Spigelian hernia-Our experience

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 114-116
Author(s):  
Ajaz A Malik ◽  
Shams Ul Bari
Keyword(s):  
High Risk ◽  
Clinical Presentation ◽  
Spigelian Hernia ◽  
Abdominal Muscles ◽  
Medical College ◽  
Semilunar Line ◽  
Rare Hernia

Background; A Spigelian hernia is a very rare hernia which develops through the aponeurotic layer between the rectus abdominal muscles medially, and the semilunar line laterally. Aim: The aim of this study is to understand the clinical presentation and management of this rare hernia. Material and methods: This study was conducted over a period of five years in the Department of Surgery SKIMS Medical College Srinagar and included all the patients diagnosed as spigelian hernia. Results: During our study, we encountered only four cases of spigelian hernia, which included three females and one male. Conclusion: The spigelian hernia is a very rare hernia seen in adults and usually there is no notable swelling on examination. Although they are rare but there is a high risk of strangulation. JMS 2018: 21 (2):114-116

Spigelian Hernia: Surgical Anatomy, Embryology, and Technique of Repair

2006 ◽  
Vol 72 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Panagiotis N. Skandalakis ◽  
Odyseas Zoras ◽  
John E. Skandalakis ◽  
Petros Mirilas
Keyword(s):  
Rectus Muscle ◽  
Abdominal Muscle ◽  
Surgical Anatomy ◽  
Spigelian Hernia ◽  
Etiologic Factor ◽  
Abdominal Muscles ◽  
Line Defects ◽  
Semilunar Line ◽  
Neonates And Infants ◽  
Wide Zone

Spigelian hernia (1–2% of all hernias) is the protrusion of preperitoneal fat, peritoneal sac, or organ(s) through a congenital or acquired defect in the spigelian aponeurosis (i.e., the aponeurosis of the transverse abdominal muscle limited by the linea semilunaris laterally and the lateral edge of the rectus muscle medially). Mostly, these hernias lie in the “spigelian hernia belt,” a transverse 6-cm-wide zone above the interspinal plane; lower hernias are rare and should be differentiated from direct inguinal or supravescical hernias. Although named after Adriaan van der Spieghel, he only described the semilunar line (linea Spigeli) in 1645. Josef Klinkosch in 1764 first defined the spigelian hernia as a defect in the semilunar line. Defects in the aponeurosis of transverse abdominal muscle (mainly under the arcuate line and more often in obese individuals) have been considered as the principal etiologic factor. Pediatric cases, especially neonates and infants, are mostly congenital. Embryologically, spigelian hernias may represent the clinical outcome of weak areas in the continuation of aponeuroses of layered abdominal muscles as they develop separately in the mesenchyme of the somatopleura, originating from the invading and fusing myotomes. Traditionally, repair consists of open anterior herniorraphy, using direct muscle approximation, mesh, and prostheses. Laparoscopy, preferably a totally extraperitoneal procedure, or intraperitoneal when other surgical repairs are planned within the same procedure, is currently employed as an adjunct to diagnosis and treatment of spigelian hernias. Care must be taken not to create iatrogenic spigelian hernias when using laparoscopy trocars or classic drains in the spigelian aponeurosis.

scholarly journals Spigelian Hernia: A Rare Hernia With Peculiar Anatomy. (Case Report And Review Of Literature)

2019 ◽  
Vol 1 (5) ◽  
Author(s):  
Ketan Ramesh Vagholkar
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Treatment Options ◽  
Spigelian Hernia ◽  
Review Of Literature ◽  
Rare Type ◽  
Anatomical Basis ◽  
Diagnostic Modalities ◽  
Lateral Ventral Hernia ◽  
Rare Hernia

Background: Spigelian hernia best described as spontaneous lateral ventral hernia is an extremely rare type of hernia. The anatomical peculiarities and diagnostic challenges need to be understood in order to surgically mange this hernia. Introduction: Spigelian hernia occurs through a defect in the spigelian fascia typically lying in the spigelian zone. Case report: A case of a large incarcerated spigelian hernia is presented to highlight the diagnostic and anatomical peculiarities of this hernia. Discussion: The anatomical basis of this hernia along with clinical presentation, diagnostic modalities and treatment options is discussed. Conclusion: Clinical suspicion confirmed by imaging is necessary for diagnosis. Surgery is the mainstay of treatment.

