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1.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(1): 9-13, ene.-mar. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-187066

RESUMO

Las hernias intestinales a través de defectos en el ligamento ancho son un cuadro clínico poco frecuente y de difícil diagnóstico. La sospecha diagnóstica y el tratamiento precoz de esta entidad son de vital importancia. Su etiología está ampliamente relacionada con intervenciones quirúrgicas previas y traumatismos asociados a gestaciones y partos previos. Tanto la clínica como las determinaciones analíticas asociadas a esta patología son inespecíficas; siendo la tomografía axial computarizada la prueba de imagen complementaria de elección para el diagnóstico y valoración de la viabilidad de los órganos afectados herniados. Históricamente la resolución de las hernias se asociaba al abordaje laparotómico. Hoy en día sabemos que las vías de abordaje mínimamente invasivas, como la laparoscópica, son factibles, y deben ser la primera elección, pudiendo además aportar beneficios en términos de recuperación y postoperatorio favorable. Presentamos el caso clínico de una hernia interna de intestino delgado a través de un defecto del ligamento ancho izquierdo, en una paciente sin antecedentes quirúrgicos ni traumáticos previos, cuyo diagnóstico y resolución requirió de la realización de una laparotomía exploradora


Intestinal hernias through the broad ligament are a rare entity and difficult to diagnose. The diagnostic suspicion and early treatment are of vital importance. Its aetiology is widely associated with previous surgical interventions and trauma associated with previous pregnancies and deliveries. Both the clinical and the analytical tests associated with this entity are non-specific. Computed axial tomography is the complementary imaging test of choice for the diagnosis and assessment of the viability of the organs involved in the hernia. Historically, the resolution of hernias was associated with the laparotomy approach. Nowadays, it is known that the use of the minimum invasion by laparoscopy is feasible, and should be of first choice, and may also provide benefits in recovery and a more favourable post-operative period. A clinical case is presented of an internal hernia of the small intestine, through a defect of the left broad ligament, in a patient with no prior surgical or traumatic history, in which the diagnosis and resolution of the condition involved the performing of an exploratory laparotomy


Assuntos
Humanos , Feminino , Adulto , Intestino Delgado/patologia , Hérnia/complicações , Ligamento Largo/anormalidades , Obstrução Intestinal/etiologia , Hérnia/etiologia , Obstrução Intestinal/complicações , Laparoscopia , Ultrassonografia , Hérnia/diagnóstico por imagem , Herniorrafia , Apendicectomia , Diagnóstico Diferencial , Dor Abdominal/etiologia
3.
J. coloproctol. (Rio J., Impr.) ; 39(3): 288-296, June-Sept. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1040323

RESUMO

ABSTRACT Introduction: The development of internal hernias due to the mesocolon defect after laparoscopic colectomy is a rare complication with only 39 cases described. There are controversies whether the closure of the defect of the mesocolon after resection of the colon could prevent the development of this complication. Objective: To describe a case of intestinal obstruction due to internal hernia through the mesocolon defect after laparoscopic rectosigmoidectomy and to perform a literature review. Case report: A 59-year-old woman was hospitalized for laparoscopic rectosigmoidectomy due to an adenocarcinoma located in the rectosigmoid junction. She underwent a rectosigmoidectomy by laparoscopy, with an extracorporeal mechanical anastomosis, without closure of the mesocolon defect. In the fifth postoperative day the patient presented an intestinal obstruction due to an internal hernia through the mesocolon defect confirmed by computerized tomography. During the exploratory laparotomy approximately 120 cm jejunum was identified through the mesocolon defect. The reduction of herniated small bowel was done without the need of intestinal resection. The mesocolon defect was corrected by continuous suture. After the reoperation, the patient presented a favorable recovery being discharged on the fifth day. Conclusion: Intestinal obstruction due to internal hernia after laparoscopic rectosigmoidectomy is a rare postoperative complication that can be avoided by the adequate closure of the mesocolon defect.


