11/158. The association of laryngoceles with ventricular phonation.Laryngoceles represent dilatations of the laryngeal saccule that may extend internally into the airway, or externally through the thyrohyoid membrane. Unilateral laryngoceles are uncommon clinical entities and bilateral laryngoceles are rare. Certain activities like glass blowing and playing a wind instrument are associated with laryngocele development, as is laryngeal carcinoma in the ventricular area. This case describes development of bilateral laryngoceles in a patient who chronically uses ventricular phonation during speech. The pathogenesis involves repetitive elevation of intralaryngeal pressure during false vocal cord approximation, exposing the ventricles to abnormally high air pressures. The pathogenesis in this case, as well as in laryngoceles associated with occupational or anatomic risk factors, is discussed.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
12/158. Herniation through both Winslow's foramen and a lesser omental defect: report of a case.The herniation of small bowel through Winslow's foramen is a rare type of internal hernia which can cause ileus; however, a hernia traversing the lesser sac is even more unusual. To the best of our knowledge, only 25 cases of herniation through Winslow's foramen and 10 cases of lesser sac hernia have been reported in the Japanese literature. We describe herein the case of a 33-year-old man who presented to our hospital complaining of abdominal pain in whom a plain abdominal radiograph revealed small bowel gas with air-fluid levels, suggesting ileus. Following admission, an ileus tube was inserted, but the intestinal shadow did not improve and surgery was performed based on suspicion of an internal hernia. Approximately 100 cm of ileum was found to have herniated through a defect in the lesser omentum after passing through Winslow's foramen. Since the herniated bowel was viable, manual reduction without resection was performed. The patient had a satisfactory postoperative course, and was discharged on postoperative day 11. There are many unknown aspects surrounding the etiology of Winslow's foramen hernia and lesser sac hernia, and although internal hernia is a rare cause of ileus, its possibility should be kept in mind.- - - - - - - - - - ranking = 20.042840236686keywords = pain (Clic here for more details about this article) |
13/158. The occurrence of a strangulated ileus due to a traumatic transmesenteric hernia: report of a case.We report herein the case of a 6-year-old boy in whom a strangulated ileus was caused by a traumatic transmesenteric hernia. The boy had fallen from his bicycle and suffered a severe blow to the abdomen. abdominal pain and vomiting developed 10 h after the accident and he was admitted to our hospital. Abdominal ultrasonogram and computed tomogram demonstrated ascites, intestinal wall thickening with fluid, and an engorged radiating mesenteric vasculature. Thus, an emergency laparotomy was performed which revealed bloody ascites, a strangulated ileus, and torsion with a transmesenteric hernia. The necrotic intestine was resected and an anastomosis was performed. Macroscopic and microscopic findings revealed a traumatic mesenteric rent. The unusual presentation of this case is discussed.- - - - - - - - - - ranking = 20.042840236686keywords = pain (Clic here for more details about this article) |
14/158. Laparoscopic closure of mesenteric defects after Roux-en-Y gastric bypass.Two case reports are presented of incarcerated small-bowel internal hernias through mesenteric defects following Roux-en-Y gastric bypass surgery (one case each of open and laparoscopic). Both patients first presented to physicians unfamiliar with bariatric surgery complaining of vague, cramping midabdominal pain, and the correct diagnosis was not revealed until laparoscopic surgery was performed. Treatment then resulted in quick recoveries. This type of hernia can evade radiologic testing. Prompt clinical recognition and treatment is necessary to prevent small-bowel infarction.- - - - - - - - - - ranking = 20.042840236686keywords = pain (Clic here for more details about this article) |
15/158. Post-traumatic spindle cell nodule misdiagnosed as a herniation of the buccal fat pad.We studied a quasi-neoplastic lesion that developed in the oral mucosa secondarily to trauma. The female patient, 2 years of age, presented with a rapidly growing nodule and the lesion was diagnosed as a herniation of the buccal fat pad. Following partial resection, no recurrence was seen. The ulcerated polypoid mass was composed of compact spindle-cell proliferation with invasion of underlying muscle and fat. Atypical stromal cells were present in the myxoid areas. The surface edematous stroma contained abundant granulation tissue-type vascularity and a mixed population of chronic inflammatory cells. On immunohistochemical study, the spindle cells were consistent with myofibroblasts. The morphologic features, proliferating cell type, and benign clinical course are identical to the post-operative spindle cell nodules that occur in the genitourinary tract.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
