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Alary, Justine, Benoist Schaal, Gabriela Chotro, Bruno Patris, and Alexandra Destrez. "Mother’s scent for motherless neonates: Responses of artificially reared lambs to ewe’s inguinal wax odor." Applied Animal Behaviour Science 258 (January 2023): 105812. http://dx.doi.org/10.1016/j.applanim.2022.105812.
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Sihombing, Bob Fernando Maruba. "Karakteristik penderita hernia inguinalis yang di rawat inap pada Rumah Sakit Bayukarta Karawang periode 2022." Intisari Sains Medis 14, no. 2 (July 4, 2023): 576–79. http://dx.doi.org/10.15562/ism.v14i2.1733.
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Background: Inguinal hernia is when intra-abdominal fat or part of the small intestine protrudes through a weak area in the lower abdominal muscles. Emergency cases can occur if the inguinal hernia is strangulated (irreponible accompanied by an impaired passage) and incarcerated (irreponible accompanied by inadequate vascularization). This study aims to determine the characteristics of inguinal hernia patients hospitalized at Bayukarta Hospital, Karawang, in 2022. Methods: This descriptive study used a cross-sectional method with secondary data from medical records. The subjects studied were 90 inguinal hernia patients who were hospitalized. The variable assessed in this study was age (years), type of work, gender, classification of organ discharge, and classification of hernia characteristics. Data were analyzed using SPSS version 20.0 for Windows. Results: The results showed two age groups with the highest inguinal hernia were the age group 46-55 years and 56-65 years, with 20 people (22.2%) each; the most jobs were laborers, as many as 34 people (37.8 %), the majority of patients were men with 83 people (92.2%). Inguinal hernia lateralis dextra in 53 people (58.9 %) and inguinal hernia reponible in 75 people (83.3%). Conclusion: The characteristics of inguinal hernia patients hospitalized at Bayukarta Hospital, Karawang, in 2022 were age group 46-65 years, laborers, men, inguinal hernia lateralis dextra and inguinal hernia reponible. Latar Belakang: Hernia inguinalis merupakan kondisi dimana lemak intra-abdominal atau bagian dari usus halus menonjol melalui area lemah di otot perut bagian bawah. Kasus kegawatdaruratan dapat terjadi apabila hernia inguinalis bersifat strangulasi (ireponibel disertai gangguan pasase) dan inkarserasi (ireponibel disertai gangguan vascularisasi). Penelitian ini bertujuan untuk mengetahui karakteristik penderita hernia inguinalis yang dirawat inap di Rumah Sakit Bayukarta, Karawang periode 2022.Metode: Penelitian deskriptif ini menggunakan metode potong lintang dengan data sekunder rekam medik. Subjek yang diteliti yaitu penderita hernia inguinalis yang dirawat inap, sebanyak 90 orang. Variabel yang dinilai pada penelitian ini adalah usia (tahun), jenis pekerjaan, jenis kelamin, klasifikasi jalur keluarnnya organ, dan klasifikasi sifat dari hernia. Data dianalisis dengan SPSS versi 20.0 untuk Windows.Hasil: Hasil penelitian diperoleh dua kelompok usia penderita hernia inguinalis tertinggi adalah kelompok usia 46-55 tahun dan 56-65 tahun masing-masing sebanyak 20 orang (22,2%), pekerjaan terbanyak yaitu buruh sebanyak 34 orang (37,8 %), jenis kelamin terbanyak yaitu laki-laki sebanyak 83 orang (92,2%). Hernia inguinalis lateralis dextra sebanyak 53 orang (58,9%) dan hernia inguinalis reponibel sebanyak 75 orang (83,3 %).Kesimpulan: Karakteristik penderita hernia inguinalis yang dirawat inap di Rumah Sakit Bayukarta periode 2022 berupa kelompok usia 46-65 tahun, pekerjaan buruh, jenis kelamin laki-laki, dengan hernia inguinalis lateralis dextra dan hernia inguinalis reponibel.
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Igirisa, Reskita A., Harsali F. Lampus, and Andriessanto C. Lengkong. "Patofisiologi dan Faktor-faktor yang Berhubungan dengan Hernia Inguinalis pada Anak." Medical Scope Journal 5, no. 1 (May 17, 2023): 38–44. http://dx.doi.org/10.35790/msj.v5i1.45120.
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Inguinal hernia in children is a common surgical problem. Albeit, pathophysiology related to the incidence of inguinal hernias and its predisposing factors are not fully accepted. This study aimed to determine the pathophysiology and the predisposing factors the lead to inguinal hernia in children. This was a literature study using various medical literatures in line with the topic from the ClinicalKey, Pubmed, and Google Scholar databases. The results obtained 11 literatures that fulfilled the criteria. The pathophysiology of inguinal hernia was closely related to the failure of processus vaginalis obliteration and genetic factors related to the formation of connective tissue. Predisposing factors for inguinal hernias included increased intra-abdominal pressure, patent processus vaginalis, low birth weight, gender, prematurity, and syndromes associated with connective tissue disorders. In conclusion, the pathophysiology of hernia inguinalis in children is strongly related to the failure of procesus vaginalis to obliterate and genetic factors in the formation of connective tissues with a variety of predisposing factors. Keywords: inguinal hernia in children; pathophysiology; risk factors; processus vaginalis; Marfan syndrome Abstrak: Hernia inguinalis pada anak merupakan suatu kejadian yang umum terjadi pada ranah bedah. Berbagai pendapat mengenai patofisiologi terkait kejadian hernia inguinalis dan faktor predisposisi yang dapat menyebabkan hernia inguinalis pada anak belum disepakati sepenuhnya. Penelitian ini bertujuan untuk mengetahui patofisiologi terkait kejadian hernia inguinalis pada anak dan faktor predisposisi kejadian ini. Jenis penelitian ialah suatu literature review menggunakan berbagai literatur kedokteran yang sejalan dengan topik dan berasal dari database ClinicalKey, Pubmed, dan Google Scholar. Hasil penelitian mendapatkan 11 literatur yang memenuhi kriteria penelitian. Patofisiologi terjadinya hernia inguinalis erat kaitannya dengan kegagalan penutupan prosesus vaginalis dan juga faktor genetik yang berhubungan dengan pembentukan jaringan ikat. Faktor predisposisi dari hernia inguinalis antara lain peningkatan tekanan intra-abdomen, prosesus vaginalis yang paten, berat badan bayi lahir rendah, jenis kelamin, prematuritas, dan sindrom terkait gangguan jaringan ikat. Simpulan penelitian ini ialah patofisiologi terjadinya hernia inguinalis pada anak erat kaitannya dengan kegagalan penutupan prosesus vaginalis dan faktor genetik dalam pembentukan jaringan ikat dengan faktor predisposisi yang bervariasi. Kata kunci: hernia inguinalis; anak; patofisiologi; faktor risiko; prosesus vaginalis; sindrom Marfan
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Loukas, Marios, Abraham El-Sedfy, R. Shane Tubbs, and Christopher Wartman. "Jules Germain Cloquet (1790–1883)–Drawing Master and Anatomist." American Surgeon 73, no. 11 (November 2007): 1169–72. http://dx.doi.org/10.1177/000313480707301120.
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Jules Germain Cloquet, the famed French anatomist, surgeon, and professor, may not be remembered as one of the pioneers of hernia surgery; however, his contributions have provided surgeons with detailed anatomical descriptions that have been useful in developing innovative surgical techniques. Cloquet has many eponyms associated with him, including: Cloquet's fascia, Cloquet's gland or lymph node of Cloquet, Cloquet's hernia, Cloquet's ligament, Cloquet's canal, and Cloquet's septum. A man blessed with artistic talents, Cloquet was the author of many theses, as well as anatomical volumes that were comparable to the works of other great anatomists of his time. His first thesis, entitled Recherches Anatomiques sur les Hernies de l'Abdomen, described the locations where inguinal and crural herniae are more likely to occur in terms of the cremaster muscle, the peritoneum, and the spermatic vessels. Wax sculpture training required extensive knowledge in the natural sciences, anatomy, physiology, and pathology, as were acquired by Jules Cloquet as a pupil of Achille-Cléophas Flaubert, the father of the famous French novelist Gustave Flaubert (author of Madame Bovary). Cloquet attracted many pupils with his innovative teaching style and implementation of anatomical preparations, drawings, and sketches on the black board with chalk. The legacy of this famed individual lives on today in the anatomical structures described by Cloquet.
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Sayuti, Muhammad, Cut Khairunnisa, Elsa Nur Salsabila, Jihan Haura, and Rani Aprilita. "Teknik Operasi dan Faktor Risiko Residif Hernia Inguinalis Lateralis di RSU Cut Meutia Kabupaten Aceh Utara." Malahayati Nursing Journal 5, no. 3 (March 1, 2023): 728–38. http://dx.doi.org/10.33024/mnj.v5i3.8104.
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ABSTRACT Lateral inguinal hernia (HIL) is a protrusion of the contents of the abdominal cavity, which comes out of the peritoneal cavity through the internal inguinal ring which is located lateral to the inferior epigastric vessels. Risk factors for inguinal hernias are increased intra-abdominal pressure due to chronic cough, constipation, ascites or heavy lifting, when there is weakness of the abdominal wall muscles due to old age, pregnancy or prematurity, surgical incisions that cause incisional hernias and the presence of obesity. The principle of management of lateral inguinal hernia is animation and surgery. Operative treatment is the only rational treatment for inguinal hernias, namely carrying out hernia repairs both openly and laparoscopically. The purpose of this study was to determine surgical techniques and risk factors for recurrent lateral inguinal hernias at Cut Meutia Hospital, North Aceh District in 2018–2021. This study used a retrospective descriptive method with a cross sectional approach. The sample in this study were all patients diagnosed with recidive lateral inguinal hernias at Cut Meutia Hospital, North Aceh District recorded in 2018 to 2021 who met the inclusion and exclusion criteria. The results showed that the incidence of recurrent HIL was 8.5%, the most common risk factor was age ≥60 years (73.3%), male sex (100%), obesity (53.3%), history of strenuous activity (100 %), history of chronic cough (60%), history of urinary retention (26.7%), history of constipation (66.67%) and the first surgical technique used in 15 patients with residual HIL was 40% non-mesh graft and 60% with a mesh of corruption. Age, gender, obesity, history of strenuous activity, history of chronic cough, urinary retention and history of constipation are risk factors for recurrent lateral inguinal hernias at Cut Meutia Hospital, North Aceh District in 2018-2021. Keywords: Lateral Inguinal Hernia, Hernia Repair, Risk Factors ABSTRAK Hernia inguinalis lateralis (HIL) adalah penonjolan isi rongga perut, yang keluar dari rongga peritoneum melalui anulus inguinalis internus yang terletak lateral dari pembuluh epigastrika inferior. Faktor risiko terjadinya hernia inguinalis adalah peningkatan tekanan intra-abdominal karena batuk kronis, sembelit, asites atau angkat berat, ketika ada kelemahan otot dinding perut karena usia tua, kehamilan atau prematuritas, sayatan operasi yang menyebabkan hernia insisional dan adanya obesitas. Prinsip penatalaksanaan hernia inguinalis lateralis adalah konservatif dan operatif. Tindakan pengobatan operatif merupakan satu-satunya pengobatan hernia inguinalis yang rasional yaitu melakukan tindakan hernia repair baik secara open maupun laparoskopik. Tujuan penelitian ini untuk mengetahui teknik operasi dan faktor risiko hernia inguinalis lateralis residif di RSUD Cut Meutia Kabupaten Aceh Utara tahun 2018–2021. Penelitian ini menggunakan metode deskriptif retrospektif dengan pendekatan cross sectional. Sampel dalam penelitian ini adalah seluruh pasien yang terdiagnosis hernia inguinalis lateralis residif di RSUD Cut Meutia Kabupaten Aceh Utara yang tercatat pada tahun 2018 sampai 2021 yang memenuhi kriteria inklusi dan eklusi. Hasil penelitian menunjukkan kejadian HIL residif sebesar 8,5%, faktor risiko terbanyak pada usia ≥60 tahun (73,3%), jenis kelamin laki-laki (100%), obesitas (53,3%), riwayat aktivitas berat (100%), riwayat batuk kronis (60%), memiliki riwayat retensio urin (26.7%), riwayat konstipasi (66,67%) dan teknik operasi pertama yang digunakan pada 15 pasien HIL residif adalah 40 % non mesh graft dan 60% dengan mesh graft. Usia, jenis kelamin, obesitas, riwayat aktivitas berat, riwayat batuk kronis, retensio urin serta riwayat konstipasi merupakan faktor risiko hernia inguinalis lateralis residif di RSUD Cut Meutia Kabupaten Aceh Utara tahun 2018 – 2021. Kata Kunci: Hernia Inguinalis Lateralis, Hernia Repair, Faktor Risiko
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Lampus, Harsali F., Jaquelin E. Lombok, and Rangga B. Rawung. "Gambaran Hernia Inguinalis pada Anak di RSUP Prof. Dr. R. D. Kandou Manado." e-CliniC 12, no. 3 (December 1, 2024): 428–33. https://doi.org/10.35790/ecl.v12i3.55438.
