ABSTRACT
Abstract Although the correct diagnosis of inguinal hernias can often be made by clinical examination, there are several situations in which imaging methods represent the best option for evaluating such hernias, their content, and the possible complications. In addition, bulging of the inguinal region is not always indicative of a hernia, because other lesions, including tumors, cysts, and hematomas, also affect the region. The objective of this pictorial essay is to demonstrate what can be identified within inguinal hernias. Differentiating the types of herniated structures is of absolute importance for planning the appropriate treatment.
Resumo Embora o diagnóstico correto possa ser muitas vezes realizado pelo exame clínico, há várias situações em que os métodos de imagem representam a melhor opção para avaliar hérnias inguinais, seu conteúdo e eventuais complicações. Além disso, os abaulamentos da região inguinal nem sempre são hérnias, pois outras lesões como tumores, cistos e hematomas também acometem este sítio. O objetivo deste ensaio é demonstrar alguns diferentes conteúdos que podem ser diagnosticados no interior de hérnias inguinais. A diferenciação dos tipos de estruturas herniadas é de suma importância no planejamento do tratamento.
ABSTRACT
Hérnia é uma protrusão de vísceras através de um orifício adquirido, tendo como constituintes o anel, conteúdo e saco herniário. As hérnias escrotais ocorrem quando, por algum defeito no anel inguinal, alguma víscera se desloca por ele, chegando até a bolsa escrotal. Sua etiologia não é completamenteelucidada, sendo a elevação da pressão intra-abdominal um dos prováveis desencadeadores. Em caninos, essa é uma condição rara e os poucos relatos citam em animais jovens. Objetivou-se descrever a ocorrência de uma hérnia escrotal unilateral esquerda com protrusão de omento maior em um cão da raça Dachshund com 14 anos de idade e com 12,1 kg de peso corporal. Para a redução do conteúdo à cavidade abdominal, foi necessária a realização de incisão na região inguinal cranial, abertura do saco herniário e a orquiectomia. Destaca-se a importância do tratamento cirúrgico da hérnia escrotal, bem como a inclusão dessa afecção no diagnóstico diferencial para afecções testiculares de cães adultos ou idosos.
Hernia is a protrusion of viscera through an acquired orifice, having as constituents the ring, contents and hernial sac. Scrotal hernias occur when, due to a defect in the inguinal ring, some viscera travel through it, reaching the scrotum. Its etiology is not completely elucidated, and the increase in intra-abdominal pressure is one of the probable triggers. In canines, this is a rare condition and the few reports mention it in young animals. The objective was to describe the occurrence of a left unilateral scrotal hernia with protrusion of the greater omentum in a 14-year-old Dachshund dog weighing 12.1 kg of body weight. To reduce the content of the abdominal cavity, it was necessary to make an incision in the cranial inguinal region, open the hernial sac and orchiectomy. The importance of surgical treatment of scrotal hernia is highlighted, as well as the inclusion of this condition in the differential diagnosis for testicular disorders of adult or elderly dogs.
Subject(s)
Animals , Dogs , Dogs/surgery , Herniorrhaphy/veterinary , Hernia/diagnosis , Omentum/surgeryABSTRACT
Hérnia é uma protrusão de vísceras através de um orifício adquirido, tendo como constituintes o anel, conteúdo e saco herniário. As hérnias escrotais ocorrem quando, por algum defeito no anel inguinal, alguma víscera se desloca por ele, chegando até a bolsa escrotal. Sua etiologia não é completamenteelucidada, sendo a elevação da pressão intra-abdominal um dos prováveis desencadeadores. Em caninos, essa é uma condição rara e os poucos relatos citam em animais jovens. Objetivou-se descrever a ocorrência de uma hérnia escrotal unilateral esquerda com protrusão de omento maior em um cão da raça Dachshund com 14 anos de idade e com 12,1 kg de peso corporal. Para a redução do conteúdo à cavidade abdominal, foi necessária a realização de incisão na região inguinal cranial, abertura do saco herniário e a orquiectomia. Destaca-se a importância do tratamento cirúrgico da hérnia escrotal, bem como a inclusão dessa afecção no diagnóstico diferencial para afecções testiculares de cães adultos ou idosos.
