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Sample records for abdominal wall wound

  1. 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.

  2. 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...

  3. 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.

  4. 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 

  5. 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

  6. 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

  7. Intraperitoneal wound in abdominal surgery

    Kahokehr, Arman Adam

    2013-01-01

    The intraperitoneal wound is often forgotten after transperitoneal surgery. This review is a on the peritoneum and the implications of peritoneal injury after surgery. This review will focus on the intraperitoneal wound response after surgical injury.

  8. 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

  9. 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...

  10. 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.

  11. 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

  12. 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...

  13. 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 ...

  14. [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

  15. 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. ...

  16. 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.

  17. 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)

  18. 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

  19. 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 ...

  20. 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, ...

  1. 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 

  2. 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...

  3. 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

  4. 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.

  5. 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...

  6. Analysis of abdominal wounds made by surgical trocars using functional luminal imaging probe (FLIP) technology.

    McMahon, Barry P; O'Donovan, Deidre; Liao, Donghua; Zhao, Jingbo; Schiretz, Rich; Heninrich, Russell; Gregersen, Hans

    2008-09-01

    The aim was to use a novel functional luminal imaging probe for evaluation of wound defects and tissue damage resulting from the use of trocars. Following general anesthesia of 4 adult pigs, 6 different trocars were randomly inserted at preselected locations in the porcine abdominal wall. The functional luminal imaging probe was used to profile the trocar holes during bag distension from 8 axial cross-sectional area measurements. The cross-sectional areas and pressure in the bag were recorded and exported to Matlab for analysis and data display. Geometric profiles were generated, and the minimum cross-sectional area and hole length (abdominal wall thickness) were used as endpoints. Successful distensions were made in all cases. The slope of the contours increased away from the narrowest point of the hole. The slope increased more rapidly toward the inner abdominal wall than toward the outer wall. The slope of the linear trend lines for the cross-sectional area-pressure relation represents the compliance at the narrowest point in the wall. The hole length (abdominal wall thickness) could be obtained at different cross-sectional area cutoff points. A cutoff point of 300 mm(2) gave good results when compared to the length of the hole measured after the tissue was excised. This technique represents a new and straightforward way to evaluate the effects of trocars on the abdominal wall. It may also prove useful in comparing techniques and technology from different manufacturers. PMID:18757380

  7. 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...

  8. Application of negative pressure wound therapy in patients with wound dehiscence after abdominal open surgery: a single center experience

    Jang, Ji Young; Shim, Hongjin; Lee, Yun Jin; Lee, Seung Hwan; Lee, Jae Gil

    2013-01-01

    Purpose Since the 1990's, negative pressure wound therapy (NPWT) has been used to treat soft tissue defects, burn wounds, and to achieve skin graft fixation. In the field of abdominal surgery, the application of NPWT is increasing in cases with an open abdominal wound requiring temporary wound closure and a second look operation. In the present study, the authors analyzed patients that underwent NPWT for postoperative wound dehiscence. Methods The computerized records of patients that had und...

  9. 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

  10. 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.

  11. 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...

  12. 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.

  13. 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.

  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. 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.)

  16. 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...

  17. [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

  18. 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

  19. 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...

  20. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... because you don't want to leave epithelial cells to create a cyst underneath there. I've ... our wound healing and will not kill the cells necessary for wound healing but will decrease your ...

  1. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... a low percentage of betadine irrigation will not affect our wound healing and will not kill the ... terms of the muscle, but that will not affect our repair. I think we have good tissue ...

  2. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... the bottom of the umbilicus sitting at the base of the wound, kind of the bottom of ... right here. Okay. Hold it right there to give the Kocher? 00:36:17 DIMITRI KOUMANIS, MD: ...

  3. 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.

  4. 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...

  5. 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.

  6. 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 ...

  7. 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.

  8. 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

  9. 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)

  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 r...

  11. 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

  12. 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...

  13. [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

  14. 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...

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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)

  1. 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.

  2. 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

  3. 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%.

  4. Comparison of primary and delayed primary closure in dirty abdominal wounds in terms of frequency of surgical site infection

    Objective: Objective of this study was to compare primary and delayed primary wound closure for dirty abdominal wounds in terms of frequency of surgical site infection. Study Design: Randomized Controlled Trial. Place and Duration of Study: Combined Military Hospital, Multan. From 16 Sep 2010 to 15 Mar 2011. Patients and Methods: A total of 110 patients were randomly divided into two groups of 55 patients each using random numbers table. Abdominal wounds of one group were closed primarily and of other group were subjected to delayed primary wound closure. The wounds were then checked for surgical site infection for seven post operative days. Results: A higher frequency of surgical site infection was observed in primary closure group (27.3%) as compared to delayed primary closure group (9.1%) which was statistically significant (p=0.013). Conclusion: Delayed primary closure is superior to primary closure in dirty abdominal wounds in terms of frequency of surgical site infection. (author)

  5. 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.

