On the casuistry of internal abdominal hernias

1937 ◽  
Vol 33 (3) ◽  
pp. 357-359
Author(s):  
F. Y. Blagovidov
Keyword(s):  
Acute Abdomen ◽  
Internal Hernia ◽  
Transverse Colon ◽  
Abdominal Cavity ◽  
Practical Experience ◽  
Internal Hernias ◽  
Abdominal Hernias

Despite the accumulated practical experience and an exhaustive description of hernias of the mesentery of the transverse colon in the latest literature (Menego and Bardesco), there is still a lot of unclear pathogenesis of this disease. Internal hernias of the abdominal cavity in the vast majority of cases are just an accidental finding during surgery. A patient with an internal hernia of the abdominal cavity who has met in our practice undoubtedly deserves to be reminded of this type of "acute abdomen".

scholarly journals Imaging Postoperative Abdominal Hernias: A Review with a Clinical Perspective

2020 ◽  
Vol 3 (S 01) ◽  
pp. S35-S48
Author(s):  
Argha Chatterjee ◽  
Rochita V. Ramanan ◽  
Sumit Mukhopadhyay
Keyword(s):  
Gastric Bypass ◽  
Acute Abdomen ◽  
Internal Hernia ◽  
Surgical Planning ◽  
Imaging Modality ◽  
Surgical Anatomy ◽  
Imaging Features ◽  
Internal Hernias ◽  
Abdominal Hernias ◽  
The Common

AbstractPostoperative internal hernia is a challenging but critical diagnosis in postoperative patients presenting with acute abdomen. Postoperative internal hernias are increasingly being recognized after Roux-en-Y gastric bypass (RYGB) and bariatric surgeries. These internal hernias have a high risk of closed-loop obstruction and bowel ischemia; therefore, prompt recognition is necessary. Computed tomography (CT) is the imaging modality of choice in cases of postoperative acute abdomen. Understanding the types of postoperative internal hernia and their common imaging features on CT is crucial for the abdominal radiologist. Postoperative external hernias are usually a result of defect or weakness of the abdominal wall created because of the surgery. CT helps in the detection, delineation, diagnosis of complications, and surgical planning of an external hernia. In this article, the anatomy, pathophysiology, and CT features of common postoperative hernias are discussed. Afterreading this review, the readers should be able to (1) enumerate the common postoperative internal and external abdominal hernias, (2) explain the pathophysiology and surgical anatomy of Roux-en-Y gastric bypass-related hernia, (3) identify the common imaging features of postoperative hernia, and (4) diagnose the complications of postoperative hernias.

Hernia interna estrangulada por plastrón en el tercio distal del apéndice cecal

2019 ◽  
Vol 62 (6) ◽  
pp. 24-27
Author(s):  
Leslie M. Leyva Sotelo ◽  
José E. Telich Tarriba ◽  
Daniel Ángeles Gaspar ◽  
Osvaldo I. Guevara Valmaña ◽  
André Víctor Baldín ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Early Diagnosis ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Internal Hernia ◽  
Wide Spectrum ◽  
Internal Hernias ◽  
Mild Abdominal Pain ◽  
Made In

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.

scholarly journals Laparoscopic Repair of Internal Transmesocolic Hernia of Transverse Colon

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Tomokazu Kishiki ◽  
Toshiyuki Mori ◽  
Yoshikazu Hashimoto ◽  
Hiroyoshi Matsuoka ◽  
Nobutsugu Abe ◽  
...  
Keyword(s):  
Small Intestine ◽  
Internal Hernia ◽  
Transverse Colon ◽  
Surgical Procedure ◽  
History Of Surgery ◽  
Case Presentation ◽  
Internal Hernias ◽  
Old Japanese ◽  
History Of ◽  
Rule Out

Introduction. Internal hernias are often misdiagnosed because of their rarity, with subsequent significant morbidity.Case Presentation. A 61-year-old Japanese man with no history of surgery was referred for intermittent abdominal pain. CT suggested the presence of a transmesocolic internal hernia. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We found internal herniation of the small intestine loop through a defect in the transverse mesocolon, without any strangulation of the small intestine. We were able to complete the operation laparoscopically. The patient’s postoperative course was uneventful and the patient was discharged on postoperative day 6.Discussion. Transmesocolic hernia of the transverse colon is very rare. Transmesocolic hernia of the sigmoid colon accounts for 60% of all other mesocolic hernias. Paraduodenal hernias are difficult to distinguish from internal mesocolic transverse hernias. We can rule out paraduodenal hernias with CT.Conclusion. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We report a case of a transmesocolic hernia of the transverse colon with intestinal obstruction that was diagnosed preoperatively and for which laparoscopic surgery was performed.