scholarly journals Spigelian hernia

1970 ◽  
Vol 8 (2) ◽  
pp. 241-243 ◽  
Author(s):  
TP Bhatia ◽  
P Ghimire ◽  
ML Panhani
Keyword(s):  
High Risk ◽  
Spigelian Hernia ◽  
Rare Type ◽  
Prolene Mesh ◽  
Diffi Cult ◽  
History Of ◽  
Semilunar Line ◽  
History Of Pain ◽  
Lateral Ventral Hernia ◽  
Symptoms And Signs

A Spigelian hernia (or lateral ventral hernia) is a hernia through the spigelian fascia, which is the aponeurotic layer between the rectus abdominis muscle medially, and the semilunar line laterally. So far, about 1000 cases have been reported worldwide. These hernias are diffi cult to diagnose as they do not present with a subcutaneous swelling and have high risk of going for strangulation. We discuss the case of a 36 year old female who presented with history of pain and lumpiness in left lower abdomen, both of which decreased on lying down. She presented to emergency with an episode severe pain at same site which subsided spontaneously. Diagnosis was confirmed on C T scan, plication and onlay prolene mesh repair performed. Spigelian hernias are rare, interparietal type of hernias which have high risk undergoing strangulation. Knowledge of symptoms and signs is vital to diagnosis and treatment of these rare type of hernias. Key words: Spigelian hernia; Interparietal hernia; Rare hernias DOI: 10.3126/kumj.v8i2.3567 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 241-243

scholarly journals Clinical study of ectopic pregnancy

2017 ◽  
Vol 6 (8) ◽  
pp. 3498
Author(s):  
Meenakshi T. Chate ◽  
Bhagyashree Chate ◽  
Kranti Chate
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Public Health Issue ◽  
Common Symptom ◽  
Age Group ◽  
Common Site ◽  
Common Risk Factor ◽  
Medical College ◽  
Endometrial Cavity ◽  
Rising Incidence

Background: Ectopic pregnancy is pregnancy that develops following implantation anywhere other than the endometrial cavity of uterus. Objective of present study was to investigate the risk factors, clinical presentation and sites of ectopic pregnancy along with management and assessment of risk of maternal mortality and morbidity.Methods: The study was undertaken at Dr. Shankar Rao Chavhan Government Medical College and Guru Govind singhji hospital, Nanded between December 2012 and May 2014 after obtaining clearance from the Hospital Ethical Committee.Results: Maximum incidence of tubal gestation occurred between the age group of 21-25 years. Greater incidence was noted in multiparous woman. Tubectomy was the most common risk factor seen in 23.65% cases. The most common symptom observed is abdominal pain seen in 92.47% cases. The most common site of ectopic was ampulla seen in 51.61% cases. The most common mode of presentation was rupture seen in 71 cases about 76.35% cases. Unilateral salpingectomy was done in 70 cases about 75.26% cases.Conclusions: Since ectopic pregnancy remains a gynecological catastrophe in countries and a major challenge to the reproductive performance of women worldwide, it should be considered a relevant public health issue. With its rising incidence, which is likely to continue increasing because of the various factors discussed, it is necessary to devise means of early detection and treatment.

scholarly journals Epidural hematoma in newborn: literature review

2020 ◽  
pp. e402020
Author(s):  
Isabela do Prado Nascimento ◽  
Gabriela Ferreira Kalkmann ◽  
Leticia Adrielle Dos Santos ◽  
Letícia Novak Crestani ◽  
Carlos Umberto Pereira
Keyword(s):  
High Risk ◽  
Literature Review ◽  
Brain Damage ◽  
Epidural Hematoma ◽  
Clinical Presentation ◽  
Rapid Identification ◽  
Intracranial Hemorrhages ◽  
Neurological Sequelae ◽  
Type Of Delivery

Introduction: Newborn represent a population at high risk for brain damage. Intracranial hemorrhages in newborn are uncommon, and epidural hematoma (EH) is rare. Material and methods: The authors present a literature review about EH in newborn. Results: EH in newborn occurs in only 2% and is frequently associated with the type of delivery. The clinical presentation is asymptomatic or heterogeneous. The diagnosis is made from anamnesis and imaging exams, and the treatment depends on the size of the EH. Conclusion: The knowledge of neurosurgeons, obstetricians and pediatricians about the occurrence of EH in newborn is extremely important. The rapid identification and management of the case is of paramount importance, to reduce neurological sequelae.

