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Showing posts with label Abdomen. Show all posts
Showing posts with label Abdomen. Show all posts

Thursday, November 2, 2017

List of All named Hernias (Hernia Eponyms/Special Hernia)


Hernia is the abnormal protusion of a viscous or a part of it through an opening with a sac covering it. It could either be internal or external and not necessarily from the abdominal cavity. The most commonly encountered are the inguinal hernias and femoral hernia. But there are certain hernias that are named and arise from its specific location or contain specific content.

Hernia Eponyms on the basis of their similarity with the adjacent ones

Name of Hernia
Description
Bochdalek’s Hernia
Congenital Posterolateral Hernia of Diaphargm
Morgagni Hernia4
Through Larry’s space in Diaphargm
Larry’s Hernia4
Gibbon Hernia
Hernia with Hydrocele
Bergers Hernia
Hernia in Pouch of Douglas
Romberg Hernia1
Concurrent Ipsilateral Direct and indirect Inguinal Hernia
Saddle Hernia1
Dual Hernia1
Lumbar Hernia
Hernia in lumbar triangles of type Petit’s and Grynfelt
Obturator Hernia
Hernia through Obturator Canal
Grynfelt Hernia
Upper Lumbar triangle Hernia
Petit’s Hernia
Lower Lumbar Triangle Hernia
Femoral Hernia        
Hernia medial to Femoral Vein in Femoral canal
Cooper’s Hernia6
Femoral Hernia with two sacs
Bilocular femoral Hernia6
Cloquet’s Hernia
Hernia Through Pectineal aponeurosis
Callison-Cloquet Hernia
Through Pectineus Muscle and its fascia
Narath’s Hernia
Behind Femoral Artery in congenital dislocation of Hip
Hesselbach’s Hernia
Lateral to Femoral Artery
Serofini’s Hernia
Behind Femoral Vessels
Laugier’s Hernia
Through Lacunar Ligament
Teale’s Hernia5
In front of Femoral Vessels
Velpeau Hernia5
Richter’s Hernia
Part of circumference of bowel wall is entrapped
Littre’s Hernia
Contains Meckel Diverticulum
Sliding Hernia
Hernia with a part of the wall formed by the viscus
Hernia En Glissae
Hernia with a part of the wall formed by the viscus
Maydl’s Hernia2
Two loops of bowel in Hernia sac with remaining part in abdomen
W Hernia/Hernia in W2
Retrograde Hernia2
Two loops of bowel in Hernia sac with remaining part in abdomen
Phantom Hernia
Localised Muscle Bulge following Muscle Paralysis
Mery’s Hernia7
Through the perineal floor  
Perineal Hernia7
Spigelian Hernia
Hernia through Speligian Fascia
Sciatic hernia
Hernia through greater or lesser sciatic foramen
Little’s hernia3
Appendix in inguinal  Hernial Sac
Amyand hernia3
De Garengeots Hernia
Incarceration of appendix within Femoral Hernia
Beclards Hernia
Femoral Hernia Through Saphenous Opening
Barth’s Hernia
Hernia Between Adbominal wall and Persistent Vitellointestinal Duct
Holthouse’s Hernia                   
Inguinal Hernia That has turned outward into the groin
Grubers Hernia
Internal Mesogastric Hernia
Mesocolic hernia
Transmesenteric Hernia
Kronlem Hernia
Inguinoproperitoneal Hernia
Trietz Hernia
Paraduodenal Hernia
Rieux Hernia
Retrocaecal Hernia



