| Internal hernia is a rare condition. These hernias are classified in different categories, depending on the location of its orifice. It should be considered in cases of acute intestinal obstruction, particularly in the absence of an external hernia or in the absence of history of previous abdominal surgery. The authors report a unique case of obstruction of the small bowel, that was almost entirely wrapped in a separate peritoneal sac. ( info) |
| Laparoscopic operations are becoming more common and replacing more traditional surgical procedures. As a result, radiologists should be aware of some of the unique complications that may occur from these types of procedures. We report two cases of incarcerated bowel hernias in lateral trocar sites. ( info) |
3/713. Transomental strangulation. A rare case of an internal hernia. A case report of a transomental herniation of the small intestine is given. Thirty-six cases of this type of intestinal obstruction are reported in the literature. The history was that of an intestinal obstruction and the diagnosis was settled at laparotomy, as in most of the reported cases. The etiology is obscure by (a) abdominal trauma, (b) inflammation, and (c) congenital defects in the omentum appear to be the most likely. ( info) |
4/713. Transvaginal evisceration of small bowel after radical hysterectomy and pelvic lymphadenectomy. Vaginal evisceration is a rare event. This case report describes a 45-year-old woman who presented 8 days following radical hysterectomy and lymph node dissection for stage 1B squamous cell carcinoma of the cervix with small bowel evisceration through the vagina. She was treated by laparotomy and resection anastamosis of a discolored part of the distal ileum. ( info) |
5/713. Calcified bodies in popliteal cysts: a characteristic radiographic appearance. Calcified bodies in popliteal cysts have a characteristic radiographic appearance which can be confirmed by arthrography. Calcified bodies may arise in the true joint due to trauma, arthropathy resulting in joint destruction, or synovial osteochondromatosis. These calcified loose bodies may pass into a popliteal cyst through posterior joint-bursal communications or can arise in a popliteal cyst by chondrometaplasia. Correct radiographic interpretation will exclude soft tissue tumors and vascular lesions as differential considerations. Management of these patients will be determined by the clinical circumstances since neither popliteal cysts nor synovial osteochondromatosis are necessarily symptomatic. ( info) |
6/713. Idiopathic spinal cord herniation: case report and review of the literature. OBJECTIVE AND IMPORTANCE: Idiopathic spinal cord herniation (ISCH) is a rare condition, reported in only 25 patients thus far, in which the thoracic cord is prolapsed through an anterior dural defect. It typically presents in middle age as either brown-sequard syndrome or spastic paraparesis. CLINICAL PRESENTATION: A 55-year-old woman initially presented at the age of 41 years with brown-sequard syndrome at the T8 disc space level on the left side. Investigations, including primitive magnetic resonance imaging, were deemed negative at that time. After a stepwise deterioration over 14 years, she presented again with spastic paraparesis and double incontinence, in addition to her previous spinothalamic dysfunction. magnetic resonance imaging at this stage suggested either ISCH or a dorsal arachnoid cyst. INTERVENTION: Through a T7-T8 laminectomy, a left-of-midline ISCH was identified and easily reduced by gentle cord traction. No dorsal arachnoid cyst was identified. The anterior dural defect was repaired with a XenoDerm patch (LifeCell Corp., Woodlands, TX). After surgery, there was improved motor and sphincter function. However, there was continued sensory disturbance. CONCLUSION: ISCH is rare cause of thoracic cord dysfunction. Despite prolonged diagnostic delay, significant clinical improvement may be obtained with ISCH reduction and anterior dural repair. ( info) |
7/713. Transmesenteric hernia after laparoscopic-assisted sigmoid colectomy. BACKGROUND AND OBJECTIVES: Laparoscopic-assisted surgery has been applied for a variety of colonic surgery. The objective of this paper is to demonstrate a possible and avoidable complication of laparoscopic colonic surgery. CASE PRESENTATION: A 47-year-old woman underwent gasless laparoscopic-assisted sigmoid colectomy. On the 20th postoperative day, she developed bowel obstruction. decompression with a long tube failed to resolve the bowel obstruction. Open laparotomy was performed. Abdominal exploration revealed a loop of the small bowel incarcerated in the mesenteric defect caused by the previous operation. Adhesiolysis was performed, and the postoperative course was uneventful. DISCUSSION: Despite technical difficulty, complete closure of the mesentery after bowel resection is strongly recommended for prevention of transmesenteric incarcerated hernia after laparoscopic surgery. ( info) |
8/713. 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. ( info) |
| lung hernia is a distinctly rare event, regardless of its location and cause. Most lung hernias are acquired traumatic thoracic hernias. All previously reported cases of acquired spontaneous lung hernia involve some aspect of trauma, most commonly caused by vigorous coughing with a subsequent rib fracture. We report a case of totally atraumatic, acquired spontaneous lung hernia. ( info) |
10/713. Idiopathic spinal cord herniation: value of MR phase-contrast imaging. We report two patients with an idiopathic transdural spinal cord herniation at the thoracic level. Phase-contrast MR imaging was helpful in showing an absence of CSF flow ventral to the herniated cord and a normal CSF flow pattern dorsal to the cord, which excluded a compressive posterior arachnoid cyst. ( info) |