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Abstract: Inguinal hernias is one of the most common surgical cases in children, especially in the first year of life. This study aimed to find out the general description related to inguinal hernias in children, such as age, sex, birth history, main complaints, family history, complications, and management. This was a retrospective and descriptive study by analyzing medical record data of inguinal hernia pediatric patients at Prof. Dr. R. D. Kandou Manado Hospital in the period of January 2021-June 2023. The results showed that the incidence of inguinal hernias in children according to medical record data was 40 patients. Variables with the highest percentages were age of 0-4 years (75%), male sex (90%), birth weight <2500 grams and gestation period <37 weeks, main complaint was a lump in the right groin (45%), no family history of inguinal hernia (87.5%), no complications (52.5%), and performed herniotomy (85%). In conclusion, inguinal hernia most often occurs in children of 0-4 years, male sex, birth weight less than 2500 grams, gestation period less than 27 weeks, a lump in the right groin as the main complaint, no family history with similar conditions, presenting without preoperative complications, and are treated with herniotomy. Keywords: inguinal hernia; children; indirect hernia; herniotomy Abstrak: Hernia Inguinalis pada anak menjadi salah satu kasus bedah anak yang paling banyak dijumpai terlebih pada tahun pertama kehidupan. Penelitian ini bertujuan untuk mengetahui gambaran umum terkait hernia inguinalis pada anak seperti usia, jenis kelamin, riwayat persalinan, keluhan utama, riwayat keluarga, komplikasi dan penatalaksanaan. Jenis penelitian ialah deskriptif retrospektif dengan menganalisis data rekam medis pasien hernia inguinalis pada anak di RSUP Prof Kandou Manado periode Januari 2021-Juni 2023. Hasil penelitian mendapatkan angka kejadian hernia inguinalis pada anak menurut data rekam medis yaitu 40 pasien dengan usia terbanyak yaitu 0-4 tahun (75%), jenis kelamin terbanyak pada laki-laki (90%), lahir dengan berat badan <2500 gram (57,5%) dan masa gestasi <37 minggu (52,5%), dengan keluhan utama benjolan di lipat paha kanan (45%). Sebagian besar pasien tidak memiliki riwayat keluarga dengan hernia inguinalis (87,5%), dirawat belum dengan komplikasi (52,5%), dan sudah dilakukan tindakan operatif herniotomi (85%). Simpuplan penelitian ini ialah hernia inguinalis paling sering terjadi pada kelompok usia anak 0-4 tahun, jenis kelamin laki- laki, berat badan lahir <2500 gram dan masa gestasi <27 minggu, keluhan utama benjolan di lipat paha kanan, tidak memiliki riwayat keluarga dengan keadaan serupa, datang tanpa komplikasi pre operatif, dan penatalaksanaan dengan tindakan operatif herniotomi. Kata kunci: hernia inguinalis; anak; hernia indirek; herniotomi
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O'Toole, Donal, Val Welch, and Beth Williams. "Immunohistochemistry of Parasitic Subepidermal Vesiculobullous Disease in American Badgers (Taxidea Taxus)." Journal of Veterinary Diagnostic Investigation 6, no. 1 (January 1994): 72–76. http://dx.doi.org/10.1177/104063879400600113.
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Some populations of free-ranging American badgers (Taxidea taxus) develop a distinctive seasonal dermatitis due to the subcutaneous filariid Filaria taxideae. Subepidermal vesicles that contain filarial ova develop in thinly haired skin of the inguinal area, proximal thigh, and ventral abdomen. The purpose of this study was to establish by immunohistochemistry whether basement membrane components colocalized with the roof or floor of vesicles and to confirm that filarial ova occur in intradermal vessels. Samples of skin with characteristic F. taxideae-induced subepidermal vesicles were collected from 10 adult male (n = 8) and female (n = 2) badgers. Samples were fixed in formalin for 1–4 days and processed routinely into paraffin wax. Immunohistochemical staining for basement membrane was attempted with anti-collagen IV antibodies (AM168-5M, AR079-5R, AB748) and antilaminin antibodies (MA078-5C, AR078-5R, L-9393). Optimal results in skin from badgers were obtained using a biotin-streptavidin technique and AR079-5R (anti-human collagen IV) and AR078-5R (anti-murine laminin). There was positive staining of the floor of vesicles in 5 of 6 badgers tested with antibodies to laminin and collagen IV. In 5/10 badgers, filarial ova and first stage F. taxideae larvae were found in dilated vascular channels of the upper dermis, and these vessels stained positively for factor VIII-related antigen. The results suggest that F. taxideae-induced subepidermal separation occurs consistently in the lamina lucida portion of the basal lamina and that filarial ova occur in dermal vessels.
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Illés, Kristóf, Judit Tamás, Damján Pekli, Rezső Szlávik, Bálint Kokas, and Attila Szijártó. "Egy ritka sérvtípus kétszeri megjelenése klinikánkon." Magyar Sebészet (Hungarian Journal of Surgery) 73, no. 4 (December 12, 2020): 167–71. http://dx.doi.org/10.1556/1046.73.2020.4.6.
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Összefoglaló. Esetismertetések: 66 éves nő vizsgálatai irreponibilis fájdalmas inguinalis terime miatt kezdődtek. Ultrahangvizsgálat során a panaszok hátterében femoralis sérvben kizárt gangraenás appendix vermiformis igazolódott. Inguinalis metszésből appendectomiát és hernioplasticát végeztünk. Posztoperatív szövődménye nem volt, szövettana appendicitist igazolt. Pár héttel később egy 76 éves, több társbetegséggel rendelkező férfi fájdalmas, sercegő gangraenás, jobb inguinalis terime miatt került átvételre. CT-vizsgálat femoralis sérvbe kizárt abscedáló appendix vermiformist ábrázolt. Inguinalis metszésből, illetve alsó median laparotomiából a féregnyúlványt a hasüregbe reponáltuk, majd appendectomia és inguinalis necrectomia történt. Posztoperatív adhéziós ileus és hasfali disruptio miatt egy alkalommal reoperáltuk, adhaesiolysist és hasfali resuturát végeztünk. Ezt követően lágyéki sebén negatív nyomásos sebkezelést alkalmaztunk, a beteget a 22. napon otthonába bocsájtottuk. Az appendix szövettana low grade mucinosus neoplasiát igazolt. Megbeszélés: A femoralis sérvbe szorult appendix vermiformis de Garengeot-sérvként ismeretes, extrém ritka incidenciájú sérvtípus, ennél is ritkább az appendix mucinosus neoplásiájával szövődő variánsa. E sérv klinikai megjelenése széles spektrumon mozoghat, pontos preoperatív diagnózisa CT-vizsgálat nélkül kifejezetten nehéz. A műtéti megoldásra többféle lehetőség választható, mely nagyban függ az esetleges komplikációktól, a rendelkezésre álló eszközöktől, az intraoperatív lelettől, valamint az operáló sebész jártasságától. Summary. Case reports: a 66-year-old woman was admitted to our Department due to a painful inguinal lump. During examinations an incarcerated femoral hernia was found with an inflamed vermiform appendix inside the hernial sac. Appendectomy and femoral hernioplasty was performed from inguinal approach. The patient was discharged home without complications. Pathological examinations of the specimen showed signs of acute appendicitis. A few weeks later a 76-year-old man with severe comorbidities was admitted to our unit due to painful gangraenous inguinal skin lesion. CT scan showed an incarcerated femoral hernia containing the appendix with subcutaneous abscess. Appendectomy, hernioplasty, and inguinal necrosectomy was performed from an inguinal and low median approach. Another operation was necessary due to postoperative obstruction and subcutaneous dehiscence. After intraabdominal adhaesiolysis and abdominal wall reconstruction negative pressure wound therapy was applied to the inguinal wound, the patient was discharged 22 days after the primary operation. Pathological examinations of the appendix showed low grade mucinous neoplasm. Discussion: The femoral hernia containing the appendix is called de Garengeot’s hernia and is one of the rarest types of inguinofemoral hernias. The clinicopathology of this type of hernia can cover a wide range of symptoms. The definitive preoperative diagnosis is relatively difficult to find without a CT-scan. The surgical approach and treatment depends on the manifestation, clinical findings and on the available equipment and the expertise of the surgeon.
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Kodzo-Grey Venyo, Anthony. "Tancho nodules (Lipogranulomatous lesions) of the Penis: A Review and Update." Journal of Surgical Case Reports and Images 6, no. 3 (April 29, 2023): 01–17. https://doi.org/10.31579/2690-1897/152.
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The practice of implanting glass or other kinds of beads in the subcutaneous tissue of the penis for the purpose of increasing the sexual pleasure of the partner has become common. The inserted glass beads have tended usually not to give rise to symptoms and normally they are only detected by chance. Lipogranuloma of penis which is also known as paraffinoma, sclerosing lipogranuloma, and Tancho nodules, may affect the penile or scrotal skin. Penile lipogranuloma is usually been known to be due to hypodermic injection of substances such as paraffin, silicone, oil, or wax into the penis for enlargement of the penis or sexual gratification. Within the scrotum, trauma, cold weather, and topical application of ointment do at times give rise to chronic inflammatory lesions within the penis that is suggesting of percutaneous absorption, which has also have been implicated in the development of Lipogranuloma of penis or Tancho nodules. Additionally, utilization of liquid paraffin instillation in to the urethra followed by urethral dilatation procedure has also been reported to have caused inflammatory nodules within the penis. Most lipogranulomas arise in men younger than 40 years who report a localized plaque or mass that may be tender and indurated, and as large as several centimetres in diameter. They may also present with some or any of the following: a nodule or nodules in the penis; a papule or plaque on the penis; a rash around a penile injection site; an ulceration or ulcerations on the penis; an abscess within the penis; sepsis following which a nodule or lesions is/are found in the penis; pulmonary embolism; pain and swelling within the penis extending into the scrotum; pain and swelling in the penis and groin; pain and swelling in the inguinal region mimicking lymph adenitis or an inguinal hernia; lower urinary tract voiding symptoms and on rarer-occasions the development of urinary retention; infertility; loss of sexual satisfaction; expression of discomfort by sexual partner during coital activity; experiencing of pain by the man within his penis during coital activity; bleeding from a penile lump during coital activity; curvature of the non-erect penis or curvature of the erect penis associated with coital penile discomfort. Biopsy of the penile lesion for pathology examination is necessary to confirm the diagnosis, especially in the absence of clinical history of injection of exogenous material into the penis.
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Mishra, Baikuntha Narayan, Sadasiba Padhy, Prabin Prakash Pahi, and Ranjit Kumar Joshi. "Mesothelial cyst in inguinal hernial sac in a male child: a case report." International Surgery Journal 8, no. 1 (December 28, 2020): 395. http://dx.doi.org/10.18203/2349-2902.isj20205912.
