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Sample records for abdominal wall defect

  1. Fetal abdominal wall defects.

    Science.gov (United States)

    Prefumo, Federico; Izzi, Claudia

    2014-04-01

    The most common fetal abdominal wall defects are gastroschisis and omphalocele, both with a prevalence of about three in 10,000 births. Prenatal ultrasound has a high sensitivity for these abnormalities already at the time of the first-trimester nuchal scan. Major unrelated defects are associated with gastroschisis in about 10% of cases, whereas omphalocele is associated with chromosomal or genetic abnormalities in a much higher proportion of cases. Challenges in management of gastroschisis are related to the prevention of late intrauterine death, and the prediction and treatment of complex forms. With omphalocele, the main difficulty is the exclusion of associated conditions, not all diagnosed prenatally. An outline of the postnatal treatment of abdominal wall defects is given. Other rarer forms of abdominal wall defects are pentalogy of Cantrell, omphalocele, bladder exstrophy, imperforate anus, spina bifida complex, prune-belly syndrome, body stalk anomaly, and bladder and cloacal exstrophy; they deserve multidisciplinary counselling and management. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Genetics Home Reference: abdominal wall defect

    Science.gov (United States)

    ... wall defects managed in a tertiary center in Japan. J Obstet Gynaecol Res. 2009 Feb;35(1): ... Reviewed : August 2016 Published : March 6, 2018 The resources on this site should not be used as a ... Department of Health & Human Services National Institutes of Health National Library of ...

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

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    Sara Fuentes

    2016-05-01

    Full Text Available BackgroundThe 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.MethodsWe performed a chart review of five cases treated in our institution.ResultsFive 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.ConclusionsPatients 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.

  4. Nonwoven polypropylene prosthesis in large abdominal wall defects in rats.

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    Reis, Patrick dos Santos Barros dos; Chagas, Vera Lucia Antunes; Silva, Jéssica Marquet; Silva, Paulo Cesar; Jamel, Nelson; Schanaider, Alberto

    2012-10-01

    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. 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. There were no significant differences between the Groups 2 and 3. 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.

  5. A Rare Anterior Abdominal Wall Defect: Omphalocele - A Case Report

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    Sandeep Vilasrao Pakhale

    2015-01-01

    Full Text Available Two most common anterior abdominal wall defects are gastroschisis and omphalocoele or exomphalos. Gastroschisis means 'stomach cleft' which is a congenital defect of the abdominal wall, usually to the right of the umbilical cord insertion and abdominal contents herniate into the amniotic sac. Exomphalos is literally translated from the Greek, means 'outside the navel'. It is also called an Omphalocele. It is a congenital abnormality in which the contents of the abdomen herniate into the umbilical cord through the umbilical ring. Textbooks grouped them together but these are different entities. These congenital malformations have a high mortality rate. Only about 60 % of children with such type of malformations survive until the end of first year of age. A male foetus of 32 weeks gestational age was sent from Dr. Ulhas Patil Medical College and Hospital, Jalgaon (Khurd to the Department of Anatomy to examine the fetus for congenital anomalies. A case report of an Omphalocele was presented. Occurrence of such cases is very rare about 2.17 per 10000 live births as reported in literature.

  6. Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE).

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    Bauer, J J; Salky, B A; Gelernt, I M; Kreel, I

    1987-01-01

    Most abdominal wall incisional hernias can be repaired by primary closure. However, where the defect is large or there is tension on the closure, the use of a prosthetic material is indicated. Expanded polytetrafluoroethylene (PTFE) patches were used to repair incisional hernias in 28 patients between November 1983 and December 1986. Twelve of these patients (43%) had a prior failure of a primary repair. Reherniation occurred in three patients (10.7%). Wound infections developed in two patients (7.1%), both of whom had existing intestinal stomas, one with an intercurrent pelvic abscess. The prosthetic patch was removed in the patient with the abscess, but the infection was resolved in the other without sequelae. Septic complications did not occur after any operations performed in uncontaminated fields. None of the patients exhibited any undue discomfort, wound pain, erythema, or induration. Complications related to adhesions, erosion of the patch material into the viscera, bowel obstruction, or fistula formation did not occur. Based on this clinical experience, the authors believe that the PTFE patch appears to represent an advance in synthetic abdominal wall substitutes. Images Fig. 1. Fig. 2(left)., Fig. 3(right). PMID:3689012

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

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    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.

