Civil Rights
Movements, leaders, victories and the continuing fight for equality.
Explore the people, places, events, achievements, struggles and stories that shaped our journey.
Movements, leaders, victories and the continuing fight for equality.
Innovation, patents, science, technology and world-changing contributions.
Pioneers, champions, Negro Leagues, records, activism and excellence.
Meet the people whose lives, choices and achievements shaped the journey.
Black towns, communities, institutions and places where history happened.
Moments that changed communities, movements, institutions and the nation.
In 1968 Shirley Chisholm became the first Black woman elected to the United States Congress. In 1972 she launched a campaign for the Democratic presidential nomination, breaking another political barrier.
MORE →Reflects the personal views, recollections, and perspective of the author, Mike Davis.
This is a personal recollection on the Move fire on May 13, 1985
| Internal hernia | |
|---|---|
| A hernia—the hole in the light-colored wall of tissue—can trap loops of the bowel or other tissue | |
| Specialty | General surgery |
| Differential diagnosis | Endometriosis, chronic pelvic pain |
Internal hernias occur when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen (congenital or acquired) in the abdominal cavity. If a loop of bowel passes through the mesenteric defect, that loop is at risk for incarceration, strangulation, or for becoming the lead point of a small bowel obstruction.[1] Internal hernias can also trap adipose tissue (fat) and nerves. Unlike more common forms of hernias, the trapped tissue protrudes inward, rather than outward.[2]
Mesenteric defects commonly occur in trauma, such as gunshot wounds to the abdomen. In trauma victims, the defect is usually closed, sometimes with resection of the associated bowel, which may have lost its blood supply.[1] Also mesenteric defects are intentionally created in the Roux-en-Y gastric bypass procedure, being classically known as a Petersen's hernia.[3] The mesenteric defect in such cases, called Petersen's defect, is located between the transverse colon and the mesentery of the alimentary limb (the segment of the jejunum from the jejunojejunostomy until the connection with the proximal segment of the stomach) at the level of the jejunojejunostomy.[4]
Internal hernias are difficult to identify in women, and misdiagnosis with endometriosis or idiopathic chronic pelvic pain is very common. One cause of misdiagnosis that when the woman lies down flat on an examination table, all of the medical signs of the hernia disappear. The hernia can typically only be detected when symptoms are present, so diagnosis requires positioning the woman's body in a way that provokes symptoms.
Both internal hernias and umbilical hernias are more common in women than men.[2]
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Internal hernias occur when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen (congenital or acquired) in the abdominal cavity. If a loop of bowel passes through the mesenteric defect, that loop is at risk for incarceration, strangulation, or for becoming the lead point of a small bowel obstruction. Internal hernias can also trap adipose tissue (fat) and nerves. Unlike more common forms of hernias, the trapped tissue protrudes inward, rather than outward. Mesenteric defects commonly occur in trauma, such as gunshot wounds to the abdomen. In trauma victims, the defect is usually closed, sometimes with resection of the associated bowel, which may have lost its blood supply. Also mesenteric defects are intentionally created in the Roux-en-Y gastric bypass procedure, being classically known as a Petersen's hernia. The mesenteric defect in such cases, called Petersen's defect, is located between the transverse colon and the mesentery of the alimentary limb (the segment of the jejunum from the jejunojejunostomy until the connection with the proximal segment of the stomach) at the level of the jejunojejunostomy. Internal hernias are difficult to identify in women, and misdiagnosis with endometriosis or idiopathic chronic pelvic pain is very common. One cause of misdiagnosis that when the woman lies down flat on an examination table, all of the medical signs of the hernia disappear. The hernia can typically only be detected when symptoms are present, so diagnosis requires positioning the woman's body in a way that provokes symptoms. Both internal hernias and umbilical hernias are more common in women than men.
Hernia repair is a surgical operation for the correction of a hernia—a bulging of internal organs or tissues through the wall that contains it. It can be of two different types: herniorrhaphy; or hernioplasty. This operation may be performed to correct hernias of the abdomen, groin, diaphragm, brain, or at the site of a previous operation. Hernia repair is often performed as an ambulatory procedure.