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Mesothelial cysts of inguinal area are extremely rare and few cases have been reported in females, arising from round ligament of uterus. Inguinal hernias are a common surgical problem in children presenting as an inguinal or inguino scrotal swelling. Usually the contents of hernial sac in a male child are intestine or omentum and in females it may contain ovary. Mesothelial cyst of round ligament may present as an inguinal mass in females, but it is very rare to find in side inguinal hernial sac of a male child. Here in we report a case of 2 year 9-month-old male child, who was operated for irreducible right congenital inguinal hernia. A pedunculated cystic mass was found to be the content and was removed. Histopathology confirmed the diagnosis of mesothelial cyst. Because of rarity, we report this case.
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Malik, Akram, Nauman Khalid, Muhammad Ali, Adeen Akram, Asad Ramzan, and Muhammad Waqas Iqbal. "Bladder Hernia; A Case Report." Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University 18, no. 2 (June 24, 2022): 139–41. http://dx.doi.org/10.48036/apims.v18i2.606.
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Inguinal bladder hernia is a rare condition usually diagnosed per-operatively. Patients may present with inguinal swelling, dysuria, hematuria,or urinary urgency. Obesity, advancing age and poor musculature are risk factors. We hereby present a case of inguinal bladder hernia in a 47-year-old obese male presented to outpatient department with history of inguino-scrotal, partially reducible swelling, lower urinary tract symptoms, off and on haematuria and dysuria. Scrotal ultrasound showed clear fluid present in the scrotum which was communicating with bladder. This was confirmed by cystography showing “dog ear”sign. Hernia containing bladder was reduced and hernioplasty was performed.
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Ramu, Abhirup H., Priyanka Kenchetty, and Aishwarya K. Chidananda. "A curious case of toddler with hernia and much more." International Surgery Journal 8, no. 9 (August 27, 2021): 2826. http://dx.doi.org/10.18203/2349-2902.isj20213628.
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Transverse testicular ectopia (TTE) with fused vas deferens is an extremely rare clinical entity. Herein, we presented a case of a 2 years old patient with left inguino-scrotal swelling associated with pain lasting for 3 days. Clinical examination revealed an empty right hemi-scrotum, a left-sided giant inguino-scrotal swelling. Laboratory tests were normal. Ultrasound imaging (US) of the scrotum demonstrated the presence of both testes in the same left hemi-scrotum with inguinal hernia and enterocele as content. Surgical intervention in suspicion of obstruction was carried out through inguinal incision. There was a congenital inguinal hernia with appendix (type 1-Amyand’s hernia) and cecum as content with two well developed testes on the same side with separate epididymis and vas deferens. Both the testes were united by a mesorchium. Hence, reduction of contents with herniotomy and both the testes were anchored to inner aspect of left thigh one above the other. We reviewed the literature for rare diagnosis of TTE.
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Bakhteyar, Md Asjad Karim, Binod Kumar, and Sushil Kumar. "Strangulated direct inguinal hernia with intraperitoneal perforation." International Surgery Journal 4, no. 12 (November 25, 2017): 4093. http://dx.doi.org/10.18203/2349-2902.isj20175418.
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Usually direct inguinal hernia doesn’t present as strangulation or incarceration as compared to indirect inguinal hernia because of earlier has wider neck. A patient of recurrent direct inguinal hernia presents as intra-scrotal gangrene and intra-peritoneal perforation. We reported a case of 65 years old male presented with septicemia and right sided strangulated direct hernia. On exploration through inguino scrotal incision and mid line laparotomy, gangrenous loop was found in scrotum and perforation was found in intra-peritoneal part of small intestine. Resection-anastomosis was done for both the parts of intestine. Inguinal Incision was closed by posterior wall closure and modified Bassini’s herniorraphy. Abdomen was closed in layers with brain. Long standing direct hernia may present as strangulation or incarceration specially in elderly but perforation and gangrene of intra-peritoneal part of small intestine is very rare.
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Smahi, F., H. Cherrabi, Z. Benmassaoud, M. T. Mellouki, K. Elghazy, B. Bouamri, and M. A. Oukhouya. "Amyand's Hernia in Children: Two Rare Cases and Review of the Literature." Scholars Journal of Medical Case Reports 12, no. 11 (November 18, 2024): 1920–24. http://dx.doi.org/10.36347/sjmcr.2024.v12i11.019.
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Amyand's hernia is rare in children. Acute appendicitis associated with this hernia is even rarer, occurring in only 0.08% of cases [3]. Clinical symptoms may vary and often resemble those of an incarcerated inguinal hernia, which may lead to a misdiagnosis prior to surgery. We report 2 cases of Amyand's claudius hernia operated on at the Souss Massa Agadir university hospital, Morocco. The first case was a 3-year-old boy scheduled for surgical cure of a simple right inguino-scrotal hernia, where a non-inflammatory appendix was revealed within the hernia sac. The second case was a 22-day-old newborn admitted to the emergency department with a strangulated right inguino-scrotal hernia. The diagnosis of Amyand's hernia was made only after surgical exploration, during which the pathological appendix was discovered in the hernia sac. This underlines the importance of considering this rare pathology when evaluating inguinal hernias, particularly in children.
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Hofmann, Katharina, Anna Rauh, Jürgen Harlizius, Christine Weiß, Tobias Scholz, Theodor Schulze-Horsel, Damián Escribano, Mathias Ritzmann, and Susanne Zöls. "Schmerz- und Stressbestimmung bei der Injektion und Kastration von Saugferkeln unter Lokalanästhesie mit Procain und Lidocain." Tierärztliche Praxis Ausgabe G: Großtiere / Nutztiere 47, no. 02 (April 2019): 87–96. http://dx.doi.org/10.1055/a-0861-9640.
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Zusammenfassung Ziel Vergleich der Wirksamkeit der Lokalanästhesie (LA) mit Procain 2 % und Lidocain 5 % bei skrotaler kombiniert mit inguinaler Applikation mit der testikulären Applikation von Lidocain 1 % zur Beurteilung der schmerzbedingten Stressreaktion auf Injektion und Kastration. Material und Methoden In 2 Teilversuchen (TV) wurden 232 männliche Saugferkel eingeschlossen und verschiedenen Gruppen zugeordnet. TV1 (n = 112): Gruppe H: Fixation der Ferkel wie bei der Injektion, keine Applikation; Gruppe L5: Applikation von Lidocain 5 % inguinal und skrotal; Gruppe P2: Applikation von Procain 2 % inguinal und skrotal; Gruppe L1: intratestikuläre Injektion von Lidocain 1 %. Eine Blutentnahme erfolgte jeweils 45 Minuten vor sowie 30 Minuten nach der Injektion (p. i.). TV2 (n = 120): Gruppe H: nur Handling wie bei der Injektion und Kastration; Gruppe K: Fixation wie bei der Injektion und betäubungslose Kastration nach 30 Minuten; Gruppen L5, P2 und L1: Verfahren wie in TV1 mit Kastration 30 Minuten nach Injektion. Jedem Ferkel wurde 75 Minuten vor sowie 30, 60 und 240 Minuten nach der Kastration (p. c.) Blut entnommen. Untersuchte Parameter waren Serumkonzentration von Kortisol und Chromogranin A (CgA) sowie Wundheilung, Gewichtsentwicklung und Verluste bis zum Absetzen. Ergebnisse TV1: In Gruppe P2 ergab sich p. i. ein signifikant höherer Anstieg der Kortisol- und CgA-Konzentration als in den anderen Gruppen. Die mittlere Kortisolkonzentration der Gruppe P2 war p. i. im Vergleich zu denen der übrigen Gruppen signifikant höher. TV2: Alle Gruppen wiesen im Vergleich zu Gruppe H 30 Minuten p. c. einen signifikanten Anstieg der Kortisolkonzentration auf. In Gruppe P2 wurde die höchste Kortisolkonzentration 60 Minuten p. c. gemessen und der Anstieg der Kortisolkonzentration fiel im Vergleich zu den restlichen Gruppen signifikant höher aus. In Gruppe L1 zeigte sich 60 Minuten p. c. ein signifikant höherer Anstieg der CgA-Konzentration als in den anderen Gruppen. Wundheilung, Körpergewicht und Verluste ließen keine signifikanten Unterschiede zwischen den Gruppen erkennen. Schlussfolgerung Die inguinale und skrotale Injektion von Procain 2 % erzeugte eine höhere neuroendokrine Stressreaktion als die inguinale und skrotale Applikation von Lidocain 5 % sowie die intratestikuläre Injektion von Lidocain 1 %. Die LA mit Procain 2 % sowie Lidocain 1 % und 5 % führte zu keiner vollständigen Schmerzausschaltung. Die Kastration unter LA mit Procain 2 % verursachte eine höhere Schmerzreaktion als die betäubungslose Kastration. In beiden Lidocaingruppen (L1, L5) traten nach Kastration tendenziell geringere Schmerzreaktionen auf als in Gruppe K. Diese Ergebnisse bieten eine Grundlage für weitere Untersuchungen und können Ansätze bieten, um Lokalanästhetika mit höherer analgetischer Potenz längerer Wirksamkeit auf geeignete Weise zu applizieren.
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Kpatékana, Simlawo, Tchangaï B, Kanassoua K, Boumé MA, Sakye A, Sambiani DM, Dosseh ED, and Songné B. "Peritonea-vaginal canal pathologies at Regional Hospital Center of Lomé-Commune (Togo): Epidemiological, anatomoclinical and therapeutic aspects." Case Studies in Surgery 3, no. 3 (July 26, 2017): 10. http://dx.doi.org/10.5430/css.v3n3p10.
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Objective: To describe epidemiological, anatomo-clinical and therapeutic aspects of peritoneo-vaginal canal pathologies (PVCP).Methods: We performed a retrospective and descriptive study on the files of PVCP cases operated in Lomé-Commune Regional Hospital (Togo). The study data concerned: the age, the occuring mode, anatomo-clinical classification, the side and treatment outcomes.Results: 107 files were collected from January 2011 to December 2015. The average age was 9.2 ± 8 years with a range from 16 months to 47 years. Twelve patients were less than 2 years and 14 patients were adults. The main consultation motive was an intermittent and painless inguinal or inguino-scrotal swelling in 89 cases (83.18%). The PVCP was in the right side in 66 patients (61.68%) and bilateral in 8 patients (7.47%). Concerning anatomo-clinical types, inguinal or inguino-scrotal hernia were more frequent (62.6%). The treatment was surgical in all cases and the average hospital stay was 2.1 days. The operative follow up was satisfactory in 94.3%. However, we noticed 4 cases of scrotal hematoma and 2 cases of parietal suppuration. The mortality rate after surgery was zero. One year back, we noticed two cases of testicular atrophy.Conclusions: Pathologies of the peritoneo-vaginal canal are frequent in our urological practice. Inguinal hernia and inguinoscrotal hernia are more represented. The surgical treatment results are successful.
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Ben Dhaou, Mahdi, Mohamed Zouari, Saloua Ammar, Amira Bouraoui, Imene Gassara, Ines Feki, Hayet Zitouni, et al. "Is there a Place for Prebiotics in the Management of Neonatal Inguinal Hernia? A Preliminary Study." Journal of Neonatal Surgery 6, no. 1 (December 31, 2016): 7. http://dx.doi.org/10.21699/jns.v6i1.488.
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The objective of this study was to assess the place of prebiotics in the management of neonatal inguinal hernia. Boys with a diagnosis of unilateral non-complicated inguinal hernia, aged less than 40 days, were prospectively followed from January 2012 to December 2014. Clinical and psychiatric data and outcomes were collected before and after prebiotics (Primalac AC) administration. Ninety-eight patients were included. There were 75 inguinal hernias and 23 inguino-scrotal hernias. Before prebiotics administration 72.2% of infants had abdominal distention and 98% had colic. After prebiotics, abdominal distention and colic regressed in 85.2% and 73.2% of patients, respectively. Hernias disappeared clinically in 66.3% of cases. The factors associated with the disappearance of hernias were the type of the hernia (p<0.001), colic (p<0.001), and abdominal distention (p<0.001). Prebiotics would be a new adjunct in the management of neonatal inguinal hernia. They decrease colic and abdominal distention, which seems helpful to prevent strangulation and probably get spontaneous resolution of small hernias.
