scholarly journals Clinical study on complicated presentations of groin hernias

2017 ◽  
Vol 5 (8) ◽  
pp. 3303 ◽  
Author(s):  
Hariprasad S. ◽  
Teerthanath Srinivas
Keyword(s):  
Femoral Hernia ◽  
Groin Hernia ◽  
Cumulative Risk ◽  
Surgical Techniques ◽  
Postoperative Outcome ◽  
Subsequent Treatment ◽  
High Rate ◽  
Age Group ◽  
Female Ratio ◽  
Groin Hernias

Background: Groin hernia is a very common type abdominal wall hernia encountered in surgical practice. Irreducibility, obstruction and strangulation are its commonest complications which usually presents as acute emergencies. Emergency repair of complicated hernias is associated with poor prognosis and a high rate of post-operative complications even with better care, improved anaesthetic management and advanced surgical techniques. The aim of this study was to determine the various modes of presentation, clinical finding, diagnostic and therapeutic strategies and to evaluate the postoperative outcome in complicated groin hernia surgeries in our set up.Methods: The study was carried out among 40 patients of groin hernia, who had complicated clinical presentation like irreducibility, strangulation and obstruction in the department of general surgery, during the period from March 2012 to June 2014. Patients were enrolled into the study after proper consent for detailed clinical examination, investigation and subsequent treatment. The Data obtained included demographic characteristics, presentation, operative findings and outcome. The patients were followed up for immediate and late complications for once a week for 1 months, once every month for the next 6 months. After data collection, analysis was done with help of by SPSS software version 21.Results: A total of 40 groin hernia patients with complicated presentation were evaluated during the study period. Among these cases 38 cases had inguinal hernias and two cases had femoral hernia. Majority of the patients were in 5th and 6th decade. Complicated presentation of groin hernia was commonly seen in males (95%) than in females (5%) with male to female ratio of 19:1. Inguinal hernia complications were seen predominantly in males and femoral hernia complications in females. Right sided hernias were more common. Incarceration was the commonest complication seen in 70% of case followed by strangulation (30%). Incarceration was high (17.5%) in the age group of 64-73 years and 44 - 53 years. Strangulation was high in the age group of 54-63 years. The duration of hernia varied for 1-2 years in 42.5% of cases and 3-6 years in 27.5% of cases. Majority of the patients (30%) presented with localized groin pain, vomiting, constipation and abdominal distension. All patients presented with swelling in the inguinoscrotal region, which was tender, and there was no impulse on coughing and 35% of patients had cardiorespiratory illness. Majority of the cases (34 numbers) were operated as emergency procedure. Viable bowel was seen in 77.5% of cases. Bowel resection and end-to-end anastomosis was done in all cases of non-viable bowel and orchidectomy in atrophied and gangrenous testis. The commonest postoperative complication encountered in the study was wound infection (22.5%) and scrotal seroma (17.50%). There was no evidence of recurrence in any of the operated cases.Conclusions: Complicated presentations of groin hernias like, incarceration and strangulation are seen in low and middle socio-economic category of people and may be associated with chronic illness. The cumulative risk of strangulation increases with time and type of hernias. Timely diagnosis and prompted surgical repair is essential to prevent the complications. 

scholarly journals Retrospective analysis of 1211 operated patients due to groin hernia with open surgical approach - single center experience

2018 ◽  
Vol 75 (1) ◽  
pp. 78-82
Author(s):  
Miroslav Markovic ◽  
Mihailo Bezmarevic ◽  
Milan Ilic ◽  
Marina Dragicevic ◽  
Aleksandar Andric
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Surgical Procedures ◽  
Femoral Hernia ◽  
Groin Hernia ◽  
Age Group ◽  
Female Ratio ◽  
Early Postoperative Complications ◽  
Significant Difference ◽  
Groin Hernias

