PURPOSE: Traditionally, the surgical repair of umbilical hernia in cirrhotic patients with ascites is avoided because of a significant recurrence rate and perioperative morbidity/mortality. However, recent reports recommend early elective surgery in these patients because surgery-related complications can be reduced with minimally invasive surgery and development of perioperative patient care. The current study was conducted to analyze safety and feasibility of umbilical hernia repairs performed in a single institute. METHODS: A single center retrospective analysis of patients' data was conducted. Eighteen patients with umbilical hernia accompanied by liver cirrhosis underwent hernia repair in the period between 2005 and 2012. The charts of these patients were reviewed and demographic data, postoperative complications, and recurrence were recorded. RESULTS: Eleven males and seven females with a mean age of 62.9 years were analyzed. Two of the patients were classified as Child's class A, 11 as Child's class B, and five as Child's class C. Four patients underwent emergency surgery because of perforations in the hernia sac in two cases and incarcerated hernias in the other two cases. Of the 18 patients who underwent surgery, four (22%) experienced a recurrence, three (17%) developed edema at the surgical sites, one (5%) experienced hepatic coma, and one (5%) showed postoperative variceal hemorrhage. All of these events occurred after emergency surgery. CONCLUSION: In contrast to traditional concepts, early and elective repair of umbilical hernia can be performed easily and safely in cirrhotic patients.
Ascites ; Edema ; Emergencies ; Female ; Hemorrhage ; Hepatic Encephalopathy ; Hernia ; Hernia, Umbilical* ; Herniorrhaphy ; Humans ; Laparoscopy ; Liver Cirrhosis ; Male ; Patient Care ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Surgical Procedures, Minimally Invasive

A case is presented of an amnionic rupture sequence which led to massive fetal ventral herniation and lordoscoliosis. Characteristic ultrasonographic findings of an omphalocele, fetal attachment to the placenta, and the absence of free-floating umbilical cord were observed.
Abnormalities, Multiple/*etiology/ultrasonography ; Adult ; Amnion ; Female ; Fetal Membranes, Premature Rupture/*complications ; Gestational Age ; Hernia, Umbilical/etiology ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Umbilical Cord/abnormalities

Umbilical hernias in calves commonly present to veterinary clinics, which are normally secondary to failure of the normal closure of the umbilical ring, and which result in the protrusion of abdominal contents into the overlying subcutis. The aim of this study was to compare the suitability of commonly-used herniorrhaphies for the treatment of reducible umbilical hernia in calves. Thirty-four clinical cases presenting to the Veterinary Teaching Hospital, Chittagong Veterinary and Animal Sciences University, Chittagong, Bangladesh from July 2004 to July 2007 were subjected to comprehensive study including history, classification of hernias, size of the hernial rings, presence of adhesion with the hernial sacs, postoperative care and follow-up. They were reducible, non-painful and had no evidence of infection present on palpation. The results revealed a gender influence, with the incidence of umbilical hernia being higher in female calves than in males. Out of the 34 clinical cases, 14 were treated by open method of herniorrhaphy and 20 were treated by closed method. Complications of hernia were higher (21%) in open method-treated cases than in closed method-treated cases (5%). Hernia recurred in three calves treated with open herniorrhaphy within 2 weeks of the procedure, with swelling in situ and muscular weakness at the site of operation. Shorter operation time and excellent healing rate (80%) were found in calves treated with closed herniorrhaphy. These findings suggest that the closed herniorrhaphy is better than the commonly-used open method for the correction of reducible umbilical hernia in calves.
Animals ; Cattle ; Cattle Diseases/*surgery ; Female ; Hernia, Umbilical/complications/surgery/*veterinary ; Male ; Surgical Procedures, Operative/adverse effects/*veterinary

OBJECTIVETo review the treatment of repair gastroschisis with autogenous umbilical cord in 13-year and evaluate its effect.

