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Sample records for abdominal wall hernias

  1. Abdominal wall hernia and pregnancy

    Jensen, K K; Henriksen, N A; Jorgensen, L N

    2015-01-01

    Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery of......PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub...... incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...

  2. ADULT ABDOMINAL WALL HERNIA IN IBADAN

    Ayandipo, O.O; Afuwape, O.O.; Irabor, D. O.; Abdurrazzaaq, A.I.

    2015-01-01

    Background: Abdominal wall hernias are very common diseases encountered in surgical practice. Groin hernia is the commonest type of abdominal wall hernias. There are several methods of hernia repair but tension-free repair (usually with mesh) offers the least recurrent rate. Aim: To describe the clinical profile of anterior abdominal wall hernias and our experience in the surgical management of identified hernias Method: The project was a retrospective study of all patients with abdominal wal...

  3. Handlebar Hernia: A Rare Type of Abdominal Wall Hernia

    Rooh-Allah Yegane

    2010-10-01

    Full Text Available Traumatic abdominal wall hernias are a type of acquired hernia secondary to blunt trauma Caused, by direct trauma from handlebar like objects. This rare hernia is named ‘Handlebar hernia'. We report a case of such hernia without any significant intra-abdominal injury. The abdominal wall defect was repaired in layers by Jones technique. Postoperative course was uneventful. The authors recommend clinical suspicion for traumatic hernia in all patients with traumatic abdominal wall injury. Definitive treatment includes surgical exploration with primary repair of all tissue layers of the abdominal wall.

  4. Bullhorn hernia: A rare traumatic abdominal wall hernia

    Bimaljot Singh

    2015-01-01

    Full Text Available Traumatic abdominal wall hernia (TAWH is rare despite the high prevalence of blunt abdominal trauma. Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation. We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region. The patient was managed by immediate surgical intervention. A surgeon must have high index of suspicion for the diagnosis of this condition as missed hernias in this setting pose a high risk of strangulation and gangrene.

  5. Connective tissue alteration in abdominal wall hernia

    Henriksen, N A; Yadete, D H; Sørensen, Lars Tue; Ågren, Sven Per Magnus; Jørgensen, Lars Nannestad

    2011-01-01

    The aetiology and pathogenesis of abdominal wall hernia formation is complex. Optimal treatment of hernias depends on a full understanding of the pathophysiological mechanisms involved in their formation. The aim of this study was to review the literature on specific collagen alterations in abdom...

  6. Bullhorn hernia: A rare traumatic abdominal wall hernia

    Bimaljot Singh; Ashwani Kumar; Adarshpal Kaur; Rachan Lal Singla

    2015-01-01

    Traumatic abdominal wall hernia (TAWH) is rare despite the high prevalence of blunt abdominal trauma. Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation. We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region. The patient was managed by immediate surgical intervention. A surgeon must have high index of suspicion for th...

  7. A rare nonincisional lateral abdominal wall hernia

    Kim, Dong-Ju; Park, Jin-Woo

    2015-01-01

    A 68-year-old woman presented a rare lateral abdominal wall hernia. Three month before admission to Chungbuk National University Hospital, she found a large protruding mass measuring 8 cm in diameter in the midaxillary line just below the costal margin upon heavy coughing. She had no history of abdominal trauma, infection, or operation previously. The mass was easily reduced manually or by position change to left lateral decubitus. CT scan showed a defect of the right transversus abdominis mu...

  8. Criteria for definition of a complex abdominal wall hernia

    Slater, N.J.; Montgomery, A.; Berrevoet, F.; Carbonell, A.M.; Chang, A.; Franklin, M.; Kercher, K.W.; Lammers, B.J.; Parra-Davilla, E.; Roll, S.; Towfigh, S.; Geffen, E. van; Conze, J.; Goor, H. van

    2014-01-01

    PURPOSE: A clear definition of "complex (abdominal wall) hernia" is missing, though the term is often used. Practically all "complex hernia" literature is retrospective and lacks proper description of the population. There is need for clarification and classification to improve patient care and allo

  9. Personalized identification of abdominal wall hernia meshes on computed tomography.

    Pham, Tuan D; Le, Dinh T P; Xu, Jinwei; Nguyen, Duc T; Martindale, Robert G; Deveney, Clifford W

    2014-01-01

    An abdominal wall hernia is a protrusion of the intestine through an opening or area of weakness in the abdominal wall. Correct pre-operative identification of abdominal wall hernia meshes could help surgeons adjust the surgical plan to meet the expected difficulty and morbidity of operating through or removing the previous mesh. First, we present herein for the first time the application of image analysis for automated identification of hernia meshes. Second, we discuss the novel development of a new entropy-based image texture feature using geostatistics and indicator kriging. Third, we seek to enhance the hernia mesh identification by combining the new texture feature with the gray-level co-occurrence matrix feature of the image. The two features can characterize complementary information of anatomic details of the abdominal hernia wall and its mesh on computed tomography. Experimental results have demonstrated the effectiveness of the proposed study. The new computational tool has potential for personalized mesh identification which can assist surgeons in the diagnosis and repair of complex abdominal wall hernias. PMID:24184112

  10. Traumatic abdominal wall hernia in two adults: a case series

    Agarwal Nitin

    2009-06-01

    Full Text Available Abstract Introduction Traumatic hernia of the abdominal wall is a rare entity. A large proportion of reported cases are in children with a particular type of injury, i.e. from a handlebar injury. In adults, the presentation can vary substantially and the diagnosis is difficult. We present two cases in adults, with widely varying presentations and management. Case presentations A 40-year-old woman from rural north India presented with a low-velocity blunt injury to the lower abdomen. She was attacked by a bull. She had a clinically evident abdominal fascial disruption with intact skin, and was hemodynamically stable. An emergency mesh repair of the defect was performed, and she recovered well. A 38-year-old man from rural north India presented with blunt trauma to the abdomen following a motor vehicle accident. He was stable, with a central abdominal parietal wall swelling and bruising. A computed tomography scan revealed herniation of bowel loops in the area with minor intra-abdominal injuries. A laparotomy, resection-anastomosis of the ischemic bowel, and primary repair of the defect was performed and he recovered well. Conclusion Following blunt abdominal trauma, particularly high-velocity injuries, a high index of suspicion must be reserved for parietal wall swellings, as missed hernias in this setting have a high risk of strangulation. Computed tomography is the best aid to diagnosis. Management of each case needs to be individualized.

  11. Traumatic Abdominal Wall Hernia After a Blunt Trauma: A Case Report

    Ersin Dumlu

    2014-06-01

    Full Text Available Traumatic abdominal wall hernia is a rare result of blunt abdominal traumas in adults. Altough the detection of the injuries of the abdominal organs is the priority in blunt traumas, abdominal wall defect may also occur in these patients. These hernias can go undetected due to preservation of the skin overlying the hernia defect. Traumatic abdominal wall hernias can have high morbidity and mortality rates due to incarceration and perforation of tubular hollow organs, especially if there is any delay. The possibility of traumatic hernia should always be considered in cases with serious blunt trauma. Computed Tomography (CT scan examinations should be performed routinely due to their high diagnostic value if trumatic hernia is suspected. In this report, a traumatic abdominal wall hernia patient who was treated by surgery has been presented with the review of the current literature.

  12. [BIOLOGICAL IMPLANTS IN ABDOMINAL WALL HERNIA REPAIR (REVIEW)].

    Abatov, N; Badyrov, R; Abatova, A; Assamidanov, E; Kaukenov, B

    2016-02-01

    The use of synthetic meshes as a material for abdominal wall hernia repair does not always ensure a recurrence-free treatment outcome and full recovery of the abdominal wall functional activity. There are well-known disadvantages such as poor resistance to infection, the infiltrate formation in the place of implantation, expressed adhesive process in cases of introperitoneal fixation, to create certain restrictions on the using of these implants for abdominal wall reconstruction. The search for alternative materials that could minimize the risk of complications, has led to the study of biological grafts. It is known that various methods for the manufacturing biological implants determine endogenous properties for each material separately, and may be cause a variety of biological responses in vivo after implantation. The question has not been resolved, what the fresh raw material is better to use for derive biological implants. In this review we investigated the interaction of different types of biological implants between the abdominal wall and the organs of abdominal cavity of the recipient, their ability to resist infection and the development of relapses, as a leading indicator of the effectiveness of hernioplasty. PMID:27001778

  13. Frequency of abdominal wall hernias: is classical teaching out of date?

    Dabbas, Natalie; Adams, K.; Pearson, K; Royle, GT

    2011-01-01

    Objectives Abdominal wall hernias are common. Various authors all quote the following order (in decreasing frequency): inguinal, femoral, umbilical followed by rarer forms. But are these figures outdated? We investigated the epidemiology of hernia repair (retrospective review) over 30 years to determine whether the relative frequencies of hernias are evolving. Design All hernia repairs undertaken in consecutive adult patients were assessed. Data included: patient demographics; hernia type; an...

  14. JAMA Patient Page: Abdominal Hernia

    ... an operation. Umbilical hernia Abdominal wall Intestinal loop Peritoneum Skin Peritoneum Umbilical annulus SYMPTOMS The first symptom of a ... vomiting, or constipation. Inguinal hernia Indirect inguinal hernia Peritoneum Deep inguinal ring Inguinal canal Superficial inguinal ring ...

  15. Adult abdominal hernias.

    Murphy, Kevin P

    2014-06-01

    Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.

  16. Abdominal wall endometrioma mimicking an incarcerated hernia: a case report

    Simoglou C

    2012-06-01

    Full Text Available Christos Simoglou,1 Paul Zarogoulidis,2 Nikolaos Machairiotis,3 Konstantinos Porpodis,2 Lambros Simoglou,4 Alexandros Mitrakas,5 Agisilaos Esebidis,5 Eirini Sarika,6 George Kouklakis,7 Alkis Iordanidis,8 Nikolaos Katsikogiannis31Cardiothoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 2Pulmonary Department, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece; 3Surgery Department (NHS, University General Hospital of Alexandroupolis, Greece; 4Surgical Clinic (NHS, Komotini General Hospital, Thrace, Greece; 51st University Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 6Biopathology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 7Gastrointestinal Endoscopy Unit, University General Hospital of Alexandroupolis, Democritus University of Thrace, 8Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, GreeceAbstract: The case of a tender, isolated abdominal wall tumor within a Pfannenstiel incision due to a seeding deposit of endometrial tissue secondary to a previous obstetric operation (caesarean section in a 39-year-old female without previously reported pelvic endometriosis is presented. The lesion clinically mimicked the appearance of an incarcerated incisional hernia at the outer corner of the healed Pfannenstiel incision. The preoperative differential diagnosis also included that of a locally forming post-operative tender granuloma and the remote possibility of an incisional endometrioma (although no link to menstruation could be made. Local malignancy was not taken as a serious possibility. Definitive diagnosis of the excised lesion was made at histology. The pre-operative diagnostic dilemma is presented, along with a short review of the literature.Keywords: endometrioma, seeding

  17. [Mutual influence and development between Gastrointestinal surgery and hernia and abdominal wall surgery].

    Chen, Shuang

    2015-11-25

    The aim of this article is to expound on the crossing and influence each other of gastrointestinal surgery and abdominal wall hernia surgery. Although these two departments are independent respectively, but due to the existence of association among anatomy, physiology and pathology, so they are also overlapping. First of all, the abdominal wall and digestive tract are interdependent, and the abdominal wall provides "protection" for gut. In case of large abdominal wall defect, intra-abdominal viscera, breathing, circulation system and spine will change accordingly. In addition, when intra-abdominal pressure increases due to various reasons, laparotomy is an effective way. But laparotomy is not an easy case, but a crisis. One of the most difficult problems is "enteroatmospheric fistulae". Therefore, to avoid serious complications after laparotomy, the concept of planned ventral hernia is proposed. When life safety is threatened by inter-abdominal hypertension, planned abdominal wall hernia is the style to save life. This is a kind of concept of innovation, and is the concrete practice of the theory of damage control surgery. For a planned abdominal wall hernia patient, it is better to wait and watch, and after making a comprehensive assessment, multidisciplinary collaboration mode should be applied to ensure the safety of surgery. PMID:26616795

  18. Sir Ganga Ram Hospital classification of groin and ventral abdominal wall hernias

    Chowbey Pradeep

    2006-01-01

    all abdominal wall hernias and is a final classification that predicts the expected level of difficulty for an endoscopic hernia repair.

  19. Coexistence of congenital diaphragmatic hernia and abdominal wall closure defect with chromosomal abnormality: two case reports

    INOUE, SEIICHIRO; ODAKA, AKIO; Muta, Yuki; Beck, Yoshifumi; Sobajima, Hisanori; Tamura, Masanori

    2016-01-01

    Background We reported two rare cases of congenital diaphragmatic hernia with abdominal wall closure defect, which were not associated with septum transversum diaphragmatic defects or Fryns syndrome. Case presentation Case 1: a Japanese baby boy was delivered at 37 weeks’ gestation by urgent cesarean section because of the diagnosis of severe fetal distress. Congenital diaphragmatic hernia with omphalocele was prenatally diagnosed with fetal ultrasound. A ruptured omphalocele was confirmed at...

  20. The management of abdominal wall hernias – in search of consensus

    Bury, Kamil; Śmietański, Maciej

    2015-01-01

    Introduction Laparoscopic repair is becoming an increasingly popular alternative in the treatment of abdominal wall hernias. In spite of numerous studies evaluating this technique, indications for laparoscopic surgery have not been established. Similarly, implant selection and fixation techniques have not been unified and are the subject of scientific discussion. Aim To assess whether there is a consensus on the management of the most common ventral abdominal wall hernias among recognised experts. Material and methods Fourteen specialists representing the boards of European surgical societies were surveyed to determine their choice of surgical technique for nine typical primary ventral and incisional hernias. The access method, type of operation, mesh prosthesis and fixation method were evaluated. In addition to the laparoscopic procedures, the number of tackers and their arrangement were assessed. Results In none of the cases presented was a consensus of experts obtained. Laparoscopic and open techniques were used equally often. Especially in the group of large hernias, decisions on repair methods were characterised by high variability. The technique of laparoscopic mesh fixation was a subject of great variability in terms of both method selection and the numbers of tackers and sutures used. Conclusions Recognised experts have not reached a consensus on the management of abdominal wall hernias. Our survey results indicate the need for further research and the inclusion of large cohorts of patients in the dedicated registries to evaluate the results of different surgical methods, which would help in the development of treatment algorithms for surgical education in the future. PMID:25960793

  1. Abdominal wall hernias in the setting of cirrhosis.

    Belghiti, J; Durand, F

    1997-01-01

    In cirrhotic patients, umbilical hernias occur almost exclusively when longstanding ascites is present. Umbilical hernias expose cirrhotic patients to potentially life-threatening complications such as strangulation (which can be precipitated by rapid removal of ascitic fluid) and rupture (which is usually preceded by cutaneous ulcerations on the surface of the hernia). In cirrhotic patients, prevention of umbilical hernias is based on prevention of ascites. When prevention has failed, medical treatment of ascites should be first attempted. In patients in whom medical treatment is effective, and after ascites has disappeared, surgical treatment of umbilical hernia can be safely performed in most cases. In patients in whom medical treatment is ineffective and who develop refractory ascites, treatment strategy for umbilical hernia depends on the presence or absence of indication for liver transplantation. In patients who are candidates for liver transplantation, careful local care with pressure bandage must be performed until transplantation. Herniorrhaphy must be performed at the time of transplantation. In patients with refractory ascites, and who are not candidates for transplantation, portocaval shunt, transjugular intrahepatic portocaval shunt (both followed by surgical herniorrhaphy when ascites has disappeared) or concomitant peritoneo-venous shunt and herniorrhaphy should be considered. In contrast to umbilical hernias, groin hernias are not markedly influenced by ascites. However, ascites is a major risk factor for surgery. Therefore, surgical repair should not be recommended in patients with ascites and poor liver function. In cirrhotic patients with incisional hernia, prosthetic devices should be avoided because of the high risk of bacterial infection. PMID:9308126

  2. Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report

    Siow, Sze Li; Wong, Chee Ming; Hardin, Mark; Sohail, Mushtaq

    2016-01-01

    Background Traumatic diaphragmatic rupture and traumatic abdominal wall hernia are two well-described but rare clinical entities associated with blunt thoracoabdominal injuries. To the best of our knowledge, the combination of these two clinical entities as a result of a motor vehicle accident has not been previously reported. Case presentation A 32-year-old Indian man was brought to our emergency department after being involved in a road traffic accident. He described a temporary loss of con...

  3. A rare case of chronic traumatic diaphragmatic hernia requiring complex abdominal wall reconstruction

    Andrea Pakula; Amber Jones; Javed Syed; Ruby Skinner

    2015-01-01

    Introduction: Traumatic diaphragmatic hernia is a rare and often under recognized complication of penetrating and blunt trauma. These injuries are often missed or there is a delay in diagnosis which can lead to enlargement of the defect and the development of abdominal or respiratory symptoms. Presentation of case: We report a case of an otherwise healthy 37 year old male who was involved in a motor vehicle accident at age twelve. He presented 25 years later with vague lower abdominal symp...

  4. Economics of abdominal wall reconstruction.

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias. PMID:24035086

  5. Hernia

    ... surrounds the muscle. This layer is called the fascia. Which type of hernia you have depends on ... problems. Surgery repairs the weakened abdominal wall tissue (fascia) and closes any holes. Most hernias are closed ...

  6. [Preoperative progressive pneumoperitoneum in the treatment of giant abdominal hernias].

    Szekeres, Pál; Krémer, Ildikó; Bukovácz, Róbert; Varga, János

    2007-10-01

    Careful preoperative treatment of giant abdominal hernias can prevent severe postoperative complications such as abdominal compartment syndrome and uncontrollable cardiorespiratory failure. Our departments have been studying the various pathological conditions associated with enormous abdominal hernias (eventration disease) and the possibilities of preventing visceral abnormalities caused by the reconstruction of the abdominal wall. Here, we present the indication, technique and the results of using progressive preoperative pneumo-peritoneum based on two cases. PMID:17984016

  7. Sir Ganga Ram Hospital classification of groin and ventral abdominal wall hernias

    Chowbey Pradeep; Khullar Rajesh; Mehrotra Magan; Sharma Anil; Soni Vandana; Baijal Manish

    2006-01-01

    Background: Numerous classifications for groin and ventral hernias have been proposed over the past five to six decades. The old, simple classification of groin hernia in to direct, inguinal and femoral components is no longer adequate to understand the complex pathophysiology and management of these hernias. The most commonly followed classification for ventral hernias divide them into congenital, acquired, incisional and traumatic, which also does not convey any information regarding the p...

  8. Open and laparo-endoscopic repair of incarcerated abdominal wall hernias by the use of biological and biosynthetic meshes

    René H Fortelny

    2016-02-01

    Full Text Available Introduction: Although recently published guidelines recommend against the use of synthetic non-absorbable materials in cases of potentially contaminated or contaminated surgical fields due to the increased risk of infection [1, 2], the use of bio-prosthetic meshes for abdominal wall or ventral hernia repair is still controversially discussed in such cases. Bio-prosthetic meshes have been recommended due to less susceptibility for infection and the decreased risk of subsequent mesh explantation. The purpose of this review is to elucidate if there are any indications for the use of biological and biosynthetic meshes in incarcerated abdominal wall hernias based on the recently published literature.Methods: A literature search of the Medline database using the PubMed search engine, using the keywords returned 486 articles up to June 2015. The full text of 486 articles was assessed and 13 relevant papers were identified including 5 retrospective case cohort studies, 2 case controlled studies, 6 case series.Results: The results of Franklin et al [23, 24, 25] included the highest number of biological mesh repairs (Surgisis® by laparoscopic IPOM in infected fields which demonstrated a very low incidence of infection and recurrence (0,7% and 5,2%. Han et al [26] reported in his retrospective study the highest number of treated patients due to incarcerated hernias by open approach using acellular dermal matrix (ADM® with very low rate of infection as well as recurrences (1,6% and 15,9. Both studies achieved acceptable outcome in a follow up of at least 3,5 years compared to the use of synthetic mesh in this high-risk population [3]Conclusion:Currently there is a very limited evidence for the use of biological and biosynthetic meshes in strangulated hernias in either open or laparo-endoscopic repair. Finally, there is an urgent need to start with randomized controlled comparative trials as well as to support registries with data to achieve more

  9. Preoperative steroid in abdominal wall reconstruction

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo;

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  10. Bone Anchor Fixation in Abdominal Wall Reconstruction: A Useful Adjunct in Suprapubic and Para-iliac Hernia Repair.

    Blair, Laurel J; Cox, Tiffany C; Huntington, Ciara R; Ross, Samuel W; Kneisl, Jeffrey S; Augenstein, Vedra A; Heniford, B Todd

    2015-07-01

    Suprapubic hernias, parailiac or flank hernias, and lumbar hernias are difficult to repair and are associated with high-recurrence rates owing to difficulty in obtaining substantive overlap and especially mesh fixation due to bone being a margin of the hernia. Orthopedic suture anchors used for ligament reconstruction have been used to attach prosthetic material to bony surfaces and can be used in the repair of these hernias where suture fixation was impossible. A prospective, single institution study of ventral hernia repairs involving bone anchor mesh fixation was performed. Demographics, operative details, and outcomes data were collected. Twenty patients were identified, with a mean age 53 (range: 35-70 years) and mean body mass index 28.4 kg/m(2) (range 21-38). Ten lumbar, seven suprapubic, and three parailiac hernias were studied. The majority were recurrent hernias (n = 13), with one to seven previously failed repairs. The mean hernia defect size was very large (270 cm(2); range: 56-832 cm(2)) with average mesh size of 1090 cm(2) (range 224-3640 cm(2)). Both Mitek GII (Depuy, Raynham, MA) and JuggerKnot 2.9-mm (Biomet, Biomedical Instruments, Warsaw, IN) anchors were used, with an average of four anchors/case (range: 1-16). Mean operative time was 218 minutes (120-495). There were three minor complications, no operative mortality, and no recurrences during an average follow-up of 24 months. Pelvic bone anchors permit mesh fixation in high-recurrence areas not amenable to traditional suture fixation. The ability to safely and effectively use bone anchor fixation is an essential tool in complex open ventral hernia repair. PMID:26140889

  11. Recurrent incisional hernia, enterocutaneous fistula and loss of the substance of the abdominal wall: plastic with organic prosthesis, skin graft and VAC therapy. Clinical case.

    Nicodemi, Sara; Corelli, Sergio; Sacchi, Marco; Ricciardi, Edoardo; Costantino, Annarita; Di Legge, Pietro; Ceci, Francesco; Cipriani, Benedetta; Martellucci, Annunziata; Santilli, Mario; Orsini, Silvia; Tudisco, Antonella; Stagnitti, Franco

    2015-01-01

    Surgical wounds dehiscence is a serious post-operatory complication, with an incidence between 0.4% and 3.5%. Mortality is more than 45%. Complex wounds treatment may require a multidisciplinary management. VAC Therapy could be an alternative treatment regarding complex wound. VAC therapy has been recently introduced on skin's graft tissue management reducing skin graft rejection. The use of biological prosthesis has been tested in a contaminated field, better than synthetic meshes, which often need to be removed. The Permacol is more resistant to degradation by proteases due to its cross-links. Surgery is still considered the best treatment for digestive fistula. A 58 years old obese woman come to our attention, she was operated for an abdominal hernia. She had a post-operatory entero-cutaneous fistula. She was submitted to bowel resection, the anastomosis has been tailored and the hernia of the abdominal wall has been repaired with biological mesh for managing such condition. She had a wound dehiscence with loss of substance and the exposure of the biological prosthesis, nearly 20 cm diameter. She was treated first with antibiotic therapy and simple medications. In addiction, antibiotic therapy was necessary late associated to 7 months with advanced medications allowed a small reduction's defect. Because of its, treatment went on for two more months using VAC therapy. Antibiotic's therapy was finally suspended. The VAC therapy allowed the reduction of the gap, between skin and subcutaneous tissue, and the defect's size preparing a suitable ground for the skin graft. The graft, managed with the vac therapy, was necessary to complete the healing process. PMID:25953007

  12. Evaluation of crosslinked and non-crosslinked biologic prostheses for abdominal hernia repair

    de Castro Brás, L. E.; Shurey, S.; Sibbons, P. D.

    2011-01-01

    Introduction Abdominal wall defects and incisional hernias represent a challenging problem. Currently, several commercially available biologic prostheses are used clinically for hernia repair. We compared the performance and efficacy of two non-crosslinked meshes in ventral hernia repair to two crosslinked prostheses in a rodent model. Methods Animals were divided into 12 groups (4 matrix types and 3 termination time-points per matrix). A ventral defect was carefully created and overlapped wi...

  13. Abdominal muscle function and incisional hernia

    Jensen, K K; Kjaer, M; Jorgensen, L N

    2014-01-01

    PURPOSE: Although ventral incisional hernia (VIH) repair in patients is often evaluated in terms of hernia recurrence rate and health-related quality of life, there is no clear consensus regarding optimal operative treatment based on these parameters. It was proposed that health-related quality...... of life depends largely on abdominal muscle function (AMF), and the present review thus evaluates to what extent AMF is influenced by VIH and surgical repair. METHODS: The PubMed and EMBASE databases were searched for articles following a systematic strategy for inclusion. RESULTS: A total of seven...... studies described AMF in relation to VIH. Five studies examined AMF using objective isokinetic dynamometers to determine muscle strength, and two studies examined AMF by clinical examination-based muscle tests. CONCLUSION: Both equipment-related and functional muscle tests exist for use in patients...

  14. Clinical study on laparoscopic vs.open treatments for geriatric abdominal wall incision hernia%腹腔镜与开放手术治疗老年腹壁切口疝的临床研究

    王嘉; 安伟德; 李玉文; 徐雪东; 张伟国

    2015-01-01

    目的 探讨开放与腹腔镜切口疝修补术对老年腹壁切口疝患者的临床疗效.方法 分析60周岁以上腹壁切口疝患者52例的临床资料,其中开放组24例,腹腔镜组28例.结果 两组在手术时间、切口感染、血清肿方面比较差异无统计学意义(P>0.05),但腹腔镜组术中出血量[(9±4) ml]、住院时间[(8±3)d]、术后疼痛7例(25.01%),明显优于开放组(P<0.05).两组均无患者死亡,随访3个月至2年,开放组复发3例,腹腔镜组未见复发.结论 两种治疗方法同样安全有效,但腹腔镜切口疝修补术具有创伤小、疼痛轻、恢复快、住院时间短等优点.%Objective To explore the clinical effectiveness of open incisional hernia repair vs.laparoscopic incisional hernia repair for geriatric abdominal wall incisional hernia.Methods The clinical data of 52 patients above 60 years old with abdominal wall incisional hernia were analyzed,including 24 cases in the open group and 28 cases in the laparoscopic group.Results No significant difference in operation time,wound infection,and seromas was observed.However,blood loss [(9 ± 4) ml] was reduced,and hospital stay [(g ±3) d] was shortened in the laparoscopic group as compared with the open group.Postoperative pain occurred in 7 cases (25.01%) of laparoscopie group.There were no deaths in both two groups.During a follow-up period of 3 months to 2 years,there were 3 relapsed cases in the open group,and no recurrence occurred in the laparoscopic group.Conclusion Both open and laparoscopic treatments are safe and effective,but laparoseopie incisional hernia repair has the less trauma,milder pain,more rapid recovery,and shorter hospital stays for geriatric abdominal wall incisional hernia.

  15. Tensor fascia lata musculocutaneous flap for abdominal wall reconstruction

    We report a case of abdominal wall reconstruction following excision of irradiated skin and a ventral hernia. A very large tensor fascia lata musculocutaneous flap was used with good results. The anatomical features of this flap make it an excellent method of abdominal wall reconstruction

  16. Repair of Postoperative Abdominal Hernia in a Child with Congenital Omphalocele Using Porcine Dermal Matrix.

    Lambropoulos, V; Mylona, E; Mouravas, V; Tsakalidis, C; Spyridakis, I; Mitsiakos, G; Karagianni, P

    2016-01-01

    Introduction. Incisional hernias are a common complication appearing after abdominal wall defects reconstruction, with omphalocele and gastroschisis being the most common etiologies in children. Abdominal closure of these defects represents a real challenge for pediatric surgeons with many surgical techniques and various prosthetic materials being used for this purpose. Case Report. We present a case of repair of a postoperative ventral hernia occurring after congenital omphalocele reconstruction in a three-and-a-half-year-old child using an acellular, sterile, porcine dermal mesh. Conclusion. Non-cross-linked acellular porcine dermal matrix is an appropriate mesh used for the reconstruction of abdominal wall defects and their postoperative complications like large ventral hernias with success and preventing their recurrence. PMID:27110247

  17. Repair of Postoperative Abdominal Hernia in a Child with Congenital Omphalocele Using Porcine Dermal Matrix

    V. Lambropoulos

    2016-01-01

    Full Text Available Introduction. Incisional hernias are a common complication appearing after abdominal wall defects reconstruction, with omphalocele and gastroschisis being the most common etiologies in children. Abdominal closure of these defects represents a real challenge for pediatric surgeons with many surgical techniques and various prosthetic materials being used for this purpose. Case Report. We present a case of repair of a postoperative ventral hernia occurring after congenital omphalocele reconstruction in a three-and-a-half-year-old child using an acellular, sterile, porcine dermal mesh. Conclusion. Non-cross-linked acellular porcine dermal matrix is an appropriate mesh used for the reconstruction of abdominal wall defects and their postoperative complications like large ventral hernias with success and preventing their recurrence.

  18. Repair of Postoperative Abdominal Hernia in a Child with Congenital Omphalocele Using Porcine Dermal Matrix

    Mylona, E.; Tsakalidis, C.; Spyridakis, I.; Mitsiakos, G.; Karagianni, P.

    2016-01-01

    Introduction. Incisional hernias are a common complication appearing after abdominal wall defects reconstruction, with omphalocele and gastroschisis being the most common etiologies in children. Abdominal closure of these defects represents a real challenge for pediatric surgeons with many surgical techniques and various prosthetic materials being used for this purpose. Case Report. We present a case of repair of a postoperative ventral hernia occurring after congenital omphalocele reconstruction in a three-and-a-half-year-old child using an acellular, sterile, porcine dermal mesh. Conclusion. Non-cross-linked acellular porcine dermal matrix is an appropriate mesh used for the reconstruction of abdominal wall defects and their postoperative complications like large ventral hernias with success and preventing their recurrence. PMID:27110247

  19. Endometriosis Abdominal wall

    Endometriosis of abdominal wall is a rare entity wi ch frequently appears after gynecological surgery. Case history includes three cases of parietal endometriosis wi ch were treated in Maciel Hospital of Montevideo. The report refers to etiological diagnostic aspects and highlights the importance of total resection in order to achieve definitive healing

  20. Incarcerated Grynfeltt-Lesshaft Hernia

    Scheffler, Max; Renard, Julien; Bucher, Pascal; Botsikas, Diomidis

    2015-01-01

    Superior lumbar triangle hernia, also known as Grynfeltt-Lesshaft hernia, denotes a subtype of abdominal wall hernia, and more specifically of lumbar hernia, occurring between the 12th rib, the internal oblique muscle, and the quadratus lumborum muscle. We report the case of a 92-year-old female patient in which this form of hernia occurred, complicated by incarceration and acute bowel obstruction. The discussion contains a short résumé of the different kinds of abdominal wall hernias.

  1. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.

    Taylor, D C; Meyers, W C; Moylan, J A; Lohnes, J; Bassett, F H; Garrett, W E

    1991-01-01

    There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months. PMID:1831010

  2. Biologic mesh for abdominal wall reconstruction

    King KS

    2014-11-01

    Full Text Available Kathryn S King,1 Frank P Albino,2 Parag Bhanot3 1School of Medicine, Georgetown University Hospital, Washington, DC, USA; 2Department of Plastic Surgery, 3Department of General Surgery, Georgetown University Hospital, Washington, DC, USA Background: Mesh reinforcement significantly decreases rates of recurrence following ventral hernia repair. Historically, biologic mesh was touted as superior in the setting of infection; however, selecting the appropriate mesh for a given clinical scenario is often a matter of debate. The purpose of this review is to highlight a number of the more commonly used biologic mesh products with a review of outcomes from the current literature. Methods: Outcomes following abdominal wall reconstruction using biologic mesh were reviewed for acellular cadaveric human dermis, cross-linked porcine dermis, non-cross-linked porcine dermis, porcine small intestine submucosa, acellular bovine pericardial, and acellular bovine dermal mesh. Studies with rigorous methods, adequate patient samples, and sufficient follow-up were selected for review. Results: Hernia recurrence rates following biologic mesh reinforcement vary widely. Porcine small intestine submucosa and bovine pericardium were associated with the lowest hernia recurrence rates. Porcine cross-linked dermal mesh products resulted in higher rates of adhesion formation and lower rates of tissue incorporation compared to non-cross-linked porcine mesh. Conclusion: Successful ventral hernia repair can be achieved with acceptable complications rates for each of the reviewed mesh products. Biologic meshes have an advantage over synthetic mesh in contaminated wounds but their use may not be cost-effective in all patient populations. Those with and/or at high risk for wound complications may also undergo repair with biologic mesh. Keywords: biologic mesh, ventral hernia repair, acellular dermal matrix 

  3. Abdominal wall hernia repair with a composite ePTFE/polypropylene mesh: clinical outcome and quality of life in 152 patients

    Iversen, E; Lykke, Anna; Hensler, M; Jørgensen, Lars Nannestad

    2010-01-01

    No consensus has yet been reached regarding the optimal mesh for the repair of small ventral hernias. A composite polytetrafluoroethylene/polypropylene mesh (Ventralex(®)) is designed for this purpose, and this paper reports its use in a larger series of patients....

  4. Multiple bowel perforation and necrotising fasciitis secondary to abdominal liposuction in a patient with bilateral lumbar hernia

    Vincent Delliere; Bertheuil, N.; Harnois, Y.; S Thienot; Gerard, M.; Robert, M; Watier, E.

    2014-01-01

    We present a rare complication of abdominal liposuction: bowel perforation and necrotizing fasciitis. Because of bilateral lumbar hernia, a 56-year-old woman had caecum and descending colon perforation during lipoplasty. She had septic shock syndrome at her admission. The authors treated this complex wound with several debridement, omental flap, NPWT and split-thickness skin graft. The incidence of abdominal wall perforation with visceral injury is 14 in 100,000 liposuctions performed. There ...

  5. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries. (orig.)

  6. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance

    Stensby, J.D. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States); Mallinckrodt Institute of Radiology, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO (United States); Baker, Jonathan C. [Mallinckrodt Institute of Radiology, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO (United States); Fox, Michael G. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States)

    2016-02-15

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries. (orig.)

  7. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance.

    Stensby, J Derek; Baker, Jonathan C; Fox, Michael G

    2016-02-01

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries. PMID:26450606

  8. Practical Approaches to Definitive Reconstruction of Complex Abdominal Wall Defects.

    Latifi, Rifat

    2016-04-01

    With advances in abdominal surgery and the management of major trauma, complex abdominal wall defects have become the new surgical disease, and the need for abdominal wall reconstruction has increased dramatically. Subsequently, how to reconstruct these large defects has become a new surgical question. While most surgeons use native abdominal wall whenever possible, evidence suggests that synthetic or biologic mesh needs to be added to large ventral hernia repairs. One particular group of patients who exemplify "complex" are those with contaminated wounds, enterocutaneous fistulas, enteroatmospheric fistulas, and/or stoma(s), where synthetic mesh is to be avoided if at all possible. Most recently, biologic mesh has become the new standard in high-risk patients with contaminated and dirty-infected wounds. While biologic mesh is the most common tissue engineered used in this field of surgery, level I evidence is needed on its indication and long-term outcomes. Various techniques for reconstructing the abdominal wall have been described, however the long-term outcomes for most of these studies, are rarely reported. In this article, I outline current practical approaches to perioperative management and definitive abdominal reconstruction in patients with complex abdominal wall defects, with or without fistulas, as well as those who have lost abdominal domain. PMID:26585951

  9. Implantation of Bladder Cancer into the Abdominal Wall; a Case Report

    M Ghafoori; M. Narooinejad; D. Saedi; Asgari, M.

    2006-01-01

    Implantation of high grade and invasive bladder carcinoma into the abdominal wall is not common and can occur as side effects of uninary bladder interventions and surgical procedures, including perforation of bladder wall during transurethral resection of the tumor. Herein, we present a case of implantation of bladder transitional cell carcinoma into abdominal wall into an incisional hernia of a previous small bowel operation; three years after the bladder tumor had been diagnosed and treated...

  10. Multiple bowel perforation and necrotising fasciitis secondary to abdominal liposuction in a patient with bilateral lumbar hernia

    Vincent Delliere

    2014-01-01

    Full Text Available We present a rare complication of abdominal liposuction: bowel perforation and necrotizing fasciitis. Because of bilateral lumbar hernia, a 56-year-old woman had caecum and descending colon perforation during lipoplasty. She had septic shock syndrome at her admission. The authors treated this complex wound with several debridement, omental flap, NPWT and split-thickness skin graft. The incidence of abdominal wall perforation with visceral injury is 14 in 100,000 liposuctions performed. There are only 12 cases of bowel perforation in literature but this complication is probably underestimated. Prompt surgical debridement is absolutely mandatory in this life threatening scenario. Lumbar hernia is very rare and should be ruled out before every abdominal liposuction clinically or with imaging modalities.

  11. A Large Intra-Abdominal Hiatal Hernia as a Rare Cause of Dyspnea

    Cem Sahin

    2015-01-01

    Full Text Available Giant hiatal hernias, generally seen at advanced ages, can rarely cause cardiac symptoms such as dyspnea and chest pain. Here, we aimed to present a case with a large hiatal hernia that largely protruded to intrathoracic cavity and caused dyspnea, particularly at postprandial period, by compressing the left atrium and right pulmonary vein. We considered presenting this case as large hiatal hernia is a rare, intra-abdominal cause of dyspnea.

  12. Use of biological meshes for abdominal wall reconstruction in highly contaminated fields

    Andrea; Cavallaro; Emanuele; Lo; Menzo; Maria; Di; Vita; Antonio; Zanghì; Vincenzo; Cavallaro; Pier; Francesco; Veroux; Alessandro; Cappellani

    2010-01-01

    Abdominal wall defects and incisional hernias represent a challenging problem. In particular, when a synthetic mesh is applied to contaminated wounds, its removal is required in 50%-90% of cases. Biosynthetic meshes are the newest tool available to surgeons and they could have a role in ventral hernia repair in a potential-ly contaminated field. We describe the use of a sheet of bovine pericardium graft in the reconstruction of abdominal wall defect in two patients. Bovine pericardium graft was placed in th...

  13. Contribution of the skin, rectus abdominis and their sheaths to the structural response of the abdominal wall ex vivo

    TRAN, Doris; Mitton, David; Voirin, David; TURQUIER, Frédéric; Beillas, Philippe

    2014-01-01

    A better understanding of the abdominal wall biomechanics could help designing new treatments for incisional hernia. In the current study, a new experimental protocol was developed to evaluate the contributions of the abdominal wall components to the mechanical response of the anterior part of the abdominal wall. The specimens underwent 3 dissections (removal of 1: skin and subcutaneous fat, 2: anterior rectus sheath, 3: rectus abdominis muscles). After each dissection, they were subjected to...

  14. Implantation of Bladder Cancer into the Abdominal Wall; a Case Report

    M. Ghafoori

    2006-05-01

    Full Text Available Implantation of high grade and invasive bladder carcinoma into the abdominal wall is not common and can occur as side effects of uninary bladder interventions and surgical procedures, including perforation of bladder wall during transurethral resection of the tumor. Herein, we present a case of implantation of bladder transitional cell carcinoma into abdominal wall into an incisional hernia of a previous small bowel operation; three years after the bladder tumor had been diagnosed and treated. In evaluating any mass lesion in the abdominal wall, it is important to consider the possibility of bladder tumor implantation.

  15. Ultrasonographic evaluation of massive abdominal wall swellings in cattle and buffaloes

    Kumar, Ashwani; Mohindroo, Jitender; Sangwan, Vandana; Mahajan, Shashi Kant; SINGH, Kiranjeet; Anand, Arun; Saini, Narinder Singh

    2014-01-01

    Eight cows and 7 buffaloes with massive abdominal wall swellings were examined. The aim of the ultrasonographic study was to learn the contents of the abdominal wall swellings. They were divided into 4 groups: Group I (prepubic tendon rupture or hernia), Group II (fibrino-cystic swelling), Group III (abscess), and Group IV (inflammatory swelling). Palpation of the swelling in semidorsal recumbency, needle aspiration, or surgery was used to confirm the diagnosis. In animals of Groups I, II, an...

  16. Abdominal wall repair with human acellular dermal autograft

    Roel E. Genders

    2011-12-01

    Full Text Available Repair of abdominal wall defects in the presence of contamination or infection is a significant problem. The loss of tissue warrants enforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive surgery. This paper presents a review of available literature of placement of an acellular human dermis to repair an abdominal fascia defect, in contaminated as well as in non-contaminated surgical fields. It is illustrated with a case report that describes the successful reconstruction of an infected abdominal wall defect with a human acellular dermis allograft. A systematic literature review was undertaken with searches performed in the Pubmed and Cochrane databases for the period up till March 2009, using the search terms Alloderm [Substance Name], Hernia [Mesh] and the key words acellular dermis, acellular dermal matrix, human acellular dermal allograft and abdominal wall defect. To assess methodological quality, each article was subjected to a modification of the methodological index for non-randomized studies (MINORS according to Slim et al. Two items from the original index were not included because none of the studies selected had an unbiased assessment of the study end points and in none of the studies was a prospective calculation of the study size performed. Seventeen studies were included in the review. Data were extracted regarding study design, number of patients, surgical technique, followup period, contaminated or non-contaminated area of the fascia defect, mortality and morbidity (hemorrhage, seroma, wound dehiscence, infection of the operative procedure, the longterm results (removal of the graft, reherniation and bulging and level of evidencey. A total of 169 short-term complications and 151 longterm complications occurred after 643 surgical procedures reconstructing both contaminated and clean abdominal wall defects by implantation of an HADA. Human acellular dermal allograft

  17. Primary Grynfeltt’s Hernia

    Belekar, Dnyanesh Madhukar; Dewoolkar, Vinayak V.; Desai, Amit A.; Butala, Ushma K.

    2013-01-01

    Lumbar hernia is a rare defect of the abdominal wall. It accounts for 2 % of all wall hernias. It is divided in two levels: superior lumbar hernia, also known as Grynfeltt’s hernia (GH), and an inferior lumbar hernia or Petit’s hernia. GH is more commonly encountered in practice, and it is mainly posttraumatic in origin. Spontaneous primary GH is quite rare. Only 250 to 300 of such cases have been reported the in literature so far. The treatment of choice is retroperitoneal surgical approach ...

  18. Treatment of Abdominal Segmental Hernia, Constipation, and Pain Following Herpes Zoster with Paravertebral Block.

    Kim, Saeyoung; Jeon, Younghoon

    2015-01-01

    Herpes zoster (HZ) most commonly occurs in elderly patients and involves sensory neurons resulting in pain and sensory changes. Clinically significant motor deficits and visceral neuropathies are thought to be relatively rare. A 72-year-old man presented with abdominal segmental hernia, constipation, and pain following HZ in the left T9-10 dermatome. Sixteen days before presentation, he had developed a painful herpetic rash in the left upper abdominal quadrant. Approximately 10 days after the onset of the rash, constipation occurred and was managed with daily oral medication with bisacodyl 5 mg. In addition, 14 days after the onset of HZ, the patient noticed a protrusion of the left upper abdominal wall. Abdominal x-ray, ultrasound of the abdomen, and electrolyte analysis showed no abnormalities. General physical examination revealed a reducible bulge in his left upper quadrant and superficial abdominal reflexes were diminished in the affected region. Electromyographic testing revealed denervational changes limited to the left thoracic paraspinal muscles and supraumbilical muscles, corresponding to the affected dermatomes. He was prescribed with 500 mg of famciclovir 3 times a day for 7 days, and pregabalin 75 mg twice a day and acetaminophen 650 mg 3 times a day for 14 days. However, his pain was rated at an intensity of 5 on the numerical analogue scale from 0 (no pain) to 10 (worst pain imaginable). A paravertebral block was performed at T9-10 with a mixture of 0.5% lidocaine 3 mL and triamcinolone 40 mg. One day after the procedure, the abdominal pain disappeared. In addition, 5 days after the intervention, the abdominal protrusion and constipation were resolved. He currently remains symptom free at a 6 month follow-up. PMID:26431148

  19. [Disease picture of intra-abdominal hernias in childhood].

    Waldschmidt, J; Pankrath, K; Charissis, G

    1985-01-01

    Through the demonstration of 3 cases (6-year-old-girl with right mesenterico-parietal hernia; 2 year-old-boy with a transverso-mesocolic hernia; 10-months-old-boy with a hernia in the mesenterium of a M.D.) we discuss the problems of intraabdominal hernia. The evaluation of the disease can take many forms. Only one third of the children remains without symptoms; the other third has a chronic evaluation and the last third an acute abdomen. Once diagnosed internal hernia must soon be operated. PMID:4058161

  20. [A case of abdominal wall actinomycosis].

    Kim, Kyung Hoon; Lee, Jin Soo; Cho, Hyeong Jun; Choi, Seung Bong; Cheung, Dae Young; Kim, Jin Il; Lee, In Kyu

    2015-04-01

    Actinomycosis is a chronic suppurative granulomatous infectious disease caused by actinomyces species that is characterized by formation of characteristic clumps called as sulfur granules. Abdominal actinomycosis is a rare disease and is often difficult to diagnose before operation. Abdominal actinomycosis infiltrating into the abdominal wall and adhering to the colon is even rarer. Most abdominal actinomycosis develops after operation, trauma or inflammatory bowel disease, and is also considered as an opportunistic infection in immunocompromised patient with underlying malignancy, diabetes mellitus, human immunodeficiency virus infection, etc. Actinomycosis is diagnosed based on histologic demonstration of sulfur granules in surgically resected specimen or pus, and treatment consists of long-term penicillin based antibiotics therapy with or without surgical resection. Herein, we report an unusual case of abdominal wall actinomycosis which developed in a patient after acupuncture and presented as abdominal wall mass that was first mistaken for abdominal wall invasion of diverticulum perforation. PMID:25896158

  1. Synovial sarcoma of the abdominal wall

    A case report of synovial sarcoma arising in the abdominal wall is presented. A brief review of the clinical and radiological features of synovial sarcoma is made. Pre-operative diagnosis of an abdominal wall synovial sarcoma is virtually impossible, but should be considered when a soft tissue swelling is found to show amorphous stippled calcification X-ray. (author)

  2. Abdominal Wall Modification for the Difficult Ostomy

    Beck, David E.

    2008-01-01

    A select group of patients with major stomal problems may benefit from operative modification of the abdominal wall. Options may include a modified abdominoplasty (abdominal wall contouring), localized flaps, or liposuction. Although frequently successful, these techniques have the potential for significant morbidity.

  3. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available COMPONENT SEPARATION FOR COMPLEX ABDOMINAL WALL RECONSTRUCTION ALBANY MEDICAL CENTER ALBANY, NY April 30, 2008 00:00:07 ANNOUNCER: This event is being ... the premiere webcast of a component separation for complex abdominal-wall reconstruction, performed by Dr. Jerome D. ...

  4. Lumbar hernia associated with chronic obstructive pulmonary disease (COPD)

    Xu, Tao; Zhang, Shuwei; Wang, Huaying; YU, WANJUN

    2013-01-01

    Lumbar hernias are very rare posterolateral abdominal wall hernias, and they are spontaneous in most adult patients. Here we report two cases of spontaneous lumbar hernias associated with chronic obstructive pulmonary disease (COPD). Some factors such as chronic cough, poor nutritional status and old age in patients with COPD would contribute to lumbar hernia.

  5. Reconstruction of full thickness abdominal wall defect following tumor resection: A case report

    Kovačević Predrag

    2014-01-01

    Full Text Available Introduction. Reconstruction of a full thickness abdominal wall defect is a demanding procedure for general and also for plastic surgeons, requiring vigorous planning and reconstruction of three layers. Case Outline. We present a case of a 70-year-old patient with a huge abdominal wall tumor with 40 years evolution. Surgery was performed under general anesthesia. Full thickness abdominal defect appeared after the tumor resection. Reconstruction followed in the same act. The defect was reconstructed using a combination of techniques, including omental flap, fascia lata graft, local skin flaps and skin grafts. After surgery no major complications were noted, only a partial skin flap loss, which was repaired using partial thickness skin grafts. The final result was described by the patient as very good, without hernia formation. Conclusion. Omenthoplasty, abdominal wall reconstruction in combination with free fascia lata graft and skin grafts can be one of good options for the reconstruction of full thickness abdominal wall defects.

  6. Acute direct inguinal hernia resulting from blunt abdominal trauma: Case Report

    Hipkins Gabrielle; Vedanayagam Maria; Biswas Seema; Leather Andrew

    2010-01-01

    Abstract We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential ...

  7. Left paramesocolic hernia presenting as post appendicectomy abdominal cocoon.

    Patel, Ramnik; Gabra, H Os; Nour, Shawqui

    2010-11-01

    We describe a rare case of left mesocolic hernia presenting as post appendicectomy intestinal obstruction in a girl. Laparotomy confirmed partial peritoneal encapsulation of upper small bowel due to herniation of jejunal loops into the left mesocolic hernia sac. Reduction of contents, resection of the sac and repair of the defect concluded the procedure uneventfully. PMID:21149902

  8. Changes in muscle strength and pain in response to surgical repair of posterior abdominal wall disruption followed by rehabilitation

    Hemingway, A.; Herrington, L.; Blower, A

    2003-01-01

    Background: Posterior abdominal wall deficiency (PAWD) is a tear in the external oblique aponeurosis or the conjoint tendon causing a posterior wall defect at the medial end of the inguinal canal. It is often known as sportsman's hernia and is believed to be caused by repetitive stress.

  9. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available COMPONENT SEPARATION FOR COMPLEX ABDOMINAL WALL RECONSTRUCTION ALBANY MEDICAL CENTER ALBANY, NY April 30, 2008 00:00: ... Koumanis. The surgery comes to you from Albany Medical Center in Albany, New York. In just moments, ...

  10. Genetics Home Reference: abdominal wall defect

    ... size and can usually be diagnosed early in fetal development, typically between the tenth and fourteenth weeks of ... organs at the abdominal wall opening late in fetal development may also contribute to organ injury. Intestinal damage ...

  11. Anesthetic Considerations for Abdominal Wall Reconstructive Surgery

    Slabach, Rachel; Suyderhoud, Johan P.

    2012-01-01

    Anesthesia considerations for abdominal wall reconstruction (AWR) are numerous and depend upon the medical status of the patient and the projected procedure. Obesity, sleep apnea, hypertension, and cardiovascular disease are not uncommon in patients with abdominal wall defects; pulmonary functions and cardiac output can be affected by the surgical procedure. Patients with chronic obstructive pulmonary disease are also at a higher risk of coughing during the postoperative awakening process, wh...

  12. Radiologic findings of abdominal wall endometriosis

    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer

  13. Radiologic findings of abdominal wall endometriosis

    Seo, Jung Wook [Inje Univ. Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2003-12-01

    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer.

  14. [Pneumoperitoneum in surgical management of giant scrotal hernias].

    Limmer, S; Miksch, T; Fiederer, M; Sterk, P

    2006-03-01

    Surgical treatment of giant abdominal hernias includes reduction of the hernia content and tension-free closure of the abdominal wall. Initial laparoscopy simulates the postoperative abdominal wall tension. Recognizing the need for a preoperative pneumoperitoneum in cases of chronic eventration may help to avoid "abdominal catastrophes" including bowel resection, abdominal compartment, and extended abdominal wall reconstruction. We report a 66-year-old man with an asymptomatic long-standing giant scrotal hernia who was admitted with sepsis and uremia caused by intestinal obstruction. PMID:16395576

  15. Laparoscopic transabdominal extraperitoneal mesh repair of lumbar hernia

    Nam, Soon Young; Kee, Se Kook; Kim, Jae Oh

    2011-01-01

    Lumbar hernias are rare posterolateral abdominal wall defects that may be congenital or acquired. There are two types of lumbar hernia, the superior lumbar hernia through Grynfeltt triangle, and the inferior lumbar hernia through Petit triangle. Many techniques have been described for the surgical repair of lumbar hernias including primary repair, local tissue flaps, and conventional mesh repair. But these open techniques require a large skin incision. We report a case of superior lumbar hern...

  16. Laparoscopic repair of an incarcerated femoral hernia

    Yagan Pillay

    2015-01-01

    Introduction: A femoral hernia is a rare, acquired condition, which has been reported in less than 5% of all abdominal wall hernias, with a female to male ratio of 4:1. Presentation of case: We report a case in a female patient who had a previous open inguinal herniorrhaphy three years previously. She presented with right sided groin pain of one month duration. Ultrasound gave a differential diagnosis of a recurrent inguinal hernia or a femoral hernia. A transabdominal preperitoneal repair...

  17. Primary lumbar hernia: A rarely encountered hernia

    Sharada Sundaramurthy; H.B. Suresh; Anirudh, A.V.; Anthony Prakash Rozario

    2016-01-01

    Introduction: Lumbar hernia is an uncommon abdominal wall hernia, making its diagnosis and management a challenge to the treating surgeon. Presentation may be misleading and diagnosis often missed. An imaging study forms an indispensable aid in the diagnosis and surgery is the only treatment option. Presentation of case: A 42 year old male presented with history of pain in lower back of 4 years duration and was being treated symptomatically over 4 years with analgesics and physiotherapy. H...

  18. Acute direct inguinal hernia resulting from blunt abdominal trauma: Case Report

    Hipkins Gabrielle

    2010-06-01

    Full Text Available Abstract We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers. To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal. Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.

  19. A preclinical evaluation of alternative synthetic biomaterials for fascial defect repair using a rat abdominal hernia model.

    Daniela Ulrich

    Full Text Available INTRODUCTION: Fascial defects are a common problem in the abdominal wall and in the vagina leading to hernia or pelvic organ prolapse that requires mesh enhancement to reduce operation failure. However, the long-term outcome of synthetic mesh surgery may be unsatisfactory due to post-surgical complications. We hypothesized that mesh fabricated from alternative synthetic polymers may evoke a different tissue response, and provide more appropriate mechanical properties for hernia repair. Our aim was to compare the in vivo biocompatibility of new synthetic meshes with a commercial mesh. METHODS: We have fabricated 3 new warp-knitted synthetic meshes from different polymers with different tensile properties polyetheretherketone (PEEK, polyamide (PA and a composite, gelatin coated PA (PA+G. The rat abdominal hernia model was used to implant the meshes (25 × 35 mm, n = 24/ group. After 7, 30, 60, 90 days tissues were explanted for immunohistochemical assessment of foreign body reaction and tissue integration, using CD31, CD45, CD68, alpha-SMA antibodies. The images were analysed using an image analysis software program. Biomechanical properties were uniaxially evaluated using an Instron Tensile® Tester. RESULTS: This study showed that the new meshes induced complex differences in the type of foreign body reaction over the time course of implantation. The PA, and particularly the composite PA+G meshes, evoked a milder early inflammatory response, and macrophages were apparent throughout the time course. Our meshes led to better tissue integration and new collagen deposition, particularly with the PA+G meshes, as well as greater and sustained neovascularisation compared with the PP meshes. CONCLUSION: PA, PA+G and PEEK appear to be well tolerated and are biocompatible, evoking an overlapping and different host tissue response with time that might convey mechanical variations in the healing tissue. These new meshes comprising different polymers may

  20. A primary idiopathic superior lumbar triangle hernia with congenital right scoliosis: A rare clinical presentation and management

    Pachani, Ankur Bhupendrakumar; Reza, Ali; Jadhav, Raviraj V; Mathews, Saumya

    2011-01-01

    Primary lumbar hernias are rarest form of hernias as compared to other ventral abdominal wall hernias. Only scattered reports of hernias of both superior and inferior lumbar triangles have appeared in both the English and foreign literature. There are only about 300 cases of primary lumbar hernia being reported. Being a rare entity, it had always posed diagnostic and treatment dilemma to the surgeons. The diagnosis requires imaging studies in such cases. Treatment of lumbar hernia is always s...