  8. Abdominal Wall Defects in Greenland 1989–2015

    DEFF Research Database (Denmark)

    Bugge, Merete; Drachmann, Gitte; Kern, Peder

    2017-01-01

    Background : In the last decades, an increasing rate of gastroschisis but not of omphalocele has been reported worldwide. Greenland is the world's largest island, but 80% is covered by an ice cap, it has a small population of around 56,000 peoples (as of 2016). The occurrence of abdominal wall de...

  9. Reconstruction of massive full-thickness abdominal wall defect

    DEFF Research Database (Denmark)

    Aydin, Dogu; Paulsen, Ida Felbo; Bentzen, Vibeke Egerup

    2016-01-01

    We demonstrate that it is possible to use a nonabsorbable mesh for abdominal wall reconstruction after total wound rupture and successfully split-skin graft directly on the mesh. Sufficient granulation tissue formation prior to skin grafting was obtained with long-term use of negative pressure...

  10. Rectus Abdominis Muscle Malignant Fibrous Histiocytoma Causing a Large Abdominal Wall Defect: Reconstruction with Biological Mesh

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    Evangelos Falidas

    2014-01-01

    Full Text Available Malignant fibrous histiocytoma (MFH is a common soft tissue sarcoma usually involving limbs and retroperitoneum. MFH of the rectus abdominis muscle is extremely rare. Surgery in similar cases leads to large abdominal wall defects needing reconstruction. Biological and synthetic laminar absorbable prostheses are available for the repair of hernia defects in the abdominal wall. They share the important feature of being gradually degraded in the host, resulting the formation of a neotissue. We herein report the case of an 84-year-old man with MFH of the rectus abdominis muscle which was resected and the large abdominal wall defect was successfully repaired with a biological mesh.

  11. Intraperitoneal microdialysis in the postoperative surveillance of infants undergoing surgery for congenital abdominal wall defect

    DEFF Research Database (Denmark)

    Risby, Kirsten; Pedersen, Mark Ellebæk; Jakobsen, Marianne S

    2015-01-01

    PURPOSE: This study aims to investigate the safety and clinical implication of intraperitoneal microdialysis (MD) in newborns operated on for congenital abdominal wall defect. PATIENTS AND METHODS: 13 infants underwent intraperitoneal microdialysis (9 with gastroschisis and 4 with omphalocele). MD...

  12. Not gastroschisis or omphalocele or anything in between: a novel congenital abdominal wall defect.

    Science.gov (United States)

    Cheung, Maija; Kakembo, Nasser; Muzira, Arlene; Sekabira, John; Ozgediz, Doruk

    2017-07-01

    Congenital abdominal wall defects occur when normal embryonic development is interrupted and most commonly results in gastroschisis or omphalocele. Other entities, such as ruptured omphalocele, vanishing gastroschisis, and patent omphalomesenteric ducts with prolapse, have also been described and can create a confusing picture. This case of a newborn with a midline abdominal defect and a mass that was intestine-like and arose from the bowel cannot be classified, and no similar reports were found. This suggests a previously undescribed abdominal wall defect with an aberrant colonic appendage.

  13. Management of Complex Abdominal Wall Defects Associated with Penetrating Abdominal Trauma

    Science.gov (United States)

    2014-05-09

    soiling at the time of injury; they all had loss of abdominal wall skin, muscle and fascia. The grading system of abdominal wall injury described by...were made to close the abdomen; bowel func- tion was slow to improve due to the systemic sepsis. It was only Box 1 Some of the principles of management...amount of tension using pulley sutures through the surrounding muscle and fascia, and an on-lay polygalactin mesh placed over this. Dermal-holding

