RESUMEN
PURPOSE: Incarcerated inguinal hernia may have very unusual hernial sac contents. In this study we aim to present clinical characteristics about incarcerated inguinal hernia of the greater omentum. METHODS: We retrospectively analyzed hospital records of 643 adult patients who underwent inguinal hernia repair from November 2001 to January 2009. The age, sex, location, type, symptom duration, body mass index (BMI), comorbidity, type of anesthesia, operative time, postoperative hospital stay and complications were reviewed. RESULTS: Of the 643 cases, 18 cases were omental incarcerated inguinal hernia group (O group). Seventeen in 18 cases of O group were male patient (NS). In O group, 16 cases were indirect type and 2 cases were femoral type (P=0.021). Mean age was younger in O group than in non-omental incarcerated inguinal hernia group (N group) (P=0.017). Duration of symptom was longer (P=0.013), and body mass index (BMI) was larger in O group (P=0.042). Operative time was longer in O group than in N group (P=0.006). CONCLUSION: The patients with omental incarcerated inguinal hernia mostly had long durations of protruding mass without pain. In these patients, operation was relatively difficult due to severe adhesion between the hernial sac and greater omentum. In addition, operative time took approximately 10 minutes longer. Therefore, general and spinal anesthesia is more feasible than local anesthesia.
Asunto(s)
Adulto , Humanos , Masculino , Anestesia , Anestesia Local , Anestesia Raquidea , Índice de Masa Corporal , Comorbilidad , Hernia Inguinal , Registros de Hospitales , Tiempo de Internación , Epiplón , Tempo Operativo , Estudios RetrospectivosRESUMEN
The use of anesthetic agents may induce a certain number of anaphylactic and anaphylactoid reactions. Anesthesiologists, therefore, are well advised to develop a rational approach to minimize risks and evaluate patients who present with histories of allergic drug reactions in the perioperative period. A 63-year-old female patient was withdrawn from operation due to anaphylactic reaction or life-threatening anaphylactoid reaction occurred during induction of anesthesia and successfully resuscitated. Thereafter, skin prick test to anesthetics including intravenous agents such as thiopental, propofol, ketamine, fentanyl and lidocaine, and muscle relaxants such as succinylcholine, vecuronium and atracurium revealed positive reactions to all the tested muscle relaxants. Next anesthetic experience was done for microvascular decompression surgery without use of muscle relaxants. Two years later, she underwent lumbar laminectomy successfully under isobaric spinal anesthesia using tetracaine.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Anafilaxia , Anestesia , Anestesia Raquidea , Anestésicos , Atracurio , Fentanilo , Ketamina , Laminectomía , Lidocaína , Cirugía para Descompresión Microvascular , Periodo Perioperatorio , Propofol , Piel , Succinilcolina , Tetracaína , Tiopental , Bromuro de VecuronioRESUMEN
The use of anesthetic agents may induce a certain number of anaphylactic and anaphylactoid reactions. Anesthesiologists, therefore, are well advised to develop a rational approach to minimize risks and evaluate patients who present with histories of allergic drug reactions in the perioperative period. A 63-year-old female patient was withdrawn from operation due to anaphylactic reaction or life-threatening anaphylactoid reaction occurred during induction of anesthesia and successfully resuscitated. Thereafter, skin prick test to anesthetics including intravenous agents such as thiopental, propofol, ketamine, fentanyl and lidocaine, and muscle relaxants such as succinylcholine, vecuronium and atracurium revealed positive reactions to all the tested muscle relaxants. Next anesthetic experience was done for microvascular decompression surgery without use of muscle relaxants. Two years later, she underwent lumbar laminectomy successfully under isobaric spinal anesthesia using tetracaine.