  6. 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.

  7. Outcome of primary closure of abdominal wounds following typhoid perforation in children in Ile-Ife, Nigeria

    Usang U

    2009-01-01

    Full Text Available Background: Abdominal wounds following surgery for typhoid perforation are classified as dirty, with an infection rate of over 40%. To date, the optimal method for closure of these wounds remains controversial. Delayed primary closure which was conventionally recommended as standard practice, is now considered to be of no value in preventing surgical site infection (SSI. This study evaluates the outcome of primary closure of this class of wounds in children in Ile-Ife, Nigeria, and advocates a multidisciplinary wound management protocol. Patients and Methods: This is a retrospective study of children aged < 1-15 years who had had surgery for typhoid perforation in a teaching hospital in south western Nigeria, over a period of ten years. Results: Thirty-two patients, 18 males and 14 females, in the ratio of 1.3:1 were managed for typhoid perforation during the ten year period. All 32 patients had primary closure of their abdominal wounds. There was primary wound healing in six (18.8% patients, while 19 (59.4% patients had surgical site infections. Wound dehiscence, intraabdominal abscess, and faecal fistulas were the other complications documented in the study. Conclusion: Abdominal wounds of typhoid perforation, though classified as being dirty, can be closed primarily with good healing outcomes. A multidisciplinary approach to wound management will reduce the incidence of wound sepsis and its associated morbidity and costs.

  8. 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.)

  9. 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.)

  10. 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

  11. Prevention of abdominal wound infection (PROUD trial, DRKS00000390: study protocol for a randomized controlled trial

    Heger Ulrike

    2011-11-01

    Full Text Available Abstract Background Wound infection affects a considerable portion of patients after abdominal operations, increasing health care costs and postoperative morbidity and affecting quality of life. Antibacterial coating has been suggested as an effective measure to decrease postoperative wound infections after laparotomies. The INLINE metaanalysis has recently shown the superiority of a slowly absorbable continuous suture for abdominal closure; with PDS plus® such a suture has now been made available with triclosan antibacterial coating. Methods/Design The PROUD trial is designed as a randomised, controlled, observer, surgeon and patient blinded multicenter superiority trial with two parallel groups and a primary endpoint of wound infection during 30 days after surgery. The intervention group will receive triclosan coated polydioxanone sutures, whereas the control group will receive the standard polydioxanone sutures; abdominal closure will otherwise be standardized in both groups. Statistical analysis is based on intention-to-treat population via binary logistic regression analysis, the total sample size of n = 750 is sufficient to ensure alpha = 5% and power = 80%, an interim analysis will be carried out after data of 375 patients are available. Discussion The PROUD trial will yield robust data to determine the effectiveness of antibacterial coating in one of the standard sutures for abdominal closure and potentially lead to amendment of current guidelines. The exploration of clinically objective parameters as well as quality of life holds immediate relevance for clinical management and the pragmatic trial design ensures high external validity. Trial Registration The trial protocol has been registered with the German Clinical Trials Register (DRKS00000390.

  12. 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.

  13. 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

  14. Paravertebral and Brachial plexus block for Abdominal flap to cover the upper limb wound

    Narendra kumar; Neelam Dogra

    2011-01-01

    We present a case report where thoracic paravertebral block and brachial plexus block were used in a sick elderly patient with poor cardiopulmonary reserve, to cover a post traumatic raw area of the upper limb by raising flap from lateral abdominal wall. The residual raw area of abdomen was then covered with the split skin graft taken from thigh.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. [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

  20. [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

  1. 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.)

  2. 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.

  3. 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...

  4. 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.

  5. 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.

  6. 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.)

  7. 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.)

  8. 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.

  9. [Should routine exploratory laparotomy be performed in the presence of an abdominal wound? Discussion apropos of 176 cases].

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

    1992-10-01

    Management of abdominal wounds is presently the subject of discussion between the partisans of routine laparotomy and those preferring "armed" surveillance. Results of study of a series of 176 abdominal wounds subjected to surgical dogma showed: that the diagnosis of non penetrating wounds (17.6%) was not always evident, due either to their anatomical localization (frontier region wounds) or to insufficient local exploration in urgent cases (6.6% of false-negatives), that the existence of serious clinical signs (50 cases) was always associated with one or more visceral lesions, requiring urgent laparotomy with a morbidity of 20% and a mortality of 8% (4 cases), that in the case of asymptomatic penetrating wounds (96 cases), routine laparotomy did nevertheless allow the diagnosis of visceral lesions in 50 cases (including 23 major lesions) but was of no utility in 46 cases (31.5% of blind laparotomies for the total series). The elevated proportion of useless laparotomies (30% in the literature), the result of a dogmatic attitude, or the risk of a delayed intervention (5 to 8%) in the series practising the selective method, led to a modification in the authors' attitude. The existence of serious signs should obviously result in a laparotomy. In their absence, and when confronted with a penetrating or doubtful (frontier region) wound, an exploratory celioscopy is proposed to ensure complete abdominal exploration, to confirm the presence or absence of penetration, to treat minimal lesions and to perform a classical laparotomy in case of evident necessity. PMID:1294583

  10. 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....