RESUMO Introdução: O desenvolvimento de hérnias internas pelo defeito mesocólico após a realização de colectomia laparoscópica é uma complicação rara com apenas 39 casos descritos. Existem controvérsias se fechamento do defeito após a ressecção do cólon preveniria o desenvolvimento desta complicação. Objetivo: Descrever um caso de obstrução intestinal por hérnia interna pelo defeito mesocólico, após retossigmoidectomia laparoscópica e revisar a literatura relacionada ao tema. Relato do caso: Mulher, 59 anos foi internada para realizar ressecção cirúrgica de adenocarcinoma localizado na junção retossigmoideana. Foi submetida à retossigmoidectomia laparoscópica, com confecção de anastomose mecânica extracorpórea. O defeito mesocólico não foi corrigido no final do procedimento. No quinto dia de pós-operatório, a doente apresentou quadro de obstrução intestinal cuja tomografia computadorizada identificou presença de hérnia interna pelo defeito do mesocólon. Na laparotomia exploradora identificou-se que aproximadamente 120 cm de alças jejunais estavam herniadas através do defeito mesocólico. Realizou-se a redução do intestino delgado herniado sem necessidade de ressecção intestinal. O defeito foi corrigido por sutura contínua. Após a reoperação a doente apresentou evolução favorável recebendo alta no quinto dia. Conclusão: Obstrução intestinal após retossigmoidectomia laparoscópica consequente à formação de hérnia interna é complicação pós-operatória rara, com alta mortalidade, que pode ser evitada pelo fechamento criterioso do defeito do mesocólico.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Adenocarcinoma , Neoplasias do Colo , Hérnia/complicações , Obstrução Intestinal , Laparoscopia , Colectomia , Mesocolo
4.
Am Surg ; 85(7): 738-741, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31405419

RESUMO

Parastomal hernias (PHs) frequently complicate enterostomy creation. Decision for PH repair (PHR) is driven by patient symptoms due to the frequency of complications and recurrences. The European Hernia Society (EHS) PH classification is based on the PH defect size and the presence/absence of concomitant incisional hernia. The aim of this study was to evaluate PHR outcomes based on EHS classification. An Institutional Review Board-approved retrospective review of a prospective database between 2009 and 2017 was performed. Patient demographics, enterostomy type, EHS classification, operative technique, and clinical outcomes (postoperative complications, 30-day readmission, and PH recurrence) were obtained. Cases were analyzed by EHS classifications I and II (SmallPH) versus III and IV (LargePH). Sixty-two patients underwent PHR (35: SmallPH, 27: LargePH). Patient groups (SmallPH vs LargePH) were similar based on American Society of Anesthesiologists Class III and obesity. Hernia recurrence was seen in 26 per cent of repairs with no difference between groups. The median recurrence-free survival was 3.9 years. There was no difference in superficial SSI, deep SSI, nonwound complications, or readmission between SmallPH and LargePH. Both small and large PHs experience similar outcomes after repair. Strategies to improve outcomes should be developed and implemented universally across all EHS PH classes.


Assuntos
Hérnia , Herniorrafia , Adulto , Idoso , Intervalo Livre de Doença , Feminino , Hérnia/complicações , Hérnia/diagnóstico , Herniorrafia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Recidiva , Estudos Retrospectivos
5.
BMJ Case Rep ; 12(8)2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31466984

RESUMO

Internal herniation through congenital sigmoid mesocolic defect as a cause of neonatal intestinal obstruction is rarely reported. Clinical judgement combined with judicious use of investigations and prompt exploration is essential to provide immediate relief of the obstruction and salvage the herniated loop of bowel, which otherwise might lead to morbidity and even death. We present a neonate with internal herniation of the ileum through a congenital mesocolic defect which was diagnosed by a prompt abdominal exploration in view of persistent clinical signs of intestinal obstruction. The relevant literature is also discussed highlighting the rarity of neonatal presentation of sigmoid mesocolic defect.