Hernia is a protrusion of viscera through an acquired orifice, having as constituents the ring, contents and hernial sac. Scrotal hernias occur when, due to a defect in the inguinal ring, some viscera travel through it, reaching the scrotum. Its etiology is not completely elucidated, and the increase in intra-abdominal pressure is one of the probable triggers. In canines, this is a rare condition and the few reports mention it in young animals. The objective was to describe the occurrence of a left unilateral scrotal hernia with protrusion of the greater omentum in a 14-year-old Dachshund dog weighing 12.1 kg of body weight. To reduce the content of the abdominal cavity, it was necessary to make an incision in the cranial inguinal region, open the hernial sac and orchiectomy. The importance of surgical treatment of scrotal hernia is highlighted, as well as the inclusion of this condition in the differential diagnosis for testicular disorders of adult or elderly dogs.
Subject(s)
Animals , Dogs , Testis/surgery , Dogs/surgery , Hernia/veterinary , Omentum/surgery , Herniorrhaphy/veterinary , Inguinal Canal/surgeryABSTRACT
El síndrome de Morris es un trastorno genético recesivo ligado al cromosoma X. Se caracteriza por fenotipo femenino y cariotipo 46 XY. Las gónadas pueden estar localizadas en los labios mayores, el canal inguinal o intraabdominal. En los casos en los que la localización está en el conducto inguinal o labios mayores, las gónadas son confundidas con hernias y son extirpadas en la infancia; cuando son intraabdominales aproximadamente el 30 % tienen el riesgo de desarrollar tumores gonadales en la edad adulta, por lo que es necesario su extirpación quirúrgica. La localización de estas se realizan con ecografía, tomografía o resonancia magnética, pero en ocasiones no es posible identificar estas estructuras, es allí donde nosotros proponemos la tomografía por emisión de positrones con 18-Fluordesoxiglucosa como herramienta diagnostica para localizar el tejido gonadal, aprovechando la captación fisiológica de este radiotrazador en el tejido testicular.
Morris Syndrome is a recessive genetic disorder linked to the X chromosome. It is characterized by a feminine phenotype and 46 XY karyotype. Gonads can be localized at the upper lips and the inguinal or intra-abdominal canal. In cases where the localization can be at the inguinal conduct or upper lips, gonads are mistaken for hernias and they are removed in childhood; when they are intra-abdominal, approximately 30% has risks of developing gonadal tumors at adulthood, so is necessary its surgical removal. Their localization can be made by ultrasound scans, tomography or magnetic resonance, but sometimes is not possible to identify these structures, so this is where we propose 18-Fluorodeoxyglucose positron emission tomography as a diagnostic tool to localize the gonadal tissue, exploiting the physiological capture of this radiotracer at the testicular tissue.
Subject(s)
Humans , Male , Adult , Young Adult , Androgen-Insensitivity Syndrome/diagnostic imaging , Fluorodeoxyglucose F18 , Positron-Emission TomographyABSTRACT
Background: Hernia is defined as abnormal protrusion of whole or a part of a viscus through the wall that contains it. Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Many factors are responsible for the formation of the inguinal hernia but, what makes a few people more susceptible to this situation is still clearly not proved. The lowness of pubic tubercle is associated with narrow origin of internal oblique muscle from lateral inguinal ligament which fails to protect the deep inguinal ring consequently lead to inguinal hernia.Methods: The study was conducted in Sardar Patel Medical College and attached hospital, Bikaner for duration of 12 months from March 2018 to February 2019. It is a case-control study with 50 cases and 50 control meeting inclusion criteria. In all patients, following parameters SS line, ST line, height, weight was recorded and evaluated.Results: The mean value of ST line in our study group is 7.37±0.182 cm which is significantly greater (p=0.0001) than the controls the mean value being 7.01±0.262 cm. In our study, 98% of cases were having ST line >7.01 cm whereas 66% of controls were ST line under 7.01 cm.Conclusions: Group of people with low lying pubic tubercle are at high risk of developing inguinal hernia.
