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1.
BMJ Case Rep ; 14(1)2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33414120

RESUMO

A 75-year-old woman presented with perineal wound dehiscence and small bowel prolapse of a perineal hernia, 6 years after extra-Levator AbdominoPerineal Excision (eLAPE) procedure for rectal cancer. She underwent emergency wound refashioning and perineal hernia repair with Parmacol mesh. Her postoperative recovery was complicated by long-standing ileus, wound infection, and she was discharged to community palliative care services. In this case report, we raise awareness of postoperative eLAPE complications and describe an unfortunate case where a postoperative perineal hernia was not repaired in a patient with multiple comorbidities.


Assuntos
Hérnia Incisional/complicações , Protectomia/efeitos adversos , Idoso , Feminino , Humanos , Hérnia Incisional/cirurgia , Neoplasias Retais/cirurgia , Deiscência da Ferida Operatória/complicações , Infecção da Ferida Cirúrgica/complicações
2.
BMJ Case Rep ; 12(12)2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31831512

RESUMO

An 83-year-old woman presented emergently with a 1-week history of increasing abdominal pain and vomiting. Imaging confirmed an incarcerated incisional hernia containing viable small bowel. Laparotomy revealed profound ischaemic insult extending beyond the hernial contents, affecting virtually the entire small bowel, consistent with acute superior mesenteric artery thrombosis. The patient underwent resection of the entire small bowel except for 20 cm of the jejunum and 15 cm of the terminal ileum. Her duodenum and large bowel were unaffected. Despite her age, comorbidities and only 35 cm of the remnant small bowel, this patient made a remarkable recovery. She transitioned from total parenteral nutrition dependence in an acute hospital setting to being discharged into the community, relying on partial parenteral nutrition two times per week in a home setting.


Assuntos
Íleo/cirurgia , Jejuno/cirurgia , Síndrome do Intestino Curto/terapia , Idoso de 80 Anos ou mais , Feminino , Humanos , Hérnia Incisional/complicações , Hérnia Incisional/cirurgia , Nutrição Parenteral Total/efeitos adversos
3.
J Surg Res ; 244: 160-165, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31295649

RESUMO

BACKGROUND: Patients with an incisional hernia often wait a significant period of time from the first referral to hernia surgery because of waiting lists, watchful waiting, or the need for preoperative optimization. It is unknown if hernia dimensions or patient-reported symptoms increase during this period. The aim of the study was to examine if incisional hernias increase in size during the time from initial assessment to surgical repair. MATERIALS AND METHODS: A prospective controlled trial was performed on patients referred to a regional hernia center for repair of an incisional hernia with a transverse fascial defect of >7 cm. All patients underwent computed tomography scans and answered the Hernia-Related Quality of Life Score questionnaire and International Physical Activity Questionnaire at first assessment and again 30 ± 2 wk later or immediately before hernia repair. Changes in fascial defect sizes and hernia sac volume were assessed along with the patient-reported outcomes. RESULTS: A total of 35 patients were included. The median fascial defect area increased from 117.3 cm2 (interquartile range 46.5-181.2) to 150.4 cm2 (62.5-199.0), P < 0.001, and the median hernia sac volume increased from 5.11 L (2.28-8.09) to 6.25 L (3.03-10.38), P < 0.001. There were no significant changes in the patient-reported outcomes. CONCLUSIONS: Incisional hernias expand during the period from the first assessment to actual hernia repair.


Assuntos
Herniorrafia/estatística & dados numéricos , Hérnia Incisional/diagnóstico por imagem , Medidas de Resultados Relatados pelo Paciente , Tempo para o Tratamento , Conduta Expectante/estatística & dados numéricos , Músculos Abdominais/diagnóstico por imagem , Músculos Abdominais/cirurgia , Idoso , Dinamarca , Progressão da Doença , Exercício Físico/fisiologia , Fáscia/diagnóstico por imagem , Feminino , Humanos , Hérnia Incisional/complicações , Hérnia Incisional/fisiopatologia , Hérnia Incisional/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia Computadorizada por Raios X
5.
Chirurgia (Bucur) ; 114(1): 12-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30830840

