Ventral Hernia

-
Hernias most commonly develop in the abdominal wall, where an area weakens and develops a tear or hole. Abdominal tissue or part of the intestines may push through this weakened area, causing pain and potentially serious complications.
Ventral hernias are a type of abdominal hernia. They may develop as a defect at birth, resulting from incomplete closure of part of the abdominal wall, or develop where an incision was made during an abdominal surgery, occurring when the incision doesn't heal properly.
Incisional hernias can develop soon after surgery or many years later. They affect as many as 30 percent of the patients who have abdominal surgery, such as an appendectomy.
Signs & Symptoms:
Ventral hernias cause a bulge or lump in the abdomen, which increases in size over time. In some cases, the lump may disappear when you lie down, and then reappear or enlarge when you put pressure on your abdomen, such as when you stand, or lift or push something heavy.

When tissue inside the hernia becomes stuck or trapped in abdominal muscle, it can cause pain, nausea, vomiting and constipation.
In rare cases, this may lead to a potentially life-threatening condition known as "strangulation," which requires emergency surgery. This occurs when the blood supply to the herniated bowel is cut off or greatly reduced, causing the bowel tissue to die or rupture. Other symptoms of a strangulated hernia include severe abdominal pain, profuse sweating, rapid heartbeat, severe nausea, vomiting and high fever.
Diagnosis:
In many cases, a hernia can be diagnosed through a physical examination of the abdomen.
Your doctor will examine the area where a ventral hernia may exist and may ask you to cough while examining your abdomen.
A CT scan may be performed as part of the diagnosis.
Treatment:
Ventral hernias are repaired by surgery. Without treatment, most hernias will increase in size.
An untreated hernia may also result in intestinal blockage and "strangulation," which requires immediate medical attention. Strangulation occurs when the blood supply to the herniated bowel is cut off or greatly reduced, causing the bowel tissue to die or rupture.Surgical repair of ventral hernias is a complicated, major procedure. Extremely large ventral hernias require a procedure called progressive pneumoperitoneum.
Laparoscopic Repair
In this approach, surgeons use a laparoscope, a tiny telescope with a television camera attached, to view the hernia from the inside. The laparoscope is placed inside a cannula, or small, hollow tube, which is inserted into the abdomen through a small incision.In most cases, three or four incisions of about 1/4 to 1/2 inch in size are made to insert the cannula, instruments used to remove any scar tissue and a special mesh. The mesh is placed behind the abdominal muscles instead of between the muscles. It is held in place by surgical tacks or sutures. This procedure is usually performed under general anesthesia. Bladder catheterization is required.

Compared to traditional hernia surgery, laparoscopic repair includes less post-surgery pain, less wound numbness and an earlier return to work and normal activities.

Comments

Post a Comment

Popular posts from this blog

Pleural Effusion

-
Image
Pleural effusion , sometimes referred to as “water on the lungs,” is the build-up of excess  fluid  between the layers of the pleura  outside the lungs. The  pleura  are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing. Differential Diagnosis Exudative malignancy, infections, connective tissue disease, pulmonary embolism, hemothorax, pancreatitis, chylothorax Trabsydatuve HF, hypoalbuminemia (GI losing enteropathy, cirrhosis, nephrotic syndrome, malnutrition), SVC obstruction, hepatohydrothorax, urinothorax, atelectasis, trapped lung, peritoneal dialysis, hypothyroidism, pulmonary embolism Note: pulmonary embolism, malignancy, and sar coidosis can present as either exudative or transudative effusions. HF following diuresis may become ‘‘pseudo exudative’’ (check albumin gradient) Clinical Features History dyspnea, cough, hemoptysis, chest pain, weight loss, fever, trauma, occup...
Read more

Pulmonary Embolism

-
Image
Pulmonary embolism  is the sudden blockage of a major blood vessel (artery) in the  lung , usually by a blood clot. In most cases, the clots are small and are not deadly, but they can damage the  lung . But if the clot is large and stops blood flow to the  lung , it can be deadly. Differential diagnosis of acute Dyspnea Respiratory Airway COPD exacerbation, asthma exacerbation, acute bronchitis, infectious exacerbation of bronchiectasis, foreign body obstruction Parenchyma pneumonia, cryptogenic organizing pneumonia, ARDS, acute exacerbation of interstitial lung disease Vascular pulmonary embolism, pulmonary hypertension Pleural pneumothorax, pleural effusion Cardiac Myocardial HF exacerbation, myocardial infarction Valvular aortic stenosis, acute aortic regurgitation, endocarditis Pericardial pericardial effusion, Tamponade Systemic sepsis, metabolic acidosis, anemia Others neuromuscular, psychogenic, anxiety Pathophysiology Virchow’...
Read more

FNAC of Salivary Gland Tumors

-
Image
Fine Needle Aspiration Cytology (FNAC) of Salivary Gland Tumors Introduction: Salivary gland neoplasms though relatively uncommon are by no means rare, accounting for 3 % of all head and neck tumors. Distribution wise 80% of the tumors occur in parotid gland, 15% in submandibular gland and less than 1% in sublingual glands. The World Health Organization (WHO) has classified the tumors of salivary gland as primary or secondary, malignant or benign and by the tissue of origin. The five broad – categories of salivary gland tumors are: Malignant tumors: e.g. Mucoepidermoid Carcinoma, Acinic cell Carcinoma and Adenoid Cystic Carcinoma, Benign tumors: e.g. Pleomorphic Adenoma, Warthin’s tumor, Myoepithelioma, Soft Tissue tumors: e.g. Hemangioma, Hematolymphoid tumors: e.g. Hodgkin’s Lymphoma & Secondary tumors. Of the malignant tumors Mucoepidermoid Carcinoma is the most common neoplasm occurring most frequently in the parotid gland. Exposure to radiation has been thought to play or...
Read more