  11. 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.

  12. 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...

  13. 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...

  14. 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.

  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. 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

  17. Postoperative abdominal wound infection – epidemiology, risk factors, identification, and management

    Azoury SC

    2015-09-01

    Full Text Available Saïd C Azoury,1 Norma Elizabeth Farrow,2 Qing L Hu,2 Kevin C Soares,1 Caitlin W Hicks,1 Faris Azar,1 Nelson Rodriguez-Unda,3 Katherine E Poruk,1 Peter Cornell,1 Karen K Burce,1 Carisa M Cooney,3 Hien T Nguyen,1 Frederic E Eckhauser1 1Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; 2School of Medicine, Johns Hopkins University, Baltimore, MD, USA; 3Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA Abstract: Surgical site infections (SSIs complicate the postoperative course of a significant proportion of general abdominal surgical patients and are associated with excessive health care costs. SSIs increase postoperative morbidity and mortality, and may require hospital admission, intravenous antibiotics, and even surgical reintervention. Risks associated with SSIs are related to both host and perioperative factors. However, a vast majority of these infections are preventable. More recently, quality initiative programs such as American College of Surgeons National Surgical Quality Improvement Program are expanding their roles to help better monitor adherence to improvement measures. Indeed, standardizing preoperative antibiotic prophylaxis timing is perhaps the most persuasive example and this has been integral to reducing postoperative SSI rates. Herein, the authors provide an update on the epidemiology, risk factors, identification, and management of wound infections following abdominal surgery. Keywords: surgical site infection, diagnosis, treatment, prevention

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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...

  4. 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...

  5. 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 ...

  6. 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.

  7. 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

  8. Angiography as an index of healing in experimental laparotomy wounds and colonic anastomoses.

    Leaper, D. J.

    1983-01-01

    The vascular anatomy of healing wounds in rat abdominal wall and obstructed large bowel was examined by sequential angiography, with particular reference to the possibility of tissue necrosis following mass closure of the abdominal wall and of dehiscence after primary anastomosis in obstructed colon. In the abdominal wall, gross distortion of the vascular anatomy one to two weeks after mass closure was accompanied by a central wound zone which had an appearance suggestive of necrosis. By the ...

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

    The tensor fascia lata is a versatile flap with many uses in reconstructive plastic surgery. As a pedicled flap its reach to the lower abdomen and groin made it an attractive option for reconstructing soft tissue defects after tumor ablation. However, debate exists on the safe dimension of the flap, as distal tip necrosis is common. Also, the adequacy of the fascia lata as a sole substitute for abdominal wall muscles has been disputable. The aim of the current study is to report our experience and clinical observations with this flap in reconstructing those challenging defects and to discuss the possible options to minimize the latter disputable issues. Patients and Methods: From April 2001 to April 2004, 12 pedicled TFL flaps were used to reconstruct 5 central abdominal wall full thickness defects and 6 groin soft tissue defects following tumor resection. ]n one case, bilateral flaps were used to reconstruct a large central abdominal wall defect. There were 4 males and 7 females. Their age ranged from 19 to 60. From the abdominal wall defects group, all repairs were enforced primarily with a prolene mesh except for one patient who was the first in this study. Patients presenting with groin defects required coverage of exposed vessels following tumor resection. All patients in the current study underwent immediate reconstruction. The resulting soft tissue defects in this study were due to resection of 4 abdominal wall desmoid tumors, a colonic carcinoma infiltrating the abdominal wall, 4 primary groin soft developed in a flap used to cover a groin defect. In the former 3 cases, The flap was simply transposed without complete islanding of the flap. In the latter case, a very large flap was harvested beyond the safe limits with its distal edge just above the knee. In addition, wound dehiscence of the flap occurred in 2 other cases from the groin group. Nevertheless, all the wounds healed spontaneously with repeated dressings. Out of the 5 cases that underwent

  10. 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...

  11. 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...

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. [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

  18. The Effect of Honey Gel on Abdominal Wound Healing in Cesarean Section: A Triple Blind Randomized Clinical Trial

    Maryam Nikpour

    2014-07-01

    Full Text Available Objective: To assess whether honey can accelerate the wound healing in women undergoing cesarean section. Methods: This was a triple blinded randomized prospective clinical trial. Women with cesarean section were randomly designated as drug (37 cases and placebo (38 cases groups. The drug group received local honey gel 25% while the placebo group received similar free-honey gel on abdominal cesarean incision twice a day for 14 days. REEDA scale (Redness, Edema, Ecchymosis, Discharge and Approximation of wound edges was used to assess wound healing. Results: The mean REEDA was 2.27 ± 2.46 and 3.91 ± 2.74 (p=0.008 on the 7th day and 0.47 ± 0.84 and 1.59± 1.95 (p=0.002 on the 14th day for the drug and placebo groups, respectively. Redness, edema and hematoma in the drug group were significantly lower on the 7th and 14th days. Conclusion: Honey was effective in healing the cesarean section incision. Using topical honey is suggested as a natural product with rare side effects in order to reduce the complications of cesarean wounds.

