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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Ann Surg ; 6: An analysis of cases. A delay in the diagnosis leads to a high rate of complications and the need of emergency surgery in many cases 3.
HERNIAS DE LA PARED ABDOMINAL by valeria rodriguez on Prezi
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. The assessed parameters were eligastrica follows: Laparoscopy approach allowed us to explore abdominal cavity and rule out quiruryica damage to the bowel loops that could have passed unnoticed. Laparoscopic diagnosis and repair of spigelian hernia: Vos D, Scheltinga M. Pain often can be provoked or aggravated by contraction of abdominal muscles or other maneuvers that increase the intra abdominal pressure 7and epigastria can help us orienting the correct diagnosis.
Twenty five patients To conclude we stress that diagnosis and treatment of Spigelian hernias is still a controversial matter, basically for the varied and uncommon presentation. Open hernioplasty followed by laparoscopic hernioplasty are the most frequent techniques performed.
Two treatment modalities can be used, transperitoneal so called intra-abdominal and extraperitoneal. When the hernia sac contents the bowel the patient can present with nausea, vomiting or altered bowel rhythm.
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After that laparoscopic approach has been widely described in literature. It is also called spontaneous lateral ventral hernia, hernia of semilunar line, hernia of the conjoint tendon or interstitial ventral hernia. In spite of this, laparoscopy in not always available for emergency surgery and also requires a learning curve.
Alicia Ruiz de la Hermosa. Apart from the type of surgical approach exists discussion about the need of a prosthetic mesh. Left side was the most frequent location. Spigelian hernia appears between the fascia of the anterior rectus, internal oblique and transverse abdominal muscles. Most of SH are situated underneath the external oblique muscle, between the different sheaths of abdominal wall, and therefore, SH are also called interstitial, intraparietal or occult hernias.
Diagnosis of Spigelian hernia is basically clinic. An important percentage of patients will present with an acute complication of the Spigelian hernia as their first symptom. There was neither serious morbidity nor mortality. Although diagnosis must be established clinically in most patients on the basis of a high level of suspicion, a proper anamnesis and a thorough physical examination, it is not possible in some cases.
Hernias de Spiegel: Nuestra experiencia y revisión de la literatura
Spigelian hernia is an uncommon variety of abdominal wall defect. Surgical technique depends on patient characteristics, type of hernia and surgeon experience.
Laparoscopy is becoming more and more frequent and its advantages have already been demonstrated. The treatment of Quuirurgica hernia is surgical and can be performed either by classic open or laparoscopic technique.
Arch Surg ; Br J Surg ; Am Surg ; 74 8: The mean age was 70 years range years. After this report only isolated cases, congenital SH associated with cryptorchidism or the Satorras-Fioretti review about abdominal wall hernias of unusual presentation which included 12 patients with Spigelian hernia 6 have been published.
In addition to previous or concomitant hernias as a risk factor we have also looked for other medical conditions such as COPD or prior epigwstrica surgery.
Popovici A, Munteanu I. We have treated 39 patients, 25 female and 14 male, with a mean age of 70 years. Am J Obstet Gynecol ; Anyway the number of patients of these studies is very small to find statistical differences.
Other common symptoms are nausea, vomiting and altered bowel rhythm although all these vary depending on hernia sac content. To date Spanish reports on this pathology are short series of cases, being epigastricz largest one published by Moreno-Egea et al in with 27 patients 5. Results Between January and December39 patients underwent surgery for Spigelian hernia.
Cir Esp ; 79 3: The first one allows to explore the contralateral side as well as the abdominal cavity and for some authors is the recommended method when there is another process requiring associated surgery because can be performed in the same intervention 6.