HERNIAS DE LA PARED ABDOMINAL ZONAS DEBILES DE LA PARED ABDOMINAL 1. Hernia epigástrica. 2. Hernia umbilical. 3. Hernia. Objective: Spigelian hernia is an uncommon abdominal wall defect. La técnica quirúrgica dependerá de las características del paciente, la hernia y la. H. epigástrica. . TÉCNICA LAPAROSCÓPICA• visualizar el defecto de la hernia y la anatomía circundante con claridad y ampliación.
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Although diagnosis must be established clinically in most patients on the basis of a high level of suspicion, a proper anamnesis and a thorough physical examination, it is not possible in some cases.
The presence of pain and a palpable lump in the typical location should alert us of its diagnosis.
The assessed parameters were as follows: During the postoperative care one patient had a wound infection and another one had a paralytic ileus.
Spigelian hernias have a multidisciplinary interest and their diagnosis involves various specialities such us surgeons, radiologists and in some instances internists and gastroenterologists when the SP presents as abdominal pain syndromes. In our experience intraabdominal approach is easy to perform and gives good results. Hhernia analysis of cases. After that laparoscopic approach has been widely described in literature.
Spigelian hernia appears between the quirkrgica of the anterior rectus, internal oblique and transverse abdominal muscles.
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Sometimes the way of presentation is a complication that requires emergency surgery. J Comput Assist Tomogr ; A delay in the diagnosis leads to a high rate of complications and the need of emergency surgery in many cases 3. Ultrasonography can establish the diagnosis but provides less specificity than CT scan as has quite false negatives in obesity patients. Carter JE, Mizes C.
Rev Cubana Cir ; 44 4. Postoperative morbidity is very low.
Lower SH are below the level of the inferior epigastric vessels and that can lead to mistake a SH for an inguinal hernia. Rev Esp Enferm Dig ; 99 9: Results Between January and December39 patients underwent surgery for Spigelian hernia.
InCarter y Mizes performed the first intra-abdominal laparoscopic correction 20 teccnica inSalvador et al published the first one in Spain The presence of any of these situations must be regarded as a starting point for correctly orienting clinical history and should lead to the diagnosis.
An important percentage of patients will present with an acute complication of the Spigelian hernia as their first symptom. When the hernia sac contents the bowel the patient can present with nausea, vomiting or altered bowel rhythm. Br J Surg ; Herhia most frequent symptom is pain and the presence of a lump.
Tècnica Quirurgica de Pared Abdominal by Krizz Luque Mora on Prezi
Am Surg ; 74 8: In those cases of diagnostic doubt is advisable to perform a sonography or tomography epiastrica, The different options include primary closure or mesh repair in cases of atrophic aponeurosis, wide defect or recurrences. We do not completely agree with this opinion henia we think a prosthetic material should not be implanted at the same time that any other surgical procedure with risk of contamination.
As regards to postoperative morbidity literature describes minimal and mild complications such as wound infections, paralytic ileus or haematomas.
J Minim Access Surg ; 4 4: Most of SH are situated underneath the external oblique muscle, hernoa the different sheaths of abdominal wall, and therefore, SH are also called interstitial, intraparietal or occult hernias.
A high index of suspicion and a thorough physical examination is needed to make a correct diagnosis, although in doubtful cases it is advisable to perform a sonography or better a tomography. To date Quirurgoca reports on this pathology are short series of cases, being the largest one published by Moreno-Egea et al in with 27 patients 5.
The treatment of Spigelian hernia is surgical and can be performed either by classic open or laparoscopic technique. The first one allows to explore the contralateral side as well as epgiastrica abdominal cavity and for some authors is the recommended method when there is another process requiring associated surgery because can be performed in the same intervention 6.
Personal experience and review of the literature.