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BERKTAŞ, Mustafa, Sabri Güngör, and İclal Balcı. "The Etiologic Agents in Fungal Infections of Hairless Skin in Gaziantep Region." European Journal of Therapeutics 4, no. 2 (June 1, 1993): 148–57. http://dx.doi.org/10.58600/eurjther-199342-1083-x.
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The etiologic agents of hairles skin fungal infections were searched in Gaziantep region, using conventional mycologic methods. Scrapings from thrunk,foot, hand and inguinal lesions of 106 male and 50 female patients were examined. 99 of this totally 156 patients' samples gave positive culture result (63.46 %). 17 (17.17 %) of this 99 culture positive patients had candida, 77 (77. 78 %) of them had dermatophyte, and the remaining 5 patients (5.05 %) had both candida and dermatophyte. 57 of isolated 82 dermatophytes (65.51 %) was Trichophyton rubrum, 20 of them (24.40 %) was Trichophyton mentagrophytes, and 5 of them (6.09 %) was Epidermophyton floccosum.Trichophyton rubrum was tlı.e primary agent affecting any parts of the body, according to the anatomicaJ distribution of the Jesion; Trichophyton mentagrophytes was the second etiologic agent except inguinaJ region, and Epiderrnophyton floccosum was the second agent for inguinal region. Consequently, our results has been compared with those of similar research groups.
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S. D., Veershetty, Manjunath K., O. G. Prakash, K. S. Hanumanthaiah, and Rajagopalan S. "A case of ectopic testis: an intraoperative enigma instead of a diagnostic enigma." International Surgery Journal 5, no. 3 (February 26, 2018): 1127. http://dx.doi.org/10.18203/2349-2902.isj20180843.
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Author present a case of persistent mullerian duct syndrome with transverse testicular ectopia with bilateral hernia uteri inguinalis in a 17 years old boy. This is a rare congenital anomaly and an uncommon form of male pseudo-hermaphroditism characterized by the persistence of well-developed Mullerian duct structures in an otherwise normal male with a 46 XY karyotype. Transverse testicular ectopia (TTE) is one of the rarest forms of testicular ectopia. In this condition, both testes are located on one inguinal side and the opposite inguinal canal and scrotum are empty. TTE associated with PMDS is much rarer. The exact cause of PMDS is uncertain. However, it is thought to result from the failure of synthesis or release of Mullerian inhibiting factor (MIF), the failure of end organs to respond to MIF, or a defect in the timing of the release of MIF. Patients with PMDS present with unilateral or bilateral cryptorchidism and an inguinal hernia containing a fallopian tube, uterus and testis. The case was diagnosed on doing diagnostic laparoscopy followed by bilateral inguinal herniorrhaphy and right Orchidectomy.
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Yahia, Ahmed M., Mohamed A. Arafa, Mohammad G. Khirallah, and Ali M. Turki. "The development of metachronous contralateral inguinal hernia after unilateral inguinal hernia repair in infants and children." Tanta Medical Journal 52, no. 3 (July 2024): 265–69. http://dx.doi.org/10.4103/tmj.tmj_3_24.
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Background Pediatric Inguinal hernia is the most common surgical procedure in infants and children with a rate of 1–5% in full-term infants. The male-to-female ratio is 5: 1. In Some children with unilateral inguinal hernia, a contralateral one may appear later known as a Metachronous Contralateral Inguinal Hernia (MCIH). Aims To determine the incidence and risk factors of MCIH development in infants and children and the necessity of routine contralateral side exploration. Patients and methods This was a prospective study that was carried out on 217 infants and children presented with a unilateral inguinal hernia. All children were subjected to ultrasonography of the inguino-scrotal region at the first presentation and a second ultrasonography was done with the appearance of a metachronous hernia. Results Increase the risk of developing a MCIH in patients with unilateral inguinal hernia with an age below 6 months, low birth weight (≤2000 gm), immaturity, patients with contralateral internal ring diameter at the primary presentation above or equal 4 mm, and the presence of an umbilical hernia. The side of the ipsilateral hernia and the sex of the patients have less effect on the development of a MCIH. Therefore, a score was built depending on these risk Factors. Conclusions The incidence of MCIH development after unilateral hernia repair in this study was 12%. A debate is still present regarding exploring the contralateral side after unilateral inguinal hernia repair.
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Hicham, Assofi, Imane Toughrai, Ibnmajdoub Hassani Karim, Ahmed Zerhouni, and Souiki Tarik. "Amyand's Hernia a form of Inguinal Hernia: A Case Report and Literature Review." SAS Journal of Surgery 10, no. 05 (May 7, 2024): 540–43. http://dx.doi.org/10.36347/sasjs.2024.v10i05.003.
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Introduction: Amyand hernia (HA) is a form of inguinal hernia considered to be very rare, and this type of hernia has occurred up to 1% of all inguinal hernia cases. In this type of inguinal hernia, the contents of the hernia is the appendix. Most patients with HA often remain asymptomatic and diagnosed intraoperatively. The diagnosis is difficult, surgery is the pillar of management. We report a case of Amyand hernia that was operationally managed in our institution. Case Report: A 50-year-old patient with a normal body mass index (BMI) with a history of right-side reducible inguino-scrotal hernia that has evolved for 4 years, he was admitted for management of elective right inguinal hernia. Two weeks before admission, he noticed worsening pain. Normal abdominal ultrasound. There was no history of abdominal pain and vomiting. The biological assessment was normal. So, with a diagnosis of partially reducible right inguinal hernia, incomplete and indirect, the patient was operated on surgical exploration, we found dense adhesions in the sac, and adhesiolysis was released which revealed a hernia of the appendix in the inguinal canal. The appendix was slightly congested with no signs of inflammation. Therefore, given the uninflated appendix, a hernia cure according to Lichtenstein with an appendectomy was performed. Simple post-operative follow-up. Clinical Conclusion: Amyand’s hernia, is a condition where the appendix is found in the hernia sac, is quite rare, accounting for only 0.4–1% of all instances of inguinal hernia. A review of the literature further emphasizes the rarity of Amyand’s hernia. Moreover, a mere 0.1% of these cases progress to acute appendicitis, often as a result of delayed presentation and overlooked diagnosis. Conclusion: Amyand’s hernia (AH) constitutes a minor percentage of all inguinal hernia cases, and its identification often occurs unexpectedly during surgery. This condition can stay symptom-free and mimic a typical inguinal hernia. .......
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Shah, Tuhin, S. Shah, BR Joshi, RJ Karkee, and RK Gupta. "Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach." Journal of Society of Surgeons of Nepal 18, no. 3 (July 25, 2016): 51. http://dx.doi.org/10.3126/jssn.v18i3.15313.
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Introduction: Since 2 decades laparoscopichernia repair has gained key role in uncomplicated inguinal hernia surgery with advantages showed by several trials and guidelines. However, its role in complicated inguinal hernia such as incarcerated, obstructed and inguino-scrotal is debatable. Cases of large inguino-scrotal raises objection to laparoscopic procedure because of anticipated problems and complications in dissecting extended hernia sac even though posterior approach is advocated as repair of choice for complicated cases. Here, we reviewed our series of patients undergoing TEP in a limited time frame.Method: Between March 2013 and June 2014, 50 consecutive patients underwent TEP repair for inguinoscrotal hernia. Patient demographics, hernia characteristics, operating time, surgical technique, conversion rate, intraoperative, postoperative complications and recurrence was recorded and analyzed using MS Excel.Results: 50 patients were recorded, 26 had unilateral and 24 had bilateral hernias. Mean age was 52 (22-72) years. The mean operation time was 70 (50-140) min. Bilateral repairs took 45% (18 min) longer than for unilateral repairs (52 + 12 min). Two (12.5%) patients required combined open surgery to transect the incarcerated omentum. There was no mortality. Morbidity was limited to asymptomatic seroma formation in 2 (12.5%) patients; 1 patient of combined open-TEP approach had wound infection, both treated conservatively. Mean follow up was 6.3 months; we recorded 2 recurrences (12.5%). The mean length of hospital stay was 1.8 days.Conclusion: We conclude that TEP can be safely employed for complicated inguinal hernias repair. Surgical experience in mandatory with tailored technique to reduce morbidity and achieve good clinical outcome with acceptable recurrence rates.
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Prabakaran, S., and K. Kasthuri Thilagam. "Persistent processus vaginalis presenting as hydrocele and hernia." International Journal of Contemporary Pediatrics 5, no. 5 (August 24, 2018): 1819. http://dx.doi.org/10.18203/2349-3291.ijcp20183513.
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Background: Inguino-scrotal swelling is a common finding in the paediatric population, attributed to the persistent processus vaginalis. But the reason why some children present with hernia and some with hydrocele is not yet clear. Histological examination of the sac may be useful in understanding the reason for this differential presentation. Hence the current study was undertaken to assess the association between type of clinical presentation and histological findings in pediatric population.Methods: A prospective observational study was done on 51 children aged below 12 years presenting with inguinoscrotal swelling and subsequently diagnosed with either hernia or hydrocele and treated with surgical intervention. The samples were sent for histological examination and analysed for association with diagnosis.Results: There were 31 Inguinal hernia and 20 Hydrocele subjects. The predominant age group was 6 to 10 years. The number of children with hydrocele right and left, inguinal hernia right and left was 21 (41.2%), 10 (19.6%), 17 (33.3%) and 3(5.9%) respectively. All hydrocele subjects had mesothelial lining, smooth muscle but scanty lymph vessels and absent inflammatory cells. 95% of the Inguinal hernia subjects had low cuboidal lining, inflammatory cells, and lymph vessels.Conclusions: Paediatric inguinal hernias and hydroceles are due to incomplete or abnormal obliteration of the processus vaginalis. Mesothelial lining, Presence of smooth muscle, Scanty lymph vessels, absence of inflammatory cells are characteristic of Hydrocele Inguinal hernia is characterized by low cuboidal lining, absence of smooth muscles, presence of lymph vessels and inflammatory cells.
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Koranga, Himadra, and R. Chandrasekaran. "A study of clinical evaluation and management of inguinoscrotal swelling in paediatric age group." International Surgery Journal 5, no. 6 (May 24, 2018): 2097. http://dx.doi.org/10.18203/2349-2902.isj20181976.
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Background: Inguino-scrotal swellings are one of the commonest problems in infancy and childhood throughout the world. They represent the conditions most frequently requiring surgical repair in the paediatric age group. In many of these cases, clinical examination may suffice to obtain a definite diagnosis, but when the diagnosis is inconclusive, ultrasonography can play an important role. Post-operative complications are usually rare following elective operation whereas minor complications do occur after emergency operation. In this study we evaluated various presentations of inguino-scrotal swellings, their management and complications in paediatric age group.Methods: This is a hospital based prospective study, to have an overview of a spectrum of the paediatric cases admitted in the department of surgery with inguino-scrotal swelling that includes 40 patients with age below 13 years, irrespective of sex. Data regarding clinical features, birth history, immunization, family history various blood and radiological investigations was noted. Incidences of associated anomalies, complications and any form of treatment given to the patient were recorded and findings were analysed.Results: Out of 40 cases, all were males with maximum number of cases between the age group of 3-4 years.24 cases were right sided, 12 left sided and 4 bilateral. Hydrocele was associated with 10 of the cases, undescended testis with 2 cases and 1 had encysted hydrocele of the cord. There were no complicated cases like incarceration, obstruction or strangulation. Post-operative complications were noted in 4 cases, out of which 2 were wound haematoma and one case each of wound infection and stitch granuloma.Conclusions: Childhood inguinal hernias are more common on right side due to delay in descent of right testis and males are more commonly affected. Congenital hydrocele may involutes spontaneously, so we should observed at least upto 1 year of age before considering repair but not in the case of congenital inguinal hernia. Inguinal herniotomy in children is a safe and effective operation.
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Joshi, Brikh Raj, Swotantra Gautam, Suresh Sah, Nabin Poudel, and Prashrit Thapa. "Outcome of Complicated Groin Hernia Repair at B.P. Koirala Institute of Health Sciences: A Retrospective Study." Birat Journal of Health Sciences 3, no. 2 (September 5, 2018): 395–98. http://dx.doi.org/10.3126/bjhs.v3i2.20932.
