◽  
Incidental Findings ◽  
Clinical Case ◽  
Standard Treatment ◽  
Clinical Status ◽  
Exploratory Laparotomy ◽  
Splenic Cyst ◽  
Splenic Cysts ◽  
The Times ◽  
Total Splenectomy

Background: Splenic cysts are rare in children. They are classified into primary and secondary, also called pseudocysts. The primary feature capsule and can be congenital, vascular or neoclassical. The diagnosis, in most cases, is incidental because it is asymptomatic clinical status. The diagnosis is confirmed by Ultrasound and / or Computed Tomography (CT) of the abdomen. Case Report: Patient, I.T.S.A, female, 11 years old, complains of increasing abdominal size. The diagnosis of splenic cyst was confirmed with an exploratory laparotomy. The pathology suggests reactive mesothelial hyperplasia. The patient underwent a total splenectomy and recovered without complications. Conclusions: Splenic cysts are incidental findings, most of the times it has been an asymptomatic clinical status. In the clinical case described, the patient showed a significant increase in the abdomen. She underwent exploratory laparotomy and, consequently, total splenectomy, which is the standard treatment in cases of giants splenic cysts.

scholarly journals Perforated Peptic Ulcer Combined with Posttraumatic Diaphragmatic Hernia in Third Gestation Trimester: a Clinical Case

2021 ◽  
Vol 11 (3) ◽  
pp. 251-255
Author(s):  
V. S. Panteleev ◽  
I. B. Fatkullina ◽  
A. Kh. Mustafin ◽  
R. S. Khalitova ◽  
A. S. Petrov
Keyword(s):  
Peptic Ulcer ◽  
Pregnant Women ◽  
Diaphragmatic Hernia ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Perforated Peptic Ulcer ◽  
Favourable Outcome ◽  
Duodenal Perforation ◽  
Duodenal Ulcers ◽  
In Pregnancy

Background. Gastric and duodenal ulcers are extremely rare in pregnancy, according to published literature. Peptic ulcer is found in 1 per 4,000 pregnant women, a figure probably underestimated due to its hampered diagnosis in pregnancy. Pregnancy peptic ulcer is considered less expected. Perforated gastric and duodenal ulcers comprise about 1.5 % of total acute abdominal diseases, and the perforation rate in ulcer patients ranges within 5–15 %. This complication afflicts the ages of 20–40 years in men much more frequently than in women. Three perforation types occur: free into abdominal cavity (87 %), contained (9 %), into lesser omentum and retroperitoneal tissue (4 %).Materials and methods. The clinical case describes surgical management of posttraumatic diaphragmatic hernia-comorbid perforated gastric ulcer in a pregnant woman in third trimester. Surgery with postoperative patient management enabled for a favourable outcome.Results and discussion. Perforation-entailing gastric and duodenal ulcers in pregnant women have received negligible attention due to rarity in clinical practice. Paul et al. described 14 cases of duodenal perforation in pregnancy, all fatal.Conclusion. Early diagnosis of surgical pathology during gestation is still difficult contributing to the development of severe complications associated with high mortality. The patient’s admission to a level III interspecialty hospital was key to enable a timely consilium-driven decision of caesarean intervention for saving the child, diagnosing intraoperatively life-threatening complicated surgical diseases and opting for radical surgery that ended in a favourable outcome.

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