  1. Dystrophies of the abdominal wall in adults: Surgical treatment

    Jayme Fortunato Athias

    1997-03-01

    Full Text Available The authors present a retrospective study of 60 patients with abdominal dystrophies, both with and without hernias, operated on in the period between 01 June 1994 and 30 January 1996. Their average age was 47 years. The incision at hernia itself and the dystrophic abdomen were the principal objects of the study. The authors show the importance of abdominal dermolipectomy for the complete recovery of the patient as well as demonstrate how it facilitates the technical manipulation of hernias. The technique of bilateral, longitudinal peritonio-aponeurotic transposition {the technique of Alcíno Lázaro da Silva was used for large incisional hernias. A variation of this technique, for hernias with a hernial ring of up to 10 cm, is proposed by the authors, which consists in the closing of the ring and the reinforcement of the suture with the hernial sac. A revision is made of the results of these procedures realized in isolation and accompanied with abdominal dermolipectomy. Forty-nine recovered without complications (81.66%, three relapsed (5%, one necrosis of the midline with respiratory failure (1.67%, one little stitch gap (1,67%, two umbilical stenosis (3,33%, two wound abscess (3.33%, one cutaneous fistula (1,67% and one death from pulmonary embolism (1.66%.

  2. Radical cystectomy and pelvic lymphadenectomy with ileal conduit urinary diversion and abdominal wall reconstruction: an interesting case of multidisciplinary management

    Sofos SS

    2015-01-01

    Full Text Available Stratos S Sofos,1 Ciaran Walsh,2 Nigel J Parr,2 Kevin Hancock11Whiston Hospital, Prescot, 2Arrowe Park Hospital, Wirral, Merseyside, UKAbstract: The ileal conduit for urinary diversion after radical cystectomy is a well-described procedure. Furthermore, parastomal hernias, prolapse, stenosis, and retraction of the stoma have been reported as some of the more common complications of this procedure. The subsequent repair of parastomal hernias with a biological mesh and the potential of the conduit to “tunnel” through it has also been described. In this case report, we present a combined repair of a large incisional hernia with a cystectomy and a pelvic lymphadenectomy for invasive bladder cancer, with the use of a biological mesh for posterior component abdominal wall primary repair as well as for support to the ileal conduit used for urinary diversion.Keywords: incisional hernia, posterior component separation, biological mesh 

  3. Soft-tissue masses in the abdominal wall

    Masses involving the abdominal wall arise from a large number of aetiologies. This article will describe a diagnostic approach, imaging features of the most common causes of abdominal wall masses, and highly specific characteristics of less common diseases. A diagnostic algorithm for abdominal wall masses combines clinical history and imaging appearances to classify lesions

  4. Sports Hernia Treatment

    Economopoulos, Kostas J.; Milewski, Matthew D.; Hanks, John B.; Hart, Joseph M.; Diduch, David R.

    2013-01-01

    Background: The minimal repair technique for sports hernias repairs only the weak area of the posterior abdominal wall along with decompressing the genitofemoral nerve. This technique has been shown to return athletes to competition rapidly. This study compares the clinical outcomes of the minimal repair technique with the traditional modified Bassini repair. Hypothesis: Athletes undergoing the minimal repair technique for a sports hernia would return to play more rapidly compared with athlet...

  5. Reconstruction of chest, abdominal walls and perineum

    Vijaykumar D; Vijayaraghavan Sundeep

    2007-01-01

    The structural integrity of the chest and abdominal walls and perineum is frequently altered by cancer extirpation. Advances in reconstructive surgery and the availability of innovative techniques have helped the cancer surgeon to proceed with radical excisions with minimum morbidity. The ability to harvest flaps from distant sites and the availability of good prosthetic materials have now become part of the routine armamentarium of the plastic surgeon engaged in reconstructive surgery of the...

  6. Implementation of the trans-abdominal partial extra-peritoneal (TAPE) technique in laparoscopic lumbar hernia repair

    Sun, Jing; Chen, Xin; Li, Jianwen; Zhang, Yun; Dong, Feng; Zheng, Minhua

    2015-01-01

    Background There is still not any standardized operative strategy that is well-accepted all over the world for lumbarhernia. We are here to investigate the feasibility of the trans-abdominal partial extra-peritoneal (TAPE) technique in lumbar hernia repair. Methods The TAPE technique was applied to 14 patients with lumbar hernia from May 2009 until January 2014. The surgical technique was described in details and follow-ups were performed for further evaluation. Results The mean age of the 14...

  7. Animal model of chronic abdominal hernia in rabbit Modelo animal de hérnia abdominal crônica em coelhos

    Walter da Silva

    2009-08-01

    Full Text Available PURPOSE: To create a feasible animal model of hernia that should be reliable to test the different types of mesh and/or surgical technique. METHODS: Thirty six male New Zealand albino rabbits were submitted to surgical procedure to provoke a standard hole in the abdominal wall. A metallic frame measuring 3 cm length and 1 cm width was allocated longitudinally on the umbilicus scar and the comprehensive three squared centimeters area was resected. A continuous 4.0 polyamide was performed to closure the subcutaneous and skin. RESULTS: During three weeks a score of signals/symptoms was performed to evaluate the wound and clinical conditions. No death or severe complications occurred. In the 3rd week the hernia ring and visceral adhesions were evaluated. Soft omental adherences were present in the hernial sac in all animals. The area of hernia ring ranged from 32.1±5.5 to 35.6±3.1 squared centimeter and the maximum was 39 cm² and the minimum was 30 cm². The model results in protrusion which was similar to a human incisional hernia with hernia sac, visceral adhesions and fibrous healing ring. CONCLUSION: The model was more reliable to test further techniques or mesh on hernia repair.OBJETIVO: Criação de um modelo animal de hérnia que seja confiável para testar as diferentes técnicas e tipos de telas. MÉTODOS: Trinta e seis coelhos foram submetidos a procedimento operatório que provocou uma falha na parede abdominal. Uma moldura metálica com 3 cm de comprimento e 1 cm de largura foi colocada longitudinalmente sobre a cicatriz umbilical e ressecada uma área de 3cm². Uma sutura contínua de poliamida 4.0 fechou a tela subcutânea e pele. RESULTADOS: durante três semanas o escore de sinais e sintomas foi coletado para avaliar as condições clínicas e da ferida operatória. Não ocorreram óbitos ou complicações graves. Na terceira semana o anel herniário e aderências peritoneais foram avaliadas. Aderências frouxas estavam presentes

  8. A comparative study between Total Extra-Peritoneal (TEP) repair and Trans Abdominal Pre-Peritoneal (TAPP) repair in management of inguinal hernia

    Nimesh Verma; Keyur Prajapati; Siddharth Mistry; Gaurav Bagmar; Ajay Kumar; Dharmik Patel

    2015-01-01

    Background: Groin hernias are the most common conditions referred to surgeons all over the world and over five lakh hernia repairs are performed annually. Our purpose in this study is to compare the results of laparoscopic hernioplasty by Total Extra-Peritoneal (TEP) technique and laparoscopic Trans Abdominal Pre-Peritoneal (TAPP) technique. Methodology: This was the prospective study conducted on cases of inguinal hernia in which half cases were operated by Laparoscopic Trans Abdominal Pre-P...

  9. Lumbar hernia misdiagnosed as a subcutaneous lipoma: a case report

    Amelio Gianfranco; Mingolla Giuseppe

    2009-01-01

    Abstract Introduction Lumbar hernia is a rare abdominal wall defect and clinical suspicion is necessary for diagnosis. Case presentation We report the case of a 40-year-old Caucasian woman with a superior lumbar hernia (Grynfeltt hernia) initially misdiagnosed as a recurrent lipoma. The correct diagnosis was made intra-operatively and the hernia was repaired using synthetic mesh. The patient was free of recurrence at 4 months after the operation. Conclusion A lumbar or flank mass should alway...

  10. Hernias

    ... Your Mood Prescription Drug Abuse Healthy School Lunch Planner How Can I Help a Friend Who Cuts? ... may induce hernias: obesity or sudden weight gain lifting heavy objects diarrhea or constipation persistent coughing or ...

  11. Splenic trauma during abdominal wall liposuction: a case report

    Harnett, Paul; Koak, Yashwant; Baker, Daryl

    2008-01-01

    A 35-year-old woman collapsed 18 hours after undergoing abdominal wall liposuction. Abdominal CT scan revealed a punctured spleen. She underwent an emergency splenectomy and made an uneventful recovery.

  12. Experimental models of longitudinal abdominal incisional hernia in rats Modelos experimentais de hérnias incisionais abdominais longitudinais, em ratos

    Danilo N. S. Paulo

    1997-12-01

    Full Text Available Abdominal incisional hernias in rats has been produced after resection of a segment of abdominal muscle. In a attempt to create a model of incisional hernia in rats, without resection of abdominal muscle, the following surgical procedures were performed: (a Rats anesthetized with ether were submitted to a 4 cm long median incision, supra and infraumbilical, followed by dissection of the subcutaneous tissue 1.5 cm laterally to the median line in each side; after, one incision was performed in the linea alba and peritoneum, with the same extension of the skin incision; the skin incision was sutured. (b Rats were submited to a suprapubic transversal incision and a scissors introduced through this incision and used to dissect the subcutaneous tissue at least 1.5 cm for each side of median line; after, the linea alba and peritoneoum were incised and the transversal skin incision sutured. (c For control, rats were submitted to a resection of a 2.5 x 4 cm of the abdominal muscles, creating a large defect in the abdominal wall. All the animal, submitted to the three different procedures, developed similar well constituted hernias. We concluded that abdominal incisonal hernias are easily induced in rats after an incision of the abdominal wall, without partial resection of abdominal muscle, since the subcutaneous have been dissected at least 1.5 cm laterally to the median line.Hérnias incisionais abdominais no rato têm sido produzidas pela ressecção de fragmento dos músculos de parede abdominal. Na tentativa de criar um modelo de hérnia incisional abdominal no rato, sem ressecção de fragmentos de músculo de parede abdominal, os seguintes procedimentos cirúrgicos foram realizados: (a Ratos anestesiados com vapores de éter foram submetidos à uma incisão longitudinal mediana supra e infra umbilical, de 4 cm de comprimento, seguida do descolamento do tecido celular subcutaneo em uma extensão de 1,5 cm lateralmente à linha mediana; de cada lado

  13. Inguinal hernia - discharge

    You or your child had surgery to repair an inguinal hernia caused by a weakness in the abdominal wall in your groin area. You or your child probably had general (asleep and pain-free) or spinal or epidural (numb from the waist down) anesthesia. If ...

  14. Abdominal Wall Schwannoma: Case Report and Review of the Literature

    Mishra, A.; Hamadto, M.; Azzabi, M.; M. Elfagieh

    2013-01-01

    A 29-year-old female had presented to surgical outpatient's department complaining of lump in the anterior abdominal wall. Ultrasound and magnetic resonance imaging revealed a solid degenerated tumor in the anterior abdominal wall. It was surgically excised, and histopathology confirmed it to be “ancient” schwannoma. To our knowledge, this is the second reported case of an abdominal wall ancient schwannoma in the medical literature.

  15. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... them on these and basically have created the team approach in dealing with these complex recurrent hernias. And I can't emphasize more the team approach, which some people forget, also includes your ...

  16. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... develop a hernia, which was repaired at the time by the surgeon who had performed the distal ... proceed with the component separation operation at this time. So if you see, we have the -- a ...

  17. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... in dealing with these complex recurrent hernias. And I can't emphasize more the team approach, which ... we have some Kochers, please? The first thing I'm going to do is we take large ...

  18. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... exact thing has been done. We've been working very hard with the general surgeons and very closely with them on these and basically have created the team approach in dealing with these complex recurrent hernias. ...

  19. Diagnosis and treatment of expanding haematoma of the lateral abdominal wall after blunt abdominal trauma

    We report a rare case of an expanding post-traumatic lateral abdominal wall haematoma. A superselective arteriogram of the deep circumflex iliac artery showed extravasation from the ascending branch, urging emergency therapy. Microcoil and Gelfoam embolisation was successfully performed. Haematomas of the abdominal wall can be divided in the common rectus sheath haematomas and the rare haematomas of the lateral abdominal wall. Differentiating both entities is essential, since there is a strong difference in their vascular supply. The typical vascular supply of the lateral abdominal wall is discussed, with emphasis on the ascending branch of the deep circumflex iliac artery. (orig.)

  20. The Intraperitoneal Tension-Free Plasty of Abdominal Wall with Mesh Use — Current State of Problem

    Romanov R.V.

    2012-12-01

    Full Text Available Tension-free plasty with synthetic mesh use is the method of choice in modern surgery of abdominal wall hernias. In the review the basics variants of mesh implantation with its benefits and drawbacks are presented. The advantages and disadvantages of Lichtenstein, TAPP, TEP, and IPOM techniques are shown. The benefits and drawbacks of intraperitoneal onlay mesh technique (IPOM are given in detail. Standard tension-free procedures in surgery of inguinal hernias are described. The important steps in prosthetic repair of medial defects in abdominal wall are estimated. There are considered the features and results of applying sublay, inlay and onlay procedures. The possibilities of preperitoneal, intraabdominal, and retromuscular placement of synthetic endoprostheses are discussed. Adverse sequela of plasty, and its suspected pathogenetic mechanisms are considered. The ways in prophylaxis of complications are shown: mesh isolation, anti-adhesive covering, sutureless and glue fixation of endoprosthesis, development of new synthetic materials. Based on the analysis of literature reports we have concluded that the danger of intraabdominal complications after IPOM is exaggerated. Tension-free intraperitoneal plasty with synthetic endoprostheses in abdominal wall hernias is a simple and reliable surgical approach.

  1. Incisional hernia as a late surgical complication of an infertile patient treated for abdominal tuberculosis

    Kameshwarachari Pushpalatha

    2015-10-01

    Full Text Available Abdominal tuberculosis (TB can be of various forms including peritoneal TB, tuberculous lymphadenopathy, gastrointestinal TB and visceral TB. The potential pathway includes direct spread to the peritoneum from infected adjacent foci, including the fallopian tubes or adnexa, or psoas abscess, secondary to tuberculous spondylitis. The exact stimulus for the inflammatory reaction is not known, but some suggest that it may arise due to a subclinical primary viral peritonitis, as an immunological reaction to gynaecological infections, or due to retrograde menstruation. The diagnosis of extra pulmonary TB can be difficult as it presents with nonspecific clinical and radiological features and requires high degree of suspicion for diagnosis. The abdominal TB, which is not so commonly seen as pulmonary TB, can be a source of significant morbidity and mortality and is usually diagnosed late due to its nonspecific clinical presentation. Approximately 15%-25% of cases with abdominal TB have concomitant pulmonary TB. Hence, it is quite important in identifying these lesions with high index of suspicion especially in endemic areas. Post and ndash; operative period in such patients is not smooth. They include prolonged hospital stay, enterocutaneous fistulae requiring re-operation upon failed conservative management, mortality associated with re-exploration, late complication being incisional hernia. Here we report a case of large incisional hernia following a laparotomy performed for non-resolving sub-acute intestinal obstruction which turned out to have tubercular origin later. The present case was managed by meshplasty using component separation technique (CST. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1666-1668

  2. [Endometriosis in the abdominal wall (author's transl)].

    Caligaris, P; Masselot, R; Ducassou, M J; Le Treut, Y; Bricot, R

    1981-01-01

    The authors give 9 case histories of endometriosis localised to the abdominal wall : 3 of them in the umbilicus, 3 in laparotomy incisions (2 of those were Caesareans), 2 of them in the round ligaments at the external opening of the inguinal canal and 1 of them in the right rectus muscle sheath in the abdomen. The functional symptomatology is rhythmical according to menstruation; it is associated with a burning type of pain, a tumour and blood loss. Over and above the theories of aetiology that are now classical, namely tubal retrograde spill, and lymphatic or venous spread, it would seem that prostaglandins and in particular the ratio of P.G.E. divided by P.D.F2 alpha can play a big role. Although Danazol is an effective treatment for endometriosis, the treatment of choice is, in these lesions that are superficial in localisation and easily accessible, to cut them out surgically. This makes it possible on the one hand to look for other intra-abdominal lesions and also on the other hand to confirm the anatomy and pathology (this was done in 7 out of 9 of our cases). PMID:6459361

  3. Relación entre la presión intrabdominal en diálisis peritoneal con las hernias y fugas The link between intra-abdominal pressure in peritoneal dialysis and hernias and fugues

    Concepción Blasco Cabañas

    2012-06-01

    ±253 ml/m². Un 23.5 % tenían una presión intrabdominal mayor a 20 cm. de H2O. En sedestación la media fue de 28±5.5 cm. de H2O y en bipedestación de 43.7±5.3 cm. de H2O. Los enfermos con presión intrabdominal > 20 cm. H2O tenían más porcentaje de hernias (50% vs 12 % y fugas pericatéter (37 % vs. 12 %. Como principales conclusiones, podemos destacar que los niveles de presión intrabdominal de nuestros pacientes son algo más elevados que en otras series. A mayor edad, mayor comorbilidad y mayor índice de masa corporal, la presión intrabdominal es más elevada. Los enfermos con presión intrabdominal elevada presentaron más episodios de hernias y fugas.Normal intra-abdominal pressure is equal to atmospheric pressure (zero. In peritoneal dialysis the introduction of intra-peritoneal liquid increases intra-abdominal pressure. In various studies it is recommended that this does not exceed 16-20cm H2O. In addition to possible abdominal discomfort, high intra-abdominal pressure can be linked to problems with the abdominal wall, such as hernias and fugues, and have implications for peritoneal transport and ultrafiltration deficit. The aims of this study were the following: to find out the intra-abdominal pressure levels in the prevalent type of patients in peritoneal dialysis, to assess the factors influencing the values for this pressure and to study the relationship between intra-abdominal pressure and the development of hernias and fugues, retrospectively. A transversal, observational and retrospective study was conducted to measure intra-abdominal pressure in the prevalent, stable patients who had been on peritoneal dialysis for more than three months. Intra-abdominal pressure was measured using the method described by Durand: patient in a supine position, with diurnal peritoneal volume. The final intra-abdominal pressure is the average of the measurements taken during inspiration and expiration, is expressed in cm H2O and the volume drained is

  4. Congenital Lumbar Hernia

    Sanjay Sharma; Gagan Bali; Satish Parihar; Neeraj Koul

    2008-01-01

    Lumbar hernia is a rare hernia. It constitutes less than one percent of all abdominal hernias. It can becongenital or acquired. Acquired can occur either spontaneously or after surgery or trauma. Only 300cases of lumbar hernia are reported till date. We report a case of congenital lumbar hernia in one month oldmale baby

  5. Congenital Lumbar Hernia

    Sanjay Sharma

    2008-01-01

    Full Text Available Lumbar hernia is a rare hernia. It constitutes less than one percent of all abdominal hernias. It can becongenital or acquired. Acquired can occur either spontaneously or after surgery or trauma. Only 300cases of lumbar hernia are reported till date. We report a case of congenital lumbar hernia in one month oldmale baby

  6. Transformation of Abdominal Wall Endometriosis to Clear Cell Carcinoma

    Maria Paula Ruiz; Darryl Lewis Wallace; Matthew Thomas Connell

    2015-01-01

    Clear cell carcinoma is the least common of the malignant transformations reported in nonpelvic sites of endometriosis. Two cases with clear cell carcinoma transformation arising from endometriosis in abdominal wall scars are presented. These patients underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic washings, and abdominal wall lesion resection. The first case had initial treatment with chemotherapy, while chemotherapy and radiation therapy were given for th...

  7. Bilateral prevascular herniae – A rare complication of aorto-uniiliac endovascular abdominal aortic aneurysm repair and femoro-femoral bypass

    Obinna Obinwa

    2015-01-01

    Full Text Available A case of a 78-year-old female with bilateral groin prevascular herniae following an emergency aorto-uniiliac EVAR and femoro-femoral bypass for a ruptured abdominal aortic aneurysm is presented. Primary repair of the herniae was achieved using a preperitoneal approach. The case emphasises a safe approach to dealing with this rare complication.

  8. Abdominal wall endometrioma mimicking an incarcerated hernia: a case report

    Simoglou C; Zarogoulidis P; Machairiotis N; Porpodis K; Simoglou L; Mitrakas A; Esebidis A; Sarika E; Kouklakis G; Iordanidis A; Katsikogiannis N

    2012-01-01

    Christos Simoglou,1 Paul Zarogoulidis,2 Nikolaos Machairiotis,3 Konstantinos Porpodis,2 Lambros Simoglou,4 Alexandros Mitrakas,5 Agisilaos Esebidis,5 Eirini Sarika,6 George Kouklakis,7 Alkis Iordanidis,8 Nikolaos Katsikogiannis31Cardiothoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 2Pulmonary Department, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece; 3Surgery Department (N...

  9. Single-incision laparoscopic total extraperitoneal repair for a Grynfeltt hernia: a case report

    Wei, Ching-Ting; Chen, Yaw-Sen; Sun, Cheuk-Kwan; Hsieh, Kun-Chou

    2014-01-01

    Introduction A superior lumbar hernia, which is also known as a Grynfeltt hernia, is a rare abdominal wall defect that can be primary or secondary to trauma or orthopedic surgery. The anatomic location of a lumbar hernia makes diagnosis and repair challenging. We successfully repaired a lumbar hernia using a single-incision laparoscopic total extraperitoneal approach. To the best of our knowledge, this is the first report of the use of this surgical technique in the treatment of a primary Gry...

  10. [Anatomy and mechanism of inguinal hernias].

    Flament, J B; Avisse, C; Delattre, J F

    1997-02-01

    Anterior abdominal wall presents a weak point between the pelvic bone and the muscular arch of transverse and internal oblique muscles. This myo-pectineal orifice, crossed by the inguinal ligament is closed by the transversalis fascia. All groin hernias, inguinal directs, indirects or femoral, result from a defect of the transversalis fascia. They have two causes. Congenital hernias result from a persisting peritoneo-vaginal canal. Acquired hernias result from a progressive weakening of the transversalis fascia depending on connective tissue insufficiency and increase of intra-abdominal pressure. PMID:9122597

  11. Randomized Clinical Trial on the postoperative use of an abdominal binder after laparoscopic umbilical and epigastric hernia repair

    Christoffersen, Mette; Olsen, B H; Rosenberg, J; Bisgaard, T

    2015-01-01

    PURPOSE: Application of an abdominal binder is often part of a standard postoperative regimen after ventral hernia repair to reduce pain and seroma formation. However, there is lack of evidence of the clinical effects. The aim of the present study was to investigate the pain- and seroma-reducing ......PURPOSE: Application of an abdominal binder is often part of a standard postoperative regimen after ventral hernia repair to reduce pain and seroma formation. However, there is lack of evidence of the clinical effects. The aim of the present study was to investigate the pain- and seroma...... abdominal binders during the first postoperative week. Standardized surgical technique, anaesthesia, and analgesic regimens were used and study observers were blinded towards the intervention. Postoperative pain (visual analogue score) on day 1 was the primary outcome. In addition, ultrasonographic...... the abdominal binder were found. CONCLUSIONS: There were no effects of an abdominal binder on pain, movement limitation, fatigue, seroma formation, general well-being, or quality of life. However, most patients claimed a subjective beneficial effect of using their abdominal binder....

  12. Synovial sarcoma of the abdominal wall: An unusual presentation

    Parag J Karkera

    2013-01-01

    Full Text Available Synovial sarcoma (SS is a malignant mesenchymal neoplasm which commonly occurs in the extremities in close association with tendon sheaths, bursae, joint capsules, and fascial structures. Rarely, SS may be present in unexpected location such as the abdominal wall. Surgical resection with wide margins is the initial standard treatment; however, a multimodal approach including radiotherapy and chemotherapy is often favored. Here, we present a case of SS of the anterior abdominal wall in a 14-year-old patient with a right upper abdominal lump. He underwent wide surgical excision and has received adjuvant chemotherapy. He is doing well on follow-up of six months.

  13. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... was yes, it did -- right here -- it did cause seromas as well. Another thing was that the ... is two things: one is it's going to cause more adherence of the Veritas to the abdominal ...

  14. Wandering ascaris coming out through the abdominal wall

    Mohd L Wani

    2013-01-01

    Full Text Available A rare case of ascaris coming out through the anterior abdominal wall is reported here. A 40-year-old female had undergone dilatation and curettage by a quack. On the second day she presented with presented with features of peritonitis. She was explored. Resection anastomosis of the ileum was done for multiple perforations of the ileum. Patient developed a fistula in the anterior abdominal wall which was draining bile-colored fluid. On the 12 th postoperative day a 10-cm-long worm was seen coming out through the fistulous tract which was found to be Ascaris lumbricoids. Ascaris lumbricoids can lead to many complications ranging from worm colic to intestinal obstruction, volvulus, peritonitis, pancreatitis, cholangiohepatitis, liver abscess and many more. Worm has been reported to come out through mouth, nostrils, abdominal drains, T-tubes etc. But ascaris coming out through the anterior abdominal wall is very rare hence reported here.

  15. Damage control apronectomy for necrotising fasciitis and strangulated umbilical hernia.

    Coyle, P

    2012-01-31

    We present a case of a 50-year-old morbidly obese woman who presented with a case of necrotizing fasciitis of the anterior abdominal wall due to a strangulated umbilical hernia. The case was managed through damage control surgery (DCS) with an initial surgery to stabilise the patient and a subsequent definitive operation and biological graft hernia repair. We emphasise the relevance of DCS principles in the management of severe abdominal sepsis.

  16. Evaluation of a Porcine Dermal Collagen (Permacol Implant for Abdominal Wall Reconstruction in a Pediatric Multitrauma Patient

    Idit Melnik

    2014-01-01

    Full Text Available The presence of a contaminated surgical field in abdominal wall defects caused by trauma presents a challenge for surgeons. Both primary suture and synthetic meshes are strongly discouraged as surgical treatments in such cases. We describe the use of a porcine dermal collagen (Permacol implant in an eight-year-old patient with multiple injuries. Three months after discharge, the child remains well with good cosmetic results. He is free of pain and has returned to full activity levels with complete wound closure and without any evidence of residual hernia. In conclusion, our experience indicates that the use of Permacol can be considered an efficient technique for reconstructing an infected abdominal wall defect of a pediatric multitrauma patient.

  17. Ultrasonographic evaluation of masses of the abdominal walls in children

    The sonographic features of seven cases of masses of the abdominal wall in children were reviewed. The sonographic manifestations of two cases of lipoma, two cases of abscess (one with intra-abdominal component), one case of lymph angioma, one case of capillary hemangioma and one due to a secondary involvement of a malignant retroperitoneal teratoma are presented. Ultrasound proved to be very useful modality in order to show the topography and the real extent of the disease. (author)

  18. Reparación de una eventración abdominal mediante técnica SILS Abdominal hernia repair with SILS technique

    M. Gascón Hove

    2011-03-01

    Full Text Available La cirugía laparoscópica se dirige hacia técnicas menos invasivas con mejores resultados cosméticos, como el abordaje SILS (Single incision laparoscopic surgery. Con los nuevos avances tecnológicos, es posible introducir en la cavidad abdominal múltiples instrumentos a través de un solo puerto. Una opción es el Tri-Port™. Presentamos un paciente con una eventración abdominal previamente reparada en otro hospital, a quien se realizó una eventroplastia tipo SILS, utilizando una única incisión. No se requirieron suturas abdominales adicionales en todo el proceso. No hubo complicaciones durante la intervención ni en el postoperatorio y el paciente se fue del hospital 48 horas después sin presentar dolor postoperatorio. La cirugía tipo SILS es factible y segura, y representa una alternativa válida a la laparoscopia convencional, aunque es técnicamente más compleja. Se necesitan más estudios para que pueda instaurarse como procedimiento estándar.Abdominal surgery is leading to less invasive and cosmetically superior approaches, such as SILS. Due to new surgical advances, it is possible to insert into the abdomen multiple instruments through a single device. One option is Tri-Port™. We report a patient with ventral hernia previously repaired in other hospital, who underwent a laparoscopic abdminal hernia repair through a single umbilical incision. No additional transabdominal sutures were utilized in this procedure. No perioperative or postoperative complications were recorded and the patient was discharged 48 hours after surgery with no postoperative pain. Single incision laparoscopic surgery (SILS hernia repair is feasable and safe, and represents a valuable alternative to a laparoscopic approach, although it is technically more complicated. Further studies are necessary to recommend it as a standard procedure.

  19. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    Al Soub, Hussam; Al-Maslamani, Eman; Al-Maslamani, Mona

    2008-01-01

    We describe here a case of abdominal abscesses due to Mycobacterium fortuitum following liposuction. The abscesses developed three months after the procedure and diagnosis was delayed for five months. The clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. This condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably r...

  20. Management of the Sequelae of Severe Congenital Abdominal Wall Defects

    Marti, Eunate; Delgado, Maria-Dolores; Gomez, Andres

    2016-01-01

    Background The survival rate of newborns with severe congenital abdominal wall defects has increased. After successfully addressing life-threatening complications, it is necessary to focus on the cosmetic and functional outcomes of the abdominal wall. Methods We performed a chart review of five cases treated in our institution. Results Five patients, ranging from seven to 18 years of age, underwent the following surgical approaches: simple approximation of the rectus abdominis fascia, the rectus abdominis sheath turnover flap, the placement of submuscular tissue expanders, mesh repair, or a combination of these techniques depending on the characteristics of each individual case. Conclusions Patients with severe congenital abdominal wall defects require individualized surgical treatment to address both the aesthetic and functional issues related to the sequelae of their defects. PMID:27218024

  1. Measurement of abdominal wall compliance in normal subjects and tetraplegic patients.

    Goldman, J M; Rose, L S; Morgan, M D; Denison, D M

    1986-01-01

    On inspiration descent of the diaphragm is opposed by the passive properties of the abdominal wall, the tone of its muscles, and the inertia of the abdominal contents. As a result, intra-abdominal pressure rises and promotes rib cage expansion. In patients with high spinal injury the diaphragm is the most important muscle of inspiration and abdominal wall displacement is more evident than in normal subjects. Abdominal wall compliance has been measured by relating gastric pressure to abdominal...

  2. A comparative study between Total Extra-Peritoneal (TEP repair and Trans Abdominal Pre-Peritoneal (TAPP repair in management of inguinal hernia

    Nimesh Verma

    2015-03-01

    Full Text Available Background: Groin hernias are the most common conditions referred to surgeons all over the world and over five lakh hernia repairs are performed annually. Our purpose in this study is to compare the results of laparoscopic hernioplasty by Total Extra-Peritoneal (TEP technique and laparoscopic Trans Abdominal Pre-Peritoneal (TAPP technique. Methodology: This was the prospective study conducted on cases of inguinal hernia in which half cases were operated by Laparoscopic Trans Abdominal Pre-Peritoneal (TAPP mesh repair while other half were treated by Total Extra-Peritoneal (TEP mesh repair of inguinal hernia in New Civil Hospital, Surat. All the patients were admitted and a detailed history and clinical examination were carried out as per written proforma. Results: This comparative study consisted of 60 patients. The most common diagnosis was right indirect inguinal hernia followed by left direct inguinal hernia in the both the groups. Overall the TEP was far better procedure compared to TAPP. The indicators like mean operative, Post-op pain, post-op hospital stay (in days and return to normal work (in days were far better than TAPP. Conclusion: Our study supports the view that laparoscopic TEP and TAPP mesh repair of inguinal hernia is safe and efficacious, but long term Randomized Control Trials with enhanced sample size and reduced confounding factors are still required to establish the absolute superiority of TEP over TAPP. [Natl J Med Res 2015; 5(1.000: 64-66

  3. Wandering ascaris coming out through the abdominal wall

    Wani, Mohd L; Rather, Ajaz A.; Parray, Fazl Q; Ahangar, Abdul G.; Bijli, Akram H.; Ifat Irshad; Nayeem-Ul-Hassan; Khan, Tahir S.

    2013-01-01

    A rare case of ascaris coming out through the anterior abdominal wall is reported here. A 40-year-old female had undergone dilatation and curettage by a quack. On the second day she presented with presented with features of peritonitis. She was explored. Resection anastomosis of the ileum was done for multiple perforations of the ileum. Patient developed a fistula in the anterior abdominal wall which was draining bile-colored fluid. On the 12 th postoperative day a 10-cm-long worm was seen co...

  4. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    Al Soub Hussam

    2008-01-01

    Full Text Available We describe here a case of abdominal abscesses due to Mycobacterium fortuitum following liposuction. The abscesses developed three months after the procedure and diagnosis was delayed for five months. The clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. This condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably result in the identification of more cases. Combination antibiotic therapy with surgical drainage in more extensive diseases is essential for cure.

  5. Segmentalliverincarcerationthrougha recurrent incisional lumbar hernia

    Nikolaos S. Salemis; Konstantinos Nisotakis; Stavros Gourgiotis; Efstathios Tsohataridis

    2007-01-01

    BACKGROUND: Lumbar hernia is a rare congenital or acquired defect of the posterior abdominal wall. The acquired type is more common and occurs mainly as an incisional defect after lfank surgery. Incarceration or strangulation of hernia contents is uncommon. METHOD: Segmental liver incarceration through a recurrent incisional lumbar defect was diagnosed in a 58 years old woman by magnetic resonance imaging. RESULTS: The patient underwent an open repair of the com-plicated hernia. An expanded polytetralfouoroethylene (e-PTFE) mesh was fashioned as a sublay prosthesis. She had an uncomplicated postoperative course. Follow-up examinations revealed no evidence of recurrence. CONCLUSIONS: Although lumbar hernia rarely results in incarceration or strangulation, early repair is necessary because of the risks of complications and the increasing dififculty in repairment as it enlarges. Surgical repair is often dififcult and challenging.

  6. Intramuscular abdominal wall endometriosis treated by ultrasound-guided ethanol injection.

    Bozkurt, Murat; Çil, A Said; Bozkurt, Duygu Kara

    2014-12-01

    Abdominal wall endometriosis (AWE) is a rare condition that usually develops in a surgical scar resulting from a Caesarean section. While commonly seen in the cutaneous and subcutaneous fat tissue at the Caesarean scar level, its intramuscular localization is quite rare. Its treatment options consist of the excision of the lesion and/or hormonal therapies, although wide surgical excision is the treatment of choice in the literature. Wide surgical excision may create a defect in the abdominal wall and may increase the risk of hernia formation and mesh complications. This case report describes the clinical and radiological findings and treatment modalities of endometriosis that have appeared in the rectus abdominis muscle of a 25-year-old patient at the Caesarean scar level. Sclerotherapy may be used for endometrioma. We present a new and alternative treatment method using ultrasound-guided intralesional ethanol injection for AWE. Compared with the complications of surgical excision, the complications of sclerotherapy by ethanol are at a more acceptable level. Sclerotherapy by ethanol injection may be an alternative treatment to surgery for AWE. PMID:24667221

  7. Laparoscopic repair of an incarcerated femoral hernia

    Pillay, Yagan

    2015-01-01

    Introduction A femoral hernia is a rare, acquired condition, which has been reported in less than 5% of all abdominal wall hernias, with a female to male ratio of 4:1. Presentation of case We report a case in a female patient who had a previous open inguinal herniorrhaphy three years previously. She presented with right sided groin pain of one month duration. Ultrasound gave a differential diagnosis of a recurrent inguinal hernia or a femoral hernia. A transabdominal preperitoneal repair was performed and the patient made an uneventful recovery. Discussion Laparoscopic repair of a femoral hernia is still in its infancy and even though the outcomes are superior to an open repair, open surgery remains the standard of care. The decision to perform a laparoscopic trans abdominal preperitoneal (TAPP) repair was facilitated by the patient having previous open hernia surgery. The learning curve for laparoscopic femoral hernia repair is steep and requires great commitment from the surgeon. Once the learning curve has been breached this is a feasible method of surgical repair. This is demonstrated by the fact that this case report is from a rural hospital in Canada. Conclusion Laparoscopic femoral hernia repair involves more time and specialized laparoscopic skills. The advantages are a lower recurrence rate and lower incidence of inguinodynia. PMID:26581083

  8. Bioprosthetic Tissue Matrices in Complex Abdominal Wall Reconstruction

    Justin M. Broyles, MD

    2013-12-01

    Conclusions: Although bioprosthetic matrix has a multitude of indications within the growing field of abdominal wall reconstruction, the functionality, regenerative capacity, and long-term fate of these products have yet to be fully established. Furthermore, the clinical performance, indications, and contraindications for each type of matrix need to be fully evaluated in long-term outcome studies.

  9. A New Rat Model for Orthotopic Abdominal Wall Allotransplantation

    William W. Lao, MD

    2014-04-01

    Conclusions: Technical, histological, and immunological aspects of a new rat model are described. These results give clues to what occurs in human abdominal wall transplantation. In addition, Th1, a proinflammatory cell, was found to be a potential biomarker for allograft rejection.

  10. Abdominal ventral hernia repair with current biological prostheses: an experimental large animal model.

    Stanwix, Matthew G; Nam, Arthur J; Hui-Chou, Helen G; Ferrari, Jonathan P; Aberman, Harold M; Hawes, Michael L; Keledjian, Kaspar M; Jones, Luke S; Rodriguez, Eduardo D

    2011-04-01

    Biologic prostheses have emerged to address the limitations of synthetic materials for ventral hernia repairs; however, they lack experimental comparative data. Fifteen swine were randomly assigned to 1 of 3 bioprosthetic groups (DermaMatrix, AlloDerm, and Permacol) after creation of a full thickness ventral fascial defect. At 15 weeks, host incorporation, hernia recurrence, adhesion formation, neovascularization, inflammation, and biomechanical properties were assessed. No animals had hernia recurrence or eventration. DermaMatrix and Alloderm implants demonstrated more adhesions, greater inflammatory infiltration, and more longitudinal laxity, but near identical neovascularization and tensile strength to Permacol. We found that porcine acellular dermal products (Permacol) contain following essential properties of an ideal ventral hernia repair material: low inflammation, less elastin and stretch, lower adhesion rates and cost, and more contracture. The addition of lower cost xenogeneic acellular dermal products to the repertoire of available acellular dermal products demonstrates promise, but requires long-term clinical studies to verify advantages and efficacy. PMID:21042180

  11. Management of stab wounds to the anterior abdominal wall

    João Baptista Rezende-Neto

    2014-01-01

    Full Text Available The meeting of the Publication "Evidence Based Telemedicine - Trauma and Emergency Surgery" (TBE-CiTE, through literature review, selected three recent articles on the treatment of victims stab wounds to the abdominal wall. The first study looked at the role of computed tomography (CT in the treatment of patients with stab wounds to the abdominal wall. The second examined the use of laparoscopy over serial physical examinations to evaluate patients in need of laparotomy. The third did a review of surgical exploration of the abdominal wound, use of diagnostic peritoneal lavage and CT for the early identification of significant lesions and the best time for intervention. There was consensus to laparotomy in the presence of hemodynamic instability or signs of peritonitis, or evisceration. The wound should be explored under local anesthesia and if there is no injury to the aponeurosis the patient can be discharged. In the presence of penetration into the abdominal cavity, serial abdominal examinations are safe without CT. Laparoscopy is well indicated when there is doubt about any intracavitary lesion, in centers experienced in this method.

  12. Bowel Obstruction and Peritoneal Dialysis: A Case Report of a Patient with Complications from a Broad Ligament Hernia

    Otani-Takei, Naoko; Akimoto, Tetsu; Sadatomo, Ai; Saito, Osamu; Muto, Shigeaki; Kusano, Eiji; Nagata, Daisuke

    2016-01-01

    Abdominal hernias are a common cause of bowel obstruction. The major types of abdominal hernias are external or abdominal wall hernias, which occur at areas of congenital or acquired weakness in the abdominal wall. An alternative entity is internal hernias, which are characterized by a protrusion of viscera through the peritoneum or mesentery. We herein present the case of a female peritoneal dialysis patient with bowel obstruction due to an internal hernia. Although an initial work-up did not lead to a correct diagnosis, an exploratory laparotomy revealed that she had intestinal herniation due to a defect in the broad ligament of the uterus, which was promptly corrected by surgery. The concerns about the perioperative dialytic management as well as the diagnostic problems regarding the disease that arose in our experience with the present patient are also discussed.

  13. Grynfeltt Hernia: A Deceptive Lumbar Mass with a Lipoma-Like Presentation

    Jonathan R. Zadeh; Buicko, Jessica L.; Chetan Patel; Robert Kozol; Lopez-Viego, Miguel A.

    2015-01-01

    The Grynfeltt-Lesshaft hernia is a rare posterior abdominal wall defect that allows for the herniation of retro- and intraperitoneal structures through the upper lumbar triangle. While this hernia may initially present as a small asymptomatic bulge, the defect typically enlarges over time and can become symptomatic with potentially serious complications. In order to avoid that outcome, it is advisable to electively repair Grynfeltt hernias in patients without significant contraindications to ...

  14. Changes in muscle strength and pain in response to surgical repair of posterior abdominal wall disruption followed by rehabilitation

    Hemingway, A; Herrington, L; Blower, A

    2003-01-01

    Background: Posterior abdominal wall deficiency (PAWD) is a tear in the external oblique aponeurosis or the conjoint tendon causing a posterior wall defect at the medial end of the inguinal canal. It is often known as sportsman's hernia and is believed to be caused by repetitive stress. Objective: To assess lower limb and abdominal muscle strength of patients with PAWD before intervention compared with matched controls; to evaluate any changes following surgical repair and rehabilitation. Methods: Sixteen subjects were assessed using a questionnaire, isokinetic testing of the lower limb strength, and pressure biofeedback testing of the abdominals. After surgery and a six week rehabilitation programme, the subjects were re-evaluated. A control group were assessed using the same procedure. Results: Quadriceps and hamstrings strength was not affected by this condition. A deficit hip muscle strength was found on the affected limb before surgery, which was significant for the hip flexors (p = 0.05). Before surgery, 87% of the patients compared with 20% of the controls failed the abdominal obliques test. Both the injured and non-injured sides had improved significantly in strength after surgery and rehabilitation. The strength of the abdominal obliques showed the most significant improvement over the course of the rehabilitation programme. Conclusions: Lower limb muscle strength may have been reduced as the result of disuse atrophy or pain inhibition. Abdominal oblique strength was deficient in the injured patients and this compromises rotational control of the pelvis. More sensitive investigations (such as electromyography) are needed to assess the link between abdominal oblique function and groin injury. PMID:12547744

  15. Lumbar hernia misdiagnosed as a subcutaneous lipoma: a case report

    Amelio Gianfranco

    2009-12-01

    Full Text Available Abstract Introduction Lumbar hernia is a rare abdominal wall defect and clinical suspicion is necessary for diagnosis. Case presentation We report the case of a 40-year-old Caucasian woman with a superior lumbar hernia (Grynfeltt hernia initially misdiagnosed as a recurrent lipoma. The correct diagnosis was made intra-operatively and the hernia was repaired using synthetic mesh. The patient was free of recurrence at 4 months after the operation. Conclusion A lumbar or flank mass should always raise suspicion of a lumbar hernia. Ultrasound and computed tomography may confirm the diagnosis. Adequate surgical treatment should be planned on the basis of etiology and hernia size. Both open and laparoscopic techniques can be used with good results.

  16. Fungal abdominal wall abscess in a renal transplant recipient

    The incidence of fungal infection is significantly higher in patients with end-stage renal disease and renal transplant recipients than in normal individuals. Candida Albicans is an uncommon cause of abdominal wall abscess. We describe a 37 year-old renal transplant recipient with such an infection. He presented with a typical clinical manifestations and an insidious course, but was successfully treated with antifungal therapy. (author)

  17. Embolotherapy using N-butyl cyanoacrylate for abdominal wall bleeding

    Choi, Young Ho; Koh, Young Hwan; Han, Dae Hee; Kim, Ji Hoon; Cha, Joo Hee; Lee, Eun Hye; Song, Chi Sung [Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2008-05-15

    We describe our experience with the use of N-butyl cyanoacrylate (NBCA) embolization of abdominal wall bleeding and we evaluate the clinical effectiveness of the procedure. Embolization was performed in nine patients with abdominal wall bleeding. The sites of embolization were the left first lumbar (n = 1), left second lumbar (n = 1), right inferior epigastric (n 2), left inferior epigastric (n = 3), right circumflex iliac (n = 1), and left circumflex iliac artery (n = 1). A coil was used with NBCA in one patient due to difficulty in selecting only a bleeding focus and anticipated reflux. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:4. Blood pressure and heart rate were measured before and after the embolization procedure, and the serial hemoglobin and hematocrit levels and transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Hemostasis was obtained in six out of the nine patients and technical success was achieved in all patients. There were no procedure-related complications. Four out of the nine patients died due to rebleeding of a subarachnoid hemorrhage (n = 1), multiorgan failure (n = 1), and hepatic failure (n =2) that occurred two to nine days after the embolization procedure. One patient had rebleeding. The five surviving patients had no rebleeding, and the patients continue to visit the clinical on an outpatient basis. NBCA embolization is a clinically safe procedure and is effective for abdominal wall bleeding.

  18. Embolotherapy using N-butyl cyanoacrylate for abdominal wall bleeding

    We describe our experience with the use of N-butyl cyanoacrylate (NBCA) embolization of abdominal wall bleeding and we evaluate the clinical effectiveness of the procedure. Embolization was performed in nine patients with abdominal wall bleeding. The sites of embolization were the left first lumbar (n = 1), left second lumbar (n = 1), right inferior epigastric (n 2), left inferior epigastric (n = 3), right circumflex iliac (n = 1), and left circumflex iliac artery (n = 1). A coil was used with NBCA in one patient due to difficulty in selecting only a bleeding focus and anticipated reflux. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:4. Blood pressure and heart rate were measured before and after the embolization procedure, and the serial hemoglobin and hematocrit levels and transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Hemostasis was obtained in six out of the nine patients and technical success was achieved in all patients. There were no procedure-related complications. Four out of the nine patients died due to rebleeding of a subarachnoid hemorrhage (n = 1), multiorgan failure (n = 1), and hepatic failure (n =2) that occurred two to nine days after the embolization procedure. One patient had rebleeding. The five surviving patients had no rebleeding, and the patients continue to visit the clinical on an outpatient basis. NBCA embolization is a clinically safe procedure and is effective for abdominal wall bleeding

  19. Comparison between general and spinal anesthesia in inguinal hernia repair in Clinical University Hospital "St. Naum Ohridski" - Skopje

    Vukovikj, Makedonka; Angelovska, Bistra; Drakalska, Elena

    2015-01-01

    Most often recommended treatment for inguinal hernia diagnosed patients is surgery. Generally, the surgical treatment includes several components: opening the subcutaneous fat by incision of the abdominal wall, mobilization of cord structures, dissection of weakened tissue and closure of inguinal canal with application of sterile synthetic mesh patch used to repair and decrease the tension in the weakened area of the abdominal wall after mobilization of hernia. Usually, the patient is given g...

  20. Abdominal wound closure: current perspectives

    Williams ZF

    2015-12-01

    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  1. Congential Lumbar Hernia with Malrotation of Left Kidney and Hydronephrosis in an Infant: A Rare Presentation

    Kapoor, Rohit; Paul, Premila; Sachdeva, Sarthak

    2014-01-01

    Congenital Lumbar hernia was previously known as Lumbocostovertebral syndrome. This syndrome consists of the presence of hemivertebrae, rib defects, abdominal wall anomalies and hypoplasia of the abdominal musculature. This case report describes a 40-hour-old infant with malrotation of left kidney and hydronephrosis in association with congenital lumbar hernia. Various congenital renal anomalies like renal pyelectasis, bilateral renal agenesis and pelviureteric junction obstruction, malascend...

  2. Laparoscopic Inguinal Hernia Repair

    ... wall to weaken or separate. What are the Advantages of Laparoscopic Inguinal Hernia Repair? Laparoscopic Hernia Repair ... underlying medical conditions. What Preparation is Required? Keep reading... Page 1 of 2 1 2 » Brought to ...

  3. Hérnia lombar encarcerada complicada com obstrução intestinal e perfuração de ceco Incarcerated lumbar hernia associated to intestinal obstruction and cecal perfuration

    Sinthia Maria Benigno Puttini; André Luiz Vianna; Luiz Guilherme Reys

    2003-01-01

    Lumbar hernia is defined as an abdominal passage through the posterior abdominal wall. Approximately 250 to 300 cases have been described in the literature, being quite infrequent. Untreated lumbar hernia may result in severe complications. The authors report a case of a 60 year old male patient presenting a large bowel obstruction and perfuration secundary to incarceration of descending colon within a lumbar hernia. This was diagnosed by clinical history and computed tomography. The patient ...

  4. Hérnia lombar encarcerada complicada com obstrução intestinal e perfuração de ceco Incarcerated lumbar hernia associated to intestinal obstruction and cecal perfuration

    Sinthia Maria Benigno Puttini

    2003-04-01

    Full Text Available Lumbar hernia is defined as an abdominal passage through the posterior abdominal wall. Approximately 250 to 300 cases have been described in the literature, being quite infrequent. Untreated lumbar hernia may result in severe complications. The authors report a case of a 60 year old male patient presenting a large bowel obstruction and perfuration secundary to incarceration of descending colon within a lumbar hernia. This was diagnosed by clinical history and computed tomography. The patient was successfully treated surgically.

  5. Component separation in abdominal trauma.

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334

  6. Abdominal Wall Hydatid Cyst: Case Report and Review of Literature

    V. Abhishek

    2012-01-01

    Full Text Available A 60-year-old woman presented with a swelling in right paraumbilical region of one-year duration. Examination revealed a painless cystic swelling 15 × 10 cm with cough impulse. Ultrasound and CECT abdomen showed a subcutaneous cystic swelling with intramuscular extension. No other intraabdominal cystic lesions were found. Surgical exploration showed a cystic lesion adherent to peritoneum without any intraperitoneal extension. Cyst was carefully excised without any spillage. Gross specimen on opening showed multiple daughter cysts consistent with hydatid cyst, confirming the diagnosis of solitary abdominal wall hydatid cyst.

  7. Current Status of Hernia Centres Around the Globe.

    Kulacoglu, Hakan; Oztuna, Derya

    2015-12-01

    Institutions specifically dedicated to treatment of abdominal wall hernias have gained popularity over the last years. This study aimed to determine the current situation of hernia centres worldwide. A web-based search was conducted using the common search engines Google and PubMed. The details recorded were as follows: name of the centre, country, establishment year, administrative structure (hospital affiliated, private practice group, or independent solo practice), whether or not the centre has its own operation room, the number of employed surgeons, preferred anaesthesia type, preferred repair type, laparoscopic technique option, case volume per year, and the number of scientific publications. A total of 182 centres were found in 30 different countries. Eighty-one (44.5 %) centres provide services as part of an affiliation within a general hospital (18 in university hospitals). Only 28 (15.5 %) of the centres have published a paper on abdominal wall hernias indexed by PubMed. The total number of papers in PubMed by 182 centres is 354. We observed that clinical outcomes in hernia centres are not shared globally by publishing them in scientific journals, and whether specific hernia surgeons and centres provide better outcomes in treating abdominal wall hernias, compared to general surgeons who deal with all kinds of surgical procedures, remains unclear. PMID:27011503

  8. Abdominal adiposity is the main determinant of the C-reactive response to injury in subjects undergoing inguinal hernia repair

    Irkulla Sashidhar

    2013-02-01

    Full Text Available Abstract Background Obesity and serum C-reactive protein (CRP (a sensitive marker of inflammatory activity are associated with most chronic diseases. Abdominal adiposity along with age is the strongest determinant of baseline CRP levels in healthy subjects. The mechanism of the association of serum CRP with disease is uncertain. We hypothesized that baseline serum CRP is a marker of inflammatory responsiveness to injury and that abdominal adiposity is the main determinant of this responsiveness. We studied the effect of abdominal adiposity, age and other environmental risk factors for chronic disease on the CRP response to a standardised surgical insult, unilateral hernia repair to not only test this hypothesis but to inform the factors which must be taken into account when assessing systemic inflammatory responses to surgery. Methods 102 male subjects aged 24-94 underwent unilateral hernia repair by a single operator. CRP was measured at 0, 6, 24 and 48 hrs. Response was defined as the peak CRP adjusted for baseline CRP. Results Age and waist:hip ratio (WHR were associated both with basal CRP and CRP response with similar effect sizes after adjustment for a wide-range of covariates. The adjusted proportional difference in CRP response per 10% increase in WHR was 1.50 (1.17-1.91 p = 0.0014 and 1.15(1.00-1.31 p = 0.05 per decade increase in age. There was no evidence of important effects of other environmental cardiovascular risk factors on CRP response. Conclusion Waist:hip ratio and age need to be considered when studying the inflammatory response to surgery. The finding that age and waist:hip ratio influence baseline and post-operative CRP levels to a similar extent suggests that baseline CRP is a measure of inflammatory responsiveness to casual stimuli and that higher age and obesity modulate the generic excitability of the inflammatory system leading to both higher baseline CRP and higher CRP response to surgery. The mechanism for

  9. A Risk Model and Cost Analysis of Incisional Hernia After Elective, Abdominal Surgery Based Upon 12,373 Cases

    Fischer, John P.; Basta, Marten N.; Mirzabeigi, Michael N.; Bauder, Andrew R.; Fox, Justin P.; Drebin, Jeffrey A.; Serletti, Joseph M.; Kovach, Stephen J.

    2016-01-01

    Objectives: Incisional hernia (IH) remains a common, highly morbid, and costly complication. Modest progress has been realized in surgical technique and mesh technology; however, few advances have been achieved toward understanding risk and prevention. In light of the increasing emphasis on prevention in today's health care environment and the billions in costs for surgically treated IH, greater focus on predictive risk models is needed. Methods: All patients undergoing gastrointestinal or gynecologic procedures from January 1, 2005 to June 1, 2013, within the University of Pennsylvania Health System were identified. Comorbidities and operative characteristics were assessed. The primary outcome was surgically treated IH after index procedures. Patients with prior hernia, less than 1-year follow-up, or emergency surgical procedures were excluded. Cox hazard regression modeling with bootstrapped validation, risk factor stratification, and assessment of model performance were conducted. Results: A total of 12,373 patients with a 3.5% incidence of surgically treated IH (follow-up 32.2 ± 26.6 months) were identified. The cost of surgical treatment of IH and management of associated complications exceeded $17.5 million. Notable independent risk factors for IH were ostomy reversal (HR = 2.76), recent chemotherapy (HR = 2.04), bariatric surgery (HR = 1.78), smoking history (HR = 1.74), liver disease (HR = 1.60), and obesity (HR = 1.96). High-risk patients (20.6%) developed IH compared with 0.5% of low-risk patients (C-statistic = 0.78). Conclusions: This study demonstrates an internally validated preoperative risk model of surgically treated IH after 12,000 elective, intra-abdominal procedures to provide more individualized risk counseling and to better inform evidence-based algorithms for the role of prophylactic mesh. PMID:26465784

  10. Comparison of two surgical techniques in large incisional hernias

    Mustafa Sit

    2014-03-01

    Full Text Available Objectives: Incisional hernias occur from incisions of previous abdominal operations. It is an often complication of abdominal interventions. Prevalence of incisional hernias is approximately 2.9% and 3.6% in vertical midline incisions and transverse incisions, respectively. Incisional hernias cause morbidity and loss of manpower. The only treatment option is surgery. We aimed to compare surgical methods of incisional hernias and discuss the postoperative data in this retrospective report. Methods: We retrospectively analyzed the data of 54 patients with large incisional hernias operated between 2007 and 2011. Results: We compared age, chronic diseases (e.g. Chronic obstructive pulmonary disease, diabetes mellitus,which may cause postoperative recurrence, gender, personal factors, such as patients undergoing incisional hernia repair mesh over solid fascia less or over than 5 cm with the placement of decolation; recurrence, the development of postoperative seroma, receiving postoperative drainage and postoperative length of hospital stay were compared. While the recurrence rate of less than 5 cm above the decolation; seroma development, no significant difference in length of hospital stay and drain times to get. Conclusion: In conclusion, we think that recurrence rate should be reduced by dissection of 5 cm intact fascia and grafting in incisional hernias of anterior abdominal wall. J Clin Exp Invest 2014; 5 (1: 36-39

  11. Congenital Spigelian Hernia and Cryptorchidism: Another Case of New Syndrome

    Dhiraj Parihar

    2013-09-01

    Full Text Available Spigelian hernia (SH is rarely seen in pediatric age group and is usually associated with cryptorchidism on the same side; termed as a syndromic association of the defect in the Spigelian fascia and absence of gubernaculum and inguinal canal. The absence of the inguinal canal has surgical implication as to placement of the undescended testis into the scrotum. A 3-month-old baby presented with spigelian hernia and ipsilateral impalpable testis. The spigelian hernia was repaired and undescended testis which was present in abdominal wall layers was brought to scrotum with cord structures anterior to external oblique muscle.

