scholarly journals INCARCERATED INGUINAL HERNIA IN NEWBORNS AND INFANTS

2021 ◽  
Vol 11 (3(41)) ◽  
pp. 41-45
Author(s):  
O. Gorbatyuk
Keyword(s):  
Inguinal Hernia ◽  
Physical Examination ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Surgical Correction ◽  
Vertical Position ◽  
Optimal Timing ◽  
Incarcerated Inguinal Hernia ◽  
Inguinal Hernias ◽  
Effective Diagnosis

Introduction. Inguinal hernias (IG) in children are a congenital pathology of the processusvaginalis and a local manifestation of the syndrome of mesenchymal insufficiency. Incarcerated IG is the most common and dangerous complication, the risk of which is significantly higher in children during the first 3 months of life. To date, there is no perfect method of pinched IG treatment in newborns and infants. Data on the optimal timing of herniotomy in newborns and infants are also insufficient and contradictory.The aim of this study is to provide our own experience in the treatment of infants with pinched inguinal hernias.Material and methods. The material of this study is 97 newborns and infants with irreducible and incarcerated inguinal hernias. Diagnosis was based on anamnesis data, physical examination methods and ultrasound data with inguinal and scrotal Doppler. Indications for review radiography of the abdominal cavity were clinical signs of acute intestinal obstruction.Results and discussion. Analyzing the obtained results, we have found that the diagnosis of hernias in 91 (93.81%) children was based on anamnestic data, complaints of parents about the presence of bulging in the groin area and physical examination of a child. The most important condition for effective diagnosis is the thorough collection of anamnestic data to determine the duration of the acute condition in a child and its dynamics. It is important to examine a child in a horizontal and vertical position. Differential diagnosis of incarcerated IG in infants was performed with acute hydrocele, torsion of the spermatic cord, inguinal lymphadenitis, etc., which are very similar to incarcerated IG in small children.Treatment of incarcerated inguinal hernias in newborns and infants has been carried out using a combined strategy, which involved the use of conservative invagination of hernia contents (49.48% of patients) followed by delayed surgical correction and emergency surgery according to urgent indications (42.27% of infants).Among 48 children treated conservatively, non- operative manual hernia invagination (Taxis - method) was effective in 46 of them or 95.83%. We used this method in children with a strangulation period up to 12 hours in the absence of inflammation signs in the pinched area.Indications for urgent herniotomy were: strangulation period of more than 12 hours (12 children), ineffectiveness of conservative treatment for 1 hour (2 patients), intractable hernia protrusion in girls (27 patients).As for the planned surgery, we support surgical correction of inguinal hernias at the age of 6-12 months, which we consider optimal.Conclusions1. Conservative manual invagination of an incarcerated inguinal hernia in newborns and infants is used in terms of pinching the contents of the hernia lasting up to 12 hours and is effective in 95.83% of cases.2.Surgical intervention for incarcerated hernia in infants should be performed in children with a duration of pinching more than 12 hours, in cases of impossibility and / or ineffectiveness of conservative invagination for 1 hour and in girls.3. Correction of a incarcerated inguinal hernia in girls is not recommended due to the high risk of ovarian damage.

scholarly journals Laparoscopic Examination and Transabdominal Preperitoneal (TAPP) Approach with Biologic Mesh for Strangulated Direct Inguinal Hernia Accompanied by Small Intestinal Perforation

2021 ◽  
Author(s):  
Tianhao Xie ◽  
Shujie Cheng ◽  
Yan Fu ◽  
Xinli Sun ◽  
Xiangxiang Ren ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
General Anesthesia ◽  
Intestinal Perforation ◽  
Abdominal Cavity ◽  
Biologic Mesh ◽  
Incarcerated Inguinal Hernia ◽  
Direct Inguinal Hernia ◽  
Inguinal Hernias ◽  
Small Intestinal