  14. Coverage of supraumbilical abdominal wall defects: The tunnelled-pedicled ALT technique.

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    Fernandez-Alvarez, Jose-Alberto; Barrera-Pulido, Fernando; Lagares-Borrego, Araceli; Narros-Gimenez, Rocio; Gacto-Sanchez, Purificación; Gomez-Cia, Tomas

    2017-02-01

    Abdominal wall defects are a challenge for reconstructive surgeons. Although the utility of anterolateral thigh perforator (ALT) flap has been well established for lower abdominal wall reconstruction, pedicled ALT flap is usually not considered for supraumbilical defects in the most recent algorithms. The purpose of this paper is to report the results of a tunneled pedicled ALT flap for reconstruction of supraumbilical defect from a series of patients. From July 2009 to September2014, six patients underwent delayed abdominal wall coverage using pedicled ALT flaps and reinforcement with polypropylene meshes. Defects occurred after surgical complications and abdominal trauma. Flaps were tunneled beneath the rectus femoris and sartorius muscles to increase the pedicle length. The size of the skin islands ranged from 22-29 × 10-14 cm. All flaps survived and the healing of the wounds was successful. Partial dehiscence of donor site occurred in one patient, and small wound dehiscence due to minimal distal necrosis was observed in another patient. No functional problems were reported in donor site, and no complications occurred in 6-68 months of follow-up. The tunneled pedicled ALT flap may provide a reliable alternative method for abdominal wall reconstruction, including supraumbilical defects. © 2015 Wiley Periodicals, Inc. Microsurgery 37:119-127, 2017. © 2015 Wiley Periodicals, Inc.

  15. TFE-PLASMA POLYMERIZED DERMAL SHEEP COLLAGEN FOR THE REPAIR OF ABDOMINAL-WALL DEFECTS

    NARCIS (Netherlands)

    VANDERLAAN, JS; LOPEZ, GP; VANWACHEM, PB; NIEUWENHUIS, P; RATNER, BD; BLEICHRODT, RP; SCHAKENRAAD, JM

    1991-01-01

    The aim of this study was to design and evaluate a degradable biomaterial for the repair of abdominal wall defects. Hexamethylenediisocyanate-tanned dermal sheep collagen (HDSC) was plasma-polymerized with tetrafluoroethylene (TFE) which resulted in a hydrophobic surface on the visceral side

  16. [Fascia lata transplant from cadaveric donor in the reconstruction of abdominal wall defects in children].

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    Peláez Mata, D; Alvarez Zapico, J A; Gutiérrez Segura, C; Fernández Jiménez, I; García Saavedra, S; González Sarasúa, J; Arriaga Flórez, M J

    2001-01-01

    Abdominal wall closure is not possible in large congenital defects, even after extensively stretching in to enlarge its capacity. The skin coverage is usually adequate but the aponeurotic defect has to be closed temporally using synthetic patches. The use of these materials leads to increase complication such as infection, fistula formation and extrusion. In addition a second operation is required to remove the material and to perform a definitive closure. The role of fascia lata in reconstruction of abdominal wall is well established as free grafts, pedicled flaps or free flaps. Bank cadaveric fascia lata is used extensively in neurosurgical, ophtalmological, orthopaedic and urogynecological procedures. This is the first description of the use of cadaveric fascia lata for the closure of large abdominal wall defects. We present two cases of congenital diaphragmatic hernia. The first patient was a newborn who presented the impossibility to close the fascia, that was salvaged by a teflón patch. Five months later the wound opened, leaving the mesh exposed that had to be removed. A cadaveric fascia lata patch was used to cover the defect, closing the skin satisfactorily. The second case was a two days newborn. We performed the diaphragmatic closure, and the aponeurotic defect was closed using cadaveric fascia lata. Cosmetic and functional appearance are satisfactory in both cases and no complications have been seen. Fascia lata patches are revascularized in the abdominal wall and incorporates into receptor tissue. They have the following advantages with respect to synthetic materials: First, the risk of complications is lower. Second, their removal is not necessary. Finally, no intraperitoneal adhesions occur. The risks of disease transmission and rejection are minimized by the Centro Comunitario de Transfusiones donor selection and processing of the cadaveric fascia lata.