  12. Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

    Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)

    2009-12-15

    Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

  13. Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

    Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

  14. Component separation in abdominal trauma

    Rawstorne, Edward; Smart, Christopher J.; Fallis, Simon A.; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and t...

  15. Primary abdominal wall clear cell carcinoma arising from incisional endometriosis

    Burcu Gundogdu; Isin Ureyen; Gunsu Kimyon; Hakan Turan; Nurettin Boran; Gokhan Tulunay; Dilek Bulbul; Taner Turan; M Faruk Kose

    2013-01-01

    A 49 year-old patient with the complaint of a mass located in the caesarean scar was admitted. There was a fixed mass 30í30 mm in diameter with regular contour located at the right corner of the pfannenstiel incision. Computed tomography revealed a (40í50í50) mm solid mass lesion with margins that cannot be distinguished from the uterus, bladder and small intestines and a heterogeneous mass lesion (50í45í55) mm in diameter, located in the right side of the anterior abdominal wall. Cytoreductive surgery including total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Final pathology was clear cell carcinoma. Clear cell carcinoma arising from an extraovarian endometriotic focus was diagnosed and the patient received 6 cycles paclitaxel-carboplatin chemotherapy as adjuvant treatment. The patient who was lost to follow-up applied to our clinic 2 years after surgery with a recurrent mass in the left inguinal region. After 3 cycles of chemotherapy, the patient's tumoral mass in the left inguinal region was excised. The result of the pathology was carcinoma metastasis. It is decided that the following treatment of the patient should be palliative radiation therapy. The patient who underwent palliative radiation therapy died of disease after 4 months of the second operation.

  16. Bilaterally Incarcerated Morgagni Hernia

    Zuhal Demirhan Yananli

    2013-06-01

    Full Text Available Morgagni hernia is a rare congenital diaphragmatic hernia. It is seen rarely bilaterally. Patients are usually asymptomatic. Therefore, diagnosis may be delayed until adulthood. Significant morbidity can occur in case complications arise and diagnosis is delayed. The patient, a 74 year-old female, presented in this article, was admitted to the emergency department with abdominal pain, vomiting, and shortness of breath. The plain abdominal radiograph of the patient revealed bowel obstruction and suspicious appearence in favor of the diaphragmatic hernia on both sides of the sternum. Computed tomography revealed bilaterally incarcerated Morgagni hernia with strangulated omentum in the right side of the sternum and a part of colon in the left side of sternum. Incarcerated organs were withdrawn to peritoneal cavity and defects of hernia were sutured primarily on laparatomy. Because bilateral incarcerated Morgagni hernia can be seen rarely, this case was reported.

  17. PRIMARY SYNOVIAL SARCOMA OF THE ABDOMINAL WALL: A CASE REPORT AND REVIEW OF THE LITERATURE

    Saif, Alsaif H.

    2008-01-01

    Synovial sarcoma is a malignant mesenchymal neoplasm which commonly occurs in the extremities of adults, in close association with joint capsules, tendon sheaths, bursae and fascial structures. Only a few cases of synovial sarcoma occurring in the abdominal wall have been reported. A case of a primary synovial sarcoma arising from the anterior abdominal wall fascial aponeurosis is presented.

  18. Primary synovial sarcoma of the abdominal wall: A case report and review of the literature

    Alsaif H Saif

    2008-01-01

    Full Text Available Synovial sarcoma is a malignant mesenchymal neoplasm which commonly occurs in the extremities of adults, in close association with joint capsules, tendon sheaths, bursae and fascial structures. Only a few cases of synovial sarcoma occurring in the abdominal wall have been reported. A case of a primary synovial sarcoma arising from the anterior abdominal wall fascial aponeurosis is presented.

  19. Malignant transformation of abdominal wall endometriosis with lymph node metastasis ☆

    Fargas Fàbregas, Francesc; Cusidó Guimferrer, Maite; Tresserra Casas, Francesc; Baulies Caballero, Sonia; Fábregas Xauradó, Rafael

    2014-01-01

    Highlights • A simple endometriosis can result in malignancy pathology, as a neoplasia. • Wall-abdominal tumors and soft tissue as a possible differential diagnosis of abdominal wall endometriosis • Preperitoneal node-metastasis as malignancy of endometriosis in previous cesarean scar

  20. [Large abdominal wall reconstruction by free flap after recurrence of a dermatofibrosarcoma protuberans].

    Le Fourn, B; Lejeune, F; Sartre, J Y; Loirat, Y; Pannier, M

    1996-12-01

    Based on a case of recurrence of a dermatofibrosarcoma protuberans of the abdominal wall, the authors discuss the need for initial wide resection of this type of skin tumour and the possibilities of repair of extensive full thickness defects of the abdominal wall by means of a latissimus dorsi myocutaneous free flap. PMID:9768175

  1. Incisional hernia as a late surgical complication of an infertile patient treated for abdominal tuberculosis

    Kameshwarachari Pushpalatha; Tushar Subhadarshan Mishra; Nerbadyswari Deep

    2015-01-01

    Abdominal tuberculosis (TB) can be of various forms including peritoneal TB, tuberculous lymphadenopathy, gastrointestinal TB and visceral TB. The potential pathway includes direct spread to the peritoneum from infected adjacent foci, including the fallopian tubes or adnexa, or psoas abscess, secondary to tuberculous spondylitis. The exact stimulus for the inflammatory reaction is not known, but some suggest that it may arise due to a subclinical primary viral peritonitis, as an immunological...

  2. Relación entre la presión intrabdominal en diálisis peritoneal con las hernias y fugas The link between intra-abdominal pressure in peritoneal dialysis and hernias and fugues

    Concepción Blasco Cabañas; Esther Ponz Clemente; Loreley Betancourt Castellanos; Sol Otero López; Dolores Marquina Parra; Carmen Gran Pueyo; Carmen Moya Mejía

    2012-01-01

    La presión intrabdominal normal es igual a la atmosférica (cero). En Diálisis Peritoneal con la introducción del líquido intraperitoneal, la presión intrabdominal aumenta. En varios estudios se aconseja que esta no supere los 16-20 cm. H2O. Además de las posibles molestias abdominales, una presión intrabdominal elevada puede tener relación con los problemas de la pared abdominal, como hernias y fugas y tener implicaciones en el transporte peritoneal y el déficit de ultrafiltración. Los objeti...

  3. A case report on management of synergistic gangrene following an incisional abdominal hernia repair in an immunocompromised obese patient

    N. Merali

    2015-01-01

    Conclusion: This case has demonstrated how a planned multidisciplinary action can produce prosperous results in a severely obese immunocompromised patient with an SSI, following an incisional hernia repair.

  4. Involvement of the chest and abdominal wall as a rave manifestation in Hodgkin's disease

    Radiological findings of chest and abdominal wall involvement in Hodgkin's disease are reported. This manifestation was diagnosed in one patient in the primary staging and in two patients during the course of the disease. Typical radiological findings are soft tissue masses in the chest and abdominal wall, in two cases with continous tumor growth of enlarged mediastinal lymphnodes into the anterior chest wall. The axial computed tomography is the best method to evaluate the extent of chest and abdominal wall involvement in Hodgkin's disease. (orig.)

  5. Effects of aging on abdominal wall healing in rats

    Biondo-Simões Maria de Lourdes Pessole

    2005-01-01

    Full Text Available PURPOSE: The aim of this study was to assess abdominal wall healing in old and young adult rats. METHODS: On average, young animals were 110 days old and old animals were 762 days old. A 4.0 cm median laparotomy was performed under anesthesia, followed by laparorrhaphy on two synthesis planes, i.e. peritoneum-muscle-aponeurosis and skin, using continuous 5.0 nylon sutures. The animals were evaluated on the 3rd, 7th, 14th and 21st postoperative days. The resistance of the two planes was studied separately and a histopathologic analysis was performed on sections stained with hematoxylin-eosin and Sirius Red. Immunohistochemical analysis was also carried out using PCNA, LCA and CD34. RESULTS: The skin scars gained resistance in a similar manner at the initial time points, but those of young rats were more resistant on the 21st day (p=0.0029. Total and type III collagen content was similar in the two groups and type I collagen content was higher in young animals on the 14th day. Inflammatory cell infiltration was more marked in the skin wounds of young animals on the 3rd day (p=0.0190. Reepithelialization was similar and angiogenesis was more intense in the skin wounds of young animals on the 14th day (p=0.0062. The peritoneum-muscle-aponeurosis wounds gained similar resistance during the early phases, but were more resistant on the 14th day (p=0.0005 and on the 21st day (p=0.0023 in old rats Collagen concentration was higher in the wounds of old animals on the 3rd day (p=0.0112 and in the wounds of young animals on the 21st day (p=0.0348. The inflammatory reaction was more intense in the wounds of old animals on the 3rd day (p=0.0060 and angiogenesis was more intense on the 14th day (0.0432. CONCLUSION: Although there are some differences in the healing course between young and old animals, age, of itself, does not impair the healing of abdominal wall wounds in rats.

  6. The Use of Tensor Fascia Lata Pedicled Flap in Reconstructing Full Thickness Abdominal Wall Defects and Groin Defects Following Tumor Ablation

    abdominal wall reconstruction, one case developed ventral hernia, in which bilateral TFL flaps were used without mesh enforcement. There was minimal donor site morbidity in the form of partial skin graft loss in 2 cases. The average follow up period in this study ranged from 6 months to 2 years. Only one patient died of distant metastasis of a see of the groin skin, 8 months postoperatively and another 2 patients with abdominal desmoid tumors developed local recurrence. The tensor fascia lata flap is a reliable and a versatile flap, with minimal donor site morbidity. Problems with the flap's vascularity of its distal part should not be encountered, if the flap is harvested within the safe limits and properly designed and the edges comfortably insetted to the defect. A pedicled flap would be appropriate for lower abdominal wall defects, and is better islanded to achieve extra mobilization and allow a tension free closure, while for groin defects, simple flap transposition should be enough. Nevertheless, reconstruction for full thickness abdominal wall defects by this flap is a static reconstruction. We therefore strongly recommend enforcing the repair with a synthetic mesh primarily to minimize the incidence of ventral hernia. However, further studies with larger number of cases are needed to confirm this observation

  7. Development of a dynamic model for ventral hernia mesh repair

    Siassi, M; Mahn, A; Baumann, E.; Vollmer, M.; Huber, G.; Morlock, M.; Kallinowski, F.

    2014-01-01

    Introduction The adequate way of mesh fixation in laparoscopic ventral hernia repair is still subject to debate. So far, simulation has only been carried out in a static way, thereby omitting dynamic effects of coughing or vomiting. We developed a dynamic model of the anterior abdominal wall. Materials and methods An aluminium cylinder was equipped with a pressure controlled, fluid-filled plastic bag, simulating the abdominal viscera. A computer-controlled system allowed the control of influx...

  8. Functional outcome after laparoscopic and open incisional hernia repair

    EKER, Hasan; Hartog, Dennis; Tuinebreijer, Wim; Kleinrensink, Gert Jan; Stam, Henk; Lange, Johan

    2010-01-01

    textabstractAbstract: Background: The debate about the advantages of laparoscopic versus open incisional hernia repair is still ongoing. The primary outcomes of already published studies are mainly recurrence, pain and quality of life. Data on postoperative abdominal wall function after these corrections is still lacking. In this single center study muscle strength and transverse abdominal muscle thickness were analysed with regard to open and laparoscopic techniques. Methods: Thirty-five pat...

  9. Blunt Abdominal Wall Disruption by Seatbelt Injury; A Case Report and Review of the Literature

    Maarten Philip Cornelissen

    2016-04-01

    Full Text Available With the introduction of the use of seatbelts in cars, mortality following motor vehicle crashes has decreased significantly. However, two patterns of injuries, the ‘seatbelt sign’ and ‘seatbelt syndrome’ have emerged. Injuries may consist of traumatic abdominal wall disruption. We present two cases of severe abdominal wall disruption caused by a seatbelt injury and treated with primary repair. A review of the literature is provided. Two patients were brought in after a high velocity Motor Vehicle Collision. Both presented with an acute abdomen and a seatbelt sign upon which the decision was made to perform emergency laparotomies. Both patients had an abdominal wall disruption along the seatbelt sign. These disruptions were primarily closed and during six months of follow-up no complications occurred. A disruption of the abdominal wall is a rare complication. However, it is a diagnosis that may not be missed as patients have a higher risk of morbidity and mortality. CT-scanning is an accurate method to detect disruptions. Closure of blunt traumatic abdominal wall disruption can be done primarily with sutures or addition of a mesh. In both cases of the severe abdominal wall disruption, primary repair without mesh in the acute phase was successful. When a laparotomy is not indicated, the abdominal wall must be assessed for disruption. If there is a disruption primary repair is a good option.

  10. Appearance of abdominal wall endometriosis on MR imaging

    Busard, Milou P.H.; Kuijk, Cees van; Waesberghe, Jan Hein T.M. van [VU Medical Center, Department of Radiology, Endometriosis Center VUMC, Amsterdam (Netherlands); Mijatovic, Velja; Hompes, Peter G.A. [VU Medical Center, Department of Gynecology, Endometriosis Center, Amsterdam (Netherlands)

    2010-05-15

    Abdominal wall endometriosis (AWE) is defined as endometrial tissue that is superficial to the peritoneum. AWE is often difficult to diagnose, mimicking a broad spectrum of diseases. The aim of this study was to describe the appearance of AWE on magnetic resonance (MR) imaging. We present ten patients with AWE (12 lesions) in which MR imaging was used for diagnosis. MR imaging included T2-weighted imaging and T1-weighted imaging with fat suppression. To assess the value of diffusion-weighted imaging (DWI) in endometriosis, four patients underwent additional DWI. The apparent diffusion coefficient (ADC) was calculated using b values of 50, 400, 800 and 1,200 s/mm{sup 2}. In most cases, the lesion was located ventral or dorsal to the aponeurosis of the rectus oblique muscle (n=6) or in the rectus abdominis (n = 5). MR of AWE lesions showed isointense or slightly hyperintense signal compared with muscle on T2-weighted images and showed isointense or slightly hyperintense signal compared with muscle on T1-weighted images with foci of high signal intensity, indicative of haemorrhage. The mean ADC value of AWE was 0.93 x 10{sup -3}/mm{sup 2}/s. MR imaging seems to be useful in determining the location and depth of infiltration in surrounding tissue preoperatively. (orig.)

  11. Appearance of abdominal wall endometriosis on MR imaging

    Abdominal wall endometriosis (AWE) is defined as endometrial tissue that is superficial to the peritoneum. AWE is often difficult to diagnose, mimicking a broad spectrum of diseases. The aim of this study was to describe the appearance of AWE on magnetic resonance (MR) imaging. We present ten patients with AWE (12 lesions) in which MR imaging was used for diagnosis. MR imaging included T2-weighted imaging and T1-weighted imaging with fat suppression. To assess the value of diffusion-weighted imaging (DWI) in endometriosis, four patients underwent additional DWI. The apparent diffusion coefficient (ADC) was calculated using b values of 50, 400, 800 and 1,200 s/mm2. In most cases, the lesion was located ventral or dorsal to the aponeurosis of the rectus oblique muscle (n=6) or in the rectus abdominis (n = 5). MR of AWE lesions showed isointense or slightly hyperintense signal compared with muscle on T2-weighted images and showed isointense or slightly hyperintense signal compared with muscle on T1-weighted images with foci of high signal intensity, indicative of haemorrhage. The mean ADC value of AWE was 0.93 x 10-3/mm2/s. MR imaging seems to be useful in determining the location and depth of infiltration in surrounding tissue preoperatively. (orig.)

  12. [Surgical treatment of the defects of the lumbar-lateral region of the abdominal wall in elderly and senile patients].

    Vorovs'kyĭ, O O

    2012-12-01

    The results of surgical treatment of 44 patients with defects in the lumbar-lateral abdomen. Age of patients ranged from 60 to 78 years. Causes defects in 32 (72.7%) patients were hernia after surgical interventions on the urinary system using lumbotomic accesses; in 4 (9.1%)--hernias, in 2 (4.5%)--eventration after applying troakar lateral openings during laparoscopic surgery; in 2 (4.5%)--hernias, in 2 (4.5%)--eventration, and in 2 (4.5%)--evisceration through aperture after removing drains for drainage of the abdominal cavity. To prevent the development of the proposed method of drainage of the abdominal cavity during laparoscopic operations (patent for useful model No 51170 from 12.07.10). Autotransplantation own tissues justified by the size of the defect W1. If there is a defect larger aloplastyc shown by the method of sub lay in the proposed original method. PMID:23610821

  13. Fibrolipoma of the Anterior Abdominal Wall: an Atypical Presentation; Fibrolipoma de la pared abdominal anterior de presentacion atipica

    Lorente, R.M.; Diaz, J. M.; Valle, Y. del; Gallego, I. [Hospital Universitario Santa Cristina. Madrid (Spain)

    2004-07-01

    Fibrolipoma is a type of lipoma that contains fibrous tissue. We present the case of an unusually large anterior abdominal wall fibrolipoma presenting rarely seem radiological characteristics which hinder its radiological diagnosis. We present the findings in ultrasound scan CT, surgery and pathological anatomy, as well as the lesion's differential diagnosis. (Author) 12 refs.

  14. [Median incisional hernias and coexisting parastomal hernias : new surgical strategies and an algorithm for simultaneous repair].

    Köhler, G

    2014-08-01

    The co-occurrence of incisional and parastomal hernias (PSH) remains a surgical challenge. Standardized treatment guidelines are missing, and the patients concerned require an individualized surgical approach. The laparoscopic techniques can be performed with incised and/or stoma-lateralizing flat meshes with intraperitoneal onlay placement. The purely laparoscopic and laparoscopic-assisted approaches with 3-D meshes offer advantages regarding the complete coverage of the edges of the stomal areas and the option of equilateral or contralateral stoma relocation in cases of PSH, which are difficult to handle due to scarring, adhesions, and large fascial defects > 5 cm with intestinal hernia sac contents. A relevant stoma prolapse can be relocated by tunnel-like preformed 3-D meshes and shortening the stoma bowel. The positive effect on prolapse prevention arises from the dome of the 3-D mesh, which is directed toward the abdominal cavity and tightly fits to the bowel. In cases of large incisional hernias (> 8-10 cm in width) or young patients with higher physical demands, an open abdominal wall reconstruction in sublay technique is required. Component separation techniques that enable tension-free ventral fascial closure should be preferred to mesh-supported defect bridging methods. The modified posterior component separation with transversus abdominis release (TAR) and the minimally invasive anterior component separation are superior to the original Ramirez technique with respect to wound morbidity. By using 3-D textile implants, which were specially designed for parastomal hernia prevention, the stoma can be brought out through the lateral abdominal wall without increased risk of parastomal hernia or prolapse development. An algorithm for surgical treatment, in consideration of the complexity of combined hernias, is introduced for the first time. PMID:24823998

  15. Tratamento cirúrgico das distrofias da parede abdominal no adulto Dystrophies of the abdominal wall in adults

    Fortunato Jayme Athias

    1998-04-01

    operações sem dermolipectomia (2,5%; uma necrose de linha média+embolia pulmonar (1,26%; e um óbito por embolia pulmonar (1,26%.The authors present a retrospective study of 79 patients with abdominal dystrophies, both with and without hernias, operated on from June 1st, 1994 to December,31,1996. Their average age was 47 years. The incisional hernia it self and the dystrophic abdomen were principal objects of the study. The authors show the importance of abdominal dermolipectomy for the complete recovery of the patient as well as demonstrate how it facilitates the technical manipulation of hernias. The technique of bilateral, longitudinal peritonio-aponeurotic transposition (the technique of Alcino Lázaro da Silva was used for large incisional hernias. This technique has been approved by its good results (5% of relapses in five years of follow up according the author. In this technique we use three levels of suture without superposing each other. The great advantage of the technique is that we use the herniary sac itself to close the ring and to strengthen. It avoids the use of meshes and the its complications (rejections, fistulas, etc.. A variation of this technique, for hernias with a hernial ring up to 10cm, is proposed by the authors, which consists in the closure of the ring and the reinforcement of the suture with the hernial sac overlapping its edge. The advantage is the facility of performing, reductions in the operative time and to avoid large dissections of the aponeurotic layer. When the herniary ring is 10cm or bigger it is possible to slack the tension by making a relaxing incision over on the anterior rectum abdominal aponeurosis and covering the wide area with the hernial sac. A review is made of the results of these procedures done associated with abdominal dermolipectomy isolated. The results are: 63 patients recovered without complications (81.66%, three relapsed (3.8%, one of extensive hematoma (1.26%, one necrosis of the midline with respiratory

  16. Abdominal closure reinforcement by using polypropylene mesh functionalized with poly-Ԑ-caprolactone nanofibers and growth factors for prevention of incisional hernia formation

    Plencner M

    2014-07-01

    Full Text Available Martin Plencner,1,2,* Barbora East,3,* Zbynek Tonar,4 Martin Otáhal,5 Eva Prosecká,1,2 Michala Rampichová,2,6 Tomáš Krejčí,3 Andrej Litvinec,2,7 Matej Buzgo,2,6 Andrea Míčková,1,2,6 Alois Nečas,8 Jirí Hoch,3 Evžen Amler1,2,9 1Institute of Biophysics, Second Faculty of Medicine, Charles University in Prague, Prague, 2Laboratory of Tissue Engineering, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, 3Department of Surgery, Second Faculty of Medicine, Charles University in Prague, Prague, 4Biomedical Centre, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, 5Department of Anatomy and Biomechanics, Faculty of Physical Education and Sport, Charles University in Prague, Prague, 6University Center for Energy Efficient Buildings, Czech Technical University in Prague, Buštehrad, 7Department of Breeding and Zoohygiene of Laboratory Animals, Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, 8Department of Surgery and Orthopedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Science Brno, Central European Institute of Technology, Brno, 9Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic *These authors contributed equally to this work Abstract: Incisional hernia affects up to 20% of patients after abdominal surgery. Unlike other types of hernia, its prognosis is poor, and patients suffer from recurrence within 10 years of the operation. Currently used hernia-repair meshes do not guarantee success, but only extend the recurrence-free period by about 5 years. Most of them are nonresorbable, and these implants can lead to many complications that are in some cases life-threatening. Electrospun nanofibers of various polymers have been used as tissue scaffolds and have been explored extensively in the last decade, due to their low cost and good biocompatibility. Their

  17. Intraperitoneal granulomatous foreign body reaction after accidental perforation of the abdominal wall. Case report

    Lanng, C; Winther-Nielsen, H; Hougen, H P

    After an accidental perforation by a wooden stake of the abdominal wall and distal ileum a 28-year-old man developed an aggressive granulomatous foreign body reaction of the greater omentum with high fever and abdominal pain. The patient was cured by omental resection and prednisone treatment....

  18. Excision of the urachal remnant using the abdominal wall-lift laparoscopy: A case report

    Kosuke Kobayashi

    2016-01-01

    Discussion and conclusion: Urachal sinus excision using the abdominal wall-lift laparoscopy seems to surpass the previously reported methods in term of safety, cosmetics, and adequacy of surgical procedures.

  19. Clear cell carcinoma arising from abdominal wall endometriosis: a unique case with bladder and lymph node metastasis

    Liu, Haiyuan; Leng, Jinghua; Lang, Jinghe; Cui, Quancai

    2014-01-01

    The malignant transformation of abdominal wall endometriosis is a rare event and poorly understood. Less than 30 cases have been reported in the literature. Most of the reported cases have a solitary tumor in the abdominal scar. A few cases have metastasis. Here we report a case of clear cell carcinoma in abdominal wall endometriosis with bladder and lymph system metastasis. The patient had a history of abdominal wall endometriosis and recently developed symptoms of urgent urination and ingui...

  20. The surgical management of soft tissue tumours arising in the abdominal wall

    Pencavel, Tim; Strauss, Dirk C; Thomas, J Meirion; Hayes, Andrew J

    2010-01-01

    Abstract Background Soft-tissue tumours can occur at almost any site, including the abdominal wall and represent a biologically diverse group of benign and malignant tumours. Methods A prospectively-kept database was searched to identify all patients with tumours resected that involved the abdominal wall. The histological diagnosis, complication rates and local recurrence rates were reported. Kaplan-Meier analysis of prognostic factors was determine...

  1. Instant Abdominal Wall Reconstruction with Biologic Mesh following Resection of Locally Advanced Colonic Cancer

    Oskay Kaya; Engin Olcucuoglu; Gaye Seker; Hakan Kulacoglu

    2012-01-01

    We present a case of immediate abdominal wall reconstruction with biologic mesh following the resection of locally advanced colonic cancer. The tumor in the right colon did not respond to neoadjuvant chemotherapy. Surgical enbloc excision, including excision of the invasion in the abdominal wall, was achieved, and the defect was reconstructed with porcine dermal collagen mesh. The patient was discharged with no complication, and adaptation of the mesh was excellent at the six-month followup.

  2. Prenatal diagnosis of a fetal abdominal eventration: a rare congenital abdominal wall defect.

    Roth, Philippe; Martin, Alain; Bawab, Fariz; Fellmann, Florence; Aubert, Didier; Maillet, Robert

    2008-01-01

    We report a case of abdominal eventration associated with cystic fibrosis, diagnosed by mid-trimester ultrasonography. The defect concerned the abdominal muscles and their aponevrotic sheath, but respected the skin. There was no associated malformation. The outcome was favorable after surgery, and the infant is well at the age of 6 months. PMID:18046068

  3. Carbon nanotubes as VEGF carriers to improve the early vascularization of porcine small intestinal submucosa in abdominal wall defect repair

    Liu Z

    2014-03-01

    Full Text Available Zhengni Liu,1,* Xueyi Feng,2,* Huichun Wang,1 Jun Ma,1 Wei Liu,3 Daxiang Cui,4 Yan Gu,1 Rui Tang,11Department of General Surgery, Shanghai Ninth People’s Hospital, Hernia and Abdominal Wall Disease Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of General Surgery, Lu’an People’s Hospital, Lu’an Affiliated Hospital of Anhui Medical University, Lu’an, Province Anhui, People’s Republic of China; 3Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, People’s Republic of China; 4Institute of Nano Biomedicine and Engineering, Key Laboratory for Thin Film and Microfabrication Technology of the Ministry of Education, Research Institute of Micro/Nano Science and Technology, Bio-X Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China *These authors contributed equally to this work Abstract: Insufficient early vascularization in biological meshes, resulting in limited host tissue incorporation, is thought to be the primary cause for the failure of abdominal wall defect repair after implantation. The sustained release of exogenous angiogenic factors from a biocompatible nanomaterial might be a way to overcome this limitation. In the study reported here, multiwalled carbon nanotubes (MWNT were functionalized by plasma polymerization to deliver vascular endothelial growth factor165 (VEGF165. The novel VEGF165-controlled released system was incorporated into porcine small intestinal submucosa (PSIS to construct a composite scaffold. Scaffolds incorporating varying amounts of VEGF165-loaded functionalized MWNT were characterized in vitro. At 5 weight percent MWNT, the scaffolds exhibited optimal properties and were implanted in rats to repair abdominal wall defects. PSIS scaffolds incorporating VEGF165-loaded MWNT (VEGF

  4. Extensive Abdominal Wall Incisional Heterotopic Ossification Reconstructed with Component Separation and Strattice Inlay.

    Suleiman, Nergis Nina; Sandberg, Lars Johan Marcus

    2016-07-01

    Symptomatic heterotopic ossification of abdominal surgical incisions is a rare occurrence. We present a 67-year-old man with severe discomfort caused by heterotopic ossification extending from the xiphoid to the umbilicus. The patient underwent an abdominal aortic aneurysm repair 3 years before our treatment. A 13 × 3.5 cm ossified lesion was excised. The resulting midline defect was closed using component separation and inlay Strattice. Tension-free midline adaptation of the recti muscles was achieved. A computed tomography scan of the abdomen 6 months after the surgery showed no recurrence or hernias. Heterotopic ossification in symptomatic patients has previously been treated with excision and primary closure. We believe that tension-free repair is important to prevent recurrence. Acellular dermal matrix may add to this effect and also compartmentalize the process. PMID:27536495

  5. Necrotizing fasciitis: literature review of contemporary strategies for diagnosing and management with three case reports: torso, abdominal wall, upper and lower limbs

    Roje Zdravko

    2011-12-01

    Full Text Available Abstract Necrotizing fasciitis (NF is an uncommon soft tissue infection, usually caused by toxin-producing virulent bacteria. It is characterized by widespread fascial necrosis primarily caused by Streptococcus hemolyticus. Shortly after the onset of the disease, patients become colonized with their own aerobic and anaerobic microflora from the gastrointestinal and/or urogenital tracts. Early diagnosis with aggressive multidisciplinary treatment is mandatory. We describe three clinical cases with NF. The first is a 69 years old man with diabetes mellitus type II, who presented with NF on the posterior chest wall, shoulder and arm. He was admitted to the intensive care unit (ICU with a clinical picture of severe sepsis. Outpatient treatment and early surgical debridement of the affected zones (inside 3 hours after admittance and critical care therapy were performed. The second case is of a 63 years old paraplegic man with diabetes mellitus type I. Pressure sores and perineal abscesses progressed to Fournier's gangrene of the perineum and scrotum. He had NF of the anterior abdominal wall and the right thigh. Outpatient treatment and early surgical debridement of the affected zones (inside 6 hour after admittance and critical care therapy were performed. The third patient was a 56 year old man who had NF of the anterior abdominal wall, flank and retroperitoneal space. He had an operation of the direct inguinal hernia, which was complicated with a bowel perforation and secondary peritonitis. After establishing the diagnosis of NF of the abdominal wall and retroperitoneal space (RS, he was transferred to the ICU. There he first received intensive care therapy, after which emergency surgical debridement of the abdominal wall, left colectomy, and extensive debridement of the RS were done (72 hours after operation of inquinal hernia. On average, 4 serial debridements were performed in each patient. The median of serial debridement in all three cases was

  6. Bilateral Congenital Diaphragmatic Hernia

    Dhua, Anjan K; Aggarwal, Satish K; NB Mathur; GR Sethi

    2012-01-01

    Bilateral congenital diaphragmatic hernia (CDH) is a rare birth defect, with a poor prognosis. We describe a case of bilateral CDH discovered while repairing the right sided CDH. Diaphragmatic defect was repaired and a silo was applied on the abdominal wound to avoid abdominal compartment syndrome. The patient however died postoperatively due to severe pulmonary hypertension.

  7. Study of Individual Characteristic Abdominal Wall Thickness Based on Magnetic Anchored Surgical Instruments

    Ding-Hui Dong

    2015-01-01

    Full Text Available Background: Magnetic anchored surgical instruments (MASI, relying on magnetic force, can break through the limitations of the single port approach in dexterity. Individual characteristic abdominal wall thickness (ICAWT deeply influences magnetic force that determines the safety of MASI. The purpose of this study was to research the abdominal wall characteristics in MASI applied environment to find ICAWT, and then construct an artful method to predict ICAWT, resulting in better safety and feasibility for MASI. Methods: For MASI, ICAWT is referred to the thickness of thickest point in the applied environment. We determined ICAWT through finding the thickest point in computed tomography scans. We also investigated the traits of abdominal wall thickness to discover the factor that can be used to predict ICAWT. Results: Abdominal wall at C point in the middle third lumbar vertebra plane (L3 is the thickest during chosen points. Fat layer thickness plays a more important role in abdominal wall thickness than muscle layer thickness. "BMI-ICAWT" curve was obtained based on abdominal wall thickness of C point in L3 plane, and the expression was as follow: f(x = P1 × x 2 + P2 × x + P3, where P1 = 0.03916 (0.01776, 0.06056, P2 = 1.098 (0.03197, 2.164, P3 = −18.52 (−31.64, −5.412, R-square: 0.99. Conclusions: Abdominal wall thickness of C point at L3 could be regarded as ICAWT. BMI could be a reliable predictor of ICAWT. In the light of "BMI-ICAWT" curve, we may conveniently predict ICAWT by BMI, resulting a better safety and feasibility for MASI.

  8. Recurrence and pseudorecurrence after laparoscopic ventral hernia repair: predictors and patient-focused outcomes.

    Carter, Stacey A; Hicks, Stephanie C; Brahmbhatt, Reshma; Liang, Mike K

    2014-02-01

    Laparoscopic ventral hernia repair (LVHR) is gaining popularity as an option to repair abdominal wall hernias. Bulging after repair remains common after this technique. This study evaluates the incidence and factors associated with bulging after LVHR. Between 2000 and 2010, 201 patients underwent LVHR at two affiliated institutions. Patients who developed recurrence or pseudorecurrence (seroma or eventration) were analyzed with univariate and multivariate analyses to identify predictors of these complications. Of the 201 patients who underwent LVHR, 40 (19.9%) patients developed a seroma, 63 (31.3%) patients had radiographically proven eventration, and 25 (12.4%) patients had a hernia recurrence. On multivariate analysis, seromas were associated with number of prior ventral hernia repairs, surgical site infections, and prostate disease. Mesh eventration was associated with hernia size and surgical technique. Tissue eventration was associated with primary hernias and surgical technique. Hernia recurrence was associated with incisional hernias and mesh type used. Recurrence and pseudorecurrence are important complications after LVHR. Large hernia size, infections, and surgical technique are important clinical factors that affect outcomes after LVHR. PMID:24480213

  9. Spontaneous rupture of incisional hernia: A rare life-threatening complication of incisional hernia

    2013-01-01

    An incisional hernia develops in the scar of a surgical incision. Spontaneous rupture of an abdominal hernia is very rare and usually occurs in incisional or recurrent groin hernia. This is a report of 50-year-old female who presented with sudden spontaneous rupture of an incisional hernia. This hernia was repaired by mesh repair after repositioning the bowel into the peritoneal cavity and excising the excess atrophied skin. The patient recovered well and was discharge after the 4th day. Spon...

  10. Lateral abdominal wall hematoma as a rare complication after carotid artery stenting: a case report

    Satomi Jyunichiro

    2009-11-01

    Full Text Available Abstract Abdominal wall hematoma is a rare and life-threatening complication after carotid artery stenting (CAS, but it can occur when activated clotting time is prolonged. We report a right lateral abdominal wall hematoma caused by rupture of the superficial circumflex iliac artery after CAS in a 72-year-old man with severe stenosis of the origin of the right internal carotid artery. We performed CAS for the targeted lesion while activated clotting time exceeded 300 seconds. After 2 hours, he complained of right lateral abdominal pain. Abdominal computed tomography revealed an extensive hematoma in the right lateral abdominal wall. Activated clotting time was 180 seconds at this point. Seven hours later, he developed hypotension and hemoglobin level dropped to 11.3 g/dl. Subsequent computed tomography showed enlargement of the hematoma. Emergent selective angiography of the external iliac artery revealed active bleeding from the right superficial circumflex iliac artery. Transcatheter arterial embolization with Gelfoam and microcoils was performed successfully. With more CAS procedures being performed, it is important for endovascular surgeons and radiologists to consider the possibility of abdominal wall hematoma in this situation.

  11. [Biological factors involved in the genesis of incisional hernia].

    Bellón, Juan M; Durán, Hipólito J

    2008-01-01

    In the context of a surgically treated abdominal wall pathology, eventration of the wall, or incisional hernia, is one of the most prevalent complications. Despite numerous improvements over the years in suture materials and closure techniques, the incidence of incisional hernia has not diminished. Several general factors can influence the wound healing process after a laparotomy, but there are also biological factors that depend on the individual patient that can to a great extent explain the un-changing incidence of this pathology. Thus, different types of collagen, certain enzymes such as metalloproteinases and factors such as smoking have been attributed a role in the appearance of incisional hernia. These features suggest the need for a biomaterial to strengthen laparotomy closures, especially midline closures, in high-risk patients and/or in those where wound healing is compromised. PMID:18208741

  12. Cold abscess of the anterior abdominal wall: An unusual primary presentation

    Mohinder Kumar Malhotra

    2012-01-01

    Full Text Available Tuberculosis is considered as ubiquitous disease as it involves any organ, but primary involvement of abdominal muscles is very rare. In most cases, the muscle involvement is secondary and is caused by either hematogenous route or direct inoculation from a tuberculous abdominal lymph node or extension from underlying tubercular synovitis and osteomyelitis. Autopsy studies have shown abdominal wall involvement in less than 1% of patients who died of tuberculosis. Antitubercular therapy is main form of management. Surgical intervention is always secondary in the form of either sonography or computerized tomography-guided aspiration or open drainage which is usually reserved for patients in whom medical treatment has failed. A case is hereby reported about primary tubercular anterior abdominal wall abscess without any evidence of pulmonary, skeletal or gastrointestinal tuberculosis in an apparently healthy individual with any past history of contact or previous antituberculosis therapy.

  13. The Limb-Abdominal Wall Complex Defects, a form of Amniotic Band Sydrome: A Rare Case Report

    Das, Sudhanshu Ku.; Maharana, Sidharth Sankar; Subudhi, Monalisa; Rao, P. V. Subha

    2013-01-01

    The limb-body wall complex defects a form of amniotic band syndrome which consists of a polymal formation with a thoracic and /or an abdominal-schisis, eventration of the internal organ and anomalies of the extremities. We are presenting a case of a limb-body wall complex defect with the phenotype of a placenta-abdominal attachment, anomalies of the abdominal wall defect, absence of the right lower limb and genitourinary defects.

  14. The Limb-Abdominal Wall Complex Defects, a form of Amniotic Band Sydrome: A Rare Case Report.

    Das, Sudhanshu Ku; Maharana, Sidharth Sankar; Subudhi, Monalisa; Rao, P V Subha

    2013-03-01

    The limb-body wall complex defects a form of amniotic band syndrome which consists of a polymal formation with a thoracic and /or an abdominal-schisis, eventration of the internal organ and anomalies of the extremities. We are presenting a case of a limb-body wall complex defect with the phenotype of a placenta-abdominal attachment, anomalies of the abdominal wall defect, absence of the right lower limb and genitourinary defects. PMID:23634417

  15. Massive Localized Lymphedema Arising from Abdominal Wall: A Case Report and Review of the Literature

    Teodóra Tóth; Yi-Che Chang Chien; Sándor Kollár; Ilona Kovács

    2015-01-01

    Massive localized lymphedema (MLL) is a rare pseudosarcomatous lesion due to localized lymphatic obstruction from variable causes. It is most common on medial aspect of thigh and inguinal region. Abdominal localization is rare and may cause clinical diagnostic confusion with other malignant tumors due to its large size. We report a case of abdominal wall MLL of a 56-year-old male patient under clinical suspicion of well differentiated liposarcoma. The literature search and differential diagno...

  16. Intramuscular Abdominal Wall Endometriosis Treated by Ultrasound-Guided Ethanol Injection

    Bozkurt, Murat; Çil, A. Said; Bozkurt, Duygu Kara

    2014-01-01

    Abdominal wall endometriosis (AWE) is a rare condition that usually develops in a surgical scar resulting from a Caesarean section. While commonly seen in the cutaneous and subcutaneous fat tissue at the Caesarean scar level, its intramuscular localization is quite rare. Its treatment options consist of the excision of the lesion and/or hormonal therapies, although wide surgical excision is the treatment of choice in the literature. Wide surgical excision may create a defect in the abdominal ...

  17. Parastomal Hernia Containing Stomach

    Barber-Millet, Sebastian; Pous, Salvador; Navarro, Vicente; Iserte, Jose; García-Granero, Eduardo

    2014-01-01

    Parastomal hernia is the most common late stomal complication. Its appearance is usually asymptomatic. We report a parastomal hernia containing stomach. A 69-year-old patient with end colostomy arrived at the emergency room presenting with abdominal pain associated with vomiting and functioning stoma. She had a distended and painful abdomen without signs of peritoneal irritation and pericolostomic eventration in the left iliac fossa. X-ray visualized gastric fornix dilatation without dilated ...

  18. Ultrasonography and CT findings of epigastric hernia: 3 case report

    Kim, Hyun [Nazarene Jesus Hospital, Daejeon (Korea, Republic of); Kang, Si Won [Taejon St. Mqary' s Hospital, Daejeon (Korea, Republic of)

    1995-02-15

    This article presents and description of the ultrasonographic and computed tomographic findings with a discussion on the imaging features in three patients with epigastric hernias, simulating abdominal wall lipomas. Ultrasonogram showed a heterogeneous hypoechoic mass encircled by echogenic rim within subcutaneous space of the abdominal wall. Computed tomographic findings were a localized fatty mass surrounded by a thin capsule in association with a focal discontinuity of the linea alba. Ultrasonogram was not diagnostic, but computed tomogram was suggestive because of the well demonstrated focal defect in linea alba.

  19. Ultrasonography and CT findings of epigastric hernia: 3 case report

    This article presents and description of the ultrasonographic and computed tomographic findings with a discussion on the imaging features in three patients with epigastric hernias, simulating abdominal wall lipomas. Ultrasonogram showed a heterogeneous hypoechoic mass encircled by echogenic rim within subcutaneous space of the abdominal wall. Computed tomographic findings were a localized fatty mass surrounded by a thin capsule in association with a focal discontinuity of the linea alba. Ultrasonogram was not diagnostic, but computed tomogram was suggestive because of the well demonstrated focal defect in linea alba

  20. Anterior Abdominal Wall Leiomyoma Arising De Novo in a Perimenopausal Woman

    Hamed A. Al-Wadaani

    2012-07-01

    Full Text Available Extrauterine or extraintestinal leiomyomas are extremely uncommon especially in the pre-peritoneal area or within the anterior abdominal wall muscles. These tumors have been ascribed to intraoperative seeding during resection of a fibroid or a leiomyoma of gut, to exogenous hormone replacement therapy or a major derangement of glucose and/or lipid metabolism. So far, there is no published report of de novo origin of anterior abdominal wall pure leiomyoma in the literature. The author herein reports a case of perimenopausal multiparous woman without any listing of previous gynecological surgery or hormone therapy who presented with a large pre-peritoneal intramuscular leiomyoma of the anterior abdominal wall. The patient underwent complete primary resection with amelioration of her symptoms.

  1. European Hernia Society guidelines on the closure of abdominal wall incisions

    Muysoms, F E; Antoniou, S A; Bury, K;

    2015-01-01

    the use of rapidly absorbable sutures. It is suggested using a slowly absorbable monofilament suture in a single layer aponeurotic closure technique without separate closure of the peritoneum. A small bites technique with a suture to wound length (SL/WL) ratio at least 4/1 is the current recommended...

  2. A case report on management of synergistic gangrene following an incisional abdominal hernia repair in an immunocompromised obese patient

    Merali, N.; Almeida, R.A.R.; Hussain, A.

    2015-01-01

    Introduction We present a case on conservative management of salvaging the mesh in an immunocompromised morbidly obese patient, who developed a synergistic gangrene infection following a primary open mesh repair of an incisional hernia. Presentation of case Our patient presented with a surgical wound infection, comorbidities were Chronic Lymphoblastic Leukemia (CLL), Body Mass Index (BMI) of 50, hypertension and diet controlled type-2 diabetes. In surgery, wide necrotic wound debridement, early and repetitive wound drainages with the use of a large pore polypropylene mesh and a detailed surgical follow up was required. High dose intravenous broad-spectrum antibiotic treatment and Negative Pressure Wound Therapy (NPWT) was administrated in combination with adopting a multidisciplinary approach was key to our success. Discussion Stoppa Re et al. complied a series of 360 ventral hernia mesh repairs reporting an infection rate of 12% that were managed conservatively. However, our selective case is unique within current literature, being the first to illustrate mesh salvage in a morbid obese patient with CLL. Recent modifications in mesh morphology, such as lower density, wide pores, and lighter weight has led to considerable improvements regarding infection avoidance. Conclusion This case has demonstrated how a planned multidisciplinary action can produce prosperous results in a severely obese immunocompromised patient with an SSI, following an incisional hernia repair. PMID:26322822

  3. Polymicrobial abdominal wall necrotizing fasciitis after cesarean section.

    DeMuro, Jp; Hanna, Af; Chalas, E; Cunha, Ba

    2012-01-01

    We report a case of a previously healthy woman after an uneventful caesarean section who developed polymicrobial necrotizing fasciitis. She was given a non-steroidal anti-inflamatory drug (NSAID) after her delivery. Her post-delivery course was complicated by septic shock, and required multiple debridements before abdominal reconstruction. This case describes the increased risk of necrotizing fasciitis with NSAID use. Unusual were the organisms causing the polymicrobial necrotizing fasciitis: Staphylococcus aureus, Enterobacter agglomerans, Acinetobacter baumannii, and two strains of Enterobacter cloacae. PMID:24960796

  4. Diagnosis and management of Spigelian hernia: A review of literature and our experience

    Mittal T

    2008-01-01

    Full Text Available Spigelian hernia occurs through slit like defect in the anterior abdominal wall adjacent to the semilunar line. Most of spigelian hernias occur in the lower abdomen where the posterior sheath is deficient. The hernia ring is a well-defined defect in the transverses aponeurosis. The hernial sac, surrounded by extraperitoneal fatty tissue, is often interparietal passing through the transversus and the internal oblique aponeuroses and then spreading out beneath the intact aponeurosis of the external oblique. Spigelian hernia is in itself very rare and more over it is difficult to diagnose clinically. It has been estimated that it constitutes 0.12% of abdominal wall hernias. The spigelian hernia has been repaired by both conventional and laparoscopic approach. Laparoscopic management of spigelian hernia is well established. Most of the authors have managed it by transperitoneal approach either by placing the mesh in intraperitoneal position or by raising the peritoneal flap and placing the mesh in extraperitoneal space. There have also been case reports of management of spigelian hernia by total extraperitoneal approach. We retrospectively reviewed our experience of ten patients between 1997 and 2007. Eight patients (8/10 presented with abdominal pain and two patients (2/10 were asymptomatic. In six patients (6/10 we performed an intraperitoneal onlay IPOM repair, in two patients (2/10 transabdominal preperitoneal repair (TAPP, and in two (2/10 total extraperitoneal repair (TEP. There were no recurrences, or other morbidity at mean follow up period of 3.2 years (range 6 months to 10 years.

  5. Impact of poroelasticity of intraluminal thrombus on wall stress of abdominal aortic aneurysms

    Polzer Stanislav; Gasser T; Markert Bernd; Bursa Jiri; Skacel Pavel

    2012-01-01

    Abstract Background The predictions of stress fields in Abdominal Aortic Aneurysm (AAA) depend on constitutive descriptions of the aneurysm wall and the Intra-luminal Thrombus (ILT). ILT is a porous diluted structure (biphasic solid–fluid material) and its impact on AAA biomechanics is controversially discussed in the literature. Specifically, pressure measurements showed that the ILT cannot protect the wall from the arterial pressure, while other (numerical and experimental) studies showed t...

  6. Determination of the Normal Bladder Wall Thickness in Adults by Trans Abdominal Ultrasound

    Fakher Rahim; Fariba Afrakhteh; Ahmad Fakhri Zahed; Mohammad Davoudi

    2010-01-01

    Background/Objective: Bladder in mature subjects can be affected by various maladies, which cause the wall thickness in the local or emission manner. Trans-abdominal ultrasonography of the bladder is one of the current methods of recognition of bladder maladies. This research aimed to measure the natural posterior-inferior and lateral wall thickness of the bladder, which is performed by ultrasonography. "nPatients and Methods: A total of 280 individuals (160 men, 120 women) in the age ra...

  7. Primary synovial sarcoma of the abdominal wall: a case report and literature review

    Kritsaneepaiboon, Supika; Sangkhathat, Surasak; Mitarnun, Winyou

    2015-01-01

    Synovial sarcoma (SS) is the fourth most common type of soft tissue sarcoma, following malignant fibrous histiocytoma, liposarcoma, and rhabdomyosarcoma. It usually occurs in the extremities near the large joints of middle-aged patients. We describe a case of synovial sarcoma of the anterior abdominal wall (SSAW) in an adolescent girl and undertake a review of the literature.

  8. Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

    Sung Kyu Bae; Seok Joo Kang; Jin Woo Kim; Young Hwan Kim; Hook Sun

    2013-01-01

    Background If a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect. Methods From 2009 to 2012, 5 patients who underw...

  9. Malignant Mesothelioma Presenting as a Giant Chest, Abdominal and Pelvic Wall Mass

    Shao, Zhi Hong; Gao, Xiao Long; Yi, Xiang Hua; Wang, Pei Jun [Tongji Hospital of Tongji University, Shanghai (China)

    2011-11-15

    Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.

  10. Parastomal hernia containing stomach.

    Barber-Millet, Sebastian; Pous, Salvador; Navarro, Vicente; Iserte, Jose; García-Granero, Eduardo

    2014-01-01

    Parastomal hernia is the most common late stomal complication. Its appearance is usually asymptomatic. We report a parastomal hernia containing stomach. A 69-year-old patient with end colostomy arrived at the emergency room presenting with abdominal pain associated with vomiting and functioning stoma. She had a distended and painful abdomen without signs of peritoneal irritation and pericolostomic eventration in the left iliac fossa. X-ray visualized gastric fornix dilatation without dilated intestine bowels, and computed tomography showed parastomal incarcerated gastric herniation. Gastrografin (Bayer Australia Limited, New South Wales, Australia) was administered, showing no passage to duodenum. She underwent surgery, with stomal transposition and placement of onlay polypropylene mesh around the new stoma. Parastomal hernias are a frequent late complication of colostomy. Only four gastric parastomal hernia cases are reported in the literature. Three of these four cases required surgery. The placement of prosthetic mesh in the moment of stoma elaboration should be considered as a potential preventive measure. PMID:25058773

  11. Case of a sigmoid colon cancer with metachronous metastases to the mesorectum and the abdominal wall

    Hadjimarcou Andreas

    2010-03-01

    Full Text Available Abstract Backround Sigmoid colon cancer metachronous metastases commonly occur in the liver and lungs with sporadic reports also to the spleen, stomach, thyroid gland, abdominal wall and upper urinary tract. This is a rare case of metachronous metastases invading the mesorectum and the abdominal wall. Case presentation A 72-year-old female underwent sigmoidectomy for stage I (T2N0 M0 sigmoid colon cancer in May 2008. In June 2009, an abdominal computed tomography scan revealed a tumor 2 cm in size at the lower anterior mesorectum and a second mass 2 cm in size at the anterior abdominal wall midline. Total colonoscopy showed no mucosal lesion. The serum carcinoembryonic antigen level was normal. A biopsy of the mesorectum tumor showed similar histologic characteristics with the primary tumor. Since no other site of recurrence was identified, an abdominoperineal resection was attempted. During the operation and after the removal of the incision recurrence, sinus bradycardia and signs of myocardial ischemia were noticed. A loop transverse colostomy was immediately perfomed and the operation was terminated. Postoperative cardiologic examination revealed an acute myocardium infract. Chemo-radiation of the mesorectum tumor and re-evaluation for surgical excision was decided. Conclusion Metachronous metastasis of the mesorectum from sigmoid colon cancer is extremely rare. Although patterns of lymphatic spread from rectal cancer to sigmoid colon have recently been demonstrated, there is no evidence of metachronous mesorectum invasion from sigmoid colon cancer. This could be the issue for future trials.

  12. Massive Localized Lymphedema Arising from Abdominal Wall: A Case Report and Review of the Literature.

    Tóth, Teodóra; Chang Chien, Yi-Che; Kollár, Sándor; Kovács, Ilona

    2015-01-01

    Massive localized lymphedema (MLL) is a rare pseudosarcomatous lesion due to localized lymphatic obstruction from variable causes. It is most common on medial aspect of thigh and inguinal region. Abdominal localization is rare and may cause clinical diagnostic confusion with other malignant tumors due to its large size. We report a case of abdominal wall MLL of a 56-year-old male patient under clinical suspicion of well differentiated liposarcoma. The literature search and differential diagnosis will be addressed. In doubt cases, immunohistochemical stain or fluorescent in situ hybridization can help to separate this entity from the other mimickers. PMID:26417468

  13. Massive Localized Lymphedema Arising from Abdominal Wall: A Case Report and Review of the Literature

    Teodóra Tóth

    2015-01-01

    Full Text Available Massive localized lymphedema (MLL is a rare pseudosarcomatous lesion due to localized lymphatic obstruction from variable causes. It is most common on medial aspect of thigh and inguinal region. Abdominal localization is rare and may cause clinical diagnostic confusion with other malignant tumors due to its large size. We report a case of abdominal wall MLL of a 56-year-old male patient under clinical suspicion of well differentiated liposarcoma. The literature search and differential diagnosis will be addressed. In doubt cases, immunohistochemical stain or fluorescent in situ hybridization can help to separate this entity from the other mimickers.

  14. [Impact of abdominoplasty on quality of life in patients, suffering anterior abdominal wall deformity and obesity].

    Dronov, O I; Koval's'ka, I O; Roshchyna, L O; Fedoruk, V I; Burov, E Iu; Fedoruk, P V

    2011-12-01

    The modern tendencies of surgery development include not only the operative procedures improvement but guaranteeing also a maximally high level achievement in the patients quality of life in the early, as well as during remote, postoperative period. The quality of life analysis was done in 132 patients, operated on for the anterior abdominal wall defects, obesity and other surgical diseases, using special questionnaire SF-36. The patients have aged 23-65 years old, in all of them the excessive body mass or obesity of abdominal type was noted. PMID:22432186

  15. Feasibility and outcome after laparoscopic ventral hernia repair using Proceed mesh

    Rosenberg, J.; Burcharth, J.

    2008-01-01

    BACKGROUND: There are many different meshes available for laparoscopic repair of ventral hernias. A relatively new product is the Proceed mesh with a bioresorbable layer against the bowels and a polypropylene layer against the abdominal wall. There are, however, no human data available. The aim of...... this study was to evaluate the feasibility and outcome after laparoscopic ventral hernia repair using the Proceed mesh in humans. METHODS: Patients presenting for laparoscopic ventral hernia repair in our department from September 2004 to October 2006 were included in the study. All patients had a...... standard laparoscopic ventral hernia repair using the Proceed mesh secured with tackers with a double crown technique. Patients were discharged according to standard discharge criteria, and follow-up was performed with a search in the national patient database and with manual search in the patients' files...