Hernia Eponyms in alphabetical order

Name of Hernia
Description
Amyand hernia3
Appendix in inguinal hernia Sac
Barth’s Hernia
Hernia Between Adbominal wall and Persistent Vitellointestinal Duct
Beclards Hernia
Femoral Hernia Through Saphenous Opening
Bergers Hernia
Hernia in Pouch of Douglas
Bilocular femoral Hernia6
Femoral Hernia with two sacs
Bochdalek’s Hernia
Congenital Posterolateral Hernia of Diaphargm
Callison-Cloquet Hernia
Through Pectineus Muscle and its fascia
Cloquet’s Hernia
Hernia Through Pectineal aponeurosis
Cooper’s Hernia6
Femoral Hernia with two sacs
De Garengeots Hernia
Incarceration of appendix within Femoral Hernia
Dual Hernia1
Concurrent Ipsilateral Direct and indirect Inguinal Hernia
Femoral Hernia        
Hernia medial to Femoral Vein in Femoral canal
Gibbon Hernia
Hernia with Hydrocele
Grubers Hernia
Internal Mesogastric Hernia
Grynfelt Hernia
Upper Lumbar triangle Hernia
Hernia En Glissae
Hernia with a part of the wall formed by the viscus
Hesselbach’s Hernia
Lateral to Femoral Artery
Holthouse’s Hernia                   
Inguinal Hernia That has turned outward into the groin
Kronlem Hernia
Inguinoproperitoneal Hernia
Larry’s Hernia4
Through Larry’s space in Diaphargm
Laugier’s Hernia
Through Lacunar Ligament
Little’s hernia3
Appendix in inguinal  Hernial Sac
Littre’s Hernia
Contains Meckel Diverticulum
Lumbar Hernia
Hernia in lumbar triangles of type Petit’s and Grynfelt
Maydl’s Hernia2
Two loops of bowel in Hernia sac with remaining part in abdomen
Mery’s Hernia7
Through the perineal floor
Mesocolic hernia
Transmesenteric Hernia
Morgagni Hernia4
Through Larry’s space in Diaphargm
Narath’s Hernia
Behind Femoral Artery in congenital dislocation of Hip
Obturator Hernia
Hernia through Obturator Canal
Perineal Hernia7
Through the perineal floor
Petit’s Hernia
Lower Lumbar Triangle Hernia
Phantom Hernia
Localised Muscle Bulge following Muscle Paralysis
Retrograde Hernia2
Two loops of bowel in Hernia sac with remaining part in abdomen
Richter’s Hernia
Part of circumference of bowel wall is entrapped
Rieux Hernia
Retrocaecal Hernia
Romberg Hernia1
Concurrent Ipsilateral Direct and indirect Inguinal Hernia
Saddle Hernia1
Concurrent Ipsilateral Direct and indirect Inguinal Hernia
Sciatic hernia
Hernia through greater or lesser sciatic foramen
Serofini’s Hernia
Behind Femoral Vessels
Sliding Hernia
Hernia with a part of the wall formed by the viscus
Spigelian Hernia
Hernia through Speligian Fascia
Teale’s Hernia5
In front of Femoral Vessels
Trietz Hernia
Paraduodenal Hernia
Velpeau Hernia5
In front of Femoral Vessels
W Hernia/Hernia in W2
Two loops of bowel in Hernia sac with remaining part in abdomen


The number in superscript suggest that the hernias with the same number are actually same with various names.


Sources
SRB’s Manual Of Surgery
https://medicallegends.blogspot.com/2015/08/named-hernias.html
http://lessons4medicos.blogspot.com/2009/07/different-eponymous-types-of-hernia.html
Internet

Wednesday, September 20, 2017

Sample History: Diarrhoea and vomiting in infant.

Sample Pediatric history writing : Vomiting and Diarrhoea

(This case is special to me because this history is digital version of the history and clinical examination I presented in my ninth semester pediatrics board examination. Most of the points are just jotted down which needs linguistic description as you present them. The parenthesized and italic words are the way it is said while the words that are just parenthesized are the justification in any point where extra elaboration may be needed. Many points may be missing but I have not corrected the things I have written in the exam sheet. Since this was a piece of exam, so many points may be missing and complete elaboration is language is absent. So I would like to apologize for that.)



Name: Ms. Pariyar
Age: 11months
Sex: Female
Address: Nala

Father: Mr. Pariyar, 23yrs Farmer,  Class 7
Mother: Mrs. Pariyar, 21yrs housewife, illiterate
Informant: Mother, hence reliable.

(Always write the level of education and profession of parents to know the level of their comprehension and their approach to child health. The informant is important as mother is the one who take cares of the child and knows the exact chronology and series of event. While other informants such as father, grandparents are not the first hand handler of the child and may only elaborate what they have been told by the mother and may not know all the details.)

Date of admission: 23rd September 2015 to ER @ 2:00pm
Date of Examination: 24th September 2015

(Ms. Pariyar, 11yrs girl from Nala, daughter of Mr and Mrs pariyar was presented to DH ER yesterday at 2:00 pm with complains of )

Chief Complaints
Vomiting for 5 hours x 1 day
                Diarrhoea for 1 day
(The history is given by mother, hence the history is reliable)

History of Present illness
According to the mother, the child was active and playful 2 days back, then she developed 8-9 episodes of vomiting, which initially contained the ingested food material (milk) and later turned greenish and watery. It was about 2 teaspoon full in each episode, foul smelling and non-projectile.
After around 6 hours, the child developed diarrhea, 10-12 episodes/day, watery with mucoid content, was foul smelling but did not contain blood in the stool. The child cries while passing the stool but not during micturition.
There is also history of fever associated with diarrhea which was mild, continuous and not associated with rash and abnormal body movement.
There is no loss of appetite, drinks vigorously. Mother gives history of infrequent micturition compared to previous times.
No cough, no shortness of breath.
No loss of consciousness or avoidance of bright light.

Treatment history:
The patient was bought to DH 2 hours after the onset of vomiting, where she was provided with IV medication which subsided the vomiting. The child has been receiving IV fluids and the child is improving as vomiting has subsided but diarrhea is yet to improve.