Bacground/Aim. Groin hernias are common pathology among men population. Only curative treatment is surgical reparation with various surgical procedures for groin hernia solving. The aim of this study was to evaluate the most prevalent surgical procedures and early postoperative complications after groin hernia reparation in large series of operated patients, and to assess the morphologic characteristics of groin hernias. Methods. The retrospective study included all patients with groin hernia who underwent surgical reparation from 2009 to 2012. In all patients a demographic characteristics, including gender and age, clinical characteristics and hernia type were analyzed. The surgical procedure for hernia solving and early postoperative complications were assessed. Results. The study included 1,211 patients. The male/female ratio was 1,127/84 (p < 0.001). Inguinal hernia was found in 1,195 patients (94.5% males). Femoral hernia was found in 16 patients (25% males and 75% females). Significant difference in distribution of inguinal and femoral hernia between genders was found (p < 0.001). In males right sided inguinal hernia was present in 57.6%. In females right sided inguinal hernia was present in 7 and left sided in 5 patients. Sixsten patients had bilateral inguinal hernia, all in males. There was no significant difference in side of inguinal hernia occurrence and gender. Right sided and left sided femoral hernias were present in the same percent in males. In females a higher occurrence in femoral hernia was found on the right side then on the left one (7:5) without significant difference. There were 71.1% of patients in the age group of 51?80 and 27.2% of patients in the age group of 61?70. Surgical procedures included: Lichtenstein in 51.2% of patients, nylondarn in 29.6% of patients, Bassini in 16.2% of patients, Lothaissen in 1.7% of patients, and Halsted in 1.4% of patients. Overall, postoperative complications were present in 78 (6.4%) of patients. Wound infection was the most common complication, occurred in 2.4% of patients. Conclusion. Prevalence of inguinal hernias is higher in men population, while femoral hernias are more common in females. The most affected population is at the age between 61 and 80 years. The most commonly used open surgical procedures for groin hernia reparation are Lichtenstein and nylon-darn. Both methods have low and similar incidence rates of postoperative complications.

scholarly journals Groin abscess, a rare complication of strangulated femoral hernia: Case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110367
Author(s):  
Khaled S Ahmad ◽  
Naif A Alenazi ◽  
Mohamed S Essa
Keyword(s):  
Femoral Hernia ◽  
Groin Hernia ◽  
Rare Complication ◽  
Ultrasound Image ◽  
Main Concern ◽  
Female Patients ◽  
Resection And Anastomosis ◽  
Groin Abscess ◽  
Groin Hernias ◽  
Bowel Strangulation

Femoral hernias account for 8%–11% of all groin hernias and 3%–5% of all anterior abdominal wall hernias. While groin hernias are more common in males, femoral hernias are developed more commonly in female, accounting for 22%–34% of all groin hernias compared with 1.1% in male. The lifetime risk of developing groin hernia in male is approximately 25% but in female less than 5%, so in all female patients with groin hernias, femoral hernias should be included in the differential diagnosis until proven otherwise. The main concern of a femoral hernia is the higher risk of bowel strangulation, presenting emergently in 32%–39% of patients. We report a case of strangulated femoral hernia in a 78-year-old female who was presented to emergency department with groin abscess based on ultrasound image; patient was then diagnosed as having strangulated femoral hernia and taken to the operating theater, where she was found having strangulated segment of small intestine, so the patient underwent bowel resection and anastomosis with repair of the defect extraperitoneally, and ultimately, the patient improved and discharged from the hospital. Strangulated femoral hernia can present with groin abscess. Furthermore, femoral hernia should be ruled out in elderly patient presented with groin abscess, especially female patients.

Case Report: Incarcerated femoral hernia containing ovary, unusual presentation of uncommon groin hernia

POCUS Journal ◽  
2016 ◽  
Vol 1 (3) ◽  
pp. 15-16 ◽  
Author(s):  
Priyank Gupta, MD, FRCR ◽  
Hadiel Kaiyasah, MRCS Glasgow ◽  
Mahra AlSuwaidi, MRCS Glasgow
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Femoral Hernia ◽  
Groin Hernia ◽  
Adult Population ◽  
Unusual Presentation ◽  
Peak Incidence ◽  
Groin Hernias

Of all groin hernias, femoral hernias account for around 2–8%. They occur four to five times more commonly in females than males and have a peak incidence in those between 30 and 60 years old [1,2]. In adult population, femoral hernias are more commonly found in patients with previous inguinal hernia repair [3].