Assuntos
Hérnia/complicações , Obstrução Intestinal/etiologia , Mesocolo/anormalidades , Doenças do Colo Sigmoide/congênito , Diagnóstico Diferencial , Humanos , Íleo/patologia , Recém-Nascido , Doenças do Recém-Nascido , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Laparotomia/métodos , Masculino , Doenças do Colo Sigmoide/complicações , Resultado do Tratamento , Ultrassonografia/métodos
6.
J Surg Res ; 244: 181-188, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299434

RESUMO

BACKGROUND: Hernias are one of the most commonly encountered surgical conditions, and every year, more than 20 million hernia repairs are performed worldwide. The surgical management of hernia, however, is largely neglected as a public health priority in developing countries, despite its cost-effectiveness. To date, the prevalence and impact of hernia have not been formally studied in a community setting in Cameroon. The aim of this study was to determine the prevalence and characteristics of untreated hernia in the Southwest region of Cameroon. METHODS: This study was a subanalysis of a cross-sectional community-based survey on injury in Southwest Cameroon. Households were sampled using a three-stage cluster sampling method. Household representatives reported all untreated hernias occurring in the past year. Data on socioeconomic factors, hernia symptoms, including the presence of hernia incarceration, and treatment attempts were collected between January 2017 and March 2017. RESULTS: Among 8065 participants, 73 persons reported symptoms of untreated hernia, resulting in an overall prevalence of 7.4 cases per 1000 persons (95% confidence limit 4.98-11.11). Groin hernias were most commonly reported (n = 49, 67.1%) and predominant in young adult males. More than half of persons with untreated hernia (56.7%) reported having symptoms of incarceration, yet 42.1% (n = 16) of these participants did not receive any surgical treatment. Moreover, 21.9% of participants with untreated hernias never presented to formal medical care, primarily because of the high-perceived cost of care. Untreated hernias caused considerable disability, as 21.9% of participants were unable to work because of their symptoms, and 15.1% of households earned less money. CONCLUSIONS: Hernia is a significant surgical problem in Southwest Cameroon. Despite over half of those with unrepaired hernias reporting symptoms of incarceration, home treatment and nonsurgical management were common. Costs associated with formal medical services are a major barrier to obtaining consultation and repair. Greater awareness of hernia complications and cost restructuring should be considered to prevent disability and mortality due to hernia.


Assuntos
Efeitos Psicossociais da Doença , Hérnia/epidemiologia , Adolescente , Adulto , Fatores Etários , Camarões/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Avaliação da Deficiência , Feminino , Virilha , Gastos em Saúde/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Hérnia/complicações , Hérnia/economia , Hérnia/terapia , Herniorrafia/economia , Herniorrafia/psicologia , Herniorrafia/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto , Prevalência , Fatores de Risco , Autocuidado/economia , Autocuidado/psicologia , Autocuidado/estatística & dados numéricos , Fatores Sexuais , Adulto Jovem
7.
Muscle Nerve ; 60(4): 428-433, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31325324

RESUMO

BACKGROUND: Muscle herniation is a muscle protrusion through a fascial defect. It is a rarely reported cause of nerve entrapment. METHODS: We present a case of superficial fibular (peroneal) neuropathy associated with a fibularis (peroneus) brevis muscle herniation and a review of the literature on nerve entrapments secondary to muscle herniation unrelated to compartment syndrome. RESULTS: Eleven cases of nerve entrapments secondary to muscle herniation were identified. The superficial fibular nerve (SFN) was the most commonly entrapped nerve by fibularis muscle herniation. Patients presented with pain, numbness, or paresthesias, and an often tender, small palpable mass with a Tinel sign. Muscle MRI or ultrasound identified the lesion, and patients responded well to fasciotomy. CONCLUSIONS: The most commonly reported nerve entrapped by muscle herniation is the SFN secondary to fibularis muscle herniation. Characteristic clinical and imaging (MRI or ultrasound) features are diagnostic, and there is a salutary response to fasciotomy.


