Articles: hernia-therapy.
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Comparative Study Clinical Trial
Comparison study of acellular dermal matrices in complicated hernia surgery.
Damage control surgery and management of the open abdomen has led to a significant improvement in survival in trauma and emergency surgical patients. However, subsequent abdominal reconstruction has become a significant challenge. The objective of this study was to compare 2 different acellular dermal matrices in regard to hernia recurrence and complications in patients who present with a large complicated ventral hernia as a result of trauma or emergency surgery. ⋯ FlexHD appears to have reduced the recurrence and laxity rates while maintaining a similar complication profile compared with AlloDerm in trauma/emergency surgery patients with large complicated ventral hernias.
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Randomized Controlled Trial
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
To assess the long-term crossover (CO) rate in men undergoing watchful waiting (WW) as a primary treatment strategy for their asymptomatic or minimally symptomatic inguinal hernias. ⋯ Men who present to their physicians because of an inguinal hernia even when minimally symptomatic should be counseled that although WW is a reasonable and safe strategy, symptoms will likely progress and an operation will be needed eventually.
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This report presents the case of a 59-year-old man with sudden severe pain in the right lower abdomen after manually reducing the right indirect inguinal hernia who had bilateral indirect inguinal hernia for 5 years. A subsequent contrast computed tomography scan with contrast of the abdomen and pelvis revealed a significant extensive retroperitoneal hematoma at the abdomen and pelvis of the right side. ⋯ The bleeding ruptured inferior epigastric artery at the interior side of the deep inguinal ring was found, the deep inguinal ring was avulsed, ligature of the inferior epigastric artery and removal of the retroperitoneal hematoma were done, and the patient was discharged from hospital on the seventh postoperative day. This is the first report in the literature on retroperitoneal hematoma caused by manual reduction of indirect inguinal hernia.
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An inguinal hernia is said to be irreducible when the content fails to return into the peritoneal cavity without surgical intervention. Irreducibility is an ever present risk in untreated inguinal hernias and its management remains an important part of pediatric surgery practice. When a hernia is irreducible, morbidity and mortality increase This risk of irreducibility is more in some patient groups. ⋯ There is a high rate of irreducibility of inguinal hernias in neonates, and in right-sided hernias Identification of risk factors in and risk stratification of patients with uncomplicated inguinal hernias will help reduce the rate of irreducible inguinal hernias and their attendant morbidities.
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Review Case Reports
Tension viscerothorax after blunt abdominal trauma: a case report and review of the literature.
Tension viscerothorax is herniation of abdominal viscera into the thorax. Tension viscerothorax can simulate tension pneumothorax. Immediate decompression with a nasogastric tube is required for hemodynamic stabilization. ⋯ Acute tension viscerothorax should be considered in the differential diagnosis of tension pneumothorax, and its initial resuscitation should include nasogastric tube insertion for immediate decompression.