RESUMO
The rarity of Spigelian hernias and the frequent subtle clinical findings can cause an important delay in diagnosis, especially in obese patients. Furthermore it has a high risk of incarceration. When this occurs, a fast recognition and adequate treatment are necessary. Treatment can be primary suture or mesh repair. More recently, the laparoscopic approach has become more popular. We present two cases of incarcerated Spigelian hernia and we give a review of the literature, with specific attention for the anatomical features and pathogenesis.
Assuntos
Hérnia Ventral/diagnóstico , Hérnia Ventral/cirurgia , Feminino , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Implantação de Prótese , Telas Cirúrgicas , Procedimentos Cirúrgicos Operatórios/métodosRESUMO
PURPOSE: To evaluate the findings from magnetic resonance (MR) imaging of the cervical spine and brain after acute whiplash injury. MATERIALS AND METHODS: Within 3 weeks of trauma, 100 patients underwent MR imaging for evaluation of the cervical spine and the brain. In addition, plain radiographs were obtained, including functional images of the cervical spine. RESULTS: Only one patient had an abnormality on the MR image that was related to trauma (ie, prevertebral edema). In 17 patients, functional images showed a kyphotic angle, but no evidence of soft-tissue injury was seen on MR images. CONCLUSION: There is no role for MR imaging in the routine work-up of patients with acute whiplash injury who have normal plain radiographic findings and no evidence of a neurologic deficit. A kyphotic angle seen on functional images of the cervical spine should not be assumed to indicate soft-tissue injury and is most likely attributable to a compensating mechanism of hypermobility at a level of the spine above that at which hypomobility occurs, which is probably the result of a muscle spasm.
Assuntos
Lesões Encefálicas/diagnóstico , Imageamento por Ressonância Magnética , Traumatismos em Chicotada/diagnóstico , Doença Aguda , Adulto , Encéfalo/patologia , Vértebras Cervicais/patologia , Estudos de Avaliação como Assunto , Feminino , Humanos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Estudos Prospectivos , Lesões dos Tecidos Moles/diagnósticoRESUMO
Three cases of transchondral fracture of the dome of the talus are reported. Two were treated surgically, one conservatively. A review of the literature is presented and the relative values of surgical intervention and conservative therapy are discussed.
