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Coexisting ipsilateral right femoral hernia and incarcerated obturator hernia.

ABSTRACT: Obturator hernia (OH) is an uncommon cause of bowel obstruction and described in elderly females in the literature. The treatment has traditionally been laparotomy because of an acute nature of the condition. However, because of old age and comorbidities that OH is associated with, general anaesthesia may need to be avoided. In the current case, a transinguinal preperitoneal approach and management are presented after delayed preoperative diagnosis of bowel obstruction caused by a coexisting right incarcerated OH and ipsilateral non-reducible femoral hernia. A 91-year-old woman had a 6-day history of nausea and vomiting. She was referred to surgery because of persisting vomiting, but without any abdominal pain. A CT scan showed a hernia in the right groin area but the diagnosis was delayed. The hernias were repaired using a preperitoneal transinguinal approach. Bowel resection was not needed. The obturator canal and the femoral ring were both covered by a Bard Polysoft patch.

SUBMITTER: Seppala TT

PROVIDER: S-EPMC4342653 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Coexisting ipsilateral right femoral hernia and incarcerated obturator hernia.

Seppälä Toni T TT Tuuliranta Mikko M

BMJ case reports 20150225

Obturator hernia (OH) is an uncommon cause of bowel obstruction and described in elderly females in the literature. The treatment has traditionally been laparotomy because of an acute nature of the condition. However, because of old age and comorbidities that OH is associated with, general anaesthesia may need to be avoided. In the current case, a transinguinal preperitoneal approach and management are presented after delayed preoperative diagnosis of bowel obstruction caused by a coexisting rig ...[more]

PMID: 25716157

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Project description:BackgroundAlthough many treatments for ipsilateral proximal and shaft femoral fractures have been developed, controversy exists regarding their optimal management. The purpose of this retrospective study was to discuss the effectiveness of the bridge-link type combined fixation system (BCFS) and evaluate functional outcomes in treating patients with these complex fractures.Patients and methodsWe retrospectively reviewed 14 cases of ipsilateral proximal and shaft femoral fractures treated from January 2012 to December 2016. All cases were treated by BCFS combined with minimally invasive percutaneous plate osteosynthesis (MIPPO). Clinical and radiographic data were collected during regular post-operative follow-up visits. Functional outcomes were determined according to the Friedman and Wyman scoring system.ResultsThe proximal femoral fractures were emergency diagnoses in 11 cases and delayed diagnoses in 3 cases. The delay time was 5-6 days, with an average of 5.3 days. The mean operation time was 179.6 min (range 135-231 min) with a blood loss volume that ranged from 430 to 535 ml (average 483.6 ml). Follow-up was conducted in 13 cases between 9 and 30 months post-operation, with an average follow-up time of 17.3 months. The proximal femoral fractures were united in 12 cases at the final follow-up. One case had nonunion 13 months after the operation, underwent valgus intertrochanteric osteotomy, and healed 6 months later. The femoral shaft fractures obtained rigid union at the latest follow-up in 12 cases. One case endured nonunion 12 months after the operation. After the revision surgery and iliac bone grafting, the fracture healed 6 months later. Eight of the cases had good functional results, 4 had fair results, and results were poor in 1 case at the final follow-up.ConclusionsThe treatment of ipsilateral proximal femoral and shaft fractures with BCFS in combination with MIPPO demonstrated a high likelihood of union for both fractures and good functional results.

Dataset Information

Coexisting ipsilateral right femoral hernia and incarcerated obturator hernia.

Publications

Coexisting ipsilateral right femoral hernia and incarcerated obturator hernia.

Similar Datasets

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