1/165. 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.- - - - - - - - - - ranking = 1keywords = pain, back (Clic here for more details about this article) |
2/165. 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.- - - - - - - - - - ranking = 0.36393964843889keywords = chest (Clic here for more details about this article) |
3/165. Symptomatic forearm muscle hernia: repair by autologous fascia lata inlay.Eleven cases of symptomatic muscle hernias of the forearm requiring surgical intervention have been described previously. Pain on extremity exertion and an unaesthetic bulge of the forearm were the primary indications for surgery. Advocated treatment modalities range from forearm fasciotomy to anatomic repair of the fascial defect. Although fasciotomy relieves the narrow fascial constriction around the herniated muscle reliably, it often yields an unappealing forearm deformity and incomplete resolution of pain on extremity exertion. Anatomic repair provides the theoretical advantage of restoring normal muscle fascia relationships while concomitantly improving the aesthetic appearance of the extremity. The authors report a case of symptomatic forearm muscle herniation treated successfully with an autologous fascia lata inlay graft.- - - - - - - - - - ranking = 0.49072867409136keywords = pain (Clic here for more details about this article) |
4/165. 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.- - - - - - - - - - ranking = 2.4924393072785keywords = abdominal pain, pain (Clic here for more details about this article) |
5/165. 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.- - - - - - - - - - ranking = 3.4022458616025keywords = pain, chest (Clic here for more details about this article) |
6/165. 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.- - - - - - - - - - ranking = 0.027600660756559keywords = upper (Clic here for more details about this article) |
7/165. Incarcerated tubal herniation, an unusual complication of operative laparoscopy and an odd cause of pelvic pain.Tubal herniation after laparoscopic surgery to relieve pelvic pain and adhesions was associated with long-term, chronic pelvic pain in the left lower quadrant. laparoscopy was performed to diagnose and reduce the herniation. review of the literature revealed no previous report of this complication.- - - - - - - - - - ranking = 2.9443720445481keywords = pain (Clic here for more details about this article) |
8/165. 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.- - - - - - - - - - ranking = 0.36393964843889keywords = chest (Clic here for more details about this article) |
9/165. Richter's hernia in Spigelian hernia.A 75-year-old woman presented with a painful abdominal lump. Clinically and sonographically it was diagnosed as an abscess. Surgical exploration revealed a Spigelian hernia with Richter's type of strangulation. The strangulated portion of the ileum had perforated, leading to abscess formation.- - - - - - - - - - ranking = 0.49072867409136keywords = pain (Clic here for more details about this article) |
10/165. 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.- - - - - - - - - - ranking = 0.027600660756559keywords = upper (Clic here for more details about this article) |
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