RESUMO

The purpose of our research is to synthesize the risk factors quoted in the literature which predispose to intra-abdominal hypertension occurrence following surgical repair of incisional hernias. We used for our research the Web of Science, Scopus and PubMed research platforms and we used the following search formula: (Intra-abdominal hypertension OR intra-abdominal pressure OR abdominal compartment syndrome) AND risk factors AND incisional hernia. The results were filtered according to the following criteria: language (English), publish year ( 2000) and access (in extenso). In this context, we chose to classify the risk factors for IAP increase in the following categories: (1) those related body habitus and anthropometry; (2) those associated with the presence of comorbidities; (3) those related to the defect of the abdominal wall; (4) those associated with the surgical management. Among the most important risk factors we mention: elevated BMI, chronic obstructive pulmonary disease, large incisional hernias with loss of domain, surgical technique used, prolonged surgeries and repeated attempts to close the defect.


Assuntos
Herniorrafia/efeitos adversos , Hérnia Incisional/cirurgia , Hipertensão Intra-Abdominal/etiologia , Humanos , Hérnia Incisional/complicações , Fatores de Risco
7.
J Med Imaging Radiat Oncol ; 63(1): 79-81, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30353980

RESUMO

The retroperitoneal space is made up of multiple communicating compartments. Here we detail an unusual case of ectopic gas almost exclusively isolated to the properitoneal space, a space in communication with the retroperitoneum. This case is a reminder that when extraperitoneal gas is identified, the retroperitoneal structures should be interrogated carefully to identify a cause.


Assuntos
Enfisema/diagnóstico por imagem , Gases , Complicações Pós-Operatórias/diagnóstico por imagem , Espaço Retroperitoneal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Enfisema/etiologia , Humanos , Hérnia Incisional/complicações , Hérnia Incisional/diagnóstico por imagem , Hérnia Incisional/cirurgia , Perfuração Intestinal/complicações , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Necrose
9.
Rev. cuba. cir ; 57(4): e606, oct.-dic. 2018. graf
Artigo em Espanhol | CUMED | ID: cum-73601

RESUMO

Las hernias incisionales son la complicación más común a largo plazo en las laparotomías con una incidencia hasta 20 por ciento. Se ha descrito la presencia de casi todos los órganos intrabdominales en el interior de una hernia. Presentamos el caso de un paciente con apendicitis aguda en una hernia incisional recidivante, su presentación clínica y una revisión de la literatura acerca de esta patología. Femenino de 75 años de edad presentó una hernia incisional recidivante estrangulada, se realizó una laparotomía exploradora, encontrando el apéndice cecal perforado. Se realizó la apendicectomía y una desbridación amplia de la piel y la grasa alrededor de la herida. Durante el internamiento se colocaron 4 sistemas de cicatrización asistida con presión negativa. Se tomó un injerto de espesor parcial del muslo izquierdo y se cubrió el defecto. Es importante estar consciente de las posibles complicaciones para determina la mejor estrategia en la cirugía(AU)


Incisional hernia is the most long-term common complication in laparotomies with an incidence rate up to 20 percent. The presence of almost all intra-abdominal organs inside a hernia has been described. Here is a 75 years-old female patient with acute appendicitis in a recurrent incisional hernia, its clinical presentation and the literature review about this pathology. This patient had strangulated recurrent incisional hernia and she underwent exploratory laparotomy to find perforated cecal appendix. Appendicectomy and extensive debridement of skin and fat around the wound were performed. During the hospitalization period, four negative pressure-assisted wound closure systems were placed. A partially thick graft was taken from the left thigh to cover the defect. It is important to be aware of the possible complications in order to determine the best surgical strategy(AU)


Assuntos
Humanos , Feminino , Idoso , Apendicectomia/métodos , Apendicite/cirurgia , Hérnia Incisional/complicações , Laparotomia/métodos , Literatura de Revisão como Assunto
10.
Rev. cuba. cir ; 57(4): e606, oct.-dic. 2018. graf
Artigo em Espanhol | LILACS | ID: biblio-991060

RESUMO

RESUMEN Las hernias incisionales son la complicación más común a largo plazo en las laparotomías con una incidencia hasta 20 por ciento. Se ha descrito la presencia de casi todos los órganos intrabdominales en el interior de una hernia. Presentamos el caso de un paciente con apendicitis aguda en una hernia incisional recidivante, su presentación clínica y una revisión de la literatura acerca de esta patología. Femenino de 75 años de edad presentó una hernia incisional recidivante estrangulada, se realizó una laparotomía exploradora, encontrando el apéndice cecal perforado. Se realizó la apendicectomía y una desbridación amplia de la piel y la grasa alrededor de la herida. Durante el internamiento se colocaron 4 sistemas de cicatrización asistida con presión negativa. Se tomó un injerto de espesor parcial del muslo izquierdo y se cubrió el defecto. Es importante estar consciente de las posibles complicaciones para determina la mejor estrategia en la cirugía(AU)