Past history
Birth
ANC: 6 ANC visits, taken folic acid, iron, calcium, 2 TT vaccines.
Natal: Cesarean delivery at DH for prolonged labor, cried immediately after birth, passed stool and urine within 24 hours.
Post natal: breastfed within 24 hours of birth.
(The mother had regular ANC visits and had taken folic acid, iron, calcium and both the TT vaccine. She underwent CS at DH for prolonged delivery. The child cried immediately after birth, the child cried immediately after birth, passed stool and urine within 24 hours. The child was breast fed within 24 hours of birth. The post natal period was uneventful.)

(The child greater than 3 years all the prenatal, natal and postnatal history may be uneventful and can be skipped without telling the minor details unless it has significant relation to birth history. The child is breast =fed generally within 1 hour of birth but since this a CS case, so the breastfeeding may have been delayed.)

Immunization
At birth BCG
6 weeks Hep B, Hib, DPT, OPV, PCV
10 weeks Hep B, Hib, DPT, OPV, PCV
14 weeks 2 vaccines Hep B, Hib, DPT, OPV, IPV (2 vaccine is the description given by mother, Pentavalent in one vaccine and IPV in the next)
9 months MR + PCV
12 months and 15 months remaining.
(The child has received the vaccination as per the National EPI Schedule for her age, the vaccinations of 12 months and 15 months are remaining.)

(All the vaccine mentioned need not be read one by one, rather National EPI Schedule includes all. Mother can describe at what age, how many shots of vaccine and oral drops the child has received. Based upon that we can confirm If the child has received the necessary vaccination or not.)

Nutrition
                Exclusively Breastfed for 1 month
                Then added powder milk
                After 3 months: Sarbottam pitho
Currently Breastfed every 1-2 hourly for 10-15 minutes
Dal + rice small bowel 100X2 gm = 200 gm calorie: 260 kcal
Snack Biscuit 3 pieces 3x 20 = 60kcal
Total 340 kcal
8 kg 800 kcal  
(The child was exclusively breastfed for 1 months and then weaned with powder milk. After 3 months of age sarbottam pitho was added to her diet. Currently she is breastfed every 1-2 hour for duration of 10-15 minutes. Besides she is fed with 2 small bowel of regular meals and 3 pieces of biscuit in snack. The total calorie intake besides breast milk is 340 kcal and the expected calorie intake needed is 800kcal)

(Calorie deficit can not be commented upon as the chold is still feeding on milk. If breast milk does not form the significant source, the calorie defecit must be calculated)
 
Development
Stands with support and walks with support (Motor)
Pincher grasp present (Fine Motor)
Uses bisyallable words and says baba and ama (language)
Interacts with mother (Social)


Past History

No history of similar illness in the past.
No chronic illness like asthma.

Family history
Mother had similar illness 1 week back.
No history of chronic illness.
(Pedigree drwaing is must in pedia, see the image) 

Socioeconomic history
Belongs to a well sustained middle class family.
Has provision of sanitary latrine and uses soap.
Drinks water from tap and spring water but does not boil the water.

Drug and Allergy history: Not present
History of Consanguinity: Not present
History of Contact to TB: Absent

Examination
Ill looking, fairly built child, is lying in supine position with yellow IV cannula with fluid flowing through the cannula.

Vitals
Pulse: 136bpm, regular euvolemic
BP: (not feasible)
RR: 47bpm , regular, thoracoabdominal
Temperature : 38oC

Anthropometry
Length:  74cm, which lies between the 10th  and 25th centile.
HC (head circumferene): 46 cm lies between the 10th and 25th centile
Weight: 8 kg
MUAC : 14cm (Mid Upper Arm circumference)

(The anthropometry data are plotted in a standard growth chart and the centile is measured or the expected values of various can be measured using various formula and the percentage of the expected and the observed can be calculated.)

>>Learn normal anthropometry values and formula to calculate them in pediatric.

Head to Toe examination
Hair looks normal in color and texture.
Fontanels are not sunken.
No discharge and redness of eyes
No dryness of eyes or sunken eyes
No nasal discharge and congestion
Mouth and oral cavity looks normal with 2 lower incisors and 1 upper incisors
Skin surface looks normal
No icterus, pallor or cyanosis.
Hydration status looks normal.

Abdominal examination
On inspection
The abdomen is protuberant and the umbilicus is centrally placed. All quadrants moving correspondingly with respiration. No visible pulsation, peristalsis or scar marks.
All quadrant moving corresponding with respiration.
Hernial orifices intact.
Perianal erythema present.

On palpation
Abdomen is soft, non tender and no local rise in temperature.
On superficial palpation, no masses palpable.
Liver is palpable 2 cm from the right costal margin which is soft, non tender and the margin is regular.
Spleen is not palpable and kidneys are not ballotable.
Kidneys are not ballotable.

On percussion, normal tympanic note is present all over the abdomen
On auscultation, normal bowel sound heard with 3 bowel sound/minute heard.

Chest: B/L equal air entry with normal vesicular breathe sound (NVBS).  S1S2M0
CNS/MSK: Grossly intact

Provisional diagnosis:   Acute Gastroenteritis
Differential Diagnoses:                 Enteric Fever
                                                Viral Hepatitis

                                                Secretory Diarrhoea