Abstract Background A direct inguinal hernia is caused by a weakness or defect in the floor of the Hesselbach triangle. It is believed that direct hernias are less likely to strangulate than indirect hernias, because the neck of the direct hernia is wide enough to avoid strangulation. Approximately 8.6% of all incarcerated inguinal hernia contents can be returned to the abdominal cavity spontaneously after general anesthesia, and intestinal ischemia or necrosis was detected by laparoscopic examination in approximately 40.9% of cases. However, which surgical approach or mesh for an acutely incarcerated and strangulated groin hernia is still no consensus. We retrospectively enrolled 12 patients with incarcerated inguinal hernias accompanied by small intestinal perforation who underwent laparoscopic examination when the hernia content spontaneously returned into the abdominal cavity after induction of general anesthesia in our institution.Results 1 of the 12 patients had developed temporary seroma; the other 2 had early postoperative pain. No evidence of hernia recurrence, chronic pain, infection, scrotal swelling, paralyticileus, persistent seroma, mortality, or any other complications were found during the follow-up. At 1 year and most recent follow-up, all patients were satisfied with the treatment outcome.Conclusions It is a necessary to detect abdominal viscera when incarcerated inguinal hernia contents return to the abdominal cavity spontaneously after general anesthesia, and laparoscopic examination is an efficient method. Laparoscopic TAPP technique with biologic meshes is a feasible method to treat strangulated inguinal hernias accompanied by small intestinal perforation. To better understand whether TAPP or biologic mesh apply to strangulated inguinal hernia (especially enterectomy) and evaluate its wider application, this treatment will need to be tested in larger clinical trials.

Laparoscopic cauterization of hernia sac in girls; the Burnia technique

2020 ◽  
Author(s):  
Sabriye Dayı
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Contralateral Side ◽  
Hernia Sac ◽  
Inguinal Hernias ◽  
Laparoscopic Techniques

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.

scholarly journals A CASE OF GIANT INGUINO- SCROTAL HERNIA

2020 ◽  
pp. 1-2
Author(s):  
Neel B. Patel ◽  
Hitendra K. Desai ◽  
Purvesh V. Doshi ◽  
Bansil V. Javia
Keyword(s):  
At Risk ◽  
Inguinal Hernia ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Abdominal Cavity ◽  
Standing Position ◽  
Hernia Sac ◽  
Scrotal Hernia ◽  
Inguinal Area ◽  
Inguinal Hernias

• An inguinal hernia is a protrusion of the contents of the abdominal cavity or peritoneal fat through a defect in the inguinal area. • The hernia sac contents are at risk of incarceration, which may lead to more serious sequelae such as bowel obstruction, and or a circulatory strangulation of the hernia contents, leading to necrosis and possible perforation of the intestine . The chance of incarceration is relatively low, between 0.3-3% per year . • GAINT INGUINAL HERNIA IS MORE UNUSUAL (APPROX 0.5% OF INGUINAL HERNIAS) AND SIGNIFICANTLY CHALLENGING IN TERMS OF SURGICAL MANAGEMENT. • IT IS DEFINED AS AN INGUINAL HERNIA THAT EXTENDS BELOW THE MIDPOINT OF INNER THIGH WHEN PATIENT IS IN STANDING POSITION.

scholarly journals Direct inguinal hernias in children

2021 ◽  
Vol 11 (2) ◽  
pp. 161-167
Author(s):  
Vyacheslav G. Svarich ◽  
Ilya M. Kagantsov ◽  
Violetta A. Svarich
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Ultrasound Examination ◽  
Laparoscopic Hernia Repair ◽  
Abdominal Cavity ◽  
Treatment Method ◽  
Long Term Results ◽  
Direct Inguinal Hernia ◽  
Surgical Department ◽  
Inguinal Hernias