  17. Differences of alternative methods of measuring abdominal wall hernia defect size: a prospective observational study.

    Science.gov (United States)

    Cherla, Deepa V; Lew, Debbie F; Escamilla, Richard J; Holihan, Julie L; Cherla, Arun S; Flores-Gonzalez, Juan; Ko, Tien C; Kao, Lillian S; Liang, Mike K

    2018-03-01

    Despite the importance of defect size, there are no standardized recommendations on how to measure ventral hernias. Our aims were to determine (1) if any significant differences existed between various methods of measuring ventral hernias and (2) the effect of these methods of measurement on selection of mesh size. A prospective study of all patients enrolled in a randomized trial assessing laparoscopic ventral hernia repair at a single institution from 3/2015 to 7/2016 was eligible for inclusion. Abdominal wall hernia defect size was determined by multiplying defect length and width obtained separately using each of five methods: radiographic (CT), intraoperative with abdomen desufflated, intraoperative with abdomen insufflated to 15 mmHg (intra-abdominal aspect), intraoperative with abdomen insufflated to 15 mmHg (extra-abdominal aspect), and clinical. The primary outcome was intraclass correlation between the five different methods of measurement for each patient. Secondary outcome was changes in mesh selection assuming a 5 cm overlap in each direction. Fifty patients met inclusion criteria for assessment. The five different measurement methods had an intraclass correlation for each patient of 0.533 (95% CI 0.373-0.697) (weak correlation) for length; 0.737 (95% CI 0.613-0.844) (moderate correlation) for width; and 0.684 (95% CI 0.544-0.810) (moderate correlation) for area. Different types of measurements affected mesh selection in up to 56% of cases. Among five common methods of measuring abdominal wall hernia defect, sizes are only weakly to moderately correlated. Further studies are needed to determine which method results in optimally sized abdominal wall prostheses and superior ventral hernia repair.

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

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    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.

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

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    Inoue, Seiichiro; Odaka, Akio; Muta, Yuki; Beck, Yoshifumi; Sobajima, Hisanori; Tamura, Masanori

    2016-01-22

    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 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 delivery. A silo was established on the day of his birth; direct closure of his diaphragmatic defect and abdominal wall closure was performed on the fifth day after his birth. Trisomy 13 was confirmed by genetic examination. His postoperative course was uneventful and he was discharged 5 months postnatally with home oxygen therapy. He was readmitted because of heart failure and died at 6 months. Case 2: a Japanese baby boy, who was prenatally diagnosed with gastroschisis, was delivered at 35 weeks' gestation by urgent cesarean section because of the diagnosis of fetal distress. Silo construction using a wound retractor was performed on the day of his birth and direct abdominal closure was performed on the tenth day after his birth. Trisomy 21 was confirmed by genetic examination. Treatment for his respiratory distress was continued after surgery. A retrosternal hernia was revealed at 6 months and direct closure of retrosternal diaphragm with the resection of hernia sac was performed. His postoperative course was uneventful and he was discharged with home oxygen therapy. Attention should be paid to chromosomal abnormality in cases in which the coexistence of congenital diaphragmatic hernia and abdominal wall closure defect are observed.

  20. A randomized controlled experimental study comparing chitosan coated polypropylene mesh and Proceed™ mesh for abdominal wall defect closure

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    S.T. Jayanth

    2015-12-01

    Conclusion: Chitosan coated polypropylene mesh was found to have similar efficacy to Proceed™ mesh. Chitosan coated polypropylene mesh, can act as an anti adhesive barrier when used in the repair of incisional hernias and abdominal wall defects.

  1. Effects of nitrofurazone on correction of abdominal wall defect treated with polypropylene mesh involved by fibrous tissue.

