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Arye Blachar - One of the best experts on this subject based on the ideXlab platform.
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Internal Hernia: an increasingly common cause of small bowel obstruction.
Seminars in Ultrasound CT and MRI, 2002Co-Authors: Arye Blachar, Michael P. FederleAbstract:Internal Hernia is an uncommon cause of small bowel obstruction that may be increasing in frequency. Because the clinical diagnosis of Internal Hernia is difficult, imaging studies such as computed tomography (CT) and small bowel follow through play an important role. Transmesenteric Hernia is the most common type and is usually related to prior abdominal surgery, especially with creation of a Roux-en-Y anastomosis (eg, liver transplantation, gastric bypass). CT may allow confident diagnosis in most cases. In this article, we review the clinical and imaging findings of Internal Hernia based on our experience with 54 cases of surgically proven Internal Hernias including 45 transmesenteric, 6 paraduodenal, and 3 omental Hernias, 39 of which had imaging studies available for review.
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radiologist performance in the diagnosis of Internal Hernia by using specific ct findings with emphasis on transmesenteric Hernia
Radiology, 2001Co-Authors: Arye Blachar, Michael P. Federle, Giuseppe Brancatelli, Mark S Peterson, J H OliverAbstract:PURPOSE: To evaluate the performance of radiologists in the diagnosis of Internal Hernia with specific computed tomographic (CT) findings. MATERIALS AND METHODS: Abdominal CT scans obtained in 42 patients were retrospectively reviewed by three radiologists. The case group consisted of 18 patients with Internal Hernias (two paraduodenal, 16 transmesenteric); the comparison group was 24 patients with no Internal Hernia. Images were reviewed in a random and blinded fashion. Individual and group performance was evaluated with receiver operating characteristic (ROC) analysis, and interobserver agreement was measured with Cronbach coefficient α. Individual CT signs relevant as predictors of transmesenteric Hernia were identified with logistic regression analysis and ranked by their odds ratio and P values. RESULTS: Both paraduodenal Hernias were diagnosed by all readers on the basis of CT signs, including a retrogastric saclike mass of small-bowel loops. Diagnosis of transmesenteric Hernia was more difficult an...
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Internal Hernia clinical and imaging findings in 17 patients with emphasis on ct criteria
Radiology, 2001Co-Authors: Arye Blachar, Michael P. Federle, Forrest S DodsonAbstract:PURPOSE: To review the clinical and radiologic features of Internal Hernia and to derive useful radiographic and CT criteria to assist in diagnosis. MATERIALS AND METHODS: Retrospective review of medical records revealed 17 patients with surgically proved Internal Hernia (three paraduodenal, 14 transmesenteric) who had 15 computed tomographic (CT) scans and three small-bowel follow-through (SBFT) images. RESULTS: CT signs common to all types of Internal Hernia included evidence of small-bowel obstruction; clustering of small bowel; stretched, displaced, crowded, and engorged mesenteric vessels; and displacement of other bowel segments, especially the transverse colon and fourth portion of the duodenum. Left-sided paraduodenal Hernias demonstrated a saclike mass of small-bowel loops interposed between the stomach and pancreatic tail and a posterior mass effect on the stomach. All three paraduodenal Hernias were diagnosed confidently at retrospective review of CT and SBFT findings. Transmesenteric Hernias d...
Michael P. Federle - One of the best experts on this subject based on the ideXlab platform.
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Internal Hernia: an increasingly common cause of small bowel obstruction.
Seminars in Ultrasound CT and MRI, 2002Co-Authors: Arye Blachar, Michael P. FederleAbstract:Internal Hernia is an uncommon cause of small bowel obstruction that may be increasing in frequency. Because the clinical diagnosis of Internal Hernia is difficult, imaging studies such as computed tomography (CT) and small bowel follow through play an important role. Transmesenteric Hernia is the most common type and is usually related to prior abdominal surgery, especially with creation of a Roux-en-Y anastomosis (eg, liver transplantation, gastric bypass). CT may allow confident diagnosis in most cases. In this article, we review the clinical and imaging findings of Internal Hernia based on our experience with 54 cases of surgically proven Internal Hernias including 45 transmesenteric, 6 paraduodenal, and 3 omental Hernias, 39 of which had imaging studies available for review.
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radiologist performance in the diagnosis of Internal Hernia by using specific ct findings with emphasis on transmesenteric Hernia
Radiology, 2001Co-Authors: Arye Blachar, Michael P. Federle, Giuseppe Brancatelli, Mark S Peterson, J H OliverAbstract:PURPOSE: To evaluate the performance of radiologists in the diagnosis of Internal Hernia with specific computed tomographic (CT) findings. MATERIALS AND METHODS: Abdominal CT scans obtained in 42 patients were retrospectively reviewed by three radiologists. The case group consisted of 18 patients with Internal Hernias (two paraduodenal, 16 transmesenteric); the comparison group was 24 patients with no Internal Hernia. Images were reviewed in a random and blinded fashion. Individual and group performance was evaluated with receiver operating characteristic (ROC) analysis, and interobserver agreement was measured with Cronbach coefficient α. Individual CT signs relevant as predictors of transmesenteric Hernia were identified with logistic regression analysis and ranked by their odds ratio and P values. RESULTS: Both paraduodenal Hernias were diagnosed by all readers on the basis of CT signs, including a retrogastric saclike mass of small-bowel loops. Diagnosis of transmesenteric Hernia was more difficult an...