AIM: Based on the accumulated clinical material, this study aims to show the possibilities of diagnosing and treating direct inguinal hernias in children. MATERIALS AND METHODS: During the period from 2000 to 2020, 3221 children with inguinal hernias were treated in the surgical department of the Republican Childrens Clinical Hospital in Syktyvkar. Of the above group of children with inguinal hernias, seven patients (0.22%) had direct inguinal hernias. The above was confirmed by ultrasound examination. In laparoscopic imaging, a rectal hernia was defined as a recess of the peritoneum of a stellate or rounded shape in the projection of the medial umbilical fossa. Two patients underwent the Bassini herniation procedure. Two children underwent laparoscopic hernia repair with intracorporeal suture insertion. In three patients, hernia repair was performed using the PRMS method. RESULTS: Long-term results were followed up from six months to 15 years. Immediate and postoperative complications were noted. No recurrence of hernia was reported. CONCLUSIONS: When establishing direct inguinal hernia diagnosis in children is clinically determined in the form of a rounded, soft-elastic formation localized medially and above the Pupart ligament next to the projection of the external (superficial) inguinal ring of the inguinal canal. It is easily set into the abdominal cavity with rumbling and confirmed by ultrasound examination results. The most preferred treatment method for direct inguinal hernia in children, in our opinion, is hernia repair using the percutaneous internal ring suturing (PIRS) method.

scholarly journals Gastric outlet obstruction secondary to incarcerated pylorus in an inguinal hernia

2014 ◽  
Vol 96 (5) ◽  
pp. e26-e27 ◽  
Author(s):  
L Creedon ◽  
O Peacock ◽  
R Singh ◽  
A Awan
Keyword(s):  
Inguinal Hernia ◽  
Small Bowel ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Incarcerated Inguinal Hernia ◽  
Common Presentation ◽  
Inguinal Hernias ◽  
Wide Range ◽  
The World ◽  
Surgical Admission

Inguinal hernias are a common presentation to surgical admission units throughout the world. The majority of presentations are due to hernias containing either fat or small bowel. However, a wide range of intra-abdominal viscera have been demonstrated in inguinal hernias. We report a case of an 87-year-old man who presented with gastric outlet obstruction secondary to an incarcerated inguinal hernia containing the gastric pylorus.

scholarly journals The use of prosthetic mesh in adult inguinal hernia repair

2019 ◽  
Vol 6 (5) ◽  
pp. 1745
Author(s):  
Laith Qauis Majeed ◽  
Mohammed Hillu Surriah ◽  
Amine Mohammed Bakkour ◽  
Ayaad Makki Saaid
Keyword(s):  
Inguinal Hernia ◽  
Groin Hernia ◽  
Abdominal Cavity ◽  
Age Groups ◽  
Abdominal Wall Hernia ◽  
Prosthetic Mesh ◽  
Age Group ◽  
Tension Free ◽  
Inguinal Hernias ◽  
Mesh Technique

Background: An abdominal wall hernia is a protrusion of a viscus or part of a viscus through an abnormal opening in the wall of the abdominal cavity. Different approaches have been described in regards to management and repair of hernia. The present study aims at showing the rate of frequency to use the prosthetic mesh versus classical repair in adult inguinal hernia.Methods: A retrospective study lasted from October 2014 to July 2018 in Al-Karama Teaching Hospital. The study Samples consist of 315 patients with inguinal hernia, the age group (20-70) years old they were diagnosed according to clinical examination. There are 76 patients operated on using mesh technique (tension free).Results: All patients in our series were male, with age group (20-70) years. However, the inguinal hernia more frequent with increase age. In age groups; (40-49) was 25 patients (32.89%). The indirect inguinal hernias are most common in the young 65% whereas direct hernias are most common in the old. In our series sixty-one (80.26%) patients with indirect inguinal hernias, eleven (11.82%) patients with direct hernias and six (5.263%) patients with pantaloon type.Conclusions: The frequent uses of mesh in inguinal hernioplasty increasing with age. Tension –free hernioplasty is technically simple surgical operation, which can be used to repair any groin hernia. The use of mesh patch with or without plug is technically easier to work than the classical methods and far simple to secure to surrounding tissues.

scholarly journals Treatment of an Atypical Case of Bilateral Nephrolithiasis in a Canine

