Hernia Research Today is a free monthly online journal that collates and summarizes the latest research about Hernia, including details on hiatal, inguinal, umbilical, abdominal, treatment.

Obturator hernia: a diagnostic challenge of small-bowel obstruction.

Liao CF, Liu CC, Chuang CH, Hsu KC

Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Obturator hernia is relatively rare and is a diagnostic challenge in the emergency department because the hernia mass is usually concealed beneath the pectineus muscle. We report the case of a 91-year-old emaciated woman with an incarcerated obturator hernia. The hernia was discovered early in the emergency department by computed tomography and was reduced by emergency laparotomy. The Howship-Romberg sign and pain from the ipsilateral thigh to the knee are important clinical manifestations raising suspicion of obturator hernia, but these did not occur in our patient. One of the clinical clues in our patient was small-bowel obstruction of unknown origin, diagnosed by computed tomography. We emphasize that emergency physicians should keep a high index of clinical suspicion for obturator hernia when encountering small-bowel obstruction in emaciated elderly women. Although we cannot shorten the time from onset of symptoms to hospital admission, we can make rapid evaluation and surgical intervention to reduce the morbidity and mortality of obturator hernia.

Published 8 January 2010 in Am J Med Sci, 339(1): 92-4.
Full-text of this article is available online (may require subscription).

Articles on Hernia published 17 December 2009:

Adhesions and incisional hernias following laparoscopic versus open surgery for colorectal cancer in the CLASICC trial.   Br J Surg, 97(1): 70-8.

BACKGROUND: This study investigated adhesive intestinal obstruction (AIO) and incisional hernia (IH) in patients undergoing laparoscopically assisted and open surgery for colorectal cancer. METHODS: In a case-note review of patients randomized to the Medical Research Council's Conventional versus Laparoscopic-Assisted Surgery In Colorectal Cancer (CLASICC) trial, primary and key secondary endpoints were AIO and IH admission rates respectively. RESULTS: Of 411 patients, 11 were admitted for AIO: ... [Abstract] [Full-text]

Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia.   Br J Surg, 97(1): 4-11.

BACKGROUND: Although there is plentiful evidence regarding the use of laparoscopic surgery for primary inguinal hernia, there is a paucity of literature concerning its role after recurrence. There has been no quantitative review of the evidence, despite suggestions that pooled analysis of existing data is required. METHODS: Medline, Embase, trial registries, conference proceedings and reference lists were searched for controlled trials of laparoscopic versus conventional open surgery for mesh ... [Abstract] [Full-text]

Articles on Hernia published 16 December 2009:

Prospective audit of parastomal hernia: prevalence and associated comorbidities.   Dis Colon Rectum, 53(1): 71-6.

PURPOSE: There is little evidence regarding the prevalence or incidence of parastomal hernia, but it is thought to be common. Repair of parastomal hernia can be troublesome, and methods of repair need to be validated based on reduced incidence following surgery. The true rate of parastomal herniation needs to be determined prospectively, and risk factors for developing such hernias need to be more clearly defined. METHODS: To determine prevalence and associated risk factors, prospective data ... [Abstract] [Full-text]

Early high C-reactive protein in infants with open abdominal wall defects does not predict sepsis or adverse outcome.   Acta Paediatr, 99(1): 126-30.

AIM: To study CRP values and relate it to outcome in infants with antenatal diagnosis of gastroschisis, exomphalos and other surgical conditions. METHODS: Over five years, infants admitted to our neonatal unit with gastroschisis, exomphalos and other surgical diagnoses were identified. Serum CRP measurements in first 5 days were studied. Group one included 33 gastroschisis patients, group two, 18 exomphalos patients, and group three, 38 patients with other surgical diagnoses. Outcome measures ... [Abstract] [Full-text]

Articles on Hernia published 8 December 2009:

Does type of mesh used have an impact on outcomes in laparoscopic inguinal hernia?   Am J Surg, 198(6): 759-64.

BACKGROUND: Theoretically, a lighter and softer mesh may decrease nerve entrapment and chronic pain by creating less fibrosis and mesh contracture in laparoscopic inguinal hernia repair. METHODS: We performed a telephone survey of patients who underwent laparoscopic inguinal hernia surgery between 2001 and 2007. We recorded patient responses for chronic pain, foreign body sensation, recurrence, satisfaction, and return to work, and then studied the effect of type of mesh (polypropylene vs ... [Abstract] [Full-text]

Articles on Hernia published 20 November 2009:

Nationwide study of early outcomes after incisional hernia repair.   Br J Surg, 96(12): 1452-7.

BACKGROUND: There are no nationwide studies on early outcomes after incisional hernia repair. METHODS: This study included all patients aged 18 years or more who had surgery for incisional hernia in Denmark between 1 January 2005 and 31 December 2006, and analysed clinical outcomes within 30 days of surgery. Patients having acute operations and those whose hernia repair was secondary to other procedures were excluded. RESULTS: Of a total of 2896 incisional hernia repairs (1872 open, 1024 ... [Abstract] [Full-text]

Articles on Hernia published 2 November 2009:

Small-bowel internal herniation through the falciform ligament: 64-row MDCT diagnosis.   Emerg Radiol, 17(1): 73-8.

We report a very rare case of internal hernia of the small bowel through a large congenital defect of the falciform ligament. A complete preoperative diagnosis was possible by 64-row multi-detector row computerized tomography. The identification of the characteristic anatomic features and landmarks of the obliterated umbilical vein-ligamentum teres-was the diagnostic key. [Abstract] [Full-text]

Articles on Hernia published 28 October 2009:

Reversible uncal herniation in a neonate with a large MCA infarct.   Brain Dev, 31(10): 763-5.

Uncal herniation due to a large cerebral infarct is well-described in adults, with high rates of morbidity and mortality. This phenomenon, however, has not been previously reported in neonates. We present a newborn male delivered via cesarean section with difficult extraction who presented with frequent seizures. He was found to have an acute left MCA territory infarct secondary to an M1 occlusion detected on MRI/MRA. He became lethargic and developed a left uncal herniation on CT at 72h of ... [Abstract] [Full-text]

© 2004-2010 Hernia Research Today. All Rights Reserved.