16/158. Paraduodenal hernia: a treatable cause of upper gastrointestinal tract symptoms.Paraduodenal hernia (PDH) is an unusual condition that is caused by congenital intestinal malrotation. Noncatastrophic presenting symptoms and their responses to surgery have not been well-characterized. barium upper gastrointestinal (UGI) series and small bowel follow-up x-rays, performed from December 1995 to September 1996, were sequentially reviewed by one radiologist (J.M.) to identify patients with small bowel series compatible with a PDH. Case histories were reviewed for symptomatic presentation, associated evaluation, and treatment. Based on the 294 UGIs and small bowel follow-throughs performed during this 10-month period, 6 cases were suspected to have a PDH. A right PDH was confirmed in the three patients who underwent surgical exploration (prevalence 1%). Preoperative patient symptoms included nausea, bilious vomiting, and right upper quadrant pain. Repair of the hernia defect resulted in complete resolution of chronic symptoms. Preoperative upper endoscopy, performed in three patients, was not helpful in identifying the disorder. Preoperative computerized tomography obtained in two patients was diagnostic for a right PDH. One symptomatic patient with vomiting and gastric stasis did not have surgery because of a terminal illness. The remaining two patients had no symptoms attributable to PDH. patients with PDH frequently have chronic UGI symptoms. An upper endoscopy cannot be used to exclude this entity. After surgery, UGI symptoms from PDH are likely to resolve.- - - - - - - - - - ranking = 20.042840236686keywords = pain (Clic here for more details about this article) |
17/158. Traumatic herniation of the heart into the right hemithorax.Pericardial rupture after blunt chest trauma is described in the literature. This case report summarises our experience with a 22-year old male patient who suffered blunt chest trauma during a motor vehicle accident. On admission no serious injuries could be detected, but 3 hours later, displacement of the heart to the right hemithorax combined with sudden cardiac failure appeared. Emergency thoracotomy revealed a right-sided rupture of the pericardium with complete herniation of the heart into the right pleural cavity and consequent strangulation by the margins of the pericardial defect.- - - - - - - - - - ranking = 118.86974943385keywords = chest (Clic here for more details about this article) |
18/158. Transdural cauda equina incarceration after microsurgical lumbar discectomy: case report.OBJECTIVE AND IMPORTANCE: Complications usually occur when they are least expected. We present an unusual case of nerve entrapment after microsurgical discectomy. CLINICAL PRESENTATION: A patient undergoing uneventful first lumbar microsurgical discectomy developed severe back and leg pain and a progressive neurological deficit during the first postoperative night. Herniation of cauda equina nerve roots had occurred through an unnoticed minimal defect in the dura, which had not caused cerebrospinal fluid leakage. The roots were incarcerated and swollen, and they filled the space of the resected nucleus pulposus. It was presumed that elevation of intra-abdominal pressure and consequent increased intraspinal pressure during extubation led to the herniation of arachnoid and cauda equina roots. The nerve roots were then trapped and incarcerated in the manner of bowel loops in an abdominal wall hernia. INTERVENTION: During reoperation, the nerve roots were repositioned into the dural sac. The patient recovered without further complications and without long-term sequelae. CONCLUSION: All dural tears that occur during intraspinal surgery, even if they are small and the arachnoid is intact, should be closed with stitches or at a minimum with a patch of muscle or gelatin sponge with fibrin glue. Care should be taken to avoid increased intra-abdominal pressure during extubation. Excessive pain and progressive neurological dysfunction occurring shortly after microsurgical lumbar discectomy or any intraspinal procedure is indicative of possible hemorrhage with subsequent compression of nerve roots. The case reported here provides anecdotal evidence that this situation can also be caused by a herniation of cauda equina nerve roots through a small dural defect that was not evident during the initial operation.- - - - - - - - - - ranking = 40.085680473373keywords = pain (Clic here for more details about this article) |
19/158. Internal hernia caused by meckel diverticulum in an infant: report of one case.intestinal obstruction caused by internal hernia due to meckel diverticulum is a rare disease. The condition is seldom diagnosed preoperatively. In this paper, we present a 10-month-old boy who suffered from abdominal pain, persistent vomiting, and mild fever for 2 days. Abdominal sonography, plain abdomen X-ray, and computed tomography merely showed mechanical ileus and partial malrotation. However, exploratory laparotomy revealed a meckel diverticulum through which the small bowel had herniated. We introduce the meckel diverticulum and internal hernia and discuss intestinal obstructions.- - - - - - - - - - ranking = 20.042840236686keywords = pain (Clic here for more details about this article) |
20/158. Subcutaneous herniation of tendon interposition after trapeziectomy in three cases: explanation and implications.We report a complication following trapeziectomy and tendon interposition. Subcutaneous herniation of the tendon interposition occurred in 3 of 412 cases in which trapeziectomy, ligament reconstruction, and tendon interposition were performed. This herniation occurred posterolaterally in the early postoperative period and resulted in dorsal swelling and superficial pain. magnetic resonance imaging was helpful in confirming the diagnosis and excision of the herniated interposition material resulted in satisfactory pain relief and functional outcome as long as metacarpal stability was present.- - - - - - - - - - ranking = 40.085680473373keywords = pain (Clic here for more details about this article) |
| <- Previous || Next -> |