2020 ◽  
Vol 48 ◽  
Author(s):  
Inácio Bernhardt Rovaris ◽  
Aline Silva Gouvêa ◽  
Tainor De Mesquita Tisotti ◽  
Gabriela Da Cruz Schaefer ◽  
Eduardo Raposo Monteiro ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Physical Examination ◽  
Urine Culture ◽  
Left Kidney ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Renal Parenchyma ◽  
Radiographic Examination ◽  
Coagulase Negative Staphylococcus ◽  
Blood Tests

Background: Less than 5% of canine uroliths are found in the kidney and ureter. The decision to remove a nephrolith is controversial and should be considered in cases of refractory infection, hematuria, presence of obstructive uropathy and compression of the renal parenchyma. The aim of this report is to describe an unusual presentation of bilateral nephrolithiasis in a dog, occupying almost the entire renal parenchyma, its clinical and imaging findings, in addition to surgical treatment and its evolution.Case: A 10-year-old male Basset Hound was evaluated at the Veterinary Medical Teaching Hospital (HCV) of the Federal University of Rio Grande do Sul (UFRGS), presenting prostration, anorexia, vomiting, diarrhea and severe hematuria for three days. On physical examination the patient was dehydrated, with pale mucous membranes, uremic breath and abdominal pain. Blood tests showed mild anemia and azotemia. In both kidneys, abdominal ultrasonography exhibited a large hyperechoic structure with deep acoustic shadowing. These same structures were observed in abdominal radiographic examination as radiopaque structures, confirming the diagnosis of bilateral nephrolithiasis. Urine culture was positive for coagulase-negative Staphylococcus sp. The patient was stabilized with fluid therapy, antiemetic, analgesics, antibiotics and whole blood transfusion. Unilateral nephrotomy of the right kidney was performed to remove the urolith. After three months, nephrotomy of the left kidney was performed to remove the other urolith. The patient was clinically stable and with no macroscopic hematuria 12 h after surgery. Two days after discharge, the patient returned prostrated in lateral recumbency, however with no alteration of parameters in physical examination. Blood tests showed anemia, thrombocytopenia, hypoalbuminemia, azotemia and hyperphosphatemia. The dog presented a convulsive episode and died shortly, eight hours later. In the necropsy examination, extensive loss of renal parenchyma was seen in both kidneys and the presence of thrombosis and areas of infarction in several organs such as spleen, liver, lungs and central nervous system.Discussion: Complications of nephrotomy include perirenal hemorrhage, hydronephrosis due to obstruction of blood clots or urine leakage to the abdominal cavity. From the necropsy findings, the surgical site did not present these complications, justifying that the surgical procedure was not directly related to death. Correction of dehydration, blood transfusion, and antibiotic therapy based on urine culture and susceptibility testing was important for initial stabilization, before surgery. However, the presence of advanced chronic kidney disease may have contributed to deterioration of the patient's clinical condition and death. The presence of thrombus and hemorrhagic areas, observed during necropsy, associated with acute onset of clinical signs and the presence of severe hypoalbuminemia, may suggest that the patient died due to a thromboembolic event, as a consequence of nephrotic syndrome. Studies show that nephrotomy can be performed with few adverse effects on renal function if the surgical technique and anesthetic management are adequate. In this case, nephrotomy was the best option for the treatment of the patient, since it enabled a rapid intervention, controlled the hematuria and allowed the removal of both uroliths without complications related to surgery.

Recommendations for patient management after manual reduction of incarcerated inguinal hernia: a literature review

2020 ◽  
Vol 99 (9) ◽  
Keyword(s):  
Inguinal Hernia ◽  
Mesh Repair ◽  
Tissue Repair ◽  
Laparoscopic Approach ◽  
Current Evidence ◽  
Surgical Team ◽  
Incarcerated Inguinal Hernia ◽  
Manual Reduction ◽  
Inguinal Hernias ◽  
Increased Risk