ABSTRACT Incisional hernia is the most long-term common complication in laparotomies with an incidence rate up to 20 percent. The presence of almost all intra-abdominal organs inside a hernia has been described. Here is a 75 years-old female patient with acute appendicitis in a recurrent incisional hernia, its clinical presentation and the literature review about this pathology. This patient had strangulated recurrent incisional hernia and she underwent exploratory laparotomy to find perforated cecal appendix. Appendicectomy and extensive debridement of skin and fat around the wound were performed. During the hospitalization period, four negative pressure-assisted wound closure systems were placed. A partially thick graft was taken from the left thigh to cover the defect. It is important to be aware of the possible complications in order to determine the best surgical strategy(AU)


Assuntos
Humanos , Feminino , Idoso , Apendicectomia/métodos , Apendicite/cirurgia , Hérnia Incisional/complicações , Laparotomia/métodos , Literatura de Revisão como Assunto
11.
Prog. obstet. ginecol. (Ed. impr.) ; 61(5): 487-490, sept.-oct. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-175084

RESUMO

La herniación de útero grávido es una complicación potencialmente grave que requiere una valoración multidisciplinar y control frecuente, ya que puede conllevar numerosas complicaciones obstétricas. Su manejo no está consensuado


Herniation of a pregnant uterus is a rare complication that requires multidisciplinary management to achieve a pregnancy to term without complications and optimal repair. Here we report a case of uterine hernia diagnosed in second trimester, its management and treatment


Assuntos
Humanos , Feminino , Gravidez , Hérnia Inguinal/complicações , Obesidade Mórbida/complicações , Hérnia Incisional/complicações , Complicações na Gravidez , Conduta Expectante , Resultado da Gravidez , Herniorrafia/métodos , Recesariana/métodos
13.
Surg Endosc ; 32(9): 3881-3889, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29492708

RESUMO

BACKGROUND: A considerable number of patients undergoing incisional hernia repair are on anticoagulant or antiplatelet therapy or have existing coagulopathy which may put them at higher risk for postoperative bleeding complications. Data about the optimal treatment of these patients are sparse. This analysis attempts to determine the rate of postoperative bleeding complications following incisional hernia repair and the consecutive rate of reoperation among patients with coagulopathy or receiving antiplatelet and anticoagulant therapy (higher risk group) compared to patients who do not have a higher risk (normal risk group). METHODS: Out of the 43,101 patients documented in the Herniamed Registry who had an incisional hernia repair, 6668 (15.5%) were on anticoagulant or antithrombotic therapy or had existing coagulopathy. The implication of that higher risk profile for onset of postoperative bleeding was investigated in multivariable analysis. Hence, other influential variables were identified. RESULTS: The rate of postoperative bleeding in the higher risk group was 3.9% (n = 261) and significantly higher compared to the normal risk group at 1.6% (n = 564) (OR 2.001 [1.699; 2.356]; p < 0.001). Additionally, male gender, use of drains, larger defect size, open incisional hernia repair, lower BMI, and higher ASA score significantly increased the risk of postoperative bleeding. The rate of reoperations due to postoperative bleeding was significantly increased in the higher risk group compared to the normal risk group (2.4 vs. 1.0%; OR 1.217 [1.071; 1.382]; p = 0.003). Likewise, the postoperative general complication rate (6.04 vs. 3.66%; p < 0.001) as well as the mortality rate (0.46 vs. 0.17%; p < 0.001) were significantly higher in the higher risk group. CONCLUSIONS: Patients with anticoagulant or antiplatelet therapy or existing coagulopathy who undergo incisional hernia repair have a significantly higher risk for onset of postoperative bleeding. The risk of bleeding complications and complication-related reoperations seems to be lower after laparoscopic intraperitoneal onlay mesh.


