The operative findings revealed a sliding Maydl’s hernia with an ischemic inner ileal pathologyshouldbeinvestigatedandtreatedappropriately. Maydl’s hernia is a very rare type of a hernia and at times presents as a deceptive condition in a strangulated hernia. There is a paucity of. #DatoQx Hernia de Maydl o #Hernia en W – 2 asas de delgado en el saco. Alta probabilidad de estrangulación!!
|Published (Last):||18 October 2017|
|PDF File Size:||6.80 Mb|
|ePub File Size:||8.70 Mb|
|Price:||Free* [*Free Regsitration Required]|
J Indian Med Assoc We did emergency laparotomy with reduction of the obstructed inguinal hernia, resection of the perforated bowel segment with ileo-ileal intussusception, end to end anastomosis and repair of the dee defect.
Maydl’s hernia, resection herbia anastomosis, strangulation of hernia. A femoral hernia presents as either discomfort in the groin together with a lump, or as intestinal obstruction with or without strangulation. A report of 5 cases. British Journal of Surgery. A skin crease incision is made over the hernia, the sac is excised and the defect in the transversus abdominis aponeurosis is closed with non-absorbable sutures.
The inguinal canal passes through the abdominal wall between the deep internal and superficial external inguinal rings. In an IIH, the sac is ligated at the deep inguinal ring and excised herniotomywhereas in a DIH the sac is formed from layers of the posterior wall of the inguinal canal and so it is not excised.
Spigelian hernias should be treated surgically because of the severity of symptoms and the risk of complications. The patient was taken for laparotomy urgently.
Patients may complain of diffuse pain in the groin together with pain in the medial side of the thigh and knee mayvl of pressure on the obturator nerve.
Alternatively, the mesh can be inserted via an extraperitoneal approach and placed deep to the defect in the posterior wall. Other systemic examinations were normal. Except in children and infants, the essential cause of an IIH is a failure of the processus vaginalis to become completely obliterated to form the ligamentum vaginale, which normally occurs within a few days after birth, and b loss of integrity of the inguinal canal see above.
The sac is dissected carefully from the cord, opened and the contents returned to the abdominal cavity. Support Center Support Center. Views Page Discussion View source History. Initial experience indicates that recurrence rates are similar to those associated with open operations. Differential diagnosis includes a lipoma, lumbar abscess or haematoma.
Ileo-colic invagination is the commonest variety, can lead to an ischemic segment and requires surgery.
Maydl’s hernia: report of a series of seven cases and review of the literature.
Operation is indicated for all other patients because of symptoms and the risk of complications. The patient’s vital parameters were normal. Marcelin Ngowe Ngowe has given final approval of the version to be published.
The classic operative procedure is a Mayo mayel Mayo repair. Consent The patient granted consent for the case to be reported. A small hernia may be difficult to palpate, especially in the obese patient.
A Rare Presentation of Maydl’s Hernia
Patients are frequently fit young males who present with epigastric pain, which may be confused with peptic ulceration or biliary disease. A scrotal presentation can be mistaken for an acute hydrocoele, testicular torsion, or epididymoorchitis [ 56 ]. External hernias are common and present as an abnormal lump which can be detected by clinical examination of the abdomen or groin. In Amyand’s jernia the decision to perform an appendicectomy and type of repair depends on the clinical presentation and is guided by Losanoff and Basson’s criteria.
With massive incisional hernias, pre-operative progressive pneumoperitoneum for 1—2 weeks may be considered to facilitate replacement of viscera into the abdominal cavity and abdominal wall closure.
Maydl’s hernia – Wikipedia
Most of the reported cases are in Africa and are attributed to the high incidence of untreated hernias [ 4 ]. An epigastric hernia is a protrusion of extraperitoneal fat, with or without a small sac of peritoneum through a defect in the linea alba anywhere between the xiphisternum and the umbilicus. Often, there is a history of a sudden increase in IAP that has pushed intestine or other contents into the sac.
Intussusception occurs when one portion of the gut becomes invaginated within an immediate adjacent segment. Treatment of lumbar hernias is difficult because of their anatomical boundaries, their size, the type of patient in whom they occur, and because they are bounded in part by muscle rather than tough aponeurotic tissue.
Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper. To quiz yourself on this article, log in to see multiple choice questions.
For type 4, where acute appendicitis is associated with a related or unrelated pathology, the management is as for types 2 and 3 hernias but the second pathology should be investigated and treated appropriately.