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    Yasojima, Edson Yuzur; Ribeiro Júnior, Rubens Fernando Gonçalves; Pessôa, Thyago Cezar Prado; Cavalcante, Lainy Carollyne da Costa; Ramos, Suzana Rodrigues; Serruya, Yuri Aarão Amaral; de Moraes, Mateus Malta

    2015-10-01

    To evaluate the effects of nitrofurazone on the correction of abdominal wall defect treated with polypropylene mesh involved by fibrous tissue in rats. A defect in the abdominal wall was created and corrected with polypropylene mesh in 20 rats. They were randomly distributed into four groups: control, fibrous mesh, nitrofurazone and nitrofurazone dip in the mesh. Euthanasia was performed in 21 post-operative days. The healing process was analyzed regarding the meshes and macroscopic and microscopic aspects. All animals had adhesions. However, no statistically significant difference (p>0.05) when compared between groups. Similarly microscopic analysis, in which there was no statistical significance level for the evaluated parameters such as mono and polymorphonuclear lymphocytes, granuloma, fibrosis, necrosis and collagen proliferation. There was no significant effect on the abdominal wall defect repair with polypropylene mesh surrounded by fibrous tissue when dipped in nitrofurazone 2%.

  2. Robotic Transversus Abdominis Release (TAR: is it possible to offer minimally invasive surgery for abdominal wall complex defects?

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    MARIA VITÓRIA FRANÇA DO AMARAL

    Full Text Available ABSTRACT We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion. The procedure proved to be technically feasible, with a still long surgical time. Considering the potential advantages of robotic surgery and those related to TAR and the results obtained when these two techniques are associated, we conclude that they seem to be a good option for the correction of complex abdominal wall defects.

  3. EXPANDED POLYTETRAFLUOROETHYLENE PATCH VERSUS POLYPROPYLENE MESH FOR THE REPAIR OF CONTAMINATED DEFECTS OF THE ABDOMINAL-WALL

    NARCIS (Netherlands)

    BLEICHRODT, RP; SIMMERMACHER, RKJ; VANDERLEI, B; SCHAKENRAAD, JM

    Contaminated defects of the abdominal wall continue to be a significant problem for patients and surgeons. The lack of sufficient tissue may require the insertion of a prosthetic material. Polypropylene (PP) mesh is still the most widely used material for this purpose, although the propensity to

  4. Use of the omentum flap as additional soft-tissue cover for abdominal wall defects reconstructed with Gore-Tex.

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    Wong, Chin-Ho; Tan, Bien-Keem; Koong, Heng-Nung; Lim, Chong-Hee; Chia, Sing-Joo; Song, Colin

    2005-11-01

    Use of alloplastic materials such as Gore-Tex and locoregional flaps for reconstruction of large abdominal wall defects has been well described. The purpose of this article is to present a novel technique of using the omentum as an interpositional flap to protect the Gore-Tex repair of the abdominal wall. Four patients with large abdominal wall defects underwent reconstruction with Gore-Tex and omentum flap. These defects resulted from tumor resection and recurrent incisional hernia. Their dimensions ranged from 15 x 10 cm to 25 x 27 cm. The Gore-Tex patch was inset using an underlay technique. The omentum was tunneled through a separate opening in the abdominal wall into the subcutaneous plane and used to cover the Gore-Tex. Skin coverage was accomplished by direct closure or myocutaneous flaps. The mean follow-up was 17 months. All wounds healed, with no hernias. One patient developed a subcutaneous abscess 6 months postoperatively, and this was treated successfully by percutaneous drainage, as the omentum had walled-off the abscess. The omentum flap served as an additional soft-tissue cover over the Gore-Tex repair to prevent exposure in the event of infection or flap breakdown. This technique is useful in situations in which delayed wound healing is anticipated or when large quantities of prosthetic material are used.

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

    LENUS (Irish Health Repository)

    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.