ABSTRACT
Abstract Emergencies involving the inguinal region and scrotum are common and can be caused by a plethora of different causes. In most cases, such conditions have nonspecific symptoms and are quite painful. Some inguinoscrotal conditions have high complication rates. Early and accurate diagnosis is therefore imperative. Ultrasound is the method of choice for the initial evaluation of this vast range of conditions, because it is a rapid, ionizing radiation-free, low-cost method. Despite the practicality and accuracy of the method, which make it ideal for use in emergency care, the examiner should be experienced and should be familiarized with the ultrasound findings of the most common inguinoscrotal diseases. On the basis of that knowledge, the examiner should also be able to make an accurate, direct, precise report, helping the emergency room physician make decisions regarding the proper (clinical or surgical) management of each case. Here, we review most of the inguinoscrotal conditions, focusing on the imaging findings and discussing the critical points for the appropriate characterization of each condition.
Resumo As emergências envolvendo a região inguinal e o escroto são frequentes, derivadas de diferentes causas, e na maioria das vezes apresentam-se clinicamente de modo não específico e bastante dolorosas. Algumas destas condições apresentam elevado potencial de gravidade, sendo imperioso um diagnóstico rápido e preciso. A ultrassonografia é, indiscutivelmente, o método de escolha na avaliação inicial de todo o vasto leque de doenças nessas regiões, sendo rápido, de baixo custo e sem uso de radiação. Além da praticidade e acurácia do método, ideal para a prática em âmbito de pronto-atendimento, a experiência do examinador, o qual deve estar familiarizado com os principais achados de imagem, é fundamental para a precisão diagnóstica. Some-se a isto a necessidade de um relatório claro e assertivo, auxiliando o médico emergencista na terapêutica apropriada a cada caso, seja clínica ou cirúrgica. Procuramos trazer uma revisão baseada nos achados de imagem das principais afecções dolorosas inguinais e escrotais, discutindo os pontos-chaves para sua adequada caracterização.
ABSTRACT
Background: The inguinal canal is an oblique intermuscular passage lying above the medial half of the inguinalligament. Its size and form vary with age and sex, although it is present in both sexes, it is most well developedin male. The inguinal canal in both sexes has been studied by many workers both in India and in other countries.It is observed that the inguinal hernia and recurrence of hernia after surgery is very common in the kosi regionof Bihar. This observational study may help the surgeons during the operation of inguinal hernia.Materials and Methods: Present study conducted at the department of Anatomy, Katihar medical college andhospital Katihar and Lord Buddha Kosi Medical College, Saharsa during the period of 2010 to 2016. The cadaverprovided for dissection to the student of first professional MBBS, are selected for the study. Cadavers withinjured groin region are not taken for the study. Measurements were done by stainless steel scale and spreadingcalliper during dissection of groin region.Results: Anatomy of inguinal canal, superficial inguinal ring, the deep inguinal ring and the related structureswas studied in details in 50 cadavers in the dissection hall at the time of dissection. During this study I havefound that the average length of inguinal canal in the male was 38.35 mm. The longest diameter of deep inguinalring is 13 mm and smallest diameter is 9 mm. The average measurement of superficial inguinal ring was 12mmalong the base and 24mm from apex to base.Conclusion: At the end of the study I have found a little variation from the established facts related to diameter ofsuperficial inguinal ring, position of deep inguinal ring and direction of fibres of external oblique aponeurosis.