scholarly journals Femoral Hernia Containing the Right Fallopian Tube: A Rare Finding

2019 ◽  
Vol 41 (08) ◽  
pp. 520-522
Author(s):  
Duarte Viveiros ◽  
André Lázaro ◽  
Hélder Carvalho
Keyword(s):  
Emergency Department ◽  
Fallopian Tube ◽  
Femoral Hernia ◽  
Surgical Repair ◽  
High Rate ◽  
Pelvic Cavity ◽  
Hernia Sac ◽  
Rare Finding ◽  
The Right ◽  
Groin Hernias

AbstractFemoral hernias comprise a small proportion of all groin hernias. They are more common in women and have a high rate of incarceration and strangulation, leading to emergency repair. A 61-year-old female patient was admitted to the emergency department complaining of a 2-day painful lump in the right groin, that had become more intense in the last 24 hours. Physical examination suggested the presence of a strangulated femoral hernia, and the patient underwent emergency surgical repair. Intraoperatively, the right fallopian tube was observed in the hernia sac. Since there were no signs of ischemia, the tube was reduced back into the pelvic cavity and the hernia was repaired. The postoperative period was uneventful, and the patient was discharged without complications, 3 days after surgery.

Laparoscopic repair of inguinal hernia: Prospective evaluation at a tertiary care center

2020 ◽  
Vol 23 (2) ◽  
pp. 54-58
Author(s):  
ABM Mahbubur Rahman ◽  
Tamjeed Alam ◽  
AHM Shamsul Alam ◽  
Fahim Ferdaus ◽  
Gazi Gias Uddin
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Tertiary Care ◽  
Groin Hernia Repair ◽  
Groin Hernias ◽  
Laparoscopic Groin Hernia Repair ◽  
Repair Techniques

Background: Treatment of groin hernias continues to evolve. The emergence of laparoscopic inguinal hernia surgery has challenged the conventional gold standard Lichtenstein’s tension free mesh repair. Laparoscopic technique to achieve surgical correction over groin hernia is increasingly being practiced in our country, and it is imperative to test the overall outcome of this technique in a tertiary care setting. Objectives: Current study was aimed at evaluating the per-operative events, early and late outcomes of laparoscopic groin hernia repair techniques. End points of evaluation were postoperative pain, hospital stay, resumption of normal activities, chronic pain and recurrence. Methods: Within a 2-year period, 45 patients of groin hernias of different clinical types underwent laparoscopic inguinal hernia repair in Bangladesh Medical College Hospital were recruited in this prospective observational study. Preoperative findings, intraoperative course, postoperative and follow-up data were analyzed to evaluate the outcomes. Observations were made regarding operating time, operative hazards, postoperative pain, incidence of early post-operative morbidities, hospital stay, resumption of activities. Total 24 months follow-up was carried out with regards to normal activity, late complications notably chronic groin pain and recurrence. Results: The mean age of 38.1±11.1 years, 27(60%) patients underwent TEP repair whereas, TAPP procedure was carried out in 18 patients (40%). For unilateral hernia repair using TEP technique, mean operative time was 50.3±4.2 mints and 61.7±5.3 mints for direct and indirect variety (D/I), with the corresponding rates for TAPP repair being 65.0±2.2 mints and 72.8±3.2 mints (D/I) respectively. Conversion rate to other operative procedure was 6.67%. The overall surgery related early post-operative morbidity was 7.4% (TEP) and 16.8% (TAPP). 3 out of 45 patients (6.67%) experienced chronic pain in the groin in the study. However, there was no single incidence of recurrence observed during the follow up period. Conclusion: Laparoscopic groin hernia repair techniques are safe and feasible, offers the benefits of minimally invasive surgery and becoming the procedure of choice specially for bilateral and recurrent inguinal hernias. Journal of Surgical Sciences (2019) Vol. 23(2): 54-58

Immunohistochemical Expression of TGF-β3 in Oral Squamous Cell Carcinoma

2019 ◽  
Vol 10 (01) ◽  
Author(s):  
Asmaa Ali Hussein
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Transforming Growth Factor ◽  
Tumor Grade ◽  
Tumor Stage ◽  
High Rate ◽  
Female Ratio ◽  
Positive Expression

