scholarly journals Laparoscopic Repair of a Large Paraesophageal Hernia with Migration of the Stomach into the Mediastinum Creating an Upside-Down Stomach

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Nasser Sakran ◽  
Hadar Nevo ◽  
Ron Dar ◽  
Asnat Raziel ◽  
Dan Hershko
Keyword(s):  
Laparoscopic Repair ◽  
Paraesophageal Hernia ◽  
Elective Surgery ◽  
Abdominal Cavity ◽  
Posterior Mediastinum ◽  
Closure Device ◽  
Rare Type ◽  
Hernia Sac ◽  
Asymptomatic Patients ◽  
Large Paraesophageal Hernia

Upside-down stomach is a relatively rare type of a large paraesophageal hernia characterized by the migration of the stomach into the posterior mediastinum. Upside-down stomach is prone to severe complications and therefore surgery is recommended even in asymptomatic patients. A 62-year-old male presented with frequent abdominal pain with nausea and vomiting that persisted for one year. The patient was obese with fatty liver and was treated medically for gastroesophageal reflux disease (GERD) for 4 years. On upper gastrointestinal CT study a level-IV paraesophageal hernia was detected with upside-down stomach, and he was referred for elective surgery. Laparoscopic surgery included reduction of the stomach into the abdominal cavity followed by dissection of the paraesophageal membrane and hernia sac. The hiatal defect was closed using a wound closure device and nonabsorbable sutures. The defect closure was reinforced using Physiomesh tucked anteriorly and sutured posteriorly to the diaphragm. Follow-up was uneventful and the patient is free of complaints. The results of this surgical intervention support previous reports that laparoscopic repair with the use of biological mesh in the setting of large paraesophageal hernia should be favorably considered.

Laparoscopic repair of large paraesophageal hernia is associated with a low incidence of recurrence and reoperation

2004 ◽  
Vol 18 (3) ◽  
pp. 444-447 ◽  
Author(s):  
J. J. Andujar ◽  
P. K. Papasavas ◽  
T. Birdas ◽  
J. Robke ◽  
Y. Raftopoulos ◽  
...  
Keyword(s):  
Laparoscopic Repair ◽  
Paraesophageal Hernia ◽  
Low Incidence ◽  
Large Paraesophageal Hernia

scholarly journals Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoki Enomoto ◽  
Kazuhiko Yamada ◽  
Daiki Kato ◽  
Shusuke Yagi ◽  
Hitomi Wake ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Abdominal Cavity ◽  
Three Dimensional ◽  
Simulation Software ◽  
3D Simulation ◽  
Diaphragmatic Defect ◽  
Intestinal Malrotation ◽  
Intestinal Loop ◽  
Bochdalek Hernia ◽  
The Right

Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.

Minimally Invasive Esophageal Procedures

2020 ◽  
Author(s):  
Jon O. Wee
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Minimally Invasive ◽  
Reflux Disease ◽  
Paraesophageal Hernia ◽  
Nissen Fundoplication ◽  
Gastroesophageal Junction ◽  
Outcome Evaluation ◽  
Barrett Esophagus ◽  
Asymptomatic Patients

In most instances, laparoscopy has replaced open procedures as the standard of care. Nevertheless, equipoise remains in the literature regarding the benefits of surgery compared with alternative treatment strategies such as medications in the case of gastroesophageal reflux disease (GERD) or endoscopic procedures in the case of achalasia. According to Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guidelines published in 2010, indications for surgery include (1) failure of medical management, (2) patient preference, (3) complications of GERD (Barrett esophagus, peptic stricture), and (4) extraesophageal manifestations (asthma, hoarseness, cough, chest pain, aspiration). This chapter is organized by surgical procedure, all of which are derivatives of the laparoscopic Nissen fundoplication. In this chapter, the authors focus on minimally invasive surgical approaches to the treatment of the following benign esophageal disorders: GERD, achalasia, and paraesophageal hernias. New in this chapter is the in-depth coverage of laparoscopic paraesophageal hernia repair. The majority of patients with paraesophageal hernias are asymptomatic, and their hernias are found incidentally with a retrocardiac gastric bubble on an upright chest x-ray or herniated gastroesophageal junction seen on a chest or abdominal computed tomographic scan. For patients who are symptomatic, surgical repair is indicated as there is no medical treatment for this mechanical problem. For asymptomatic patients, clinical judgment needs to be used. All surgical procedures are covered by preoperative evaluation, operative planning, and operative technique, with a troubleshooting note for every step. Procedure complications, postoperative care, and outcome evaluation follow each procedure, listing the most current reports and data. This review contains 10 figures, 9 tables and 49 references Keywords: Minimally invasive surgery, esophagectomy, myotomy, gastroesophageal reflux disease, Barrett esophagus, Nissen fundoplication, fundoplication, paraesophageal hernia