ABSTRACT
ABSTRACT Background: Inguinal herniotomy is the most common surgery performed by pediatric surgeons. Aim: To compare the results and complications between two conventional methods of pediatric inguinal herniotomy with and without incising external oblique aponeurosis in terms of recurrence of hernia and other complications. Methods: This one blinded clinical trial study was conducted on 800 patients with indirect inguinal hernia. Inclusion criterion was children with inguinal hernia. The first group underwent herniotomy without incising external oblique aponeurosis and second group herniotomy with incising external oblique aponeurosis. Recurrence of hernia and other complications including ileoinguinal nerve damage, hematoma, testicular atrophy, hydrocele, ischemic orchitis, and testicular ascent were evaluated. Results: Recurrence and other complications with or without incising external oblique aponeurosis had no significant difference, exception made to hydrocele significantly differed between the two groups, higher in the incision group. Conclusion: Herniotomy without incising oblique aponeurosis can be appropriate choice and better than herniotomy with incising oblique aponeurosis. Children with inguinal herniotomy can be benefit without incising oblique aponeurosis, instead of more interventional traditional method.
RESUMO Racional: Herniotomia inguinal é a operação mais comum realizada por cirurgiões pediátricos. Objetivo: Comparar os resultados e complicações entre dois métodos convencionais de herniotomia inguinal pediátrica, com e sem incisão de aponeurose oblíqua externa, em termos de recorrência de hérnia e outras complicações. Métodos: Este estudo cego foi realizado em 800 pacientes com hérnia inguinal indireta. Os critérios de inclusão foram crianças com hérnia inguinal. O primeiro grupo foi submetido à herniotomia sem incisão de aponeurose oblíqua externa e o segundo grupo herniotomia com ela. Foram avaliadas recorrência da hérnia e outras complicações, incluindo lesão do nervo ileoinguinal, hematoma, atrofia testicular, hidrocele, orquite isquêmica e ascensão testicular. Resultados: A recorrência e outras complicações com ou sem incisão da aponeurose oblíqua externa não apresentaram diferença significativa, com exceção feita à hidrocele significativamente diferenciada entre os dois grupos, maior no grupo com incisão. Conclusão: A herniotomia sem incisão da aponeurose do oblíquo externo pode ser escolha adequada e melhor do que a herniotomia com incisão dela. As crianças com herniotomia inguinal podem ser beneficiadas sem incisão da aponeurose, em vez do método tradicional mais intervencionista.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Herniorrhaphy/methods , Aponeurosis/surgery , Hernia, Inguinal/surgery , Postoperative Complications/epidemiology , Single-Blind Method , Treatment OutcomeABSTRACT
The area of inguinal canal and scrotum is complex and concealment where many clinical problems especially congenital abnormalities in infant occur.As the reasons of embryonic development and anatomy,most of the clinical problems have close inner link and external relationship.Evaluation and management of the infant with abnormalities in this area involves in structural restoration,prevention and treatment of severe emergencies,or in fertility and testicular tumorigenesis after puberty.As the structure and the long-term function and influence of this area,the studies on here are still focused and the knowledge always update.
ABSTRACT
The area of inguinal canal and scrotum is complex and concealment where many clinical problems especially congenital abnormalities in infant occur.As the reasons of embryonic development and anatomy,most of the clinical problems have close inner link and external relationship.Evaluation and management of the infant with abnormalities in this area involves in structural restoration,prevention and treatment of severe emergencies,or in fertility and testicular tumorigenesis after puberty.As the structure and the long-term function and influence of this area,the studies on here are still focused and the knowledge always update.
ABSTRACT
Objective To analyze CT manifestations of inguinal canal lipomas (ICLS).Methods CT datas of 104 pa tients with ICLS was retrospectively analyzed.And the imaging features were observed by MPR.Results The main CT manifestations of the ICLS were fat density in the inguinal canal and were unconnected with the abdominal fat.Among the 104 ICLSpatients,male (90/104,86.54％) was more than famale(14/104,13.46％;x2=55.538,P＜0.001).Thele sions were located at bilateral sides in 8 cases,left side in 66 cases and right side in 30 cases.The lesions in left side were more than those in right side (x2 13.500,P＜0.001).The mean maximum cross-sectional area of ICLS was (3.89 ± 2.12)cm2.There was no statistically significant difference between male and famale in maximum cross-sectional area (t=1.038,P=0.302).Conclusion In ICLS patients,male is more than famale.And more lesions are located at the left side.The CT manifestations of ICLS have certain characteristics,and MPR images are helpful in diagnosing ICLS.