scholarly journals Strangulated internal hernia through the lesser omentum with intestinal necrosis: a case report

2002 ◽  
Vol 120 (3) ◽  
pp. 84-86 ◽  
Author(s):  
Gustavo Gibin Duarte ◽  
Belchor Fontes ◽  
Renato Sérgio Poggetti ◽  
Marcos Roberto Loreto ◽  
Paulo Motta ◽  
...  
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Clinical Manifestations ◽  
Acute Intestinal Obstruction ◽  
Main Task ◽  
Intestinal Necrosis ◽  
Lesser Omentum ◽  
Lesser Sac ◽  
Internal Hernias

CONTEXT: Internal hernias account for only 0.2 to 0.9% of the cases of intestinal obstruction. They do not have specific clinical manifestations, and are usually diagnosed during laparotomy for acute intestinal obstruction. Internal hernias through the lesser omentum are extremely rare. CASE REPORT: We report here the case of a 36-year-old patient who underwent exploratory laparotomy for acute intestinal obstruction. An internal hernia through the lesser omentum was found, with a strangulated ileal segment passing through the perforation into an abscess within the lesser sac. The surgical procedures included ileal resection, primary anastomosis, abscess removal, and placement of a drain in the lesser sac. The patient was reoperated 6 days later for abdominal sepsis; a lesser sac abscess was removed and the abdominal incision was left open. The patient stayed in the Intensive Care Unit for 15 days, and eventually left the hospital on the 28th post-admission day, with complete recovery thereafter. CONCLUSION: The early diagnosis of acute intestinal obstruction and immediate indication for laparotomy is the main task of the surgeon when faced with a case of acute abdomen with a hypothesis of internal hernia, so as to minimize severe postoperative complications, as illustrated by the present case.

scholarly journals Necrotizing sarcoid granulomatosis with clinical presentations of recurrent acute abdomen. Case report and literature review

2017 ◽  
Vol 89 (11) ◽  
pp. 60-68 ◽  
Author(s):  
V I Vasilyev ◽  
S G Palshina ◽  
B D Chaltsev ◽  
S G Radenska-Lopovok ◽  
T N Safonova
Keyword(s):  
Acute Abdomen ◽  
Clinical Laboratory ◽  
Morphological Changes ◽  
Abdominal Cavity ◽  
High Dose ◽  
Drug Induced ◽  
Serological Tests ◽  
Surgical Interventions ◽  
First Case ◽  
Clinical Presentations

The authors have described the world’s first case of necrotizing sarcoid granulomatosis (NSG) in a 22-year-old woman with the clinical presentations of acute abdomen, which are associated with abdominal lymph nodal infiltration and necrosis, obvious constitutional disturbances (fever, nocturnal sweats, and significant weight loss), high inflammatory activity (anemia, leukocytosis, high erythrocyte sedimentation rates and C-reactive protein levels), the gradual appearance of splenic and hepatic necrotic foci, and infiltration into the lung and lacrimal glands with the development of unilateral uveitis. The patient underwent five surgical interventions, several needle biopsies for recurrent abdominal syndrome, and long-term antibiotic treatment for presumed sepsis, which had caused drug-induced hepatitis. Bacteriological examination of blood, puncture samples, and removed abdominal cavity tissues, serological tests, and immunomorphogical study of biopsy samples and removed tissues yielded negative results for the presence of bacterial, fungal, and tuberculosis infections. NSG was diagnosed on the basis of the systemic nature of the lesion, the presence of granulomas with severe abdominal lymph nodal necrosis and necrotizing granulomatous/lymphocytic vasculitis in the mesentery and removed spleen, as well as the absence of granulomas in the spleen, appendix, and biopsy materials of the liver, colonic mucosa, and parotid gland. Fludarabine therapy was first used in world practice due to the inefficient treatment with high-dose glucocorticoids and cyclophosphamide and to a disease relapse when reducing their doses. The paper gives a detailed review of the literature on the clinical, laboratory, radiological, and morphological manifestations of the disease, which allow the differential diagnosis of NSG with different variants of granulomatous lesions. Based on the 5-year follow-up of the patient and on the analysis of clinical, laboratory, radiological, and morphological changes, the authors uphold the concept that the disease is an independent nosological entity: necrotizing angiitis with sarcoid reactions, rather than the entity of nodular or classic sarcoidosis.

