Submitted by: Ma. Kay Bernadette T.

Lumbab, RN

Eisenmenger syndrome
(Source: http://www.nlm.nih.gov/medlineplus/ency/article/007317.htm)

Eisenmenger syndrome is a condition that affects blood flow from the heart to the lungs in some babies who have structural problems of the heart.

Causes
Eisenmenger syndrome is caused by a defect in the heart. Most often, babies with this condition are born with a hole between the two pumping chambers -- the left and right ventricles -- of the heart (ventricular septal defect). The hole allows blood that has already picked up oxygen from the lungs to flow back into the lungs, instead of going out to the rest of the body. Other heart defects that can lead to Eisenmenger syndrome include:
Atrioventricular canal defect Atrial septal defect Cyanotic heart disease Patent ductus arteriosus Truncus arteriosus

Over time, increased blood flow can damage the small blood vessels in the lungs. This causes high blood pressure in the lungs. As a result, the blood backs up and does not go to the lungs to pick up oxygen. Instead, the blood goes from the right side to the left side of the heart, allowing oxygen-poor blood to travel to the rest of the body. Eisenmenger syndrome usually develops before a child reaches puberty. However, it also can develop in young adulthood.

Symptoms

Bluish lips, fingers, toes, and skin (cyanosis) Chest pain Coughing up blood Dizziness Swelling in the joints caused by too much uric acid (gout)

Fainting Feeling tired Shortness of breath Stroke

Exams and Tests

The doctor will examine the child. During the exam, the doctor may find:
Abnormal heart rhythm (arrhythmia) Enlarged ends of the fingers or toes (clubbing) Heart murmur (an extra sound when listening to the heart)

The doctor will diagnose Eisenmenger syndrome by looking at the patient's history of heart problems. Tests may include:
Complete blood count (CBC) Chest x-ray MRI scan of the heart Putting a thin tube in an artery to view the heart and blood vessels and measure pressures (cardiac catheterization) Test of the electrical activity in the heart (electrocardiogram) Ultrasound of the heart (echocardiogram)

The number of cases of this condition in the United States has dropped because doctors are now able to diagnose and correct the defect sooner, before the irreversible damage to the small lung arteries occurs.

Treatment
Older children with symptoms may have blood removed from the body (phlebotomy) to reduce the number of red blood cells, and then receive fluids to replace the lost blood (volume replacement). Children may receive oxygen, although it is unclear whether it helps to prevent the disease from getting worse. Children with very severe symptoms may need a heart-lung transplant.

Outlook (Prognosis)
How well the infant or child does depends on whether another medical condition is present, and the age at which high blood pressure develops in the lungs. Patients with this condition can live 20 to 50 years.

Possible Complications

Bleeding (hemorrhage) in the brain Congestive heart failure Gout Heart attack Hyperviscosity (sludging of the blood because it is too thick with blood cells)

Infection (abscess) in the brain Kidney failure Poor blood flow to the brain Stroke Sudden death

When to Contact a Medical Professional

Call your health care provider if your infant develops symptoms of Eisenmenger syndrome.

Prevention
Surgery as early as possible to correct the heart defect can prevent Eisenmenger syndrome.

Alternative Names
Eisenmenger complex; Eisenmenger disease; Eisenmenger reaction; Eisenmenger physiology

Submitted by: Ma. Kay Bernadette T. Lumbab, RN What is a Ventral Hernia? There is as such, no clear Ventral Hernia Definition for you. A Ventral Hernia is normally described as a hernia, or a protrusion of an organ inside the abdomen such as the intestine or the bowel. In normal circumstances, the surrounding muscles and body tissues keep a organ inside the cavity. But in case of Ventral Hernia, the protruded organ comes out through the cavity and pushes the abdominal wall. The protrusion is visible from the outside in the form of a bulge in the abdomen. The condition is curable but quite difficult to treat. It causes much discomfort in a person. Ventral Hernia Symptoms Ventral Hernias are characterized by a lot of symptoms, which can be external as well as internal. These are : Pain Ventral Hernias are normally painless and even touching the bulge causes no ache in the sufferers body. But incarcerated hernias can cause much pain. These are protrusions that fail to enter back into the original cavity that they come out from. In acute cases, necrosis may take place. Blood supply to the protruded part is cut off and the organ tissues die due to lack of nutrition. This leads to a case of strangulated hernia, causing much pain to the sufferer. Patients with Ventral Hernia experience pain especially during strain, such as while coughing or lifting heavy objects. Bulge The protruded organ is visible as a bulge in the sufferer. It remains viewable even when the patient is lying down. Nausea Incarcerated ventral hernia can cause serious bodily discomfort to the sufferer. The person may experience nausea due to this reason. Vomiting The nauseating feeling in Incarcerated hernia sufferers can also make them vomit. No bowel Movement Patients with Incarcerated hernia conditions often suffer from an inability to have a bowel movement.