ABSTRACT
PURPOSE: The purpose of this study is to describe the ultrasonographic findings of ovary-containing hernias of the canal of Nuck. METHODS: This was a retrospective analysis of 22 hernia cases of the canal of Nuck. The following gray scale and color Doppler ultrasonographic features were analyzed: the site and the size of the hernia, the texture of the hernia contents, and the presence or absence of blood flow in the hernia contents. RESULTS: All of the patients had swelling of the right inguinal region (n=10), left inguinal region (n=8), or both (n=2). On ultrasonography, the hernias appeared as either solid masses (n=17) or solid masses containing cysts (n=5). The mean anteroposterior diameter of the hernia sac of the canal of Nuck was 9.1 mm (range, 5 to 18 mm). The mean anteroposterior diameters of the hernia sac were 11.6 mm (range, 7.6 to 18 mm) for hernias containing an ovary, and 8.3 mm (range, 5 to 13 mm) for hernias containing omental fat. During surgery, among the 17 cases with solid-appearing hernia contents on ultrasonography, omental fat was identified in the hernia sac in four cases, but no structure was identified in 13 cases. All five cases that appeared as solid masses containing cysts on ultrasonography contained ovary tissue in the hernia sac. Among the four cases of ovary-containing hernias, color Doppler ultrasonography identified blood flow within the ovary in three cases, but no flow signal was seen in one case of incarcerated hernia. CONCLUSION: Ultrasonography may be helpful for the diagnosis of ovary-containing hernias of the canal of Nuck by detecting solid masses containing small cysts.
Subject(s)
Female , Humans , Diagnosis , Hernia , Inguinal Canal , Ovary , Retrospective Studies , Ultrasonography , Ultrasonography, Doppler, ColorABSTRACT
Herniation of the appendix into an inguinal canal is known as an Amyand hernia. Due to its nonspecific symptoms, clinical diagnosis is extremely difficult, and an accurate preoperative diagnosis of Amyand hernia with ultrasound (US) and CT is rarely reported. Herein, we reported a typical case of Amyand hernia in a 74-year-old male in which the correct diagnosis was made using inguinal US and contrast-enhanced abdominopelvic CT. US and CT findings of Amyand hernia showed a target-like tubular structure within the inguinal canal.
Subject(s)
Aged , Humans , Male , Appendix , Diagnosis , Hernia , Inguinal Canal , UltrasonographyABSTRACT
Undescended testes or cryptorchidism in the most common congenital anomaly of male reproductive system. The descent is multifactorial with gubernaculums playing major role. The failure of descent can be at trans-abdominal or inguino-scrotal phase. Locating undescended testes is important in view of low fertility and high rate of occurrence of neoplasm in them. Ultrasound is the standard imaging technique of choice in children with a non-palpable testis as it is non-invasive and does not use ionizing radiation. Position of testis is also important in deciding whether patient will need abdominal or inguinal exploration. The aim was to study the position of undescended testes by high frequency ultrasound and its embryonic explanation. Total 41 boys with undescended testes underwent high frequency ultrasound. The location of testis was noted followed by its size and echotexture. Thirty patients had unilateral and 11 had bilateral undescended testes. The prevalence was more on right side (16 out of 30). Out of total 52, 46 (88 percent testis were located by ultrasound. Six (12 percent) testes could not be located. Five (10 percent) were retractile testes. Out of remaining 41, 26 (63 percent) were located in inguinal canal and 15 (37 percent) were located in abdomen. Out of 15 abdominal testes 9 were located just proximal to inguinal canal and 6 were located in deep pelvis. High frequency ultrasound was able to locate the position of undescended testes in majority (88 percent of the cases...