  16. Bilateral congenital lumbar hernias in a patient with central core disease--A case report.

    Lazier, Joanna; Mah, Jean K; Nikolic, Ana; Wei, Xing-Chang; Samedi, Veronica; Fajardo, Carlos; Brindle, Mary; Perrier, Renee; Thomas, Mary Ann

    2016-01-01

    Congenital lumbar hernias are rare malformations caused by defects in the development of the posterior abdominal wall. A known association exists with lumbocostovertebral syndrome; however other associated anomalies, including one case with arthrogryposis, have been previously reported. We present an infant girl with bilateral congenital lumbar hernias, multiple joint contractures, decreased muscle bulk and symptoms of malignant hyperthermia. Molecular testing revealed an R4861C mutation in the ryanodine receptor 1 (RYR1) gene, known to be associated with central core disease. This is the first reported case of the co-occurrence of congenital lumbar hernias and central core disease. We hypothesize that ryanodine receptor 1 mutations may interrupt muscle differentiation and development. Further, this case suggests an expansion of the ryanodine receptor 1-related myopathy phenotype to include congenital lumbar hernias. PMID:26684984

  17. Grynfeltt Hernia: A Deceptive Lumbar Mass with a Lipoma-Like Presentation

    Zadeh, Jonathan R.; Buicko, Jessica L.; Patel, Chetan; Kozol, Robert; Lopez-Viego, Miguel A.

    2015-01-01

    The Grynfeltt-Lesshaft hernia is a rare posterior abdominal wall defect that allows for the herniation of retro- and intraperitoneal structures through the upper lumbar triangle. While this hernia may initially present as a small asymptomatic bulge, the defect typically enlarges over time and can become symptomatic with potentially serious complications. In order to avoid that outcome, it is advisable to electively repair Grynfeltt hernias in patients without significant contraindications to surgery. Due to the limited number of lumbar hernioplasties performed, there has not been a large study that definitively identifies the best repair technique. It is generally accepted that abdominal hernias such as these should be repaired by tension-free methods. Both laparoscopic and open techniques are described in modern literature with unique advantages and complications for each. We present the case of an unexpected Grynfeltt hernia diagnosed following an attempted lipoma resection. We chose to perform an open repair involving a combination of fascial approximation and dual-layer polypropylene mesh placement. The patient's recovery was uneventful and there has been no evidence of recurrence at over six months. Our goal herein is to increase awareness of upper lumbar hernias and to discuss approaches to their surgical management. PMID:26697256

  18. Grynfeltt Hernia: A Deceptive Lumbar Mass with a Lipoma-Like Presentation

    Jonathan R. Zadeh

    2015-01-01

    Full Text Available The Grynfeltt-Lesshaft hernia is a rare posterior abdominal wall defect that allows for the herniation of retro- and intraperitoneal structures through the upper lumbar triangle. While this hernia may initially present as a small asymptomatic bulge, the defect typically enlarges over time and can become symptomatic with potentially serious complications. In order to avoid that outcome, it is advisable to electively repair Grynfeltt hernias in patients without significant contraindications to surgery. Due to the limited number of lumbar hernioplasties performed, there has not been a large study that definitively identifies the best repair technique. It is generally accepted that abdominal hernias such as these should be repaired by tension-free methods. Both laparoscopic and open techniques are described in modern literature with unique advantages and complications for each. We present the case of an unexpected Grynfeltt hernia diagnosed following an attempted lipoma resection. We chose to perform an open repair involving a combination of fascial approximation and dual-layer polypropylene mesh placement. The patient’s recovery was uneventful and there has been no evidence of recurrence at over six months. Our goal herein is to increase awareness of upper lumbar hernias and to discuss approaches to their surgical management.

  19. Components separation in complex ventral hernia repair: surgical technique and post-operative outcomes.

    Ross, Samuel W; Oommen, Bindhu; Heniford, B Todd; Augenstein, Vedra A

    2014-03-01

    There are over 350,000 ventral hernia repairs (VHR) performed in the United States annually and a variety of laparoscopic and open surgical techniques are described and utilized. Complex ventral hernias such as recurrent hernias, those with infected mesh, open wounds, coexisting enteric fistulas, parastomal hernias, and massive hernias-especially those with loss of abdominal domain-require sophisticated repair techniques. Many of these repairs are performed via an open approach. Ideally, the aim is to place mesh under the fascia with a large overlap of the defect and obtain primary fascial closure. However, it is often impossible to bring together fascial edges in very large hernias. Component separation is an excellent surgical technique in selected patients which involves release of the different layers of the abdominal wall and in turn helps accomplish primary fascial approximation. The posterior rectus sheath, external oblique or the transverse abdominis fascia can be cut and allows for closure of fascia in a tension free manner in a majority of patients. In this chapter we describe the various techniques for component separation, indications for use, how to select an appropriate type of release and post-operative outcomes. PMID:24700223

  20. Suture granuloma of the abdominal wall with intraabdominal extension 12 years after open appendectomy

    Goran Augustin; Dragan Korolija; Mate Skegro; Jasminka Jakic-Razumovic Goran

    2009-01-01

    Most complications after appendectomy occur within ten days;however,we report the unusual case of a suture granuloma 12 years after open appendectomy.The afebrile 75-year-old woman presented with a slightly painful palpable mass in the right lower abdomen.There was no nausea or vomiting and bowel movements were normal.She lost 10 kg during the 3 mo before presentation.The patient had undergone an appendectomy 12 years previously.Physical examination revealed a tender mass,10 cm in diameter,under the appendectomy scar.The preoperative laboratory findings,tumor markers and plain abdominal radiographs were normal.Multi-slice computed tomography scanning showed an inhomogenous abdominal mass with minimal vascularization in the right lower abdomen 8.6 cm×8 cm×9 cm in size which communicated with the abdominal wall.The abdominalwall was thickened,weak and bulging.The abdominalwall mass did not communicate with the cecumor the ascending colon.Complete excision of the abdominalwall mass was performed via median laparotomy.Histopathological examination revealed a granuloma with a central abscess.This case report demonstrates that a preoperative diagnosis of abdominal wall mass after open appendectomy warrants the use of a wide spectrum of diagnostic modalities and consequently different treatment options.

  1. Synovial sarcoma of the abdominal wall: Imaging findings and review of the literature

    Haas, R.J. de; Bonenkamp, J.J.; Flucke, U.E.; Rooy, J.W.J. de

    2015-01-01

    Synovial sarcoma is the fourth most common type of soft-tissue sarcoma (following undifferentiated pleomorphic sarcoma, liposarcoma, and rhabdomyosarcoma), and should be considered a high-grade neoplasm with a high number of local recurrences and late metastases. Synovial sarcoma predominantly occurs in adolescents and young adults, and typically arises near the joints of the lower extremity. However, this tumor can also occur at uncommon sites such as the abdominal wall, which is illustrated...

  2. Mixed endometrioid and serous carcinoma developing in abdominal wall endometriosis following Cesarean section

    Da Ines, David; Montoriol, Pierre Francois; Petitcolin, Virginie; Garcier, Jean-Marc (Dept. of Radiology and Medical Imaging, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France)), email: ddaines@chu-clermontferrand.fr; Bourdel, Nicolas; Canis, Michel (Dept. of Obstetrics and Gynecology, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France)); Charpy, Cecile (Dept. of Pathology, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France))

    2011-06-15

    Abdominal wall endometriosis is unusual and mostly occurs in scars following Cesarean section. Although malignant transformation is rare, it must be recognized in order to benefit from radical resection. We report a very rare case of mixed endometrioid and serous carcinoma developing in a Cesarean section endometriosis scar and the way we managed it using surgery and chemotherapy. 18-FDG PET-CT imaging was performed to correctly stage the disease

  3. Clear cell sarcoma of the abdominal wall with peritoneal sarcomatosis: CT features

    Clear cell sarcoma, also called malignant melanoma of soft parts, is an uncommon neoplasm that involves tendons or aponeuroses of the lower extremity. The CT features of a clear cell sarcoma arising from the abdominal wall with later peritoneal dissemination are described. Peritoneal sarcomatosis from soft tissue sarcomas is a very rare condition previously unreported in the radiologic literature. Metastases to peritoneal surfaces must therefore be considered a possible site for systemic dissemination of soft tissue sarcomas. (orig.)

  4. Mixed endometrioid and serous carcinoma developing in abdominal wall endometriosis following Cesarean section

    Abdominal wall endometriosis is unusual and mostly occurs in scars following Cesarean section. Although malignant transformation is rare, it must be recognized in order to benefit from radical resection. We report a very rare case of mixed endometrioid and serous carcinoma developing in a Cesarean section endometriosis scar and the way we managed it using surgery and chemotherapy. 18-FDG PET-CT imaging was performed to correctly stage the disease

  5. Primary leiomyosarcoma of the abdominal wall mimicking nodular fasciitis in a child

    Yuhki Koike; Hiroki Imaoka; Kohei Otake; Mikihiro Inoue; Keiichi Uchida; Masato Kusunoki

    2015-01-01

    We report the case of an 8-year-old boy with a 30-mm solid mass in the right lower quadrant of the abdominal wall. Computed tomography revealed that the tumor was on the lateral border of the rectus abdominis, and surgical resection was performed. Despite difficulty in differentiating this mass from nodular fasciitis, pathologic analysis and immunohistochemical staining led to the diagnosis of leiomyosarcoma.

  6. Intrauterine Contraceptive Device Migration Presenting as Abdominal Wall Swelling: A Case Report

    Imtiaz Wani

    2011-01-01

    Full Text Available A number of complications are reported with the use of intrauterine contraceptive devices. These may pursue asymptomatic course or present as an acute abdomen after migration into peritoneal cavity. The authors here are reporting an abdominal wall swelling caused by transuterine migration of a copper intrauterine contraceptive device in a 28-year-old female. An open approach was used, and impacted foreign body was retrieved.

  7. Unilateral agenesis of the abdominal wall musculature: An early muscle deficiency.

    Gerard-Blanluet, Marion; Port-Lis, Marylin; Baumann, Clarisse; Perrin-Sabourin, Laurence; Ebrad, Patrick; Audry, Georges; Delezoide, Anne-Lise; Verloes, Alain

    2010-11-01

    Prune-belly sequence (PBS) usually results from early urethral obstruction. In rare cases, PBS seems to be due to a faulty primary development of the parietal mesenchyme leading to underdevelopment of the abdominal wall musculature, and disorganization of the smooth muscles in the urinary tract. We report on two patients with segmental, unilateral wall musculature deficiency associated with homolateral agenesis of ribs. One patient also had hemivertebrae and the other one ipsilateral diaphragmatic eventration and aplasia cutis. This combination of anomalies may represent a localized deficiency in the development of somitic mesoderm mesenchyme during early embryogenesis. PMID:20949627

  8. [Hematoma of the abdominal wall. A case report: pitfall of Seldinger method via femoral artery].

    Hiramatsu, Hisaya; Sugiura, Yasushi; Takeda, Ririko; Nanba, Hiroki

    2009-02-01

    We reported a case of an abdominal wall hematoma which caused by Seldinger method via the femoral artery. A 48-year-old female, suffered from direct carotid cavernous fistula, was treated by transfemoral transvenous embolization (TVE). The whole procedure was completed without difficulty except minor resistance of guide wire manipulation during left femoral artery catheterization. Four hours later, the patient became hypotensive and showed the sign of impending shock without definitive causes. Nine hours after the embolization a huge hematoma of the abdominal wall was found. It required the total 1200 m/ of blood transfusion before her blood pressure returned to normal. She recovered fully from this event and discharged uneventfully. There is a speculation that a deep circumflex iliac artery (DCIA) was injured with an angle-shaped guide wire and bled into the abdominal wall. And subsequent systemic heparinization prevented the coagulation process, resulting a large hematoma. Anatomically, an angle-shaped guide wire is easily able to migrate into DCIA. To prevent a vascular injury, it is very important to manipulate a guide wire under fluoroscopic control and to select a J-shaped guide wire instead of an angle-shaped one. PMID:19227158

  9. Immunohistochemical evaluation of fibrillar components of the extracellular matrix of transversalis fascia and anterior abdominal rectus sheath in men with inguinal hernia

    Rogério De Oliveira Gonçalves

    2014-01-01

    Full Text Available OBJECTIVE: to evaluate the role of fibrillar extracellular matrix components in the pathogenesis of inguinal hernias. METHODS: samples of the transverse fascia and of the anterior sheath of the rectus abdominis muscle were collected from 40 men aged between 20 and 60 years with type II and IIIA Nyhus inguinal hernia and from 10 fresh male cadavers (controls without hernia in the same age range. The staining technique was immunohistochemistry for collagen I, collagen III and elastic fibers; quantification of fibrillar components was performed with an image analysis processing software. RESULTS: no statistically significant differences were found in the amount of elastic fibers, collagen I and collagen III, and the ratio of collagen I / III among patients with inguinal hernia when compared with subjects without hernia. CONCLUSION: the amount of fibrillar extracellular matrix components did not change in patients with and without inguinal hernia.

  10. Experiences of repairing large defect on adominal wall with artificial mesh and myocutaneous flap

    Hongliang Bai; Jiansheng Wang; Jun Yang; Li Wang

    2006-01-01

    Objective: To evaluate the results of repairing large defect on abdominal wall with artificial meshes (expansible polytetrafluoroethylene, e-PTFE and Composix Mesh). Methods: Four cases with large defect of abdominal wall caused by abdominal wall tumors or injuries were repaired with artificial meshes and myocutaneous flaps. Results: The cases were followed up 7 months to 2.5 years with no complications such as incisional hernia, bowel adhesion and exposure of the prosthetic materials.Conclusion: The combined use of artificial meshes contained e-PTFE and myocutaneous flaps is a reliable and effective method for repairing large defect on abdominal wall.

  11. Impact of poroelasticity of intraluminal thrombus on wall stress of abdominal aortic aneurysms

    Polzer Stanislav

    2012-08-01

    Full Text Available Abstract Background The predictions of stress fields in Abdominal Aortic Aneurysm (AAA depend on constitutive descriptions of the aneurysm wall and the Intra-luminal Thrombus (ILT. ILT is a porous diluted structure (biphasic solid–fluid material and its impact on AAA biomechanics is controversially discussed in the literature. Specifically, pressure measurements showed that the ILT cannot protect the wall from the arterial pressure, while other (numerical and experimental studies showed that at the same time it reduces the stress in the wall. Method To explore this phenomenon further a poroelastic description of the ILT was integrated in Finite Element (FE Models of the AAA. The AAA model was loaded by a pressure step and a cyclic pressure wave and their transition into wall tension was investigated. To this end ILT’s permeability was varied within a microstructurally motivated range. Results The two-phase model verified that the ILT transmits the entire mean arterial pressure to the wall while, at the same time, it significantly reduces the stress in the wall. The predicted mean stress in the AAA wall was insensitive to the permeability of the ILT and coincided with the results of AAA models using a single-phase ILT description. Conclusion At steady state, the biphasic ILT behaves like a single-phase material in an AAA model. Consequently, computational efficient FE single-phase models, as they have been exclusively used in the past, accurately predict the wall stress in AAA models.

  12. Femoral hernia repair

    ... bulges out of a weak spot in the groin. Usually this tissue is part of the intestine. ... Your surgeon makes a cut (incision) in your groin area. The hernia is ... wall. This repairs the weakness in the wall. At the end ...

  13. Morgagni hernia - laparoscopic approach

    Şt.O. Georgescu

    2013-09-01

    Full Text Available INTRODUCTION: Morgagni hernia is due to a diaphragmatic defect, retrosternal congenital hernia being a rare form of hernie. The diagnosis is usually in childhood but there are cases that are found in adult or as a intraoperative surprise. The condition is asymptomatic or has nonspecific clinical manifestations or clinical dressing of often occlusive complications. The diagnosis is established by Rx thoracic imaging, barium enema or computed tomography (CT eso-gastro-duodenal passage. Treatment consists of reducing the hernia with or without dissection and resection of the hernia sac and diaphragmatic defect closure by suture the fascia endotoracica retrosternal and retrocostala or rectus abdominis sheath or plastic bag. CASE PRESENTATION: We present a case of a 49 years old woman admitted in our department for an insidious onset, several months ago, with postprandial upper abdominal pain, flatulence and nausea. CT scan revealed a mass of 95 / 130 / 80 mm, narrowly defined with homogeneous structure and negative densities (fat in the lower and middle mediastinum, outlining opacity described in cardiofrenic sinus radiography. The aspect was characteristic for a Morgagni hiatus hernia. Exploratory laparoscopy was performed using a 30º laparoscope inserted through a 10 mm supraombilical trocar; it revealed the parietal defect (Morgagni hernia and the herniation of greater omentum. Two additional 5 mm trocars are then inserted; the escaped great omentum was reintegrated and the parietal defect was laparoscopically sutured. To note, the peritoneal hernia sac was abandoned. Postoperative course was uneventful. A review of the literature data was also performed. CONCLUSION: Minimally invasive surgery is feasible, safe and tends to become “gold standard” therapeutic approach for the treatment of Morgagni hernia.

  14. Adipocyte in vascular wall can induce the rupture of abdominal aortic aneurysm.

    Kugo, Hirona; Zaima, Nobuhiro; Tanaka, Hiroki; Mouri, Youhei; Yanagimoto, Kenichi; Hayamizu, Kohsuke; Hashimoto, Keisuke; Sasaki, Takeshi; Sano, Masaki; Yata, Tatsuro; Urano, Tetsumei; Setou, Mitsutoshi; Unno, Naoki; Moriyama, Tatsuya

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a vascular disease involving the gradual dilation of the abdominal aorta. It has been reported that development of AAA is associated with inflammation of the vascular wall; however, the mechanism of AAA rupture is not fully understood. In this study, we investigated the mechanism underlying AAA rupture using a hypoperfusion-induced animal model. We found that the administration of triolein increased the AAA rupture rate in the animal model and that the number of adipocytes was increased in ruptured vascular walls compared to non-ruptured walls. In the ruptured group, macrophage infiltration and the protein levels of matrix metalloproteinases 2 and 9 were increased in the areas around adipocytes, while collagen-positive areas were decreased in the areas with adipocytes compared to those without adipocytes. The administration of fish oil, which suppresses adipocyte hypertrophy, decreased the number and size of adipocytes, as well as decreased the risk of AAA rupture ratio by 0.23 compared to the triolein administered group. In human AAA samples, the amount of triglyceride in the adventitia was correlated with the diameter of the AAA. These results suggest that AAA rupture is related to the abnormal appearance of adipocytes in the vascular wall. PMID:27499372

  15. A COMPARATIVE STUDY IN LAPAROSCOPIC INGUINAL HERNIA REPAIR BETWEEN FIXATION VS NON-FIXATION OF MESH

    Ayush; Rajeev; Lakshman Singh

    2016-01-01

    INTRODUCTION An inguinal hernia is a weakness in the wall of the abdominal cavity that is large enough to allow escape of soft body tissue or internal organ, especially a part of the intestine. It usually appears as a lump and for some peoples can cause pain and discomfort, limit daily activities and the ability to work. If the bowel strangulates or becomes obstructed it can be life-threatening. A hernia is repaired generally using a synthetic mesh either with open surgery or increasing...

  16. ESOPHAGUS-STOMACH-ABDOMINAL WALL DRAINAGE FOR DELAYED INTRATHORACIC ESOHPAGEAL PERFORATIONLI

    李国庆; 单根法; 张辅贤; 钟竑

    2003-01-01

    Objective To design a technique of esophagus stomach abdominal wall drainage for the delayed intrathoracic esophageal perforation and to improve the therapeutic results.MethodsFour patients were treated by this simplified technique. There were 1 case of lower intrathoracic esophageal perforation to the left thorax, 1 high and 2 middle perforation to the right. This technique used two plastic tubes (chest tube) in a diameter about 1.2cm. One tube served as an intercostal drainage tube to drain purulent effusion, the other was inserted abdominally through stomach to the esophagus about 10cm above the esophageal perforation.ResultsThe four patients were treated successfully by the esophagus stomach abdominal wall drainage. There was no mortality or severe morbidity or complication. Hospitalizations were shortened. ConclusionThis technique is simple, safe and effective. It may provide a more promising alternative method of treatment for delayed esophageal perforation, especially in the critically ill patients. The procedure can also be extended to deal with esophagus stomach anastomotic leak.

  17. Femoral hernia

    A retrospective study of 18 patients with femoral hernia assessed by herniography is presented. Although a palpable lump was present in 11 patients (61%), the diagnosis of a femoral hernia was not made before herniography. Surgical exploration was performed in 12 patients and a femoral hernia was found and repaired with beneficial outcome in 9 of them. In conclusion: herniography is of value for the diagnosis of a femoral hernia in patients with obscure groin pain. (author). 14 refs.; 2 figs

  18. Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings

    Rafailidis Vasileios

    2013-01-01

    Full Text Available Perforation of the inflamed diverticula is a common diverticulitis complication. It usually leads to the formation of a local abscess. In some rare cases, the inflammatory process may spread towards extra-abdominal sites like the anterior or posterior abdominal wall or the thigh and form an abscess in these sites. We present the case of a 73-year-old man with a history of pain at the lower left quadrant of the abdomen for 20 days and a visible mass in this site. Ultrasonography and computed tomography revealed this mass to be an abscess of the abdominal wall which had been formed by the spread of ruptured sigmoid diverticulitis by continuity of tissue through the lower left abdominal wall. Local drainage of the abscess was performed and the patient was discharged after alleviation of symptoms and an uneventful course. We also discuss causes of abdominal wall abscesses along with the possible pathways by which an intra-abdominal abscess could spread outside the abdominal cavity.

  19. Abdominal Wall Desmoid Tumor in a Pregnant Woman and Cesarean Section Managment

    M Mojibian

    2013-08-01

    Full Text Available Increased risk of sporadic desmoid tumor occurs in increased estrogen level (pregnancy and surgical incisions (abdominal and thorasic. The frequency of desmoid tumors in the general population is 2.4 to 4.3 cases. The case is 30 year old woman with history of previous cesarean section. In fourth month of pregnancy,ultrasonography revealed a 5×7 cm mass in lower segment of the uterus(leiomyoma. The tumor diameter was 20 cm in term gestation. The time of cesarean , incision of skin was done above the umbilicus and below the sternum and incision of uterus was done from fondus vertically down. After delivery, the mass which was separated from uterus and located in the abdominal wall was extracted. The histological investigation diagnosed a desmoid tumor.

  20. Comparing the Preoperative Ultrasound and Intraoperative Findings of Inguinal Hernia in Children.

    Nazanin Eshraghi

    2009-01-01

    Full Text Available Introduction: Today, repair of inguinal hernia is one of the most common pediatric operations performed. Inguinal hernia is a type of ventral hernia that occurs when an intra-abdominal structure, such as the bowel or omentum, protrudes through a defect in the abdominal wall. Proper diagnosis and timed treatment of inguinal hernias are of very important significance. Considering the high prevalence of pediatric inguinal hernias, it is pivotal to employ an easily-performed, non-invasive and accurate modality for the diagnosis; and ultrasonography seems to fit the criteria. Also ultrasonography can be used as a tool for probing the contralateral probable hernias in unilateral cases. This study aimed at comparing the preoperative ultrasonography and intra-operative findings of inguinal hernia in children. "nMaterials and Methods: In a cross-sectional setting, children aged 0-14 years with the probable diagnosis of inguinal hernia referred to Tabriz Children's Hospital were recruited during a 24-month period. All the children were evaluated preoperatively with ultrasonography of the groin (with a linear 7.5 MHZ probe at rest and during crying or upright position. The findings of ultrasonography of the affected side and the contralateral region were compared with the intra-operational findings. Accordingly, diagnostic efficiency of ultrasonography in children's inguinal hernias and probable involvement of the contralateral side was determined. "nResults: One hundred and twenty three patients, 106 males and 17 females with the mean age of 18.53±25.64 months (10 day to 12 years were enrolled in the study. One hundred and eighteen (95.9% patients underwent surgery and revealed to have a true inguinal hernia. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of preoperative ultrasonography was 97%, 98.8%, 99.4%, 99.1% and 97.6%, respectively. The specificity and accuracy of ultrasonography in the

  1. Observation of a Flowing Duct in the Abdominal Wall by Using Nanoparticles.

    Jang, HyunSuk; Yoon, Joohwan; Gil, HyunJi; Jung, Sharon Jiyoon; Kim, Min-Suk; Lee, Jin-Kyu; Kim, Young-Jae; Soh, Kwang-Sup

    2016-01-01

    The primo vascular system (PVS) is being established as a circulatory system that corresponds to acupuncture meridians. There have been two critical questions in making the PVS accepted as a novel liquid flowing system. The first one was directly to show the flow of liquid in PVS and the second one was to explain why it was not observed in the conventional histological study of animal tissues. Flow in the PVS in the abdominal cavity was previously verified by injecting Alcian blue into a primo node. However, the tracing of the dye to other subsystems of the PVS has not been done. In the current work we injected fluorescent nanoparticles (FNPs) into a primo node and traced them along a primo vessel which was inside a fat tissue in the abdominal wall. Linea alba is a white middle line in the abdominal skin of a mammal and a band of fat tissue is located in parallel to the linea alba in the parietal side of the abdominal wall of a rat. In this fat band a primo vessel runs parallel to the prominent blood vessels in the fat band and is located just inside the parietal peritoneum. About the second question on the reason why the PVS was not in conventional histological study the current work provided the answer. Histological analysis with hematoxyline and eosine, Masson's trichrome, and Toluidine blue could not discriminate the primo vessel even when we knew the location of the PVS by the trace of the FNPs. This clearly explains why the PVS is hard to observe in conventional histology: it is not a matter of resolution but the contrast. The PVS has very similar structure to the connective tissues that surround the PVS. In the current work we propose a method to find the PVS: Observation of mast cell distribution with toluidine blue staining and the PN has a high density of mast cells, while the lymph node has low density. PMID:26937963

  2. Observation of a Flowing Duct in the Abdominal Wall by Using Nanoparticles.

    HyunSuk Jang

    Full Text Available The primo vascular system (PVS is being established as a circulatory system that corresponds to acupuncture meridians. There have been two critical questions in making the PVS accepted as a novel liquid flowing system. The first one was directly to show the flow of liquid in PVS and the second one was to explain why it was not observed in the conventional histological study of animal tissues. Flow in the PVS in the abdominal cavity was previously verified by injecting Alcian blue into a primo node. However, the tracing of the dye to other subsystems of the PVS has not been done. In the current work we injected fluorescent nanoparticles (FNPs into a primo node and traced them along a primo vessel which was inside a fat tissue in the abdominal wall. Linea alba is a white middle line in the abdominal skin of a mammal and a band of fat tissue is located in parallel to the linea alba in the parietal side of the abdominal wall of a rat. In this fat band a primo vessel runs parallel to the prominent blood vessels in the fat band and is located just inside the parietal peritoneum. About the second question on the reason why the PVS was not in conventional histological study the current work provided the answer. Histological analysis with hematoxyline and eosine, Masson's trichrome, and Toluidine blue could not discriminate the primo vessel even when we knew the location of the PVS by the trace of the FNPs. This clearly explains why the PVS is hard to observe in conventional histology: it is not a matter of resolution but the contrast. The PVS has very similar structure to the connective tissues that surround the PVS. In the current work we propose a method to find the PVS: Observation of mast cell distribution with toluidine blue staining and the PN has a high density of mast cells, while the lymph node has low density.

  3. A comparison of modelling techniques for computing wall stress in abdominal aortic aneurysms

    McGloughlin Timothy M

    2007-10-01

    Full Text Available Abstract Background Aneurysms, in particular abdominal aortic aneurysms (AAA, form a significant portion of cardiovascular related deaths. There is much debate as to the most suitable tool for rupture prediction and interventional surgery of AAAs, and currently maximum diameter is used clinically as the determining factor for surgical intervention. Stress analysis techniques, such as finite element analysis (FEA to compute the wall stress in patient-specific AAAs, have been regarded by some authors to be more clinically important than the use of a "one-size-fits-all" maximum diameter criterion, since some small AAAs have been shown to have higher wall stress than larger AAAs and have been known to rupture. Methods A patient-specific AAA was selected from our AAA database and 3D reconstruction was performed. The AAA was then modelled in this study using three different approaches, namely, AAA(SIMP, AAA(MOD and AAA(COMP, with each model examined using linear and non-linear material properties. All models were analysed using the finite element method for wall stress distributions. Results Wall stress results show marked differences in peak wall stress results between the three methods. Peak wall stress was shown to reduce when more realistic parameters were utilised. It was also noted that wall stress was shown to reduce by 59% when modelled using the most accurate non-linear complex approach, compared to the same model without intraluminal thrombus. Conclusion The results here show that using more realistic parameters affect resulting wall stress. The use of simplified computational modelling methods can lead to inaccurate stress distributions. Care should be taken when examining stress results found using simplified techniques, in particular, if the wall stress results are to have clinical importance.

  4. Appendicitis associated with a strangulated Littre's hernia

    Quail, Jacob F; Romeo C. Ignacio

    2015-01-01

    A 12 year-old boy presented with right lower abdominal and groin pain. Intraoperatively, he was found to have acute appendicitis associated with a strangulated Meckel's diverticulum, or Littre's hernia. Both the appendix and Meckel's diverticulum were resected laparoscopically while the inguinal hernia was repaired four months later. We present an uncommon finding of a strangulated Littre's hernia discovered concurrently with acute appendicitis. The presentation, management and review of the ...

  5. [Management of umbilical hernia in cirrhotic patients].

    Loriau, J; Manaouil, D; Mauvais, F

    2002-06-01

    The treatment of umbilical hernia in the setting of cirrhosis poses unique and specific management problems due to the pathophysiology of cirrhotic ascites. The high intra-abdominal pressures generated by ascites when applied to areas of parietal weakness are the cause of hernia formation and enlargement. Successful surgical treatment depends on minimization or elimination of ascites. Umbilical rupture and hernia strangulation are the most life-threatening complications of umbilical hernia with ascites and they demand urgent surgical intervention. In non-emergency situations, medical therapy to control ascites should precede hernia repair. When ascites is refractory to medical therapy, treatment will vary depending on whether transplantation is an option. In liver transplantation candidates, hernia repair can be performed at the end of the transplantation procedure. If transplanation is not envisaged, concomitant treatment of both ascites and hernia is best achieved by placement of a peritoneo-venous shunt at the time of the parietal repair. PMID:12391663

  6. GAINT INGUINOSCROTAL HERNIA – LICHTENSTEIN’S TENSION FREE REPAIR WITHOUT LOSS OF DOMAIN: CASE REPORT

    Sreekant

    2015-03-01

    Full Text Available Inguinal hernia is one of the most surgical common diseases in clinical practice. The history of inguinal hernia repair originated in the ancient times and the treatment has evolved, developed and changed since. [1] The most recent one is the concept of tension - free repair which remains popular among surgeons today. It is interesting to note, though, that numerous literatures have been published on this disease in the small anatomical space despite its simplicity. In the past couple of years, most publications focused on laparoscopic surgery and the different types of prosthetic mesh. Giant inguinal hernia, however, is more unusual and significantly challenging in terms of surgical management. It is defined as an ingu inal hernia that extends below the midpoint of inner thigh when the patient is in standing position. [2] No treatment has been adopted as standard procedure for this uncommon disease and several repair techniques are suggested by published articles and case reports. Further, the absence of large scale comparative study is expected to continue due to the relatively low number of cases. As a result, choosing a surgical procedure is made difficult and the decision must be made intraoperatively. A 55 - year - old ma le patient presented with Left Giant inguinal hernia and compromised quality of life due to pain and sexual discomfort. Lichtenstein’s polypropylene mesh repair was done after reducing the sac contents (omentum and ileum with partial omentectomy. There wa s no loss of intra - abdominal domain. Postoperative period was uneventful. In literature many techniques are available to increase the intra - abdominal cavity (a Creating progressive preoperative pneumoperitoneum (b Creation of ventral wall defect (c surg ical debulking of hernia contents. Recurrence is prevented by reconstruction of the abdominal wall using Marlex mesh and a Tensor fasciae lata flap. Laparoscopic repair is associated with more recurrence

  7. Intensity modulated radiation-therapy for preoperative posterior abdominal wall irradiation of retroperitoneal liposarcomas

    Purpose: Preoperative external-beam radiation therapy (preop RT) in the management of Retroperitoneal Liposarcomas (RPLS) typically involves the delivery of radiation to the entire tumor mass: yet this may not be necessary. The purpose of this study is to evaluate a new strategy of preop RT for RPLS in which the target volume is limited to the contact area between the tumoral mass and the posterior abdominal wall. Methods and Materials: Between June 2000 and Jan 2005, 18 patients with the diagnosis of RPLS have been treated following a pilot protocol of pre-op RT, 50 Gy in 25 fractions of 2 Gy/day. The Clinical Target Volume (CTV) has been limited to the posterior abdominal wall, region at higher risk for local relapse. A Three-Dimensional conformal (3D-CRT) and an Intensity Modulated (IMRT) plan were generated and compared; toxicity was reported following the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events v3.0. Results: All patients completed the planned treatment and the acute toxicity was tolerable: 2 patients experienced Grade 3 and 1 Grade 2 anorexia while 2 patients developed Grade 2 nausea. IMRT allows a better sparing of the ipsilateral and the contralateral kidney. All tumors were successfully resected without major complications. At a median follow-up of 27 months 2 patients developed a local relapse and 1 lung metastasis. Conclusions: Our strategy of preop RT is feasible and well tolerated: the rate of resectability is not compromised by limiting the preop CTV to the posterior abdominal wall and a better critical-structures sparing is obtained with IMRT

  8. Abdominal wall protrusion following herpes zoster Protrusão de parede abdominal secundária a herpes zoster

    Facundo Burgos Ruiz Junior; Jullyanna Sabrysna Morais Shinosaki; Wilson Marques Junior; Marcelo Simão Ferreira

    2007-01-01

    We present the case of a 62-year-old woman with abdominal segmental paresis consequent to radiculopathy caused by zoster, which was confirmed by electroneuromyography. The paresis resolved completely within three months. Recognition of this complication caused by zoster, which is easily misdiagnosed as abdominal herniation, is important for diagnosing this self-limited condition and avoiding unnecessary procedures.Apresenta-se caso de uma paciente de 62 anos com paresia abdominal segmentar, c...

  9. Determination of the Normal Bladder Wall Thickness in Adults by Trans Abdominal Ultrasound

    Fakher Rahim

    2010-05-01

    Full Text Available Background/Objective: Bladder in mature subjects can be affected by various maladies, which cause the wall thickness in the local or emission manner. Trans-abdominal ultrasonography of the bladder is one of the current methods of recognition of bladder maladies. This research aimed to measure the natural posterior-inferior and lateral wall thickness of the bladder, which is performed by ultrasonography. "nPatients and Methods: A total of 280 individuals (160 men, 120 women in the age range of 15-25 years old, admitted to the ultrasonography unit of Imam Khomeini Hospital of Ahwaz from 31 August 2008 to 2009 were enrolled into the study. The ultrasonography was performed in sagittal and axial positions. "nResults: The mean of the posterior inferior wall thickness was 2.22±0.52 mm, the mean of the lateral wall thickness was 2.24±0.52, the thickness of the posterior-inferior wall in men was 2.02±0.5 mm, and the thickness of the posterior-inferior wall in women was 2.23±0.54 mm. Similarly, the thickness of the lateral wall was 2.22±0.51 mm in men and the thickness of the wall was 2.26 ± 0/54 mm for women. The thickness of the posterior-inferior wall in the 15-19 years age group was 1.93±0.42 mm and in the 20-25 years age group was 2.47±0.46 mm. The thickness of the lateral wall in the 15-19 years age group was 1-96±0.43 years and in the 20-25 years age group was 247±0.46 mm."nConclusion: By gathering information about normal bladder wall thickness, ultrasound can help the pathologist or urologist in the diagnosis and suspicion, especially in cases such as cyst, neurogenic bladder wall and/or infiltration of the bladder wall.

  10. Management of Anterior Abdominal Wall Defect Using a Pedicled Tensor Fascia Lata Flap: A Case Report

    K. D. Ojuka

    2012-01-01

    Full Text Available Degloving injuries to anterior abdominal wall are rare due to the mechanism of injury. Pedicled tensor fascia lata is known to be a versatile flap with ability to reach the lower anterior abdomen. A 34-year-old man who was involved in a road traffic accident presented with degloving injury and defect at the left inguinal region, sigmoid colon injury, and scrotal bruises. At investigation, he was found to have pelvic fracture. The management consisted of colostomy and tensor fascia lata to cover the defect at reversal. Though he developed burst abdomen on fifth postoperative day, the flap healed with no complications.

  11. Management of Anterior Abdominal Wall Defect Using a Pedicled Tensor Fascia Lata Flap: A Case Report

    K. D. Ojuka; Nangole, F.; M. Ngugi

    2012-01-01

    Degloving injuries to anterior abdominal wall are rare due to the mechanism of injury. Pedicled tensor fascia lata is known to be a versatile flap with ability to reach the lower anterior abdomen. A 34-year-old man who was involved in a road traffic accident presented with degloving injury and defect at the left inguinal region, sigmoid colon injury, and scrotal bruises. At investigation, he was found to have pelvic fracture. The management consisted of colostomy and tensor fascia lata to cov...

  12. A large infiltrating fibrous hamartoma of infancy in the abdominal wall with rare associated tuberous sclerosis

    Han, Hye-Jeong; Lim, Gye-Yeon [The Catholic University of Korea, Department of Radiology, St. Mary' s Hospital, Seoul (Korea); You, Chang-Young [The Catholic University of Korea, Department of Pathology, St. Mary' s Hospital, Seoul (Korea)

    2009-07-15

    Tuberous sclerosis is a complex autosomal-dominant neurocutaneous syndrome characterized by hamartomatous malformations of fibrous and connective tissues in various organs. Although various histologic types of soft-tissue masses can occur with tuberous sclerosis, we present a unique case of fibrous hamartoma of infancy presenting as large infiltrating cutaneous and subcutaneous masses in the abdominal wall in a 4-year-old boy with tuberous sclerosis. Although the co-occurrence of tuberous sclerosis and fibrous hamartoma of infancy is very rare, it should be considered in the differential diagnosis of subcutaneous soft-tissue masses found in children with tuberous sclerosis. (orig.)

  13. Abdominal Wall Hematoma as a Rare Complication following Percutaneous Coronary Intervention

    Moon, In Tae; Sohn, Young Seok; Lee, Ji Young; Park, Hwan Cheol; Choi, Sung Il; Kim, Soon Gil; Oh, Ji Young

    2016-01-01

    Abdominal wall hematoma is a rare but potentially serious vascular complication that may develop after coronary angiographic procedures. In particular, an oblique muscle hematoma caused by an injury of the circumflex iliac artery is very rare, yet can be managed by conservative treatment including hydration and transfusion. However, when active bleeding continues, angiographic embolization or surgery might be needed. In this study, we report an uncommon case of injury to the circumflex iliac artery by an inappropriate introduction of the hydrophilic guidewire during the performance of a percutaneous coronary intervention.

  14. A large infiltrating fibrous hamartoma of infancy in the abdominal wall with rare associated tuberous sclerosis

    Tuberous sclerosis is a complex autosomal-dominant neurocutaneous syndrome characterized by hamartomatous malformations of fibrous and connective tissues in various organs. Although various histologic types of soft-tissue masses can occur with tuberous sclerosis, we present a unique case of fibrous hamartoma of infancy presenting as large infiltrating cutaneous and subcutaneous masses in the abdominal wall in a 4-year-old boy with tuberous sclerosis. Although the co-occurrence of tuberous sclerosis and fibrous hamartoma of infancy is very rare, it should be considered in the differential diagnosis of subcutaneous soft-tissue masses found in children with tuberous sclerosis. (orig.)

  15. Sonographic Appearance of Abdominal Wall at the Left Flank of Laparotomy Incision Site in Ettawah Grade Does

    M. F. Ulum; D. R. Setiadi; B. Panjaitan; M. Noordin; Amrozi .

    2014-01-01

    The aim of this study was to describe the sonographic appearance of abdominal wall at the left flank of laparotomy incision site in 11 mated Ettawah grade does. Brightness-mode ultrasound examination by using transducer with frequency of 5.0-6.0 MHz was conducted to grouping the does based on their pregnancy statuses. The incision site of the abdominal wall at left flank laparotomy was transcutaneous-scanned as long as 8 cm vertically. The sonographic appearance of the laparotomy wall thickne...

  16. Acute appendicitis presenting with abdominal wall and right groin abscess: A case report

    Mustafa Yildiz; Ahmet Sevki Karakayali; Saadet Ozer; Hilal Ozer; Aydin Demir; Bugra Kaptanoglu

    2007-01-01

    We report a case of right lower abdominal wall and groin abscess resulting from acute appendicitis. The patient was an 27-year-old man who had no apparent abdominal signs and was brought to the hospital due to progressive painful swelling of right lower abdomen and the groin for 10 d. Significant inflammatory changes of soft tissue involving the right lower trunk were noted without any apparent signs of peritonitis. Laboratory results revealed leukocytosis. Abdominal ultrasonography described the presence of abscess at right inguinal site also communicating with the intraabdominal region. Right inguinal exploration and laparotomy were performed and about 250 mL of pus was drained from the subcutaneous tissue and preperitoneal space. No collection of pus was found intraabdominally and subserous acute appendicitis was the cause of the abscess. The patient fully recovered at the end of the second post-operation week. This case reminds us that acute appendicitis may have an atypical clinical presentation and should be treated carefully on an emergency basis to avoid serious complications.

  17. Obesidad mórbida: caso excepcional de reconstrucción de pared abdominal Morbid obesity: an exceptional patient. Apronectomy and new abdominal wall reconstruction

    F.J. Gabilondo Zubizarreta

    2006-09-01

    Full Text Available Presentamos una nueva técnica para la reconstrucción de la pared abdominal, con material sintético en una paciente que padeciendo un cuadro de obesidad mórbida sin cirugía ni traumatismo previo, sufre una diástasis de músculos rectos de su pared abdominal por la que se produce una evisceración intestinal que al alojarse en el faldón abdominal y añadirse un proceso de acumulación de líquidos en el intersticio semejante al linfedema, supuso como tratamiento una resección superior a los 60 Kg. entre sólidos y líquidos y una estrategia y técnica nuevas de reconstrucción del defecto de la pared abdominal.The aim of this work is to show a new technique for reconstruction of the abdominal wall with synthetic matherial in a patient with morbid obesity. The disease has no relation with antecedents of previous surgery or trauma and is asociated with a dyasthasis of the rectus abdomini muscles which has conditionated a intestinal evisceration.This evisceration is accommodated in the abdominal apron and is associated with a great accumulation of fluid (liquid in the interstitium, which seems a linphedema. Taking account the combination of liquid and soft tissues the resection is larger than 60 Kg. and this has forced us to develop new strategies for the menagement of the patient and techniques for the reconstruction of the abdominal wall defect.

  18. The muscles of the infrapubic abdominal wall of a 6-month-old Crocodylus niloticus (Reptilia: Crocodylia).

    Fechner, R; Schwarz-Wings, D

    2013-06-01

    The muscles of the infrapubic abdominal wall of crocodilians play an important role in their ventilatory mechanism. Yet the anatomy and homology of these muscles is poorly understood. To gain new insights into the anatomy of the crocodilian infrapubic abdominal wall, we dissected a specimen of Crocodylus niloticus. Origin and insertion of the muscles, as well as their arrangement relative to each other was examined in great detail. The findings were compared with those of other crocodilian taxa to detect potential variability of the muscles of interest. The homology of the muscles was studied by comparing the muscles of the crocodilian infrapubic abdominal wall with those of other diapsids. In Crocodylus niloticus, the infrapubic abdominal wall consists of four muscles: Musculus truncocaudalis, M. ischiotruncus, and Mm. rectus abdominis externus and internus. The arrangement of the muscles of the infrapubic abdominal wall of Crocodylus niloticus is consistent with that found in most other crocodilian taxa. In some crocodilian taxa, an additional muscle, M. ischiopubis, is found. In the remaining diapsids, only M. rectus abdominis is present. The crocodilian M. truncocaudalis, M. ischiotruncus and, if present, M. ischiopubis appear to be derivates of M. rectus abdominis; the development of those might be related to the evolution of the unique crocodilian ventilatory mechanism. PMID:22909340

  19. Gross hematuria as the presentation of an inguinoscrotal hernia: a case report

    Ansari Kayvan

    2011-12-01

    Full Text Available Abstract Introduction Several complications have been reported with inguinal hernias. Although hematuria and flank pain, either as the presentation or as a complication of inguinal hernia, are infrequent, this condition may lead to the development of obstructive uropathy, which can have diverse manifestations. Case presentation A 71-year-old Iranian man with Persian ethnicity presented with new onset episodes of gross hematuria and left-sided flank pain. A physical examination revealed a large and non-tender inguinal hernia on his left side. An initial workup included an abdominal ultrasound, an intravenous pyelogram and cystoscopy, which showed left hydronephrosis and a bulging on the left-side of his bladder wall. On further evaluation, computed tomography confirmed that his sigmoid colon was the source of the pressure effect on his bladder, resulting in hydroureteronephrosis and hematuria. No tumoral lesion was evident. Herniorrhaphy led to the resolution of his signs and symptoms. Conclusion Our case illustrates a rare presentation of inguinal hernia responsible for gross hematuria and unilateral hydronephrosis. Urologic signs and symptoms can be caused by the content of inguinal hernias. They can also present as complications of inguinal hernias.

  20. Effect of copaiba oil on correction of abdominal wall defect treated with the use of polypropylene/polyglecaprone mesh

    Edson Yuzur Yasojima; Renan Kleber Costa Teixeira; Abdallah de Paula Houat; Felipe Lobato da Silva Costa; Edvaldo Lima Silveira; Marcus Vinicius Henriques Brito; Gaspar de Jesus Lopes Filho

    2013-01-01

    PURPOSE: To evaluate the effects of copaiba oil on the correction of abdominal defect treated with the use of polypropylene/polyglecaprone mesh in rats. METHODS: A defect in the abdominal wall was created and corrected with polypropylene/polyglecaprone mesh in 36 rats. They were randomly distributed into three groups: control, copaiba by oral administration (gavage) and copaiba oil dip in the mesh. Euthanasia was performed after seven, 14 and 21 post-operative days. The healing process was an...

  1. Abdominal wall metastasis of uterine papillary serous carcinoma in a post-menopausal woman: a case report.

    Park, Jung-Woo; Hwang, Sung-Ook

    2014-04-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy. PMID:25371890

  2. Spontaneous extrusion of peritoneal catheter of ventriculoperitoneal shunt through the intact abdominal wall: Report of two cases

    Souvagya Panigrahi

    2012-01-01

    Full Text Available Among the various complications associated with ventriculoperitoneal shunt (VPS surgery, migration of the peritoneal catheter is one of the rarest complications. We report two cases of spontaneous extrusion of the peritoneal portion of the VPS through the intact abdominal wall at an area unrelated to the surgical incision. Both were conscious and had no neurological deficits. There were no signs of infection. The peritoneal end of the shunt was removed through the abdomen. Shunt revision was performed. The patients were discharged 8 days after the revision without any complications. At 6-month follow-up, both of them are doing well. Possible mechanisms of abdominal wall perforation are discussed. Pulling the extruded peritoneal end through abdominal wall decreases the possibility of infection and is probably the best way of management.

  3. Sonographic Appearance of Abdominal Wall at the Left Flank of Laparotomy Incision Site in Ettawah Grade Does

    M. F. Ulum

    2014-12-01

    Full Text Available The aim of this study was to describe the sonographic appearance of abdominal wall at the left flank of laparotomy incision site in 11 mated Ettawah grade does. Brightness-mode ultrasound examination by using transducer with frequency of 5.0-6.0 MHz was conducted to grouping the does based on their pregnancy statuses. The incision site of the abdominal wall at left flank laparotomy was transcutaneous-scanned as long as 8 cm vertically. The sonographic appearance of the laparotomy wall thickness showed that in all groups of does were similar and not different statistically. The thickness of oblique external and oblique internal abdominal muscles increased in the pregnant does as compared to non-pregnant does (P<0.05.

  4. Isolated Abdominal Wall Actinomycosis Associated with an Intrauterine Contraceptive Device: A Case Report and Review of the Relevant Literature

    Sinan Carkman

    2010-01-01

    Full Text Available Isolated abdominal wall actinomycosis in the presence of an intrauterine contraceptive device (IUCD is extremely rare and only six such cases have been reported in the literature. We report a case where clinical and radiological examinations revealed a pseudotumor within the anterior abdominal wall. After being lost to follow-up, the patient presented two years later with the enlargement of the mass. The mass including the affected anterior abdominal wall was completely excised. The diagnosis of actinomycosis was established postoperatively by histopathological examination. Further questioning concerning her gynecological history revealed long-term use of the same IUCD. Surgical excision of the actinomycotic pseudotumour and removal of the IUCD followed by antibiotic therapy resulted in the full recovery of the patient.

  5. Abdominal wall protrusion following herpes zoster Protrusão de parede abdominal secundária a herpes zoster

    Facundo Burgos Ruiz Junior

    2007-04-01

    Full Text Available We present the case of a 62-year-old woman with abdominal segmental paresis consequent to radiculopathy caused by zoster, which was confirmed by electroneuromyography. The paresis resolved completely within three months. Recognition of this complication caused by zoster, which is easily misdiagnosed as abdominal herniation, is important for diagnosing this self-limited condition and avoiding unnecessary procedures.Apresenta-se caso de uma paciente de 62 anos com paresia abdominal segmentar, confirmada por eletroneuromiografia, conseqüente a uma radiculopatia devida a zoster. A paresia resolveu-se completamente em três meses. O reconhecimento desta complicação do zoster, passível de confusão com hérnia abdominal, é importante para o diagnóstico desta condição auto-limitada, sem a utilização de procedimentos desnecessários.

  6. The physical properties of two biomaterials and their effects in repairing abdominal wall defects in rat

    Guan-yu WANG

    2011-05-01

    Full Text Available Objective To compare the physical properties of porcine small intestinal submucosa(P-SIS and porcine pericardium(P-PC and their effects in repairing abdominal wall defects in rat,in order to look for a more suitable biomaterial for repairing abdominal wall defect.Methods P-SIS and P-PC were harvested from 5 BA-MA Mini-Pigs(around 50kg within 4h of sacrifice.P-SIS was prepared with Abraham’s method,and P-PC was prepared with Trypsin+Triton X-100 method.The strength against butting force,strength against expansion force,water vapor permeability,thickness and tensile strength were then respectively tested.48 male SD rats weighed from 290g to 310g were randomly divided into 2 groups(24 each.Abdominal wall defects(3cm×2cm were created by surgery and repaired with P-SIS or P-PC respectively.Animals were sacrificed at the 2nd,4th,6th and 8th week after operation.The tensile strength and expansion rate of implanted materials and the development of adhesions were measured and observed.Results The thickness of P-PC(0.17±0.01mm was about 3 times that of P-SIS(0.05±0.01mm;The strength against expansion force of P-PC(52.10±6.50 Psi was about 8 times that of P-SIS(6.70±0.45 Psi;The strength against butting force of P-PC(166.86±16.15N was about 6 times of P-SIS(25.94±2.92N;The tensile strength of P-PC(31.80±6.16MPa was about 3 times that of P-SIS(11.81±2.50MPa.The water vapor permeability of P-SIS [4772.82±279.64 g/(m2·d] was about 1.5 times that of P-PC [3108.28±233.69g/(m2·d].The tensile strength of both materials declined significantly after implantation,recovered slowly from the 4th week on,and returned to normal after 6 weeks.The area of P-SIS implant gradually shrank after implantation;the implanted area of P-PC was 5.05±0.27cm2 at the 2nd week,9.99±0.89cm2 at the 4th week,6.83±0.19cm2 at the 6th week,and 10.63±0.91cm2 at the 8th week.The implanted area of P-PC was larger than that of P-SIS 4 weeks after implantation(P < 0.05.The

  7. The use of a subfascial vicryl mesh buttress to aid in the closure of massive ventral hernias following damage-control laparotomy.

    Tobias, Adam M; Low, David W

    2003-09-01

    Damage control laparotomy for life-threatening abdominal conditions has gained wide acceptance in the management of exsanguinating trauma patients as well as septic patients with acute abdomen. Survivors considered too ill to undergo definitive abdominal wall closure are temporized, often with skin grafting on granulated viscera. These maneuvers compromise the integrity of the anterior abdominal wall and result in a subset of patients with loss of abdominal domain and massive, debilitating ventral hernias. A retrospective review was conducted of 21 such patients (16 men, five women) who underwent elective abdominal wall reconstruction at the Hospital of the University of Pennsylvania between November of 1998 and October of 2000. The purpose of this study was to report the authors' experience with these complex abdominal wall reconstructions. A double-layer, subfascial Vicryl mesh buttress was used in all repairs to aid in reestablishing abdominal wall integrity. The mean hernia size was 813 cm2 (range, 75 to 1836 cm2), and the average interval to definitive repair was 24.4 months (range, 3 weeks to 11 years). Mean follow-up was 13.5 months (range, 1 month to 40 months). Twenty patients (95 percent) had successful ventral hernia repair. Four patients with massive hernias (924 to 1836 cm2) required submuscular Marlex mesh implantation. Two patients (10 percent) developed abdominal compartment syndrome that required surgical decompression. One patient (5 percent) developed an incisional hernia at a prior colostomy site. Four patients (19 percent) had superficial skin dehiscence that healed secondarily with daily wound care. There were no mesh infections. In most cases, successful single-stage repair of large ventral hernias following damage control laparotomy can be achieved using a subfascial Vicryl mesh buttress in combination with other established reconstructive techniques. Massive defects exceeding 900 cm2 typically require permanent mesh implantation to achieve

  8. Congenital hernia of the umbilical cord associated with extracelomic colonic atresia and perforation of gut in a newborn

    Kamalesh Pal

    2014-01-01

    Full Text Available Congenital hernia of the umbilical cord (CHUC is a rare congenital entity compared to more common post-natally occurring umbilical hernia. Although recognized as a distinct entity since 1920s, CHUC is often misdiagnosed as a small omphalocele, resulting in its underreporting. We present the first case report of CHUC associated with extracelomic colonic atresia, complicated by perinatal perforation in a newborn. We also discuss the differentiating features from other anterior abdominal wall defects such as omphalocele and gastroschisis including its embryogenesis.

  9. Oral, intestinal, and skin bacteria in ventral hernia mesh implants

    Langbach, Odd; Kristoffersen, Anne Karin; Abesha-Belay, Emnet; Enersen, Morten; Røkke, Ola; Olsen, Ingar

    2016-01-01

    Background In ventral hernia surgery, mesh implants are used to reduce recurrence. Infection after mesh implantation can be a problem and rates around 6–10% have been reported. Bacterial colonization of mesh implants in patients without clinical signs of infection has not been thoroughly investigated. Molecular techniques have proven effective in demonstrating bacterial diversity in various environments and are able to identify bacteria on a gene-specific level. Objective The purpose of this study was to detect bacterial biofilm in mesh implants, analyze its bacterial diversity, and look for possible resemblance with bacterial biofilm from the periodontal pocket. Methods Thirty patients referred to our hospital for recurrence after former ventral hernia mesh repair, were examined for periodontitis in advance of new surgical hernia repair. Oral examination included periapical radiographs, periodontal probing, and subgingival plaque collection. A piece of mesh (1×1 cm) from the abdominal wall was harvested during the new surgical hernia repair and analyzed for bacteria by PCR and 16S rRNA gene sequencing. From patients with positive PCR mesh samples, subgingival plaque samples were analyzed with the same techniques. Results A great variety of taxa were detected in 20 (66.7%) mesh samples, including typical oral commensals and periodontopathogens, enterics, and skin bacteria. Mesh and periodontal bacteria were further analyzed for similarity in 16S rRNA gene sequences. In 17 sequences, the level of resemblance between mesh and subgingival bacterial colonization was 98–100% suggesting, but not proving, a transfer of oral bacteria to the mesh. Conclusion The results show great bacterial diversity on mesh implants from the anterior abdominal wall including oral commensals and periodontopathogens. Mesh can be reached by bacteria in several ways including hematogenous spread from an oral site. However, other sites such as gut and skin may also serve as sources for the

  10. Aesthetic aspects of abdominal wall and external genital reconstructive surgery in bladder exstrophy-epispadias complex.

