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1.
West Indian med. j ; 47(suppl. 2): 33, Apr. 1998.
Artigo em Inglês | MedCarib | ID: med-1869

RESUMO

The comparative differences in pullout suture strength between rectus muscle and sheath and linea alba were studied in cadaveric models. A suture simulating the rectus repair procedure and one using just linea alba were used. Forces were measured on a tensiometer. Mean rectus force was found to account for over 59 percent variability. Both force uniformly decrease towards the symphysis pubis. This suggests that the rectus, when used for incisional hernia repair, may contributed significantly to wound strength. Additionally, our findings may help to elucidate the observance that incisional hernias are commonly subumbilical and occur mostly in females.(AU)


Assuntos
Humanos , Suturas , Hérnia/etiologia
2.
West Indian med. j ; 41(1): 40, Apr. 1992.
Artigo em Inglês | MedCarib | ID: med-6442

RESUMO

Recurrence-free repair of midline ventral abdominal wall herniae continues to challenge surgeons despite the abundance of described techniques. Based on the observation that spontaneous herniation through the rectus abdominis muscles is unknown, a new technique of repair was devised. The recti and their sheath on either side of the hernial defect are directly brought together to obliterate the hernia, while the intervening linea alba and intact hernia sac are "keeled" into the abdominal cavity. Using this technique, 85 consecutive midline abdominal herniae were repaired over an 11 year period. The follow-up period was between 18 months and 12 years, and there was one recurrence (1.2 percent). On re-operation, technical error was judged the cause of recurrence and the patient remains well 18 months following the second operation. The rectus repair is recommended as a highly effective method of dealing with ventral midline wall herniae (AU)


Assuntos
Humanos , Hérnia/cirurgia , Músculos Abdominais/cirurgia
3.
West Indian med. j ; 37(2): 110-3, June 1988.
Artigo em Inglês | MedCarib | ID: med-11703

RESUMO

Incarcerated obturator hernia is rare, only approximately 550 cases appearing in the literature since the first case was reported in 1924. The three cases treated at the University Hospital of the West Indies are presented. They demonstrate many of the clinical features of the condition. Most cases occur in elderly women and they almost always present with symptoms amd signs of small bowel obstruction. Pressure on the obturator nerve by the hernial sac in the obturator nerve by the hernial canal results in a positive Howship-Romberg sign in about 50 percent of the patients. If the diagnosis is suspected pre-operatively, confirmation may be obtained by computerized tomography. This, however, seems unnecessary as prompt exploration is advisable due to the high incidence of gangrene of the bowel. At surgery, attempts at reduction frequently result in damage to the small bowel, and resection is often necessary due to injury or gangrene. Closure of the entrance to the canal with interrupted non-absorbable sutures is adequate, and prosthetic material is necessary only for very large defects. The high mortality rate reported is probably due to the age and poor general condition of affected patients (AU)


Assuntos
Idoso , Idoso de 80 Anos ou mais , Masculino , Hérnia do Obturador/diagnóstico , Hérnia/diagnóstico , Obstrução Intestinal , Hérnia/cirurgia , Jamaica
4.
West Indian med. j ; 35(3): 170-4, Sept. 1986.
Artigo em Inglês | MedCarib | ID: med-11580

RESUMO

Sixty per cent of the paediatric surgical procedures at the University Hospital of the West Indies are performed as day cases, without any significant complications. This allows better utilization of the available bed space, increased turnover and improved cosy efficiency. Parents of one hundred consecutive day-care paediatric surgical patients were asked to answer a questionnaire during their post-operative follow-up visit in order to ascertain their opinion regarding the procedure and to obtain a socio-economic profile of the group. Forty per cent of the children were with single parents or other guardians. Twenty-five per cent were unemployed and, of those employed, the majority were blue collarworkers. In spite of these adverse socio-economic conditions, ninety-six per cent of the parents opted to accept the day-care procedure again or recommend it for another child without any modification. Pain was a significant post-operative complaint, and improved post-operative analgesia would make it even more acceptable. Day-care surgery is not only medically and economically attractive but also well accepted by the parents (AU)


Assuntos
Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Ambulatórios , Atitude Frente a Saúde , Pais , Circuncisão Masculina , Hérnia/cirurgia , Jamaica
5.
J Med Assoc Jamaica ; 3(2): 5-6, Aug. 1968.
Artigo em Inglês | MedCarib | ID: med-15531

RESUMO

250 cases of acute intestinal obstruction treated at the University Hospital over a ten year period were analysed. The incidence of the various causes of obstruction have been recorded. The overall mortality was 8.4 percent. The single most important factor contributing to this mortality was delay in diagnosis and operation. (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Obstrução Intestinal/etiologia , Obstrução Intestinal/mortalidade , Jamaica , Intussuscepção/mortalidade , Aderências Teciduais/complicações , Hérnia/mortalidade , Gangrena
6.
Surg Gynecol Obstet ; 122(2): 261-3, Feb. 1966.
Artigo em Inglês | MedCarib | ID: med-12983

RESUMO

In the 650 patients with acute intestinal obstruction treated in the past 11 years at the University College Hospital of the West Indies in Jamaica, obstruction due to hernia, adhesions, or intussusception occurred in 2 of every 3 patients. Obstructions due to malignant lesions were infrequently seen and those due to diverticulitis and mesentric vascular occlusion were not encountered. The overall mortality rate was 8.4 per cent. Gangrenous obstructions were associated with a high mortality. Strangulated abstructions, in which intestinal resection was unnecessary, were attended by a lower mortality than simple obstruction. The most important factors influencing mortality were found to be the age of the patient, the mortality being highest at the extremes of life, and the duration of the delay in seeking medical attention.(Summary)


Assuntos
Humanos , Aderências Teciduais/complicações , Neoplasias do Colo/complicações , Hérnia/complicações , Obstrução Intestinal/etiologia , Intussuscepção/complicações , Jamaica
7.
West Indian med. j ; 6(2): 123-5, June 1957.
Artigo em Inglês | MedCarib | ID: med-12860

RESUMO

A case of spigelian hernia is described. It is pointed out that in a population where many types of abdominal hernia are common, such cases may be encountered from time to time. Some features of the surgical anatomy are indicated and the danger of strangulation explained on the basis of these. (AU)


Assuntos
Humanos , Pessoa de Meia-Idade , Feminino , Hérnia/cirurgia , Jamaica
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