  19. 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.

  20. 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

  1. 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.)

  2. 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

  3. 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...

  4. 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...

  5. 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...

  6. 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.

  7. 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...

  8. 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.

  9. 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

  10. 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

  11. [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

  12. 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.

  13. 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

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

    Fortunato Jayme Athias

    1998-04-01

    Full Text Available Os autores apresentam um estudo retrospectivo de 79 pacientes portadores de distrofias abdominais acompanhadas ou não de hérnias, operados no período compreendido entre 01/06/94 a 31/12/96. A idade média foi de 46 anos. A hérnia incisional isoladamente e o abdome distrófico (em avental foram o principal objetivo do estudo. Enfatizam a importância da dermolipectomia abdominal para a completa recuperação do paciente bem como demonstram facilitar o manuseio técnico das hérnias. A técnica da transposição peritônio-aponeurótica longitudinal bilateral (técnica de Lázaro da Silva foi utilizada para as grandes hérnias incisionais. É uma técnica já consagrada, que consta de três planos de suturas sem superposição dos mesmos. Sua recidiva em cinco anos de seguimento tem sido em tomo de 5% segundo estudos do próprio autor. A grande vantagem técnica é que, usando o saco herniário (quanto maior e mais espesso, melhor como fechamento e reforço do anel, evita-se o uso de prótese com todos os inconvenientes da mesma (fístulas, rejeições etc. Uma variante desta técnica, para as hérnias com anel herniário de até 10cm, é proposta pelos autores, e consiste no fechamento do anel e reforço da sutura com o saco herniário, em jaquetão. A vantagem seria a facilidade de execução e diminuição do tempo operatório, além de evitar dissecções extensas das camadas aponeuróticas. Quando o anel herniário alcançar 10cm e existir ligeira tensão, deve-se realizar incisão relaxadora na aponeurose anterior dos retos e recobrir a superfície cruenta com o próprio saco herniário que deverá estar íntegro. Esta técnica ainda requer maior observação clínica. É feita a revisão dos resultados dos procedimentos realizados isoladamente e acompanhados com dermolipectomia abdominal: 63 pacientes (81,66% evoluíram sem complicações, cinco recidivas (6,3%; um caso de hematoma extenso (1,26%; dois casos de abscesso de parede em

  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. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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...

  4. 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.

  5. 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.

  6. 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...

  7. 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.)

  8. 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.

  9. 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.)

  10. 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.

  11. 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...

  12. 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.

  13. 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.

  14. Wounding coordinately induces cell wall protein, cell cycle and pectin methyl esterase genes involved in tuber closing layer and wound periderm development.

    Neubauer, Jonathan D; Lulai, Edward C; Thompson, Asunta L; Suttle, Jeffrey C; Bolton, Melvin D

    2012-04-15

    Little is known about the coordinate induction of genes that may be involved in agriculturally important wound-healing events. In this study, wound-healing events were determined together with wound-induced expression profiles of selected cell cycle, cell wall protein, and pectin methyl esterase genes using two diverse potato genotypes and two harvests (NDTX4271-5R and Russet Burbank tubers; 2008 and 2009 harvests). By 5 d after wounding, the closing layer and a nascent phellogen had formed. Phellogen cell divisions generated phellem layers until cessation of cell division at 28 d after wounding for both genotypes and harvests. Cell cycle genes encoding epidermal growth factor binding protein (StEBP), cyclin-dependent kinase B (StCDKB) and cyclin-dependent kinase regulatory subunit (StCKS1At) were induced by 1 d after wounding; these expressions coordinated with related phellogen formation and the induction and cessation of phellem cell formation. Genes encoding the structural cell wall proteins extensin (StExt1) and extensin-like (StExtlk) were dramatically up-regulated by 1-5 d after wounding, suggesting involvement with closing layer and later phellem cell layer formation. Wounding up-regulated pectin methyl esterase genes (StPME and StPrePME); StPME expression increased during closing layer and phellem cell formation, whereas maximum expression of StPrePME occurred at 5-14 d after wounding, implicating involvement in later modifications for closing layer and phellem cell formation. The coordinate induction and expression profile of StTLRP, a gene encoding a cell wall strengthening "tyrosine-and lysine-rich protein," suggested a role in the formation of the closing layer followed by phellem cell generation and maturation. Collectively, the genes monitored were wound-inducible and their expression profiles markedly coordinated with closing layer formation and the index for phellogen layer meristematic activity during wound periderm development; results were more