To the casuistry of strangulated hernias of Douglas space

1937 ◽  
Vol 33 (4) ◽  
pp. 490-491
Author(s):  
M. V. Dunier
Keyword(s):  
Internal Hernia ◽  
Abdominal Cavity ◽  
Surgical Methods ◽  
Methods Of Treatment

The question of an internal hernia of the abdominal cavity is still little developed both from the anatomical and from the clinical side; as well as little developed surgical methods of treatment of these hernias.

Use of Bioabsorbable Tissue Reinforcement Reduces Incidence of Internal Hernia in Roux-en-Y Gastric Bypass Patients

2018 ◽  
Vol 84 (11) ◽  
pp. 1756-1761
Author(s):  
Michael W. Love ◽  
Roosbeh Mansour ◽  
Allyson L. Hale ◽  
Eric S. Bour ◽  
Ihab Shenouda ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Soft Tissue ◽  
Internal Hernia ◽  
Tissue Scaffold ◽  
Internal Hernias ◽  
Early Evidence ◽  
Hernia Formation ◽  
Tissue Matrix ◽  
Tissue Defects ◽  
Prospective Database

Internal hernias are one of the most devastating late, postsurgical complications associated with laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to determine whether placement of a bioabsorbable tissue matrix in soft tissue defects after gastric bypass resulted in a lower incidence of internal hernia development. Prospective database was used to identify all patients who underwent LRYGB between January 2002 and January 2016. These patients were then retrospectively reviewed to determine the development of internal hernia. Before 2009, the retro-Roux defect was left open during the primary operation and the defect at the jejunojejunostomy was closed with sutures or staples. Beginning in 2009, all soft tissue internal defects were reinforced with an 8 cm 3 8-cm piece of bioabsorbable matrix. The incidence of subsequent internal hernia development was compared between these two groups: no bioabsorbable matrix versus use of a bioabsorbable matrix. A total of 2771 patients underwent LRYGB during our study period. From these, 1215 procedures were performed without tissue reinforcement and 1556 were performed using a bioabsorbable matrix. During the study period, 274 patients developed an internal hernia. Patients who did not have tissue reinforcement at closure had a significantly higher internal hernia rate [225/1215 (18.5%) vs 49/1556 (3.1%), P < 0.005]. This study demonstrates a statistically significant reduction in internal hernia formation after LRYGB with the addition of a bioabsorbable tissue matrix. Although prospective studies are needed, early evidence suggests that reinforcement with a bioabsorbable tissue scaffold is an effective method for minimizing internal hernias after LRYGB.

Internal Hernia: Postoperative Complication of Roux-en-Y Gastric Bypass Surgery

2006 ◽  
Vol 72 (7) ◽  
pp. 581-585 ◽  
Author(s):  
Aaron Eckhauser ◽  
Alfonso Torquati ◽  
Yassar Youssef ◽  
Joan L. Kaiser ◽  
William O. Richards
Keyword(s):  
Gastric Bypass ◽  
Length Of Stay ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
The United States ◽  
Morbidity And Mortality ◽  
Transverse Mesocolon ◽  
Surgical Morbidity ◽  
Internal Hernias ◽  
Clinical Awareness

Obesity surgery is becoming one of the most common general surgery procedures done in the United States. Internal hernias are a known and increasingly more common occurrence after laparoscopic roux-en-Y gastric bypass (LRYGB). Increased clinical awareness of this complication will lead to decreased surgical morbidity and mortality. We retrospectively reviewed our database of 529 patients who had undergone LRYGB from 2000 to 2005 and identified those presenting with intestinal obstruction from an internal hernia. The type of internal hernia (jejunojejunostomy, transverse mesocolon, roux limb mesentery [Peterson's hernia]), length of time from presentation to operative intervention, and length of stay were obtained for all patients. Of 529 laparoscopic retrocolic retrogastric LRYGBs, 13 internal hernias (2.5%) were identified in 13 different patients. Eight of the hernias were at the mesenteric defect created by the jejunojejunostomy (62%), 3 originated from the transverse mesocolon defect (23%), and 2 were a Peterson's hernia (15%). The median time from initial operation to repair was 150 days. The average time from presentation to operative repair was 29.2 hours (range, 5–67.5 hours). The median length of stay was 3 days (range, 1.5–45 days). Eleven hernias were repaired laparoscopically (85%). There were no mortalities associated with obstruction from the internal hernia. Intestinal obstruction from an internal hernia after LRYGB is becoming increasingly more common. General awareness of this condition and high clinical suspicion allow for prompt surgical intervention with decreased morbidity and mortality.