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Introduction: Groin hernias are common problem worldwide with approximate incidence of 5%. Indirect inguinal hernia is the commonest hernia irrespective of gender. The prevalence as well as complication of inguinal hernia will increase with increasing age. Strangulation, the most common serious complication of inguinal hernia occurs in 1 to 3 % of the patients. Outcome of the treatment depends on the duration of presentation, co-morbidities and extent of the surgery.Objective: The objectives were to study the different clinical presentation, surgical options and outcome of complicated groin hernia in tertiary care centre.Methodology: This retrospective review of case sheet was conducted in the department of surgery. We reviewed the record file of complicated groin hernia patients, irrespective of age and gender from January 2008 to December 2016 (8 years). Ethical Clearance was obtained from institutional review committee. Statistical analysis was performed using SPSS for windows, version 11.5(SPSS Inc.,Chicago,IL). The data were presented in percentage, mean and standard deviation.Results Out of 45 patients, majority were male 37(82.2%) and commonly effected age group was more than 60 years 18(40%) followed by infants and adolescents. Majorities had complicated inguinal hernias 42 (93.3%) followed by femoral hernia, i.e. 3(7%). Majority of patient underwent inguino-scrotal exploration 26(57.77%) followed by herniotomy 9(20%) and hernioplasty 7(15.55%). Most of the patients were discharged from the hospital 37(82.2%).Conclusion: Most common type of complicated hernia is inguinal hernia; irreducibility and pain were commonest symptoms at presentation. Commonly performed operation is inguinoscrotal exploration and herniorraphy with good surgical outcome.BJHS 2018;3(2)6:395-398.
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Tamegnon, Dossouvi, Kanassoua Kouliwa Kokou, Amouzou Efoe-Ga Olivier, Kassegne Iroukora, Adabra Komlan, and Dosseh Ekoué David. "Prise En Charge Des Hernies De L’aine Au Chu-Kara (Togo)." European Scientific Journal, ESJ 17, no. 21 (June 30, 2021): 256. http://dx.doi.org/10.19044/esj.2021.v17n21p256.
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Objectif: Evaluer la prévalence de la hernie de l’aine et d’analyser sa prise en charge au CHU-Kara (Togo). Matériel et Méthode: Il s’est agi d’une étude rétrospective et descriptive qui a été menée du 1er juillet 2014 au 31 décembre 2019 soit 66 mois au CHU Kara. Ont été inclus dans notre étude tous les patients âgés de plus de 15 ans présentant une hernie de l’aine compliquée ou non et ayant été pris en charge pendant la période d’étude. Les patients de moins de 15 ans présentant hernie de l’aine ou les autres formes de hernie de la paroi abdominale ont été exclus de notre étude. Résultats: Au cours de notre période d’étude nous avions opéré 444 hernies de l’aine dont 26 bilatérales sur les 2557 interventions réalisées en chirurgie générale. Parmi les patients opérés de hernie, 371 étaient des hommes et 60 des femmes avec une sex-ratio de 6,1.L’âge moyen était de 48 ans ±17,2.Toutes les professions étaient représentées dominées par les cultivateurs suivies des femmes au foyer. Après examen clinique les formes inguinales et inguino-scrotales prédominaient avec respectivement 60,8% et 37,6%. Parmi ces hernies de l’aine colligées 82 (18,5%) étaient étranglées et 6(1,4%) cas de récidives. Au plan thérapeutique, tous les patients avaient été opérés sous anesthésie loco-régionale. Les techniques opératoires utilisées étaient celle du Bassini dans 355 cas, le Shouldice dans 53 cas, le Lichtenstein dans 26 cas et le Mac Vay dans 10 cas. La durée moyenne du séjour était de 3,7 jours ±4,2. La morbidité a été de 6,5% dominée essentiellement par les hématomes de bourses et les suppurations pariétales. La mortalité est de 0,5%. Conclusion: La hernie de l’aine est très fréquente dans notre pratique. La hernie inguinale est la forme la plus rencontrée. Elle pose le problème de sa prise en charge dans les pays à ressources limitées. Une prise en charge précoce et efficiente permettra de réduire la morbi-mortalité dans nos pays pauvres.
Objective: To assess the prevalence of groin hernia and to analyze its management at Kara Teaching Hospital, Togo. Materials and Method: This was a retrospective and descriptive study that was carried out from July 1, 2014, to December 31, 2019, i.e., 66 months at the Kara Teaching Hospital. All patients over 15 years of age with a complicated or uncomplicated groin hernia who were treated during the study period were included in our study. Patients under 15 years of age with a groin hernia or other forms of abdominal wall hernia were excluded from our study. Results: During our study period, we operated on 444 groin hernias, including 26 bilateral out of the 2557 procedures performed in general surgery. Among the hernia operated patients, 371 were men and 60 were women with a sex ratio of 6.1. The mean age was 48 ± 17.2. All professions were represented dominated by farmers followed by housewives. After clinical examination, the anatomo-clinical varieties found were dominated by inguinal forms (60.8%), followed by inguino-scrotal forms (37.6 %). Among collected groin hernias, 82(18.5%) were strangulated alongside with 6(1.4%) cases of recurrence. Therapeutically, all the patients had been operated on under locoregional anesthesia. All patients had undergone hernia repair by laparotomy. The surgical technique used was that of Bassini in 355 cases, Shouldice in 53 cases, Lichtenstein in 26 cases, and Mac Vay in 10 cases. The associated pathologies were taken care of at the same operating time. The mean length of stay was 3.7 days ± 4.2. Morbidity was 6.5%, which is mainly dominated by bursa hematomas and parietal suppurations. Mortality was 0.5%. Conclusion: Groin hernias are very common in our practice. The inguinal hernia is the most common form. Some countries lack adequate resources to effectively treat groin hernia. Early and efficient treatment will reduce morbidity and mortality in poor countries.
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Sheng, Tan Shong, Mohd Shahrulsalam Mohd Shah, and Norsuhana Omar. "Obstructed left – sided Amyand’s hernia in a toddler." Bangladesh Journal of Medical Science 22, no. 2 (April 11, 2023): 449–53. http://dx.doi.org/10.3329/bjms.v22i2.65011.
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Amyand’s hernia refers to an inguinal hernia which contained the vermiform appendix in the hernia sac. It is more commonly found on the right side in relation to anatomical location of the vermiform appendix and left – sided Amyand’s hernia is very rare. Herein, we report a case of left – sided Amyand’s hernia with bowel obstruction in a 1 year 4 months old boy. The left groin mass was firm and tender, with skin erythema. However, the mass could not be completed incarcerated into the abdominal cavity. His abdomen was distended with sluggish bowel sound. A diagnosis of intestinal obstruction secondary to obstructed left inguino – scrotal hernia was made, and laparotomy was performed. During laparotomy, transverse skin incision was made on the upper abdomen, and the left inguinal canal was opened in accordance with the usual inguinal hernia repair. The hernia sac contained the appendix, caecum and twisted terminal ileal loops. Small bowel resection with primary anastomosis was performed with left herniorrhaphy. Appendix was preserved due to its normal appearance. He remained well during follow up with no hernia recurrence and testicular atrophy Bangladesh Journal of Medical Science Vol. 22 No. 02 April’23 Page : 449-453
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Ram, Shri, and Dharamanjai Kumar Sharma. "A Study of Initial Experience of Trans-Abdominal PrePeritonial Inguinal Hernia Repair at aTertiary Care Center." New Indian Journal of Surgery 12, no. 4 (December 31, 2021): 247–52. http://dx.doi.org/10.21088/nijs.0976.4747.12421.9.
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Introduction: Inguinal hernia surgery remains till date one of the most commonly performed surgeries. Overall decrease in recurrence rate along with shorter hospital stay, faster return to normal activities and a lower incidence of post-operative pain has led to the widespread acceptance of laparoscopic hernia repair especially Laparoscopic Transabdominal Preperitoneal repair in the management of inguinal hernia. The study was done to evaluate the initial experience of a tertiary care center in the laparoscopic hernia repair including the intra and post-operative complications and associated technical difficulties. Methodology: This prospective, descriptive study was performed in 22 patients during the period of 2018 to 2021. The patients were evaluated thoroughly for the predisposing factors, technical aspects of the procedure, intra-operative details, post-operative complications and the time taken for the procedure were noted. The patients were also followed up for a period of 6 months for late complications. Results: All the patients in the study group were male and majority of them were older than 40 years. Majority of the patients had heavy work as the risk factor and all of them presented with inguinal or inguino-scrotal swelling which reduced by itself. Majority of patents had right indirect and incomplete inguinal hernia. The mean operative time in initial cases were longer, but on acquiring experience, the operating time came down to approximately 90 minutes. The complications associated with the procedure were minimal with a return to normal routine in a mean of 15 days. Conclusion: Laparoscopic hernia repair is a significantly lengthier procedure especially in the learning phase of the surgeon’s team, but the operative time decreases with increasing experience. Good technique and knowledge about laparoscopic anatomy of inguinal region ensures minimal complications and faster recovery. Keywords: TAPP; TEP; Laparoscopic Hernia Repair; Inguinal Hernia Surgery.
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Suwardi, Suwardi, Nirwan Nirwan, Yeni Rimadeni, Saiful Oetama, and Halimatussakdiah Halimatussakdiah. "Application of Slow Deep Breathing Exercise in Reducing Pain Intensity in Pre-Operative Patients with Lateral Inguinal Hernia Sinistra: Case Study." Journal Keperawatan 3, no. 2 (December 31, 2024): 187–93. https://doi.org/10.58774/jourkep.v3i2.93.
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Background: Inguinal hernia occurs when there is a protrusion of the contents of a cavity through a weak part of the inguinal gap in the abdominal wall. The occurrence of inguinal hernia is caused by repeated and continuous increase in intra-abdominal pressure. The increase in inguinal hernia cases has now reached 20 million cases, most of which are suffered by late adults to the elderly with the main problem being acute pain and its management through herniotomy. Slow Deep Breathing Exercise is one of the non-pharmacological therapies that is often used to overcome acute pain felt by pre-operative patients. Purpose: To provide an overview of the application of slow deep breathing in the management of acute pain in preoperative patients with left lateral inguinal hernia treated at the Zainoel Abidin Regional General Hospital, Banda Aceh. Methods: Descriptive research with case studies through the nursing process approach from assessment, nursing diagnosis, planning, implementation, and evaluation. The subject of the study was 1 Pre-Operative Hernia Inguinalis Lateralis Sinistra patient who was treated in the internal medicine room who was given Slow Deep Breathing Exercise intervention. The research instruments used to collect data were medical surgical nursing care sheets and pain measuring instruments using the Numeric Rating Scale. Results: After implementing Slow Deep Breathing Exercise twice a day (duration 15 minutes during the intervention) for 3 days combined with oxygen therapy via nasal cannula (3 liters/minute), the patient's main problem, namely acute pain, decreased from a scale of 8 to 6 with all patient activities still being assisted. Conclusion: Based on the research results, it can be concluded that the patient's problem, namely acute pain, was partially resolved through the Slow Deep Breathing Exercise intervention because the pain still often occurs with an uncertain duration and interferes with the patient's basic needs.
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Igna, Cornel, Roxana Dascalu, Daniel Bumb, Bogdan Sicoe, and Larisa Schuszler. "SURGICAL MANAGEMENT BY STANDING LAPAROSCOPY AND INGUINAL CELIOTOMY APPROACH OF THE CRYPTORCHID CANADIAN PONY STALLION – CASE REPORT." Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. Veterinary Medicine 73, no. 2 (November 29, 2016): 259. http://dx.doi.org/10.15835/buasvmcn-vm:12071.