  15. 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

  16. 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

  17. 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

  18. EVALUATION OF HYPOGLYCEMIC AND WOUND HEALING ACTIVITIES OF LANTANA WIGHTIANA WALL. EX GAMBLE LEAVES

    K. Srinivas Reddy

    2011-12-01

    Full Text Available Lantana wightiana Wall, a member of Verbenaceae is an unarmed sub shrub, up to 3 m tall. The present study was aimed at evaluating the hypoglycemic and wound healing activities of Lantana wightiana. The leaves were collected, shade dried and extracted with water and ethanol-water (1:1 by maceration for 72h. The aqueous extract was used for anti diabetic activity in both normal and alloxan induced diabetic rats and hydro alcoholic extract along with leaf juice were evaluated for their wound healing activity in Excision wound model. Studies on the aqueous leaf extract of the plant L. wightiana revealed that the extract caused significant reduction in the blood glucose levels in the rats. The extract was found to produce marked reduction in blood glucose concentration between 2-4 hours of administration in alloxan induced hyperglycemic rats at tested dose levels. The studies on wound healing activity revealed that the nitrofurazone treated animals showed 95.19% healing on 14th day of study. On the other hand, the hydro alcoholic extract and leaf juice treated group showed 87.13% and 94.19% healing respectively.

  19. 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...

  20. 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.

  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. 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.

  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. 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.

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen

    Hlebowicz, Joanna; Hansson, Johan; Lindstedt, Sandra

    2011-01-01

    Purpose Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) compared with other wound therapy techniques. However, the method has occasionally been associated with increased development of intestinal fistulae. The present study measures microvascular blood flow in the intestinal wall and the omentum before and during NPWT. Methods Six pigs underwent midline incision and application of NPWT to the open abdomen. The microvascular blood flow in...

  11. 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.

  12. 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

  13. 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

  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. 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

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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...

  4. 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.

  5. A cost-effectiveness analysis of fistula treatment in the abdominal region using a new integrated fistula and wound management system

    Keiding, Hans; Skovgaard, Rasmus

    2008-01-01

    -effectiveness analysis with wear time, material costs, and labor costs taken into account. RESULTS: A longer wear time for each pouch as well as simpler handling by nurses amounted to an average lower cost of $83 per day of treatment with the FWMS. A large variation was observed in the collected data. However, the......OBJECTIVE: To evaluate wear time and costs of a new fistula and wound management system (FWMS) compared to standard fistula treatments. METHODS: Data were collected from 22 patients with an abdominal fistula recruited from 5 sites in the United States. This economic evaluation was based on a cost...

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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)

  11. 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...

  12. 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

  13. 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

  14. 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...

  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. 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

  17. Low-cost Negative-pressure Wound Therapy Using Wall Vacuum: A 15 Dollars by Day Alternative

    Chaput, Benoit; Garrido, Ignacio; Eburdery, Harold; Grolleau, Jean Louis; Chavoin, Jean Pierre

    2015-01-01

    Background: Negative-pressure wound therapy (NPWT) has been marketed for about 20 years and remains popular. The only real obstacle to NPWT is the cost; therefore, we designed an inexpensive NPWT connected to a wall vacuum. Here, we report the feasibility and safety of this product, which we call PROVACUUM (Z-Biotech, Saint-Avertin, France). Methods: As a first step, the constraints imposed on the manufacturer were equipment quality similar to that of commercial NPWT systems, with an average ...

  18. Trauma abdominal: estudo das lesões mais frequentes do sistema digestório e suas causas Abdominal trauma: study of the most frequent wounds of digestive system and its causes

    Jurandir Marcondes Ribas-Filho

    2008-12-01

    increasing, and severity is determined by injury to vital structures in the abdomen and associated injuries. AIM: To identify the causes of abdominal trauma, the most frequently injured digestive viscera, the presence of injuries in other anatomic regions and the relationship of abdominal trauma to sex and age group. METHOD: Thirty-four patients from the Sistema Único de Saúde [the public healthcare system] were selected, all diagnosed with abdominal trauma and seen from January 2005 through September 2005 at the Hospital Universitário Evangélico de Curitiba. Data collection was performed with the aid of a previously formulated protocol. RESULTS: It was found that 91% of the victims were males. The most affected age group was in its third decade of life. Regarding the classification of traumatic injuries, 58.82% presented with open trauma wounds and 41.18% with contusions. Falls accounted for 44 % of contusions, followed by traffic accidents with 35%. The most common open wounds were caused by firearms in 56% of cases and by knives in 44%. Small intestine injury occurred in 31% of the open wounds, followed by liver, colon and kidney injury, with 23% each. In contusions, 60% of the patients sustained spleen injuries. The thorax was the region most frequently associated with abdominal trauma (31%. CONCLUSION: The leading causes of abdominal trauma were gunshot wounds (penetrating trauma and falls (blunt trauma. The most frequently injured viscera in blunt trauma were the parenchymatous ones (spleen and liver, and intestines, liver and kidneys in penetrating trauma. Most patients were males, predominantly in their third decade of life.