    VanderBrink, Brian A; Stock, Jeffrey A; Hanna, Moneer K

    2006-03-01

    Long-term follow-up of patients born with classical bladder exstrophy-epispadias complex (EEC) reveals that many of them suffer from poor self-image, and the aesthetic aspects of the genitalia and lower abdomen acquire greater significance with age. In this article, we review the aesthetic outcomes in performing puboplasty, umbilicoplasty, and genitoplasty in patients born with EEC. Retrospective review of the cosmetic and functional outcomes in 116 patients born with EEC treated by puboplasty, umbilicoplasty, or genitoplasty was performed. Satisfaction with the cosmetic and functional outcomes of these three reconstructive surgeries was high following initial reconstructive efforts (> 90%). Attention to cosmesis during abdominal wall and genital reconstruction for EEC helps to improve a patient's perception of body image and self-esteem. Our experience with these procedures over the past 25 years demonstrated that the efforts directed toward aesthetics have been well worthwhile. PMID:16527001

  11. Laparoscopic management of a traumatic lumbar hernia: about a case

    Vandermeulen, Morgan; Detry, Olivier

    2015-01-01

    Traumatic Lumbar hernia (TLH) is a very rare clinical entity with about 100 cases reported worldwide. It is a difficult challenge when encountered and there is no consensus on the best management: early or delayed, open or laparoscopic. We report the clinical case of a 28-year-old man who suffered from a TLH after a 6- meter-high fall. The diagnosis was based on CT imaging showing a defect in the postero-lateral abdominal wall by disinsertion of the lumbar origin of transverse, internal a...

  12. MR imaging of acute pancreatitis: Correlation of abdominal wall edema with severity scores

    Yang, Ru, E-mail: yangru0904@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Jing, Zong Lin, E-mail: jzl325@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Zhang, Xiao Ming, E-mail: zhangxm@nsmc.edu.cn [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Tang, Wei, E-mail: tw-n-g-up@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Xiao, Bo, E-mail: xiaoboimaging@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Huang, Xiao Hua, E-mail: nc_hxh1966@yahoo.com.cn [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Yang, Lin, E-mail: llinyangmd@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Feng, Zhi Song, E-mail: fengzhisong@medmail.com.cn [Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China)

    2012-11-15

    Objective: To study MRI findings of abdominal wall edema (AWE) in acute pancreatitis as well as correlations between AWE and the severity of acute pancreatitis according to the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation III (APACHE III) scoring system. Materials and methods: A total of 160 patients with AP admitted to our institution between December 2009 and March 2011 were included in this study. MRI was performed within 48 h after admission. MRI findings of acute pancreatitis were noted, including AWE on the MRI. The abdominal wall area was divided into quarters, and each area involved was recorded as 1 point to score the severity of AWE. The severity of acute pancreatitis was studied using both the MRSI and the APACHE III scoring system. Spearman correlation of AWE with the MRSI and the APACHE III scoring system was analyzed. Results: In 160 patients with acute pancreatitis, 53.8% had AWE on MRI. The average AWE score was 1.2 {+-} 1.4 points. The prevalence of AWE was 30.5%, 64.5% and 100% in mild, moderate and severe AP, respectively, according to MRSI. AWE on MRI was correlated with MRSI scores (r = 0.441, p = 0.000). According to APACHE III scores, the averages were 2.0 {+-} 1.1 and 2.6 {+-} 1.1 points in mild AP and severe AP, respectively (P = 0.016). AWE was slightly correlated with the APACHE III scores (r = 0.222, p = 0.005). Conclusion: AWE on MRI in acute pancreatitis is common, which may be a supplementary indicator in determining the severity of AP.

  13. Comparison of two porcine-derived materials for repairing abdominal wall defects in rats.

    Zhengni Liu

    Full Text Available OBJECTIVE: The purpose of this study was to compare the mechanical properties, host responses and incorporation of porcine small intestine submucosa (PSIS and porcine acellular dermal matrix (PADM in a rat model of abdominal wall defect repair. MATERIALS AND METHODS: Prior to implantation, PSIS and PADM were prepared and evaluated in terms of structure and mechanical properties. Full-thickness abdominal wall defects were created in 50 Sprague-Dawley rats, and were repaired using either PSIS or PADM. Rats were sacrificed 1, 2, 4, 8 and 12 weeks post-repair and examined for herniation, infection, adhesions, contraction, and changes in the thickness and strength of the tissues incorporated at the defect sites. Histopathology and immunohistochemistry were performed to analyze inflammatory responses, collagen deposition and vascularization. RESULTS: PADM showed more dense collagen deposition and stronger mechanical properties than PSIS prior to implantation (P<0.01. However, the mechanical properties observed after integration with the surrounding native tissues was similar for PADM and PSIS. Both PADM and PSIS showed significant contraction by week 12. However, PADM tissue induced less adhesion and increased in thickness more slowly, and showed less infiltration by foreign giant cells, polymorphonuclear cells, and mononuclear cells. Improved remodeling of host tissue was observed after PSIS implantation, which was apparent from the orientation of bands of fibrous connective tissue, intermixed with newly formed blood vessels by Week 12. CONCLUSION: PSIS showed weaker mechanical properties prior to implantation. However, after implantation PSIS induced more pronounced host responses and showed better incorporation into host tissues than PADM.

  14. MR imaging of acute pancreatitis: Correlation of abdominal wall edema with severity scores

    Objective: To study MRI findings of abdominal wall edema (AWE) in acute pancreatitis as well as correlations between AWE and the severity of acute pancreatitis according to the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation III (APACHE III) scoring system. Materials and methods: A total of 160 patients with AP admitted to our institution between December 2009 and March 2011 were included in this study. MRI was performed within 48 h after admission. MRI findings of acute pancreatitis were noted, including AWE on the MRI. The abdominal wall area was divided into quarters, and each area involved was recorded as 1 point to score the severity of AWE. The severity of acute pancreatitis was studied using both the MRSI and the APACHE III scoring system. Spearman correlation of AWE with the MRSI and the APACHE III scoring system was analyzed. Results: In 160 patients with acute pancreatitis, 53.8% had AWE on MRI. The average AWE score was 1.2 ± 1.4 points. The prevalence of AWE was 30.5%, 64.5% and 100% in mild, moderate and severe AP, respectively, according to MRSI. AWE on MRI was correlated with MRSI scores (r = 0.441, p = 0.000). According to APACHE III scores, the averages were 2.0 ± 1.1 and 2.6 ± 1.1 points in mild AP and severe AP, respectively (P = 0.016). AWE was slightly correlated with the APACHE III scores (r = 0.222, p = 0.005). Conclusion: AWE on MRI in acute pancreatitis is common, which may be a supplementary indicator in determining the severity of AP.

  15. Paraduodenal hernia and jejunal diverticulosis.

    Goodney, Philip P; Pindyck, Frank

    2004-02-01

    A case of left-sided paraduodenal hernia and jejunal diverticulosis is described in 75-year-old man who presented with chronic intermittent abdominal pain, weight loss, and anemia. A brief review of the epidemiology, pathogenesis, and clinical presentation displays the variety of symptoms associated with these rare conditions. PMID:14731138

  16. Analysis of sublay prosthetic repair for abdominal incisional hernias%腹膜前置补片修补法治疗腹壁切口疝的临床探讨

    王嘉; 徐雪东; 安伟德; 李玉文; 邓中慧; 张伟国; 陈帅

    2014-01-01

    Objective To discuss clinical effective methods for repairing abdominal incisional hernias with mesh in the open surgery .Methods One hundred and twenty -eight cases of abdominal incisional hernia in the open surgery were ana-lyzed retrospectively in our hospital from Jan 2004 to Dec 2012 .Two cases were repaired with Inlay , 25 cases with Onlay and 101 cases with Sublay .The treatment effects of the three methods were compared .Results All of the cases were cured with no serious postoperative complications .Among all cases who were followed up during 5-48 months, 1 case recurred in the group of Inlay(50%), 5 cases recurred in the group of Onlay(20%)and 4 cases recurred in the group of Sublay (4%).Conclusion Sublay has a lower recurrence rate , thus is considered as a satisfactory model for repair of abdominal incisional hernias in the open surgery .%目的:探讨在开放手术中补片修补腹壁切口疝的有效方法。方法回顾性分析2004年1月-2012年12月经大连医科大学附属第一医院诊治的腹壁切口疝患者中开放手术128例患者的临床资料。其中2例行肌间置补片修补法(Inlay),25例行肌筋膜前置补片修补法(Onlay),101例行腹膜前置补片修补法(Sublay)。观察3种方法的疗效。结果128例均痊愈出院,无严重并发症,随访5~48个月, Inlay组复发1例(50%), Onlay组复发5例(20%), Sublay组复发4例(4%)。结论 Sublay法治疗腹壁切口疝复发率低,在开放手术中是治疗腹壁切口疝的理想方法。

  17. A case of extraperitoneal stoma-associated internal hernia after abdominoperineal resection.

    Yokoyama, Yuichiro; Kawai, Kazushige; Kazama, Shinsuke; Yoneyama, Satomi; Tanaka, Junichiro; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Nozawa, Hiroaki; Kanazawa, Takamitsu; Yamaguchi, Hironori; Ishihara, Soichiro; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

    2014-01-01

    Published reports concerning internal hernias after extraperitoneal stoma construction are scarce. In our present report, we describe the case of a 56-year-old man who was referred to our hospital for the treatment of rectal cancer. He underwent abdominoperineal resection of the rectum with sigmoidostomy using an extraperitoneal route. On the ninth postoperative day, the patient experienced sudden and intense abdominal pain and was diagnosed with strangulation of the small intestine due to a stoma-associated internal hernia. Therefore, an emergency laparotomy was performed. The surgical findings showed that the small intestine protruded through the space between the sigmoid colon loop and the abdominal wall in a cranial-to-caudal direction. The strangulated portion of the small intestine was recovered, and the orifice of herniation was closed. No recurrence of internal herniation was observed during the follow-up period. PMID:24886644

  18. De Garengeot’s Hernia: a Diagnostic Challenge

    Tancredi, Antonio; BELLAGAMBA, RICCARDO; Cotugno, Michele; Impagnatiello, Elvira; La Torre, Pasquale; Masi, Maurizio; Ciavarella, Giacomo

    2015-01-01

    Surgical literature defines the case of acute appendicitis in a sac of femoral hernia as de Garengeot’s hernia. The diagnosis remains a very hard challenge for surgeon because the symptoms are aspecific and the most effective tools for preoperative evaluation (as abdominal computed tomography and abdominal ultrasound scan) can often be indeterminate or misinterpreted. We report the case of an 85-year-old white male admitted to our unit complaining of a 1-day history of vague abdominal pain, n...

  19. Histochemical and immunohistochemical analysis of ruptured atherosclerotic abdominal aortic aneurysm wall

    Tanasković Irena

    2010-01-01

    Full Text Available Background/Aim. The main complication of the atherosclerotic abdominal aortic aneurism (AAA is her rupture that begins with lesion in intima and rupture. The purpose of this work was to determine immunocytochemical and morphofunctional characteristics of the cells in aortic wall in ruptured atherosclerotic abdominal aortic aneurysm. Method. During the course of this study, 20 samples of atherosclerotic AAA were analyzed, all of them obtained during authopsy. The samples were fixed in 4% formalin and embedded in paraffin. Sections of 5 μm thickness were stained histochemically (of Heidenhain azan stain and Periodic acid Schiff - PAS stain and immunocytochemically using a DAKO LSAB+/HRP technique to identify α-smooth muscle actin (α-SMA, vimentin, myosin heavy chains (MHC, desmin, S-100 protein, CD45 and CD68 (DAKO specification. Results. The results of our study showed that ruptured atherosclerotic AAA is characterized by a complete absence of endothelial cells, the disruption of basal membrane and internal elastic lamina, as well as a presence of the remains of hypocellular complicated atherosclerotic lesion in intima. On the plaque margins, as well as in the media, smooth muscle cells (SMCs are present, which express a α-SMA and vimentin (but without MHC or desmin expression, as well as leukocyte infiltration, and a large number of foam cells. Some of the foam cells show a CD68-immunoreactivity, while the others show vimentin- and S-100 protein-immunoreactivity. Media is thinned out with a disorganized elastic lamellas, while adventitia is characterized by inflammatory inflitrate (infection. Conclusion. Rupture of aneurysm occurs from the primary intimal disruption, which spreads into thinned out media and adventitia. Rupture is caused by unstable atherom, hypocellularity, loss of contractile characteristics of smooth muscle cells in intima and media, neovascularization of the media, as well as by the activity of the macrophages in the

  20. Effect of copaiba oil on correction of abdominal wall defect treated with the use of polypropylene/polyglecaprone mesh

    Edson Yuzur Yasojima

    2013-02-01

    Full Text Available PURPOSE: To evaluate the effects of copaiba oil on the correction of abdominal defect treated with the use of polypropylene/polyglecaprone mesh in rats. METHODS: A defect in the abdominal wall was created and corrected with polypropylene/polyglecaprone mesh in 36 rats. They were randomly distributed into three groups: control, copaiba by oral administration (gavage and copaiba oil dip in the mesh. Euthanasia was performed after seven, 14 and 21 post-operative days. The healing process was analyzed regarding the meshes and macroscopic and microscopic aspects. RESULTS: All animals had abdominal adhesions, which were smaller in the copaiba (gavage group (p<0.05. In microscopy, all animals had an acute inflammation stage and the inflammatory response was best characterized by foreign body-type granulomas around the mesh fragments, which was not found in the mesh fragments within the copaiba dip group. There was a greater area of necrosis and fibrosis in the copaiba dip group compared to the control group (p<0.05. The copaiba (gavage group had a greater quantity of collagen fibers compared to the control group. CONCLUSION: Copaiba oil administered by gavage decreased the amount of abdominal adhesions, besides accelerating the process of collagen fibers formation, without damages within the early stages of healing. However, when used by dip directly on the mesh, it had corrosive effects compromising the healing process of the abdominal wall.

  1. Reconstrucción de las secuelas de la pared abdominal en pacientes con extrofia de cloaca Reconstruction of abdominal wall sequelae in patients with cloacal extrophy

    P. Iwanyk

    2009-06-01

    Full Text Available Los defectos abdominales congénitos de la línea media inferior, como la extrofia cloacal, se producen por fallos en el mesodermo entre la región umbilical y la membrana cloacal provocando severos defectos viscerales, musculares y óseos. Los reiterados intentos para la reconstrucción de los tractos intestinal y génitourinario en este tipo de malformaciones, pueden ocasionar secuelas graves en la pared malformada. La complejidad de esta malformación y los numerosos procedimientos a los que deben ser sometidos estos pacientes, requieren de un abordaje interdisciplinario desde el inicio del tratamiento y en cada una de las etapas reconstructivas a fin de evitar, al máximo, las lesiones de los tejidos abdominales para lograr, al final, una pared adecuada. Presentamos 2 casos de reconstrucción de la pared abdominal en sendos pacientes de sexo femenino con secuelas importantes de extrofia cloacal, utilizando tejidos expandidos, colgajos musculares y complementando el tratamiento en una de las pacientes con una malla protésica. En ambos casos, y a pesar de la falta de tejido provocada por la malformación y las secuelas de múltiples cirugías, obtuvimos un buen resultado funcional y estético.Abdominal congenital defects of the middle line have their origin in developmental faults of mesoderm between the umbilical region and the cloacal membrane, originating visceral, muscular and osseous defects in the abdominal wall. Repeated attempts to reconstruct the intestinal and genitourinary tract here and in other malformations, can cause serious sequeals in the previously deformed abdominal wall. We present 2 cases of abdominal wall reconstruction in patients with serious sequelae of cloacal extrophy. Complexity of this malformation calls for an interdisciplinary treatment to avoid the severe damage that may be caused during reconstructive attempts. In spite of lack of tissue because of the malformation and the sequelae of multiple surgeries we

  2. Mesh tuck repair of ventral hernias of the abdomen: a new, simplified technique for sublay herniorrhaphy.

    East, J M

    2007-12-01

    There is biomechanical advantage to placing mesh in the retro-myofascial plane for repair of ventral abdominal hernias. Intra-abdominal pressure applied to the periphery of the mesh increases apposition to the abdominal wall rather than causing distraction and this translates, in general, into lower recurrence rates than after "inlay" and "onlay" mesh placement. Traditionally, retro-myofascial mesh is placed in the pre-peritoneal or retro-muscular space. Both traditional techniques require extensive dissection and placement of large sheets of mesh which can cause symptomatic impairment of abdominal wall compliance. Pre-peritoneal dissection can be particularly tedious due to pathological adherence of peritoneum to the posterior abdominal wall in longstanding primary and incisional hernias. In the technique described, mesh is tucked into the retro-myofascial plane without any dissection into pre-peritoneal, retro-muscular or peritoneal spaces. The operation is less tedious, takes less time to perform, can often be done under local anaesthesia, demands less mesh and achieves similar recurrence rates to traditional retro-myofascial mesh repairs. Sixty-one operations have been performed by the author using this technique, with a recurrence rate of 8.2% after 13 years to 3 months of follow-up (median, 3.75 years) and 9.3% if patients with less than one year of follow-up are excluded Factors predisposing to recurrence after mesh repair of ventral hernias are numerous and complex. A fair comparison of recurrence rates between this technique and traditional retro-myofascial repairs requires a randomized controlled trial but the crude recurrence rate for this operation falls well within the range reported for traditional repairs from other studies. PMID:18646495

  3. [Lumbar hernias in adults. Apropos of 4 cases and review of the literature].

    Le Neel, J C; Sartre, J Y; Borde, L; Guiberteau, B; Bourseau, J C

    1993-10-01

    Lumbar hernias are rare (2% of abdominal wall hernias). Symptomatology consists frequently only of an arch formation seen best with the patient sitting and when coughing. In adults it is twice as frequent in women and on the left side. Acute events, dominated by incarceration of a digestive segment, particularly colic, often suggest the diagnosis (10% of cases). Diagnosis is simple when confronted with a large hernia, but difficulties arise with those less than 5 cm in diameter, often diagnosed as a lipoma or parietal tumor. Conventional radiographs and ultrasound images are usually sufficient to establish the correct diagnosis and to determine the content of the hernial sac, but computed tomography scans can provide data on the exact limits of the defect and allow evaluation of possible problems during surgical repair. Rarely congenital (10%), these hernias occur either secondary to a violent lumbo-abdomino-pelvic injury (25%) or following surgical intervention to the lumbar region (50% of cases). Small hernias can be repaired using the direct approach but larger deficits require the insertion of a reinforcing non absorbable prosthesis. Long term results, both for the 4 cases reported and those published in the literature, were assessed as satisfactory. PMID:8276908

  4. A COMPARATIVE STUDY IN LAPAROSCOPIC INGUINAL HERNIA REPAIR BETWEEN FIXATION VS NON-FIXATION OF MESH

    Ayush

    2016-02-01

    Full Text Available INTRODUCTION An inguinal hernia is a weakness in the wall of the abdominal cavity that is large enough to allow escape of soft body tissue or internal organ, especially a part of the intestine. It usually appears as a lump and for some peoples can cause pain and discomfort, limit daily activities and the ability to work. If the bowel strangulates or becomes obstructed it can be life-threatening. A hernia is repaired generally using a synthetic mesh either with open surgery or increasingly using less invasive laparoscopic procedures. AIMS AND OBJECTIVES To compare and evaluate Laparoscopic hernia repair (trans-abdominal pre-peritoneal and total extra peritoneal repair (TAPP & TEP using Prolene mesh with or without fixation. MATERIAL AND METHODS Our study was conducted in dept. of surgery, Government Medical College and associated Dr. Susheela Tiwari Hospital. A total sample of 100 patients who underwent inguinal hernia repair as an elective surgery. 50 of whom underwent fixation of mesh (fixation will be done either by tacker or suture. Rest 5o underwent non fixation of mesh. RESULTS In our study Statistically there was non-significant heterogeneity in operating time (p = 0.15, post-operative pain (p = 0.45, post-operative complications (p = 0.55 and length of hospital stay (p = 0.11 were statistically comparable between two techniques of mesh fixation in LIHR. The risk of developing chronic groin pain (p = 0.67 and risk of hernia recurrence (p = 0.77 was also similar. CONCLUSION NMF in LIHR does not increase the risk of hernia recurrence. It is comparable with TMF in terms of operation time, post-operative pain, post-operative complications, length of hospital stay and chronic groin pain. Therefore, based upon the results of our study NMF approach may be adopted routinely and safely in LIHR.

  5. Refining the course of the thoracolumbar nerves: a new understanding of the innervation of the anterior abdominal wall.

    Rozen, W M; Tran, T M N; Ashton, M W; Barrington, M J; Ivanusic, J J; Taylor, G I

    2008-05-01

    Previous descriptions of the thoracolumbar spinal nerves innervating the anterior abdominal wall have been inconsistent. With modern surgical and anesthetic techniques that involve or may damage these nerves, an improved understanding of the precise course and variability of this anatomy has become increasingly important. The course of the nerves of the anterior abdominal is described based on a thorough cadaveric study and review of the literature. Twenty human cadaveric hemi-abdominal walls were dissected to map the course of the nerves of the anterior abdominal wall. Dissection included a comprehensive tracing of nerves and their branches from their origins in five specimens. The branching pattern and course of all nerves identified were described. All thoracolumbar nerves that innervate the anterior abdominal wall were found to travel as multiple mixed segmental nerves, which branch and communicate widely within the transversus abdominis plane (TAP). This communication may occur at multiple locations, including large branch communications anterolaterally (intercostal plexus), and in plexuses that run with the deep circumflex iliac artery (DCIA) (TAP plexus) and the deep inferior epigastric artery (DIEA) (rectus sheath plexus). Rectus abdominis muscle is innervated by segments T6-L1, with a constant branch from L1. The umbilicus is always innervated by a branch of T10. As such, identification or damage to individual nerves in the TAP or within rectus sheath is unlikely to involve single segmental nerves. An understanding of this anatomy may contribute to explaining clinical outcomes and preventing complications, following TAP blocks for anesthesia and DIEA perforator flaps for breast reconstruction. PMID:18428988

  6. Cough induced rib fracture, rupture of the diaphragm and abdominal herniation

    Wurl Peter

    2006-11-01

    Full Text Available Abstract Cough can be associated with many complications. In this article, we present a 59 year old male patient with a very rare combination of a cough related stress fracture of the ninth rib, a traumatic rupture of the diaphragm, and an abdominal wall herniation. The hernia was repaired through surgical treatment without bowel resection, the diaphragm and the internal and oblique abdominal muscle were adapted, and the abdomen was reinforced with a prolene net. Although each individual injury is well documented in the literature, the combination of rib fracture, abdominal herniation and diaphragm rupture has not been reported.

  7. Primary Hydatid Cyst of Umbilicus, Mimicking an Umbilical Hernia

    Tarahomi, Mohammadreza; Alizadeh Otaghvar, Hamidreza; Ghavifekr, Nazila hasanzadeh; Shojaei, Daryanaz; Goravanchi, Farhood; Molaei, Amir

    2016-01-01

    Hydatid cyst caused by Echinococcus granulosus demonstrates an endemic infection in several countries such as Middle Eastern countries. Liver is the most frequently involved organ, followed by the lung. The case we present is solitary primary localization of cyst in abdominal wall which is extremely rare. A 57-year-old woman presented with an abdominal wall lesion in umbilical area that had been evolving for about 2 years with recent complaint of pain and discomfort. We detected a midline abdominal mass 12⁎13 centimeters in diameter which was bulged out in umbilicus. Preoperative clinical diagnosis of incarcerated umbilical hernia was made due to its physical examination while surgical exploration disproved the primary diagnosis and we found cystic mass adherent to superficial fascia without any communication to peritoneal space. The cyst was excised completely without any injury or perforation of containing capsule. The diagnosis of hydatid cyst was confirmed by histopathological examination of specimen. The retrograde evaluation showed no involvement of other organs. The patient was followed for two years and no recurrence of hydatid disease has been observed. Hydatid cyst should be considered as a differential diagnosis of abdominal wall and umbilical lesions especially in endemic regions.

  8. COMPARATIVE STUDY OF LICHTENSTEIN VERSUS DESARDA REPAIR FOR INGUINAL HERNIA

    Sowmya,; Deepak G

    2015-01-01

    BACKGROUND Inguinal hernia repair is the most frequently performed operation in any general surgical unit. The Bassini’s, Shouldice and other tissue-based techniques are still being acceptable for primary inguinal hernia repair. Desarda’s technique is originally a tissue based hernia repair using an undetached strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal. The aim of the present study was to compare Lichtenstein hernia repair and ...

  9. A case of the vacuum phenomenon as a mechanism of gas production in the abdominal wall.

    Mishima, Kentaro; Omori, Kazuhiko; Ohsaka, Hiromichi; Takeda, Jun; Ishikawa, Kouhei; Obinata, Mariko; Oode, Yasumasa; Sugita, Manabu; Yanagawa, Youichi

    2015-06-01

    A 40-year-old man experienced a collision with a car while driving a motorcycle in which the car was in the opposite lane and made a right turn. The patient was thrown approximately 10 m from the point of collision and, as he exhibited a consciousness disturbance, was transferred to our department. He had a score of 13 on the Glasgow Coma Scale with sinus tachycardia on arrival. He showed guarding of the abdomen. A pan scan disclosed traumatic subarachnoid hemorrhage, intraventricular hemorrhage, fractures of the atlas, thoracic spine, sternum and left femur, and gas in the abdomen located just in front of the stomach. As the gas in the abdomen was initially judged to be free air, the patient underwent emergency laparotomy. However, no signs of perforation or injury were detected throughout the entire digestive tract. The accumulation of minute gas (vacuum phenomenon) occurs as traumatic impact. As representative mimics of free air were not observed during surgery in the present case, we believe that the traumatic impact to the patient's abdomen as a result of the collision caused the accumulation of gas in the abdominal wall due to vacuum phenomenon. Physicians should be aware of this clinical entity to accurately recognize the mechanism of gas formation in patients showing negative laparotomy findings for gas in the abdomen. This unique case adds additional information regarding the documented etiologies of mimics of pneumoperitoneum. PMID:25600235

  10. Urinary Bladder Adenocarcinoma Metastatic to the Abdominal Wall: Report of a Case with Cytohistologic Correlation

    Vikas Nath

    2016-01-01

    Full Text Available We report a case of adenocarcinoma metastatic to the abdominal wall in a 71-year-old man with a history of primary bladder adenocarcinoma. CT-guided core biopsy was performed; imprints and histologic sections showed malignant glands lined by tumor cells with hyperchromatic nuclei and prominent nucleoli, infiltrating through skeletal muscle. Immunohistochemistry revealed positivity for CK7, membranous/cytoplasmic β-catenin, caudal-type homeobox transcription factor 2 (CDX2, and α-methylacyl coenzyme A racemase and negativity for CK20, p63, prostate-specific antigen (PSA, and prostate-specific acid phosphatase (PSAP. These findings were interpreted as metastatic adenocarcinoma, consistent with bladder primary. Primary bladder adenocarcinoma is a rare malignancy arising within glandular metaplasia and is associated with cystitis cystica and cystitis glandularis. Predisposing factors include bladder exstrophy, schistosomiasis, and other causes of chronic bladder irritation. This tumor is divided into intestinal, clear cell, and signet ring cell subtypes. Treatment involves radical cystectomy with pelvic lymph node dissection, and prognosis is unfavorable. Primary bladder adenocarcinoma should be differentiated from urachal adenocarcinoma, which arises from urachal remnants near the bladder dome, and secondary adenocarcinoma, or vesical involvement by adenocarcinoma from a different primary. CK7, CK20, CDX2, thrombomodulin, and β-catenin can help distinguish primary bladder adenocarcinoma from colonic adenocarcinoma; PSA and PSAP can help distinguish primary bladder adenocarcinoma from prostate adenocarcinoma.

  11. Active behavior of abdominal wall muscles: Experimental results and numerical model formulation.

    Grasa, J; Sierra, M; Lauzeral, N; Muñoz, M J; Miana-Mena, F J; Calvo, B

    2016-08-01

    In the present study a computational finite element technique is proposed to simulate the mechanical response of muscles in the abdominal wall. This technique considers the active behavior of the tissue taking into account both collagen and muscle fiber directions. In an attempt to obtain the computational response as close as possible to real muscles, the parameters needed to adjust the mathematical formulation were determined from in vitro experimental tests. Experiments were conducted on male New Zealand White rabbits (2047±34g) and the active properties of three different muscles: Rectus Abdominis, External Oblique and multi-layered samples formed by three muscles (External Oblique, Internal Oblique, and Transversus Abdominis) were characterized. The parameters obtained for each muscle were incorporated into a finite strain formulation to simulate active behavior of muscles incorporating the anisotropy of the tissue. The results show the potential of the model to predict the anisotropic behavior of the tissue associated to fibers and how this influences on the strain, stress and generated force during an isometric contraction. PMID:27111629

  12. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    Wang Yang [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Wei, E-mail: wangyang301301@yahoo.com.cn [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Longxia; Wang Junyan; Tang Jie [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China)

    2011-07-15

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

  13. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

  14. Changing trend in congenital abdominal wall defects in Eastern region of Ireland.

    McDonnell, R

    2002-09-01

    In the past six years, there have been reports from abroad of an unexplained rise in the birth prevalence rate of the congenital abdominal wall defect gastroschisis, while rates for the macroscopically similar anomaly omphalocoele have remained stable. The Dublin EUROCAT Registry of congenital anomalies monitors trends in the birth prevalence of birth defects in the eastern region of Ireland. We analysed births of children with omphalocoele and gastroschisis born in the period 1981-2000, with comparisons of a number of demographic and obstetric variables. During the 20 year period the birth prevalence rate for omphalocoele remained stable at 2.5\\/10,000 births, whereas the rate for gastroschisis increased significantly during the 1990s from 1.0\\/10,000 in 1991 to 4.9\\/10,000 in 2000. Most of the increase occurred among mothers under 25 years of age. Omphalocoele was associated with a relatively high proportion of other major congenital anomalies. This study showed that there has been an unexpected rise in the birth prevalence of gastroschisis in the region, similar to that experienced in other countries in the same time period and likely to have common aetiological features.

  15. Immersive virtual reality for visualization of abdominal CT

    Lin, Qiufeng; Xu, Zhoubing; Li, Bo; Baucom, Rebeccah; Poulose, Benjamin; Landman, Bennett A.; Bodenheimer, Robert E.

    2013-03-01

    Immersive virtual environments use a stereoscopic head-mounted display and data glove to create high fidelity virtual experiences in which users can interact with three-dimensional models and perceive relationships at their true scale. This stands in stark contrast to traditional PACS-based infrastructure in which images are viewed as stacks of two dimensional slices, or, at best, disembodied renderings. Although there has substantial innovation in immersive virtual environments for entertainment and consumer media, these technologies have not been widely applied in clinical applications. Here, we consider potential applications of immersive virtual environments for ventral hernia patients with abdominal computed tomography imaging data. Nearly a half million ventral hernias occur in the United States each year, and hernia repair is the most commonly performed general surgery operation worldwide. A significant problem in these conditions is communicating the urgency, degree of severity, and impact of a hernia (and potential repair) on patient quality of life. Hernias are defined by ruptures in the abdominal wall (i.e., the absence of healthy tissues) rather than a growth (e.g., cancer); therefore, understanding a hernia necessitates understanding the entire abdomen. Our environment allows surgeons and patients to view body scans at scale and interact with these virtual models using a data glove. This visualization and interaction allows users to perceive the relationship between physical structures and medical imaging data. The system provides close integration of PACS-based CT data with immersive virtual environments and creates opportunities to study and optimize interfaces for patient communication, operative planning, and medical education.

  16. Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

    Sung Kyu Bae

    2013-01-01

    Full Text Available Background If a chronically infected abdominal wound develops, complications such asperitonitis and an abdominal wall defect could occur. This could prolong the patient’s hospitalstay and increase the possibility of re-operation or another infection as well. For this reason,a solution for infection control is necessary. In this study, surgery using a rectus abdominismuscle myofascial splitting flap was performed on an abdominal wall defect.Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture,cesarean section, or uterine myoma were chosen. In each case, during the first week afteroperation, the wound showed signs of infection. Surgery was chosen because the wounds didnot resolve with dressing. Debridement was performed along the previous operation woundand dissection of the skin was performed to separate the skin and subcutaneous tissue fromthe attenuated rectus muscle and Scarpa’s fascial layers. Once the anterior rectus sheath andmuscle were adequately mobilized, the fascia and muscle flap were advanced medially sothat the skin defect could be covered for reconstruction.Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation,no major complication occurred. In addition, all of the patients showed satisfaction in termsof function and esthetics at 3 to 6 months post-surgery.Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic andfunctional benefits over previous methods of abdominal defect treatment, and notably, itenabled infection control by reconstruction using muscle.

  17. Meconial peritonitis in a rare association of partial ileal apple-peel atresia with small abdominal wall defect

    V. Insinga

    2014-06-01

    Full Text Available Intestinal atresia type III B (apple peel and gastroschisis are both congenital malformations who require early surgical correction in neonatal age. Their association is very rare. We present the case of a full term infant with partial apple peel ileal atresia and a small defect of the anterior abdominal wall, complicated by in utero intestinal perforation and subsequent meconial peritonitis. We observed a partial atresia of small intestine, with involvement of terminal ileus savings of jejunum and a large part of the proximal ileum, small anterior abdominal wall defect with herniation of few bowel loops, intestinal malrotation. Paralytic ileus and infections are the main causes of morbidity and mortality at neonatal age. In our case, in spite of the mild phenotype, prognosis has been complicated by the onset of functional bowel obstruction, caused by chemical peritonitis resulting from contact with either amniotic fluid and meconium.

  18. Delayed traumatic diaphragmatic hernia

    Lu, Jing; Wang, Bo; Che, Xiangming; Li, Xuqi; Qiu, Guanglin; He, Shicai; Fan, Lin

    2016-01-01

    Abstract Background: Traumatic diaphragmatic hernias (TDHs) are sometimes difficult to identify at an early stage and can consequently result in diagnostic delays with life-threatening outcomes. It is the aim of this case study to highlight the difficulties encountered with the earlier detection of traumatic diaphragmatic hernias. Methods: Clinical data of patients who received treatment for delayed traumatic diaphragmatic hernias in registers of the First Affiliated Hospital of Xi’an Jiaotong University from 1998 to 2014 were analyzed retrospectively. Results: Six patients were included in this study. Left hemidiaphragm was affected in all of them. Most of the patients had a history of traffic accident and 1 a stab-penetrating injury. The interval from injury to developing symptoms ranged from 2 to 11 years (median 5 years). The hernial contents included the stomach, omentum, small intestine, and colon. Diaphragmatic injury was missed in all of them during the initial managements. All patients received operations once the diagnosis of delayed TDH was confirmed, and no postoperative mortality was detected. Conclusions: Delayed TDHs are not common, but can lead to serious consequences once occurred. Early detection of diaphragmatic injuries is crucial. Surgeons should maintain a high suspicion for injuries of the diaphragm in cases with abdominal or lower chest traumas, especially in the initial surgical explorations. We emphasize the need for radiographical follow-up to detect diaphragmatic injuries at an earlier stage. PMID:27512848

  19. Abdominal Wall Metastasis of Uterine Papillary Serous Carcinoma in a Post-Menopausal Woman: A Case Report

    Park, Jung-Woo; Hwang, Sung-Ook

    2014-01-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT rev...

  20. Right congenital pleuro-peritoneal hiatus hernia

    Sankar DK

    2009-12-01

    Full Text Available Congenital diaphragmatic hernias are of various types which are due to the defect in the diaphragm and can be encountered in any period of life. Left mediastinal shift with right congenital diaphragmatic hernia is rare and life threatening malformation. We describe a case of right congenital diaphragmatic hernia of a newborn male infant, which died shortly after birth. The lobes of the liver were enlarged and occupied whole of the abdominal cavity. The stomach and intestinal loops were herniated into the right pleural cavity and partly into the left pleural cavity. Severe hypoplastic right lung, trilobed left lung and dextrocardia also were observed.

  1. Laparoscopic surgery for treatment of incisional lumbar hernia

    M. Tobias-Machado; Freddy J. Rincon; Marco T. Lasmar; Zambon, Joao P; Roberto V. Juliano; Eric R. Wroclawski

    2005-01-01

    OBJECTIVE: To present results obtained with laparoscopic correction of incisional lumbar hernia in patients with minimum follow-up of 1 year. MATERIALS AND METHODS: We prospectively studied 7 patients diagnosed with incisional lumbar hernia after physical examination and computerized tomography. We used laparoscopic transperitoneal access through 3 ports. One polypropylene mesh was introduced in the abdominal cavity and fixed by titanium clamps to the margins of the hernia ring following rele...

  2. Benign Ancient Schwannoma of the abdominal wall: An unwanted birthday present

    Ram Manisha

    2010-01-01

    Full Text Available Abstract Background There has been a recent growth in the use of whole body Computerised Tomography (CT scans in the private sector as a screening test for asymptomatic disease. This is despite scant evidence to show any positive effect on morbidity or mortality. There has been concern raised over the possible harms of the test in terms of radiation exposure as well as the risk and anxiety of further investigation and treatment for the large numbers of benign lesions identified. Case Presentation A healthy 64 year old lady received a privately funded whole body CT scan for her birthday which revealed an incidental mass in the right iliac fossa. This was investigated with further imaging and colonoscopy and as confident diagnosis could not be made, eventually excised. Histology demonstrated this to be a benign ancient schwannoma and we believe this to be the first reported case of an abdominal wall schwannoma in the English literature Conclusions Ancient schwannomas are rare tumours of the peripheral nerve sheaths more usually found in the head, neck and flexor surfaces of extremities. They are a subtype of classical schwannomas with a predominance of degenerative changes. Our case highlights the pitfalls of such screening tests in demonstrating benign disease and subjecting patients to what turns out to be unnecessary invasive investigation and treatment. It provides evidence as to the consequences of the large number of false positive results that are created by blind CT scanning of asymptomatic patients i.e. its tendency to detect pseudodiesease rather than affect survival rates. Should the number of scans increase there may be an unnecessary burden on NHS resources due to the large numbers of benign lesions picked up, that are then referred for further investigation.

  3. Ultrastructural characteristics of the vascular wall components of ruptured atherosclerotic abdominal aortic aneurysm

    Tanasković Irena

    2013-01-01

    Full Text Available The aim of this study was to determine the ultrastructural characteristics of cell populations and extracellular matrix components in the wall of ruptured atherosclerotic abdominal aortic aneurysm (AAA. We analyzed 20 samples of ruptured AAA. For orientation to the light microscopy, we used routine histochemical techniques by standard procedures. For ultrastructural analysis, we applied transmission electron microscopy (TEM. Our results have shown that ruptured AAA is characterized by the remains of an advanced atherosclerotic lesion in the intima followed by a complete absence of endothelial cells, the disruption of basal membrane and disruption of internal elastic lamina. On plaque margins as well as in the inner media we observed smooth muscle cells (SMCs that posses a euchromatic nucleus, a well-developed granulated endoplasmic reticulum around the nucleus and reduced myofilaments. The remains of the ruptured lipid core were acellular in all samples; however, on the lateral sides of ruptured plaque we observed a presence of two types of foam cells (FCs, spindle- and star-shaped. Fusiform FCs possess a well-differentiated basal lamina, caveolae and electron dense bodies, followed by a small number of lipid droplets in the cytoplasm. Star-shaped FCs contain a large number of lipid droplets and do not possess basal lamina. On the inner margins of the plaque, we observed a large number of cells undergoing apoptosis and necrosis, extracellular lipid droplets as well as a large number of lymphocytes. The media was thinned out with disorganized elastic lamellas, while the adventitia exhibited leukocyte infiltration. The presented results suggest that atherosclerotic plaque in ruptured AAA contains vascular SMC synthetic phenotype and two different types of FCs: some were derived from monocyte/macrophage lineage, while others were derived from SMCs of synthetic phenotype. The striking plaque hypocellularity was the result of apoptosis and necrosis

  4. Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system

    Yue WANG; Heng CUI; Yan ZHAO; Zhi-qi WANG

    2009-01-01

    Objectives: The use of gasless laparoscopy with an abdominal wall-lifting device for benign gynecological diseases was compared to conventional laparoscopy with CO_2 pneumoperitoneum. Methods: From February 2007 to July 2007, 76 women with uterine and/or adnexal benign diseases and candidates for laparoscopic surgery were recruited in this study. Thirty-two women underwent gasless laparoscopic surgery and 44 women underwent pneumoperitoneum laparoscopic surgery. Results: Diverse pathologies, including adnexal cyst, uterine myoma and ectopic pregnancy, were treated successfully with gasless laparoscopic surgery. Compared with the patients in the pneumoperitoneum group, the similar hospital stay (P=0.353) and in-traoperative blood loss (P=0.157) were observed. However, the mean operative time in the gasless group was significantly longer than that in the pneumoperitoneum group (P=0.003). No severe intraoperative or postoperative complications were found in either group, except for one case of laparotomic conversion in the pneumoperitoneum group due to dense pelvic adhesions. The total hospital charges were significantly less in the gasless group than in the pneumoperitoneum group (P=0.001). In 38 cases of ovarian cyst resection, the mean operative time in the gasless group remained longer than that in the pneumoperitoneum group (P=0.017). The total hospital charges were also significantly less in the gasless group than in the pneumoperitoneum group (P<0.001). Con-clusion: Our preliminary results demonstrated that the laparoscopic procedure using the gasless technique was a safe, effective method to treat benign gynecological diseases. Moreover, it was easy to master. As a minimally invasive treatment, gasless laparoscopic surgery provides a good choice to patients in the undeveloped regions in China without increasing the patients' and the government's burden significantly.

  5. Parastomal hernias after radical cystectomy and ileal conduit diversion.

    Donahue, Timothy F; Bochner, Bernard H

    2016-07-01

    Parastomal hernia, defined as an "incisional hernia related to an abdominal wall stoma", is a frequent complication after conduit urinary diversion that can negatively impact quality of life and present a clinically significant problem for many patients. Parastomal hernia (PH) rates may be as high as 65% and while many patients are asymptomatic, in some series up to 30% of patients require surgical intervention due to pain, leakage, ostomy appliance problems, urinary obstruction, and rarely bowel obstruction or strangulation. Local tissue repair, stoma relocation, and mesh repairs have been performed to correct PH, however, long-term results have been disappointing with recurrence rates of 30%-76% reported after these techniques. Due to high recurrence rates and the potential morbidity of PH repair, efforts have been made to prevent PH development at the time of the initial surgery. Randomized trials of circumstomal prophylactic mesh placement at the time of colostomy and ileostomy stoma formation have shown significant reductions in PH rates with acceptably low complication profiles. We have placed prophylactic mesh at the time of ileal conduit creation in patients at high risk for PH development and found it to be safe and effective in reducing the PH rates over the short-term. In this review, we describe the clinical and radiographic definitions of PH, the clinical impact and risk factors associated with its development, and the use of prophylactic mesh placement for patients undergoing ileal conduit urinary diversion with the intent of reducing PH rates. PMID:27437533

  6. Incisional subcutaneous endometrioma of the abdominal wall: report of two cases; Endometriose sous cutanee sur cicatrice de la paroi abdominale anterieure. A propos de deux observations

    Merran, S.; Karila-Cohen, P. [Federation Mutualiste Parisienne, Dept. d' Imagerie Medicale, 75 - Paris (France)

    2004-04-01

    Endometriosis occurs in up to 15% of menstruating women. Abdominal wall involvement is rare and always secondary to an invasive procedure. The authors report the imaging and clinical findings of two patients with subcutaneous endometrioma following cesarean section. (author)

  7. Tension-free procedures in the treatment of groin hernias

    Milić Dragan J.

    2003-01-01

    patch repair the PerFix plug and patch repair, the Prolene Hernia System bilayer patch repair and Trabucco’s sutureless preshaped hernioraphy. General surgeons today have access to a wider and more sophisticated range of synthetic biomaterials for use in hernia repair than ever before. The advantages and disadvantages of each of these devices must be understood however, before surgeons select any of these implants. Meanwhile, a 1997 study of various biomaterials used in abdominal wall hernia repair further reported that the risk of infection, seroma formation biomaterial-related intestinal obstructions, and other complications can be minimized or eliminated by understanding the process underlying these problems and taking proper precautions. The surgeon's choice of the prosthesis used in hernia repair is based on a combination of factors, including patient characteristics; clinical experience, training, interest, and skill; understanding of the range of products available and the clinical studies that may have been performed on each; and the surgeon's familiarity with a particular product and/or surgical approach. Innovations in technique and product design will no doubt continue to spur advances in hernia repair, and it is hoped that they will continue to improve outcomes. The availability of these outcomes data, along with the ongoing accumulation of clinical experience with a broad range of materials and techniques, will help surgeons to better identify the most appropriate prosthesis for the clinician and the patient. It appears that herniology will remain in the realm of the surgeon, since it is doubtful that any medical measures will replace the operative treatment for abdominal wall hernias. Although operative procedures are not yet ideal important advances have been made in herniorrhaphy resulting in improved outcomes: The use of local techniques has maximized the safety of anesthesia time needed for care has been minimized, with most procedures now being done

  8. A new technique of pulmonary hernia surgical repair using intramedullary titanium implants

    Wcisło, Szymon; Wawrzycki, Marcin; Misiak, Piotr; Brocki, Marian

    2015-01-01

    Introduction In this paper we present a new method of pulmonary hernia surgical treatment. Pulmonary hernia is a rare pathology. The first description of pulmonary hernia was made by Roland in 1499. The world literature describes only a little more than 300 cases of pulmonary hernia. Pulmonary hernia is defined as the projection of the lung tissue covered by the parietal pleura beyond the normal boundaries of the pleural cavity, through the pathological holes in the chest wall. During our wor...

  9. Use of a porcine dermal collagen implant for contaminated abdominal wall reconstruction in a 105-year-old woman: a case report and review of the literature

    Melnik, Idit; Goldstein, Dimitry; Yoffe, Boris

    2015-01-01

    Introduction Repair of contaminated abdominal wall defect in a geriatric patient is a challenge for the surgeon. We present the case of the oldest patient (105-years old) to successfully undergo a single-stage repair of a contaminated abdominal wall defect with a Permacol™ implant. Case presentation A 105-year-old Caucasian woman presented to our emergency room with a clinical and radiological diagnosis of small bowel obstruction due to prior operative adhesions. She underwent laparotomy with...

  10. Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress

    Davarcı, I.; M. Karcıoğlu; K. Tuzcu; İnanoğlu, K.; Yetim, T. D.; Motor, S.; Ulutaş, K. T.; Yüksel, R.

    2015-01-01

    Objective. To compare the effects of pneumoperitoneum on lung mechanics, end-tidal CO2 (ETCO2), arterial blood gases (ABG), and oxidative stress markers in blood and bronchoalveolar lavage fluid (BALF) during laparoscopic cholecystectomy (LC) by using lung-protective ventilation strategy. Materials and Methods. Forty-six patients undergoing LC and abdominal wall hernia (AWH) surgery were assigned into 2 groups. Measurements and blood samples were obtained before, during pneumoperitoneum, and ...

  11. Repair of abdominal wall defects in vitro and in vivo using VEGF sustained-release multi-walled carbon nanotubes (MWNT composite scaffolds.

    Zhicheng Song

    Full Text Available OBJECTIVE: Porcine acellular dermal matrices (ADM have been widely used in experimental and clinical research for abdominal wall repair. Compared to porcine small intestinal submucosa (SIS, the effect of these matrices on the regenerative capacity of blood vessels is still not ideal. Multi-walled carbon nanotubes (MWNTs can more effectively transport VEGF to cells or tissues because of their large specific surface area and interior cavity. In this study, we explored the safety and efficacy of implanted VEGF-loaded MWNT composite scaffolds in vitro and vivo to repair abdominal wall defects. MATERIALS AND METHODS: VEGF-loaded MWNTs were prepared by a modified plasma polymerization treatment. Four composite scaffolds were evaluated for cytotoxicity, proliferation, and release dynamics. We created 3 cm×4 cm abdominal wall defects in 43 Sprague-Dawley rats. After implantation times of 2, 4, 8, and 12 weeks, the scaffolds and the surrounding tissues were collected and examined by gross inspection, biomechanical testing, and histological examination. RESULTS: A 5-10 nm poly(lactic-co-glycolic acid (PLGA film was evenly distributed on MWNTs. The 3% MWNT composite group showed lower cytotoxicity and appropriate release performance, and it was thus tested in vivo. In rats with the 3% composite implanted, host cells were prevented from migrating to the ADM at 2 weeks, vascularization was established more rapidly at 12 weeks, and the values for both the maximum load and the elastic modulus were significantly lower than in the ADM-alone group (p<0.01. Histological staining revealed that the MWNT was still not completely eliminated 12 weeks after implantation. CONCLUSION: MWNTs were able to carry VEGF to cells or tissues, and the 3% MWNT composite material showed lower cytotoxicity and had an appropriate release performance, which prompted faster vascularization of the ADM than other scaffolds. Nevertheless, the MWNTs induced harmful effects that should be

  12. Metastatic ovarian carcinoma presenting as an incarcerated femoral hernia

    Suzanne M. Beecher

    2015-01-01

    Conclusion: In cases, where there is a known intra-abdominal malignancy & the presence of an incarcerated hernia, there should be a high index of suspicion for the presence of tumour within the hernial contents.

  13. Ovarian Spigelian hernia: A radiological diagnosis

    We describe that case of a 54 year old lady with achondroplasia who presented with ongoing left sided abdominal pain. Ultrasound and abdominal computerized tomography images demonstrated an enlarged left ovary and Fallopian tube trapped between the rectus abdominus and the lateral semilunar line under cover of the external oblique aponeurosis. A left sided salpingoophrectomy with mesh herniorrhaphy was performed and histological analysis confirmed the hernia contents were a hydrosalpinx and normal ovary. This case report presents the unusual radiographic images and intraoperative photographs of an ovarian Speglian hernia.

  14. Uncommon presentation of actinomycosis mimicking colonic cancer: Colon actinomycosis with invasion of the abdominal wall

    Ilhan Bali

    2015-04-01

    Full Text Available Actinomycosis is an uncommon chronic suppurative infectious disease that is caused by Actinomycetes organisms, which are gram-positive, microaerophilic, anaerobic bacteria. Herein, we present the case of a 42-year-old female patient who underwent surgical exploration following presentation with abdominal pain and an abdominal mass, initially thought to be a malignancy. Histological examination of the specimen revealed colon actinomycosis. [Arch Clin Exp Surg 2015; 4(2.000: 107-110

  15. Abdominal wall metastasis in scar after open resection of an adrenocortical carcinoma

    Nikhil Gupta

    2011-12-01

    Full Text Available A 42-year-old man patient presented with progressively increasing, occasionally painful lump in the left upper and central abdomen. Investigations revealed well-defined capsulated left adrenocortical carcinoma. Tumor was resected successfully along with left kidney. Tumor recurred in the abdominal surgical scar 1.5 years after surgery. We are reporting this case because of rarity of metastatic recurrence of an adrenocortical carcinoma in the abdominal surgical scar 1.5 years after resection of primary tumor.

  16. Plain abdominal film and abdominal ultrasound in intestine occlusion

    Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificy of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecistis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echigenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus

  17. New technical approach for the repair of an abdominal wall defect after a transverse rectus abdominis myocutaneous flap: a case report

    Kaemmer Daniel A

    2008-04-01

    Full Text Available Abstract Introduction Breast reconstruction with autologous tissue transfer is now a standard operation, but abnormalities of the abdominal wall contour represent a complication which has led surgeons to invent techniques to minimize the morbidity of the donor site. Case presentation We report the case of a woman who had bilateral transverse rectus abdominis myocutaneous flap (TRAM-flap breast reconstruction. The surgery led to the patient developing an enormous abdominal bulge that caused her disability in terms of abdominal wall and bowel function, pain and contour. In the absence of rectus muscle, the large defect was repaired using a combination of the abdominal wall component separation technique of Ramirez et al and additional mesh augmentation with a lightweight, large-pore polypropylene mesh (Ultrapro®. Conclusion The procedure of Ramirez et al is helpful in achieving a tension-free closure of large defects in the anterior abdominal wall. The additional mesh augmentation allows reinforcement of the thinned lateral abdominal wall.

  18. Porcine acellular lung matrix for wound healing and abdominal wall reconstruction: A pilot study.

    Fernandez-Moure, Joseph S; Van Eps, Jeffrey L; Rhudy, Jessica R; Cabrera, Fernando J; Acharya, Ghanashyam S; Tasciotti, Ennio; Sakamoto, Jason; Nichols, Joan E

    2016-01-01

    Surgical wound healing applications require bioprosthetics that promote cellular infiltration and vessel formation, metrics associated with increased mechanical strength and resistance to infection. Porcine acellular lung matrix is a novel tissue scaffold known to promote cell adherence while minimizing inflammatory reactions. In this study, we evaluate the capacity of porcine acellular lung matrix to sustain cellularization and neovascularization in a rat model of subcutaneous implantation and chronic hernia repair. We hypothesize that, compared to human acellular dermal matrix, porcine acellular lung matrix would promote greater cell infiltration and vessel formation. Following pneumonectomy, porcine lungs were processed and characterized histologically and by scanning electron microscopy to demonstrate efficacy of the decellularization. Using a rat model of subcutaneou implantation, porcine acellular lung matrices (n = 8) and human acellular dermal matrices (n = 8) were incubated in vivo for 6 weeks. To evaluate performance under mechanically stressed conditions, porcine acellular lung matrices (n = 7) and human acellular dermal matrices (n = 7) were implanted in a rat model of chronic ventral incisional hernia repair for 6 weeks. After 6 weeks, tissues were evaluated using hematoxylin and eosin and Masson's trichrome staining to quantify cell infiltration and vessel formation. Porcine acellular lung matrices were shown to be successfully decellularized. Following subcutaneous implantation, macroscopic vessel formation was evident. Porcine acellular lung matrices demonstrated sufficient incorporation and showed no evidence of mechanical failure after ventral hernia repair. Porcine acellular lung matrices demonstrated significantly greater cellular density and vessel formation when compared to human acellular dermal matrix. Vessel sizes were similar across all groups. Cell infiltration and vessel formation are well-characterized metrics of incorporation

  19. Rare Hernias Presenting as Acute Abdomen- A Case Series

    Ulahannan, Sansho Elavumkal; Kurien, John S; Joseph, Aneesh; Kurien, Annie Sandhya; Varghese, Sandeep Abraham; Thomas, Bindhya; Varghese, Fobin

    2016-01-01

    Hernia is an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. It can be divided into internal, external and diaphragmatic hernias. Most of them can be asymptomatic. If they become symptomatic they can present with features of intestinal obstruction, incarceration or strangulation. In this case series we compare the incidence of these rare presentations of hernias with world literature and to warn surgeons not to cut the obstructing band in cases of internal hernias. In this case series, we review the clinical details of 7 rare presentations of hernia, who presented with various types of hernias to a tertiary care centre in Kerala over a period of one year. Of these 7 cases 6 cases were internal hernias (3 left paraduodenal hernias, 2 transmesentric hernias, and 1 pericaecal hernia) and a case of spigelian hernia above the level of umbilicus. All of them presented as acute abdomen in the emergency department. Among these 7 cases, only one case was diagnosed preoperatively. Three patients had bowel gangrene and had to undergo resection- anastomosis of the bowel. The survival rate among these cases was 100% as compared to 50% in the world literature if they had been left untreated. Even though internal hernias are a rare entity, we need to have it as a differential diagnosis in case of intestinal obstruction, in a previously non-operated abdomen.

  20. An epidemiologic study of congenital malformations of the anterior abdominal wall in more than half a million consecutive live births.