A SCROTAL ABDOMEN IN AN ELDERLY PATIENT MANAGED BY HERNIOPLASTY WITHOUT DEBULKING OF THE HERNIA CONTENTS: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
pp. 15-17
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Piyas Sengupta ◽  
Tuhinsubhra Manda
Keyword(s):  
Elderly Patient ◽  
Abdominal Cavity ◽  
Wound Dehiscence ◽  
Uneventful Recovery ◽  
General Surgeon ◽  
Respiratory Compromise ◽  
Hernia Sac ◽  
Long Duration ◽  
Giant Inguinoscrotal Hernia ◽  
Mesh Hernioplasty

Background: Scrotal abdomen is not a common today, but most challenging case even in experienced general surgeon, as there is no standard surgical procedure. They present as a huge inguinoscrotal swelling for a longstanding, neglected to treatment, because fear of operative intervention and remote places where medical service is inadequate. The morbidity and mortality also high because of forced reduction of the herniated viscera to the abdominal cavity, which is accustomed to being relatively empty for long duration, may cause alteration in the intra-abdominal and intra-thoracic pressures, leading to complications such as ACS, precipitation of cardiovascular or respiratory compromise, hernia recurrence and wound dehiscence . We present this ca Case presentation: se of giant inguinoscrotal hernia of a 72 years old male who had difculty in performing his daily activities. Patient underwent emergency mesh repair after reduction of content through inguinal approach. Giant inguinal hernia containing almost whole abdomen with terminal 50 cm ileum, caecum, appendix, ascending colon, hepatic exure of colon and transverse colon with omentum in the hernia sac and the patient had an uneventful recovery with eventual discharge on postoperative day 8. The giant inguinal hernias are uncommon in today's surgical Conclusion: practice. Management of which is challenging with grave complications but early intervention and postoperative monitoring to raised IAP and its complications which can save the patient. We report this case of an elderly patient with an acute presentation of scrotal abdomen with contents as both direct and indirect component which has been managed successfully with tension free open mesh hernioplasty and biological repair without debulking of the hernia contents and this case supported by a review of the literature.

scholarly journals De Garengeot’s hernia - a case of incarcerated femoral hernia with acute gangrenous appendicitis and literature review

2020 ◽  
Vol 73 (7-8) ◽  
pp. 239-244
Author(s):  
Veselin Stanisic ◽  
Miodrag Radunovic ◽  
Miljan Zindovic ◽  
Balsa Stanisic
Keyword(s):  
Literature Review ◽  
Femoral Hernia ◽  
Extensive Literature ◽  
Rare Type ◽  
Hernia Sac ◽  
Urgent Surgery ◽  
Gangrenous Appendicitis ◽  
Defect Repair ◽  
De Garengeot’S Hernia ◽  
Immediate Surgery

Introduction. De Garengeot?s hernia is a rare type of femoral hernia that contains the appendix within the hernia sac and it is found in 0.5-5% of cases. The incidence of appendicitis within the de Garengeot?s hernia is 0.08-0.13%. We present a case of de Garengeot?s hernia with a gangrenous appendicitis and an extensive literature review of published cases. Case Report. We present a case of a 68-year-old woman who underwent urgent surgery due to an incarcerated femoral hernia and preoperatively undiagnosed de Garengeot?s hernia with a gangrenous appendicitis within the femoral hernia sac. Conclusion. De Garengeot?s hernia is most commonly diagnosed intraoperatively and requires immediate surgery in order to avoid complications. There are no recommendations regarding the choice of surgical procedure for femoral defect repair.

scholarly journals Variations and management for patients with craniocervical junction arteriovenous fistulas: Comparison of dural, radicular, and epidural arteriovenous fistulas

2021 ◽  
Vol 12 ◽  
pp. 411
Author(s):  
Shunji Matsubara ◽  
Hiroyuki Toi ◽  
Hiroki Takai ◽  
Yuko Miyazaki ◽  
Keita Kinoshita ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Elective Surgery ◽  
Vascular Diseases ◽  
Craniocervical Junction ◽  
Vascular Lesions ◽  
Imaging Studies ◽  
Venous Reflux ◽  
Arteriovenous Fistulas ◽  
Asymptomatic Patients