METHODSTwenty-two newborns who underwent the repair gastroschisis with autogenous umbilical cord between 1992 and 2005. The physical growth, intelligence measuring, area of operation in abdomen in the survived 18 cases were observed and followed-up.

RESULTSEighteen patients recovered uneventfully, survival rate is 82%, their growth is well. They all developed incisional hernia near the operation, 9 cases recovered himself, 2 cases was operated to repair the abdominal hernia, 7 cases is under observed.

CONCLUSIONSThe material is adopted easily in the operating, autogenous umbilical cord is elastic tissue and no toxicity could relax the abdominal press effectively after the operation, the survival rate is high.

Female ; Follow-Up Studies ; Gastroschisis ; surgery ; Hernia, Ventral ; etiology ; Humans ; Infant, Newborn ; Male ; Postoperative Complications ; Umbilical Cord ; transplantation

PURPOSE: Single-port laparoscopic cholecystectomy may result in postoperative complication in patients with cholecystitis. An additional right subcostal port could make laparoscopic surgery safe in these patients. We suggest the transumbilical laparoscopic cholecystectomy with additional port, which can be performed safely regardless of cholecystitis. METHODS: Consecutive 291 patients underwent transumbilical laparoscopic cholecystectomy in the Department of Surgery by a single surgeon. We have usually used the globe port in the transumbilical area and an additional right subcostal port. RESULTS: The mean operation time was 44.0+/-15.2 min (range: 20-140). The mean hospital stay after operation was 4.0+/-2.3 days (range: 1-9). Postoperative complications were umbilical hernia (n=7) and bile leakage (n=3). There was no in-hospital mortality. CONCLUSION: Transumbilical laparoscopic cholecystectomy can be performed in patients with most of benign gallbladder disease. And, an additional right subcostal port could be helpful in ensuring safe transumbilical laparoscopic cholecystectomy, even in patients with cholecystitis.
Bile ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Gallbladder Diseases ; Hernia, Umbilical ; Hospital Mortality ; Humans ; Laparoscopy ; Length of Stay ; Postoperative Complications

Isolated absence of the ductus arteriosus is extremely rare condition although the ductus arteriosus may be hypoplastic or aplastic in association with other aortic arch anomalies. Authors described a case of isolated agenesis of the ductus arteriosus documented by postmortem examination of a newborn infant who died of pneumonia following operation for a large omphalocele. The heart showed ventricular septal defect. However, no other cardiovascular anomalies were associated in this case. There were three vessels that were taking off from the aorta consisted of the right brachiocephalic artery, left common carotid-artery and left subclavian artery. The anteriorly located pulmonary artery was divided into the right and left pulmonary arteries. There was no connection of vessel between the pulmonary artery and the aorta.
Abnormalities, Multiple/embryology/pathology ; Ductus Arteriosus/*abnormalities ; Heart Defects, Congenital/embryology/pathology ; Hernia, Umbilical/complications ; Humans ; Infant, Newborn ; Male