    Baird, P A; MacDonald, E.C.

    1981-01-01

    The records of an ongoing health surveillance registry that utilizes multiple sources of ascertainment were used to study the incidence rate of congenital malformations of the anterior abdominal wall in live-born children in British Columbia during the period 1964--1978 inclusive. No overall increase in incidence rate of these anomalies was detected during the study period. The estimated live-born incidence rates were: one in 4,175 live births for omphalocoele, one in 12,328 live births for g...

  1. INGUINAL HERNIA REPAIR USING LIGHT AND HEAVY POLYPROPYLENE MESH: A COMPARATIVE STUDY

    Ganesh Babu

    2016-03-01

    Full Text Available BACKGROUND To compare and analyse the difference between heavy and light polypropylene mesh for the following outcomes- foreign body sensation, chronic pain, recurrence, patient postoperative recovery time and return to normal activities. METHODS Study includes patients admitted in Surgery Department, MVJ Medical College and Research Hospital, Hoskote, Bangalore, for Inguinal Hernia. A total of 60 patients studied who underwent Lichtenstein’s mesh repair were divided into two groups of 30 each using randomization by equal allocation. The study period was from November 2014 to July 2015. CONCLUSION The comparative study between light and heavy polypropylene mesh in Lichtenstein’s mesh repair for inguinal hernia showed Light mesh is superior to Heavy mesh in terms of lesser stiffness over abdominal wall postoperatively, lesser foreign body sensation, lesser severity of chronic pain, whereas heavy mesh had lower recurrence rates as compared to light mesh.

  2. Laparoscopic transabdominal extraperitoneal repair of lumbar hernia

    Sharma A

    2005-01-01

    Full Text Available Lumbar hernias need to be repaired due to the risk of incarceration and strangulation. A laparoscopic intraperitoneal approach in the modified flank position causes the intraperitoneal viscera to be displaced medially away from the hernia. The creation of a wide peritoneal flap around the hernial defect helps in mobilization of the colon, increased length of margin is available for coverage of mesh and more importantly for secure fixation of the mesh under vision to the underlying fascia. Laparoscopic lumbar hernia repair by this technique is a tensionless repair that diffuses total intra-abdominal pressure on each square inch of implanted mesh. The technique follows current principles of hernia repair and appears to confer all benefits of a minimal access approach.

  3. Endoscopic inguinal hernia repair

    M.T.T. Knook

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery on

  4. Blood Vessel Matrix Seeded with Cells: A Better Alternative for Abdominal Wall Reconstruction—A Long-Term Study

    Maciej Nowacki

    2015-01-01

    Full Text Available Purpose. The aim of this study was to present abdominal wall reconstruction using a porcine vascular graft seeded with MSC (mesenchymal stem cells on rat model. Material and Methods. Abdominal wall defect was prepared in 21 Wistar rats. Acellular porcine-vascular grafts taken from aorta and prepared with Triton X were used. 14 aortic grafts were implanted in place, of which 7 grafts were seeded with rat MSC cells (Group I, and 7 were acellular grafts (Group II. As a control, 7 standard polypropylene meshes were used for defect augmentation (Group III. The assessment method was performed by HE and CD31 staining after 6 months. The mechanical properties have been investigated by Zwick&Roell Z0.5. Results. The strongest angiogenesis and lowest inflammatory response were observed in Group I. Average capillaries density was 2.75, 0.75, and 1.53 and inflammatory effect was 0.29, 1.39, and 2.72 for Groups I, II, and III, respectively. The means of mechanical properties were 12.74±1.48, 7.27±1.56, and 14.4±3.7 N/cm in Groups I and II and control, respectively. Conclusions. Cell-seeded grafts have better mechanical properties than acellular grafts but worse than polypropylene mesh. Cells improved mechanical and physiological properties of decellularized natural scaffolds.

  5. Diagnostic value of susceptibility-weighted imaging of abdominal wall endometriomas during the cyclic menstrual changes: A preliminary study

    Objective: The purpose of this study is to investigate the value of susceptibility-weighted imaging (SWI) for the evaluation of cyclic morphological and hemorrhagic changes in abdominal wall endometriomas (AWE). Materials and methods: Fourteen patients with a total of 17 lesions who were admitted with complaints of abdominal wall mass and cyclic pain were evaluated by MRI. Patients were scanned during the first three days of the menstrual cycle and during the mid-cycle phase (day 13–15). In addition to conventional images SWI was performed. The signal changes within the lesions on SWI were compared and graded on both studies. Results: There was no significant difference in the size of the lesions in the early days of the menstruation compared to the mid-menstrual period. The SWI taken on mid-cycle phase showed that the center was hyperintense and the peripheral zone was hypointense in all lesions. A signal void related to increased blood and the shrinkage of complete disappearance of hyperintensity in the venter of the lesion was seen 15 (88%) of the 17 cases on the SWI series performed during the menstrual phase scan. Conclusion: SWI is a sensitive technique and has the capability to show hemorrhage and deposition of hemosiderin within the lesions. For patients suspected with AWE, valuable diagnostic findings may be obtained if the MRI examination including SWI is performed during the early and mid phase menstrual cycle

  6. Diagnostic value of susceptibility-weighted imaging of abdominal wall endometriomas during the cyclic menstrual changes: A preliminary study

    Solak, Aynur, E-mail: aynursolak@yahoo.com [Radiology Department of Sifa University Hospital, 35240, Fevzipasa Boulvard 172/2, Basmane, Izmir (Turkey); Şahin, Neslin, E-mail: neslinshn@gmail.com [Radiology Department of Sifa University Hospital, 35240, Fevzipasa Boulvard 172/2, Basmane, Izmir (Turkey); Genç, Berhan, E-mail: be.genc@hotmail.com [Radiology Department of Sifa University Hospital, 35240, Fevzipasa Boulvard 172/2, Basmane, Izmir (Turkey); Sever, Ali Rıza, E-mail: arsever@hotmail.com [Department of Radiology, Maidstone Hospital, Breast Unit, Maidstone, Kent (United Kingdom); Genç, Mine, E-mail: drminegenc@hotmail.com [Department of Gynecology and Obstetrics, Sifa University Hospital, 35240, Fevzipasa Boulvard 172/2, Basmane, Izmir (Turkey); Sivrikoz, Oya Nermin, E-mail: onsoral@yahoo.com [Pathology Department of Sifa University Hospital, 35240, Bornova, Izmir (Turkey)

    2013-09-15

    Objective: The purpose of this study is to investigate the value of susceptibility-weighted imaging (SWI) for the evaluation of cyclic morphological and hemorrhagic changes in abdominal wall endometriomas (AWE). Materials and methods: Fourteen patients with a total of 17 lesions who were admitted with complaints of abdominal wall mass and cyclic pain were evaluated by MRI. Patients were scanned during the first three days of the menstrual cycle and during the mid-cycle phase (day 13–15). In addition to conventional images SWI was performed. The signal changes within the lesions on SWI were compared and graded on both studies. Results: There was no significant difference in the size of the lesions in the early days of the menstruation compared to the mid-menstrual period. The SWI taken on mid-cycle phase showed that the center was hyperintense and the peripheral zone was hypointense in all lesions. A signal void related to increased blood and the shrinkage of complete disappearance of hyperintensity in the venter of the lesion was seen 15 (88%) of the 17 cases on the SWI series performed during the menstrual phase scan. Conclusion: SWI is a sensitive technique and has the capability to show hemorrhage and deposition of hemosiderin within the lesions. For patients suspected with AWE, valuable diagnostic findings may be obtained if the MRI examination including SWI is performed during the early and mid phase menstrual cycle.

  7. Reproducibility of The Abdominal and Chest Wall Position by Voluntary Breath-Hold Technique Using a Laser-Based Monitoring and Visual Feedback System

    Purpose: The voluntary breath-hold (BH) technique is a simple method to control the respiration-related motion of a tumor during irradiation. However, the abdominal and chest wall position may not be accurately reproduced using the BH technique. The purpose of this study was to examine whether visual feedback can reduce the fluctuation in wall motion during BH using a new respiratory monitoring device. Methods and Materials: We developed a laser-based BH monitoring and visual feedback system. For this study, five healthy volunteers were enrolled. The volunteers, practicing abdominal breathing, performed shallow end-expiration BH (SEBH), shallow end-inspiration BH (SIBH), and deep end-inspiration BH (DIBH) with or without visual feedback. The abdominal and chest wall positions were measured at 80-ms intervals during BHs. Results: The fluctuation in the chest wall position was smaller than that of the abdominal wall position. The reproducibility of the wall position was improved by visual feedback. With a monitoring device, visual feedback reduced the mean deviation of the abdominal wall from 2.1 ± 1.3 mm to 1.5 ± 0.5 mm, 2.5 ± 1.9 mm to 1.1 ± 0.4 mm, and 6.6 ± 2.4 mm to 2.6 ± 1.4 mm in SEBH, SIBH, and DIBH, respectively. Conclusions: Volunteers can perform the BH maneuver in a highly reproducible fashion when informed about the position of the wall, although in the case of DIBH, the deviation in the wall position remained substantial

  8. Atypical right diaphragmatic hernia (hernia of Morgagni, spigelian hernia and epigastric hernia in a patient with Williams syndrome: a case report

    Rashid Farhan

    2009-01-01

    Full Text Available Abstract Introduction Williams syndrome is rare genetic disorder resulting in neurodevelopmental problems. Hernias of the foramen of Morgagni are rare diaphragmatic hernias and they mostly present on the right side, in the anterior mediastinum. They are usually asymptomatic and are difficult to diagnose, especially in patients with learning disabilities. Case presentation This 49-year-old woman with Williams syndrome, cognitive impairment and aortic stenosis presented to physicians with right-sided chest pain. She had previously undergone repair of her right spigelian and epigastric hernia. Her abdominal examination was unremarkable. Chest X-ray suggested right-sided diaphragmatic hernia and pleural effusion for which she received treatment. The computed tomography scan showed a diaphragmatic hernia with some collapse/consolidation of the adjacent lung. Furthermore, the patient had aortic stenosis and was high risk for anaesthesia (ASA grade 3. She underwent successful laparoscopic repair of her congenital diaphragmatic hernia leading to a quick and uneventful postoperative recovery. Conclusion These multiple hernias suggest that patients with Williams syndrome may have some connective tissue disorder which makes them prone to develop hernias especially associated with those parts of the body which may have intracavity pressure variations like the abdomen. Diaphragmatic hernia may be the cause of chest pain in these patients. A computed tomography scan helps in early diagnosis, and laparoscopic repair helps in prevention of further complications, and leads to quick recovery especially in patients with learning disabilities. In the presence of significant comorbidities, a less invasive operative procedure with quick recovery becomes advisable.

  9. Panniculitis of the abdominal wall: Diagnosis by In-111-WBC and radiogallium

    Radioindium imaging (In-111-oxine-white blood cells), performed in a massively obese male, revealed a pattern of activity that was thought to represent a ptotic colon. The patient was restudied with Ga-67 citrate and a similar anterior pattern of activity was noted. On the lateral view of the abdomen, markers established that the activity was external to the abdominal cavity. This corresponded to an active panniculitis which was successfully drained. (orig.)

  10. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    Al Soub Hussam; Al-Maslamani Eman; Al-Maslamani Mona

    2008-01-01

    We describe here a case of abdominal abscesses due to Mycobacterium fortuitum following liposuction. The abscesses developed three months after the procedure and diagnosis was delayed for five months. The clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. This condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably...

  11. Avoiding Complications in Abdominal Wall Surgery: A Mathematical Model to Predict the Course of the Motor Innervation of the Rectus Abdominis.

    Tessone, Ariel; Nava, Maurizio; Blondeel, Phillip; Spano, Andrea

    2016-02-01

    Ever since its introduction, the transverse rectus abdominis myocutaneous flap has become the mainstay of autologous breast reconstruction. However, concerns regarding donor site morbidity due to the breach of abdominal wall musculature integrity soon followed. Muscle-sparing techniques, eventually eliminating the muscle from the flap all-together with the deep inferior epigastric artery perforator flap, did not eliminate the problem of abdominal wall weakness. This led to the conclusion that motor innervation might be at fault. Studies have shown that even in the presence of an intact rectus abdominis muscle, and an intact anterior rectus sheath, denervation of the rectus abdominis muscle results in significant abdominal wall weakness leading to superior and inferior abdominal bulges, and abdominal herniation. Our aim was to establish a mathematical model to predict the location of the motor innervation to the rectus abdominis muscle, and thus provide surgeons with a tool that will allow them to reduce abdominal morbidity during deep inferior epigastric artery perforator and free muscle-sparing transverse rectus abdominis myocutaneous surgery. We dissected 42 cadaveric hemiabdomens and mapped the course of the thoracolumbar nerves. We then standardized and analyzed our findings and presented them as a relative map which can be adjusted to body type and dimensions. Our dissections show that the motor innervation is closely related to the lateral vascular supply. Thus, when possible, we support the preferred utilization of the medial vascular supply, and the preservation of the lateral supply and motor innervation. PMID:26756600

  12. Amyand's hernia: A case report

    Sofia Anagnostopoulou; Dimitrios Dimitroulis; Theodore G Troupis; Maria Allamani; Alexandros Paraschos; Antonios Mazarakis; Nikolaos I Nikiteas; Alkiviadis Kostakis

    2006-01-01

    The presence of vermiform appendix in inguinal hernia is rare and is known as Amyand's hernia. We report an Amyand's hernia, where the appendix was found in a right inguinal hernia in one male cadaver aged ninety two years.

  13. VARIABLES IN LAPAROSCOPIC MANAGEMENT OF VENTRAL HERNIA

    Raghvendra Kumar

    2015-05-01

    Full Text Available BACKGROUND: The explosion of video - assisted surgery in past 20 years wa s a result of the development of compact , high resolution , charged coupled devices that could be mounted on the internal end of flexible endoscopes or on the external end of the Hopkins telescope . Coupled with bright light sources , fibre optic cables , and high resolution video monitors , the videoendoscope has changed our understanding of surgical anatomy and reshaped surgical practice . AIMS AND OBJECTIVES : Aims of our study were , 1. To evaluate how much overlap of mesh is optimal for the hernia repair. 2. T o analyze and evaluate the minimum number of the transfascial stitches for optimal fixation of the mesh with the abdominal wall . 3 . To analyze and evaluate the minimum numbers of the tacks for optimal fixation of the mesh with abdominal wall . 4 . To analyze and evaluate post - op recovery time , complications and recurrence . MATERIAL & METHODS: A Prospective study was carr i ed out on patients presenting with complaints suggestive of ventral ( incisional hernia in the Emergency or Outpatients Department of surger y M . L . B . Medical College , Jhansi . The study time was between May 2010 - September 2012 . OBSERVATION: In our study Length of post - op hospital stay is reduced to 2 . 75 days , operative time is reduced to average 48 . 5 minutes Vs 60 to 90 minutes in previous s tudies , In our study , the fixation of mesh is done with absorbable suture ( vicryl2 - 0 , prolene 2 - 0 and tackers , Incidence of enterotomy is 0 . 5% , seroma formation is reported in 4% of the patients , which is managed conservatively . CONCLUSION: 1 . Requires ad vance expertise of operating surgeon . 2 . Prolene mesh can be placed intra peritoneally , we have not found any post - op complication in total duration of our study . 3 . While placing the mesh in preperitoneum only fixation at the four corners of the mesh is r equired . 4 . Mesh fixation can also be done with the

  14. Clinical spectrum of internal hernia. A surgical emergency

    The purpose of this study was to define the indicators of bowel ischemia caused by congenital or acquired internal hernia, based on our 10-year experience in one center. We reviewed the medical records, imaging studies, and operative findings of 20 patients who underwent surgery for an internal hernia at our medical center between 1995 and 2005. The clinical characteristics and related indicators of the patients with, and those without bowel ischemia were compared and analyzed statistically. The subtypes of congenital internal hernia (CIH) included transmesenteric (n=6, 60%), paraduodenal (n=2, 20%), and pericecal (n=2, 20%) hernia. The abdominal surgical procedures preceding acquired internal hernia (AIH) were Roux-en-Y anastomosis (n=6, 60%) and appendectomy (n=3, 30%). Transmesenteric hernia was the most prevalent type of CIH in children. Abdominal rebound tenderness, advanced leukocytosis (>18000/mm3), or a high level of manual band form (>6%) were the positive predictive factors for bowel ischemia, whereas a history of chronic intermittent abdominal pain was a negative indicator. No recurrence was noted during the 10-year study period. The overall mortality rate was 20%, attributable to enteral bacteria sepsis in all cases. Internal hernia is a rare but lethal condition. Early diagnosis and prompt surgical intervention provide the only chance of a successful outcome. (author)

  15. Diaphragmatic hernia in horse: case report

    Augusto Jose Savioli de Almeida Sampaio

    2012-12-01

    Full Text Available The diaphragmatic hernia is a rare cause of colic in equine and may be congenital or acquired. The intestine is commonly involved in cases of diaphragmatic hernia, and clinical signs are related to the intestinal segment involved and the extension, obstruction may occur from a simple process to a strangulating. Often, clinical signs are characterized by acute abdominal whit severe pain, dyspnea and tachypnea. The diagnosis of diaphragmatic hernia can be difficult, and in most cases only is established during surgery or at necropsy. This paper reports a diaphragmatic hernia case in a quarter horse stallion, with 14 years of age showing acute abdominal signs. The clinical examination showed tachycardia, tachypnea and absence of intestinal motility. Turbidity, increase of leukocytes and protein was observed in the analysis of peritoneal fluid. Exploratory laparotomy was performed, but due to the presence of hemorrhagic mesentery, intestinal ischemia, and irreducible incarceration of the jejunum in epiploic foramen, euthanasia was decided. Furthermore, at necropsy, was observed a diaphragmatic hernia with presence of the small intestine in the thorax.

  16. Strangulated obturator hernia - an unusual presentation of intestinal obstruction.

    Zeeshan, Saqib

    2012-01-31

    An 81-year-old Caucasian emaciated female presented with 3 days history of colicky abdominal pain nausea, projectile vomiting and abdominal distension. A pre-operative diagnosis of mechanical bowel obstruction was made. The absence of characteristic clinical signs in this thin elderly woman with a small bowel obstruction failed to provide a pre-operative diagnosis. She underwent a midline laparotomy and resection and anastomosis of small bowel and repair of the strangulated right obturator hernia. The high mortality rate associated with this type of abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and prompt surgical intervention if the survival rate is to be improved.

  17. Radiographic observation of congenital diaphragmatic hernia

    Five cases of congenital diaphragmatic hernia. Case 1: A female infant, birth weight 2.25 kg, Apgar score 10, normal delivery at 11:33 P.M. on Feb.8, 1972. Lt side congenital diaphragmatic hernia. Case 2: A female infant, birth weight 1.48 kg, Apgar score 5, normal delivery at 11:20 A.M. on Oct.14, 1972. Lt. side congenital diaphragmatic hernia. This infant was twin. this infant's mother was toxemia. Case 3; A 33 years old women was admitted to the our hospital because of Lt.hip joint pain without other symptoms. Date of admission: Jan. 8, 1973. Rt side congenital diaphragmentic hernia. Case 4: A 4 month infant male was admitted to the our hospital because of vomiting, dyspnea and abdominal pain. He had cyanosis intermittently after one month ago. This infant was normal delivered. The family history was not contributory. Date of admission: This infant was normal delivered. The family history was not contributory. Date of admission: Aug. 30, 1971. Rt side congenital diaphragmatic hernia. Case 5: A 13 years old girl was admitted to our hospital because of general weakness without other symptoms. This patient was normal delivered. The family history was not contributory. Date of admission: March. 15, 1973. Lt. side congenital diaphragmentic hernia

  18. A prospective study assessing the efficacy of abdominal computed tomography scan without bowel preparation in diagnosing intestinal wall and luminal lesions in patients presenting to the emergency room with abdominal complaints

    Michal Mizrahi; Yoav Mintz; Avraham Rivkind; David Kisselgoff; Eugene Libson; Mayer Brezis; Eran Goldin; Oren Shibolet

    2005-01-01

    AIM: To evaluate the positive predictive value of abdominal non-prepared computed tomography (CT) for diagnosing intestinal lumen or wall lesions in patients presenting to the emergency room (ER) with abdominal complaints.METHODS: For 1-year we prospectively evaluated all ER patients hospitalized after abdominal CT scan detected either intraluminal or intestinal wall lesions. These patients underwent colonoscopy serving as gold standard. Patients with prior abdominal pathology or CT findings of appendicitis or diverticulitis were excluded.RESULTS: Five hundred and sixty-eight abdominopelvic CT scans were performed in the ER, 96 had positive colonic findings. Sixty-two patients were excluded, 46 because of diverticulitis or appendicitis, 16 because of prior abdominal pathology. Of the remaining 34 patients, 14 did not undergo colonoscopy during hospitalization.Twenty eligible patients were included in the study. The positive predictive value of the CT scans performed in the ER was calculated to be 45% (95% CI 25-67).CONCLUSION: CT findings correlated with colonoscopic findings only in approximately half of the cases. Relying on non-prepared CT scan findings in planning patient management and colonoscopy may lead to unnecessary diagnostic work-ups.

  19. Penis auto-amputation and chasm of the lower abdominal wall due to advanced penile carcinoma: a case report

    Baltogiannis Dimitrios

    2011-12-01

    Full Text Available Abstract Introduction Penile cancer is uncommon. When penile cancer is left untreated, at an advanced stage it can have tragic consequences for the patient. Case presentation Our case report does not concern a new manifestation of penile cancer, but an interesting presentation with clinical significance that emphasizes the need to diagnose and treat penile cancer early. It is an unusual case of a neglected penile cancer in a 57-year-old Greek man that led to auto-amputation of the penis and a large chasm in the lower abdominal wall. The clinical staging was T4N3M0 and our patient was treated with a bilateral cutaneous ureterostomy, chemotherapy and radiotherapy. Our patient died 18 months after his first admission in our clinic. Conclusions Emphasis must be placed on early diagnosis and treatment of penile cancer, so further development of the disease can be prevented.

  20. Bleichner’s hernia – lumbar hernia

    Petersen, Katherine; Snikeris, Jaclyn; Hall, Timothy S.

    2013-01-01

    Summary Background: We present a case of a lumbar hernia and a review of the literature of this rare hernia type. Case Report: The case and the review will discuss the unusual presentations reported, common etiologies, the importance of early operative repair based on the high rate of incarceration and the recent recommendations regarding repair techniques. Conclusions: Lumbar hernias are rare cases, but should be pursued in diagnosis and treated aggressively because of the high rate of incar...

  1. Left paraduodenal hernias; Hernias paraduodenales izquierdas

    Lopez-Negrete, L.; Garcia-Lozano, J.; Sanchez, J. L.; Tejeiro, A.; Sala, J. [Hospital Valle del Nalon. Riano-Sama. Asturias (Spain)

    2002-07-01

    We report two cases of left paraduodenal internal hernias located in the fossa of Landzert that were diagnosed by CT. Internal hernias are an infrequent cause of acute abdomen, due to the intestinal sub occlusion they produce. Left paraduodenal hernias are responsible for about 50% of internal hernias. CT makes it possible to demonstrate the group of herniated loops between the stomach, fourth segment of the duodenum, descending colon, and tail of the pancreas. The identification of the loops in an atypical position together with displaced blood vessels (mesenteric vessels) and colon gives concerns on them a typical radiological semiology that makes them easily identifiable. (Author) 9 refs.

  2. Littre′s hernia in a paediatric patient

    Daorui Qin

    2014-01-01

    Full Text Available Meckel′s diverticulum (MD is the most common congenital abnormality of the gastrointestinal tract that is generally asymptomatic and manifests only in a specific way when complications exist. Littre′s hernia is a rare complication of MD . The definition of Littre′s hernia is based upon the protrusion of a MD through a potential abdominal opening accompanied in some cases by incarceration, inflammation, or necrosis. The most common site of Littre′s hernia is the inguinal canal, usually on the right. It is difficult to diagnose before surgery. We report a 4-month-old boy with Littre′s hernia, including join with incarcerated hernia in the left side.

  3. Hernias (For Parents)

    ... with them. Hernias in kids can be treated (hernia repair is the one of the most common surgeries ... intestine that is caught and squeezed in the groin area may block the passage of food though ...

  4. Inguinal hernia repair

    Caruana-Dingli, Gordon

    1998-01-01

    A hernia usually presents as a painful lump in the groin, often associated with a large strain but it may also be asymptomatic and coincidentally discovered on routine examination. The incidence of hernia increases with age but a large number affected are working men and they can be severely disabled by the condition. Inguinal hernia is a common condition and 763 hernia operations were carried out in Government hospitals in Malta and Gozo during 1997.

  5. Unusual perforated appendicitis within umbilical hernia: CT findings.

    Arnáiz, J; Ortiz, A; Marco de Lucas, E; Piedra, T; Jordá, J; Arnáiz, A M; Pagola, M A

    2006-01-01

    We present the first imaging report of perforated appendicitis in an umbilical hernia. Computed tomography demonstrated a gas-forming abscess within an umbilical hernia and the cecum was found inside the hernial sac, with an inner relation to the abscess. Computed tomographic findings suggested appendicitis as possible diagnosis, which was confirmed at surgery. Physicians must consider appendicitis within the differential diagnosis of an abdominal abscess located near to the cecum, even at an unexpected location. PMID:16465570

  6. Radiologic investigation after laparoscopic inguinal hernia repair

    Laparoscopic instead of open surgical repair of inguinal hernias is becoming more frequent. Radiologists may expect different postoperative findings depending on the technique used. We studied how radiology had been used postoperatively and what findings were encountered after laparoscopic herniorraphy. Postoperative radiologic examinations related to hernia repair of all consecutive patients that had had laparoscopic herniorraphy in Malmoe University hospital between 1992 and 1998 were retrospectively evaluated. A total of 538 groins were included, 3.9% (n=21) of these were postoperatively examined with ultrasound (n=10), herniography (n=7), plain abdominal films (n=2), CT (n=1), or fistulography (n=1). Significant findings were found in five groins, namely, one sinus tract, two hematomas, one small bowel obstruction, and one recurrence of hernia. Four insignificant seromas were found. The characteristics of the findings and pitfalls are described. Symptoms resulting in radiologic examination are rare after laparoscopic herniorraphy. The radiologist must be familiar with the spectrum of such findings. (orig.)

  7. Sportsman hernia; the review of current diagnosis and treatment modalities.

    Paksoy, Melih; Sekmen, Ümit

    2016-01-01

    Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature. PMID:27436937

  8. Primary lumbar hernia: A rarely encountered hernia

    Sharada Sundaramurthy

    2016-01-01

    Conclusion: A surgeon may encounter a primary lumbar hernia perhaps once in his lifetime making it an interesting surgical challenge. Sound anatomical knowledge and adequate imaging are indispensable. Inspite of advances in minimally invasive surgery, it cannot be universally applied to patients with lumbar hernia and management requires a more tailored approach.

  9. An inguinal hernia sac tumor of extrahepatic cholangiocarcinoma origin

    Yamazaki Hidehiro

    2006-03-01

    Full Text Available Abstract Background Metastatic hernia sac tumor from biliary malignancy is extremely rare with only one such case previously reported. We herein report an additional case of extrahepatic cholangiocarcinoma presenting as a hernia sac tumor. Case presentation A 78-year-old man presented with an irreducible right inguinal hernia associated with a firm tumor, 2.0 cm in diameter. A computed tomography scan demonstrated a soft tissue density mass with heterogeneous enhancement within the right inguinal canal. The patient underwent a hernia repair and the hernia sac tumor was resected. Histological examination of the tumor revealed a metastatic adenocarcinoma suggesting the tumor was of pancreato-biliary origin. Further investigation using imaging studies disclosed a primary tumor in the upper bile duct. The patient died of the disease nine months after the resection. Conclusion Hernia sac tumors should be considered when an irreducible, growing mass appears within an inguinal hernia. Computed tomography may be useful for the early detection of hernia sac tumors from undiagnosed intra-abdominal malignancies.

  10. Incarcerated recurrent Amyand's hernia

    Quartey, Benjamin; Ugochukwu, Obinna; Kuehn, Reed; Ospina, Karen

    2012-01-01

    Amyand's hernia is a rarity and a recurrent case is extremely rare. A 71-year-old male with a previous history of right inguinal hernia repair presented to the emergency department with a 1-day history of pain in the right groin. A physical examination revealed a nonreducible right inguinal hernia. A computed tomography scan showed a 1.3-cm appendix with surrounding inflammation within a right inguinal hernia. An emergent right groin exploration revealed an incarcerated and injected non-perforated appendix and an indirect hernia. Appendectomy was performed through the groin incision, and the indirect hernia defect was repaired with a biological mesh (Flex-HD). We hereby present this unique case – the first reported case of recurrent Amyand's hernia and a literature review of this anatomical curiosity. PMID:23248506

  11. The laparoscopic transperitoneal approach for irreducible inguinal hernias: Perioperative outcome in four patients

    Jagad Rajan

    2009-01-01

    Full Text Available Background : Incarceration and strangulation are the most feared complications of inguinal hernia. Till date, incarcerated hernias have traditionally been treated by conventional open repair. Reports are now available for the feasibility of laparoscopic repair of incarcerated inguinal hernia. Here, we described our experience with the transperitoneal approach for incarcerated hernias. Materials and Methods : Between January 2008 and May 2008, four patients were presented with a history of irreducible hernia, abdominal distention and vomiting. All the patients had right-sided inguinal hernia. Reductions of the hernia contents were not possible in any patient. The patients were treated on emergency basis with laparoscopic transabdominal preperitoneal hernia repair. Retrospective analyses of all the patients were done. Results: Reduction of the bowel was achieved in all but one patient, who required the division of the internal ring on lateral side. Transperitoneal mesh repair was performed. No major complications were encountered. One patient developed seroma formation that was treated conservatively. Conclusion: Laparoscopic transperitoneal approach has the advantage of observation of the hernia content for a longer period of time. The division of the internal ring can be done under direct vision. Other intra-abdominal pathology and opposite side hernia can be diagnosed and treated at the same time.

  12. Diagnosis and perioperative management of ruptured AAA mimicking symptomatic groin hernia

    Klein, Holger Jan; Becker, Daniel; Rancic, Zoran

    2016-01-01

    INTRODUCTION: Ruptured abdominal aortic aneurysm (RAAA) can infrequently present as symptomatic groin hernia. This misleading form of presentation often leads to erroneous preoperative management resulting in poor survival. CASE PRESENTATION: Two patients with RAAA mimicking symptomatic groin hernia underwent different preoperative managements pointing out the importance of the principles of hypotensive haemostasis in the scope of this emergency scenario. CONCLUSION: Computed Tomography...

  13. Diagnosis and perioperative management of ruptured AAA mimicking symptomatic groin hernia

    Holger Jan Klein; Daniel Becker; Zoran Rancic

    2016-01-01

    Introduction: Ruptured abdominal aortic aneurysm (RAAA) can infrequently present as symptomatic groin hernia. This misleading form of presentation often leads to erroneous preoperative management resulting in poor survival. Case presentation: Two patients with RAAA mimicking symptomatic groin hernia underwent different preoperative managements pointing out the importance of the principles of hypotensive haemostasis in the scope of this emergency scenario. Conclusion: Computed Tomography...

  14. Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report.

    Good, Daniel W

    2011-01-01

    The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia.

  15. Late return of function after intrathoracic torsion of the spleen in congenital diaphragmatic hernia

    Thorup, Jørgen Mogens; Pedersen, P V

    1986-01-01

    A case of late presentation of a left posterolateral diaphragmatic hernia in a four-year-old boy is reported. Shortly after incidental diagnosis of the diaphragmatic hernia, he was admitted with acute abdominal symptoms and laparotomy was performed. The stomach, small intestine, part of the colon...

  16. Enxerto homólogo congelado de diafragma na correção dos defeitos da parede abdominal de ratos Diaphragma frozen homograft for rats' abdominal wall defects repair

    Paola Maria Brolin Santis-Isolan

    2009-08-01

    diaphragma frozen homografts used for rats' abdominal wall defects repair. METHOD: Thirty wistar rats with abdominal wall resection and reconstruction using frozen diaphragma homografts were compared to twenty other rats submitted to abdominal wall incision and closure (control. Animals were euthanized after 3 and 6 months and abdominal walls were avaliated histologically with H/E and Picrosiriud Red staining and tensiometric evaluation. RESULTS: The tensiometric parameters were greater in the experimental group at 3 months after surgery. The percentage of mature collagen was significantly greater at 6 months after surgery in control and experimental groups. Tensiometric parameters and type I collagen as well maturation collagen index and rupture maximal strength were statistically correlated after 3 and 6 months. CONCLUSION: Frozen diaphragma homograft can be an alternative to repair the defects of abdominal wall.

  17. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure—A Review

    Qian Huang

    2016-01-01

    Full Text Available Open abdomen (OA has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient’s physiological condition allows.

  18. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure-A Review.

    Huang, Qian; Li, Jieshou; Lau, Wan-Yee

    2016-01-01

    Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient's physiological condition allows. PMID:26819597

  19. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure—A Review

    Huang, Qian; Li, Jieshou; Lau, Wan-yee

    2016-01-01

    Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient's physiological condition allows. PMID:26819597

  20. Congenital diaphragmatic hernia; masquarding as hydropneumothorax

    RP Yadav

    2014-04-01

    Full Text Available Congenital diaphragmatic hernia occurs in about 1 in 3000 births among which over 90% of the patients will be diagnosed either antenatally or will present with respiratory distress in the first few hours of life and about 5% to 30% of diaphragmatic hernias present beyond the neonatal period. The extent of herniation of abdominal viscera into the thorax may vary, leading to acute or intermittent symptoms. The inappropriate insertion of a chest drain, although relieving the symptoms temporarily, may result in serious consequences by damaging intrathoracic abdominal viscera. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 54-56 DOI: http://dx.doi.org/10.3126/jcmsn.v9i3.10223   

  1. Amyad's hernia while reparing the bilateral inguinal hernia

    Arif Aslaner

    2015-01-01

    Full Text Available Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  2. Ipsilateral occult hernias during endoscopic groin hernia repair

    Jain Mayank; Khanna Shashi; Sen Bimalendu; Tantia Om

    2008-01-01

    Endoscopic repair of groin hernias allows the surgeon to have a complete view of the groin and pelvis to diagnose occult hernias both ipsilaterally and contralaterally. These occult hernias can then be treated simultaneously and may reduce the incidence of recurrence and persistent symptoms. The authors present four unusual cases where occult hernias were found ipsilaterally during an endoscopic repair. All these occult hernias were treated along with the clinically diagnosed hernia at the sa...

  3. Amyad's hernia while reparing the bilateral inguinal hernia

    Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

    2015-01-01

    Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  4. Expansion abdominoplasty for a pregnant woman with severe abdominal wall contracture due to a major burn during childhood: a case report.

    Takeda, Kohsuke; Sowa, Yoshihiro; Numajiri, Toshiaki; Nishino, Kenichi

    2013-06-01

    Normal abdominal expansion that occurs as a result of hormonal actions during pregnancy may be prevented by the presence of excessive scar tissue in individuals who have received severe burns. In these instances, the lack of abdominal expansion may cause maternal pain and put the infant at risk. A 23-year-old pregnant woman presented with severe abdominal wall contracture due to a major burn sustained during childhood. At 20 weeks of pregnancy, expansion abdominoplasty, consisting of zigzag incisions in the fascia to release the contracture and a split-thickness skin graft, was performed. The patient gave birth, via a planned cesarean operation at 36 weeks of pregnancy, to a baby girl in good condition; the postpartum course was uneventful. PMID:23673563

  5. Nonwoven polypropylene prosthesis in large abdominal wall defects in rats Tela de polipropileno sem tecelagem na correção de grandes defeitos da parede abdominal em ratos

    Patrick dos Santos Barros dos Reis

    2012-10-01

    Full Text Available PURPOSE: To evaluate, in large abdominal wall defects surgically shaped in rats, if a synthetic polypropylene nonwoven prosthesis could be used as a therapeutic option to conventional polypropylene mesh. METHODS: Twenty four (24 Wistar rats were enrolled into three groups. Group 1 (Simulation group with an abdominal wall defect of 3 X 3 left untreated and Groups 2 and 3, respectively treated with a conventional polypropylene mesh and a polypropylene nonwoven (NWV prosthesis to cover the breach. At the 45th postoperatively day, adhesion (area and strength and vascularization of Groups 2 and 3 were evaluated. The histological preparations with Hematoxylin-Eosin, Tricromium of Masson, Pricrosirius red and polarization with birefringence, and also the structural analysis of the prostheses carried on by Thermogravimetry and Differential Scanning Calorimetry were also assessed. RESULTS: There were no significant differences between the Groups 2 and 3. CONCLUSION: In rats, the polypropylene nonwoven prosthesis showed to be safe and has to be considered as an alternative to conventional mesh manufactured by weaving in the treatment of great defects of the abdominal wall.OBJETIVO: Avaliar, em grandes defeitos da parede abdominal produzidos cirurgicamente em ratos, se uma prótese sintética de polipropileno sem tecelagem poderia ser utilizada como alternativa terapêutica às telas convencionais de polipropileno. MÉTODOS: Vinte e quatro ratos foram distribuídos em três grupos numericamente iguais. Grupo 1 (Simulação, no qual um defeito de 3 x 3 cm foi constituído na parede abdominal sem tratamento. Uma tela convencional de polipropileno e uma tela de polipropileno sem tecelagem foram colocadas para cobrir o defeito, nos grupos 2 e 3 , respectivamente. No 45º dia de pós-operatório foram avaliadas a área e a força das aderências, além da vascularização. Também foram analisados os preparados histológicos com Hematoxilina-eosina, Tricr

  6. Huge incisional hernia: A case report

    Elganainy, Ehab; Abd-Elsayed, Alaa A

    2008-01-01

    Introduction The incidence of incisional hernia depends on many factors factors including old age, sex, obesity, bowel surgery, suture type, chest infection, abdominal distension and wound infection. Case report A 55 years old woman presented at out institute, she had an operation 19 years ago – elsewhere – to remove a branched stone from her right kidney and admitted for two months into the hospital at this time as she had troubles with her surgical wound and she had repeated secondary sutur...

  7. Autogenous skin transplant for repair of traumatic ventral hernia in sheep

    Nazhvani Dehghani, Seifollah; Nasrollahy, Mohtaram

    2006-01-01

    Traumatic ventral abdominal hernia is common in sheep. Fifteen adult sheep affected with large ventral hernia defect were treated. Skin was harvested from the same sheep and replaced for the defective abdominal muscle and sutured. Subcutaneous tissue and skin were opposed over the transplanted skin and sutured. The animals were evaluated clinically, haematologically and by biopsy. Clinically, the animals ate and drank normally after surgery. The transplanted skins were perfectly secured in pl...

  8. Is prophylactic embolization of the hepatic falciform artery needed before radioembolization in patients with {sup 99m}Tc-MAA accumulation in the anterior abdominal wall?

    Ahmadzadehfar, Hojjat; Sabet, Amir; Muckle, Marianne; Haslerud, Torjan; Biersack, Hans Juergen; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Moehlenbruch, Markus; Meyer, Carsten; Wilhelm, Kai; Schild, Hans Heinz [University Hospital Bonn, Department of Radiology, Bonn (Germany)

    2011-08-15

    While influx of chemoembolic agents into the hepatic falciform artery (HFA) from the hepatic artery can cause supraumbilical skin rash, epigastric pain and even skin necrosis, the significance of a patent HFA in patients undergoing radioembolization is not completely clear. Furthermore, the presence of tracer in the anterior abdominal wall seen in {sup 99m}Tc-macroaggregated albumin ({sup 99m}Tc-MAA) images, which is generally performed prior to radioembolization, has been described as a sign of a patent HFA. The aim of this retrospective study was to evaluate the incidence and consequences of {sup 99m}Tc-MAA accumulation in the anterior abdominal wall, indicating a patent HFA, in patients undergoing radioembolization of liver tumours. A total of 224 diagnostic hepatic angiograms combined with {sup 99m}Tc-MAA SPECT/CT were acquired in 192 patients with different types of cancer, of whom 142 were treated with a total of 214 radioembolization procedures. All patients received a whole-body scan, and planar and SPECT/CT scans of the abdomen. Only patients with extrahepatic {sup 99m}Tc-MAA accumulation in the anterior abdominal wall were included in this study. Posttreatment bremsstrahlung SPECT/CT and follow-up results for at least 3 months served as reference standards. Tracer accumulation in the anterior abdominal wall was present in pretreatment {sup 99m}Tc-MAA SPECT/CT images of 18 patients (9.3%). The HFA was found and embolized by radiologists before treatment in one patient. In the remaining patients radioembolization was performed without any modification in the treatment plan despite the previously mentioned extrahepatic accumulation. Only one patient experienced abdominal muscle pain above the navel, which started 24 h after treatment and lasted for 48 h without any skin changes. The remaining patients did not experience any relevant side effects during the follow-up period. Side effects after radioembolization in patients with tracer accumulation in the

  9. Estudo das telas cirúrgicas de polipropileno/poliglecaprone e de polipropileno/polidioxanona/celulose oxidada regenerada na cicatrização de defeito produzido na parede abdominal de ratos Study of surgical meshes of polypropylene/polyglecaprone and polypropylene/polydioxanone/oxidized regenerated cellulose on the healing of defects produced in abdominal wall of rats

    Marcia Regina Zanello Pundek

    2010-06-01

    different surgical meshes (Proceed® and Ultrapro® on the healing of defects produced in abdominal wall of rats evaluating the macroscopic, microscopic and tensiometric parameters. METHOD: Thirty two Wistar rats were divided into two groups of 16 animals and four groups of eight animals euthanized within 15 and 30 days for evaluation. The macroscopic variables were: the presence of hematoma at the edges of the sutures of the surgical mesh in the abdominal wall; the knitting of the surgical mesh and the edge of the wound; presence of infection at the surgical site; presence of viscera fistulas on the surgical mesh; presence of adhesions in the abdominal cavity; presence of incisional hernia. During microscopy the stages of the inflammatory process of healing where evaluated, and tensiometry evaluated the tensile force required to rupture the material. RESULTS: The knitting of the mesh and the edge of the surgical wound was better in the 15 days Ultrapro subgroup than in the 15 days Proceed subgroup; within 30 days the knitting was similar in both subgroups. There was no significant difference for the variable of macroscopy. Both groups in both periods had the same proportion of cases with chronic inflammation, but there were higher scores of inflammation in the 15 days Ultrapro subgroup than the 30 days Ultrapro subgroup. The subgroup 15 days Ultrapro showed greater rupture strength than the subgroup 15 days Proceed, but in 30 days there were no difference. Ultrapro showed equal rupture strength in both periods, but 30 days Proceed showed greater rupture strength than 15 days Proceed. CONCLUSION: The meshes are similar in variables.

  10. Successful Treatment of Mesenteric Varices by Retrograde Transvenous Obliteration by the Delivery of N-butyl-2-cyanoacrylate via an Abdominal Wall Vein

    Ikeda, Osamu; Nakasone, Yutaka; Yokoyama, Koichi; Inoue, Seijiro; TAKAMORI, HIROSHI; Baba, Hideo; Yamashita, Yasuyuki

    2013-01-01

    Bleeding from mesenteric varices associated with portal hypertension is occasionally life-threatening. A 53-year-old man who had undergone esophageal transection for esophageal varices and balloon-occluded retrograde transvenous obliteration for gastric varices presented with melena due to ruptured mesenteric varices. He was treated by injecting N-butyl-2-cyanoacrylate via an abdominal wall vein to obtain retrograde transvenous obliteration.

  11. Clinical trial of doxycycline for matrix metalloproteinase-9 inhibition in patients with an abdominal aneurysm doxycycline selectively depletes aortic wall neutrophils and cytotoxic t cells

    Lindeman, J. H. N.; Abdul-Hussien, H.; van Bockel, J H; Wolterbeek, R.; Kleemann, R.

    2009-01-01

    Background-Doxycycline has been shown to effectively inhibit aneurysm formation in animal models of abdominal aortic aneurysm. Although this effect is ascribed to matrix metalloproteinase-9 inhibition, such an effect is unclear in human studies. We reevaluated the effect of doxycycline on aortic wall protease content in a inical trial and found that doxycycline selectively reduces neutrophil-derived proteases. We thus hypothesized that doxycycline acts through an effect on ascular nflammation...

  12. Recurrent groin hernia

    Cox, P J; Leach, R D; Ellis, Harold

    1981-01-01

    One hundred consecutive recurrences following repair of inguinal hernias have been studied; 62 were direct, 30 indirect, 7 pantaloon and one a femoral hernia. Half the indirect recurrences occurred within a year of repair and probably represented failure to detect a small indirect sac. Later indirect recurrences probably represented failure to repair the internal ring. Nine of the direct hernias were medial funicular recurrences and represented failure to anchor the darn medially. The rest of...

  13. Incarcerated recurrent Amyand's hernia

    Benjamin Quartey; Obinna Ugochukwu; Reed Kuehn; Karen Ospina

    2012-01-01

    Amyand′s hernia is a rarity and a recurrent case is extremely rare. A 71-year-old male with a previous history of right inguinal hernia repair presented to the emergency department with a 1-day history of pain in the right groin. A physical examination revealed a nonreducible right inguinal hernia. A computed tomography scan showed a 1.3-cm appendix with surrounding inflammation within a right inguinal hernia. An emergent right groin exploration revealed an incarcerated and injected non-perfo...

  14. Left paraduodenal hernias

    We report two cases of left paraduodenal internal hernias located in the fossa of Landzert that were diagnosed by CT. Internal hernias are an infrequent cause of acute abdomen, due to the intestinal sub occlusion they produce. Left paraduodenal hernias are responsible for about 50% of internal hernias. CT makes it possible to demonstrate the group of herniated loops between the stomach, fourth segment of the duodenum, descending colon, and tail of the pancreas. The identification of the loops in an atypical position together with displaced blood vessels (mesenteric vessels) and colon gives concerns on them a typical radiological semiology that makes them easily identifiable. (Author) 9 refs

  15. Relationship between ultrasonic differential diagnosis of inguinal hernia and etiology%超声对腹股沟疝的鉴别分型诊断与其病因学关系的研究

    杨林; 向慧娟; 周佩

    2012-01-01

    目的 探讨超声检查在腹股沟疝鉴别分型诊断中的价值,为临床选择最佳手术方式提供重要参考.方法 对176例临床可疑腹股沟疝患者进行超声检查,记录腹股沟区包块的声像特征、血供、血液运行情况,以及与周围组织、血管的位置关系等,并与手术结果进行对照分析.结果 经超声诊断腹股沟疝的176例患者中,与手术结果相符者173例,超声诊断符合率达98.3%.其中斜疝146例,疝门直径4 cm,疝内容物经直疝三角右后向前不进入阴囊,仅于腹股沟区形成异常回声区,局部腹壁无明显改变,疝囊位于精索静脉内后方,疝囊外侧可见腹壁下动静脉血流束伴行,腹压增大时,疝内容物可见肠壁略变薄,层次结构尚清晰.结论 超声可根据疝门大小、腹压变化前后局部腹壁厚度、疝内容物及疝囊与腹壁下动脉位置关系等情况的观察,直观地鉴别斜疝与直疝,是术前诊断及鉴别腹股沟疝分型的首选影像学方法.%Objective To explore the value of ultrasound in differential diagnosis and typing of inguinal hernia, and to provide important reference for choosing the best way for clinical surgery. Methods One hundred and seventy-six patients with clinical suspicious inguinal hernia underwent ultrasonography, the ultrasonic features and blood supply situation of lesions in groin area, the relationship between surrounding tissue and blood vessels were recorded, the results were compared with those of surgery. Results In 176 patients, there were 173 cases consistent with surgery (173/176, 98.3%) , including 146 cases of indirect hernia, the diameter of hernia door was 4 cm, hernia content passed through Hesselbach triangle and went forward to form abnormal echo mass in the groin area, there was no changes in the abdominal wall. The hernial sac was located medical and posterior to the spermatic vein and medical to inferior epigastric artery and vein. When the abdominal pressure

  16. Incarcerated diaphragmatic hernia--differential diagnoses.

    Bukvić, Nado; Versić, Ana Bosak; Bacić, Giordano; Gusić, Nadomir; Nikolić, Harry; Bukvić, Frane

    2014-12-01

    The incarceration of diaphragmatic hernia is very rare. We present a case of a four-year-old girl who developed the incarceration of left-sided diaphragmatic hernia, who, until then, was completely asymptomatic. This incarceration of the hernia represented a surgical emergency presenting as obstructive ileus and a severe respiratory distress which developed from what appeared to be full health. During a brief pre-operative examination a number of differential diagnoses were suggested. Along with the laboratory blood analysis (complete blood count and acid-base balance) a plain thoracic and abdominal radiography was done (babygram). After that, through an inserted nasal-gastric tube, barium meal of the upper gastrointestinal tract was done, showing abdominal organs in the left half of the thorax and a significant shift of the mediastinum to the right. With an urgent upper medial laparotomy we accessed the abdominal cavity and made the correct diagnosis. An opening was shown in the rear part of the left hemi-diaphragm with thickened and edematous edges, approx. 6 cm in diameter with incarcerated content. The incarcerated abdominal organs (stomach, transversal colon, small intestine and spleen) gradually moved into the abdominal cavity. The opening was closed with nonresorptive sutures (TiCron) size 2-0 with aprevious control and ventilated expansion of the well-developed left lung. In postoperative course the acid-base balance quickly recovered, as well as the general state of the patient and radiography showed a good expansion and lucency of the lung parenchyma and a return of the mediastinum into the middle part of the thorax. PMID:25842758

  17. Vertical compared with transverse incisions in abdominal surgery

    Grantcharov, T P; Rosenberg, J

    2001-01-01

    . SETTING: Teaching hospital, Denmark. SUBJECTS: Patients undergoing open abdominal operations. INTERVENTIONS: For some of the variables (burst abdomen and incisional hernia) it was considered adequate to include retrospective studies. Studies were identified through Medline, Cochrane library, Embase, and a......, and late complications (incisional hernia). RESULTS: Eleven randomised controlled trials and seven retrospective studies were identified. The transverse incision offers as good an access to most intra-abdominal structures as a vertical incision. The transverse incision results in significantly less...

  18. Congenital Abdominal Wall Defects

    Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels

    2016-01-01

    related complications; and post-discharge gastrointestinal surgery. RESULTS: GDM was placed in 34 (gastroschisis=27, omphalocele=7) patients during the study period. Complete closure of the fascia was obtained in one patient with omphalocele and in 22 patients with gastroschisis. Mesh related surgical...

  19. Foreign body granuloma in the anterior abdominal wall mimicking an acute appendicular lump and induced by a translocated copper-T intrauterine contraceptive device: a case report

    Ansari Maulana Mohammed

    2009-04-01

    Full Text Available Abstract Introduction Intrauterine contraceptive devices may at times perforate and migrate to adjacent organs. Such uterine perforation usually passes unnoticed with development of potentially serious complications. Case presentation A 25-year-old woman of North Indian origin presented with an acute tender lump in the right iliac fossa. The lump was initially thought to be an appendicular lump and treated conservatively. Resolution of the lump was incomplete. On exploratory laparotomy, a hard suspicious mass was found in the anterior abdominal wall of the right iliac fossa. Wide excision and bisection of the mass revealed a copper-T embedded inside. Examination of the uterus did not show any evidence of perforation. The next day, the patient gave a history of past copper-T Intrauterine contraceptive device insertion. Conclusions Copper-T insertion is one of the simplest contraceptive methods but its neglect with inadequate follow-up may lead to uterine perforation and extra-uterine migration. Regular self-examination for the "threads" supplemented with abdominal X-ray and/or ultrasound in the follow-up may detect copper-T migration early. To the best of our knowledge, this is the first report of intrauterine contraceptive device migration to the anterior abdominal wall of the right iliac fossa.

  20. Tissue state of anterior abdominal wall in rats after implantation of alloplastic material, processed with collagen, in the abdominal cavity and in contact with hollow organs

    Belyanskyi L.S.

    2010-01-01

    Full Text Available A research purpose was to investigate the tissue reactions on implantation of polypropylene mesh, processed withcollagen, after the plastic of experimental defect at rats at intraperitoneal localization of prosthesis in contact with holloworgans. Research was performed in two experimental groups. Group 1 – at 27 rats an experimental defect of of anterior abdominalwall of size 3 cm, with further transabdominal fixation of the polypropylene mesh of size 1×1,5 cm on parietal peritoneumin contact with hollow organs, was performed. Group 2 – at 28 rats at analogous conditions the intraperitoneal fixationof polypropylene mesh, processed with collagen, was performed. Morphological analysis of scar tissue formation phasesin rats in the implantation region in the abdominal cavity and contact with hollow organs from the data of cellular and fiberstructures stereological characteristics of connective tissue with hemodynamic characteristics shows substantial benefits ofuse of polypropylene mesh, processed with collagen, during 4 weeks after experimental hernioplasty.

  1. Fatores de risco associados à deiscência aponeurótica no fechamento da parede abdominal Risk factors associated to aponeurotic dehiscence in abdominal wall closure

    Olival Cirilo Lucena da Fonseca-Neto; Rômulo Vasconcelos; Antônio Lopes de Mirian

    2008-01-01

    RACIONAL: A deiscência aponeurótica do abdômen após intervenções cirúrgicas responde por índices de morbi-mortalidade em torno de 9% a 49% e apresenta incidência aproximada de 0,5% a 3%. OBJETIVO: Identificar os fatores de risco mais prevalentes e elaborar aspecto epidemiológico do perfil dos pacientes susceptíveis à esta complicação. MÉTODOS: Foram estudados no período de março a agosto de 2005 15 pacientes que estiveram internados e que apresentaram deiscência aponeurótica abdominal, proven...

  2. Burden of congenital inguinal hernia and hydrocele in northern and southern Nigeria: An opportunity for awareness creation

    Musa Ibrahim

    2014-01-01

    Full Text Available Background: Nigeria, with a population of >150 million people in which half of the population are children encounters challenges in paediatric surgery practice in rural areas. There are paediatric surgeons in Nigeria, but majority practice in tertiary health facilities in cities. The poor rural dwellers have little or no access to such highly trained specialists. Hence, children with congenital and acquired paediatric surgical pathologies including anterior abdominal wall defects not only grow up with these diseases to adulthood, they are also exposed to various health hazards posed by unqualified personnel. Therefore, we are evaluating the burden of congenital inguinal hernia/hydrocele in northern and southern Nigeria for awareness creation and the way forward. Materials and Methods: Data obtained from organised free hernia missions to the rural populace from northern and southern Nigeria by the West African Collage of Surgeons in 2010 and Kano State Government in 2013 was analysed. Results: A total of 811 patients aged from 3 months (0.25 years to 35 years was screened and found to have congenital hernia and/or hydrocele from the two centres. 171 (21.1% were successfully operated, while the remaining 640 (78.9% could not benefit from a surgical procedure during the missions. There were n = 46 (26.9% patients with various forms of genital mutilations/and or surgical mismanagements among the operated patients. Conclusion: The burden of congenital anterior abdominal wall defects among Nigerian children is high. A little effort could bring succor and create awareness among this group of people.