Squamous cell carcinoma characterized by poor prognosis due to aggressive tumor growth and dissemination high rate of tumor cell . age ranged of patient case included in the study 40-62 years and mean age 55±99. The sex distribution male/female ratio 1:1. Male case 15 and female 15 of the present study The results of clinical forums showed in the current study was endophytic 10(33.3%) in the same time Exophytic were presented in 20 cases (76.7%). Regarding distribution of the tumors site, the preponderance of them 19 cases 73.3% were located alveolar mucosa, followed by in the tongue 11 cases(36.7%) Tumor stage was analyzed and recorded in Oral squamous cell carcinoma included cases, the preponderance of them were Stage II 11 cases 36.7% followed by stage III 10 cases 33.3% , 9 cases 30.0% were stage I. While Concerning tumor grade, majority of them 15 cases 50% had grade II moderately differentiated SCC, while 11 cases 36.7% had grade III poorly differentiated SCC and 4 cases 13.3% had grade I well differentiated SCC Positive TGF-β3 immunostaining was detected as cell with staining brown color, all tissues sections included show Positive expression based on IHC teqnique. Positive Transforming Growth Factor TGF-β3 Immuno staining was found in all case results and display that 4 samples with percentage 13.3% expressed strong positive 87.67 ± 1.45 expression , 11cases 36.7% showed 51.33 ±0.88 positive expression moderate at the same time 15 samples 50.0% showed positive weak expression.

Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. (Preprint)

2019 ◽  
Author(s):  
Waheed Atilade Adegbiji ◽  
Shuaib Kayode Aremu ◽  
AbdulAkeem Adebayo Aluko
Keyword(s):  
Foreign Body ◽  
Head And Neck ◽  
Clinical Features ◽  
University Teaching ◽  
Age Group ◽  
Geriatric Population ◽  
Female Ratio ◽  
Common Diagnosis ◽  
Foreign Body Impaction ◽  
Nose And Throat

BACKGROUND Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. OBJECTIVE This study aimed at determining prevalence, sociodemographic features, aetiology, clinical features, Complications and sources ofreferral of geriatric otorhinolaryngological, head and neck emergency in our center. METHODS This was a prospective hospital based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat Department of Ekiti State University Teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using pretested interviewers questionnaire.All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts and pie charts. RESULTS Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60-64). There were 38.6% males with male to female ratio of 1:1.5. The main aetiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumour. Main anatomical distribution of geriatric otorhinolaryngology emergency were 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. Common diagnosis in this study were 15.9% sinonasal tumour, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (<13 weeks) occurred in 1 week in 74.2% and 2-13 weeks In 19.7%. Commonest time of presentation was daytime in 65.9%. Major sources of referral were 43.2% general practitioner and 31.1% casualty officers. Presentation of geriatric otorhinolaryngology emergency were mainly ear, nose and throat clinic in 59.8% with accident and emergency in 28.8%. Commonest associated comorbid illnesses among the geriatric patients were 18.2% hypertension, 14.4% arthritis and 9.8% diabetes mellitus. CONCLUSIONS Geriatric otorhinolaryngological emergency are common pathology with associated with comorbid illnesses. Detailed clinical assessment are mandatory for effective management outcome.

Prevalence of Entamoeba histolytica and Giardia lamblia in Children in Kadhmiyah Hospital

2012 ◽  
Vol 36 (1) ◽  
pp. 1-5
Author(s):  
Amjed Qays Ibrahim
Keyword(s):  
Entamoeba Histolytica ◽  
Giardia Lamblia ◽  
Age Group ◽  
Significant Relation ◽  
Female Ratio ◽  
Male Ratio ◽  
Infectivity Rate ◽  
Stool Samples

In this study we collect 1520 stool samples during the period from September to December 2010 from children whom their ages between 1 month - 12 years. The results showed that the total infection of Entamoeba histolytica was 9.80% , and Giardia lamblia was 1.77%. And the male ratio that infected with Entamoeba histolytica was 9.83% , while the female ratio was 9.74%; and the male infected with Giardia lamblia was 1.51% , while the female ratio was 2.18%. The result showed that the high average of infection with Entamoeba histolytica and Giardia lamblia in age group from 1 month to 2 years. And there is no significance difference between gender and infectivity rate of Entamoeba histolytica and Giardia lamblia under P≤0.05. Also it showed that there were significant relation between Age group and infectivity rate of Entamoeba histolytica and Giardia lamblia.

