Incarcerated paraesophageal hernia David B. Dunn, Gary Quick
DOI: http://dx.doi.org/10.1016/0735-6757(90)90292-8
The American Journal of Emergency Medicine , Vol. 8 , Issue 1 ,
Published in issue: January 1990
x The case of an 80-year-old woman with an incarcerated paraesophageal hernia is presented. Among diaphragmatic hernias, the paraesophageal or type II hernia occurs with an incidence of 5%, sliding or type I hernia occurs with an incidence of 95%. Incarcerated paraesophageal hernia is a surgical emergency requiring rapid decompression and reduction to minimize catastropic consequences of hemorrhage, perforation, and visceral infarction. The clinical presentation and diagnostic workup of the patient with incarcerated type II diaphragmatic hernia are discussed.
Incarceration of the uterus in pregnancy Edward Patterson, Anthony M Herd
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90047-4
The American Journal of Emergency Medicine , Vol. 15 , Issue 1 ,
Published in issue: January 1997
x Uterine incarceration is a rare complication of pregnancy, usually presenting between 12 and 20 weeks' gestation, when the gravid uterus normally ascends through the pelvic brim. Conditions such as pelvic inflammatory disease, endometriosis, postoperative adhesions, posterior wall leiomyomas, and pelvic contraction may lead to fixed retroflexion of the uterus, predisposing to this condition. A case of incarceration is presented. Clinical features, diagnosis, treatment, and potential complications are discussed.
A surgical emergency due to an incarcerated paraesophageal hernia Chi-Chung Chang, Chiu-Liang Tseng, Yu-Che Chang
DOI: http://dx.doi.org/10.1016/j.ajem.2008.05.009
The American Journal of Emergency Medicine , Vol. 27 , Issue 1 ,
Published in issue: January 2009
x Paraesophageal hernias (PEHs) are hernias in which the gastroesophageal junction stays where it belongs (attached at the level of the diaphragm), but part of the stomach passes or bulges into the chest beside the esophagus. It represents a small proportion of all hiatal hernias. It can lead to severe complications like incarceration, volvulus, or strangulation, which are true emergencies in the emergent department (ED). Paraesophageal hernia rarely features on a list of differential diagnoses of acute chest or epigastric pain.
Acute incarcerated inguinal hernia attributed to sexual intercourse Collette D Wyte, James Stowell
DOI: http://dx.doi.org/10.1016/0735-6757(95)90271-6
The American Journal of Emergency Medicine , Vol. 13 , Issue 1 ,
Published in issue: January 1995
The delayed-action stab, resulting in an incarcerated diaphragmatic hernia Eugene Albu, Virendra Parikh, Divyakant Gandhi
DOI: http://dx.doi.org/10.1016/0735-6757(92)90228-P
The American Journal of Emergency Medicine , Vol. 10 , Issue 3 ,
Published in issue: May 1992
Intermittant obstruction of an incarcerated hiatal hernia with a total thoracic stomach Thomas M. Bozzuto
DOI: http://dx.doi.org/10.1016/0735-6757(90)90232-O
The American Journal of Emergency Medicine , Vol. 8 , Issue 5 ,
Published in issue: September 1990
x A case of intermittent obstruction of a sliding hiatal hernia is presented. The obstruction occurred when the patient's stomach was totally above the diaphragm. The anatomy of sliding hiatal hernias is discussed, as well as the presenting signs and symptoms of obstruction in sliding hiatal hernias.
Altered consciousness and lethargy from compromised intestinal blood flow in children Wolfgang Pumberger, Ingrid Dinhobl, Peter Dremsek
DOI: http://dx.doi.org/10.1016/j.ajem.2004.04.010
The American Journal of Emergency Medicine , Vol. 22 , Issue 4 ,
Published in issue: July 2004
x Altered state of consciousness and lethargy could be early and cardinal complaints in diseases that actually originate within the abdomen. Thirteen children were seen at our departments in whom impairment of the individual’s mental state preceded the appearance of common gastrointestinal symptoms. Whereas in infants with intussusception of childhood neurological signs and symptoms have been rarely mentioned, references to an altered state of consciousness and lethargy in volvulus, strangulation or bowel incarceration have not been previously reported.