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SURGICAL MANAGEMENT BY STANDING LAPAROSCOPY AND INGUINAL CELIOTOMY APPROACH OF THE CRYPTORCHID CANADIAN PONY STALLION – CASE REPORT Cornel IGNA1*, Roxana DASCALU1, Daniel BUMB1, Bogdan Sicoe1, Larisa SCHUSZLER1 1 Banat’s University of Agricultural Science and Veterinary Medicine, “King Michael I of Romania” from Timisoara, Romania *Corresponding author, e-mail: ignacornel@gmail.com Keywords: cryptorchidectomy, inguinal celiotomy, laparoscopic, stallion pony Introduction: Laparoscopic surgery has become an accepted method of identification and removal of intra-abdominal testes in the horse. Wilson and Madison – 1989 describe the use of laparoscopy to diagnose an abdominal retained testes. Since then numerous laparoscopic cryptorchidectomy techniques have been described. Aims: In the encountered specialty literature there are few reports in which standing laparoscopic cryptorchidectomy could not be performed in stallions including miniature horse too. Because there are no informations regarding laparoscopic surgery in large animals in romanian literature this report describes the surgical management of a Canadian pony diagnosed with partial abdominal unilaterally cryptorchidism at which laparoscopic castration has failed and the removal of the retained testicle has been made through inguinal celiotomy. Materials and Methods: A 4-year-old unilaterally cryptorchid Canadian pony was admitted for castration. The left testis was in the scrotum, but neither the right testis nor the right epididymis could be located by external palpation of the right inguinal canal. The proposed treatment was laparoscopic cryptorchidectomy with pony standing in stock. With a long-handled forceps inserted into the abdominal cavity, the testis cord is gently grasped and moderate traction without success in bringing the testicle into the abdomen - retained testis. After the failure of laparascopic cryptorchidectomy but having an exact diagnosis - partial abdominal unilaterally cryptorchidism, we have proceeded to open cryptorchidectomy via inguinal approach with pony anesthetized and positioned in dorsal recumbency. Results: This case report reveals that the major disadvantage of the cryptorchidectomy by flank approach is the inability to remove an inguinally retained testis. Conclusion: If the location of the testis is unknown, the standing laparoscopic diagnose can be decisive. Cryptorchidectomy via inguinal approach and noninvasive method for identifying and everting the vaginal process by traction of the inguinal extension of the gubernaculum testis are commonly facile procedure.
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Hacker, Neville F., Ellen Barlow, Stephen Morrell, and Katrina Tang. "Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival." Cancers 13, no. 22 (November 19, 2021): 5806. http://dx.doi.org/10.3390/cancers13225806.
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Background: Lower limb lymphedema is a long-term complication of inguino-femoral lymphadenectomy and is related to the number of lymph nodes removed. Our hypothesis was that lymph nodes lateral to the femoral artery could be left in situ if the medial nodes were negative, thereby decreasing this risk. Methods: We included patients with vulvar cancer of any histological type, even if the cancer extended medially to involve the urethra, anus, or vagina. We excluded patients whose tumor extended (i) laterally onto the thigh, (ii) posteriorly onto the buttocks, or (iii) anteriorly onto the mons pubis. After resection, the inguinal nodes were divided into a medial and a lateral group, based on the lateral border of the femoral artery. Results: Between December 2010 and July 2018, 76 patients underwent some form of groin node dissection, and data were obtained from 112 groins. Approximately one-third of nodes were located lateral to the femoral artery. Positive groin nodes were found in 29 patients (38.2%). All patients with positive nodes had positive nodes medial to the femoral artery. Five patients (6.6%) had positive lateral inguinal nodes. The probability of having a positive lateral node given a negative medial node was estimated to be 0.00002. Conclusion: Provided the medial nodes are negative, medial inguino-femoral lymphadenectomy may suffice and should reduce lower limb lymphedema without compromising survival.
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Albarghouth, Mohamad Hatem, Claudia Schulze, Robin Bothmann, and Amir Hamza. "Einfluss der Resektionsränder und des Zeitpunkts der inguinalen Lymphadenektomie auf die Lokalrezidivrate und die Überlebensrate bei Patienten mit Peniskarzinom." TumorDiagnostik & Therapie 44, no. 07 (August 29, 2023): 479–86. http://dx.doi.org/10.1055/a-2110-9488.
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Zusammenfassung Hintergrund In einer monozentrischen Analyse soll der Einfluss der Resektionsränder und des Zeitpunkts der inguinalen Lymphadenektomie auf die Lokalrezidivrate und die Überlebensrate bei Männern mit histologisch gesichertem Peniskarzinom untersucht werden. Material und Methoden Im Zeitraum von 2011–2021 wurden insgesamt 31 männliche Patienten in unserem Krankenhaus bezüglich ihres Peniskarzinoms behandelt. 32% dieser Patienten zeigten dabei einen lokal fortgeschrittenen Primärbefund. Eine totale Penektomie wurde bei 9 Patienten, eine partielle Penektomie bei 17 Patienten und eine lokale Exzision in 5 Fällen durchgeführt. Eine bilaterale inguinale Lymphadenektomie wurde bei 16 Patienten durchgeführt. Die Patienten wurden bezüglich des minimalen Abstands der Resektionsränder (<1cm vs. >1cm) und dann erneut anhand des Zeitpunkts der inguinalen Lymphadenektomie (<6 Monate vs. >6 Monate) in 2 Gruppen eingeteilt. Die Ergebnisse wurden bezüglich der Lokalrezidivrate und der Überlebensrate analysiert. Ergebnisse Das 1-Jahres-rezidivfreie Überleben lag bei 84%. Das 1-Jahres-Gesamtüberleben lag bei 70,9% (5 Jahre: 60,9%). Die 1-Jahres-Überlebensrate lag bei 68,7% im Falle, dass der minimale Abstand zum Resektionsrand unter 1cm lag, und bei 73,4%, wenn der minimale Abstand zum Resektionsrand über 1cm lag. Die Rate an Lokalrezidiven nach einem Jahr war geringer, wenn die inguinale Lymphadenektomie innerhalb der ersten 6 Monate nach Diagnosestellung durchgeführt wurde (38,5% versus 66,7%). Diese Unterschiede waren statistisch jedoch nicht signifikant. Schlussfolgerung Ein minimaler Abstand zum Resektionsrand unter 1cm und eine frühzeitige inguinale Lymphadenektomie verbesserten statistisch nicht signifikant das Gesamtüberleben oder reduzierten statistisch die Rezidivrate (p=0,611; p=0,375).
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Woelber, Linn, Mareike Bommert, Katharina Prieske, Inger Fischer, Christine zu Eulenburg, Eik Vettorazzi, Philipp Harter, et al. "Pelvic Lymphadenectomy in Vulvar Cancer – Does it make sense?" Geburtshilfe und Frauenheilkunde 80, no. 12 (December 2020): 1221–28. http://dx.doi.org/10.1055/a-1120-0138.
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AbstractSince the publication of the updated German guideline in 2015, the recommendations for performing pelvic lymphadenectomy (LAE) in patients with vulvar cancer (VSCC) have changed considerably. The guideline recommends surgical lymph node staging in all patients with a higher risk of pelvic lymph node involvement. However, the current data do not allow the population at risk to be clearly defined, therefore, the indication for pelvic lymphadenectomy is still not clear. There are currently two published German patient populations who had pelvic LAE which can be used to investigate both the prognostic effect of histologically verified pelvic lymph node metastasis and the relation between inguinal and pelvic lymph node involvement. A total of 1618 patients with primary FIGO stage ≥ IB VSCC were included in the multicenter AGO CaRE-1 study (1998 – 2008), 70 of whom underwent pelvic LAE. During a retrospective single-center evaluation carried out at the University Medical Center Hamburg-Eppendorf (UKE), a total of 514 patients with primary VSCC treated between 1996 – 2018 were evaluated, 21 of whom underwent pelvic LAE. In both cohorts, around 80% of the patients who underwent pelvic LAE were inguinally node-positive, with a median number of three affected groin lymph nodes. There were no cases of pelvic lymph node metastasis without inguinal lymph node metastasis in either of the two cohorts. Between 33 – 35% of the inguinal node-positive patients also had pelvic lymph node metastasis; the median number of affected groin lymph nodes in these patients was high (> 4), and the maximum median diameter of the largest inguinal metastasis was > 40 mm in both cohorts. Pelvic lymph node staging and pelvic radiotherapy is therefore probably not necessary for the majority of node-positive patients with VSCC, as the relevant risk of pelvic lymph node involvement was primarily found in node-positive patients with high-grade disease. More, ideally prospective data collections are necessary to validate the relation between inguinal and pelvic lymph node involvement.
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Hyde, S. E., S. Valmadre, N. F. Hacker, M. S. Schilthuis, P. T. Grant, and J. Van Der Velden. "Squamous cell carcinoma of the vulva with bulky positive groin nodes—nodal debulking versus full groin dissection prior to radiation therapy." International Journal of Gynecologic Cancer 17, no. 1 (January 2007): 154–58. http://dx.doi.org/10.1111/j.1525-1438.2006.00769.x.
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Patients with clinical palpable involved groin lymph nodes and squamous cell cancer of the vulva are frequently treated by a full inguinal-femoral lymph node dissection followed by adjuvant radiotherapy to the groins and pelvis. Theoretically, less radical surgery for the groin such as nodal debulking, where only the macroscopically involved nodes are resected, allowing radiotherapy to treat any remaining microscopic disease may potentially decrease morbidity without compromising survival The objective of this retrospective study was to compare the groin recurrence rate and survival (disease specific and overall survival) of patients with clinically involved groin nodes and squamous cell carcinoma of the vulva treated either by a full inguino-femoral lymphadenectomy or by a nodal debulking followed by radiotherapy. Forty patients from three separate databases who met these criteria were identified. Patients were treated either by a full inguino-femoral lymphadenectomy or by a debulking of the clinically involved inguinal lymph nodes. All patients received adjuvant radiotherapy to the groins. In these two groups, there was no difference in groin recurrence rate expressed as groin recurrence-free survival (P= 0.247). In a univariate analysis, both overall and disease-free survival were better in the group of patients treated by nodal debulking. However, in a multivariate analysis, other variables such as extracapsular growth were independent predictors for survival while the method of surgical dissection for the groin had no independent significant impact on survival.
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Viqar Aslam, Muhammad Bilal, Waqar Alam Jan, Alina Zaidi, Muhammad Ayaz, and Lubna Gul. "Comparison of non-mesh vs mesh technique for inguinal hernias. A randomized clinical study." Professional Medical Journal 31, no. 04 (April 1, 2024): 514–17. http://dx.doi.org/10.29309/tpmj/2024.31.04.7784.
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Objective: To assess the efficacy of mesh with non-mesh techniques in the management of primary inguinal hernias. Study Design: Randomized Clinical Trail. Setting: Teaching Hospital Peshawar. Period: March 2022 till January 2023. Methods: This RCT study was conducted 166 on individuals with primary, reducible inguinal or inguino-scrotal hernias based on predetermined inclusion criteria. For the purpose of hernia repair, they were split into two groups: non-mesh and mesh repair. Computer-generated random numbers were contained in sealed opaque envelopes. Acute groin discomfort, the amount of time needed to return to duty, and sequelae were evaluated as clinical outcomes. SPSS version 23 was used to enter and analyzed the data. Results: Age range for mesh group was 33-65 while for non-mesh 34-65. Observed Male to female ratio was 9:1. In both groups, there was no discernible difference in pain. There were notable variations in the amount of time needed to resume work. Conclusion: Both repairs techniques are effective to treat hernias but mesh repair has superior results.
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Dewan, Dr Md Nayeem, Dr Prosunto Kumar Das, Dr Abu Masud Al Mamun, Dr Farid Uddin Ahamad, Dr S. M. Sarwar Jahan, and Dr Shaikh Adnan Rakib. "Aetiopathologiacl Pattern of Intestinal Obstruction among Different Age Group." Scholars Journal of Applied Medical Sciences 10, no. 12 (December 5, 2022): 2117–23. http://dx.doi.org/10.36347/sjams.2022.v10i12.012.