La criptorquidia o testículos no descendidos es la anomalía congénita más común del sistema reproductivo masculino. El descenso es multifactorial, donde el gubernaculum testis juega un rol fundamental. El fracaso de descenso puede ocurrir en fase trans-abdominal o inguino-escrotal. Conocer la localización de los testículos no descendidos es importante en vista de la baja fertilidad y alta tasa de incidencia de neoplasia en ellos. La ecografía es la técnica imagenológica estándar y de elección en niños con testículos no palpables, ya que no es invasiva y no utiliza radiación ionizante. La posición del testículo también es importante para decidir si el paciente necesita exploración abdominal o inguinal. El objetivo fue estudiar la posición de los testículos no descendidos por ultrasonido de alta frecuencia y su explicación embrionaria. Un total de 41 niños con testículos no descendidos se sometieron a ultrasonido de alta frecuencia. Se estudió la ubicación, tamaño y ecotextura del testículo no descendido. Treinta pacientes presentaron el testículo no descendido de manera unilateral y 11 bilateral. La prevalencia fue mayor en el lado derecho (16 de 30). Del total de 52 de testículos, 46 (88 por ciento) fueron localizados por ultrasonido. Seis (12 por ciento) no pudieron ser localizados. Cinco (10 por ciento) fueron testículos retráctiles. De los 41 testículos no descendidos, 26 (63 por ciento) se localizaron en el canal inguinal y 15 (37 por ciento) en el abdomen. De los 15 en posición abdominal, 9 se encontraron justo proximal al canal inguinal y 6 en la pelvis profunda. El ultrasonido de alta frecuencia fue capaz de localizar la posición de los testículos no descendidos en la mayoría (88 por ciento) de los casos...
Subject(s)
Humans , Male , Adolescent , Infant , Child, Preschool , Child , Cryptorchidism/pathology , Cryptorchidism , Inguinal CanalABSTRACT
Objective To investigate the clinical therapeutic effectiveness of laparoscopic high ligation of spermatic vein method, modified Palomo procedure and ligating of spermatic vein via inguinal canal for varicocele. Methods All 135 patients with varicocele who underwent varicocele were divided into three groups by random number table method: laparoscopic high ligation of spermatic vein method group (group A, 50 cases), modified Palomo procedure group(group B, 70 cases) and ligating of spermatic vein via inguinal canal group (group C, 15 cases). The surgery time,the length of stay,the hospital expenses,and the quality of their semen were collected at different time points (preoperation, 1,6,12 months after operation) and assessed,the recurrence rate,the pregnant outcomes of their spouses and the testicle atrophy rate 18 months postoperation were followed-up. Results There was no significant difference in the surgery time and the length of stay among three groups (P> 0.05). But the hospital expenses in group A was significantly higher than that in group B and group C (P 0.05). During the follow-up of 18 months, the recurrence rate in semen group C (13.3% ,2/15) was significantly higher than that in group A (0) and group B (1.4%, l/70)(P 0.05). No testicle atrophy happened during follow-up. Conclusions Laparoscopic surgery and modified Palomo procedure are safe,convenient and effective surgical techniques. Modified Palomo procedure is recommended for unilateral varicocele. Laparoscopic surgery has advantages for recurrent and bilateral varicocele.
ABSTRACT
Estudio descriptivo, analítico, y comparativo, realizado en cadáveres de embriones, fetos y adultos del género masculino, pertenecientes al laboratorio de Anatomía de la Facultad de Medicina. Transcribir los hallazgos embriológicos del descenso testicular normal y darnos cuenta que la gónada masculina fue el asiento de la mayoría de las patologías encontradas en nuestros pacientes y resueltas felizmente por los procedimientos quirúrgicos y médicos correspondientes, que he considerado complemento del estudio primario de las disecciones anatómicas.Ojala, este trabajo el primero de su género en este medio, permita que nuestra Facultad sea conocida fuera del contexto regional.