Assuntos
Hérnia/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Síndromes de Compressão Nervosa/diagnóstico por imagem , Neuropatias Fibulares/diagnóstico , Adulto , Eletromiografia , Fasciotomia , Feminino , Hérnia/complicações , Humanos , Imagem por Ressonância Magnética , Síndromes de Compressão Nervosa/etiologia , Síndromes de Compressão Nervosa/cirurgia , Condução Nervosa , Neuropatias Fibulares/etiologia , Ultrassonografia
8.
World Neurosurg ; 129: 81-84, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31158530

RESUMO

BACKGROUND: Idiopathic spinal cord herniation is a rare condition that involves spinal cord herniation through a defect in the ventral dura. CASE DESCRIPTION: We present a case of a 61-year-old woman who initially presented in 2016 with an approximately 1-year history of burning right lower extremity pain and gait instability. Her neurologic examination was consistent with thoracic Brown-Sequard syndrome, and spinal magnetic resonance imaging showed a focal defect in the ventral dura at the superior aspect of T4 with the left aspect of the cord herniating into the defect. In 2018, she underwent a T3-T4 laminectomy with T3 pedicle take down and medial facetectomy, with reduction of the herniated cord. CONCLUSIONS: Idiopathic spinal cord herniation is an uncommon spinal cord disorder with a paucity of data reported. Our case report of a classic case of idiopathic spinal cord herniation presenting as Brown-Sequard syndrome and managed surgically will contribute to the data in this field.


Assuntos
Síndrome de Brown-Séquard/etiologia , Síndrome de Brown-Séquard/cirurgia , Hérnia/complicações , Doenças da Medula Espinal/etiologia , Doenças da Medula Espinal/cirurgia , Feminino , Hérnia/diagnóstico , Hérnia/patologia , Herniorrafia/métodos , Humanos , Pessoa de Meia-Idade
10.
BMJ Case Rep ; 12(4)2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31040145

RESUMO

We present a case of a 16-year-old girl with interruption of papyracea lamina and herniation of the periorbital fat covered by a bone shell. The patient presents with a history of diplopia and visual disturbances ever since she can remember. Thanks to radiological imaging and biopsy, we have done differential diagnosis with periorbital lipoma, intraosseous lipoma and intramuscular lipoma of medial rectus. Diagnostic for images is necessary for a correct operative planning. Endoscopic sinus surgery with computer-assisted navigation is the safest and most effective method to remove the lesion that was closely related to the medial rectum muscle and to the anterior ethmoidal artery. The patient after surgery and in 1 year of follow-up reports the disappearance of symptoms.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Diplopia/cirurgia , Endoscopia , Hérnia/diagnóstico por imagem , Doenças Orbitárias/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos , Tecido Adiposo/patologia , Tecido Adiposo/cirurgia , Adolescente , Diplopia/diagnóstico por imagem , Diplopia/etiologia , Diplopia/fisiopatologia , Endoscopia/métodos , Feminino , Hérnia/complicações , Humanos , Doenças Orbitárias/complicações , Doenças Orbitárias/diagnóstico por imagem , Doenças Orbitárias/patologia , Seios Paranasais , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
Acta Med Port ; 32(3): 240-243, 2019 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-30946797

RESUMO

Internal hernias are a rare cause of bowel obstruction (1%) and can be caused by broad ligament defects in 4% to 7% of the cases. These defects may be congenital or acquired and are classified according to its anatomical location. This paper reports three cases of small bowel obstruction by broad ligament hernia. The patients, three women aged from 35 to 51 years old, were admitted to the emergency department with small bowel obstruction. An exploratory laparotomy was performed during which an internal hernia through a broad ligament defect was identified. In all cases the hernia content was reduced and the defect closed. One of the patients required a segmental enterectomy. All patients had a favorable outcome. This paper aims to raise awareness about the broad ligament hernia as a cause of bowel obstruction, namely in middle-aged women with no surgical history.


Assuntos
Ligamento Largo , Hérnia/complicações , Obstrução Intestinal/etiologia , Intestino Delgado , Adulto , Feminino , Humanos , Laparotomia , Pessoa de Meia-Idade
12.
World Neurosurg ; 126: 310-313, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30885870

RESUMO

BACKGROUND: Stiff neck or nuchal rigidity is a significant clinical sign of neurologic disease. It is commonly associated with meningitis, subarachnoid hemorrhage, and posterior fossa tumors. It may also occur as a result of tonsillar impaction following pressure in the infratentorial compartment from an expanding posterior fossa mass. It is, however, not commonly known to be associated with uncal herniation. CASE DESCRIPTION: We report a recent experience on this association. CONCLUSIONS: In the presence of stiff neck or nuchal rigidity in a patient with clinical signs of uncal herniation from a temporal arachnoid cyst, this unusual association could possibly be owing to the effect of increased pressure in the posterior fossa from massive shift of brain tissue posteriorly following a rapid rise in middle cranial fossa pressure consequent on an acute enlargement of the cyst. A false impression of acute meningeal irritation in such a situation could be quite misleading, resulting in late diagnosis and subsequently a delay in timely intervention.


