PubMed · 5915489
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A Hanche-Olsen. 1966-09-15. [Retroperitoneal hernia].. https://pubmed.ncbi.nlm.nih.gov/5915489/
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Lung hernia is defined as a protrusion of lung parenchyma beyond the confines of the musculoskeletal thorax. Lung hernias can be classified according to location (i.e., cervical, thoracic, or diaphragmatic) and etiology. Approximately 80% of reported cases of lung hernia are acquired, usually related to trauma or surgery. Symptoms are few, infrequent, and vague. A painless, local, and inconstant bulging is evident on physical examination. The diagnosis of a lung herniation is accomplished using chest radiographs in the most cases. Surgery is usually reserved for large hernias or incarcerated hernias.
STUDY DESIGN: This is a report of a patient in whom spinal cord herniation into a pseudomeningocele resulted in progressive myelopathy. OBJECTIVE: To describe the outcome of a 59-year-old man who visited Osaka University Hospital complaining of gait disturbance. He had undergone cervical laminectomy to resect a spinal cord tumor 14 years previously. SUMMARY OF BACKGROUND DATA: Pseudomeningocele is an extremely rare condition and can be overlooked. In addition, cord herniation into the pseudomeningocele rarely can be diagnosed before surgical exploration. Our patient represents the first case we are aware of in which magnetic resonance imaging could clearly demonstrate not only the pseudomeningocele, but the herniation of the cord into the cyst. METHODS: Magnetic resonance imaging was used for preoperative and postoperative investigation. RESULTS: The pseudomeningocele was resected to improve the neurologic status of the patient. During the operation, the herniated cord was successfully reduced into the original subarachnoid space by the release of adhesion. Most symptoms subsided soon after surgery. Magnetic resonance imaging could delineate not only the cyst and cord herniation, but the medullary pathology. The distribution of high-intensity areas on T2-weighted images suggested the cord damage. CONCLUSION: Magnetic resonance imaging revealed not only the cyst and cord herniation, but medullary pathology, too.
The reported frequency of incisional hernias, after operative gynecological laparoscopy, at extraumbilical trocar sites is one per 32 puncture sites created by a 12-mm trocar. A new closure technique of suturing with the Grice Needle (Ideas for Medicine, Inc., Clearwater, FL) before removing the trocars was utilized to close 80 lateral trocar sites (42 consecutive laparoscopic myomectomies). The trocar sizes in this study were 12 mm and 18 mm. This is the largest reported series of lateral trocar-site closures. No hematomas or bleeding or incisional hernias have resulted from use of this technique. This closure allows the surgeon to completely close both peritoneum and fascia, of the lateral trocar sites, under direct laparoscopic visualization without the loss of pneumoperitoneum or risk of inadvertent injury to the small bowel.