Hernia complications

Finally be aware of the fact that diseases in the upper part of the gastrointestinal tract are common in the elderly and can cause severe complications and even be fatal. Drugs that are often used in the elderly due to chronic diseases with inflammation and pain are often the cause of gastritis, peptic ulcers and hiatus hernia. The risks of medication side effects as a reason for the problem must be taken into account when treating elderly for peptic ulcers and stomach pain. 

Contraindications Glaucoma, obstructive uropathy, obstructive disease of Gl-anti-cholinergic tract, paralytic ileus, intestinal atony of the elderly or debilitated patient, unstable cardiovascular status in acute hemorrhage, severe ulcerative colitis especially if complicated by toxic megacolon, myasthenia gravis, hiatal hernia associated with reflux esophagitis, hypersensitivity to any component of f he formulaf ion, acuf e infermiffenf porphyria. 

Simple dietary advice about bulk foods can mitigate minor bowel disturbances. More serious complications that can arise include paralytic ileus, which can be life-threatening, especially in the elderly (78). A less well-known adverse effect is the potential for aggravating or even possibly inducing a hiatus hernia, presumably due to an anticholinergic effect on the cardiac sphincter (79). 

Hernias likewise do not constitute a general contraindication. (228) In numerous cases, we have observed no complications. (253) Large hiatus hernias are, however, an accepted contraindication. 

Lemmer, J.H., Strodel, W.E., Eckhauser, F.E. Umbilical hernia incarceration a complication of medical therapy of ascites. Amer. X Gastroenterol. 1983 78 295 - 296... 

Complications 89 Congenital Esophageal Stenosis 90 Esophageal Duplication 91 Esophageal Bronchus 91 Vascular Ring Abnormalities 93 Hiatal Hernia 94... 

The pattern of complications is common for all types of hernia. The complications are irreducibility, obstruction and strangulation. Irreducible (incarcerated) hernia may be due to a narrow neck or adhesion of contents to the sac wall. In obstruction, the intestine in the hernia gets obstructed due to a narrow neck, adhesion or volvulus, but it is viable. Strangulation results when there is compromise to venous drainage and later arterial supply of the contents. In obstructed hernia there is colicky pain, abdominal distension and vomiting. Incarcerated hernia is present at rest it is irreducible and usually contains some fluid in the sac that can be seen on sonography (Fig. 5.2b Rettenbacher et al. 2001). In obstructed hernia the patient has symptoms of intestinal obstruction. There are dilated bowel loops... 

Basoglu M, YUdirgan MI, YUmaz I, Bahk A, Celebi F, Atamanalp SS, et al. Late complications of incisional hernias following prosthetic mesh repair. Acf ChirBelg 2004 104 425-8. 

It is widely assumed that tramnatic injiuy to the nerve is the major cause of post-operative neiu-opathlc pain, but it is probably more complicated than this suggestion. It is also likely that the particular procedure and sensory systems in the surgical field contribute. Additionally, in some patients, continuous inflammatory responses, such as after inguinal hernia repair, drive the chronic response. However, it is the role of peripheral nociceptor sensitization that seems to be at the center of this issue. 

Weber P. Dose-dependent relapse of hiatus hernia after administration of intrathecal baclofen treatment - a rare complication. Childs Nerv Syst 2013 29 873-5. 

PD complications can be divided into acute or chronic and infectious or noninfectious. Imaging with ultrasound, CT, and eventually MRI can contribute significantly to appropriate treatment of many situations (Taylor 2002). Acute catheter dysfunction may be caused by malposition and can be seen on a plain abdominal radiograph. Development of inguinal hernias is caused by the permanently increased intra-abdominal pressure, and herniotomy is frequently needed. Acute respiratory distress should raise suspicion of hydrothorax caused by thoracic leakage of peritoneal fluid (Rose and Conley 1989). A chest X-ray can show this complication (Fig. 21.3). Infections of the exit site, the subcutaneous tunnel, and peritonitis are the most common infectious complications. Proper treatment with intraperitoneal antibiotics is mandatory. The incidence of peritonitis is estimated to be one infection per 13 treatment months. Recurrent peritonitis may lead to catheter removal. Tunnel infections typically show pericatheter fluid collection, and US is important for early detection and follow-... 

Entrapment of the femoral nerve is a rare condition resulting from a variety of space-occupying processes in the iliacus compartments, such as hematoma, iliacus abscess, iliopsoas bursitis or iatrogenic complications after vessel cannulation, during fracture fixation with metallic plates or inguinal hernia repair. In severe neuropathy, wasting and weakness of the quadriceps muscle, a reduced knee reflex and... 

Breakdown of suture lines and leakage are a common complication of the early postoperative phase. Afferent loop syndrome is a specific problem of Billroth II procedures and is caused by mechanical obstruction usually from adhesions. Internal hernias, extrinsic compression, bowel stenosis may also occur. Bezoar formation in the gastric remnant, anastomotic ulcers, incisional hernia of the abdominal wall and hiatal hernia are all also potential complications. Stenosis of the gastrojejunostomy after Billroth II procedures leads to obstruction (Fig. 13.14). Fistula after Billroth II is rare (Fig. 13.15). Tumour of the gastric renmant can be due to recurrence or present as a primary carcinoma of the stump (Fig. 13.16). 

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