A descriptive, analytical, and comparative study performed on cadavers of fetuses and adults of the male gender in the Anatomy Laboratory of the Medical School. We inform the embryological findings related with the normal testicular descent and highlight the fact that most pathological entities found in these patients originate in the male gonad, and that they were successfully resolved by means of surgical and medical treatment modalities, considering that this constitutes a complement of the primary study derived from anatomical dissection.We expect that this work, the fist of its kind in our region, will allow a better recognition of our Faculty of Medicine outside its original context.
Subject(s)
Humans , Anatomy , Embryology , Histology , Inguinal Canal , Pathology, SurgicalABSTRACT
We report here on two cases of testicular torsion in the inguinal canal, and there have been only rare published reports on this condition. Doppler ultrasound was used for making the diagnosis in the present two cases, which were initially considered to be inguinal hernia.
Subject(s)
Child , Humans , Male , Cryptorchidism , Hernia, Inguinal , Inguinal Canal , Spermatic Cord TorsionABSTRACT
OBJETIVO: Avaliar as diferenças anatômicas na região inguinal de fetos e adultos do gênero masculino, assim como a existência de uma possível base morfológica para a maior incidência de hérnias inguinais à direita em crianças e adultos. MÉTODOS: Foram dissecados 20 fetos natimortos e 20 cadáveres humanos adultos in natura, todos do gênero masculino, comparando-se o comprimento do canal inguinal, o maior diâmetro dos anéis inguinais superficial e profundo em ambos os lados de cada cadáver e a existência ou não de superposição entre os anéis superficial e profundo. RESULTADOS: Não foram observadas, nos dois grupos, diferenças significativas na comparação das medidas dos anéis profundos e superficiais, assim como dos canais inguinais, com seus respectivos contralaterais em cada espécime. Entretanto, houve diferença significativa entre os diâmetros dos anéis inguinais homolaterais, sendo o anel superficial maior do que o profundo nos fetos (p = 0,0002) e nos cadáveres adultos (p < 0,0001). A razão canal inguinal/altura mostrou diferença significativa entre os grupos (p<0,0001), evidenciando que o canal inguinal em fetos é relativamente mais curto que em adultos. Foi observada, também, superposição dos anéis inguinais superficial e profundo ipsilaterais em dois fetos, porém não houve em nenhum dos adultos. CONCLUSÃO: A morfometria dos canais e anéis inguinais não justifica a maior incidência de hérnia do lado direito no gênero masculino.
OBJECTIVE: To evaluate the anatomical differences of fetus and adults concerning the inguinal region of male gender, as well as the presence of possible morphological basis for the higher incidence of inguinal hernias in the right side in both groups. METHODS: Twenty human stillborn fetuses and twenty in natura adult male corpses were dissected in order to compare the length of the inguinal canals, the longer diameter of the deep and superficial inguinal rings in both sides of each corpse, and the presence or not of overlap between the deep and superficial rings. RESULTS: No statistically significant differences were observed in both groups regarding the measures of the deep and the superficial rings, as well as the inguinal canals, when in comparison to the respective contralateral anatomical structures of each specimen. Nevertheless, there was a statistically significant difference between the diameter of homolateral inguinal rings, once the superficial ring was longer than the deep ring in fetus (p=0.0002) and adult corpses (p<0.0001). The ratio inguinal canal/height showed to be statistically different between both groups (p<0.0001), since the inguinal canal in fetus is shorter than in adults. It was also observed overlapping of homolateral superficial and deeper inguinal rings in two fetuses, but none in adults. CONCLUSION: Morphometric analysis of the inguinal canals and rings does not justify the higher incidence of hernias in the right side in the male gender.
