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At least 19 recordsLinked to original sources
PubMed1975

External herniae: ventral herniae and summary.

1. In three articles, inguinal, femoral, and ventral herniae have been discussed, one of the aims being to draw the attention of those who are new to surgery in the tropics to some of the things the author thought were peculiar to these herniae. Experiences in the 1,100-bed Korle Bu Hospital, Accra, where a retrospective survey showed that 609 external herniaw were mended in 15 months, formed the basis of the discussions. 2. The applied anatomy of the inguinal canal of adult Ghanaians was described. Three things were pointed out: the infantile type of inguinal hernia was the rule not the exception; the floor and the conjoint tendon were well developed and useful for repair; the pubic branch of the inferior epigastric artery was normal not aberrant. 3. IN Accra inguinal herniae are big and a man's disease. The differential diagnosis of scrotal hernia includes vaginal hydrocele, scrotal elephantiasis, testicular tumours, and tuberculous epididymoorchitis. A case was made in favour of differentiating between direct and indirect inguinal herniae preoperatively. 4. Elective herniorrhaphy was recommended as the treatment of choice and operative techniques were described. The suture material to employ for the Bassini repair must be non-absorbable, e.g. silk or nylon. Whereas herniotomy is adequate in children, in women herniorrhaphy is combined with clearance and obliteration of the inguinal canal. 5. The author did not recommend a truss for an inguinal let alone a femoral hernia. There is suggestive evidence that even in the tropics a man's hernia could be safely repaired on an out-patient basis. 6. Since femoral hernia is rare, it was recommended that in the interest of the patients, skillful surgeons should repair them. 7. The surgical anatomy of the femoral canal, and clinical features of femoral hernia were described. The differential diagnosis included inguinal hernia, abscesses in the groin, hydrocele of the femoral canal, saphena varix, lymphadenopathy, simple tumours and aneurysm of the femoral artery. 8. The treatment of choic is a surgical operation of which three were named and one described ("the low" operation of Lockwood). Recurrence is rare...

Cesarean Section↗
PubMed2026

Genetic Susceptibility to Incisional Hernia Evaluation of Hernia Polygenic Risk Scores.

OBJECTIVES: Incisional hernia (IH) affects 13-30% of people after abdominal surgery, resulting in substantial morbidity and costs. While clinical risk factors have been studied extensively, genomic risk for IH is incompletely understood. We aimed to evaluate the impact of polygenic risk scores (PRS) on IH risk prediction. METHODS: We created and evaluated three PRS for abdominal hernia, ventral hernia and latent hernia susceptibility for prediction of IH in an institutional biobank. The primary outcome was defined as the diagnosis or repair of an IH based on ICD-9/10-CM/PCS and CPT codes. Clinical covariates included age, sex, body mass index (BMI), smoking status, index procedure type, and perioperative surgical site infection. A phenome-wide association study (PheWAS) was performed to assess clinical associations with increased PRS. We then tested the ability of the PRS to improve prediction for IH by modeling clinical covariates with and without PRS in patients who underwent abdominal surgery. Model performance was assessed using 10 iterations of 5-fold cross-validation to estimate Brier scores and area under the receiver operating characteristic curve (AUROC), which were compared using cross-model Bayesian analysis of variance. RESULTS: In 55,809 subjects, assessed PRS was significantly associated with incisional, umbilical, and ventral hernia on PheWAS, with 1.19 greater odds of developing IH per 1-SD increase in PRS (95% CI: 1.13-1.25, P < 0.001). Of 9,909 subjects who underwent qualifying abdominal surgery, 706 developed IH. In this cohort, the latent hernia susceptibility PRS was associated with a 16% increased hazard of developing IH per 1-SD increase (HR 1.16; 95% CI: 1.07-1.26; P < 0.001). Compared to a predictive model using clinical covariates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC = 0.660, 95% CI: 0.653-0.666), addition of the PRS showed similar Brier score and AUROC estimates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC: 0.667, 95% CI: 0.661-0.673) at five years. Cross-model Bayesian analysis demonstrated >99% probability of practical equivalence when trying to detect a difference of &#x2265; 0.02. CONCLUSION: All three PRS for hernia were independently associated with IH, suggesting that genomic factors contribute significantly to IH development. However, none of the three PRS meaningfully improved clinical IH risk prediction in patients who underwent abdominal surgery. This suggests that clinical comorbidities and surgical techniques may be equally as important as genomic architecture.