scholarly journals Otomycosis, frequency, clinical features, predisposing factors and treatment implications

2020 ◽  
Vol 6 (4) ◽  
pp. 664
Author(s):  
Manjunath K. ◽  
Amardeep Singh ◽  
Manjunatha Rao S. V.
Keyword(s):  
Salicylic Acid ◽  
Antifungal Agents ◽  
Clinical Presentation ◽  
Predisposing Factors ◽  
Descriptive Statistics ◽  
Research Centre ◽  
Medical College ◽  
The Difference ◽  
Hospital Research

<p class="abstract"><strong>Background:</strong> The aim of this study was to determine the frequency of otomycosis, the clinical presentation, predisposing factors and treatment outcome.</p><p class="abstract"><strong>Methods:</strong> This observational study was conducted at ENT Department of Basaveshwara Medical College and Hospital, Research centre, Chitradurga from May 2018 to June 2019, 13 months study. There were 50 patients with documented diagnosis of otomycosis. There were 19 (38%) males and 31 (62%) females. The age of patients ranged from 3 years to 65 years with mean age of 32.5 years. Mean follow-up time was 1 year (~13 months). The frequency, predisposing factors and most common symptoms of otomycosis were recorded along with the response to different Antifungal agents were observed and results were recorded in percentages. Data were analysed using SPSS 12 software. Results are based on descriptive statistics.  </p><p class="abstract"><strong>Results:</strong> We prescribed 1% clotrimazole drops or lotion in 58% of patients and 2% salicylic acid in 31% cases. Both of these agents are effective. Topical 1% clotrimazole drops yielded highest resolution rate with lowest recurrent rate. To analyse the efficacy of 1% clotrimazole and 2% salicylic acid. We applied Z-test to calculate the difference between two proportions of patients before treatment with those patients who remained uncured after treatment.</p><p class="abstract"><strong>Conclusions:</strong> Otomycosis commonly prevented with hearing loss, pruritus, otalgia and otorrhoea. It usually resolves with local toilet of ear and installation of antifungal agents.</p>

scholarly journals Hepatitis B Awareness Among Medical Students And Their Vaccination Status In A Medical College In Western UP.

2019 ◽  
pp. 57-59
Author(s):  
Rajni Dawar ◽  
Tabassum Yasmin ◽  
Ajay Kumar Jha
Keyword(s):  
Medical Students ◽  
High Risk ◽  
Data Collection ◽  
Hepatitis B ◽  
Health Care Professionals ◽  
Hepatitis B Surface Antigen ◽  
Vaccination Status ◽  
Hepatitis B Vaccination ◽  
Universal Precautions ◽  
Medical College

Background: India is in the intermediate hepatitis B virus endemicity zone with hepatitis B surface antigen prevalence among the general population ranging from 2% to 8%.Health care professionals are at a high risk of getting .Hep B infection which can be prevented by strategies like vaccination, increasing awareness and following universal precautions. The present study was conducted on medical students (3rd Semester) to evaluate their knowledge regarding HBV and to know their vaccination status. Also along with data collection, students were educated about hepatitis B vaccine and about universal precautions before they start with their clinical postings. Methods: Cross sectional study was carried out on 3rd semester MBBS students (batch 2012-2013). All the students present on the day of data collection were included in the study and interviewed using pretested questionnaire. Data was analyzed using percentages. Results: Most of the students had good knowledge about disease and modes of transmission & prevention. Surprisingly only 56.6 percent were aware of high risk of transmission to health professional and doctors. Main source of information was media (85.4percent).Nearly 82% of the students were immunized and main reason among those unimmunized was unawareness about vaccine availability. Conclusions: It is recommended that Hepatitis B vaccination should be made available for all unimmunized students who enter medical profession. The orientation and sensitization programm should be held to create awareness regarding HBV infection preferably at the time of admission into medical college ,else no later than start of their clinical posting.

