Tratamiento de la hernia de spiegel con mallas de polipropileno. Nuevo enfoque terapéutico / Treatment of Spigelian hernia using polypropylene mesh. A new therapeutic approach

La hernia de Spiegel es una hernia ventrolateral, rara y generalmente mal diagnosticada. Su incidencia de presentación complicada es alta y en nuestra serie ha sido del 55,5 por ciento. La exploración complementaria ideal por su accesibilidad y fiabilidad es la ecografía. Aunque la reparación anatómica se considera suficiente por su mínima incidencia de recidivas, creemos aconsejable la utilización de mallas de polipropileno. Presentamos una amplia serie de 9 casos tratados en nuestro hospital en 16 años (AU)

[Perforation of hollow viscera in abdominal injuries]. / Perforación de víscera hueca en traumatismos abdominales.

OBJECTIVE: This is a retrospective study to evaluate our results in the treatment of abdominal trauma. DESIGN: We have analysed the incidence, the clinical characteristics, the diagnosis, the indications for laparotomy, the therapeutic methods and the morbidity-mortality. During the last 14 years we have operated on 29 hollow viscus injuries. They were divided into two groups: Eleven with penetrating or open trauma and 18 with blunt or closed traumatism. RESULTS: In the cases of blunt trauma 36.8% of injuries were located in the proximal jejunum, 21% in the terminal ileum, 15% in the colon. In the cases of penetrating trauma, small intestinal perforation predominated (46.9%). In 23.5% of the cases the colon was affected. Morbidity in blunt trauma was 38.8% and 0% in penetrating trauma. The mortality in the two groups has been zero. CONCLUSIONS: The most common surgical procedure practised for injuries to the small intestine was simple suture, and for injuries to the colon, colostomy. The most usual surgical procedures in penetrating trauma were simple suture in all small intestine injuries and for colonic lesions half had primary closure and half suture plus colostomy.