Assuntos
Anticoagulantes/farmacologia , Transtornos da Coagulação Sanguínea/complicações , Fibrinolíticos/farmacologia , Herniorrafia/efeitos adversos , Hérnia Incisional/cirurgia , Hemorragia Pós-Operatória/epidemiologia , Trombose/tratamento farmacológico , Idoso , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Hérnia Incisional/complicações , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Reoperação , Fatores de Risco , Suíça/epidemiologia , Trombose/complicações
14.
Medicine (Baltimore) ; 97(13): e0269, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29595689

RESUMO

RATIONALE: Internal hernia due to postoperative adhesions sometimes causes small bowel obstruction (SBO) and requires emergency surgery. The difficulties in the management of SBO with internal hernia include accurate diagnosis and estimation of its ischemic degree and of the risk of SBO recurrences following the surgical procedure. Laparoscopic surgery is a noninvasive to reduce postoperative adhesions and therefore has been widely used recently. However, surgeons often tend to hesitate in applying laparoscopic surgery for SBO because of some situational disadvantages such as poor operating space or iatrogenic bowel injury. Hence, laparoscopic surgery is still not yet the standard procedure for SBO caused by internal hernia. Thus, the establishment of an appropriate procedure for SBO due to internal hernia is required. PATIENT CONCERNS: We experienced 3 SBO cases caused by postoperative internal hernia. The first patient was a 59-year-old man who had temporary loop-ileostomy for a perforated sigmoid colon due to diverticulitis. Severe hypogastralgia and vomiting occurred suddenly on the 33rd postoperative day. The second patient was an 81-year-old man who had been hospitalized due to epigastralgia of unknown origin. He had a surgical history of omentum patching for a perforated duodenum 20 years ago. The third patient was a 72-year-old female who presented at our hospital after sudden and severe hypogastralgia. She had a surgical history of sigmoidectomy for her sigmoid colon cancer 22 years ago. DIAGNOSIS: A contrast computed tomography (CT) revealed a suspected closed loop obstruction of their bowels and immediate surgical treatments were required. INTERVENTION: We tried SPS using the surgical glove method as an initial approach for their SBO caused by postoperative internal hernia. OUTCOMES: Two of these 3 cases completely underwent SPS treatment, which afforded accurate diagnosis of SBO. Laparotomy following SPS, which allowed accurate diagnosis, was judged to be appropriate and was performed in the third case. All the patients were discharged without any complications and SBO have not recurred after their discharge. Finally, we established a new strategy using SPS for SBO with internal hernia. LESSONS: Our experience suggests that SPS is a promising strategy as an initial surgical approach for SBO with internal hernia.


Assuntos
Herniorrafia/métodos , Hérnia Incisional/complicações , Hérnia Incisional/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Laparoscopia/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
World J Surg ; 42(4): 974-980, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29018922

RESUMO

PURPOSE: Incisional hernia repair (IHR) with a mesh is necessary to achieve low recurrence rates and pain relief. In the short term, quality of life (QoL) is restored by IHR. Two centers pioneered the IHR in Sweden with the highly standardized Rives-Stoppa technique using a retromuscular mesh. We assessed long-term follow-up of recurrence rate and QoL. METHODS: Medical records were searched for IHRs performed from 1998 to 2006 and included living patients with midline repairs. Questionnaires about physical status, complaints, and QoL (SF-36) were mailed, offering a clinical examination. Assessment of medical records of later surgery was performed in 2015. RESULTS: Three hundred and one patients with midline incisional repairs were identified, and 217 accepted participation. Of these, 103 attended a clinical examination. Follow-up was 7 years until examination and 11 years to reassessment of medical records. In 26%, recurrent hernias were repaired. Postoperative complications were 26% Clavien-Dindo grade I-II and 1% grade III-IV. Mesh infections occurred in 1.4% without mesh removals, and 4% were reoperated because of complications. Overall recurrence rate was 8.1% and two-third of which were diagnosed at clinical examination. Recurrence after primary and recurrent hernia repair was 7.1 and 10.9%, respectively. Of all patients, 80% were satisfied; dissatisfaction was primarily caused by recurrence and chronic pain. SF-36 scores were 0.2 SD lower than the norm in all subscales, similar to those with 1-2 chronic conditions. CONCLUSIONS: Midline retromuscular mesh IHR has a low long-term recurrence rate even after recurrent repair. Patient satisfaction was high although QoL was reduced.