Femoral hernia: The dire consequences of a missed diagnosis Gideon P Naude, Sarah Ocon, Fred Bongard
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90184-4
The American Journal of Emergency Medicine , Vol. 15 , Issue 7 ,
Published in issue: November 1997
x Femoral hernia has always presented more difficulty in diagnosis than other external abdominal hernias. The incidence of incarceration and strangulation is higher in our series than the published literature would suggest. A retrospective study was performed at our institution from February 1990 to June 1995. In that period, 22 patients were operated on for femoral hernia. There were 16 women and 6 men, average ages 51 and 48 years, respectively. The men weighed on average 209 lb, and the women, 154 lb.
The bodystuffer syndrome: A clandestine form of drug overdose James R. Roberts, Dennis Price, Lewis Goldfrank, Lorraine Hartnett
DOI: http://dx.doi.org/10.1016/0735-6757(86)90245-7
The American Journal of Emergency Medicine , Vol. 4 , Issue 1 ,
Published in issue: January 1986
x The case histories of five people who ingested drugs in an attempt to conceal illegal substances when they were confronted by police are reported. They presented to an emergency department in various clinical states ranging from asymptomatic to comatose. This syndrome has been called “bodystuffing” by the authors, who differentiate it from “bodypacking,” which is the ingestion of drugs for the purpose of smuggling. Bodystuffers may ingest one or more drugs, usually deny the ingestion, and are often not discovered until symptoms develop.
The effectiveness of an ED-based violence prevention program Leslie S. Zun, LaVonne Downey, Jodi Rosen
DOI: http://dx.doi.org/10.1016/j.ajem.2005.05.009
The American Journal of Emergency Medicine , Vol. 24 , Issue 1 ,
Published in issue: January 2006
x Youth violence continues to be a problem in the United States, most prominent in the inner-city minority youth population. The recurrence rate for repeat violence has been reported from 6% to 44% with a 5-year mortality of 20%. This study describes the results of a program to reduce violence recurrence based in the ED.
Acute urinary retention secondary to an incarcerate gravid uterus Marc S. Nelson
DOI: http://dx.doi.org/10.1016/0735-6757(86)90074-4
The American Journal of Emergency Medicine , Vol. 4 , Issue 3 ,
Published in issue: May 1986
x Acute urinary retention has many etiologies. In the pregnant patient, especially at the end of the first trimester, an incarcerated gravid uterus is a rare but possible cause. The patient discussed is a 30-year-old, gravida 4, para 2012, woman who was 14 weeks pregnant and who presented complaining of lower abdominal pain, urinary frequency, urgency, and nocturia. Based on the patient's symptoms, a diagnosis of a urinary tract infection was made, and antibiotic therapy was begun. Her symptoms failed to resolve, however, and she was referred for further evaluation, which eventually revealed an incarcerated gravid uterus.
Profound hypothermia secondary to normal ziprasidone use Gregory M. Gibbons, David A. Wein, Richard Paula
DOI: http://dx.doi.org/10.1016/j.ajem.2007.11.033
The American Journal of Emergency Medicine , Vol. 26 , Issue 6 ,
Published in issue: July 2008
x Clinically significant hypothermia is a commonly evaluated condition in emergency medicine. Most cases are related to prolonged exposure to the environment, infection, or endocrinopathies. Presented here is a case of hypothermia likely induced by an atypical antipsychotic medication. A 69-year-old incarcerated man presented to our emergency department with an oral temperature of 85°F (29.4°C). The patient was taking ziprasidone (Geodon, Pfizer, New York, NY) 80 mg twice daily. Atypical antipsychotic medications have been implicated in numerous cases of clinically significant hypothermia.
Acute hemiscrotum due to inguinoscrotal Littre hernia: a case report Murat Akin, Osman Kurukahvecioglu, Tugan Tezcaner, Ahmet Ziya Anadol, Kahraman Onur
DOI: http://dx.doi.org/10.1016/j.ajem.2008.02.023
The American Journal of Emergency Medicine , Vol. 26 , Issue 8 ,
Published in issue: October 2008
x Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract that is generally asymptomatic and only manifests in a specific way when complications exist. An unusual complication of MD is known as Littre hernia. It comprises less than 1% of all MD. Littre hernia is the protrusion of an MD through a potential abdominal opening. Usual sites of Littre hernia are right inguinal (50% of cases), umbilical hernia (20%), and femoral hernia (20%). We report a case of Littre hernia in a boy who presented with acute scrotal pain and swelling.