scholarly journals Management of Idiopathic Thrombocytopenic Purpura in Adult: A Review Article

2012 ◽  
Vol 2 (1) ◽  
pp. 24-28
Author(s):  
Mohammad Ferdous Ur Rahaman ◽  
Farzana Rahman ◽  
Mohammad Salman ◽  
Md. Abdul Kader ◽  
Md. Abdul Kalam Azad
Keyword(s):  
Clinical Presentation ◽  
Protein A ◽  
Spontaneous Remission ◽  
Aminocaproic Acid ◽  
Review Article ◽  
Bleeding Complications ◽  
Medical College ◽  
Chronic Disorder ◽  
Insidious Onset ◽  
Epsilon Aminocaproic Acid

Idiopathic thrombocytopenic purpiira (ITP), also known as primary immune or autoimmune thmmbocytopenic purpura, is a common cause of thrombocytopenia and bleeding complications in children and adults. It mav be confused with other causes of thrombocvtopenia and is treated with agents that varv in efjicacv, toxicity, and cost. Clinical presentation very in children and adult. In children, ITP is usually an acute, self-limited disorder that resolves spontaneously: in adults, it is typically a chronic disorder with a more insidious onset. In about one third of adults with ITP, the condition is persistent and relatively resistant to most treatments .Available evidence suggests that only about 5% of adults with chronic ITP have spontaneous remission. The principal therapeutic options for ITP include glucocorticoids, intravenous immunoglobulin and splenectomy. Other treatments have been used for refractory cases; these include intravenous anti-Rh (D), azathioprine, cyclophosphamide, danazol, vinca alkaloids, ascorbic acid, colchicine, interferon-alpha, combination chemotherapy, protein A, immunoadsorption, cyclosporine, epsilon-aminocaproic acid, plasma exchange, and accessory splenectomy. Journal of Shaheed Suhrawardy Medical College Vol 2No.1 June 2010 page 24-28 DOI: http://dx.doi.org/10.3329/jssmc.v2i1.12348

scholarly journals Assessment of risk of developing diabetes using Indian diabetes risk score in the urban field practice area of Rajarajeswari Medical College and Hospital, Bangalore

2019 ◽  
Vol 7 (1) ◽  
pp. 170
Author(s):  
Nazia N. Shaik ◽  
Swapna M. Jaswanth ◽  
Shashikala Manjunatha
Keyword(s):  
At Risk ◽  
High Risk ◽  
Risk Score ◽  
Diabetes Risk ◽  
Low Risk ◽  
Risk Category ◽  
Moderate Risk ◽  
Medical College ◽  
Field Practice ◽  
Diabetes Risk Score

Background: Diabetes is one of the largest global health emergencies of the 21st century. As per International Federation of Diabetes some 425 million people worldwide are estimated to have diabetes. The prevalence is higher in urban versus rural (10.2% vs 6.9%). India had 72.9 million people living with diabetes of which, 57.9% remained undiagnosed as per the 2017 data. The objectives of the present study were to identify subjects who at risk of developing Diabetes by using Indian diabetes risk score (IDRS) in the Urban field practice area of Rajarajeswari Medical College and Hospital (RRMCH).Methods: A cross sectional study was conducted using a Standard questionnaire of IDRS on 150 individuals aged ≥20 years residing in the Urban field practice area of RRMCH. The subjects with score <30, 30-50, >or =60 were categorized as having low risk, moderate risk and high risk for developing diabetes type-2 respectively.Results: Out of total 150 participants, 36 (24%) were in high-risk category (IDRS≥60), the majority of participants 61 (41%) were in the moderate-risk category (IDRS 30–50) and 53 (35%) participants were found to be at low-risk (<30) for diabetes. Statistical significant asssociation was found between IDRS and gender, literacy status, body mass index (p<0.0000l).Conclusions: It is essential to implement IDRS which is a simple tool for identifying subjects who are at risk for developing diabetes so that proper intervention can be carried out at the earliest to reduce the burden of diabetes.

Clinical Presentation and Treatment of High-Risk Sarcoidosis

2021 ◽  
Author(s):  
David M. Perlman ◽  
Muthya Tejasvini Sudheendra ◽  
Yuka Furuya ◽  
Chetan Shenoy ◽  
Rajat Kalra ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Presentation
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