Introduction: Topic of this review is to provide a systematic overview of the current evidence on the management of patients after manual reduction of an incarcerated inguinal hernia. Methods: Available literature regarding incarcerated or strangulated inguinal hernias published until March 2019 was obtained and reviewed. 32,021 papers were identified, of which only 20 were of a sufficient value to be used in this review. Results: The terms ‘incarcerated’ and ’strangulated’ are used interchangeably in the literature making separate analysis of these two entities almost impossible, although manual reduction is very unlikely to be successful when the hernia has strangulated contents. Following successful manual reduction, mesh repair is generally superior compared to pure tissue repair with regard to recurrence rates. Nevertheless, mesh repair is associated with a significant increase in the surgical site infection (SSI) rate, especially when bowel necrosis is present. The laparoscopic approach provides the benefits of avoiding an unnecessary laparotomy and reducing associated morbidity, but it does require the availability of appropriate equipment and an appropriately skilled surgical team. Conclusion: A mesh repair is generally superior to a pure tissue repair in the surgical management of emergency inguinal hernias, reducing the recurrence rate, but can be associated with an increased risk of SSI depending on the level of contamination. The laparoscopic approach is recommended if an experienced surgical team and necessary equipment are available.

Overuse of Previsit Ultrasound in Patients Referred for Treatment of Inguinal Hernias

2019 ◽  
Vol 85 (3) ◽  
pp. 261-265
Author(s):  
Bryce French ◽  
Caleb Van Essen ◽  
Christopher Mcdonald ◽  
Andrew Ting
Keyword(s):  
Health Care ◽  
Inguinal Hernia ◽  
Physical Examination ◽  
Sensitivity And Specificity ◽  
Clinical Examination ◽  
Medical Records ◽  
High Sensitivity ◽  
Patient Demographics ◽  
Inguinal Hernias ◽  
Case Outcome

Inguinal ultrasound (US) has a high sensitivity and specificity for the diagnosis of inguinal hernias but is often performed unnecessarily, adding cost and time to treatment. The aim of our study was to assess the rate and necessity of US before clinical examination by a hernia surgeon. Medical records of patients referred for an inguinal hernia from April through July 2017 were reviewed. These cases were analyzed for patient demographics, physical examination (PE) findings, previsit imaging, health-care system of surgeon, and case outcome. Twenty-nine per cent of patients had an inguinal US before visiting a surgeon. Sixty-three per cent of patients who underwent an US had a palpable hernia on PE, and 76 per cent had a positive PE by the surgeon. Patients without a hernia on referring provider's PE underwent US 59 per cent of the time. Inguinal USs are being ordered unnecessarily by referring providers. Physical examination by referring providers and surgeons should be the primary tool for diagnosis of an inguinal hernia.

Uncomplicated adult inguinal hernia repair under local anaesthesia and spinal anaesthesia

2020 ◽  
Vol 11 (3) ◽  
pp. 3212-3221
Author(s):  
Naniwadekar R G
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Spinal Anaesthesia ◽  
Local Anaesthesia ◽  
Control Group ◽  
Early Ambulation ◽  
Inguinal Hernias ◽  
Hernia Inguinal ◽  
The Subject ◽  
Prolonged Hospital

Multiple researchers have given numerous guidelines in the clinical management of this disorder in the late nineteenth and twentieth centuries, after comprehensive works on the subject. As a result, a very wide variety of surgical procedures are now available to the surgeon to suit the requirement. There have been numerous advances in the management of inguinal hernia. Inguinal hernias can conveniently be repaired under all kinds of anaesthesia, namely general, spinal and local. Whereas the general anaesthesia requires the services of an experienced anaesthetist and new devices and spinal anaesthesia requires postoperative impairment while local anaesthesia is safe to prescribe, easy and efficient and does not cause postoperative complications. This work consisted of a study group of twenty-five adult patients of uncomplicated inguinal hernias, who after repair of hernias, which after repair of hernias were allowed early ambulation and had a short hospital, stay of one day post operatively. The second control group consisted of similar twenty-five patients who are subjected to conventional delayed ambulation and prolonged hospital stay. The results of repair in the two groups were compared; the available literature on the subject was reviewed. The implementation of ”shortstay surgery” not only relieves the waiting list in hospitals but also offers an economic boost and provides the patient with some social advantages.

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