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Background: Intestinal obstruction demands early diagnosis and proper management to reduce morbidity and mortality. The morbidity and mortality is still high despite modern medical and technical facilities. This study was undertaken to highlight the aetiopathological pattern of intestinal obstruction among different age group for early diagnosis and management. Thus reducing the fatal outcome by preventing complications. Objective: To evaluate aetiopathological pattern of intestinal obstruction among different age group. Methods: This cross sectional observation study was done in the Surgery Department of Dhaka Medical College Hospital, from July 2008 to 2009. Total 150 cases of clinically diagnosed obstruction were included in this study. All cases were clinically evaluated followed by thorough investigations and their causes were established. The final diagnoses were based on preoperative findings and in some cases histopathological findings of the respected specimen. Result: 150 Patients were included in this study with the median age 34.5+10.9 years. Male to Female ratio3:1.Clinical diagnosis demonstrates that nearly half(48%) of the patients had inguinal hernia,13.3% had post operative bands and adhesions,12.5% had intestinal; tuberculosis,12.7% had intestinal maligacy, 6.7% had volvulus of sigmoid colon. In this study of association of causes of intestinal obstruction in relation to age showed that young adults (Age-35 or below) had higher frequency of inguinial hernia (55.2%) compared to those that were middle aged or elderly (more than 35 years of age) P<0.05 indicating significant difference between the two groups. Conclusion: This study showed inguinal hernia to be significant cause of intestinal obstruction in young adults compared to those who were middle-aged or elderly. Inguinal hernia though always not complicates but it should be taken seriously as a potential cause of intestinal obstruction and elective operation should be advocated whenever .......
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Chernyh, A. V., E. N. Lyubyh, V. G. Vitchinkin, and E. I. Zakurdaev. "A novel method for assessing valvular mechanism of deep inguinal ring considering the objective topographic anatomical criteria." Kazan medical journal 95, no. 3 (June 15, 2014): 460–64. http://dx.doi.org/10.17816/kmj1536.
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Aim. To develop a method to assess the valvular mechanism of deep inguinal ring based on objective topographic anatomical criteria. Methods. The research was performed on 123 native corpses of persons without pathology of the anterior abdominal wall. Morphometric examination of the inguinal canal was carried out. The shape of the inguinal gap was determined, inguinal gap and inguinal canal length was measured, as well as deep inguinal ring length and height and deep inguinal ring height. Oval fissured inguinal gap was revealed in 49 (39.8%) persons, intermediate oval - in 51 (41.5%), triangular - in 23 (18.7%). Results. The dependence of the length of the inguinal canal, inguinal gap length, deep inguinal ring size and its standing height on the inguinal gap shape was examined. The method for an objective assessment of the deep inguinal ring valvular mechanism was proposed. The method is based on determining the deep inguinal ring location in reference to the internal oblique abdominal muscles by estimating the integral rate of the inguinal canal length and the inguinal gap length and deep inguinal ring height. Three options for the deep inguinal ring location: upper lateral, lower medial and boundary location are described. Deep inguinal ring positions were determined by cluster analysis. In cases of upper lateral position, which was observed in 28 (22.8%) of cases, the valvular mechanism of deep inguinal ring was stable. In cases of deep inguinal ring lower medial position (41 cases, 33.3%), the opposite results were gained. In cases of deep inguinal ring boundary location (54 cases, 43.9%), the valvular mechanism is stable, but may become insolvent if destructive changes of the lateral abdominal muscles and deep inguinal ring expansion were present. Conclusion. An objective method of assessing the deep inguinal ring valvular mechanism, based on determining the deep inguinal ring location in reference to the oblique abdominal muscles was developed.
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Pun, Ashis, and Roshan Khatri. "Left Sided Amyand’s Hernia with Sliding Component." Journal of Nepal Medical Association 52, no. 189 (March 31, 2013): 285–87. http://dx.doi.org/10.31729/jnma.577.
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The eponym ‘Amyand hernia’ coined in recognition of Claudius Amyand, the first surgeon to successfully perform appendectomy in a hernia sac containing appendix, refers to the vermiform appendix within inguinal hernia.
Here, we present a rare case, of Amyand’s hernia in an 18 month-old boy who was brought with an inguino-scortal swelling which later on exploration was left sided Amyand’s hernia with sliding component.
Amyand’s hernia is not very often seen in the clinical practice and its pre-operative diagnosis is very difficult hence awareness of this disease condition is essential for preoperative suspicion and even diagnosis of the condition.
Keywords: Amyand’s hernia; acute appendicitis; hernial repair.
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Johansen, N., C. D. Vyrdal, and T. Bisgaard. "Nationwide Results on Chronic Pain After Bilateral Transabdominal Preperitoneal Inguinal Hernia Repair." Scandinavian Journal of Surgery 109, no. 4 (September 13, 2019): 289–94. http://dx.doi.org/10.1177/1457496919874483.
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Background: Majority of studies on chronic postoperative inguinal pain has described the occurrence after unilateral inguinal hernia repair. Endo-laparoscopic repair, for example, laparoscopic transabdominal preperitoneal inguinal hernia repair, has been recommended for primary bilateral symptomatic inguinal hernias, although the literature on chronic postoperative inguinal pain among this type of patients is limited. The present study analyzed chronic postoperative inguinal pain following bilateral transabdominal preperitoneal inguinal hernia repair. Methods: Nationwide consecutive patients who underwent bilateral transabdominal preperitoneal inguinal hernia repair (July 2012–June 2013) were recruited from the Danish Inguinal Hernia Database and cross-checked with hospital files and the National Patient Registry. A prospective follow-up was performed with a standardized postal questionnaire including questions on functional performance status assessed by a modified version of the Activity Assessment Scale. The primary outcome was incidence of chronic postoperative inguinal pain defined as moderate to severe pain-related impairment of everyday activities. Pain was registered according to the two individual groin areas. Furthermore, the overall incidence of chronic postoperative inguinal pain per operated inguinal hernia was calculated. Intensity of experienced pain (Activity Assessment Scale score) was compared between patients reporting pain from one versus both groin areas. Results: In total, 209 patients (418 hernia repairs) were analyzed (questionnaire response rate 83%). The median follow-up time was 27 months (22–34 months). In total, 27 of 209 patients (13%) complained of chronic postoperative inguinal pain from either one ( n = 17) or both ( n = 10) groin areas after bilateral transabdominal preperitoneal inguinal hernia repair. The incidence of chronic inguinal pain per operated hernia was 9%. The intensity of impairment due to pain (Activity Assessment Scale score) did not differ significantly between patients with chronic postoperative inguinal pain in one (19%) versus both sides (30%), p = 0.056. Conclusion: Bilateral transabdominal preperitoneal inguinal hernia repair for symptomatic inguinal hernias was related to a high incidence (13%) of chronic postoperative inguinal pain and decreased functional performance status.
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Nawaz, Yassir, Mihir Barvalia, Gurinder Rana, M. Zain Khakwani, Khizr Azim, Rahul Patel, Sohira Idrees, Gail Baker, Marc Cohen, and Najam Wasty. "Poorly recognized age-related downward deviation of the inguinal ligament." SAGE Open Medicine 4 (January 1, 2016): 205031211667556. http://dx.doi.org/10.1177/2050312116675565.
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Objective: To determine factors affecting actual inguinal ligament course in live human subjects. Introduction and hypothesis: Although the expected inguinal ligament course is supposedly a straight line extending from anterior superior iliac spine to pubic tubercle, the actual inguinal ligament course is frequently depicted a priori by a downward bowing dotted line. There are no studies in a live subject supporting this assumption. We hypothesized this assumption is indeed valid and is related to among other factors a lifelong effect of gravity and lax abdominal musculature on the inguinal ligament course. Methods: We retrospectively reviewed 54 consecutive computed tomography scans of the abdomen and pelvis randomly distributed across all age groups. Actual inguinal ligament course was visualized by reconstructing images using Terracon software. Vertical distance from the lowest point of actual inguinal ligament course to the expected inguinal ligament course was measured. We used multiple linear regression analysis to study the correlation between degree of inguinal ligament deviation and several variables. Results: Actual inguinal ligament course was below the expected inguinal ligament course in 52 of 54 patients. The mean deviation was 8.2 ± 5.9 mm. Advanced age was significantly associated with greater downward bowing of the inguinal ligament (p = 0.001). Conclusion: Actual inguinal ligament course is often well below the expected inguinal ligament course; this downward bowing of the inguinal ligament is especially pronounced with advancing age. Operators need to be mindful as this downward bowing can lead to supra-inguinal sticks causing vascular complications.
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Mahalingam, Kokilavani, and Lakshmi Sundararajan. "Abdominoscrotal Hydrocele - Considerations." Journal of Indian Association of Pediatric Surgeons 29, no. 4 (July 2024): 360–63. http://dx.doi.org/10.4103/jiaps.jiaps_6_24.
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ABSTRACT Aim: The aim of the study was to highlight the pathology, clinical spectrum, and approach considerations in abdominoscrotal hydrocele (ASH). Materials and Methods: Our study included eight children with ASH from 2015 to 2022. The demographics, clinical presentation, investigations, operative details, and postoperative outcome were collected retrospectively from case files. Results: The age of presentation ranged from 11 months to 2½ years. Six lesions were on the right side and two were on the left side. One child presented with an acute scrotum and underwent emergency inguinal exploration, revealing hemorrhagic fluid after trauma. Others presented with tense inguinoscrotal swelling, which was fully reducible but refilled promptly after emptying. Preoperative ultrasound showed the abdominal component in 50%, while others were detected intraoperatively. All of them were approached inguinally, and the hydrocele sac was traced proximally to the abdominal component through the internal ring. This was drained and a partial excision of the extraperitoneal sac was done. An additional patent processus vaginalis (PPV) was identified in 87%, dissected up to the deep ring, and ligated. On follow-up, there was no recurrence. Conclusion: ASH is an uncommon condition that should be identified and dealt with appropriately. Physical examination and ultrasonography are usually sufficient for diagnosis. The inguinal approach is a safe, simple method and an extension of the standard operation for the hydrocele. One must keep in mind to explore for an additional narrow PPV to prevent the recurrence of hydrocele.
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Osuoji, Roland I., and Michael A. Bankole. "Do Infants and Children have Measurable Inguinal Canals?" Journal of Nepal Paediatric Society 33, no. 3 (December 15, 2013): 182–85. http://dx.doi.org/10.3126/jnps.v33i3.8355.
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Introduction: Herniotomy is a common procedure performed by Paediatric Surgeons. However, opinions differ as to whether to open the inguinal canal when performing this procedure or not. Those who advocate performing herniotomy without opening the inguinal canal believe that in early childhood, the superficial inguinal ring is directly superimposed on the deep inguinal ring, there being no appreciable inguinal canal in this age group. Our study was planned to open the inguinal canal and simply measure the distance between the pubic tubercle medially and the inferior epigastric vessels laterally. Finding a measurable inguinal canal in all cases studies debunks the belief that the superficial inguinal ring frequently overlaps the deep inguinal ring. Materials and Methods: From October 2007 to September 2008 and from May 2012 to April 2013 the inguinal canals of 75 children from 1 day to 2 years old were measured during herniotomies and orchidopexies. Premature babies were excluded from this study. The inguinal canals were all opened. Using a simple sterilized metallic ruler, the distance between the ipsilateral inferior epigastric vessels and the ipsilateral pubic tubercle was measured. Results: The lengths of the inguinal canals ranged from 1cm to 4.5 cm (mean 2.88cm+/-.71cm SD). The shortest inguinal canal length was 1 cm while the longest inguinal canal was 4.5 cm. Conclusion: Children with inguinal hernia up to the age of 2 years have a measurable inguinal canal and we suggest the excision of the hearnial sac superficial to the external inguinal ring runs the risk of leaving substantial sac behind proximal to the transfixing suture, even when some traction is applied to the sac before applying the transfixing suture. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8355 J. Nepal Paediatr. Soc. 2013;33(3):182-185
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Mohanapriya, T., T. R. Karthikeyan, K. Balaji Singh, and T. Arulappan. "Ilio inguinal neurectomy in inguinal hernia." International Surgery Journal 4, no. 9 (August 24, 2017): 2977. http://dx.doi.org/10.18203/2349-2902.isj20173729.