  3. Peritoneopericardial diaphragmatic hernia in cats

    Peritoneopericardial diaphragmatic hernia in a cat is often an incidental finding on a routine thoracic or abdominal radiograph. Clinical signs are nonspecific-usually respiratory (dyspnea) or gastrointestinal(vomiting or diarrhea). Some of the cats with this anomaly are asymptomatic. The physical examination may be normal: muffled heart sounds are the most common abnormality noted during a physical examination. Cats of many breeds are affected, although 26% of reported cases were inPersians. Age of the cat at diagnosis ranged from 6 days to 14 years. Thirty of the 52 reported cases were in females. Diagnostic studies used to confirm the diagnosis included echocardiography, upper gastrointestinal study, ultrasonography, angiography, positive-contrast peritoneography, and laparotomy. Surgical correction was reportedly successful in 22 of 25 cats

  4. Hernia incisional gigante

    Ada Arleny Pérez Mayo

    2014-08-01

    Full Text Available Se presentó el caso de paciente femenina de 53 años, intervenida por primera vez en el Hospital Nacional de San Pedro Necta del Departamento de Huehuetenango, en Guatemala, por una hernia incisional de 26 años de padecimiento. Se realizó cuidadosa preparación preoperatoria, que incluyó la antisepsia local de la piel y la aplicación de enemas evacuantes con Cloruro de Sodio al 0,9%. La técnica utilizada consistió en una incisión en Losange alrededor de la cicatriz anterior. Se procedió al cierre del anillo único de más de 10 cm de diámetro y la colocación de malla de polipropileno supra aponeurótica, con sutura no absorbible monofilamentosa. Fue posible el restablecimiento de la capacidad toraco-abdominal, al regresar las asas intestinales contenidas en el saco herniario a la cavidad. Se administró ceftriaxona, como antibiótico profiláctico. La paciente evolucionó satisfactoriamente y la estadía reportada fue de siete días. No ocurrieron complicaciones como seroma, hematoma o infección de la herida quirúrgica, que se atribuyó, en buena medida, a la colocación oportuna de drenajes durante 48 horas del postoperatorio. No hubo recidiva herniaria, con un seguimiento promedio de 19 meses; ni existieron manifestaciones de rechazo, atribuibles al material protésico

  5. 造口旁疝修补术中难点及处理原则%Difficulties and principles of parastomal hernia repair

    刘昶; 纪艳超

    2014-01-01

    造口旁疝是指与肠造口有关的疝,是腹部造口术后最常见的晚期并发症,可引起肠梗阻、肠坏死等严重并发症。外科手术是治愈造口旁疝的惟一方法,但手术本身尚有许多不确定的因素,存在肠管损伤、复发、肠瘘、感染等并发症,是疝外科领域中的难点问题。在不损伤肠管、保证造口肠管的血供、有效修补缺损的前提下,尽可能减少并发症的发生和降低复发率。行造口旁疝修补手术须注意:游离显露要充分,尽量关闭腹壁的组织缺损和疝环,并选择合适大小的补片;在腔镜下缝合固定补片时尽可能的控制气腹压在1.1~1.3 kPa以下;术区应根据创面分离大小留置引流。%Parastomal hernia refers to colostomy related hernia,and is the most common later complication after abdominal stoma surgery that can cause serious complication, like intestinal obstruction,intestinal necrosis. Parastomal hernia can only be cured by surgery. However,the surgery itself contains many uncertain factors,may causes bowel injury, relapse, intestinal fistula, infection and other complications. So it is the difficult point in the field of hernia surgery. The premises of laparoscopy hernia surgery are without damaging the bowel and blood supply, reducing complications and relapse rate. There are many points should be paid attention to, such as full free expose, closing the abdominal wall tissue defects and hernia ring, selecting appropriate size of the patch, controlling abdominal pressure under 1.1-1.3 kPa and using suited size of drainage tube.

  6. Does mechanical massage of the abdominal wall after colectomy reduce postoperative pain and shorten the duration of ileus? Results of a randomized study.

    Le Blanc-Louvry, Isabelle; Costaglioli, Bruno; Boulon, Catherine; Leroi, Anne-Marie; Ducrotte, Philippe

    2002-01-01

    The aim of this study was to determine the effectiveness of mechanical abdominal massage on postoperative pain and ileus after colectomy. We hypothesized that parietal abdominal stimulation could counteract induced pain and postoperative ileus, through common spinal-sensitive pathways, with nociceptive visceral messages. After preoperative randomization, 25 patients (age 52 +/- 5 years) underwent active mechanical massage by intermittent negative pressure on the abdominal wall resulting in aspiration (Cellu M50 device, LPG, Valence, France), and 25 patients (age 60 +/- 6 years) did not receive active mechanical massage (placebo group). Massage sessions began the first day after colectomy and were performed daily until the seventh postoperative day. In the active-massage group, amplitude and frequency were used, which have been shown to be effective in reducing muscular pain, whereas in the placebo group, ineffective parameters were used. Visual analogue scale (VAS) pain scores, doses of analgesics (propacetamol), and delay between surgery and the time to first passage of flatus were assessed. Types and dosages of the anesthetic drugs and the duration of the surgical procedure did not differ between groups. From the second and third postoperative days, respectively, VAS pain scores (P < 0.001) and doses of analgesics (P < 0.05) were significantly lower in patients receiving active massage compared to the placebo group. Time to first passage of flatus was also significantly shorter in the active-massage group (1.8 +/- 0.3 days vs. 3.6 +/- 0.4 days, P < 0.01). No adverse effects were observed. These results suggest that mechanical massage of the abdominal wall may decrease postoperative pain and ileus after colectomy. PMID:11986017

  7. Avaliação fitoterápica da Jatropha gossypiifolia L. na cicatrização de suturas na parede abdominal ventral de ratos Phytotherapic evaluation of Jatropha gossypiifolia L. on rats ventral abdominal wall wound healing

    José Ulcijara Aquino

    2006-01-01

    L., which is used in popular medicine is considered to have good diuretic effect in hypertension and is also used as a laxative drug. It seems to have a healing effect, although not proved till now. PURPOSE: To evaluate the influence of intraperitoneum administration of Jatropha Gossypiifolia L., in suture healing of ventral abdominal wall of rats, through tensiometric measurement, macro and microscopic aspect of post-operative period. METHODS: Forty wistar male rates were allocated in two groups of 20 animals . After the incision and exposure of abdominal cavity 1 ml/kg/weight of 0,9% sodium chloride solution was injected in control group, and in the other one the injection was of 1 ml/kg/weight of a gross ethanol extract of Jatropha gossypiifolia L. The suture of the abdominal wall was than performed with polypropylene separated stitches. The animals were followed-up and killed in the third and seventh days. The ventral abdominal wall was macroscopically analyzed, the resistance strength to strain was measured and it was also studied the histological aspects. RESULTS: On macroscopic examination more intense adhesion was found on the group of Jatropha in both third and seventh post-operative days. The strain evaluation was meanly greater on Jatropha group also in third and seventh days. CONCLUSION: The histological comparative analysis between the different groups showed that the acute inflammatory process was meanly greater for the Jatropha group in third and seventh post-operative days. The vascular neoformation was significantly greater in third pos-operative day of Jathopha group; the other histological parameters were just alike. The intraperitoneum injection of Jatropha extract did not have any significant improvement for the wound healing on ventral abdominal wall on the evaluated animals in this study, no matter if analyzed at the third or seventh pos-operative days.

  8. Difficult weaning in delayed onset diaphragmatic hernia

    Ahmed Syed

    2009-01-01

    Full Text Available Diaphragmatic injuries are relatively rare and result from either blunt or penetrating trauma. Regardless of the mechanism, diagnosis is often missed and high index of suspicion is vital. The clinical signs associated with a diaphragmatic hernia can range from no outward signs to immediately life-threatening respiratory compromise. Establishing the clinical diagnosis of diaphragmatic injuries (DI can be challenging as it is often clinically occult. Accurate diagnosis is critical since missed DI may result in grave sequelae due to herniation and strangulation of displaced intra-abdominal organs. We present a case of polytrauma with rib fracture and delayed appearance of diaphragmatic hernia manifesting as difficult weaning from ventilatory support.

  9. Repair of massive ventral hernias with the separation of parts technique: reversal of the 'lost domain'.

    Hadad, Ivan; Small, William; Dumanian, Gregory Ara

    2009-04-01

    Massive ventral hernia repairs are sometimes complicated by the "loss of domain". The separation of parts hernia repair reverses the loss of domain by increasing intra-abdominal volume, but not by elevating the hemidiaphragms into the thoracic cavity. Hernia repair in patients with a "loss of abdominal domain" is thought to be associated with postoperative pulmonary difficulties. A retrospective chart review was performed on 102 patients treated by a single surgeon. The 10 patients with matching preoperative and postoperative abdominal CT scans were computer-analyzed for intra-abdominal volume changes and diaphragm height measurements. Postoperative pulmonary complications in these 102 patients were recorded. Intra-abdominal volume increased after separation of parts hernia repair from 8600 +/- 2800 mL to 9700 +/- 2700 mL (P = 0.01). Diaphragm height did not statistically change. Two of the 102 patients had prolonged intubations, and seven other patients were ventilated briefly. The separation of parts technique is able to close large ventral hernias without a high incidence of pulmonary complications as a result of its ability to expand the abdominal domain without a change in diaphragmatic height. PMID:19385289

  10. Efeitos de duas técnicas de incentivo respiratório na mobilidade toracoabdominal após cirurgia abdominal alta Effects of two respiratory incentive techniques on chest wall mobility after upper abdominal surgery

    Maria Elaine Trevisan

    2010-12-01

    with the Voldyne device, and group 2 (n=6, submitted to a split-inspiration pattern training. Chest wall expansion was rated by measuring thorax circumferences before surgery and on the 1st, 3rd, and 5th post-operative (PO days. In both groups a significant decrease was found in circumference values on the 1st PO day, which gradually recovered, until on the 5th PO day no significant differences were found as compared to pre-operative measures. Group 1 showed significantly better thoracic-abdominal expansion rates than group 2's, as well as higher recovery time rates all through. Though both breathing techniques used were effective, inspiratory incentive using the Voldyne device showed better results in recovering chest mobility after upper abdominal surgery.

  11. Recombinant human bone morphogenetic protein 2-induced heterotopic ossification of the retroperitoneum, psoas muscle, pelvis and abdominal wall following lumbar spinal fusion

    Shah, Raj K. [The George Washington University School of Medicine, Washington, DC (United States); Moncayo, Valeria M.; Pierre-Jerome, Claude; Terk, Michael R. [Emory University School of Medicine, Radiology Department, Musculoskeletal Division, Atlanta, GA (United States); Smitson, Robert D. [Emory University School of Medicine, Atlanta, GA (United States)

    2010-05-15

    A 45-year-old man presented with vertebral collapse at L5 as an initial manifestation of multiple myeloma and underwent spinal fusion surgery using recombinant human bone morphogenetic protein-2 (rhBMP-2). Subsequent computed tomography (CT) scans and X-rays revealed heterotopic ossification of the left psoas muscle, pelvis, and anterior abdominal wall. While the occurrence of heterotopic ossification has previously been reported when rhBMP-2 has been used for spinal fusion surgery, this case demonstrates that it can occur to a much greater degree than previously seen. (orig.)

  12. Ipsilateral occult hernias during endoscopic groin hernia repair

    Jain Mayank

    2008-01-01

    Full Text Available Endoscopic repair of groin hernias allows the surgeon to have a complete view of the groin and pelvis to diagnose occult hernias both ipsilaterally and contralaterally. These occult hernias can then be treated simultaneously and may reduce the incidence of recurrence and persistent symptoms. The authors present four unusual cases where occult hernias were found ipsilaterally during an endoscopic repair. All these occult hernias were treated along with the clinically diagnosed hernia at the same surgery with excellent results and no post-operative morbidity.

  13. Athletic pubalgia (sports hernia).

    Litwin, Demetrius E M; Sneider, Erica B; McEnaney, Patrick M; Busconi, Brian D

    2011-04-01

    Athletic pubalgia or sports hernia is a syndrome of chronic lower abdomen and groin pain that may occur in athletes and nonathletes. Because the differential diagnosis of chronic lower abdomen and groin pain is so broad, only a small number of patients with chronic lower abdomen and groin pain fulfill the diagnostic criteria of athletic pubalgia (sports hernia). The literature published to date regarding the cause, pathogenesis, diagnosis, and treatment of sports hernias is confusing. This article summarizes the current information and our present approach to this chronic lower abdomen and groin pain syndrome. PMID:21419964

  14. Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

    Good, Daniel W

    2011-05-03

    Abstract Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.

  15. Image-guided intensity-modulated radiotherapy for refractory bilateral breast cancer in a patient with extensive cutaneous metastasis in the chest and abdominal walls

    Lu YF

    2016-05-01

    Full Text Available Yueh-Feng Lu,1 Yu-Chin Lin,2 Kuo-Hsin Chen,3,4 Pei-Wei Shueng,1 Hsin-Pei Yeh,1 Chen-Hsi Hsieh1,5,6 1Division of Radiation Oncology, Department of Radiology, 2Division of Oncology and Hematology, Department of Medicine, 3Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, 4Department of Electrical Engineering, Yuan-Ze University, Taoyuan, 5Department of Medicine, 6Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Abstract: Treatment for bilateral breast cancer with chest wall and abdominal skin invasion normally involves conventional radiotherapy (RT; however, conventional RT provides inadequate target volume coverage and excessive treatment of large volumes of normal tissue. Helical tomotherapy (HT has the ability to deliver continuous craniocaudal irradiation that suppresses junction problems and provides good conformity of dose distribution. A 47-year-old female with stage IV bilateral breast cancer with chest wall and pectoralis major muscle invasion, lymphadenopathy, bilateral pleural effusion, and multiple bone metastases received chemotherapy and target therapy beginning in January 2014; 4 months after the initiation of chemotherapy, computed tomography revealed progression of chest and abdominal wall invasion. A total dose of 70.2 Gy was delivered to both breasts, the chest wall, the abdominal wall, and the bilateral supraclavicular nodal areas in 39 fractions via HT. The total planning target volume was 4,533.29 cm3. The percent of lung volume receiving at least 20 Gy (V20 was 28%, 22%, and 25% for the right lung, left lung, and whole lung, respectively. The mean dose to the heart was 8.6 Gy. Follow-up computed tomography revealed complete response after the RT course. Grade 1 dysphagia, weight loss, grade 2 neutropenia, and grade 3 dermatitis were noted during the RT course. Pain score decreased from 6 to 1. No cardiac, pulmonary, liver, or intestinal toxicity

  16. Autopsy features in a newborn baby affected by a central congenital diaphragmatic hernia.

    Bolino, Giorgio; Gitto, Lorenzo; Serinelli, Serenella; Maiese, Aniello

    2015-03-01

    Congenital diaphragmatic hernia is a congenital malformation of the diaphragm, resulting in the herniation of the abdominal organs into the thoracic cavity. The most common types of congenital diaphragmatic hernia are Bochdalek hernia (postero-lateral hernia), Morgagni hernia (anterior defect), and diaphragm eventration (abnormal displacement of part or all of an otherwise intact diaphragm into the chest cavity). Congenital diaphragmatic hernia is a life-threatening pathology in infants, and a major cause of death due to pulmonary hypoplasia and pulmonary hypertension. We present a fatal case of congenital diaphragmatic hernia in a newborn. At the autopsy, a central defect of the diaphragm was found, 8 × 5 cm in size, that led to a herniation of the small intestine, the right lobe of the liver, and the right adrenal gland into the thorax. An esophageal atresia was associated with the congenital diaphragmatic hernia. The lungs showed severe hypoplasia and atelectasia. Physicians should pay attention to a prenatal diagnosis of congenital diaphragmatic hernia in order to prevent newborn fatalities. PMID:25573226

  17. Sports Hernia (Athletic Pubalgia)

    ... the American Academy of Orthopaedic Surgeons. .org Sports Hernia cont. Surgical Treatment Surgical procedure. Surgery to repair the torn tissues in the groin can be done as a traditional, open procedure ...

  18. Obesity-Associated Abdominal Elephantiasis

    Ritesh Kohli

    2013-01-01

    Full Text Available Abdominal elephantiasis is a rare entity. Abdominal elephantiasis is an uncommon, but deformative and progressive cutaneous disease caused by chronic lymphedema and recurrent streptococcal or Staphylococcus infections of the abdominal wall. We present 3 cases of patients with morbid obesity who presented to our hospital with abdominal wall swelling, thickening, erythema, and pain. The abdominal wall and legs were edematous, with cobblestone-like, thickened, hyperpigmented, and fissured plaques on the abdomen. Two patients had localised areas of skin erythema, tenderness, and increased warmth. There was purulent drainage from the abdominal wall in one patient. They were managed with antibiotics with some initial improvement. Meticulous skin care and local keratolytic treatment for the lesions were initiated with limited success due to their late presentation. All three patients refused surgical therapy. Conclusion. Early diagnosis is important for the treatment of abdominal elephantiasis and prevention of complications.

  19. Laparoscopic repair of a Bochdalek hernia in an adult woman.

    Sutedja, Barlian; Muliani, Yenny

    2015-08-01

    Bochdalek hernia (BH) is a congenital defect of the diaphragm that usually presents in the neonatal period with life threatening cardiorespiratory distress. It is rare for BH to remain silent until adulthood. A 51-year-old woman presented with progressive dyspnea and abdominal symptoms, but without a history of trauma. The diagnosis of BH was made based on chest X-ray and CT. The hernia was repaired by the laparoscopic technique, and the patient made an uneventful recovery. This report validates the feasibility of laparoscopic repair of BH in an adult, which should be within the capability of an advanced laparoscopic surgeon. PMID:26303737

  20. Morgagni hernia - laparoscopic approach

    Şt. O. Georgescu; Paula Popa; Felicia Crumpei; Cristina Cijevschi Prelipcean

    2013-01-01

    INTRODUCTION: Morgagni hernia is due to a diaphragmatic defect, retrosternal congenital hernia being a rare form of hernie. The diagnosis is usually in childhood but there are cases that are found in adult or as a intraoperative surprise. The condition is asymptomatic or has nonspecific clinical manifestations or clinical dressing of often occlusive complications. The diagnosis is established by Rx thoracic imaging, barium enema or computed tomography (CT) eso-gastro-duodenal passage. Treatme...

  1. STOPPA’S REPAIR FOR INGUINAL HERNIA: STILL AN IDEAL PROCEDURE

    Durganna

    2015-08-01

    Full Text Available BACKGROUND : Inguinal hernia repairs are commonly performed operations. GPRVS is one of the methods . Also known as Stoppa s repair uses large prosthetic mesh placed in preperitoneal plane covering both the hernial orifices i . e ., it covers the whole Myopectineal Orifice Bilaterally. Stoppas repair is use full in cases of bilateral hernias, recurrent and multi recurrent hernias, unilateral hernias where risk of recurrence is more i . e. , When associated with COPD, BPH, Poor abdominal tone and previous surgery. Purpose of present study is to know the role of Stoppa s repair in management of inguinal hernias especialy Bilateral , recurrent and unilateral hernias which are at the risk of recu rrence. METHODS: Study done in victoria hospital attached toBangalore medical college and research centre . 250 cases were included for stoppa s repair. Bilateral hernias , recurrent hernias, unilateral hernias with one or more risk factors for recurrence and femoral hernias . Demographic data such as age, gender, occupation, smoking, symptoms as well as comorbid conditions such as chronic obstructive pulmonary disease, prostatism, and recurrence were collected. Duration of surgery was also noted. Complications such as seroma, hematoma, orchitis, and wound infection were recorded. Duration of hospital stay was recorded. Chronic groin pain and recurrences in each group were also recorded. RESULTS: Out of 250 patients 225 had bilateral inguinal hernia and 25 unila teral inguinal hernia , 48 were recurrent and 7 were re recurrent hernia. All the patients were males with age group between 21 to 80 years. All the patients had swelling in the groin region 43.3 % of patients had associated pain. Direct hernia was common v ariety in this study as mean age in the study was more than 40 yrs. Most of the patients had one or the other risk factor for recurrence smoking was most common 76.6% . O ther risk factors are COPD , BPH , Poor abdominal tone, previous surgery

  2. Perineal hernias in children: Case report and review of the literature

    Dragan Kravarusic

    2012-01-01

    Full Text Available Perineal hernias (pelvic floor hernias are extremely rare occurring through defects in musculature of the pelvic floor. This report presents a successfully treated case of primary perineal hernia and takes a review of the existing literature. The case of a 14-month-old girl with a great perineal hernia is presented. Diagnosis was secured by barium enema. The pelvic defect was successfully treated by primary suture with prolene. The literature shows many different approaches for treatment of perineal hernia, such as open or laparoscopic mesh repair, and perineal, abdominal or combined access in the adult, but our case like others confirms that primary closure of the hernial orifice through a perineal approach is also feasible in children.

  3. Esophageal hiatal hernia in three exotic felines--Lynx lynx, Puma concolore, Panthera leo.

    Hettlich, Bianca F; Hobson, H Phil; Ducoté, Julie; Fossum, Theresa W; Johnson, James H

    2010-03-01

    Hiatal hernia was diagnosed in three exotic felines-lynx (Lynx lynx), cougar (Puma concolore), and lion (Panthera leo). All cats had a history of anorexia. Thoracic and abdominal radiographs showed evidence of a soft tissue mass within the caudal mediastinum suggestive of a hiatal hernia in all animals. A barium esophagram was performed in one case. All animals underwent thoracic or abdominal surgery for hernia reduction. Surgical procedures included: intercostal thoracotomy with herniorrhaphy and esophagopexy (lynx and cougar), and incisional gastropexy (lion). Concurrent surgical procedures performed were gastrotomy for gastric foreign body removal and jejunostomy tube placement. Clinical signs related to the hiatal hernia disappeared after surgery and recurrence of signs was not reported for the time of follow-up. PMID:20722259

  4. Lateral repair of parastomal hernia.

    Amin, S. N.; Armitage, N. C.; Abercrombie, J. F.; Scholefield, J H

    2001-01-01

    INTRODUCTION: Parastomal hernia is a common complication of stoma construction. Although the majority of patients are asymptomatic, about 10% require surgical correction. AIMS: We describe a new surgical approach for the repair of parastomal hernias, which avoids both the need for laparotomy and stoma mobilization. PATIENTS AND METHODS: Nine patients (4 female) with parastomal hernia underwent surgical repair. Median age was 55 years (range 38-73 years). There were 8 para-ileostomy herniae an...

  5. Mechanical properties of mesh materials used for hernia repair and soft tissue augmentation.

    Peter P Pott

    Full Text Available BACKGROUND: Hernia repair is the most common surgical procedure in the world. Augmentation with synthetic meshes has gained importance in recent decades. Most of the published work about hernia meshes focuses on the surgical technique, outcome in terms of mortality and morbidity and the recurrence rate. Appropriate biomechanical and engineering terminology is frequently absent. Meshes are under continuous development but there is little knowledge in the public domain about their mechanical properties. In the presented experimental study we investigated the mechanical properties of several widely available meshes according to German Industrial Standards (DIN ISO. METHODOLOGY/PRINCIPAL FINDINGS: Six different meshes were assessed considering longitudinal and transverse direction in a uni-axial tensile test. Based on the force/displacement curve, the maximum force, breaking strain, and stiffness were computed. According to the maximum force the values were assigned to the groups weak and strong to determine a base for comparison. We discovered differences in the maximum force (11.1±6.4 to 100.9±9.4 N/cm, stiffness (0.3±0.1 to 4.6±0.5 N/mm, and breaking strain (150±6% to 340±20% considering the direction of tension. CONCLUSIONS/SIGNIFICANCE: The measured stiffness and breaking strength vary widely among available mesh materials for hernia repair, and most of the materials show significant anisotropy in their mechanical behavior. Considering the forces present in the abdominal wall, our results suggest that some meshes should be implanted in an appropriate orientation, and that information regarding the directionality of their mechanical properties should be provided by the manufacturers.

  6. A Rare Cause of Small Bowel Obstruction in Adults: Left Paraduodenal Internal Hernia

    Sardarian, Hossein; Maleki, Iradj; Mortazian, Meisam; Jafari, Ramezan; Tayebi, Pouya; Saberifiroozi, Mehdi

    2012-01-01

    A 47 years old lady presented with repeated intermittent, colicky, left upper, and periumblical abdominal pain associated with nausea and vomiting since two years prior to admission. Each episode of the pain spontaneously subsided after bilious vomiting. The patient had no history of surgery, abdominal trauma or intra-abdominal infection, weight loss or previous history for small bowel obstruction (SBO). MRI enterography was suggestive of internal hernia and surgery documented left paraduoden...

  7. In need of a patch UP: Recurrent congenital diaphragmatic hernia presenting with a large pleural effusion

    Farhana Shariff

    2014-10-01

    Full Text Available We report a case of recurrent congenital diaphragmatic hernia (CDH presenting with a large unilateral pleural effusion. A 12-year old boy who had a left sided CDH repaired in the neonatal period, presented with fever, lethargy, and non-productive cough. Chest radiograph demonstrated a loculated pleural effusion. Computed tomography scan revealed recurrent herniation of abdominal contents. To our knowledge, this is the first reported case of a recurrent congenital diaphragmatic hernia presenting with large pleural effusion.

  8. A RARE CASE OF PROLAPSED OMPHALOMESENTERIC DUCT WITH RUPTURED UMBILICAL HERNIA

    Satish Jain; Monica Jain; Indersain Gupta; Singhal, R. P.

    2014-01-01

    Strangulated ileal intussusceptions into the Meckel’s diverticulum (which is caused by an incomplete obliteration of omphalomesentric duct) and coming out through ruptured umbilical hernia is an extremely rare presentation. A 3- months- old male child presented with low grade fever, refusal to feed and episodes of discomfort often alternating with long period of sleepiness and lethargy. On abdominal examination loops of intestine were seen at the site of ruptured umbilical hernia....

  9. Spontaneous transmesenteric hernia: a rare cause of small bowel obstruction in an adult

    Poras Chaudhary

    2013-02-01

    Full Text Available The authors report a case of spontaneous transmesenteric hernia with strangulation in an adult. Transmesenteric hernia (TMH is a rare cause of small bowel obstruction and is seldom diagnosed preoperatively, and most TMHs in adults are related to predisposing factors, such as previous surgery, abdominal trauma, and peritonitis. TMH are more likely to develop volvulus and strangulation or ischemia. A brief review of etiology, clinical features, diagnosis, and treatment is discussed.

  10. Adverse effect left congenital diaphragmatic hernia to position and function of the fetal heart

    Adhi Pribadi; Johanes Cornelius Mose

    2015-01-01

    Background: There many heart problems in patients with CDH. Methods: Between January 2012 and July 2015, three pregnancies (1:2153) performed ultrasound examination to investigate suspected CDH. All symptoms displayed descriptively in table. Results: In prenatal life, ultrasonography has a high sensitivity for detection of congenital diaphragmatic hernia. The definite ultrasonographic diagnosis of fetal congenital diaphragmatic hernia lies on the visualization of abdominal organs in th...

  11. Small bowel ischaemia resulting from delayed presentation of an incarcerated right-sided diaphragmatic hernia

    Hopkins, JC; Gash, K; Armstrong, CP

    2011-01-01

    A 51 year old man presented with a short history of severe upper abdominal pain and vomiting. An initial chest radiograph demonstrated gas in the right subphrenic space and a subsequent CT scan demonstrated a hernia through the mid-part of the right hemi-diaphragm, containing small bowel and omentum. A detailed history revealed that there had been trauma to the right side of the chest approximately 12 years previously. An emergency laparoscopy revealed a right sided diaphragmatic hernia conta...

  12. Effects of enoxaparin on the healing of abdominal wall in rats: study on breaking strength and histopatology Efeitos da enoxaparina sobre a cicatrização da parede abdominal de ratos: estudo da força de ruptura e histopatológico

    Paulo Gonçalves de Oliveira; João Batista de Sousa; Luiz Guilherme C. V. Reys; Albino Verçosa Magalhães; Francieli de Sousa Rabelo; Karla Cardoso Muniz

    2006-01-01

    PURPOSE: To evaluate the influence of enoxaparin on the abdominal wall healing. METHODS: Sixty Wistar male rats were randomly distributed into two experimental groups. Group E: consisted of 30 rats, submitted to abdominal suture and treated with enoxaparin in a dose of 1 mg/kg of body weight, subcutaneously administered from immediate postoperative until the 7th day; Group C: consisted of 30 rats submitted to abdominal suture and treated with the equivalent dose per volume of NaCl 0.9%. The a...

  13. Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

    Edivaldo Massazo Utiyama

    2015-02-01

    Full Text Available OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years; 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

  14. [Giant hernias with loss of domain: what is the best way to prepare patients?].

    Balaphas, Alexandre; Morel, Philippe; Breguet, Romain; Assalino, Michela

    2016-06-15

    Giant hernias with loss of domain induce physiological modifications that impair quality of life and make more complex their surgical management. A good preparation of patients before surgery is the key to an eventless postoperative course. The progressive pre-operative pneumoperitoneum (PPP) is one of the described abdominal augmentation protocols which can help patients to tolerate hernia content reintegration and avoid components separation technique during hernia repair. This article describes the management of these complex patients. We also report the case of a patient who follows successfully a PPP protocol. PMID:27487621

  15. Orientation, anisotropy, clustering, and volume fraction of smooth muscle cells within the wall of porcine abdominal aorta

    Tonar Z.

    2008-11-01

    Full Text Available We analyzed tissue samples of the normal porcine abdominal aorta using stereological assessment of histological sections through the tunica media layer. The results demonstrated that the local volume fraction of smooth muscle cells within tunica media does not differ among samples taken round the circumference of the artery, and that volume fraction can be assessed in sections stained with green trichrome as well as with immunohistochemistry against actin. The distribution of angles between the long axes of nuclei of the smooth muscle cells and the radial direction was different from normal. The profiles of smooth muscle cells were distributed in an isotropic, but an inhomogeneous manner.

  16. A nicotina atua como fator deletério na reparação da parede abdominal The nicotine has a deleterious effect on the healing of abdominal wall

    Aldo da Cunha Medeiros

    2003-01-01

    Full Text Available OBJETIVO: Avaliar o efeito da nicotina na cicatrização da camada musculoaponeurótica da parede abdominal. MÉTODOS: Estudo experimental em que foram usados 16 ratos da raça Wistar pesando em média 210± 8g, separados aleatoriamente em 2 grupos de 8. Nos animais do grupo A foi implantado disco de nicotina (Nicotinel Ò na dose de 5mg/Kg de peso/dia no subcutâneo da região dorsal, trocado a cada dois dias, a partir do 5º dia antes da operação em que foi feita laparotomia mediana de 5 cm, até o 10º dia de observação. No grupo B (controle foram usados discos de celulose com o mesmo diâmetro. Tubo de silicone multiperfurado foi implantado no subcutâneo a 1cm da lesão da parede abdominal. A camada musculoaponeurótica e a pele foram suturadas com fio de nylon 5-0. No 10º dia pós-operatório foi colhido 1ml de líquido seroso do tubo de silicone por punção percutânea para dosagem de pO2 e os animais receberam dose letal de anestésico. Foi ressecado um segmento da camada musculoaponeurótica com 2cm de largura para tensiometria, em seguida processado e corado em HE e tricrômico de Masson para análise quantitativa dos dados histopatológicos em sistema digitalizado. A análise estatística foi feita pelo ANOVA e teste Newman-Keuls, com significância 0,05. RESULTADOS: No grupo A a pO2 do líquido tecidual atingiu o valor 17,75± 3,4 mmHg e no grupo B (controle a pO2 = 40,75± 6,4 mmHg (pOBJETIVE: An experimental study was done to evaluate the effect of nicotine on the healing of abdominal wall. METHODS: Sexteen Wistar rats weighing 210± 8g were randomly separated into two groups of eight rats each. In the group A Nicotine (Nicotinel Ò was implanted in the back subcutaneous 5mg/Kg each two days, begining at the fifth preoperative day. A 5cm median laparotomy was done, sutured with nylon 5-0 and the rats were observed in individual cages. The group B (control didn’t use nicotine. A multiperfurated silicone tube was implanted

  17. Finite Element Implementation of a Structurally-Motivated Constitutive Relation for the Human Abdominal Aortic Wall with and without Aneurysms

    Enevoldsen, Marie Sand; Henneberg, Kaj-Åge; Lönn, L;

    2011-01-01

    The structural integrity of the abdominal aorta is maintained by elastin, collagen, and vascular smooth muscle cells. Changes with age in the structure can lead to develop-ment of aneurysms. This paper presents initial work to capture these changes in a finite element model (FEM) of a structural-ly-motivated...... anisotropic constitutive relation for the “four fiber family” arterial model. First a 2D implementation is used for benchmarking the FEM implementation to fitted biaxial stress-strain data obtained experimentally from four different groups of persons; 19-29 years, 30-60 years, 61-79 years and abdominal aortic...... maximum axial and hoop stress in the group of AAA patients was 94.9 kPa (±0.283 kPa) and 94.3 kPa (±0.224 kPa) at maximum stretch ratios of 1.043 and 1.037, respectively. In the 3D simulations, the maximum stress is also found to occur in the AAA patient group, with the highest stress in the...

  18. Major abdominal evisceration injuries in dogs and cats: 12 cases (1998-2008).

    Gower, Sara B; Weisse, Chick W; Brown, Dorothy C

    2009-06-15

    OBJECTIVE- To describe the clinical characteristics, treatment, complications, and outcome of dogs and cats treated surgically for major abdominal evisceration. DESIGN- Retrospective case series. ANIMALS- 8 dogs and 4 cats. PROCEDURES- Medical records from January 1998 through March 2008 were reviewed to identify animals that underwent surgery for major abdominal evisceration. Data regarding cause of evisceration, signalment, physiologic variables, and hematologic variables were collected. Details of treatment, duration of hospitalization, and outcome were recorded. Linear regression analysis was performed to evaluate the association of signalment, physiologic variables, and hematologic variables on the number of days of hospitalization. RESULTS- Major abdominal evisceration was secondary to a traumatic event in 4 animals and to postsurgical dehiscence in 8 animals. All animals had evisceration of the intestines and gross contamination with dirt, leaves, or litter. Two animals eviscerated the spleen, and 1 animal had a perforated colon and was leaking feces into the peritoneal cavity. All animals underwent exploratory abdominal surgery. Surgical procedures performed included resection of compromised intestine, body wall repair, diaphragmatic hernia repair, nephrectomy, splenectomy, and primary colonic repair. All animals survived to discharge from the hospital. Median duration of hospitalization was 4 days (range, 1 to 7 days). Factors associated with an increase in duration of hospitalization included evisceration secondary to trauma, high lactate concentration at time of admission, and small body size. CONCLUSIONS AND CLINICAL RELEVANCE- Despite the dramatic appearance of major abdominal evisceration in cats and dogs, prompt and aggressive medical and surgical intervention can provide a favorable outcome. PMID:19527132

  19. Laparoscopic surgery for treatment of incisional lumbar hernia

    M. Tobias-Machado

    2005-08-01

    Full Text Available OBJECTIVE: To present results obtained with laparoscopic correction of incisional lumbar hernia in patients with minimum follow-up of 1 year. MATERIALS AND METHODS: We prospectively studied 7 patients diagnosed with incisional lumbar hernia after physical examination and computerized tomography. We used laparoscopic transperitoneal access through 3 ports. One polypropylene mesh was introduced in the abdominal cavity and fixed by titanium clamps to the margins of the hernia ring following release of the peritoneum. RESULTS: All cases were successfully completed with no conversion required. Mean surgical time was 120 minutes and discharge from hospital occurred between the 1st and the 2nd postoperative days. There were no intraoperative complications or hernia recurrence in any case. Postoperatively, we had 2 minor complications: one case of seroma that resolved spontaneously after 60 days and one patient presenting lumbar pain that persisted until the 3rd postoperative month. The return to usual activities occurred on average 3 weeks following intervention. Of the 7 patients, 6 were satisfied with the esthetical and functional effect produced by the procedure. CONCLUSIONS: The surgical correction of incisional lumbar hernia by laparoscopic access is an excellent option for a minimally invasive treatment, with adequate long-term results.

  20. How should an infected perinephric haematoma be drained in a tetraplegic patient with baclofen pump implanted in the abdominal wall? – A case report

    Watt John WH

    2002-09-01

    Full Text Available Abstract Background We present a case to illustrate controversies in percutaneous drainage of infected, perinephric haematoma in a tetraplegic patient, who had implantation of baclofen pump in anterior abdominal wall on the same side as perinephric haematoma. Case presentation A 56-year-old male with C-4 tetraplegia had undergone implantation of programmable pump in the anterior abdominal wall for intrathecal infusion of baclofen to control spasticity. He developed perinephric haematoma while he was taking warfarin as prophylactic for deep vein thrombosis. Perinephric haematoma became infected with a resistant strain of Pseudomonas aeruginosa, and required percutaneous drainage. Positioning this patient on his abdomen without anaesthesia, for insertion of a catheter from behind, was not a realistic option. Administration of general anaesthesia in this patient in the radiology department would have been hazardous. Results and Conclusion Percutaneous drainage was carried out by anterior approach under propofol sedation. The site of entry of percutaneous catheter was close to cephalic end of baclofen pump. By carrying out drainage from anterior approach, and by keeping this catheter for ten weeks, we took a risk of causing infection of the baclofen pump site, and baclofen pump with a resistant strain of Pseudomonas aeruginosa. The alternative method would have been to anaesthetise the patient and position him prone for percutaneous drainage of perinephric collection from behind. This would have ensured that the drainage track was far away from the baclofen pump with minimal risk of infection of baclofen pump, but at the cost of incurring respiratory complications in a tetraplegic subject.

  1. Comparison of Synthetic and Biologic Mesh in Ventral Hernia Repair Using Components Separation Technique.

    Sandvall, Brinkley K; Suver, Daniel W; Said, Hakim K; Mathes, David W; Neligan, Peter C; Dellinger, E Patchen; Louie, Otway

    2016-06-01

    Ventral hernia repair (VHR) for large abdominal wall defects is challenging. Prior research established that the use of mesh is superior to suture closure alone and that component separation is an effective technique to combat loss of abdominal domain. Studies comparing component separation technique (CST) outcomes utilizing synthetic versus biologic mesh are limited. A retrospective review was conducted of 72 consecutive patients who underwent VHR with CST between 2006 and 2010 at our institution. Surgeon preference and the presence of contamination guided whether synthetic mesh (27 patients) or biologic mesh (45 patients) was used. Mean follow-up interval for all comers was 13.9 months and similar in both groups (P > 0.05). Degree of contamination and severity of premorbid medical conditions were significantly higher in the biologic mesh group, as reflected in the higher Ventral Hernia Working Group (VHWG) score (2.04 versus 2.86). Clinical outcomes, as measured by both minor and major complication rates and recurrence rates, were not significantly different. Minor complication rates were 26% in the synthetic group and 37% in the biologic group and major complication rates 15% in the synthetic group and 22% in the biologic group. There was 1 recurrence (4%) in the synthetic mesh group versus 5 (11%) in the biologic mesh group. Multivariable analysis for major complications revealed no significant difference for either synthetic or biologic mesh while controlling for other variables. Subset analysis of uncontaminated cases revealed recurrence rates of 4% in the synthetic mesh group and 6% in the biologic mesh group. VHR using CST and either synthetic mesh or biologic mesh resulted in low recurrence rates with similar overall complication profiles, despite the higher average VHWG grading score in the biologic mesh group. Our results support the VHWG recommendation for biologic mesh utilization in higher VHWG grade patients. In VHWG grade 2 patients, our clinical

  2. Algunas hernias abdominales anteriores

    Salazar Sánchez, Augusto

    2011-01-01

    Las hernias epigástricas se presentan en dos tipos de individuos: los atléticos y los asténicos. Son casi una exclusividad del sexo masculino. En los atléticos aparecen durante la juventud y son la consecuencia de esfuerzos durante los cuales la resistencia de la línea alba cede a la presión intraabdominal, produciendose una ruptura de esa línea, generalmente de tamaño muy pequeño pero suficiente para que por allí pase una porción de la grasa pre-peritoneal, quedando constituida la hernia. Má...

  3. Laparoscopic Hernia Repair—When Is a Hernia Not a Hernia?

    Szczebiot, Lukasz; Cota, Alwyn

    2013-01-01

    A wide range of diagnoses can present as inguinal hernia. Laparoscopic techniques are being increasingly used in the repair of inguinal hernias and offer the potential benefit of identifying additional pathology. The authors present the first reported case of a hydrocele of the canal of Nuck diagnosed laparoscopically. We review the incidence of identifying additional pathology through laparoscopy for inguinal hernia repair. We suggest that in patients with atypical presenting features of a hernia, the transabdominal preperitoneal, rather than a totally extraperitoneal, approach to groin hernia repair should be considered because of its greater diagnostic potential. PMID:24398212

  4. Laparoscopic hernia repair--when is a hernia not a hernia?

    Bunting, David; Szczebiot, Lukasz; Cota, Alwyn

    2013-01-01

    A wide range of diagnoses can present as inguinal hernia. Laparoscopic techniques are being increasingly used in the repair of inguinal hernias and offer the potential benefit of identifying additional pathology. The authors present the first reported case of a hydrocele of the canal of Nuck diagnosed laparoscopically. We review the incidence of identifying additional pathology through laparoscopy for inguinal hernia repair. We suggest that in patients with atypical presenting features of a hernia, the transabdominal preperitoneal, rather than a totally extraperitoneal, approach to groin hernia repair should be considered because of its greater diagnostic potential. PMID:24398212

  5. Distinct defects in collagen microarchitecture underlie vessel-wall failure in advanced abdominal aneurysms and aneurysms in Marfan syndrome

    Lindeman, J.H.N.; Ashcroft, B.A.; Beenakker, J.-W.M.; Es, M. van; Koekkoek, N.B.R.; Prins, F.A.; Tielemans, J.F.; Abdul-Hussien, H.; Bank, R.A.; Oosterkamp, T.H.

    2010-01-01

    An aneurysm of the aorta is a common pathology characterized by segmentalweakeningof the artery.Althoughit isgenerally accepted that the vessel-wall weakening is caused by an impaired collagen metabolism, a clear association has been demonstrated only for rare syndromes such as the vascular type Ehl

  6. COPAIBA OIL INFLUENCES VENTRAL HERNIA REPAIR WITH VICRYL® MESH?

    YASOJIMA, Edson Yuzur; TEIXEIRA, Renan Kleber Costa; HOUAT, Abdallah de Paula; COSTA, Felipe Lobato da Silva; YAMAKI, Vitor Nagai; FEITOSA-JUNIOR, Denilson José Silva; SILVA, Carlos Augusto Moreira; BRITO Marcus Vinicius Henriques

    2015-01-01

    Background: The use of meshes in hernia surgical repair promoted revolution in the surgical area; however, some difficulties had come, such as a large area of fibrosis, greater postoperative pain and risk of infection. The search for new substances that minimize these effects should be encouraged. Medicinal plants stand out due possible active ingredients that can act on these problems. Aim: To check the copaiba oil influence in the repair of abdominal defects in rats corrected with Vicryl(c)...

  7. LAPAROSCOPIC TRANSABDOMINAL PRE-PERITONEAL (TAPP) PROCEDURE FOR GROIN HERNIA.

    R Moldovanu

    2013-01-01

    The laparoscopic approach for the groin hernia repair has several advantages: decreased immediate and late postoperative pain, less numbness in inguinal aria, less mesh infection and a rapid recovery. However the good outcomes are not granted, and there are some key points to be followed for better postoperative results. The aim of this video is to highlight these TAPP (TransAbdominal Pre-Peritoneal) related key points, from the operative indication, pre operative preparation and surgical pro...

  8. INGUINAL HERNIA REPAIR - ACTUAL STATUS

    R.Van Hee

    2007-04-01

    Full Text Available Even in 2006, there are a lot of controversy about the best technique for inguinal hernia repair. The factors that influence the choice of the technique are: uni- or bilateral hernia, “Nyhus” type of hernia, complicated hernia, large inguino-scrotal hernia, recurrent hernia or previous surgery, preferred type of anaesthesia. Surgeon has to answer to three question when he choices a type of hernia repair: What are there specific indications for this repair? What are the specific complications of the repair technique? What are the results with the repair technique? In the literature there are a lot of studies which give comparisons about the techniques of hernia repair: type and rate of complications, recurrence rate, costs and economic impact. There are various types of evidence: retrospective studies, prospective randomized trials, meta-analyses. This paper reviews some of the literature studies about: techniques of open non-mesh hernia repair, types of open mesh repair, mesh vs non-mesh open techniques, open vs laparoscopique techniques and types of laparoscopic hernia repair techniques. Conclusion: Open non-mesh repairs should be avoided. Lichtenstein mesh repair is the best open technique. Laparoscopic techniques (TAPP &TEP induce: less pain, shorter hospital stay, earlier return to work, more rapid resumption of activities and lower recurrence rates but at a higher cost, especially in “non-working” population.

  9. Ventral hernia repair

    You will probably receive general anesthesia (asleep and pain-free) for this surgery. If your hernia is small, you may receive a spinal or epidural block and medicine to relax you. You will be awake, but pain-free. Your surgeon will make a surgical cut in ...

  10. Appendicitis within Morgagni Hernia and simultaneous Paraesophageal Hernia

    Bettini, Anna; Ulloa, Jesus G.; Harris, Hobart

    2015-01-01

    Background Morgagni hernia is a congenital diaphragmatic defect that rarely presents with symptomatic findings in adults. The presence of one diaphragmatic defect may decrease the occurrence of a separate diaphragmatic defect. Appendicitis may be a unique presentation of incarcerated bowel in a Morgagni defect. Case presentation Review of recent literature and presentation of a patient with Morgagni defect. Only five cases of simultaneous Morgagni hernia and paraesophageal hernia have been de...

  11. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Ghodratollah Maddah

    2014-05-01

    Full Text Available The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag. The study population comprised of 11 (57.9% male and 8 (42.1% female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9% patients, subjective judgment that the fascia closure is too tight in 6 (31.6% patient's damage control surgery in one patient (5.3% and development of abdominal compartment surgery in one patient (5.3%. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4% patients, post operative intestinal fistula in 4 (21.1% patients, post traumatic intra abdominal bleeding in 3 (15.8% patients and intestinal obstructions in 3 (15.8% patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0% patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1 early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3% late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54 months. Currently 10 patients (52.6% are alive at a follow up of 45 (range 1

  12. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Maddah, Ghodratollah; Shabahang, Hossein; Abdollahi, Abbas; Zehi, Vahid; Abdollahi, Mohsen

    2014-01-01

    The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag). The study population comprised of 11 (57.9%) male and 8 (42.1%) female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9%) patients, subjective judgment that the fascia closure is too tight in 6 (31.6%) patient's damage control surgery in one patient (5.3%) and development of abdominal compartment surgery in one patient (5.3%). Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4%) patients, post operative intestinal fistula in 4 (21.1%) patients, post traumatic intra abdominal bleeding in 3 (15.8%) patients and intestinal obstructions in 3 (15.8%) patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0%) patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1) early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3%) late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54) months. Currently 10 patients (52.6%) are alive at a follow up of 45 (range 1

  13. The inheritance of groin hernia

    Burcharth, J; Pommergaard, H C; Rosenberg, Jacob

    2013-01-01

    Groin hernia has been proposed to be hereditary; however, a clear hereditary pattern has not been established yet. The purpose of this review was to analyze studies evaluating family history and inheritance patterns and to investigate the possible heredity of groin hernias.......Groin hernia has been proposed to be hereditary; however, a clear hereditary pattern has not been established yet. The purpose of this review was to analyze studies evaluating family history and inheritance patterns and to investigate the possible heredity of groin hernias....

  14. Health Technology Assessment of laparoscopic compared to conventional surgery with and without mesh for incisional hernia repair regarding safety, efficacy and cost-effectiveness

    Willich, Stefan

    2008-03-01

    Full Text Available Introduction: Incisional hernias are a common complication following abdominal surgery and they represent about 80% of all ventral hernia. In uncomplicated postoperative follow-up they can develop in about eleven percent of cases and up to 23% of cases with wound infections or other forms of wound complications. Localisation and size of the incisional hernia can vary according to the causal abdominal scar. Conservative treatment (e. g. weight reduction is only available to relieve symptoms while operative treatments are the only therapeutic treatment option for incisional hernia. Traditionally, open suture repair was used for incisional hernia repair but was associated with recurrence rates as high as 46%. To strengthen the abdominal wall and prevent the development of recurrences the additional implantation of an alloplastic mesh is nowadays commonly used. Conventional hernia surgery as well as minimally invasive surgery, introduced in the early 90s, make use of this mesh-technique and thereby showed marked reductions in recurrence rates. However, there are possible side effects associated with mesh-implantation. Therefore recommendations remain uncertain on which technique to apply for incisional hernia repair and which technique might, under specific circumstances, be associated with advantages over others. Objectives: The goal of this HTA-Report is to compare laparoscopic incisional hernia repair (LIHR and conventional incisional hernia repair with and without mesh-implantation in terms of their medical efficacy and safety, their cost-effectiveness as well as their ethical, social und legal implications. In addition, this report aims to compare different techniques of mesh-implantation and mesh-fixation as well as to identify factors, in which certain techniques might be associated with advantages overothers. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of

  15. The Characteristics and Surgical Approach in Post-Traumatic Diaphragmatic Hernia: A Single Center Experience

    Mushtaq Ahmed Chowdhary

    2013-07-01

    Full Text Available Objectives: The aim of this study was to evaluate the surgical approach in post traumatic diaphragmatic hernia Methods: This prospective cross-sectional study was conducted in the Department of cardiovascular and thoracic surgery, Sher-i- Kashmir Institute of Medical Sciences (SKIMS, Kashmir, India. We included all patients with post traumatic diaphragmatic hernia undergoing operation in our center from May 2009 to November2011. A detailed history was taken for each patient along with comprehensive general, physical, systemic and local examination of all cases. Operative findings included associated intra-abdominal injuries, and herniated intra-abdominal organs. Post-operative complications, mortality and survival were recorded and reported. Results: The mean age of the patients was 32±1 years and there were 16 (76.1% men and 5 (23.8% women among the patients. Thoracotomy was performed in 14 patients (66.7%, laparotomy in 6 patients (28.6% and combined procedure was used in 1 patient (4.7%. The reduction of hernia contents with repair of diaphragmatic rent was done in 11 (52.2% of the patients and splenectomy with repair of rent in 6 (28.6%. Traumatic diaphragmatic hernia had 81.8% survival rate, no pre-operative mortality and 14.3% post operative mortality rate.Conclusion: Thoracotomy is the most common approach in post traumatic diaphragmatic hernia. Laparotomy is preferred in patients having acute trauma with associated intra-abdominal injuries.

  16. A PROSPECTIVE STUDY ON MANAGEMENT OF INCISIONAL HERNIAS

    Deepak R

    2014-06-01

    Full Text Available OBJECTIVE: To study the age and sex incidence, various factors leading to incisional hernia, methods to control them and various types of surgical repair by mesh and their complications. BACKGROUND DATA: Incisional hernia is a common surgical condition with a reported incidence of 5-11% of patients subjected to abdominal operations. Many factors are associated with incisional hernia like age, sex, obesity, chest infections, type of suture material, type of incision and most important wound infection. All of them present a challenging problem to the surgeon. So this study has been undertaken to assess the magnitude of this condition and different modalities in surgical repair by mesh in our setup. MATERIALS & METHODS: This is a prospective study of 70 cases of incisional hernia who attended to OPD and emergency department of Sri B. M. Patil medical college Hospital & Research Centre from March 2012 to March 2014. Data were collected from the patients ie, clinical history, examination and appropriate investigations. Documentations of patients which include identification, history, clinical finding, investigative tests, operation findings, operative procedures and complications during the stay in hospital and during subsequent follow up period, were all recorded in a proforma specially prepared. RESULTS: In our series of 70 patients, clinical details of 70 patients were available. Females (80%, n=48 out- numbered males (20%, n=12 and the highest incidence was in the age group of 30 to 60 years with mean age of 45 years. Gynecological operation accounted for 73.3% (n=50 of the index operations, with lower midline incision resulting in 53.3%(n=44 of the incisional hernias. The polypropylene mesh placed overlay or inlay method. All patients attended our follow up ranging from 3 months to 2 year. Two recurrences were noticed in inlay mesh repair group. CONCLUSION: Based on our analysis, we believe that overlay mesh repair is superior to inlay mesh

  17. Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature.

    Suwa, Katsuhito; Okamoto, Tomoyoshi; Yanaga, Katsuhiko

    2016-07-01

    The laparoscopic technique for repairing ventral and incisional hernias (VIH) is now well established. However, several issues related to laparoscopic VIH repair, such as the high recurrence rate for hernias with large fascial defects and in extremely obese patients, are yet to be resolved. Additional problems include seroma formation, mesh bulging/eventration, and non-restoration of the abdominal wall rigidity/function with only bridging of the hernial orifice using standard laparoscopic intraperitoneal onlay mesh repair (sIPOM). To solve these problems, laparoscopic fascial defect closure with IPOM reinforcement (IPOM-Plus) has been introduced in the past decade, and a few studies have reported satisfactory outcomes. Although detailed techniques for fascial defect closure and handling of the mesh have been published, standardized techniques are yet to be established. We reviewed the literature on IPOM-Plus in the PubMed database and identified 16 reports in which the recurrence rate, incidence of seroma formation, and incidence of mesh bulging were 0-7.7, 0-11.4, and 0 %, respectively. Several comparison studies between sIPOM and IPOM-Plus seem to suggest that IPOM-Plus is associated with more favorable surgical outcomes; however, larger-scale studies are essential. PMID:26198897

  18. Left Sided Hydro-pneumothorax in a Operated Case of Left Diaphragmatic Hernia Repair: A Diagnostic Dilemma

    Hombalkar, Narendra Narayan; Dalvi, Santosh Bhimrao; Gurav, Prakash Dattatray

    2015-01-01

    Diaphragmatic hernia in adults often presents with overlapping respiratory and abdominal symptoms. They may be simple diaphragmatic eventrations or undiagnosed Bochdalek’s hernias or may even be of post traumatic variety. Diaphragmatic hernias may be asymptomatic, present only with respiratory symptoms, or may present with obstruction and strangulation of involved bowel loops with faeco-pneumothorax. The index case was operated for open diaphragmatic hernia repair six years back and admitted for breathlessness with absence of abdominal signs and symptoms. Patient subsequently developed hydro-pneumothorax during conservative management. Emergency laparotomy revealed a gastric ulcer which perforated into the left chest giving rise to hydro-pneumothorax. In present study we would like to report how this unusual presentation led to dilemma in diagnosis and surgical intervention thus increasing the morbidity and mortality of the patient at our institute. PMID:26023591

  19. Diagnosis of an Inguinal Hernia after a Blunt Inguinal Trauma with an Intestinal Perforation

    Moustafa, Farès; Avouac, Julien; Vaz, Marie-Aude; Schmidt, Jeannot

    2014-01-01

    Introduction. Inguinal hernias are very common in men. A clinical exam can do the diagnosis easily. But bowel perforation inside an inguinal hernia caused by a directly blunt trauma is rare and can have important consequences. Up to now, there have been a few case reports that described blunt injury to the inguinal area causing traumatic perforation of the bowel in the inguinal hernia. Case Report. We present a case of a 45-year-old Eastern European man with a small perforation of ileal bowels and a peritonitis after direct blunt trauma to the inguinal hernia region, with no inguinal hernia known by the patient, and show how the diagnosis can be difficult. Conclusion. This case shows that external forces, that may seem too trivial to cause intraperitoneal injury, can cause significant injury when applied to a patient with a hernia and shows how a careful examination, with the help of an abdominal CT scan, is important even if the patient do not seem to have an inguinal hernia. PMID:24839569

  20. Laparoscopic Hernia Repair—When Is a Hernia Not a Hernia?

    Bunting, David; Szczebiot, Lukasz; Cota, Alwyn

    2013-01-01

    A wide range of diagnoses can present as inguinal hernia. Laparoscopic techniques are being increasingly used in the repair of inguinal hernias and offer the potential benefit of identifying additional pathology. The authors present the first reported case of a hydrocele of the canal of Nuck diagnosed laparoscopically. We review the incidence of identifying additional pathology through laparoscopy for inguinal hernia repair. We suggest that in patients with atypical presenting features of a h...

  1. The sports hernia: a cause of chronic groin pain.

    Hackney, R. G.