  19. 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.

  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. 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. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot

    Christos Stefanou

    2016-01-01

    Full Text Available Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically.

  3. 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

  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

    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.

  6. Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect

    Fabio Caviggioli

    2014-01-01

    Full Text Available Reconstruction of open abdominal defects is a clinical problem which general and plastic surgeons have to address in cooperation. We report the case of a 66-year-old man who presented an abdominal dehiscence after multiple laparotomies for a sigmoid-rectal adenocarcinoma that infiltrated into the abdominal wall, subsequently complicated by peritonitis and enteric fistula. A cutaneous dehiscence and an incontinent abdominal wall resulted after the last surgery. The abdominal wall was reconstructed using a biological porcine cross-linked mesh Permacol (Covidien Inc., Norwalk, CT. Negative Pressure Wound Therapy (NPWT, instead, was used on the mesh in order to reduce wound dimensions, promote granulation tissue formation, and obtain secondary closure of cutaneous dehiscence which was finally achieved with a split-thickness skin graft. Biological mesh behaved like a scaffold for the granulation tissue that was stimulated by the negative pressure. The biological mesh was rapidly integrated in the abdominal wall restoring abdominal wall continence, while the small dehiscence, still present in the central area, was subsequently covered with a split-thickness skin graft. The combination of these different procedures led us to solve this complicated case obtaining complete wound closure after less than 2 months.

  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. 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

  9. 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

  10. 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.)

  11. 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...

  12. 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

  13. Dermatan sulfate epimerase 1 deficient mice as a model for human abdominal wall defects

    Gustafsson, Renata; Stachtea, Xanthi; Maccarana, Marco; Grottling, Emma; Eklund, Erik; Malmström, Anders; Oldberg, Åke

    2014-01-01

    Background Dermatan sulfate (DS) is a highly sulfated polysaccharide with a variety of biological functions in extracellular matrix organization and processes such as tumorigenesis and wound healing. A distinct feature of DS is the presence of iduronic acid, produced by the two enzymes, DS-epimerase 1 and 2, which are encoded by Dse and Dsel, respectively. Methods We have previously shown that Dse knockout (KO) mice in a mixed C57BL/6–129/SvJ background have an altered collagen matrix structu...

  14. 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.

  15. 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.

  16. 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 

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. Abdominal shotgun trauma: A case report

    Toutouzas, Konstantinos G; Larentzakis, Andreas; Drimousis, Panagiotis; Riga, Maria; Theodorou, Dimitrios; Katsaragakis, Stylianos

    2008-01-01

    Introduction One of the most lethal mechanisms of injury is shotgun wound and particularly the abdominal one. Case presentation We report a case of a 45 years old male suffering abdominal shotgun trauma, who survived his injuries. Conclusion The management of the abdominal shotgun wounds is mainly dependent on clinical examination and clinical judgment, while requires advanced surgical skills.

  3. 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.

  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. 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

  7. 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...

  8. 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.

  9. 芦荟汁对小鼠腹部伤口愈合情况影响的研究%What is the impact of research on Aloe juice to abdominal wound healing in mice

    漆平强; 杨莉; 郑慧凝; 张之弥; 周雪萍; 麦沥丹; 杨勇军; 孙魏巍

    2014-01-01

    目的:本课题主要研究芦荟汁对小鼠腹部伤口愈合情况影响。方法选择40只成年小鼠为研究对象并随机分为2组。分别采用0.9%生理盐水和芦荟鲜汁对两组进行涂擦小鼠伤口,观察小鼠在给药后一周伤口愈合情况。结果与对照组比较,实验组小鼠的伤口愈合情况明显好转:有效率比较(P<0.05)。结论芦荟汁对小鼠腹部伤口愈合具有促进作用。%Objective The main subject of research is to study the impact of aloe juice on mice abdominal wound healing. Meth-ods 40 adult mices for the study were randomly divided into two groups. Respectively 0.9% physiological saline and aloe vera juice rubbed on the two groups mice wounds, mices were observed after administration of one week in wound healing. Results Compared with control groups, the experimental groups were significantly improved wound healing: there are more efficient ( P<0.05). Conclusion Aloe juice has the promoting effect on abdominal wound healing in mice.