PURPOSE: Although urachal anomalies are rarely observed clinically, they often give rise to a number of problems, such as infection and late malignant changes. Because of variable clinical presentations, uniform guidlines for evaluation and treatment are lacking. The authors discuss the problems involved in both the diagnosis and the treatment of these anomalies. METHODS: We retrospectively analyzed 15 patients (9 males and 6 females) who had undergone surgery for urachal anomalies from July 1995 to December 1999. RESULTS: The age distribution ranged from 14 days to 38 years old, and the male to female ratio was 1.5:1. The 4 variants of urachal anomalies included a urachal sinus in 7 patients (47%), a urachal cyst in 4 (27%), a patent urachus in 3 (20%), and a bladder diverticulum in 1 (6%). The presenting complaint was periumbilical discharge in 6 patients, fever in 5, umbilical granuloma in 4, low abdominal mass in 3, and low abdominal pain in 1. Eight combined anomalies were seen in 7 patients; 2 umbilical hernias, 1 inguinal hernia, 1 hydrocele, 1 urachal vessel anomaly, 1 vesicoureteral reflux, 1 hydronephrosis, 1 Hirschsprung's disease, and 1 hypertrophic pyloric stenosis. Ultrasound examination disclosed a cyst or a sinus in 5 patients, and CT was performed in 1 case. Excision was performed in all patients, and there was no postoperative complication or recurrence. CONCLUSION: Urachal anomalies most frequently present in infancy or childhood, and the initial presentation is umbilical discharge with infection. Furthermore, the large number of associated genitourinary and gastrointestinal anomalies suggests that a complete work-up for these conditions should be performed. Definitive surgical excision appears to be appropriate for most patients.
Abdominal Pain ; Adult ; Age Distribution ; Diagnosis ; Diverticulum ; Female ; Fever ; Granuloma ; Hernia, Inguinal ; Hernia, Umbilical ; Hirschsprung Disease ; Humans ; Hydronephrosis ; Male ; Postoperative Complications ; Pyloric Stenosis, Hypertrophic ; Recurrence ; Retrospective Studies ; Ultrasonography ; Urachal Cyst ; Urachus ; Urinary Bladder ; Vesico-Ureteral Reflux

PURPOSE: Although urachal anomalies are rarely observed clinically, they often give rise to a number of problems, such as infection and late malignant changes. Because of variable clinical presentations, uniform guidlines for evaluation and treatment are lacking. The authors discuss the problems involved in both the diagnosis and the treatment of these anomalies. METHODS: We retrospectively analyzed 15 patients (9 males and 6 females) who had undergone surgery for urachal anomalies from July 1995 to December 1999. RESULTS: The age distribution ranged from 14 days to 38 years old, and the male to female ratio was 1.5:1. The 4 variants of urachal anomalies included a urachal sinus in 7 patients (47%), a urachal cyst in 4 (27%), a patent urachus in 3 (20%), and a bladder diverticulum in 1 (6%). The presenting complaint was periumbilical discharge in 6 patients, fever in 5, umbilical granuloma in 4, low abdominal mass in 3, and low abdominal pain in 1. Eight combined anomalies were seen in 7 patients; 2 umbilical hernias, 1 inguinal hernia, 1 hydrocele, 1 urachal vessel anomaly, 1 vesicoureteral reflux, 1 hydronephrosis, 1 Hirschsprung's disease, and 1 hypertrophic pyloric stenosis. Ultrasound examination disclosed a cyst or a sinus in 5 patients, and CT was performed in 1 case. Excision was performed in all patients, and there was no postoperative complication or recurrence. CONCLUSION: Urachal anomalies most frequently present in infancy or childhood, and the initial presentation is umbilical discharge with infection. Furthermore, the large number of associated genitourinary and gastrointestinal anomalies suggests that a complete work-up for these conditions should be performed. Definitive surgical excision appears to be appropriate for most patients.
Abdominal Pain ; Adult ; Age Distribution ; Diagnosis ; Diverticulum ; Female ; Fever ; Granuloma ; Hernia, Inguinal ; Hernia, Umbilical ; Hirschsprung Disease ; Humans ; Hydronephrosis ; Male ; Postoperative Complications ; Pyloric Stenosis, Hypertrophic ; Recurrence ; Retrospective Studies ; Ultrasonography ; Urachal Cyst ; Urachus ; Urinary Bladder ; Vesico-Ureteral Reflux