    1993-01-01

    The management of chronic pain in sportsmen and women requires consideration of a wide differential diagnosis. A syndrome caused by a distension of the posterior inguinal wall is described, effectively an early direct inguinal hernia. The diagnosis can be made from certain aspects of the history and examination, which are described. The results of surgical repair to the posterior inguinal wall are excellent. The procedure was carried out on 14 sportsmen and one woman. There is an 87% return t...

  2. COMPARATIVE STUDY OF LICHTENSTEIN VERSUS DESARDA REPAIR FOR INGUINAL HERNIA

    Sowmya

    2015-12-01

    Full Text Available BACKGROUND Inguinal hernia repair is the most frequently performed operation in any general surgical unit. The Bassini’s, Shouldice and other tissue-based techniques are still being acceptable for primary inguinal hernia repair. Desarda’s technique is originally a tissue based hernia repair using an undetached strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal. The aim of the present study was to compare Lichtenstein hernia repair and Desarda herniorrhaphy. METHODS A total of 40 patients with primary unilateral inguinal hernia were subjected either to Desarda herniorrhaphy or Lichtenstein hernioplasty. The patients were followed in terms of recurrence rate, post-operative complications, convalescence, chronic pain and cost effectiveness. RESULTS During the followup all patients had either mild or moderate pain, but the pain intensity was more in Lichtenstein repair compared to Desarda repair in the immediate postoperative period. In Lichenstein repair patients had chronic groin pain even at the end of one year, but none of the patients in Desarda repair had chronic groin pain. Complications such as seroma and wound infection were less in Desarda repair. Time taken to resume normal activities was significantly less in case of Desarda herniorrhaphy; however, there was no recurrence observed in both the groups during the followup period. Average cost incurred for Desarda repair was significantly less than Lichtenstein repair. CONCLUSION Lichtenstein method of hernia repair is simple and safe. But the mesh prosthesis has its drawbacks. Desarda hernia repair is based on physiological principles and the results are good with less convalescence period and fewer recurrences and no chronic groin pain. It is more cost effective.

  3. Emprego do saco herniário no reforço parietal nas hérnias inguinais indiretas do adulto Repair of inguinal indirect hernia using the hernial sac in reinforcement wall of adult

    Pedro Lúcio de Souza

    1998-06-01

    proposta de utilização do saco herniário, como um reforço da hérnia inguinal, mostrou-se um recurso de fácil e rápida execução, com custo operacional baixo, não expondo o paciente ao aumento do número de complicações.This prospective study reports 80 repairs of inguinal indirect hernias of groin. All patients were men, 18-65 years old, with internal inguinal ring ranging from 1cm to 3.5cm in diameter, corresponding to type 2 in Nyhus'classification of inguinal- femoral hernias. The objective was to investigate the probable advantages of using the hernial sac as an additional reinforcement, together with the usual, of posterior wall of the inguinal canal. The internal ring was encircled by a sling from the hernial sac graft. The patients were divided into two groups. In both groups, the statistical texts showed no siginificant diferences between averages of age, weight and height of the patients and between diameter of infernal ring. In the group A, the reinforcement was made by means of the iliopubic tract repair. In the group B, the hernial sac was applied as a reinforcing patch. the graft would then fit snugly against the cord to form a new internal ring. This technique is easy and spends, in average, nine minutes. Hernial sac is a tissue constituted predominantly of conjunctive fibers, fatty cels, blood vessels and straight muscular fibers until 25% of the cases. In the only patient who underwent reoperation, the graft was found to be transformed into a thick fibrous tissue barrier at the floor of the inguinal canal. After a 24-month follow-up, the author concluded that hernioplasty using the hernial sac in repair of inguinal indirect hernia offers a simplified, rapid and inexpensive solution. In addition, the operative means do not cause increase of post-operative complications.

  4. Congenital diaphramatic hernia

    Kline-Fath, Beth M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Fetal Care Center of Cincinnati, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States)

    2012-01-15

    Congenital diaphragmatic hernia, despite advances in therapy, remains a complex condition with significant morbidity and mortality. The etiology of the disorder is still incompletely understood, though the pulmonary hypoplasia and pulmonary hypertension that develop secondarily must be overcome to improve survival. Prenatal US and fetal MRI have helped in the development of a greater understanding of this disease. Also with these modalities, measurement techniques have been developed in an attempt to provide prognosticators for the development of pulmonary hypoplasia and pulmonary hypertension. There is a broad range of approaches for performing these measurements, and variability among imaging centers is noted. Despite inconsistent approaches, these techniques have become the foundation for counseling and prenatal and postnatal therapy. It is hoped that with further research with prenatal US and fetal MRI and the development of innovative medical and surgical therapies that the morbidity and mortality of children with congenital diaphragmatic hernias can be significantly reduced. (orig.)

  5. Nationwide prevalence of groin hernia repair

    Burcharth, Jakob Hornstrup Frølunde; Pedersen, Michael; Bisgaard, Thue;

    2013-01-01

    Groin hernia repair is a commonly performed surgical procedure in the western world but large-scaled epidemiologic data are sparse. Large-scale data on the occurrence of groin hernia repair may provide further understanding to the pathophysiology of groin hernia development. This study was...... undertaken to investigate the age and gender dependent prevalence of groin hernia repair....

  6. Metachronous contralateral pediatric inguinal hernia

    RM Nataraja

    2010-08-01

    Full Text Available RM Nataraja, AA MahomedDepartment of Pediatric Surgery and Urology, Royal Alexandra Children’s Hospital, Brighton, UKDate of preparation: April 20, 2010. Conflict of interest: None declaredClinical question: Should routine contralateral inguinal region exploration be done to prevent a metachronous contralateral pediatric inguinal hernia?Results: The incidence of a metachronous contralateral pediatric inguinal hernia is 6.4% in both genders. Sixteen contralateral groin explorations need to be done to prevent one metachronous contralateral pediatric inguinal hernia.Implementation:• Routine exploration of the asymptomatic contralateral groin is not recommended.• Infants less than one month old with an inguinal hernia should receive immediate specialist referral.• Older infants and children with a reducible hernia should be referred to the pediatric surgical outpatient department.• Pediatric patients with an original left-sided hernia or who were less than six months old at the time of the first hernia repair should receive regular follow-up in the primary health care setting.Keywords: metachronous contralateral pediatric inguinal hernia, exploration

  7. Complex ventral hernia repair with a human acellular dermal matrix and component separation: A case series

    Alvaro Garcia

    2015-09-01

    Conclusion: Patients at high risk for post-operative events due to comorbidities, prior abdominal infection and failed mesh repairs do well following component separation reinforced with a human bioprosthetic mesh. Anticipated post-operative complications were managed conservatively and at a median 2-year follow-up, a low rate of hernia recurrence was observed with this approach.

  8. Bochdalek hernia and repetitive pancreatitis in a 33 year old woman

    Medina Andrade Luis Angel

    2014-01-01

    CONCLUSION: Bochdalek hernia is a rare find in adults who require treatment immediately after diagnosis because of the high risk of complications. When presented with data from pancreatitis is recommended to complete the medical treatment of pancreatitis before surgery to obtain the best results, unless it exist another abdominal complication.

  9. Abdominal Adhesions

    ... adhesions? Abdominal adhesions can cause intestinal obstruction and female infertility—the inability to become pregnant after a year of trying. Abdominal adhesions can lead to female infertility by preventing fertilized eggs from reaching the uterus, ...

  10. Abdominal Ultrasound

    ... It is used to help diagnose pain or distention and evaluate the kidneys, liver, gallbladder, pancreas, spleen ... variety of conditions, such as: abdominal pain or distention. abnormal liver function. enlarged abdominal organ. stones in ...

  11. Unusual Contents of the Femoral Hernia

    Ahmed Alzaraa

    2011-01-01

    Different contents in the femoral hernia have been reported in the literature, but herniation of the fallopian tube in a femoral hernia is very rare due to its normal anatomical position. Case Presentation. A female patient was admitted to the surgical ward for a lump in the right groin. Clinical examination confirmed a right femoral hernia. The patient underwent surgery to repair the hernia. Intraoperatively, the right uterine tube was found in the hernia. The tube was reduced back into the ...

  12. A case of de Garengeot hernia: the feasibility of laparoscopic transabdominal preperitoneal hernia repair

    Saud Al-Subaie; Hatem Mustafa; Noura Al-Sharqawi; Mohanned Al-Haddad; Feras Othman

    2015-01-01

    Introduction: de Garengeot hernia is described as the presence of an appendix in a femoral hernia. This rare hernia usually presents with both diagnostic and therapeutic dilemmas. Presentation of case: We report a case of a 59 year-old woman with a one-year history of a right irreducible femoral hernia. She underwent diagnostic laparoscopy with an intraoperative diagnosis of de Garengeot hernia. This was followed by a laparoscopic transabdominal preperitoneal (TAPP) approach for hernia rep...

  13. Predictive Factors in the Outcome of Surgical Repair of Abdominal Rectus Diastasis

    Clay, Leonard; Stark, Birgit; Gunnarsson, Ulf

    2016-01-01

    Background: The aim of this study was to define the indicators predicting improved abdominal wall function after surgical repair of abdominal rectus diastasis (ARD). Preoperative subjective assessment quantified by the validated Ventral Hernia Pain Questionnaire (VHPQ) was related to relative postoperative functional improvement in abdominal muscle strength. Methods: Fifty-seven patients undergoing surgery for ARD completed the VHPQ before surgery. Preoperative pain assessment results were compared with the relative improvement in muscle strength measured with the BioDex system 4. Results: There was a correlation between the relative improvement in muscle strength measured by the BioDex System 4 for flexion at 30 degrees (P = 0.046) and 60 degrees per second (P = 0.004) and the preoperative question, “Do you find it painful to sit for more than 30 minutes?” There was also a correlation between BioDex improvement for flexion at 30 degrees (P = 0.022) and for isometric work load (P = 0.038) and the preoperative question, “Has abdominal pain limited your ability to perform sports activities?” The VHPQ responses also formed a pattern with a fairly good correlation between other BioDex modalities (with the exception of extension at 60 degrees per second) and the response to the question regarding complaints when performing sports. Postoperative visual analog scale ratings of abdominal wall stability correlated to the questions regarding complaints when sitting (P = 0.040) and standing (P = 0.047). No other correlation was seen. Conclusion: VHPQ ratings concerning pain while being seated for more than 30 minutes and pain limiting the ability to perform sports are promising indicators in the identification of patients likely to benefit from surgical correction of their ARD. PMID:27579227

  14. Cirugía mínimamente invasiva de la hernia inguinal Minimally invasive surgery of the inguinal hernia

    J. M. Olea

    2005-01-01

    Full Text Available El abordaje mínimamente invasivo de la hernia inguinal presenta ventajas respecto a los abordajes convencionales anteriores en las hernias inguinales bilaterales y recurrentes, si bien los resultados iniciales fueron malos, se sumaron nuevos problemas derivados del abordaje laparoscópico. El objetivo de este artículo es describir la técnica quirúrgica y analizar los resultados preliminares de nuestra serie de 600 hernioplastias totalmente extraperitoneales realizadas en la Clínica Universitaria de Navarra. La complicación intraoperatoria más frecuente (25,7% fue la apertura accidental del peritoneo. No hubo complicaciones intrabdominales asociadas. En el seguimiento hubo 9 (1,5% recidivas y 13 reintervenciones. Once (1,8% pacientes desarrollaron dolor neuropático transitorio en el territorio del fémoro-cutáneo. En nuestra experiencia el abordaje totalmente extraperitoneal es una técnica especialmente indicada en hernias recidivadas y bilaterales. Las ventajas presentes en cuanto a dolor y disconfort postoperatorio, recuperación de la actividad física y laboral, y los buenos resultados en cuanto a recidivas y dolor neuropático nos animan a indicarla no sólo en las hernias inguinales recidivadas o bilaterales sino en las primarias.The minimally invasive approach to the inguinal hernia shows advantages with respect to previous conventional approaches in bilateral and recurrent inguinal hernias; while the initial results were bad, new problems were added deriving from the laparoscopic approach. The aim of this article is to describe the surgical technique and analyse the preliminary results of our series of 600 totally extra-peritoneal hernioplasties, performed at the University Clinic of Navarra. The most frequent complication (25.7% was the accidental rupture of the peritonea. There were no associated intra-abdominal complications. In the follow-up there were 9 relapses (1.5% and 13 reinterventions. Eleven (1.8% of the patients

  15. Pyloro-duodenal hernia with formation of enterocutaneous fistula in a buffalo calf following a dog attack

    G. Kamalakar

    2015-09-01

    Full Text Available A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy.

  16. Tratamento cirúrgico das hérnias incisionais: experiência pessoal usando a malha de polipropileno monofilamentar-márlex Surgical treatment of incisional hernias: personal experience with polypropylene monofilament mesh-marlex

    José Moreira Lima

    2002-04-01

    Full Text Available OBJETIVO: Relatar a experiência pessoal no tratamento cirúrgico de hérnias incisionais com a utilização da malha de polipropileno monofilamentar-márlex. MÉTODOS: Foram operados e seguidos 74 pacientes portadores de hérnia incisional originada de tratamento cirúrgico de diferentes afecções da cavidde abdominal, com idade entre 30 e 94 anos, sendo 39 do sexo feminino e 35 do sexo masculino. Destes 41,9% foram submetidos a hernioplastia incisional pela primeira vez e 58,1% já haviam tentado o tratamento sem sucesso. A técnica operatória usada foi a dissecção do saco herniário, ressecção da fibrose resultante de operações anteriores e fixação de tela de márlex substituindo ou reforçando a fáscia transversal por baixo dos músculos da parede abdominal. RESULTADO: 74 pacientes foram operados e seguidos de 1975 a 1995. Na última revisão, em maio de 1998, três pacientes haviam falecido, dois de doenças cardíacas e um de doença neoplasia. Apenas um paciente (1,3% apresentou recidiva, no início da experiência. Este foi reoperado e terve sua hérnia incisional curada. CONCLUSÃO: o uso da tela de márlex tecnicamente aplicada é o método ideal para a cura definitiva das hérnias incisionais.BACKGROUND: Personal experience in the treatment of incisional hernia with the use of polypropylene monofilament mesh - marlex, is discussed. METHOD: Seventy-four patients, with ages ranging from 30 to 94 years (39 females and 35 males, with hernia secundary to surgical abdominal procedures, were studied. Half (41,9% of these patients were submitted to surgical correction for the first time, however 58,1% were recurrences. Dissection of hernia sac, excision of old fibrosis and marlex mesh interposition were carried out to reinforce transversalis fascia under the muscles of the abdominal wall. RESULTS: Seventy-four patients were operated uppon from 1975 to 1995. Last follow-up carried out in 1998 disclosed three deaths not related to

  17. Laparoscopic management of foramen of Winslow incarcerated hernia.

    Daher, Ronald; Montana, Laura; Abdullah, Jarrah; d'Alessandro, Antonio; Chouillard, Elie

    2016-12-01

    Foramen of Winslow hernia (FWH) is a rare and often overlooked diagnosis with a high mortality rate. Widespread availability of cross-sectional imaging allows early diagnosis and prompt management. In this setting, before ischemia occurs, explorative laparoscopy would be the most suitable approach. Experience, however, remains sparse, and technical difficulties may be encountered. This is the case of a 38-year-old Caucasian woman who presented to the emergency department for a sudden epigastric pain. Physical exam was unremarkable, and routine blood tests were within normal range. An abdominal computed tomography (CT) scan confirmed the diagnosis of ileocaecal herniation through the foramen of Winslow. Under urgent laparoscopy, the caecum appeared viable but incarcerated in the lesser sac. Caecal puncture was the key to achieving atraumatic reduction of the hernia and bowel salvage. PMID:26943685

  18. Congenital diaphragmatic hernia in a post-partum woman.

    Abdullah, M

    2003-03-01

    Congenital diaphragmatic hernia (CDH) is rare in adults. We report a 24 year old woman presenting with shortness of breath, chest pain and nausea after the birth of her first baby. Clinical examination, plain radiography and a CT scan revealed herniation of abdominal contents into her left chest. Via a midline laparotomy, the contents were reduced and the defect repaired, using a mesh. She remains symptom-free three years since her surgery and even after a second childbirth. A brief review of the literature reporting adult diaphragmatic hernia of congenital origin accompanies this case report. We conclude that symptomatic CDH in adults usually presents as an emergency with gastrointestinal and occasionally respiratory complications. Early diagnosis and repair is essential to avoid subsequent morbidity and mortality. PMID:14556332

  19. Eventrações lombares: revisão tardia de 20 pacientes Large lumbar hernias: review of 20 patients

    Fernando A. B. Pitrez

    2006-02-01

    Full Text Available INTRODUÇÃO: Desde a primeira descrição em 1731 por DeGarangoet até 1994 poucos casos de hérnia lombar incisional (HLI foram relatados, restringindo-se a aproximadamente 300 casos. No entanto, esse número deve ser muito maior do que o encontrado na literatura pesquisada1,2. Não há maiores relatos com experiência significativa nesta afecção e, da mesma forma, não há descrição de uma técnica cirúrgica padrão para sua correção. OBJETIVO: Transmitir a experiência dos autores, alcançada no tratamento cirúrgico dos pacientes com HLI, confrontando-a com os dados vigentes na literatura. MÉTODO: Foram analisados, retrospectivamente, 20 casos de hérnia lombar submetidos ao tratamento cirúrgico no Serviço de Cirurgia Geral da ISCMPA/FFFCMPA nos últimos 10 anos. RESULTADOS: Foram identificados 20 pacientes, a idade média foi de 49 anos (28 - 68 anos. A maioria (19 casos correspondeu a hérnias incisionais lombares. O seguimento médio foi de 60 meses (5-72 meses, porém sete casos não compareceram às revisões ambulatoriais de rotina. Não houve recidiva nos casos acompanhados em um seguimento que variou de seis meses a 8,5 anos. Em um caso persistiu o abaulamento, dois apresentaram seroma, e um apresentou infecção de ferida operatória. CONCLUSÕES: Os autores recomendam a intervenção convencional, com reparo primário nos casos com diâmetro inferior a 5 cm e a utilização de tela nos casos em que há tensão na linha de sutura.BACKGROUND: An incisional lumbar hernia after a flank incision is a problem in hernia surgery. In recent decades preperitoneal prosthetic herniorrhaphy became a widely accepted procedure for abdominal wall hernias, but there are no reports with more than 6 cases. To evaluate outcome and technique of repair the flank hernias we reviewed our data on every patient who underwent this type of repair. METHODS: We identified 20 patients who underwent hernia repair after incisional or traumatic hernia of

  20. Lumbar hernia: a diagnostic dilemma

    Ahmed, Syed Tausif; Ranjan, Rajeeva; Saha, Subhendu Bikas; Singh, Balbodh

    2014-01-01

    Lumbar hernia is one of the rare cases that most surgeons are not exposed to. Hence the diagnosis can be easily missed. This leads to delay in the treatment causing increased morbidity. We report a case of lumbar hernia in a middle-aged woman. It was misdiagnosed as lipoma by another surgeon. It was a case of primary acquired lumbar hernia in the superior lumbar triangle. Clinical and MRI findings were correlated to reach the diagnosis. We also highlight the types, the process of diagnosis an...

  1. Late presentation of congenital diaphragmatic hernia: Case report

    Radović Saša V.

    2015-01-01

    Full Text Available Introduction. Congenital diaphragmatic hernia (CDH is a defect of the diaphragm with the penetration of organs of the abdominal cavity into thorax. Localization and size of the defect of the diaphragm condition the time and range of clinical manifestation. The most common is unilateral, without hernia sac, located on the left side, through posterolateral opening of the diaphragm and with clinical manifestation during the neonatal period. Smaller subgroup consists of patients with presentation outside the neonatal period with anatomic defect on the right side as is the case with our patient. Case Outline. Female infant aged seven months was hospitalized because of repeated episodes of shortness of breath and cough, with lack of progress in body weight. The discomforts had been present for the previous two months with an inadequate response to bronchodilator and antibiotic therapy used. After clinical, radiographic, ultrasound and computed tomography treatment, the right-sided diaphragmatic hernia was diagnosed, so surgical treatment followed. The defect of the diaphragm with hernia sac, through which the right lobe of the liver with visible line of entrapment, in the form of “hourglass”, is pushed into thoracic cavity, was intraoperatively identified. The reposition of the right lobe of the liver in the abdominal cavity along with reconstruction of the diaphragm using interrupted mattress sutures was performed. Conclusion. The late manifestation of CDH should be suspected in cases of inexplicable acute or chronic respiratory or gastrointestinal symptoms with pathological radiography of the thorax. Accurate diagnosis and timely minimally invasive surgical intervention ensure an excellent prognosis.

  2. Comparação entre o uso de fio inabsorvível (polipropileno e fio absorvível (poliglactina 910 na fixação de prótese de polipropileno em correção de defeitos músculo-aponeurótico da parede abdominal: estudo experimental em ratos Comparison between fixation of polypropylene mesh with polypropylene suture and polyglactin 910 suture for treatment of muscle-aponeurotic defects of abdominal wall: experimental study in rats

    Álvaro Gianlupi

    2004-04-01

    (polypropylene one. METHODS: Eighty-one male rats of the Wistar breed, weighing from 180g to 220g, were submitted to a longitudinally resection of a musculoaponeurotic and peritoneal segment (3x2 cm of the abdominal wall. Reconstruction was performed by reinforcement with polypropylene mesh, overlaid on the aponeurosis. They were distributed in two groups according to the thread used for mesh fixation as follows: (1 polyglactin 910 group, fixed with 8 stitches 4.0 Polyglactin 910 suture; and (2 Polipropylene group, fixed with 4.0 polypropylene suture. The skin suture was performed with 4.0 nylon continuous stitches. After 90 days, animals were sacrificed and submitted to macroscopic evaluation for the presence of hernias. Histologic samples were stained for Hematoxylin-Eosine and Sirius-Red and were assessed for signs of cicatrization such as chronic inflammatory reaction, fibrosis, suture absortion and percentage of fibrosis by computer-assisted video morfometric technic. RESULTS: There was no significant difference between the groups studied in relation to hernia formation (p=0,194. The histologic study showed significant increase of fibrotic reaction in the polipropylene group (p=0,0005, but this finding was not confirmed in the video-morfometric evaluation. Considering chronic inflammatory reaction, there was no difference between groups in relation to giant cells, lymphocytes and neutrophils. However, in the polipropylene group, macrophages were significantly increased (p=0,02. Polyglactin 910 has not been absorved 90 days after the procedure. CONCLUSIONS: The results of this study suggest that the fixation of polipropilene mesh is effective using absorbable sutures in the repair of ventral (incisional hernias.

  3. Small Bowel Obstruction Secondary to Femoral Hernia; Case Report and Review of the Literature

    Akrami, Majid; Karami, MohamamdYasin; Zangouri, Vahid; Deilami, Iman; Maalhagh, Mehrnoush

    2016-01-01

    Femoral hernias account for 2% to 4% of groin hernias, are more common in women, and are more appropriate to present with strangulation and require emergency surgery.This condition may lead to symptoms of bowel obstruction or strangulation and possible bowel resection-anastomosis. To the best of our knowledge, there is few reports of strangulated femoral hernia.We herein present an 82-year-old lady who presented with a 5-day history of abdominal pain, nausea and vomiting. On examination, the patient had a generalized tenderness and distention. The working diagnosis at this time was a bowel obstruction. A computed tomography scan revealed the hernia occurring medial to the femoral vessels and below the inguinal ligament .Laparotomy was performed and patient was treated successfully with surgical therapy.Herniawas repaired and a small bowel resection was performed with end to end anastomosis. The postoperative course was uneventful, and the patient was doing well at a 12-month follow-up visit. Obstructing femoral hernia of the small bowel is rare and the physician should suspect femoral hernia as a bowel obstruction cause. PMID:27162928

  4. Tailored approach in inguinal hernia repair – Decision tree based on the guidelines

    FerdinandKöckerling

    2014-06-01

    Full Text Available The endoscopic procedures TEP and TAPP and the open techniques Lichtenstein, Plug and Patch and PHS currently represent the gold standard in inguinal hernia repair recommended in the guidelines of the European Hernia Society, the International Endohernia Society and the European Association of Endoscopic Surgery. 82 % of experienced hernia surgeons use the "tailored approach", the differentiated use of the several inguinal hernia repair techniques depending on the findings of the patient, trying to minimize the risks. The following differential therapeutic situations must be distinguished in inguinal hernia repair: unilateral in men, unilateral in women, bilateral, scrotal, after previous pelvic and lower abdominal surgery, no general anaesthesia possible, recurrence and emergency surgery. Evidence-based guidelines and consensus conferences of experts give recommendations for the best approach in the individual situation of a patient. This review tries to summarized the recommendations of the various guidelines and to transfer them into a practical dicision tree for the daily work of surgeons performing inguinal hernia repair.

  5. Gastric dilatation and volvulus in a brachycephalic dog with hiatal hernia.

    Aslanian, M E; Sharp, C R; Garneau, M S

    2014-10-01

    A brachycephalic dog was presented with an acute onset of retching and abdominal discomfort. The dog had a chronic history of stertor and exercise intolerance suggestive of brachycephalic airway obstructive syndrome. Radiographs were consistent with a Type II hiatal hernia. The dog was referred and within hours of admission became acutely painful and developed tympanic abdominal distension. A right lateral abdominal radiograph confirmed gastric dilatation and volvulus with herniation of the pylorus through the hiatus. An emergency exploratory coeliotomy was performed, during which the stomach was derotated, and an incisional gastropexy, herniorrhaphy and splenectomy were performed. A staphylectomy was performed immediately following the exploratory coeliotomy. The dog recovered uneventfully. Gastric dilatation and volvulus is a potentially life-threatening complication that can occur in dogs with Type II hiatal hernia and should be considered a surgical emergency. PMID:24871205

  6. Abdominal Assessment.

    Fritz, Deborah; Weilitz, Pamela Becker

    2016-03-01

    Abdominal pain is one of the most common complaints by patients, and assessment of abdominal pain and associated symptoms can be challenging for home healthcare providers. Reasons for abdominal pain are related to inflammation, organ distention, and ischemia. The history and physical examination are important to narrow the source of acute or chronic problems, identify immediate interventions, and when necessary, facilitate emergency department care. PMID:26925941

  7. [Differential diagnosis of abdominal pain].

    Frei, Pascal

    2015-09-01

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain. PMID:26331201

  8. Intestinal Perforation in Obstructed Umbilical Hernia due to Wedged Plum Seed

    Mujalde, Vikram Singh; Gupta, Shilpi; Gupta, Pradeep Kumar; Bhandari, Anu; Mathur, Praveen

    2016-01-01

    The foreign body ingestion is a rare cause of gastrointestinal perforation in children and is typically seen with sharp foreign bodies or button batteries. Herein, we report an 11-month old male baby who presented with obstructed umbilical hernia. Abdominal radiograph showed dilated small bowel loops, while ultrasonography and CT scan suggested presence of a foreign body. Laparotomy revealed obstructed umbilical hernia with a plum seed being stuck in the terminal ileum causing intestinal perforation. Resection and anastomosis of intestine was performed. PMID:27398326

  9. Case-based discussion: an unusual manifestation of diaphragmatic hernia mimicking pneumothorax in an adult male.

    Vyas, Pradeep Kumar; Godbole, Chintamani; Bindroo, Susheel Kumar; Mathur, Rajiv S; Akula, Bharathi; Doctor, Nilesh

    2016-12-01

    Diaphragmatic hernia is an important cause of emergency hospital admission associated with significant morbidity. It usually results from congenital defect or rupture in the diaphragm due to trauma. Prompt and appropriate diagnosis is necessary in patients with this condition, as surgical intervention by either abdominal or thoracic approach may be necessary. Here, we report a case of left-sided diaphragmatic hernia presenting with sudden onset of breathlessness, respiratory distress and left-sided chest pain radiating to the abdomen, mimicking pneumothorax, treated successfully with surgical intervention. PMID:26924754

  10. Metachronous contralateral pediatric inguinal hernia

    Mahomed, Anies

    2010-01-01

    RM Nataraja, AA MahomedDepartment of Pediatric Surgery and Urology, Royal Alexandra Children’s Hospital, Brighton, UKDate of preparation: April 20, 2010. Conflict of interest: None declaredClinical question: Should routine contralateral inguinal region exploration be done to prevent a metachronous contralateral pediatric inguinal hernia?Results: The incidence of a metachronous contralateral pediatric inguinal hernia is 6.4% in both genders. Sixteen contralateral groin explorations n...

  11. An Umbilical/Paraumbilical Hernia as a Sign of an Intraabdominal Malignancy in the Elderly

    Kenig Jakub

    2014-04-01

    Full Text Available The umbilical area can present with a variety of signs associated with an intra abdominal malignancy. An umbilical/paraumbilical hernia might itself be a sign of an internal malignancy. The correlation between the presence of an umbilical/paraumbilical hernia and an intra abdominal malignancy has been previously based only on case reports. The aim of the study was to evaluate the significance of an umbilical/paraumbilical hernia as a symptom of an intraabdominal malignancy. Material and methods. A retrospective analysis was performed; review of the medical records of 145 patients (113 female and 32 male; mean age 66.4±11.9 with an umbilical/paraumbilical hernia treated during the period of 2005-2013. Twenty-three patients (15.9% were diagnosed with an intra abdominal malignancy; 34% were in the age group over 75 years of age. Results. The most common malignancies were: colorectal cancer, followed by pancreatic cancer, and cancers of the adnexa and kidneys. The patients with a concomitant malignancy identified were significantly older than those without a malignancy. In 65% of patients, the diagnosis was made postoperatively. Logistic regression analysis demonstrated that age, the presence of preoperative symptoms, anemia, and weight loss were independent risk factors for concomitant abdominal cancer. Conclusion. The findings of this study support intensive preoperative diagnostic evaluation of elderly patients that are qualified for surgery for an umbilical/paraumbilical hernia. This is particularly important because most of these patients had a small/medium hernia orifice, which did not allow for accurate manual abdominal exploration. Currently, the routine preoperative diagnostic evaluation is often insufficient for an accurate diagnosis

  12. [Left internal paraduodenal hernia: a case in a young adult].

    Maillet, B; Le Treut, Y P; Boutboul, R; Devred, P; Maurin, B; Bricot, R

    1984-12-01

    The authors report the case of a left paraduodenal hernia which involved almost the entire small intestine in a 15 year old girl who presented with recurrence episodes of acute abdominal pain associated with König's syndrome. Radiologic examination (plain film of the abdomen and upper GI series with small bowel follow-through) was suspicious, but did not establish the diagnosis due to unfamiliarity with the radiologic appearance of the condition. The roentgenograms are shown as well as the intraoperative findings. Anatomic, pathophysiologic, clinical, and radiologic characteristics are reviewed. PMID:6532308

  13. LAPAROSCOPIC TRANSABDOMINAL PRE-PERITONEAL (TAPP PROCEDURE FOR GROIN HERNIA.

    R. Moldovanu

    2013-06-01

    Full Text Available The laparoscopic approach for the groin hernia repair has several advantages: decreased immediate and late postoperative pain, less numbness in inguinal aria, less mesh infection and a rapid recovery. However the good outcomes are not granted, and there are some key points to be followed for better postoperative results. The aim of this video is to highlight these TAPP (TransAbdominal Pre-Peritoneal related key points, from the operative indication, pre operative preparation and surgical procedure, until the post operative follow up.

  14. Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series

    Pavlidis Theodoros; Ballas Konstantinos; Symeonidis Nikolaos; Tsitlakidis Anastasios; Pavlidis Efstathios; Baltatzis Minas; Lalountas Miltiadis; Psarras Kyriakos; Sakantamis Athanassios

    2011-01-01

    Abstract Introduction A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia. Case presentations We retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%). A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis), presen...

  15. wall

    Irshad Kashif

    2016-01-01

    Full Text Available Maintaining indoor climatic conditions of buildings compatible with the occupant comfort by consuming minimum energy, especially in a tropical climate becomes a challenging problem for researchers. This paper aims to investigate this problem by evaluating the effect of different kind of Photovoltaic Trombe wall system (PV-TW on thermal comfort, energy consumption and CO2 emission. A detailed simulation model of a single room building integrated with PV-TW was modelled using TRNSYS software. Results show that 14-35% PMV index and 26-38% PPD index reduces as system shifted from SPV-TW to DGPV-TW as compared to normal buildings. Thermal comfort indexes (PMV and PPD lie in the recommended range of ASHARE for both DPV-TW and DGPV-TW except for the few months when RH%, solar radiation intensity and ambient temperature were high. Moreover PVTW system significantly reduces energy consumption and CO2 emission of the building and also 2-4.8 °C of temperature differences between indoor and outdoor climate of building was examined.

  16. Hiatal hernia: An unusual presentation of dyspnea

    Seied Ahmad Mirdamadi

    2010-01-01

    Full Text Available Context : Hiatal hernia is an infrequent but serious cause of dyspnea. We report a case of acute dyspnea and paroxysmal nocturnal dyspnea secondary to hiatal hernia and epicardial fat pad. Case Report : A 78-year-old woman presented with dyspnea and paroxysmal nocturnal dyspnea. Lab data and physical examination were normal. Computed tomography scan demonstrated a large hiatal hernia and epicardial fat pad. Conclusion : Although rare, hiatal hernia should be suspected in patients who develop unexplained dyspnea.

  17. Mini-mesh repair for femoral hernia

    Hakan Kulacoglu

    2014-01-01

    INTRODUCTION: Femoral hernia consists only 4% of all primary groin hernias. It is described as “the Bête Noire of Hernias” because of its nature and anatomy which is difficult to understand for the surgeons and tendency to recurrence. Although there is some large series of femoral hernia in the literature, few studies prospectively comparing repair techniques especially for this type of hernia has been published. A new technique named mini-mesh repair is described here. PRESENTATION OF CAS...

  18. Nationwide Prevalence of Groin Hernia Repair

    Burcharth, Jakob; Pedersen, Michael; Bisgaard, Thue; Pedersen, Carsten; Rosenberg, Jacob

    2013-01-01

    Introduction Groin hernia repair is a commonly performed surgical procedure in the western world but large-scaled epidemiologic data are sparse. Large-scale data on the occurrence of groin hernia repair may provide further understanding to the pathophysiology of groin hernia development. This study was undertaken to investigate the age and gender dependent prevalence of groin hernia repair. Methods In a nationwide register-based study, using data from the Civil Registration System covering al...

  19. Current Trends in Laparoscopic Ventral Hernia Repair

    Misiakos, Evangelos P.; Patapis, Paul; Zavras, Nick; Tzanetis, Panagiotis; Machairas, Anastasios

    2015-01-01

    Background and Objectives: The purpose of this study was to analyze the surgical technique, postoperative complications, and possible recurrence after laparoscopic ventral hernia repair (LVHR) in comparison with open ventral hernia repair (OVHR), based on the international literature. Database: A Medline search of the current English literature was performed using the terms laparoscopic ventral hernia repair and incisional hernia repair. Conclusions: LVHR is a safe alternative to the open met...

  20. Influence of metoclopramide on abdominal wall healing in rats subjected to colonic anastomosis in the presence of peritoneal sepsis induced Influência da metoclopramida na cicatrização da parede abdominal de ratos submetidos à anastomose colônica na vigência de sepse peritonial induzida

    Naiara Galvão da Silva

    2011-01-01

    Full Text Available PURPOSE: To evaluate the effects of metoclopramide on abdominal wall healing in rats in the presence of sepsis. METHODS: 40 rats divided into two groups of twenty animals, subdivided into two subgroups of 10 animals each: group (E - treated with metoclopramide, and saline-treated control group. The two groups were divided into subgroups of 10 to be killed on the 3rd day (n = 10 or day 7 (n = 10 after surgery. Sepsis was induced by cecal ligation and puncture. We performed also the section and anastomosis in left colon. The synthesis of the abdominal wall was made with 3-0 silk thread. We measured the breaking strength of the abdominal wall and made the histopathological evaluation. RESULTS: on 3rd day postoperative, the average breaking strength in the E group was 0.83 ± 0.66 and in group C was 0.35 ± 0.46 (p = 0.010. On the seventh day, the breaking strength in group E was11.44 ± 5.07, in group C 11.66 ± 7.38 (p = 1.000. The E7 group showed lower inflammatory infiltration, foreign body reaction, fibrin than control. CONCLUSION: animals treated with metoclopramide had a higher resistance of the abdominal wall on the 3rd postoperative day.OBJETIVO: Avaliar os efeitos da metoclopramide na cicatrização da parede abdominal de ratos na vigência de sepse. METHODS: 40 ratos divididos em dois grupos de 20 animais, subdivididos em dois subgrupos de 10 animais cada: grupo (E - tratado com metoclopramida, e o grupo controle tratado com solução fisiologica. Os dois grupos foram divididos em subgrupos de de 10 para serem mortos no dia 3 (n = 10 ou o dia 7 (n = 10 após a cirurgia. A sepse foi induzida por ligadura e perfuração cecal. Foi realizada também a secção e anastomose em cólon esquerdo. A síntese da parede abdominal foi feita com fio de seda 3-0. Mediu-se a força de ruptura da parede abdominal e foi feita uma avaliação histopatológica. RESULTADOS: No dia 3 pós-operatório, a força média de ruptura no grupo E foi de 0,83 ± 0

  1. Increased nuchal translucency and diaphragmatic hernia. A case report.

    Daniilidis, A; Balaouras, D; Psarra, N; Chitzios, D; Tzafettas, M; Balaouras, G; Vrachnis, N

    2015-01-01

    Increased nuchal translucency (NT) thickness is present in 40% of fetuses with diaphragmatic hernia, including 80% of those that result in neonatal death and in 20% of the survivors. A 33-year-old nulliparous woman had first trimester scan at 12 weeks. The fetus had a NT of 2.3 mm, normal ductus venosus (DV), and tricuspid doppler and present nasal bone. Pregnancy-associated plasma protein A (PAPP-A) was 0.59 MoM and beta-human chorionic gonadotropin (b-hCG) 2.56 MoM. The couple did not opt for chorionic villous sampling (CVS) and repeat ultrasound examination was advised. At 18 weeks, ultrasound revealed left sided diaphragmatic hernia. The couple consented for termination of the pregnancy. The molecular test showed normal karyotype and male gender. In such cases with intrathoracic herniation of abdominal viscera, the increased NT may be the consequence of venous congestion due to mediastinal compression. The prolonged compression of the lungs causes pulmonary hypoplasia. Increased NT with normal fetal karyotype is associated with structural fetal anomalies like diaphragmatic hernia and screening at 16-18 weeks is imperative. PMID:26054128

  2. Type IV hiatal hernia post laparoscopic Nissen fundoplication: report of a case.

    Awad, Z T

    2001-01-01

    A postoperative hiatal hernia is a rare but serious complication of fundoplication. We report herein a 62-year-old female who presented with abdominal pain and vomiting 2 years following laparoscopic Nissen fundoplication. At laparotomy, the stomach and the transverse colon were intrathoracic (type IV hiatal hernia); the esophageal hiatus was markedly dilated with no evidence that they had been approximated. At 18 months follow-up, she is doing very well apart from occasional heartburn. A high index of suspicion is needed to diagnose postoperative hiatal hernias. A routine closure of the crura with nonabsorbable suture material and an avoidance of iatrogenic pneumothorax may help to reduce the occurrence of this problem.

  3. A case of ultrasound diagnosis of fetal hiatal hernia in late third trimester of pregnancy.

    Di Francesco, Stefania; Lanna, Mariano Matteo; Napolitano, Marcello; Maestri, Luciano; Faiola, Stefano; Rustico, Mariangela; Ferrazzi, Enrico

    2015-01-01

    Congenital hiatal hernia is a condition characterized by herniation of the abdominal organs, most commonly the stomach, through a physiological but overlax esophageal hiatus into the thoracic cavity. Prenatal diagnosis of this anomaly is unusual and only eight cases have been reported in the literature. In this paper we describe a case of congenital hiatal hernia that was suspected at ultrasound at 39 weeks' gestation, on the basis of a cystic mass in the posterior mediastinum, juxtaposed to the vertebral body. Postnatal upper gastrointestinal tract series confirmed the prenatal diagnosis. Postnatal management was planned with no urgency. Hiatal hernia is not commonly considered in the differential diagnosis of fetal cystic chest anomalies. This rare case documents the importance of prenatal diagnosis of this anomaly for prenatal counseling and postnatal management. PMID:25984374

  4. Laparoscopic intraperitoneal mesh fixation with fibrin sealant of a Spigelian hernia

    Huber, Nadine; Paschke, Stephan; Henne-Bruns, Doris; Brockschmidt, Claas

    2013-01-01

    Spigelian hernia is a rare clinical entity and has a subtle clinical presentation with vague abdominal pain, which can cause an important delay in diagnosis. Given the relatively high risk of incarceration the diagnosis of Spigelian hernia is an indication for surgical repair. Laparoscopic Spigelian mesh herniorraphy has gained recognition as an effective tension-free method and is associated with lower recurrence. Appropriate fixation techniques are however required to reduce complications such as nerve irritation, hematoma, and postoperative chronic pain. In this case report we describe a novel approach in laparoscopic mesh repair of Spigelian hernia, securing a lightweight composite mesh with fibrin sealant. This fixation seems to be a reasonable, feasible alternative to the standard tissue-penetrating mesh fixation. PMID:26504700

  5. Laparoscopic intraperitoneal mesh fixation with fibrin sealant of a Spigelian hernia

    Huber, Nadine

    2013-08-01

    Full Text Available Spigelian hernia is a rare clinical entity and has a subtle clinical presentation with vague abdominal pain, which can cause an important delay in diagnosis. Given the relatively high risk of incarceration the diagnosis of Spigelian hernia is an indication for surgical repair. Laparoscopic Spigelian mesh herniorraphy has gained recognition as an effective tension-free method and is associated with lower recurrence. Appropriate fixation techniques are however required to reduce complications such as nerve irritation, hematoma, and postoperative chronic pain. In this case report we describe a novel approach in laparoscopic mesh repair of Spigelian hernia, securing a lightweight composite mesh with fibrin sealant. This fixation seems to be a reasonable, feasible alternative to the standard tissue-penetrating mesh fixation.

  6. Abdominal trauma

    The potential for multiple intraperitoneal and retroperitoneal organ injuries often makes accurate clinical evaluation of abdominal trauma patients difficult. Additionally, patients may be unresponsive, have unreliable abdominal physical examinations, or have concurrent serious head and cervical spine injuries which delay diagnosis of and attention to abdominal problems. In these situations radiologic abdominal imaging is often requested. To expedite patient evaluation, close cooperation between the emergency physician and the radiologist is essential. It is the clinical stability of the traumatized patient that dictates the extent of radiologic imaging. Life-threatening hypotension, positive peritoneal signs, or clear evidence of penetrating abdominal injury are indications for immediate surgery. Stable patients with signs suggesting intra-abdominal injury will benefit by further radiologic evaluation with appropriate imaging modalities. The selection of an appropriate modality in any one clinical situation depends upon many criteria including accessibility to diagnostic equipment, the sensitivity and specificity of each technique, and the expertise and preference of the attending radiologist. A suggested scheme for evaluating abdominal trauma patients is presented. Most aspects of this evaluation scheme will be discussed in depth

  7. Abdominal trauma

    Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

  8. Left posterolateral strangulated congenital diaphragmatic hernia in children: About a case at the Charles de Gaulle Paediatric Teaching Hospital in Ouagadougou (Burkina Faso

    Emile Bandré

    2015-01-01

    Full Text Available Late presentation of congenital diaphragmatic hernia is uncommon. It poses considerable diagnostic challenges when it strangulates. The authors report a case of a left posterolateral strangulated congenital diaphragmatic hernia in a 5-year-old child diagnosed at the stage of acute intestinal occlusion with intestinal necrosis and managed successfully. A strangulated congenital diaphragmatic hernia should be suspected in the case of an association of sudden-onset respiratory and digestive manifestations with no sign of trauma or specific pulmonary history. It then requires an antero posterior thoracic X-ray or, even better, a thoracic-abdominal scan to confirm the diagnosis.

  9. Pain after groin hernia repair

    Callesen, T; Bech, K; Nielsen, R;

    1998-01-01

    BACKGROUND: The purpose of the study was to provide a detailed description of postoperative pain after elective day-case open inguinal hernia repair under local anaesthesia. METHODS: This was a prospective consecutive case series study. After 500 hernia operations in 466 unselected patients aged ...... between types of surgery or hernia. CONCLUSION: Pain remained a problem despite the pre-emptive use of opioids, non-steroidal anti-inflammatory drugs and local anaesthesia, irrespective of surgical technique.......BACKGROUND: The purpose of the study was to provide a detailed description of postoperative pain after elective day-case open inguinal hernia repair under local anaesthesia. METHODS: This was a prospective consecutive case series study. After 500 hernia operations in 466 unselected patients aged 18......-90 years, pain was scored (none, light, moderate or severe) at rest, while coughing and during mobilization, daily for the first postoperative week and after 4 weeks. Pain scores were added together over the first postoperative week. RESULTS: On days 1, 6 and 28, 66, 33 and 11 per cent respectively had...

  10. Sonography in Children with Acute Abdominal Pain: 5 Years Experience in Only Children Medical Center in Khorasan

    S. A. Alamdaran

    2008-01-01

    Full Text Available Background/Objective: acute abdominal pain is one important dilemma in pediatric patients. The purpose of this paper is to present our experience about diagnostic value of sonography in children with acute abdominal pain."nPatients and Methods: During a period of 5 years (march 2002 to march 2007; we studied clinical, sonographical and surgical data of more than 5000 children with acute abdominal pain in only children medical center in khorasan at Dr. Sheikh Children hospital."nResults: Approximately in more than 90% children with acute abdominal pain, mesenteric lymphadenitis [enlarged mesenteric lymph nodes (≥4mm and/or mural thickening of the terminal ileum (≥8mm] and gastroenteritis (enlarged mesenteric lymph nodes with generalize thickened bowel wall were sonographic diagnosis. In all this patients, sonographic diagnosis was documented with clinical course and outcome, except in three that pelvic appendicitis was final surgical diagnosis. "nAppendicitis, intussusception and bowel obstruction [mainly due to inflammatory or tumoral mass] were uncommon causes. The rare sonographic diagnoses were peritonitis in 8, malrotation (abnormal mesenteric vessels position in 3, pancratitis in 3, diaphragmatic hernia with gastric volvulus (abnormal mesenteric vessels position in 2, ovarian torsion in 2, pylonephritis in 1, mechel diveticulitis in 1. Final clinical and surgical diagnosis in three patients with peritonitis diagnosis was gastroenteritis. In children with acute abdominal pain, there was normal sonography report only in few cases. "nConclusion: common and uncommon causes of acute abdominal pain in children are limited and in almost all of these patients, sonographic diagnosis is completely reliable.

  11. Hernia de Spiegel Spigelian hernia. Report of 23 cases

    JORGE LEÓN S; ALBERTO ACEVEDO E; VERÓNICA DELLEPIANE P

    2011-01-01

    La hernia de Spiegel es infrecuente. Existen en Latinoamérica pocas publicaciones sobre este tema. El objetivo de esta presentación es dar cuenta, mediante 23 casos, de algunos aspectos de su presentación. El siguiente es un estudio observacional descriptivo, que analiza una serie de pacientes intervenidos con el diagnóstico de hernia de Spiegel en nuestro centro en un período de 10 años. Los instrumentos de análisis fueron la ficha clínica, la información existente en la base de datos EpiInf...

  12. Abdominal sounds

    ... during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation. Increased ( hyperactive ) bowel sounds ...

  13. DIAGNOSTIC DILEMMA IN INGUINAL HERNIA REPAIR

    Shreyas

    2014-07-01

    Full Text Available Tumors presenting in the inguinal hernia sac are considered to be extremely rare, with the more common neoplasms metastasizing from the gastrointestinal tract, ovary and prostate. We report the case of Non-Hodgkin’s lymphoma identified in the inguinal hernia sac following hernia repair. Patient presented with obstructed inguinal hernia and was taken up for emergency surgery. Twelve previous cases of a lymphoma diagnosed during hernia repair have been described in the English literature. This case illustrates the value of routine microscopic evaluation of hernia sacs found from inguinal/femoral herniorrhaphies, as it may be the primary presentation of an asymptomatic metastatic lymphoma. Additionally, it underscores the importance of the surgeon's role in screening hernia sacs if the practice of submitting only macroscopically abnormal specimens for microscopic evaluation is adopted.

  14. Incarcerated recurrent Amyand′s hernia

    Benjamin Quartey

    2012-01-01

    Full Text Available Amyand′s hernia is a rarity and a recurrent case is extremely rare. A 71-year-old male with a previous history of right inguinal hernia repair presented to the emergency department with a 1-day history of pain in the right groin. A physical examination revealed a nonreducible right inguinal hernia. A computed tomography scan showed a 1.3-cm appendix with surrounding inflammation within a right inguinal hernia. An emergent right groin exploration revealed an incarcerated and injected non-perforated appendix and an indirect hernia. Appendectomy was performed through the groin incision, and the indirect hernia defect was repaired with a biological mesh (Flex-HD. We hereby present this unique case - the first reported case of recurrent Amyand′s hernia and a literature review of this anatomical curiosity.

  15. Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children

    Slepov, Oleksii; Kurinnyi, Sergii; Ponomarenko, Oleksii; Migur, Mikhailo

    2016-01-01

    Background: Due to scarcity of congenital diaphragmatic hearnias of Morgagni (CDHM), non-specific clinical presentation in the pediatric age group, we aimed to investigate the incidence, clinical manifestations, anatomical characteristics, and develop diagnostic algorithm and treatment of CDHM in children. Materials and Methods: The patients’ records of children with CDHM treated in our hospital during past 20 years were retrospectively reviewed for the age at diagnosis, gender, clinical findings, anatomical features, operative details and outcome. Results: Since 1995 to 2014 we observed 6 (3 boys, 3 girls) patients with CDHM, that comprise 3.2% of all congenital diaphragmatic hernia cases (n = 185). Age at diagnosis varied from 3 mo. to 10y.o. Failure to thrive was main symptom in 4 patients, followed by recurrent respiratory infections (n = 3), dyspnea (n = 3), and gastrointestinal manifestations: constipation (n = 2), abdominal pain (n = 1). Work-up consisted of plain X-ray for all (n = 6), upper GI (n = 3), barium enema (n = 2), sonography (n = 6) and CT (n = 2). Abdominal approach used in 5 patients, and thoracotomy in one. Herniated contents were: liver lobes (n = 4), transverse colon (n = 3) and greater omentum (n = 1). 5 had right-sided lesion, 1- left-sided. Defect repaired using local tissues. Post-operative course was uneventful; all patients appeared well during follow-up. Conclusion: CDHM is very uncommon anomaly, very occasionally diagnosed at the early age. Failure to thrive and recurrent respiratory infections are most frequent clinical manifestations. In suspected CDHM we advocate the following work-up: plain chest and abdominal X-ray, contrast study (upper GI series or barium enema), ultrasonographic screen and CT scan. Surgical repair via abdominal approach, using local tissues and hernia sac removal is preferred. PMID:27251653

  16. Clinical trial of doxycycline for matrix metalloproteinase-9 inhibition in patients with an abdominal aneurysm doxycycline selectively depletes aortic wall neutrophils and cytotoxic t cells

    Lindeman, J.H.N.; Abdul-Hussien, H.; Bockel, J.H. van; Wolterbeek, R.; Kleemann, R.

    2009-01-01

    Background-Doxycycline has been shown to effectively inhibit aneurysm formation in animal models of abdominal aortic aneurysm. Although this effect is ascribed to matrix metalloproteinase-9 inhibition, such an effect is unclear in human studies. We reevaluated the effect of doxycycline on aortic wal

  17. Late-onset diaphragmatic hernia after percutaneous radiofrequency ablation of hepatocellular carcinoma: a case study.

    Abe, Tomoyuki; Amano, Hironobu; Takechi, Hitomi; Fujikuni, Nobuaki; Sasada, Tatsunari; Yoshida, Makoto; Yamaki, Minoru; Nakahara, Masahiro; Noriyuki, Toshio

    2016-12-01

    Percutaneous radiofrequency ablation (RFA) is widely used as an effective treatment of liver tumors. Several reported complications associated with RFA are due to thermal damage of neighboring organs. The present report presents a case of diaphragmatic hernia associated with RFA and hepatocellular carcinoma (HCC). A 72-year-old woman with S5 and S8 HCCs was treated repeatedly with RFA and transcatheter arterial chemoembolization for 3 years. After the third course of RFA to target the recurring S5 HCC, acute abdominal pain and dyspnea suddenly occurred. Contrast-enhanced computed tomography revealed intrusion of the transverse colon through the right diaphragmatic hernia. In addition, the colon was dilated and showed changes suggestive of ischemic conditions. An emergency surgery was performed to close the hernia by using non-absorbable sutures to preserve the colon. The patient was discharged without any complications 13 days after the surgery. The first-line treatment of this disease involves surgical intervention. Diaphragmatic hernia is a rare complication of RFA. The present case suggests that patients who undergo several rounds of RFA require surveillance for diaphragmatic hernias. PMID:26976615

  18. Videolaparoscopic cholecystectomy. Analysis of the clinical and functional aspects of mechanical lifting of the abdominal wall Colecistectomia videolaparoscópica. Análise de aspectos clínicos e funcionais da suspensão mecânica da parede abdominal

    Marco Aurelio SANTO

    2001-01-01

    Full Text Available Background - Mechanical lifting of the abdominal wall, a method based on traction and consequent elevation of the abdominal wall, is an alternative procedure to create enough intra-abdominal space necessary for videolaparoscopic surgery, dispensing the need for intraperitoneal gas insufflation. Objective - This study aims to evaluate the technical feasibilility of this procedure to carry out a videolaparoscopic cholecystectomy, while analyzing the clinical and functional aspects of this technique. Patients and Methods - In the Digestive Tract Surgery Discipline of the Medical School at the University of São Paulo, São Paulo, SP, Brazil, was created the equipment to perform videolaparoscopic surgery using this method. The equipment has two sections: an external part which consisted of a frame attached to the operating table, inside which there is a sliding steel cable, moved by a ratched which is located at the lower end of one of the frame rods; the internal rod, the support, has an "L" shape, and its horizontal branch is made up of three turning rods and which is connected to the steel cable after insertion into the abdominal cavity. Ten patients underwent videolaparoscopic cholecystectomy using this equipment. The time taken to install the equipment, the operating area characteristics, the interference from the lifting equipment on surgical movements and on the intra-operative cholangiography, the measurements made of the force used during traction and extension of the abdominal wall elevation, and the medication required for post-operative analgesia were all evaluated. Results - There were no intra-operative complications, and in none of the cases was it found necessary to convert to open surgery. We considered the insertion a safe and uncomplicated procedure, and the traction system efficient. Apart from the elevation of the abdominal wall, the distribution of the viscera inside the abdominal cavity is fundamental for the operating area

  19. Laparoscopic repair of a rare acquired abdominal intercostal hernia

    Dilip Dan

    2014-01-01

    CONCLUSION: Although AIH is a rare condition, the pathophysiology seems relatively straightforward and the use of CT scan is recommended to confirm the diagnosis. The laparoscopic approach, with all its established benefits, appears to be a safe and feasible option in its management.

  20. High Level Lomber Disc Hernias

    Ateş, Özkan; Tarım, Özcan; Koçak, Ayhan; Önal, S. Çağatay; Çaylı, Süleyman R.; Şahinbeyoğlu, Baran; Tektaş, Şevket

    2002-01-01

    Aim: The scope of this study is to investigate the correlation between the clinical and radiological findings of high level lomber disc hernia (L1-2, L2-3, L3-4) and surgical outcome. Material and Method: 23 high level lomber disc hernia out of 262 lomber disc cases operated between January1996 and November 2001 at the department of Neurosurgery , Faculty of Medicine, İnönü Üniversity (Malatya Turkey) were retrospectively reviewed. Results: 39.1% of the cases were male and...