  10. Emergency treatment of acute necrotizing fasciitis of abdominal wall complicated with septic shock%急性腹壁坏死性筋膜炎合并脓毒性休克的救治

    高戈; 冯喆; 刘韬滔; 周新平

    2015-01-01

    Objective To investigate the diagnosis and treatment of acute necrotizing fasciitis complicated with septic shock and improve the level of early diagnosis and comprehensive treatment. Methods The early diagnosis,incision and drainage for early lesions,emergency treatment for septic shock,organ function supporting and delayed wound repair were reported in three cases of acute necrotizing fasciitis of abdominal wall complicated with septic shock and multiple organ dysfunction syndromes with a review of related literature.Results The three patients were welly recovered with good wound healing af-ter early diagnosis,timely incision and drainage,positive emergency treatment for septic shock,stabilization for vital signs and delayed wound repair.Conclusion The comprehensive therapy of early diagnosis,time-ly debridement and drainage,delayed wound repair,emergency treatment for septic shock and organ func-tion supporting is crucial to improve the outcome for patients of acute necrotizing fasciitis complicated with septic shock.%目的:探讨急性坏死性筋膜炎合并脓毒性休克的诊断和治疗,提高早期诊断和综合救治水平。方法报告3例急性腹壁坏死性筋膜炎合并脓毒性休克、多器官功能衰竭的早期诊断和早期病灶的切开引流、脓毒性休克的抢救和脏器功能支持、后期创面的修复和愈合,并复习国内外相关文献。结果3例诊断后及时手术切开引流、积极抢救脓毒性休克稳定生命体征、后期切口拉拢缝合、创面愈合良好,患者痊愈。结论早期明确诊断、及时切开清创引流、延期修复创面并结合积极抢救休克和脏器功能支持的综合治疗是救治急性坏死性筋膜炎合并脓毒性休克的关键。

  11. Analysis of the tensile strength on the healing of the abdominal wall of rats treated with infliximab Análise da força tênsil na cicatrização da parede abdominal de ratos tratados com infliximabe

    João Vieira Lopes

    2008-10-01

    Full Text Available PURPOSE: To evaluate the effects of infliximab, a murine/human chimeric monoclonal antibody, on the tensile strength of abdominal wall surgical wounds. METHODS: Sixty Wistar healthy male rats with initial body weight between 215 and 390 g and 60 and 90 days of age were randomly assigned into two groups, E (Experimental and C (Control with 30 animals each. Group E animals received a single subcutaneous dose of 5mg/Kg of infliximab, and Group C animals received equivalent subcutaneous volume of a solution of 0.9% NaCl. After 48h, animals from both groups were submitted to a 4 cm median incision in the abdominal wall, including all layers that had been reconstituted with continuous suture of the aponeurotic muscle and skin, with 5.0 nylon thread. Then, Group E animals were separated by simple allotment into three subgroups named E3, E7 and E14 with ten animals each, and those from group C into C3, C7, C14 and were submitted, respectively, the reoperation and euthanasia at the third, seventh and fourteenth postoperative day. The anterior abdominal wall, which was resected during reoperation, was cut with No 15 scalpel lamina perpendicularly to the surgical wound. Each specimen, in the form of a 6 cm x 2 cm strip, was fixed by the extremity so that the suture line was equidistant from the fixation points of the dynamometer, in order to undergo the tensile strength test. The dynamometer, which was gauged for each series of measures, was calibrated to apply velocity to the 25 mm/min rupture test; the rupture value was expressed in N (Newton. Prior to euthanasia, the abdominal vena cava was identified and punctured in order to collect blood for TNF-α dosage. RESULTS: The mean tensile strength found for animals from subgroups E3, E7, E14, C3, C7, C14 were, respectively, 16.03, 18.69, 27.01, 28.40, 27.22, 29.15 and 24.30 N. In the results of the multiple comparisons tests, significant differences (pOBJETIVO: Avaliar os efeitos do infliximabe, anticorpo

  12. 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 ...

  13. 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...

  14. Low-cost Negative-pressure Wound Therapy Using Wall Vacuum: A 15 Dollars by Day Alternative

    Garrido, Ignacio; Eburdery, Harold; Grolleau, Jean Louis; Chavoin, Jean Pierre

    2015-01-01

    Background: Negative-pressure wound therapy (NPWT) has been marketed for about 20 years and remains popular. The only real obstacle to NPWT is the cost; therefore, we designed an inexpensive NPWT connected to a wall vacuum. Here, we report the feasibility and safety of this product, which we call PROVACUUM (Z-Biotech, Saint-Avertin, France). Methods: As a first step, the constraints imposed on the manufacturer were equipment quality similar to that of commercial NPWT systems, with an average treatment cost of $15/d. Then, we conducted a prospective study of patients with indications for NPWT from September 2013 to January 2015. Data collected included ease of use, quality of materials, and occurrence of complications during treatment. Results: We enrolled 23 patients with a mean age of 50.8 years. The average duration of treatment was 8.5 days (range, 3–21 days). The dressings were changed every 3.3 days (range, 2–4 days). Two hematomas occurred that required surgical revision and the transfusion of 2 units after large debridement of pressure ulcer. No other adverse events or infections occurred. The surgeons found that our device was similar to commercial NPWT devices. Conclusions: We developed an inexpensive NPWT that costs an average of $15/d. Our process is not intended to replace portable or stand-alone devices with batteries, but rather offers a less expensive alternative for hospitalized patients and makes NPWT accessible to the most precarious countries and institutions. PMID:26180719

  15. 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.