Assuntos
Hérnia Ventral/cirurgia , Herniorrafia/métodos , Hérnia Incisional/cirurgia , Qualidade de Vida , Idoso , Dor Crônica/etiologia , Feminino , Seguimentos , Hérnia Ventral/complicações , Herniorrafia/efeitos adversos , Humanos , Hérnia Incisional/complicações , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Recidiva , Reoperação , Telas Cirúrgicas/efeitos adversos , Inquéritos e Questionários , Fatores de Tempo
16.
Rev. guatemalteca cir ; 23(1): [41-47], ene-dic,2017.
Artigo em Espanhol | LILACS | ID: biblio-884886

RESUMO

Introducción. La hernia Incisional es una complicación frecuente de la cirugía abdominal sobre todo en pacientes que presentan factores de riesgo para desarrollar la misma. El sistema de salud pública no cuenta con suficiente encamamiento para estos pacientes para la realización de una cirugía electiva. La reparación laparoscópica y su aplicación en una unidad de cirugía ambulatoria se ha convertido en una opción para estos pacientes. El presente estudio busca evaluar los resultados de la reparación de la hernia incisional por vía laparoscópica y su aplicación en cirugía ambulatoria. Métodos. Se realizó un estudio retrospectvo de pacientes a quienes se le realizo reparación laparoscópica del año 2010 al año 2016, evaluando los factores de riesgo para la hernia incisional, el tamaño, su localización más frecuente, cierre del defecto, estancia hospitalaria, tiempo quirúrgico, malla utilizada, que tipo de analgésico se utilizaron a su egreso, sus complicaciones, su manejo y el seguimiento a los 8 días, 30 días y cada 2 meses durante un año. Resultados. Se incluyeron un total de 50 pacientes, siendo más frecuente en el sexo femenino. El principal factor de riesgo para el aparecimiento de la hernia incisional fue cirugías múltiples de origen obstétrico. La localización más frecuente fue la línea media infra umbilical. En 80% de los casos se realizó cierre por afrontación del defecto. En 100% de los casos se colocó malla separadora de tejido. El tiempo operatorio promedio fue de 70 minutos. El 75% de los pacientes fueron dados de alta el mismo día de la cirugía, el resto se ingresó al hospital, por condiciones de dolor post operatorio, complicaciones transoperatorias (2 casos) o reparación de un defecto grande (mayor de 15 centímetros). La mayor parte de los pacientes respondieron adecuadamente al uso de analgésicos por vía oral (75%), el resto se utilizó una combinación de dos analgésicos. Conclusiones. La técnica laparoscópica es una técnica adecuada y segura para la reparación de la hernia incisional aplicada en cirugía ambulatoria. Además, permite tratar a los pacientes que la sufren sin recargar la capacidad hospitalaria.


Introduction. Incisional hernia is a common abdominal surgical complication in patents with risk factors. Public hospitals don´t have enough beds to admit patents and perform the repair in an elecitve way, so ambulatory laparoscopic technique became a feasible alternative. The aim of the study is to evaluate our experience with ambulatory laparoscopic incisional hernioplasty. Methods. This retrospective study includes all the patents that presented an incisional hernia and were repaired by ambulatory laparoscopic hernioplasty between 2010 and 2016. We evaluated the presence of risk factors, the size of the hernia defect and location, the type of closure, operative time, type of mesh, length of hospitalization, analgesic treatment and management of complications. Results. We treated 50 patents. The main risk factor for incisional hernia was multiple gynecological surgeries. The most common site was at the infraumbilical medial line. In 80% of the patents we performed a complete defect closure. In all patents we used a two layer mesh. The mean operative time was 70 minutes. 75% of patents were discharged the same day and the rest of the patents were hospitalized because of uncontrolled pain, perioperative complications (2 cases) or extensive defects (above 15 centimeters in diameter). 75% of patents needed one analgesic and the rest a combination of two. Conclusions. Laparoscopic incisional hernioplasty can be safely performed in an ambulatory program and reduce the need of hospitalization.


Assuntos
Humanos , Masculino , Feminino , Abdome/cirurgia , Número de Leitos em Hospital , Hérnia Incisional/complicações , Laparoscopia/métodos , Estudos Retrospectivos
17.
BMJ Case Rep ; 20172017 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-28827432

RESUMO

The vermiform appendix (whether inflamed or not) within a hernia is very rare occurrence. We present the unprecedented case of a normal appendix found within a Pfannenstiel incisional hernia. A diagnostic laparoscopy was performed as appendicitis was suspected. However, the tip of a normal appendix was visualised within a previous Pfannenstiel incision. Laparoscopic appendicectomy was carried successfully and the patient was discharged. The patient later returned for a successful elective laparoscopic incisional hernia repair.