Subject(s)
Adolescent , Adult , Aged , Humans , Male , Middle Aged , Young Adult , Fetus/pathology , Hernia, Inguinal/pathology , Inguinal Canal/pathology , Age Factors , Cadaver , Young AdultABSTRACT
Os autores relatam um caso de hidrocele abdominoescrotal em um lactente. É forma rara de hidrocele, que ocorre em crianças e adultos. A causa não está esclarecida, e o diagnóstico é clínico. O tratamento dessa doença é cirúrgico e deve ser precoce a fim de evitar o aparecimento de complicações.
The authors report a case of abdominoescrotal hydrocele in an infant. It is a rare sort of hydrocele that occurs in children and adults. The cause is not clear and the diagnosis is clinical. The treatment of that disease is surgical and it should be early enough in order to avoid the appearance of complications.
Subject(s)
Humans , Male , Infant , Inguinal Canal , Abdominal Cavity , Testicular Diseases , Scrotum/pathology , Testicular HydroceleABSTRACT
OBJETIVO: Comparar os resultados da hernioplastia inguinal pelas técnicas de Shouldice modificada por Berliner (SB), que realiza dois planos de sutura superpostos e de Falci-Lichtenstein (FL) que utiliza prótese de polipropileno. MÉTODO: Foram estudados prospectivamente 312 pacientes operados pelo mesmo cirurgião entre 1997 e 2004. O Grupo 1 constou de 84 pacientes operados pela técnica de FL e o Grupo 2 foi formado por 228 pacientes operados pela técnica de SB. Todos eram masculinos, maiores de 18 anos e portadores de hérnias inguinais tipo 3A, 3B e 4 da classificação de Nyhus. Os grupos foram semelhantes em relação a idade, lado operado, tipo de hérnia, anestesia empregada e tempo de seguimento (média de 3,5 anos). RESULTADOS: A duração média dos procedimentos foi de 53 min no Grupo 1 e de 57 min no Grupo 2 (p=0,2982); a permanência hospitalar foi menor que 24h para 94 por cento dos pacientes do Grupo 1 e 92 por cento do Grupo 2 (p=0,8050); a incidência de complicações foi de 9,5 por cento no Grupo 1 e de 12,3 por cento no Grupo 2 (p=0,5557) sendo a mais comum o hematoma/equimose e a taxa de recidiva foi de 1,2 por cento no Grupo 1 e de 5,4 por cento no Grupo 2 (p=0,0935). Nenhum desses resultados apresentou diferença significante. CONCLUSÃO: A técnica SB mostrou-se comparável à técnica de FL em homens, maiores de 18 anos com hérnias tipo 3 A, 3 B e 4 de Nyhus, além de não exigir material protético.
BACKGROUND: To compare the results of the inguinal hernia repair with the Falci-Lichtenstein (FL) tecnique that uses polypropylene mesh and the Shouldice modified by Berliner (SB) tecnique, a repair in two layers of continuous suture. METHODS: It is presented a prospective study of 312 patients operated on between 1997 and 2004 by one single surgeon. Group 1 was composed for 84 patients treated with the FL repair and group 2 for 228 patients with the SB repair. All the patients were men, over 18 years , with types 3 A, 3 B and 4 hernias according to the Nyhus classification. The groups were similar in age, operated side, hernia type, anestesia and follow up period. RESULTS: Mean operative time was 53min in group 1 and 57min in group 2 (p=0,2982); length of hospital stay was 1 day in 94 percent of the cases in group 1 and 92 percent in group 2 (p=0,8050); postoperative complication rate was 9,5 percent in group 1 and 12,3 percent in group 2 (p=0,5557) and the most frequent was hematoma/ecchymosis. The recurrence rate at 3,5 years mean follow up time was 1,2 percent in group 1 and 5,4 percent in group 2 (p=0,0935). None of these results were significant. CONCLUSION: The SB repair proved to be as good as the FL tecnique in men, over 18 years with type 3 A, 3 B and 4 inguinal hernias; besides it do not require a mesh prosthesis.