Bayesian analysis↗
PubMed1992

Anatomical laparoscopic hernia repair of direct or indirect inguinal hernias using the transversalis fascia and iliopubic tract.

Fourteen patients with symptomatic inguinal hernias underwent anatomic repair, which approximates the transversalis muscle and fascia to the iliopubic tract. Polyproprolene mesh was used to obliterate the canal space formerly occupied by the hernia sac. Nine patients were operated on for a direct inguinal hernia, four for an indirect hernia, and one recurrent direct hernia. Two patients required the laparoscopic approach to abandoned in favor of an open method. The remaining 12 patients underwent laparoscopic repair and were discharged within 23 h of the procedure.

Adult↗
PubMed1978

"Paratransplant" hernia. Three patients with a new variant of internal hernia.

Three cases of bowel obstruction due to internal hernia caused by entrapment of bowel or omentum through a defect in the peritoneum covering the transplanted kidney are described. All three patients survived due to early surgical intervention and reduction of the hernia and/or resection of necrotic bowel or omentum. In view of the high mortality of peritonitis in transplant patients, early surgical treatment is indicated in all cases of intestinal obstruction to avoid the sequelae of bowel infarction. This "paratransplant" hernia represents the newest type of internal hernia described.

Adult↗
PubMed1977

Ventral hernia with a skin-covered Silastic sheet for newborn infants with a diaphragmatic hernia.

The persistently high mortality rate for newborn infants with a congenital diaphragmatic hernia, which is symptomatic and treated in the first 24 hours of life, is due to multiple pulmonary and vascular factors. This demands the exclusion of any additional compromising elements. The effects of increased intra-abdominal pressure due to replacement of the intestine into the abdomen can be avoided by the formation of a ventral hernia. A large hernia can be produced best by suturing a sheet of Dacron reinforced Silastic to the fascia of a midline abdominal incision and covering it with skin flaps. This nonreactive prosthesis will remain in place for several months and later can be removed simply. This technique was used successfully in three infants and should improve the survival rate of precariously balanced newborn infants operated upon during the first few hours of life.

Female↗
PubMed1979

[Posterior gastro-esophago-phreno-plasty (PGEPP) in the treatment of hiatal hernia and of esophagogastric reflux. Experience in over 500 cases. Anterior gastro-esophago-phreno-plasty (AGEPP) in the prevention of sliding hiatal hernia and of esophagogastric reflux. Experience in over 300 cases].

On the basis of the anatomophysiological assumption that the abdominal oesophagus is kept in its seat by the meso-oesophagus and that the complex functional role of the gastro-oesophageal junction is conditioned essentially by the inferior oesophageal sphincter under the influence of intra-abdominal and endogastric pressure variables, posterior gastro-oesophagophreno-plasty (p.g.p.p.) is proposed to offset the destruction or severe insufficiency of the meso-oesophagus and hence for the treatment of hiatal hernia and of regurgitation. This retro-oesophageal tuberous valve involves simultaneous fixation of the stomach and oesophagus to the pillars of the diaphragm, first on the right and then on the left, and the fixation of the fundus to the left diaphragmatic dome. Anterior gastro-oesophago-phreno-plasty is proposed on the basis of the finding that damage of any kind to the meso-oesophagus can cause the oesophagus to rise in the chest and thus disturb inferior sphincter function and possibly lead to the onset of regurgitation and hernia. The pre-oesophageal tuberous valve employed involves simultaneous fixation of stomach and oesophagus to the pillars of the diaphragm, first left and then right, and the fixation of the fundus to the left diaphragmatic dome. Anterior plasty is almost always confined to patients who have undergone vagotomy of the trunk without complex isolation of the oesophagus.

Diaphragm↗
PubMed1977

Richter hernia in a sacral foramen: new site for richter hernia.

This is a report of the first case to my knowledge, of a Richter hernia occurring in a sacral foramen. A 60-year-old woman had gradual onset of postsacral pain and swelling. The area was drained and small intestinal contents found. Laparotomy showed that a Richter hernia had occurred in the third right sacral foramen. The bowel had incarcerated and perforated into the posterior sacral area, without leakage into the peritoneal cavity.

Colon↗