De Garengeot hernia: the ultrasound and computed tomographic findings in an 81-year-old woman Jianpeng Hao, Junchao Yao, Dawei Guo, Wenyu Sun, Jian Liang, Xiaofeng Jiang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.003
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: November 11 2013
x The presence of appendix within a femoral hernia is a rare condition in an incarcerated femoral hernia. It has a characteristic groin mass, and the diagnosis of appendicitis is mainly made intraoperatively. A specific imaging appearance (ultrasonography, computed tomography [CT]) allows accurate prospective diagnosis. The recognition of this rare femoral hernia helps us to choose appropriate therapeutic approach. We report a case of an 81-year-old woman who present with painful and nonreducible groin mass.
Massive parastomal hernia with strangulation Oyu Kwon, Kyeongryong Lee, Seungwhan Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2007.03.027
The American Journal of Emergency Medicine , Vol. 26 , Issue 1 ,
Published in issue: January 2008
x Parastomal hernia in patients with ileostomy or colostomy is not an uncommon complication in the emergency department (ED). However, parastomal hernia with incarceration or strangulation is a relatively uncommon late complication, which can be seen in an emergency care facility. We present a case study of a patient with a massive strangulated parastomal hernia who was treated with emergency treatment and repair.
Amyand hernia: a case of an unusual inguinal herniace Gerard S. Doyle, Christy McCowan
DOI: http://dx.doi.org/10.1016/j.ajem.2007.10.028
The American Journal of Emergency Medicine , Vol. 26 , Issue 5 ,
Published in issue: June 2008
x Amyand hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Presence of the appendix in the sac complicates the management of inguinal hernias. The appendix may be more prone to rupture when contained within a hernia sac, and herniation of an inflamed appendix into the scrotum can mimic an acute scrotum. A 50-year-old man presented with right lower quadrant abdominal pain associated with chills and anorexia.
Splenic laceration caused by chronic posttraumatic diaphragmatic hernia Gamal Mostafa, Brent D. Matthews, B.Todd Heniford, Ronald F. Sing, Andrew D. Perron
DOI: http://dx.doi.org/10.1053/ajem.2001.27144
The American Journal of Emergency Medicine , Vol. 19 , Issue 6 ,
Published in issue: October 2001
x —Injury to the diaphragm is a challenging diagnostic problem with a myriad of potential clinical presentations. In the acute phase, these injuries are commonly missed. The resulting diaphragmatic hernias are notorious for delayed presentation and complicated clinical picture. This report describes a patient with a missed diaphragmatic injury caused by an isolated stab wound to the left lower chest. The patient represented 6 months after his original injury in hemorrhagic shock because of a splenic capsular laceration, caused by an incarcerated diaphragmatic hernia.
Ultrasound-guided reduction of a Spigelian hernia in a difficult case: An unusual use of bedside emergency ultrasonography Michael Blaivas
DOI: http://dx.doi.org/10.1053/ajem.2002.29565
The American Journal of Emergency Medicine , Vol. 20 , Issue 1 ,
Published in issue: January 2002
x —Herniation through the abdominal wall is the most common wound complication after abdominal surgery.1 The rate of incisional herniation ranges from 2% to 11% with recurrent herniation in 20% to 46%.2 Another type of abdominal wall herniation is the Spigelian hernia. It is a hernia in an area of transition from muscle to aponeurosis in the transverses abdominis.3 Spigelian hernias account for 2% of abdominal wall hernias.4 It is often missed or misdiagnosed and presents emergently with incarceration or strangulation in up to 25% of cases.
Internal hernia presenting as pseudomyocardial infarction Michael Ardelt, Johanna Taut, Yves Dittmar, Falk Rauchfuss, Rene Fahrner, Hubert Scheuerlein, Utz Settmacher
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.031
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: November 28 2014
x We report the case of a 54-year-old man with an internal hernia presenting as myocardial infarction. The patient presented at the emergency department with acute epigastric pain. In the electrocardiography at admission, there were ST elevations in the leads V2 and V3 . The patient had a medical history of an anterior wall infarction 18 years earlier. Because of the previous myocardial infarction, the diagnosis of another ST-elevated myocardial infarction was initially made. However, emergency coronary angiography ruled out myocardial infarction.
Acute sigmoid diverticulitis within a nonincarcerated hernia Nicholas Arnold, Amy A. Ernst
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.022
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: December 22 2014
x Separately, diverticulitis and inguinal hernias are both common findings in emergency medicine. However, diverticulitis within a reducible hernia has not been previously reported. We present a case of sigmoid diverticulitis within a nonincarcerated easily reducible hernia treated with conservative management. Our review of literature did not reveal any previously documented cases of this type of presentation.