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Background: Inguinal hernia is one of the most common surgery done in any hospital. Chronic inguinal pain is one of the common problem these patients complain of. This study aims at evaluating the long-term outcomes of neuralgia and paraesthesia following routine ilioinguinal nerve division, compared to nerve preservation when performing Lichtenstein’s inguinal hernia repair.Methods: The present study is a randomized controlled trial of 60 cases of inguinal hernias admitted in General Surgery Department in our hospital. The patients were randomly chosen into Lichtenstein hernia repair with ilioinguinal neurectomy or Lichtenstein hernia repair with nerve preservation. After surgery, all patients were monitored carefully for pain and paraesthesia. Pain was assessed using visual analogue scale. Paraesthesia was assessed by the monofilament test and evaluated after comparison with the opposite side.Results: In the present study, the incidence of pain as well as the severity of pain is far higher in the nerve preservation study group as opposed to the neurectomy study group. Hypaesthesia is not a significant complication following ilioinguinal neurectomy and does not significantly add to the morbidity of the patient.Conclusions: Prophylactic neurectomy can be an appropriate solution in the prevention of chronic groin pain following Lichtenstein inguinal hernia repair and can be considered as an ideal inclusion into the standard hernia repair procedures. Hypoesthesia is not a significant complication following ilioinguinal neurectomy and does not significantly add to the morbidity of the patient.
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Musa-Olomu, Abdus-Samiu A., Titilayo M. Musa, Nurudeen A. Adeleke, Nurudeen T. Abdulraheem, and Abdulwahab A. Ajape. "One stage repair of giant inguinal herniae: a feasible option." Egyptian Journal of Surgery 42, no. 3 (July 2023): 697–704. http://dx.doi.org/10.4103/ejs.ejs_143_23.
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Background Surgical repair of giant inguino-scrotal hernia (GIH), based mainly on anatomical considerations and minimal organ resection; without the use of mesh or pneumo-peritoneum. Patients/method Over a-15-year period (2005-2019), all patients managed for GIH were reviewed. They had an elevation of the scrotum, and foot of the bed, to allow for the reducible part of the hernia to gradually return and expand the abdominal cavity. Volume estimations of the hernias were done applying Archimedes’ principle followed by a-5-day bowel preparations. Abdomino-inguinal/Inguinal incisions (depending on the size), were made to repair the hernias taking advantage of the special anatomical make-up of the abdominal cavity. Results A total of 20 male patients with GIH were treated; 13 were on the right while seven were left-sided. All the GIHs were repaired successfully without any serious morbidity; one patient had a scrotal hematoma that was managed conservatively and another developed a ventral hernia (5 cm long), which was repaired at a later day. An average of 6 months follow-up revealed no recurrence or any other complications. Conclusion Surgical techniques in the repair of GIH are many and varied but its rarity has made the adoption of any specific technique(s) impossible. A fairly large series like ours over many years might be a fruitful attempt at solving this problem.
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Amsriza, Fadli Robby, and Rizka Fakhriani. "Amyand’s Hernia: A Rare Case Report." Berkala Kedokteran 17, no. 2 (September 29, 2021): 159. http://dx.doi.org/10.20527/jbk.v17i2.11677.
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Abstract: Amyand’s hernia is described in the inguinal hernia sac as being the presence of an appendix vermiformis. It is a rare condition the incidence is about 1 per cent of all inguinal hernias. It is often diagnosed incidentally during inguinal hernia surgery. The main treatment method of Amyand’s hernia is surgery. We report a case of 63 years old man who presented with right inguinal groin bulge for 1 month with the previous repaired right inguinal hernia 5 years ago. On clinical examination revealed a 6 cmx8 cm firm, nontender, irreponible mass in the right inguinal region. He was diagnosed as right sided irreponible inguinal hernia. He was undergoing the elective surgery. Intra-operative, the hernia sac was laterally found in the inferior epigastric vessels and separated from sperm cord to deep inguinal ring. The hernia sac was opened. A non-inflamed appendix was seen. Appendectomy was performed, and the hernia was repaired by Halsted’s repair. Amyand’s hernia is a rare condition. The correct diagnosis is usually made intraoperative. Keywords: Amyand’s hernia, appendectomy, hernia repair, inguinal hernia.
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Ali, Sheikh Ziarat, Waqas Aziz, Kiran Qamar, Fariha Aslam, Mehtab Tipu Chaudary, and Nazia Rubab Maqbool. "Comparison of Mean Pain Score with Inguinal Block under Gen. Anes. versus Subarachnoid Block in Adult Pts UIH." Pakistan Journal of Medical and Health Sciences 16, no. 4 (April 26, 2022): 308–10. http://dx.doi.org/10.53350/pjmhs22164308.
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Objective: To compare the mean pain score with inguinal block under general anesthesia versus subarachnoid block in adult patients undergoing inguinal hernioplasty. Design of the Study: Randomized controlled trial Study Settings: This cross-sectional study was conducted at Department of Anesthesiology, Sir Ganga Ram Hospital, Lahore from January 2021 to June 2021. Materials and Methods: Sample of 200 cases was included through non probability purposive sampling. In group A, patients were given inguinal block and in group B, patients were given subarachnoid block. In Inguinal block group, a 10mL of Bupivacaine (0.5%) will be given at junction of 2/3 form umbilicus and 1/3 from anterior superior iliac spine after administration of general anesthesia with laryngeal mask airway. Patients were followed at 1, 2 and finally on 4 hours after surgery for measurement of pain. Results: The mean age of 39.63±6.50 years. Out of total 200 patients, 186 (93%) were males and 14 (7%) were females. The mean pain score at 1st hour in inguinal group was 0.76±0.87 whereas pain score in Subarachnoid block was 1.18±0.92. Similarly after 2nd hour inguinal group pain score was 0.88±0.84 and with Subarachnoid block was 1.33±1.04. At 3rd hour, with inguinal block mean pain score was 1.02±0.92 and with Subarachnoid block was 1.80±1.20. At 4th hour, with inguinal block mean pain score was 1.59±1.07 and with Subarachnoid block was 3.09±1.60. Statistically there is highly significant difference of mean pain score between both groups i.e. p-value<0.05. There was drastic increase in mean main score at 4th hour with subarachnoid block as compared to inguinal block showing that inguinal block is more effective in reducing pain after 4 hours of surgery. Conclusion: It was concluded from results of this study that inguinal block is more beneficial in controlling pain after inguinal hernia surgery as compared to subarachnoid block Keywords: Inguinal Hernia, Inguinal block, Spinal anesthesia, General anesthesia
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Rai, Vijeth, Ranadheer Raju Cholaraju Siva, and Gagan Deep. "Incarcerated Amyand hernia: a rare entity." International Surgery Journal 7, no. 8 (July 23, 2020): 2748. http://dx.doi.org/10.18203/2349-2902.isj20203269.
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Right sided inguinal hernia containing vermiform appendix in its sac is called as amyand’s hernia. It accounts for ∼1% of all inguinal hernias. It is an intra operative finding during an inguinal hernia repair. A 64 years old male patient came with complains of swelling in the right inguinal region, associated with pain and vomiting. On examination of the right inguinal region there was a tender irreducible swelling palpable. Based on the characteristic finding it was diagnosed clinically as right sided irreducible obstructed inguinal hernia. Ultrasound abdomen was done which was suggestive of right inguinal hernia with herniation of bowel and omentum with features of strangulated/ obstructed hernia. Patient was taken up for right inguinal hernia repair and appendix was noted in the hernial sac intra-operatively. Although occurrence of amyand’s hernia is rare. The attendant surgeon should be vigilant about the presence of it. Preoperative diagnosis of amyand’s hernia is not common because in majority of cases objective of imaging is to exclude conditions that predispose to inguinal hernia formation. The Losanoff and Basson’s criterion is used as a guide for deciding whether to perform appendectomy and type of repair, depend on the clinical scenario.
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Любых, E. Lyubykh, Малеев, Yu Maleev, Черных, A. Chernykh, Закурдаев, and E. Zakurdaev. "To the Question about the Peculiarities of the Structure of Transverse Abdominal Fascia at the Persons of Different Sex, Age and with Different Form of the Inguinal Period." Journal of New Medical Technologies 21, no. 2 (August 13, 2014): 21–26. http://dx.doi.org/10.12737/4990.
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The study was aimed at finding new structural features of the rear wall of the inguinal canal, the use of which allow to improving the prevention of inguinal hernias. The study involved 123 corpses of different sex and age. Anatomical and physiological nature of the valve mechanism inguinal canal, the peculiarities of the structure of the back wall in individuals of different sex and age were revealed; the various forms of inguinal gap were studied. Using cluster analysis of transverse fascia thickness abdominal length and height of the deep inguinal ring was one of three variants of the structure back wall of the inguinal canal: a strong, transient and weak. The technique of determining the location of the deep inguinal ring relative to the edge of the internal oblique abdominal muscles is offered. The use of this technique objectively reflects the anatomical and physiological characteristics of the inguinal canal as a whole. In interpreting the results of a valve mechanism of deep inguinal ring should be considered ineffective in the medial or medial edge of the boundary location of the deep inguinal ring relative to the internal oblique abdominal muscles. Functional and anatomical factors that contribute to the formation of inguinal hernias were identified. It is proved that the triangular shape of the inguinal gap causes a high risk of inguinal hernias. In both sexes the transverse abdominal fascia becomes thinner with age, and the deep inguinal ring increases in size. The obtained data will improve the effectiveness of preventive measures.
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Embleton, Didem Baskın, Ahmet A. Tuncer, and Salih Çetinkurşun. "Telephone survey of inguinal hernia repair patients older than 5 years for chronic pain." International Surgery Journal 5, no. 6 (May 24, 2018): 2045. http://dx.doi.org/10.18203/2349-2902.isj20181998.
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Background: Little is known about chronic pain in the inguinal region following inguinal hernia repair in children. A study was conducted to examine whether pain is an important complication of inguinal hernia surgery in children.Methods: A telephone survey was performed of former patients who had undergone inguinal hernia repair and are now older than 5 years. A questionnaire was prepared and the questions were asked by paediatric surgeons.Results: There were 66 former patients now older than 5 years old. Patients had inguinal hernia repair at between 11 days and 14 years of age (mean 3.24 years). Age during telephone survey was between 5 and 18 years (mean 7.48 years). One patient had late pain related to direct inguinal hernia occurrence (1.5%). Three patients described non-specific abdominal pain unrelated to the inguinal operation. None of the patients were taking painkillers.Conclusions: Although this is a small sample group, chronic pain does not seem to be a serious problem after inguinal hernia repair in children.
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Gorovyi, Victor I., Volodymyr O. Shaprynskyi, Ihor V. Baralo, Oleh M. Kapshuk, Vasylysa G. Suleimanova, Ihor I. Dovgan, and Valentyn R. Taheiev. "ONE-STAGE PROSTATECTOMY ACCOMPANIED BY HERNIOPLASTY TO IMPROVE QUALITY-OF-LIFE OUTCOMES OF PATIENTS WITH COMBINED SURGICAL PATHOLOGIES." Wiadomości Lekarskie 76, no. 12 (2023): 2601–6. http://dx.doi.org/10.36740/wlek202312108.
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The aim: To evaluate whether simultaneous inguinal hernioplasty during prostatectomy confers benefits on quality-of-life outcomes. Materials and methods: 152 patients with prostatic adenoma were observed. The general group included 32 (21%) patients with prostatic adenoma and hernia inguinalis, who underwent one-stage prostatectomy accompanied with hernioplasty. 120 (79%) persons of comparison group underwent a prostatectomy only. The average age of the comparison group was 68.0±7.0 years, the general group - 67.1±6.9 years; the average prostate volume was 94.4±42.3 cm3 and 91.2±32.6 cm3 respectively. Hernia inguinalis was in 32 patients of the general group, in 4 of them - on both sides (36 cases totally). Results: The average time of retropubic prostatectomy in both groups was the same, and simultaneous hernioplasty took 35.0±17.4 minutes. The frequency of early and late bleeding after prostatectomies in the general group was 6.25% (2 cases) and 7.5% (9 cases) in the comparison group. No deaths were noted in two groups. The quality-of-life outcomes after the one-stage prostatectomy accompanied with hernioplasty in 6 and 12 months were statistically better than before these operations. Conclusions: Performing one-stage prostatectomy accompanied with hernioplasty does not worsen the immediate and long-term results of operation, instead it helps to eliminate two diseases at the same time from one surgical approach.