Giant Hernia with Incarceration
- 1 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 2 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 3 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 4 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 5 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 6 Service de chirurgie générale, hôpital de Sikasso, Sikasso, Mali
- 7 Service de chirurgie générale, hôpital de Sikasso, Sikasso, Mali
- 8 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 9 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 10 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 11 Service de chirurgie générale, hôpital de Sikasso, Sikasso, Mali
- 12 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 13 Centre de référence de la Commune VI, Bamako, Mali
- 14 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 15 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 16 Service de chirurgie générale, hôpital de Sikasso, Sikasso, Mali
- 17 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 18 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 19 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 20 Centre de référence de la Commune VI, Bamako, Mali
- 21 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
- 22 Service de chirurgie générale, hôpital universitaire, Bamako, Mali
Abstract
Introduction: </b> Giant hernias induce changes which reduce the quality of life of patients and make their surgical management complex. Adequate preoperative preparation of the patient guarantees good postoperative progress. It is necessary to avoid resorting to a technique of separation of the compartments during the cure. Here we report the case of a patient who benefited a successful cure using the Ramirez technique. <b> Observation: </b> We report the case of a 60-year-old patient admitted to an outpatient clinic for abdominal swelling evolving for 30 years without the notion of trauma gradually increasing in volume. The interrogation and physical examination led to the diagnosis of a giant white line hernia with incarceration. A preoperative assessment and a preanesthetic consultation were carried out. Intraoperatively, the cecum, transverse colon, sigmoid, jejunum and greater omentum were incarcerated in the bag. After adhesiolysis we proceeded to resect the bag and cure it using the Ramirez technique. The consequences were simple and the patient was discharged on day 4 after her dressing and was seen on day 15, 1 month , 3 months and 1 year. The patient benefited from the placement of an abdominal compression sheath for 3 months. <b> Conclusion: </b> Success in the management of prosthetic material in the absence of prosthetic material depends on good preoperative preparation and the mastery of certain surgical techniques.
- Sabbagh, C., Dumont, F., Robert, B., Badaoui, R., Verhaeghe, P. and Regimbeau, J.-M. (2011) Peritonea Volume Is Predictive of Tension-Free Fascia Closure of Large Incisional Hernias with Loss of Domain: A Prospective Study. Hernia, 15, 559-565. https://doi.org/10.1007/s10029-011-0832-y
- Balaphas, A., et al. (2016) Giant Hernias with Loss of Citizenship. Revue Médicale Suisse, 12, 1170-1173.
- Ventral Hernia Working Group, et al. (2010) Incisional Ventral Hernias: Review of Literature and Recommendations Regarding the Grading and Technique of Repair. Surgery, 148, 544-558. https://doi.org/10.1016/j.surg.2010.01.008
- Trivellini, G., et al. (1984) Surgical Treatment of Large Eventrations. Study of a Technic Adapted to Disorders of Respiratory Compliance. Chirurgie, 110, 116-122.
- Ramirez, O.M., Ruas, E. and Dellon, A.L. (1990) “Components Separation” Method for Closure of Abdominal-Wall Defects: An Anatomic and Clinical Study. Plastic and Reconstructive Surgery, 86, 519-526. https://doi.org/10.1097/00006534-199009000-00023
- Alam, N.N., Narang, S.K., Pathak, S., Daniels, I.R. and Smart, N.J. (2016) Methods of Abdominal Wall Expansion for Repair of Incisional Herniae: A Systematic Review. Hernia, 20, 191-199. https://doi.org/10.1007/s10029-016-1463-0