Cases reported "Hernia"

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1/136. Nerve root herniation secondary to lumbar puncture in the patient with lumbar canal stenosis. A case report.

    STUDY DESIGN: A very rare case of nerve root herniation secondary to lumbar puncture is reported. OBJECTIVE: To describe the characteristic clinical features of this case and to discuss a mechanism of the nerve root herniation. SUMMARY OF BACKGROUND DATA: There has been no previous report of nerve root herniation secondary to lumbar puncture. methods: A 66-year-old woman who experienced intermittent claudication as a result of sciatic pain on her right side was evaluated by radiography and magnetic resonance imaging, the results of which demonstrated central-type canal stenosis at L4-L5. The right sciatic pain was exacerbated after lumbar puncture. myelography and subsequent computed tomography showed marked stenosis of the thecal sac that was eccentric to the left, unlike the previous magnetic resonance imaging finding. RESULTS: At surgery, a herniated nerve root was found through a small rent of the dorsocentral portion of the thecal sac at L4-L5, presenting a loop with epineural bleeding. The herniated nerve root was put back into the intrathecal space, and the dural tear was repaired. CONCLUSION: Lumbar puncture can be a cause of nerve root herniation in cases of lumbar canal stenosis. The puncture should not be carried out at an area of stenosis.
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ranking = 1
keywords = back
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2/136. Pleural incarceration of the gastric graft after trans-hiatal esophagectomy.

    We report on a 73-year-old man who underwent a transhiatal esophagectomy for a T2N1M0 adenocarcinoma of the distal esophagus and developed an incarcerated herniation of the gastric graft through a defect in the right mediastinal pleura. The patient experienced delayed gastric emptying postoperatively, which was initially suggested by barium swallow. The gastric herniation was unidentified by early postoperative swallowing studies and endoscopies. After diagnosis by a later computed tomographic scan and barium study, the herniation was reduced by incising the mediastinal pleura from the diaphragm to the apex of the chest and by plication of the stomach longitudinally in order to reduce its intrathoracic diameter.
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ranking = 33.723749918972
keywords = chest
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3/136. Small bowel obstruction secondary to herniation through a 5-mm laparoscopic trocar site following laparoscopic lymphadenectomy.

    Incisional hernias occur in <1% of women undergoing operative laparoscopy and are mostly limited to trocar sites > or =10 mm. This is a report of a 54-year-old woman with endometrial cancer who presented with nausea, vomiting and abdominal pain 1 week following laparoscopically-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. Abdominal radiographs and computed tomography demonstrated small bowel obstruction and herniation through a 5-mm trocar site. Reduction of the hernia and closure of the fascial incision were performed at exploratory laparotomy with normal recovery. Bowel herniation can occur through 5-mm trocar sites following prolonged operative laparoscopy. The peritoneum and fascia of these incisions should be closed.
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ranking = 170.79277907493
keywords = abdominal pain
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4/136. Traumatic cardiac herniation diagnosed by echocardiography and chest CT scanning: report of a case.

    A 62-year-old man who had suffered fractures of the left chest wall and hemothorax 1 year earlier was admitted to our hospital with multiple injuries as a result of a traffic accident. Chest drainage was immediately performed under the diagnosis of left hemothorax followed by immobilization of fractures of the femur and radius. On the second day after admission, he suddenly developed severe chest pain and dyspnea after sitting up in bed. echocardiography and chest computed tomography (CT) showed herniation of the left ventricle into the left thoracic cavity, whereby a diagnosis of cardiac herniation due to rupture of the pericardium was made and an emergency surgical repair was successfully performed. Only eight cases of patients surviving after traumatic cardiac herniation have been reported in japan; however, this is the first in which a preoperative diagnosis was made by echocardiography and chest CT scanning prior to surgical repair.
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ranking = 269.78999935178
keywords = chest
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5/136. An endoscopic technique for decompressive fasciotomy.