Assuntos
Cistos Aracnóideos/complicações , Hérnia/complicações , Rigidez Muscular/complicações , Cistos Aracnóideos/patologia , Cistos Aracnóideos/cirurgia , Fossa Craniana Média/patologia , Fossa Craniana Posterior/patologia , Hérnia/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Lobo Temporal/patologia , Resultado do Tratamento
14.
World J Surg ; 43(2): 415-424, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30229382

RESUMO

BACKGROUND: The objective of this study is to explore the association between frailty and surgical recovery over a 6-month period, in elderly patients undergoing elective abdominal surgery. METHODS: A total of 144 patients were categorized as frail, pre-frail, and non-frail based on five criteria: weight loss, exhaustion, weakness, slowness, and low activity. Recovery to preoperative functional status (activities of daily living (ADL) and instrumental activities of daily living (IADL)), cognition, quality of life, and mental health was assessed at 1, 3, and 6 months postoperatively. A repeated measure logistic regression was used to analyze the effect of frailty on recovery over time. The effect of frailty on hospitalization outcomes was also evaluated. RESULTS: Mean age was 78 ± 5 years with 17.4% of patients categorized as frail, 60.4% pre-frail, and 22.2% non-frail. At 6 months, the percent of patients who had recovered to preoperative values were: ADL 90%; IADL 76%; cognition 75.5%; mental health 66%; and quality of life 70%. While more frail patients experienced adverse hospitalization outcomes and fewer had recovered to preoperative functional status, these differences were not found to be statistically significant. Overall, frailty status was not significantly associated with the trajectory of recovery or hospitalization outcomes. CONCLUSION: Strong, institutional commitment to quality surgical care, as well as appropriate strategies for older patients, may have mitigated the impact of frailty on recovery. Further research is needed to examine the role of frailty in the surgical recovery process.


Assuntos
Abdome/cirurgia , Doenças do Sistema Digestório/cirurgia , Procedimentos Cirúrgicos Eletivos/reabilitação , Fragilidade/complicações , Hérnia/complicações , Herniorrafia/reabilitação , Atividades Cotidianas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Convalescença , Doenças do Sistema Digestório/complicações , Doenças do Sistema Digestório/reabilitação , Feminino , Avaliação Geriátrica , Humanos , Masculino , Período Pós-Operatório , Indicadores de Qualidade em Assistência à Saúde , Qualidade de Vida , Recuperação de Função Fisiológica
15.
Urology ; 124: e1-e3, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30472257

RESUMO

Diaphragmatic herniations of the ureter are a rare occurrence overall, with fewer than 10 cases reported. Obstructing nephrolithiasis in the setting of diaphragmatic ureteral herniation has sparsely been documented. Management options to consider include ureteroscopy and laser lithotripsy to alleviate obstruction in herniated ureters. The abnormal path of the ureter and surrounding structures pose unique risks that require careful attention and a high level of operator skill. We present imaging of an 84-year-old woman incidentally found to have right ureteral herniation through the diaphragm with an obstructing 8 mm stone in the right proximal ureter with moderate hydronephrosis.


