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Scia%c Hernia: Among other things LIZ SIM
CONEY ISLAND HOSPITAL
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Case presenta%on Pa$entis70yofwhopresentedwithonedayhistoryofworseningle6upperandlowerabdominalpainthatradiatedtotheback.
PMHx:HTN,HepCMELD6,Cirrhosis,gastrinoma,asthma,GERD
PSHx:cholecystectomy,thyroidectomy,gastrinomaresec$on
Meds:Lasix,synthroid,nadolol,aldactone
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Case presenta%on Exam◦ Abdomens,nt,nd◦ Enlargementofle6gluteus,Np,noskinchanges◦ MSKunabletoambulateduetopain
Labs◦ 137/101/22/17/0.91/186◦ 7.2>12.3/39.7<101◦ LA1.3
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Case presenta%on
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Case presenta%on
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Case presenta%on Exploratorylaparotomy,smallbowelresec$on,repairofscia$cherniawithmesh
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Post Op Course POD1–Pigtailplacement,bowelfunc$on
POD3-5◦ Diuresis◦ Diet◦ CTremoved
POD6◦ DChome
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Ques%ons?
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Scia%c Hernia Protrusionintogreaterandlesserscia$cforamina
Adultfemaleswithchronicpelvicpain
E$ology:unknown
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Symptoms Obstruc$on Lowerbackpain
Ureteralobstruc$on
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Workup Musthavehighsuspicion
CTAP
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Anatomy
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Anatomy
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Treatment Surgery◦ Open
◦ Trans-gluteal◦ transabdominal
◦ Laparoscopic
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Outcomes Nodata
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MESH MeshRepairVsNon-Meshrepair…meta-analysis◦ 232papersnarrowedto9◦ Outcomes
◦ Surgicalsiteinfec$on◦ recurrence
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MESH Resultsofprosthe$cmeshrepairinemergencymanagementofacutelyincarceratedand/orstrangulatedgroinhernias:a10yearstudy◦ Prospec$ve◦ 234pa$ents◦ Woundinfec$on6%,meshinfec$onin0.5%
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Conclusion Scia$cherniasarerare Meshcanbeusedevenwhenresec$ngbowelifyouhavegoodpa$entselec$on
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References Seifarth,F.G,Kundu,N.andMagnuson,K.K.PediatricSurgeryInterna$onal(2014)30:541.
Vbaker,R.J.&Fischer,J.E.(2001)MasteryofSurgery.Philadelphia:LippincoNWilliams&Wilkins6thedi$on
Henta$,H.Doiugz,W.,Dziri,C.MeshRepairVs.NonmeshrepairstrangulatedInguinalhernia:Systema;cReviewwithMeta-Analysis.WorlJSurg201438:2784-2790
Bessa,SS.Abdel-faNh,Al-says,Korayem.Resultsofprostehteicmeshrepairinemergencymanagementofacutelyincarceratedand/orstrangulatedgroinhernias:a10yearstudy.Hernia2015909-14
Losanoff.J.Basson,Gruber.Weaver.Scia;cherniaacomprehensivereviewofworldliterature.TheAmericanJournalofSurgery.2010pg52-59
Dulskas,A.,Poskus,E.,Jurevicius,S.etal.Giantglutellipomapresen;ngasascia;chernia.Hernia201519:857
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Ques%ons?
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Name that hernia
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Name the hernia
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Name that hernia
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Ques%on GrynfelNhernia Spigelianhernia
Obturatorhernia
Intramuralhernia
Howship-Romberg
Lumbararea
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