    A guiding principle of minimally invasive techniques in plastic surgery is improvement of the aesthetic outcome, usually by reducing morbidity from postsurgical scarring. The elimination or reduction of scars has already been so achieved during elevation of fascial flaps and for the harvest of fascial grafts. A natural extension of this endoscopic experience is decompressive fasciotomy, which has now been performed successfully in the upper extremity. Using endoscopic guidance, this is actually a simple, rapid, and safe procedure with minimal morbidity, and should also be apropos for the lower extremity, where compartment syndromes are a more common malady.
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ranking = 2.0694460508739
keywords = upper
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6/136. pneumothorax necessitans presenting as a presternal pneumothoracocele.

    A 31-year-old woman who is an intravenous drug abuser developed sternoclavicular joint infection with mediastinal and subcutaneous tissue abscesses that communicated through an erosion in the manubrium caused by osteomyelitis. Air entrapment from a subsequent apical pneumothorax formed a localized anterior "pneumothoracocele." We referred to this condition as "pneumothorax necessitans," and we suggest including it in the differential diagnosis of anterior chest wall masses.
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ranking = 33.723749918972
keywords = chest
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7/136. spinal cord herniation into an extensive extradural meningeal cyst: postoperative analysis of intracystic flow by phase-contrast cine MRI.

    We report a patient with idiopathic spinal cord herniation who underwent postoperative myelography and phase-contrast cine magnetic resonance imaging (MRI) to clarify the condition of the ventral cystic lesion into which the spinal cord had been herniated. This 58-year-old man showed symptoms and signs compatible with brown-sequard syndrome. A myelogram and MRI showed that the spinal cord was incarcerated in a small space, and this finding led to the diagnosis of spinal cord herniation. In the operation, the herniated spinal cord was returned to the initial intradural space, and the dural defect was enlarged to prevent recurrence of the herniation. After the operation, leg muscle strength improved and bladder and bowel dysfunction resolved, but analgesia was unchanged. Postoperative myelography revealed a very large extradural cystic lesion, which extended from C2 to L1 vertebral level. A cerebrospinal fluid (CSF) flow study of the intradural space disclosed a near-normal pattern, but the intracystic CSF dynamics were abnormal. In the intracystic space at just the upper level of the lesion, cranial flow (reverse directional flow in comparison with the intradural flow) was seen in the systolic cycle after momentary fast caudal flow, and these CSF dynamics may have been related to the spinal cord herniation.
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ranking = 2.0694460508739
keywords = upper
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8/136. Tracheal ring herniation following percutaneous dilatational tracheostomy and its resection under endoscopic control.

    A 76-year-old patient had an elective percutaneous dilatational tracheostomy (PDT) under endoscopic control in the intensive care unit. Twelve days later when her general condition improved, two attempts at decannulation failed due to upper airway obstruction above the tracheostomy site. bronchoscopy showed herniation of the anterior tracheal wall above the tracheostomy tube occluding 80 per cent of the lumen. The herniated anterior segment was elevated and partially resected under endoscopic guidance. The patient made a full recovery and was decannulated on the first post-operative day. Pitfalls and possible complications of PDT are discussed.
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ranking = 2.0694460508739
keywords = upper
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9/136. Incarcerated postraumatic intercostal lung hernia. Case report and review of the literature.

    Traumatic lung hernia is a rare diagnosis. A 52-year-old female motorvehicle passenger was admitted as a trauma patient after a motorvehicle accident. She was found to have an incarcerated lung hernia. Size of the hernia, incarceration and respiratory insufficiency mandated immediate surgical intervention with reposition, drainage and stabilisation of the chest wall. The postoperative course was uneventful. The management of the patient is discussed and the available literature reviewed.
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ranking = 33.723749918972
keywords = chest
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10/136. A novel diagnosis of left paraduodenal hernia through laparoscopy.

    A congenital intraperitoneal hernia, also known as a "paraduodenal hernia," is an extremely rare cause of intestinal obstruction. These hernias, which are caused by variations in intestinal rotation, present with symptoms ranging from intermittent abdominal pain to acute obstruction. Preoperative diagnosis is rare, and conventional treatment is usually by laparotomy. Laparoscopic diagnosis and repair has recently been reported in japan. We present as case of a left paraduodenal hernia diagnosed and treated laparoscopically and a review of the literature.
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ranking = 170.79277907493
keywords = abdominal pain
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