Tenderness Patients may often experience tenderness in the affected area of the abdomen. Enhanced Heart Rate The heart rate may often increase in sufferers with stomach hernia condition causing much discomfort. Growing Bulge When the patient has an incisional hernia condition, the bulge may grow bigger in size with passing time. Ventral Incisional Hernia occurs when an old surgical wound of a person does not heal properly. What causes Ventral Hernia?

Picture 1 - Ventral Hernia Source biotechfordummies Ventral Hernias may develop due to a number of reasons. A lot of system disorders may contribute to give rise to herniation inside the abdomen. The common causes for Ventral Hernia development are Weakening of Abdominal Walls When the walls of the abdominal cavity become weaker, it may lead to herniation.

Infected Surgical Wound A Ventral Hernia may also occur if a surgical wound in the body of a person gets infected after operation. Hematoma If a blood clot forms in the area where a surgical incision took place, it may also give rise to a hernia. Malnourishment In some cases, the operated area does not heal due to malnourishment. This may be due to lack of blood supply in the area due to some cause. Tearing of Stitches If a newly stitched area undergoes strain, the stitches may open. The area may start bleeding and it can also get infected. This can cause a hernia. Obesity Increased body fat often makes healing of an operated area more difficult. This again, can cause a rupture in the smooth muscle tissue. Age Aged people find it very difficult to heal after stitches. Unhealed surgical wounds can lead to hernia.
Coughing Intense coughing can cause a tear in the surgical stitches and reopen wounds. This can lead to infection and herniation. Ventral Hernia Treatment Ventral Hernia is a serious condition and it is best to get it treated as soon as possible. If there is a case of more severe condition, such as Strangulated Hernia, an immediate medical treatment is required. Medical Ventral Hernia Treatment The treatment of the condition generally involves Ventral Hernia repair through operation. Most cases of Ventral Hernia treatment require Ventral Hernia surgery. The surgical method may be Abdominal Ventral Hernia Operation The purpose of the surgical operation is to support the abdominal muscles and replace the protruding organs. The Hernia operation is known as Herniorrhaphy. A large incision is made in such operations and the recovery usually takes much long time. Laparoscopic Ventral Hernia Repair The repairing is done by using laparoscopes, or small cameras. A small incision is made through which the camera and instruments are inserted and used for operation.

Picture 2 - Ventral Hernia Surgery Source medivisuals

Picture 3 Ventral Hernia Surgery Source nucleusinc

The patient is usually advised some lifestyle changes following the operation for quick recovery. The sufferer is also advised to take precautions against respiratory infections that may cause sneezing or coughing, which may put strain on the stitches and open the wound.

Picture 4 Ventral Hernia Repair with Mesh Source lapsurg

Picture 5 Laparoscopic Ventral Hernia Repair Source doereport

In some cases, doctors carry out Ventral Hernia repair with mesh or synthetic material. Meshes are used to hold the weakened tissues in place and prevent them from rupture by stretching. This is known as a Tension free method of muscle repair.

Ventral Hernia Treatment at Home The treatment of the condition can be aided by following some simple steps at home. These include :

Incorporating high fiber foods into the diet and drinking more fluids. This will prevent constipation. Avoid smoking. Regular exercise. Lifting weights should be done wearing supportive garments.

Ventral Hernia Pictures Ventral Hernias are often difficult to understand for people from non-medical background. Here is a collection of pictures on Ventral Hernia that will help you know the condition better. If you have an abdominal bulge and suspect it to be a Ventral Hernia, you can check out these pictures to make sure.

Picture 6 Ventral Hernia Source fnu.ac.fj

Picture 7 Ventral Hernia Source arcticboy

Ventral Hernia is a serious condition that may give rise to severe, life-threatening symptoms. If you detect a bulge symptomatic of Ventral Hernia in yourself or anyone you know, get immediate medical attention. This will help you enjoy good health and avoid a lot of future complications.

Ventral Hernia Repair Every year in the U.S., surgeons repair nearly 384,000 ventral hernias.21 As with any treatment for a ventral hernia, it begins with a discussion with your doctor about the best course of action to deal with your specific problem. Traditionally this surgery is performed using a single large incision or open procedure. However, as the technology has advanced, more and more are being performed using minimally invasive procedures (with small incisions), which may provide important advantages during your recovery. Here are the two options surgeons have for ventral hernia repair: Generally in an open ventral hernia repair, the surgeon:

Makes an incision through skin, muscle, and protective tissue in your abdomen at the site of the hernia. The size of the incision depends on the size of the hernia. Dissects the hernia sac free and removes adhesions. Pushes the contents of the hernia into place. Sometimes places artificial mesh over the hernia, and then binds the abdominal wall to the mesh. Closes the incision with sutures or surgical staples.

In a minimally invasive ventral hernia repair, the surgeon:

Makes several -inch incisions apart from the hernia. Inflates your abdomen with air or carbon dioxide. Inserts a miniature camera called a laparoscope into your abdomen through one of the incisions, and watches the images on a video monitor. Dissects the hernia sac free and removes adhesions. Uses advanced, long-handled instruments inserted through the other incisions to pull the organs back into proper position, and then reinforces the abdominal wall with artificial mesh from underneath. Closes each small incision with sutures.