A vitelline duct (VD) anomaly is a relatively common congenital abnormality of the umbilical area. The anomalies include patent vitelline duct (PVD), cyst, fistula or sinus. The incidence is approximately 2% of the populations, but development of symptoms is rare. Recently, we experienced two cases; PVD accompanied by a smallomphalocele and intestinal volvulus due to mesenteric band between Meckel's diverticulum and the mesentery. Thereafter,we evaluated the data of vitelline duct anomalies for 27 years. From 1980 to 2006, 18 cases of VD anomalies were reviewed based on the hospital records retrospectively. There were 15 boys and 3 girls and age ranged from 2 days to 15 years. Among the 18 cases, 15 cases were symptomatic and consisted of Meckel's diverticulum (10 cases), PVD (4 cases) and umbilical polyp (1 case). Three asymptomatic cases of Meckel's diverticulum were found incidentally were and were observed without resection. Ten cases of Meckel's diverticulum were presented with intestinal bleedings (4 cases), intestinal obstructions (5 cases) and perforation (1 case). Wedge resections and segmental resections of ileum were performed in 8 patients and 2 patients, respectively. Postoperative complications were adhesive ileus (1 case) and wound seroma (1 case). Small omphaloceles were accompanied in two of 4 PVD patients. There was 1 small omphalocele case which was accompanied by a prolapse of ileum. In summary, VD anomalies were more common in male and more than half of them were found in patients less than 1 year of age. PVD was diagnosed most frequently in neonates. Meckel's diverticulum presented with intestinal obstruction more frequently than bleeding.
Adhesives ; Child* ; Congenital Abnormalities ; Female ; Fistula ; Hemorrhage ; Hernia, Umbilical ; Hospital Records ; Humans ; Ileum ; Ileus ; Incidence ; Infant, Newborn ; Intestinal Obstruction ; Intestinal Volvulus ; Male ; Meckel Diverticulum ; Mesentery ; Polyps ; Postoperative Complications ; Prolapse ; Retrospective Studies ; Seroma ; Umbilicus ; Vitelline Duct* ; Vitellins* ; Wounds and Injuries

PURPOSE: Perinatal mortality rates have been used as a summary statistic for evaluating child health and medical status. Neonatal mortality rates have decreased over the past 30 years in Korea. To understand the current status of neonatal surgical gastrointestinal diseases in Daegu?Busan area, we have studied about neonatal gastrointestinal diseases with their clinical features, postoperative outcome, and mortality rates. METHODS: A clinical analysis on 202 neonates who underwent neonatal surgery from January 1996 to July 2003 at Pusan National University, Kyungpook National University, Youngnam University, and Daegu Catholic University was carried out. RESULTS: The main diseases of surgical conditions were anorectal malformation (23.8%), atresia/ stenosis of midgut (13.4%) and pyloric stenosis (13.4%). The male to female ratio was 2.8:1. Thirty-five cases (17.0%) had one or more associated anomalies including congenital heart disease, cryptoorchidism, hydronephrosis, and chromosomal anomaly. Twenty cases (10.0%) were diagnosed by antenatal ultrasound. Patients with esophageal atresia had the longest hospitalization for 54.6 days. Postoperative complications occurred in 18 cases (8.9%). The main postoperative complications were wound infection (3.5%) and anastomotic leakage (2.5%). Overall mortality was 5.9%. Diaphragmatic hernia showed the highest mortality rate (37.5%), and esophageal atresia (28.6%) and omphalocele (20.0%) were followed. CONCLUSION: The current status of neonatal surgical gastrointestinal diseases in Daegu?Busan area has improved because the disease categories are various, postoperative complications and mortality rates are decreased.
Anastomotic Leak ; Busan ; Child ; Child Health ; Constriction, Pathologic ; Daegu ; Esophageal Atresia ; Female ; Gastrointestinal Diseases* ; Gyeongsangbuk-do ; Heart Defects, Congenital ; Hernia, Diaphragmatic ; Hernia, Umbilical ; Hospitalization ; Humans ; Hydronephrosis ; Infant ; Infant Mortality ; Infant, Newborn ; Korea ; Male ; Mortality ; Perinatal Mortality ; Postoperative Complications ; Pyloric Stenosis ; Ultrasonography ; Wound Infection