Entral feeding tube insertion after esophagectomy: Technique via transgastric conduit or transduodenal.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 210-210
Author(s):  
Takashi Ogata ◽  
Tetsushi Nakajima ◽  
Kazuki Kano ◽  
Yukio Maezawa ◽  
Kousuke Ikeda ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Internal Hernia ◽  
Gastric Tube ◽  
Abdominal Cavity ◽  
Feeding Tube ◽  
Gastric Conduit ◽  
Round Ligament ◽  
Insertion Point ◽  
Tube Insertion ◽  
Gastric Tube Reconstruction

210 Background: We always used early enteral feeding after esophagectomy as perioperative management. The common procedure for feeding tube insertion is jejunostomy, but sometimes complication such as internal hernia was occurred. In case of retrosternal gastric tube reconstruction, we usually inserted feeding tube through gastric conduit. But in case of posterior mediastinal gastric tube reconstruction, this procedure was not available because of the distance between abdominal wall and gastric tube. So we have developed the new procedure for feeding tube insertion using the mobilized round ligament of liver. Methods: The aims of the study is to clarify the safety of these procedures. In case of retrosternal reconstruction, we usually inserted feeding tube from prepylorus of gastric conduit, and feeding tube was delivered through pyloric ring to 3rd portion of duodenum(Procedure A). Insertion point of the tube was always close to abdominal wall, and easy to be guided to extra-abdomen. On the other hand, in case of posterior reconstruction, we used the new procedure as below(Procedure B). At first, the round ligament of liver was cut at the liver edge. Next, feeding tube was inserted 15~20cm from anterior wall of 2nd portion of duodenum with Witzel suture fixation. After that, feeding tube was led to outside of the abdominal wall through in the mobilized round ligament. The cut edge of round ligament was fixed to the duodenum wall with 4-point suture at tube insertion point, and finally feeding tube completely surrounded by round ligament without direct exposure to the abdominal cavity. And to prevent internal hernia, the space between abdominal wall and mobilized round ligament was covered by omental fat. Results: From January 2012 to December 2014, 126 cases were inserted by procedure A, and from June 2015 to February 2016, 35 cases were done by procedure B. There was no trouble derived from the feeding tube insertion such as intra-operative bleeding, leakage of digestive juice, infectious complication, ileus, and there was no trouble in removal at outpatients in both procedures. Conclusions: Both procedures were safe, so we can manage the feeding tube insertion route by the reconstruction route after esophagectomy.

scholarly journals Rupture of rudimentory horn pregnancy with catastrophic haemorrhage

1970 ◽  
Vol 2 (2) ◽  
pp. 75-77
Author(s):  
Lalita Joshi
Keyword(s):  
Key Words ◽  
Acute Abdomen ◽  
Peritoneal Cavity ◽  
Abdominal Cavity ◽  
Broad Band ◽  
Antenatal Clinic ◽  
Free Fluid ◽  
Second Trimester ◽  
Rudimentary Horn

A 20 yrs primigravida who had attended antenatal clinic 2 weeks back, presented with shock acute abdomen and jaundice at 18 weeks of gestation. Clinically their was evidence of free fluid in the abdominal cavity. Ultrasonography showed dead fetus with haemoperitoneum which was massive at laparotomy. There was rupture of the rudimentary horn on the left side. This was attached to the normal uterus with the broad band. The placenta and fetus in a sac was lying in the peritoneal cavity. The tubes and ovaries on both sides were found normal. Key Words: Rudimentary horn, hemoperitoneum, acute abdomen in second trimester.   doi:10.3126/njog.v2i2.1461 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 75 - 77

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