A STUDY ON THE CLINICAL AND SUB-CLINICAL FEATURES OF BACTERIAL SKIN INFECTIONS

2020 ◽  
pp. 56-61
Author(s):  
Anh Mai Ba Hoang ◽  
Phuong Nguyen Thi Thanh ◽  
My Nguyen Thi Tra ◽  
Nguyen Le Thi Cao ◽  
Nam Tran Ngoc Khanh
Keyword(s):  
Systemic Effect ◽  
High Rate ◽  
Skin Infections ◽  
Age Group ◽  
Normal Number ◽  
Dermatology Clinic ◽  
Functional Symptoms ◽  
Common Skin ◽  
Keywords Infection ◽  
Bacterial Skin Infections

Background: Bacterial skin infections are common due to the bacteral invasion into the skin and cause a variety of clinical manifestation. In order to assess the characteristics of this group, we conducted this study to evaluate the clinical and main subclinical features. Methods: A total of 95 patients were diagnosed with bacterial skin infections at Dermatology Clinic of Hue University of Medicine and Pharmacy Hospital from June 2015 to May 2016, of which 34 patients had some tests and 19 patients had samples for culture. Results: The age group of 16 - 30 years old was the most popular: 50.5%; High rate of patients came for consultation in winter (49.5%), most patients had no fever. For functional symptoms, pain accounted for the highest proportion: 71.6%. The most common skin lesion was nodule: 38.8%, the lower extremities were the most common position: 38.9%. Furuncle had the highest incidence: 45.3%. For main laboratory tests, most patients had a normal number of leucocyte: 71.4%; ESR increased by two times accounting for a rate of 20.6%; culture results showed Staphylococcus aureus being a highest percentage: 57.9%. Conclusion: Most skin infections localized and were less systemic effect, the most common agent was S. aureus. Keywords: infection, bacteria, skin, fever, S. aureus

scholarly journals Surgery at Cranio-vertebral (CV) Junction: Our Experience of 32 Cases

1970 ◽  
Vol 29 (2) ◽  
pp. 78-84
Author(s):  
FH Chowdhury ◽  
MR Haque ◽  
NKSM Chowdhury ◽  
MS Islam ◽  
Z Raihan ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Techniques ◽  
Clinical Findings ◽  
Type I ◽  
College Hospital ◽  
Chiari Malformation Type I ◽  
Female Ratio ◽  
Medical College ◽  
Neoplastic Lesion ◽  
Wide Range

Cranio vertebral (CV) junction is one of the critical sites for surgery. It's anatomy, physiological aspects and pathological involvement varies in a wide range of margins. Common problems are developmental anomalies, traumatic involvement, inflammatory, infective and neoplastic lesion. Management of these problems varies a lot from each other. Aim of the article is to overview the pathologies in this area and to study presentations, investigations, surgical procedures and results of these pathologies. We prospectively analyzed 32 cases of Cranio-vertebral (CV) region surgery in the Department of Neurosurgery Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from 2000 to 2008. In our series, male and female ratio was 7.2:1. Pathologies were atlanto- axial dislocation (AAD), Chiari malformation type –I, schwannoma, meningioma, hydatid cyst and tuberculosis. Common clinical findings were- neck pain, quadriparesis, quadriplegia, hand atrophy, autonomic dysfunction and hypertension. Various types of surgical procedures were done in this series according to the pathology. Death was in 01 case, neurological deterioration seen in one case, 2 cases were neurologically stable and 28 cases (87.5%) improved neurologically where one was non useful improvement (Frankel grade-C). Complete pre operative radiological study is a very important adjunct for a successful surgical result. Proper evaluation of patients with selection of appropriate surgical procedures along with safe surgical techniques are the necessary things for successful surgery in this area. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7952 (J Bangladesh Coll Phys Surg 2011; 29: 78-84)

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