A hernia (pl.: hernias or herniae, from Latin, meaning 'rupture') is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. The term is also used for the normal development of the intestinal tract, referring to the retraction of the intestine from the extra-embryonal navel coelom into the abdomen in the healthy embryo at about 71⁄2 weeks. Various types of hernias can occur, most commonly involving the abdomen, and specifically the groin. Groin hernias are most commonly inguinal hernias but may also be femoral hernias. Other types of hernias include hiatus, incisional, and umbilical hernias. Symptoms are present in about 66% of people with groin hernias. This may include pain or discomfort in the lower abdomen, especially with coughing, exercise, or urinating or defecating. Often, it gets worse throughout the day and improves when lying down. A bulge may appear at the site of hernia, that becomes larger when bending down. Groin hernias occur more often on the right than left side. The main concern is bowel strangulation, where the blood supply to part of the bowel is blocked. This usually produces severe pain and tenderness in the area. Hiatus, or hiatal hernias often result in heartburn but may also cause chest pain or pain while eating. Risk factors for the development of a hernia include smoking, chronic obstructive pulmonary disease, obesity, pregnancy, peritoneal dialysis, collagen vascular disease, and previous open appendectomy, among others. Predisposition to hernias is genetic and occur more often in certain families. Deleterious mutations causing predisposition to hernias seem to have dominant inheritance (especially for men). It is unclear if groin hernias are associated with heavy lifting. Hernias can often be diagnosed based on signs and symptoms. Occasionally, medical imaging is used to confirm the diagnosis or rule out other possible causes. The diagnosis of hiatus hernias is often done by endoscopy. Groin hernias that do not cause symptoms in males do not need immediate surgical repair, a practice referred to as "watchful waiting". However most men tend to eventually undergo groin hernia surgery due to the development of pain. For women, however, repair is generally recommended due to the higher rate of femoral hernias, which have more complications. If strangulation occurs, immediate surgery is required. Repair may be done by open surgery, laparoscopic surgery, or robotic-assisted surgery. Open surgery has the benefit of possibly being done under local anesthesia rather than general anesthesia. Laparoscopic surgery generally has less pain following the procedure. A hiatus hernia may be treated with lifestyle changes such as raising the head of the bed, weight loss and adjusting eating habits. The medications H2 blockers or proton pump inhibitors may help. If the symptoms do not improve with medications, a surgery known as laparoscopic Nissen fundoplication may be an option. Globally in 2019, there were 32.53 million prevalent cases of inguinal, femoral, and abdominal hernias, with a 95% uncertainty interval ranging from 27.71 to 37.79 million. Additionally, there were 13.02 million incident cases, with an uncertainty interval of 10.68 to 15.49 million. These figures reflect a 36.00% increase in prevalent cases and a 63.67% increase in incident cases compared to the numbers reported in 1990. About 27% of males and 3% of females develop a groin hernia at some point in their lives. Inguinal, femoral and abdominal hernias were present in 18.5 million people and resulted in 59,800 deaths in 2015. Groin hernias occur most often before the age of 1 and after the age of 50. It is not known how commonly hiatus hernias occur, with estimates in North America varying from 10% to 80%. The first known description of a hernia dates back to at least 1550 BC, in the Ebers Papyrus from Egypt.
A hiatal hernia or hiatus hernia is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest. This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn. Other symptoms may include trouble swallowing and chest pains. Complications may include iron deficiency anemia, volvulus, or bowel obstruction. The most common risk factors are obesity and older age. Other risk factors include major trauma, scoliosis, and certain types of surgery. There are two main types: sliding hernia, in which the body of the stomach moves up; and paraesophageal hernia, in which an abdominal organ moves beside the esophagus. The diagnosis may be confirmed with endoscopy or medical imaging. Endoscopy is typically only required when concerning symptoms are present, symptoms are resistant to treatment, or the person is over 50 years of age. Symptoms from a hiatal hernia may be improved by changes such as raising the head of the bed, weight loss, and adjusting eating habits. Medications that reduce gastric acid such as H2 blockers or proton pump inhibitors may also help with the symptoms. If the condition does not improve with medications, a surgery to carry out a laparoscopic fundoplication may be an option. Between 10% and 80% of adults in North America are affected.
Before the 1921 destruction of Tulsa’s Greenwood District, Black residents had created a remarkable center of business and community life. The district included stores, professional offices, entertainment venues and homes owned by Black citizens. Understanding Greenwood means learning what was built—not only what was burned.
MORE →Brown v. Board of Education in 1954.