Assuntos
Apendicite/cirurgia , Apêndice/cirurgia , Hérnia Incisional/cirurgia , Apendicectomia/métodos , Apendicite/diagnóstico , Apêndice/anatomia & histologia , Apêndice/patologia , Diagnóstico Diferencial , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Hérnia Incisional/complicações , Hérnia Incisional/patologia , Laparoscopia/métodos , Pessoa de Meia-Idade , Resultado do Tratamento
18.
Gac méd espirit ; 19(2)May-Ago. 2017. ilus
Artigo em Espanhol | CUMED | ID: cum-69154

RESUMO

La hernia incisional es una complicación frecuente de la cirugía abdominal, se presenta entre el 2 al 20 por ciento de los pacientes laparotomizados. Entre sus complicaciones se describen la incarceración aguda, el atascamiento y la estrangulación. Objetivo: Describir el caso inusual de una paciente portadora de hernia incisional eviscerada. Reporte de caso: Anciana de 78 años, diabética tipo II, con vitíligo, hipertensión arterial controlada, presentó además hernia incisional voluminosa recidivada, la cual sufrió ruptura espontánea de pared y piel con evisceración. Fue tratada mediante hernioplastia con prótesis preperitoneal de polipropileno y cierre aponeurótico parcial. A los tres años de seguimiento posoperatorio los resultados fueron excelentes. Conclusiones: Es inusual esta complicación y se comparó con reportes similares que justifican y avalan la conducta asumida. La ruptura espontánea de la cubierta y piel de una hernia incisional recidivada y su evisceración a través del defecto es infrecuente, se le realizó hernioplastia protésica preperitoneal con favorables resultados posoperatorios(AU)


The incisional hernia is a frequent complication of the abdominal surgery; it is presented between the 2 to 20 percent of the patients with laparotomy. Among their complications they are described: Incarcerated hernia, blockage or obstruction and strangulation. Objective: To describe the unusual case of a patient carrier with an incisional hernia with evisceration. Case report: A 78 years old, aged woman, type II diabetic, with vitiligo, controlled hypertension, carrier of incisional hernia too, voluminous, recurrent, which suffered spontaneous rupture of wall and skin, with evisceration. She was treated by hernioplasty with a polypropylene preperitoneal prosthesis and partial aponeurotic closure. At three years post-operative follow-up the results were excellent. Conclusions: It is an unusual complication that is compared with similar reports that justify and support the assumed behavior. The spontaneous rupture of the cover and skin of a recurrent incisional hernia and its evisceration through the defect are uncommon, preperitoneal hernioplasty prosthesis with favorable postoperative results was performed(AU)


Assuntos
Humanos , Feminino , Idoso , Hérnia Abdominal/cirurgia , Hérnia Incisional/complicações , Hérnia Incisional/cirurgia , Cavidade Abdominal/cirurgia , Exenteração Pélvica
20.
Am J Surg ; 214(3): 468-473, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28693839

RESUMO

BACKGROUND: Incisional Hernia (IH) repair in patients with Inflammatory Bowel Disease (IBD) has not been well studied. METHODS: Outcomes of 170 patients with IBD who underwent IH repair were included in the study. RESULTS: The incidence of recurrence after IH repair in IBD is 27%. Patients with Crohn's disease (CD) had larger defects at the time of repair, higher proportion of bowel resection and a longer postoperative stay when compared to Ulcerative colitis (UC). The only significant predictor of recurrence after IH repair was the number of previous bowel resections prior to hernia repair (HR 1.59, p < 0.01). Three cases (10%) of late onset enterocutaneous fistulas were identified in patients who underwent IH repair with synthetic mesh inlay. CONCLUSION: Surgical repair results in a recurrence of IH in 27% of patients with IBD. The number of previous bowel resections is the only factor that correlates with development of recurrent IH in IBD.


Assuntos
Herniorrafia , Hérnia Incisional/complicações , Hérnia Incisional/cirurgia , Doenças Inflamatórias Intestinais/complicações , Procedimentos Cirúrgicos do Sistema Digestório , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Resultado do Tratamento
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