HERNIAS DE LA PARED ABDOMINAL ZONAS DEBILES DE LA PARED ABDOMINAL 1. Hernia epigástrica. 2. Hernia umbilical. 3. Hernia. Objective: Spigelian hernia is an uncommon abdominal wall defect. La técnica quirúrgica dependerá de las características del paciente, la hernia y la. H. epigástrica. . TÉCNICA LAPAROSCÓPICA• visualizar el defecto de la hernia y la anatomía circundante con claridad y ampliación.
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A very important factor to be aware of during physical examination is the difference between lower SH and inguinal hernias. CT scan is the recommended investigational imaging study, moreover if laparoscopic approach is going to be employed so that any hernia sac content can be properly quirurica 17,6. When the hernia sac contents the bowel the patient can present with nausea, vomiting or altered bowel rhythm. In addition to epivastrica or concomitant hernias as a risk factor we have also looked for other medical conditions such as COPD or prior abdominal surgery.
HERNIAS DE LA PARED ABDOMINAL by valeria rodriguez on Prezi
Epjgastrica authors’ own experience and a review of the literature. Two treatment modalities can be used, transperitoneal so called intra-abdominal and extraperitoneal. The presence of pain and a palpable lump in the typical location should alert us of its diagnosis.
Spigelian hernias have a multidisciplinary interest and their diagnosis involves various specialities such us surgeons, radiologists and in some instances internists and gastroenterologists when the SP presents as abdominal pain syndromes.
Most of these hernias occur distal to the umbilicus, within the spigelian hernia belt or Spangen area which is a transverse band between the line joining both anterior superior iliac spines and a parallel line 6 cm cranial at the level of the umbilicus 1,2. Other common symptoms are nausea, vomiting and altered bowel rhythm although all these vary depending on hernia sac content.
The hernia appears to peak in the fifth decade of life and is more common in women. As regards to postoperative morbidity literature describes minimal and mild complications such as wound infections, paralytic ileus or haematomas.
It occurs because of a weak area of spiegelian fascia which is localized between the semilunar line and the lateral edge of the anterior rectus muscle.
Rev Tdcnica Enf Ap Digest ; The semilunar line extends from the costal margin to the pubic spine and it shows transitional area from muscle to aponeurosis of the transverse muscle of the abdomen.
Arch Surg ; Only a small percentage of SH 0. Ruiz de la Hermosa, I. Some authors obtain without mesh as good results as with it, and they currently recommend mesh-free repair, either for conventional repair like Hsieh 23 or for laparoscopy repair like Bittner Laparoscopy is becoming more and more frequent and its advantages have already been demonstrated.
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All of our patients had symptomatic SH. In spite of this, laparoscopy in not always available quiurgica emergency surgery and also requires a learning curve. The presence of any of these situations must be regarded as a starting point for correctly orienting clinical history and should lead to the diagnosis.
As other authors, we consider open surgery 6 as the technique of choice when incarceration is present although we have performed a laparoscopy approach in a patient who underwent an emergency surgery. Diagnosis of Spigelian hernia is basically clinic. The treatment of Spigelian hernia should be surgical. A high index of suspicion and a thorough physical examination is needed to make a correct diagnosis, although in doubtful cases it is advisable to perform a sonography or better a tomography.
Postoperative morbidity is quirurgca low.
Although diagnosis must be established clinically in most patients on the basis of a high level of suspicion, epigaastrica proper anamnesis and a thorough physical examination, it is not possible in some cases. The mean age was 70 years range years.
Anyway the number of patients of these studies is very small to find statistical differences. J Minim Access Surg ; 4 4: In these cases the hernia sac penetrates the external oblique aponeurosis and lie below the subcutaneous fat making easy during physical examination to feel the bulge.
Tècnica Quirurgica de Pared Abdominal by Krizz Luque Mora on Prezi
Cir Esp ; 79 3: J R Coll Surg Edinb ; However it was Klinkosch in who first described a spontaneous lateral ventral hernia at the level of Spieghel’s semilunar line 4. The different options include primary closure or mesh repair in cases of atrophic aponeurosis, wide defect or recurrences. Left side was the most frequent location.
Ugeskr Laeger ; Clinical diagnosis does require a high index of suspicion. Laparoscopic repair of spigelian hernia: Surgical technique depends on patient characteristics, type of hernia and surgeon experience.
Introduction Spigelian hernia is an uncommon variety of epigatrica wall defect. The treatment of Spigelian hernia is surgical and can be performed either by classic open or laparoscopic technique. There are no tevnica differences in literature about their right or left location and there aren’t in our series either.
The hernia location is unknown in 5 of our patients as the medical history didn’t include this information, which is a frequent limitation of retrospective studies.
Pain often can be provoked or aggravated by contraction of abdominal muscles or other maneuvers that increase the intra abdominal pressure 7and this can help us orienting the correct diagnosis. Personal experience and review of the literature.
Ultrasonography can establish the diagnosis but provides less specificity than CT scan as has quite false negatives in obesity patients. Diagnosis and treatment hernka Spigelian hernia. Apart from the type of surgical approach exists discussion about the need of a prosthetic mesh.
Ann Surg ; 6: