ABSTRACT
Spigelian hernias represent 1-2% of all abdominal wall hernias. The pathogenesis often involves a dehiscence of the transverse and internal oblique muscle aponeurosis. The diagnosis is made by physical examination; but sometimes it is complicated by obesity. The risk of strangulation is important and can reach 30%. The abdominal CT scan is helpful in the description of hernia's topography and sometimes in diagnostic confirmation. The treatment is surgical. The rate of recurrence after direct closure is considerable. Synthetic mesh repair seems to be a more adequate alternative. The advent of laparoscopy has improved the management of these hernias.
Subject(s)
Hernia, Ventral/diagnosis , Hernia, Ventral/surgery , Laparoscopy/methods , Abdominal Muscles/pathology , Hernia, Ventral/etiology , Humans , Recurrence , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Diverticulitis, Colonic/complications , Intestinal Fistula/complications , Sigmoid Diseases/complications , Uterine Diseases/complications , Aged , Diverticulitis, Colonic/diagnostic imaging , Female , Humans , Intestinal Fistula/diagnostic imaging , Radiography , Sigmoid Diseases/diagnostic imaging , Uterine Diseases/diagnostic imagingSubject(s)
Appendectomy , Appendicitis/etiology , Cecal Diseases/surgery , Endometriosis/surgery , Laparoscopy , Adult , Cecal Diseases/diagnosis , Endometriosis/diagnosis , Female , HumansABSTRACT
Hydatid disease is endemic in Tunisia and has been considered as one of the most common surgical pathology. Several localizations have been described, but hydatidosis of the liver is the most frequent clinical entity. Primary hydatid cyst of the gallbladder is very rare. We report in this observation a new case of primary hydatid cyst of the gallbladder diagnosed by Magnetic Resonance Imaging (MRI).
Subject(s)
Cholecystitis/diagnosis , Echinococcosis/diagnosis , Magnetic Resonance Imaging , Abdominal Pain/etiology , Adult , Cholecystectomy , Cholecystitis/complications , Cholecystitis/parasitology , Cholecystitis/surgery , Diagnostic Imaging/methods , Echinococcosis/complications , Echinococcosis/surgery , Endemic Diseases , False Negative Reactions , Female , Humans , Nausea/etiology , TunisiaABSTRACT
AIM: The objective of this study is to evaluate the feasibility, efficacy and safety of laparoscopic repair for perforated duodenal ulcer. METHODS: One hundred and sixty patients were treated by coelioscopic procedure for a perforated duodenal ulcer. The procedure consists on a suture of perforated ulcer associated with a peritoneal lavage. A medical treatment of Helicobacter pylori associated with an inhibitor of the protons pomp was conducted. RESULTS: The coelioscopic procedure permitted to confirm the diagnostic of perforated duodenal ulcer in all cases. A simple suture of the ulcer was done in 155 cases. The conversion was compulsory in 5 cases, because of difficulties of the peritoneal lavage in 2 cases, a bleeding associated with perforation of the ulcer in one case and associated stenosis in 2 cases. Mean duration was 90 min (extremes 50 - 120 min). Complications occur in 3,1%. They were post - operative peritonitis in 3 cases and duodenal fistulae in 2 cases. All patients were reviewed at 16 months. A recurrence, either clinical or endoscopic occurs in 4 cases because of no adhesion to medical treatment. CONCLUSION: Coelioscopic treatment of perforated duodenal ulcer is a safe and efficacy method. It permits to avoid potential septic and parietal complications of laparotomy. The actual efficacy of medical treatment mustn't allow place to the radical treatment of ulcerous illness.