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Internal Hernia clinical and imaging findings in 17 patients with emphasis on ct criteria
Radiology, 2001Co-Authors: Arye Blachar, Michael P. Federle, Forrest S DodsonAbstract:PURPOSE: To review the clinical and radiologic features of Internal Hernia and to derive useful radiographic and CT criteria to assist in diagnosis. MATERIALS AND METHODS: Retrospective review of medical records revealed 17 patients with surgically proved Internal Hernia (three paraduodenal, 14 transmesenteric) who had 15 computed tomographic (CT) scans and three small-bowel follow-through (SBFT) images. RESULTS: CT signs common to all types of Internal Hernia included evidence of small-bowel obstruction; clustering of small bowel; stretched, displaced, crowded, and engorged mesenteric vessels; and displacement of other bowel segments, especially the transverse colon and fourth portion of the duodenum. Left-sided paraduodenal Hernias demonstrated a saclike mass of small-bowel loops interposed between the stomach and pancreatic tail and a posterior mass effect on the stomach. All three paraduodenal Hernias were diagnosed confidently at retrospective review of CT and SBFT findings. Transmesenteric Hernias d...
Do Joong Park - One of the best experts on this subject based on the ideXlab platform.
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Internal Hernia after gastrectomy for gastric cancer in minimally invasive surgery era
Gastric Cancer, 2019Co-Authors: Kyong Min Kang, Yo Seok Cho, Sa Hong Min, Yoontaek Lee, Ki Bum Park, Young Suk Park, Sang Hoon Ahn, Do Joong ParkAbstract:The incidence and clinical presentation of Internal Hernia after gastrectomy have been changing in the minimally invasive surgery era. This study aimed to analyze the clinical features and risk factors for Internal Hernia after gastrectomy for gastric cancer. We retrospectively analyzed Internal Hernia after gastrectomy for gastric cancer in 6474 patients between January 2003 and December 2016 at Seoul National University Bundang Hospital. Multivariable logistic regression was performed to evaluate risk factors. Internal Hernias identified by computed tomography or surgical exploration were 111/6474 (1.7%) and the median interval time was 450 days after gastrectomy. Fourteen (0.9%) of the 1510 patients who underwent open gastrectomy and 97 (2.0%) of the 4964 patients who underwent laparoscopic gastrectomy developed Internal Hernia. Of the 6474 patients, Internal Hernia developed in 0 (0%), 9 (1.1%), 40 (3.1%), 56 (3.3%), 6 (2.3%), and 0 (0%) patients who underwent Billroth I, Billroth II, Roux-en-Y, uncut Roux-en-Y, double tract, and esophagogastrostomy reconstructions, respectively. Fifty-nine (53.2%) of 111 patients with symptomatic Hernia underwent surgery. Of the 59 Internal Hernias, treated surgically, 32 (53.2%), 27 (45.8%), and 0 (0%) were identified in jejunojejunostomy mesenteric, Petersen’s, and transverse colon mesenteric defects, respectively. In multivariate analysis, non-closure of mesenteric defects (P < 0.01), laparoscopic approach (P < 0.01), and totally laparoscopic approach (P = 0.03) were independent risk factors for Internal Hernia. The potential spaces such as Petersen’s, jejunojejunostomy mesenteric, and transverse colon mesenteric defects should be closed to prevent Internal Hernia after gastrectomy for gastric cancer.
Shengder Hsu - One of the best experts on this subject based on the ideXlab platform.
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meckel s diverticulum incarcerated in a transmesocolic Internal Hernia
World Journal of Gastroenterology, 2014Co-Authors: Shengder HsuAbstract:Intestinal obstruction is a common complication associated with Meckel’s diverticulum in adults. The diverticulum itself or its fibrous band can lead to an intestinal volvulus, intussusceptions, or closed-loop obstructions, which require surgery. The incarceration of Meckel’s diverticulum in either inguinal or femoral Hernia sacs (Littre’s Hernia) is another, less common, etiology underlying intestinal obstruction. This case report describes a 45-year-old man who had an obstruction associated with a Meckel’s diverticulum that passed through a congenital defect in the mesocolon into the right subphrenic space. The patient, who had not undergone abdominal surgery previously, came to the emergency room with acute onset of intermittent epigastric pain and abdominal distention. Computed tomography images showed the presence of a segment of the small bowel and a diverticulum in the right subphrenic space and paracolic gutter. The twisted mesentery and the dilated loops of the proximal small bowel were indicative of an intestinal volvulus and obstruction. Meckel’s diverticulum complicated by a transmesocolic Internal Hernia was diagnosed, and this condition was confirmed during emergency surgery. The patient’s postoperative recovery was uneventful. This case report highlights another presentation of Meckel’s diverticulum, that is, in combination with a transmesocolic Internal Hernia. This etiology may lead to an intestinal volvulus and necessitate early surgery.
Satheesh Krishna - One of the best experts on this subject based on the ideXlab platform.
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diagnostic accuracy of mri for diagnosis of Internal Hernia in pregnant women with prior roux en y gastric bypass
American Journal of Roentgenology, 2018Co-Authors: Satheesh Krishna, Matthew D F Mcinnes, Nicola Schieda, Sabarish Narayanasamy, Adnan Sheikh, Ania Z KielarAbstract:OBJECTIVE. The purpose of this study was to evaluate the accuracy of MRI for the diagnosis of Internal Hernia (IH) in pregnant women who have undergone Roux-en-Y gastric bypass (RYGB). MATERIALS AN...