Background: Craniocervical junction arteriovenous fistulas (CCJAVFs) are known to be rare, but variations and clinical behaviors remain controversial. Methods: A total of 11 CCJAVF patients (M: F=9:2, age 54–77 years) were investigated. Based on the radiological and intraoperative findings, they were categorized into three types: dural AVF (DAVF), radicular AVF (RAVF), and epidural AVF (EDAVF). Results: There were four symptomatic patients (subarachnoid hemorrhage in two, myelopathy in one, and tinnitus in one) and seven asymptomatic patients in whom coincidental CCJAVFs were discovered on imaging studies for other vascular diseases (arteriovenous malformation in one, intracranial DAVF in two, ruptured cerebral aneurysm in two, and carotid artery stenosis in two). Of these 11 patients, 2 (18.2%) had multiple CCJAVFs. Of 14 lesions, the diagnoses were DAVF in 5, RAVF in 3, and EDAVF in 6 (C1–C2 level ratio =5:0, 2:1, 3:3). Patients with DAVF/RAVF in four lesions with intradural venous reflux underwent surgery, although an RAVF remained in one lesion after embolization/radiation. Since all six EDAVFs, two DAVFs, and one RAVF had neither feeder aneurysms nor significant symptoms, no treatment was provided; of these nine lesions, one DAVF and one RAVF remained unchanged, whereas six EDAVFs showed spontaneous obliteration within a year. Unfortunately, however, one DAVF bled before elective surgery. Conclusion: CCJAVFs have many variations of shunting site, angioarchitecture, and multiplicity, and they were frequently associated with coincidental vascular lesions. For symptomatic DAVF/RAVF lesions with intradural drainage, surgery is preferred, whereas asymptomatic EDAVFs without dangerous drainage may obliterate during their natural course.

scholarly journals Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

2020 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen ◽  
Jun Wang
Keyword(s):  
Inguinal Hernia ◽  
Doppler Ultrasound ◽  
Vas Deferens ◽  
Abdominal Cavity ◽  
Undescended Testes ◽  
Processus Vaginalis ◽  
Hernia Sac ◽  
Patent Processus Vaginalis ◽  
Contralateral Patent Processus Vaginalis ◽  
Laparoscopic Orchiopexy

Abstract Background Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination. Conclusion Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

CHARGE syndrome in a fetus with a large paraesophageal hernia presenting prenatally as esophageal atresia

2014 ◽  
Vol 43 (6) ◽  
pp. 713-714 ◽  
Author(s):  
E. Tempfer-Bentz ◽  
R. B. Troebs ◽  
C. Sonntag ◽  
G. A. Rezniczek ◽  
C. Tempfer
Keyword(s):  
Esophageal Atresia ◽  
Paraesophageal Hernia ◽  
Charge Syndrome ◽  
Large Paraesophageal Hernia

The role of computed tomography in optimizing the surgical treatment of ventral hernias

2021 ◽  
Vol 29 (1) ◽  
pp. 70-77
Author(s):  
K. Yu. Parkhomenko ◽  
V. A. Vovk
Keyword(s):  
Computed Tomography ◽  
Ventral Hernia ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Spiral Computed Tomography ◽  
Spiral Computed ◽  
Chronic Appendicitis ◽  
Hernia Sac ◽  
Ventral Hernias ◽  
Preoperative Examination

In spite of a high informative value, spiral computed tomography is currently an additional optional examination and it is not included in domestic and foreign preoperative examination protocols. Purpose – assessing the feasibility of spiral computed tomography in the complex of presurgery examination of patients with ventral hernias. Materials and methods. The paper deals with analyzing the diagnostic findings of 35 patients with ventral hernias treated at Surgery Department of Municipal Non-Commercial Enterprise of Kharkiv Regional Council “Regional Clinical Hospital” during 2018–2019 period. All patients were operated on after compulsory and additional examinations according to the existing guidelines. Spiral computed tomography was an additional examination for all patients. The frequency of symptoms detected by means of computed tomography and confirmed during surgery was analyzed.  Results. Most of the signs revealed during tomography and associated with the combined abdominal pathology, were completely confirmed by laparoscopic exploration of the abdominal cavity and pelvis. Spiral computed tomography was of particular value in patients clinically diagnosed with chronic appendicitis. When assessing the ventral hernia, it was possible not only to clearly determine its content and location towards the abdominal line, but also, before surgery, to calculate the width and length of the hernia gate and the volume of the organs in hernia sac. Unlike ultrasonography, computed tomography makes it possible to thoroughly evaluate the dimensions of the hernia gate and the state of the muscular aponeurotic layer of the anterior abdominal wall. Not least important is diagnosing the combined abdominal pathology, including the oncological one, which has no clinical manifestations but still has to be exposed to surgery. Conclusions. In the complex of preoperative examination of patients with ventral hernias, spiral computed tomography provides useful information on the anatomical features of ventral hernia and the combined abdominal pathology that requires surgical intervention. These data aid in planning a favorable type of hernioplasty of ventral hernia and simultaneous surgery. Spiral computed tomography is recommended to be added to the standard protocol of presurgery examination of patients with ventral hernias.

scholarly journals Large paraesophageal hernia in elderly patients: Two case reports of laparoscopic posterior cruroplasty and anterior gastropexy

2019 ◽  
Vol 65 ◽  
pp. 189-192
Author(s):  
Wissam G. El Hajj Moussa ◽  
Simon E. Rizk ◽  
Nidal C. Assaker ◽  
Elias S. Makhoul ◽  
Elie H. Chelala
Keyword(s):  
Elderly Patients ◽  
Paraesophageal Hernia ◽  
Case Reports ◽  
Large Paraesophageal Hernia ◽  
Anterior Gastropexy
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