  16. 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.

  17. 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.

  18. 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...

  19. 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

  20. Bacterial wall products induce downregulation of vascular endothelial growth factor receptors on endothelial cells via a CD14-dependent mechanism: implications for surgical wound healing.

    Power, C

    2012-02-03

    INTRODUCTION: Vascular endothelial growth factor (VEGF) is a potent mitogenic cytokine which has been identified as the principal polypeptide growth factor influencing endothelial cell (EC) migration and proliferation. Ordered progression of these two processes is an absolute prerequisite for initiating and maintaining the proliferative phase of wound healing. The response of ECs to circulating VEGF is determined by, and directly proportional to, the functional expression of VEGF receptors (KDR\\/Flt-1) on the EC surface membrane. Systemic sepsis and wound contamination due to bacterial infection are associated with significant retardation of the proliferative phase of wound repair. The effects of the Gram-negative bacterial wall components lipopolysaccharide (LPS) and bacterial lipoprotein (BLP) on VEGF receptor function and expression are unknown and may represent an important biological mechanism predisposing to delayed wound healing in the presence of localized or systemic sepsis. MATERIALS AND METHODS: We designed a series of in vitro experiments investigating this phenomenon and its potential implications for infective wound repair. VEGF receptor density on ECs in the presence of LPS and BLP was assessed using flow cytometry. These parameters were assessed in hypoxic conditions as well as in normoxia. The contribution of CD14 was evaluated using recombinant human (rh) CD14. EC proliferation in response to VEGF was quantified in the presence and absence of LPS and BLP. RESULTS: Flow cytometric analysis revealed that LPS and BLP have profoundly repressive effects on VEGF receptor density in normoxic and, more pertinently, hypoxic conditions. The observed downregulation of constitutive and inducible VEGF receptor expression on ECs was not due to any directly cytotoxic effect of LPS and BLP on ECs, as measured by cell viability and apoptosis assays. We identified a pivotal role for soluble\\/serum CD14, a highly specific bacterial wall product receptor, in

  1. 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.

  2. 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.)

  3. 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

  4. 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.

  5. Postoperative infection of an abdominal mesh due to methicillin resistant Staphylococcus Aureus - A case report

    Ashok R

    2004-01-01

    Full Text Available Methicillin resistant Stephylococcus aureus (MRSA infection has now become a major problem in hospitals. We present a case of postoperative infection MRSA where the primary source of the infection was found to be an abdominal mesh that was used to reinforce the abdominal wall. After one year of surgery, the patient developed wound dehiscence and discharge. MRSA was isolated from the wound, mesh, external nares, throat and axilla. Initially she was started on clindamycin and discharged from the hospital. After 5 months, patient came back to the hospital with infection at the same site. The patient was then treated with vancomycin and MRSA clearance. She responded to the treatment with complete healing of the wound and clearance of MRSA.

  6. Abdominal trauma

    Radiologic evaluation of abdominal trauma must provide a quick and accurate assessment of the lesions in order to improve the management of the patient. The technique used varies depending on the mechanism of the trauma (blunt trauma or stab wounds) and the hemodynamic status. Radiologic evaluation is usually performed in blunt trauma whereas stab wound trauma is usually explored surgically. The various techniques available are standard radiographs, ultrasonography, computed tomography and arteriography. The role of magnetic resonance imaging in the immediate evaluation is still not well defined. It appears to be useful method in the delayed evaluation of diaphragmatic trauma. Computed tomography is the method most commonly performed in trauma patients. This technique is accurate and allows correct assessment of the lesions. The disadvantages are the radiation induced and the need for a hemo-dynamically stable patient. The aim of the radiologic evaluation is to provide the clinicians with an accurate description of the lesions. It can help in the management of the patient usually in association with clinical and laboratory data. It can also guide interventional procedures (drainage, embolization...). Finally, it allows radiographic follow-up when conservative treatment is performed. (authors). 26 refs., 11 figs., 1 tab

  7. [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

  8. 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...

  9. Randomized comparison of polyglycolic acid and polyglyconate sutures for abdominal fascial closure after laparotomy in patients with suspected impaired wound healing

    Osther, P J; Gjøde, P; Mortensen, Sophie Berit Bondegaard; Mortensen, P B; Bruhn, Jesper Bartholin; Gottrup, F

    1995-01-01

    to the development of fascial disruption and incisional hernia. Wound infection demanding surgical intervention was found in 7 per cent of patients with polyglyconate sutures and in 16 per cent of those with polyglycolic acid sutures (P = 0.04). Monofilament polyglyconate suture does not reduce the...

  10. 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.