Assuntos
Hérnia Diafragmática/complicações , Hérnia/complicações , Nefrolitíase/complicações , Obstrução Ureteral/etiologia , Idoso de 80 Anos ou mais , Feminino , Hérnia/diagnóstico por imagem , Hérnia Diafragmática/diagnóstico por imagem , Humanos , Nefrolitíase/diagnóstico por imagem , Doenças Ureterais/complicações , Doenças Ureterais/tratamento farmacológico , Obstrução Ureteral/diagnóstico por imagem
16.
Asian J Endosc Surg ; 12(2): 189-191, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29882384

RESUMO

A 74-year-old man presented at our hospital with complaints of abdominal pain, nausea, and vomiting. He had undergone laparoscopic radical cystectomy and ileal conduit for urinary bladder cancer 1 month earlier. The patient had abdominal distention, resonant sounds on percussion, and diffuse abdominal tenderness without rebound or guarding. Abdominal CT revealed dilated jejunal loops herniated through a cord-like structure. Based on these findings, emergency surgery was performed, and intestinal dilatation into the space between the ureter, the ileal conduit, and the sacral bone was detected. The loops were released manually and were not resected. To the best of our knowledge, this is the first case report of small bowel obstruction due to internal hernia caused by the ureter after laparoscopic radical cystectomy and ileal conduit. Retroperitonealization and the minimum required mobilization of the ureters may be necessary when urinary diversion is constructed, especially in laparoscopic or robotic surgeries.


Assuntos
Hérnia/complicações , Obstrução Intestinal/cirurgia , Intestino Delgado , Complicações Pós-Operatórias/cirurgia , Ureter , Derivação Urinária , Idoso , Cistectomia , Humanos , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Laparoscopia , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/cirurgia
17.
J Radiol Case Rep ; 13(11): 10-17, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32190181

RESUMO

Muscle hernias of the extremities most commonly occur in the leg, between the knee and ankle. Symptomatic muscle hernias in the leg are rare cause of chronic leg pain and neuropathy, and not routinely encountered in surgical practice. Although this condition is especially an esthetic problem, with palpable subcutaneous soft tissue mass, it can lead to spontaneous pain, cramp, local tenderness or potentially neuropathic symptoms. Moreover, among leg muscles involved in this process, peroneus brevis is less frequent than tibialis anterior. Magnetic Resonance Imaging is the method of choice in establishing the diagnosis. Symptomatic cases can be treated surgically in different ways, the preferred one is nerve releasing with fasciotomy. The purpose of this case report is to present the Magnetic Resonance findings of a superficial nerve compression due to a peroneus brevis muscle herniation.


Assuntos
Hérnia/diagnóstico por imagem , Doenças Musculares/diagnóstico por imagem , Síndromes de Compressão Nervosa/etiologia , Neuropatias Fibulares/etiologia , Feminino , Hérnia/complicações , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Doenças Musculares/complicações
19.
Tunis Med ; 96(6): 393-396, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30430480

RESUMO

Gastric volvulus is an abnormal rotation of the stomach around his axis. The chronic presenting, as the acute one, is considered as a surgical emergency. We report 4 cases of chronic gastic volvulus. In 2 cases, it was a mesenterico-axial volvulus while in the 2 other cases it was an organo-axial volvulus. The barium enema made the diagnosis in all cases. The volvulus was secondary to a hernia in 3 cases and an agenesis of left diaphragmatic dome with ligament laxity in 1 case. All the patients underwent surgery. The laparoscopic approach was used in two patients.


Assuntos
Enema Opaco/métodos , Laparoscopia/métodos , Volvo Gástrico/diagnóstico , Adulto , Idoso , Doença Crônica , Feminino , Hérnia/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Volvo Gástrico/etiologia , Volvo Gástrico/cirurgia
20.
Ear Nose Throat J ; 97(9): E23-27, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30273438

RESUMO

In this article we report the case of a 41-year-old man with bilateral aural fullness and hearing loss. On examination he was found to have bilateral, dehiscent anterior canal walls with herniation of the mandibular condyle. This herniation partially obstructed the canals and contributed to his symptoms. To the best of our knowledge, this is only the third reported case of bilateral spontaneous temporomandibular joint herniation, and only 28 cases of unilateral spontaneous herniation can be found in the English language literature. While it is a rare phenomenon, it should be considered when evaluating a patient with fluctuating ear symptoms.


Assuntos
Perda Auditiva/diagnóstico , Hérnia/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Adulto , Diagnóstico Diferencial , Perda Auditiva/etiologia , Hérnia/complicações , Humanos , Masculino , Côndilo Mandibular , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/complicações
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