  6. Polypropylene mesh seeded with fibroblasts: A new approach for the repair of abdominal wall defects in rats.

    Science.gov (United States)

    Mohsina, A; Kumar, Naveen; Sharma, A K; Shrivastava, Sameer; Mathew, Dayamon D; Remya, V; Sonal; Maiti, S K; Singh, Kiranjeet; Singh, K P

    2017-06-01

    The purpose of study was to develop bioengineered scaffolds by seeding primary mouse embryo fibroblast cells (p-MEF) on polypropylene mesh and to test its efficacy for the repair of abdominal wall defects in rats. The study was conducted on 18 clinically healthy adult Wistar rats of either sex. The animals were randomly divided into two equal groups having nine animals in each group. In both the groups a 20mm×20mm size full thickness muscle defect was created under xylazine and ketamine anesthesia in the mid-ventral abdominal wall. In group I the defect was repaired with polypropylene mesh alone and in group II it was repaired with p-MEF seeded polypropylene mesh. Matrices were implanted by synthetic absorbable suture material (polyglycolic acid) in continuous suture pattern. The efficacy of the bio-engineered matrices in the reconstruction of full thickness abdominal wall defects was evaluated on the basis of macro and histopathological observations. Macroscopic observations revealed that adhesions with skin and abdominal viscera were minimum in group II as compared to group I. Histopathological observations confirmed better fibroplasia and collagen fiber arrangement in group II. No recurrence of hernia was found in both the groups. Hernias are effectively repaired by implanting polypropylene mesh. However, this work demonstrates that in vitro seeding of mesh with fibroblasts resulted in earlier subsidization of pain, angiogenesis and deposition of collagen, increased thickness of matrices with lesser adhesions with underlying viscera. On the basis of the results p-MEF seeded mesh was better than non-seeded mesh for repair of abdominal wall defects in rats. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Inflammatory reaction and tensile strength of the abdominal wall after an implant of polypropylene mesh and polypropylene/poliglecaprone mesh for abdominal wall defect treatment in rats.

    Science.gov (United States)

    Biondo-Simões, Maria de Lourdes Pessole; Moura, Paula Almeida Pamponet; Colla, Kelly; Tocchio, Anna Flávia Zonato; Morais, Camila Gomes de; Miranda, Renata Augusta de; Robes, Rogério Ribeiro; Ioshii, Sérgio Ossamu

    2014-01-01

    To compare the inflammatory reaction and the growing resistance of the abdominal wall with the use of poliglecaprone meshes and polypropylene meshes associated with poliglecaprone in the correction of abdominal defects. Seventy-seven Wistar rats were divided into three groups: CG (non-operated animals: EG (polypropylene mesh) and UG (polypropylene and poliglecaprone mesh). A muscular and aponeurotic defect was formed and treated according to the group. Evaluations were made after 4, 7, 14, 28 and 56 days. The resistance and inflammatory pattern were studied. There was a gradual and significant gain in resistance, regularly in the EG and irregularly in the UG, which was lower on the 14th day (p=0.008). The inflammatory reaction was acute and more intense in the UG on the fourth day. At all other times, the inflammatory pattern was acute to chronic, similar in both groups, with minimum intensity on the 56th day. The greater resistance offered by the polypropylene mesh was regular and ascending, stabilizing on the 28th day, while that of the polypropylene/poliglecaprone was not even. In the end, the resistances were similar. The inflammatory response was greater in the UG on the fourth day and similar at all other times.

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

    International Nuclear Information System (INIS)

    Rifaat, M.A.; Abdel Gawad, W.S.

    2005-01-01

    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

  9. Congenital lateral abdominal wall hernia.

    Science.gov (United States)

    Montes-Tapia, Fernando; Cura-Esquivel, Idalia; Gutiérrez, Susana; Rodríguez-Balderrama, Isaías; de la O-Cavazos, Manuel

    2016-08-01

    Congenital abdominal wall defects that are located outside of the anterior wall are extremely rare and difficult to classify because there are no well accepted guidelines. There are two regions outside of the anterior wall: the flank or lateral wall; and the lumbar region. We report the case of a patient with an oval 3 cm-diameter hernia defect located above the anterior axillary line, which affects all layers of the muscular wall. An anorectal malformation consisting of a recto-vestibular fistula was also identified, and chest X-ray showed dextrocardia. The suggested treatment is repair of the defect before 1 year of age. Given that the anomalies described may accompany lateral abdominal wall hernia, it is important to diagnose and treat the associated defects. © 2016 Japan Pediatric Society.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Comparative study between polypropylene and polypropylene/poliglecaprone meshes used in the correction of abdominal wall defect in rats.

    Science.gov (United States)

    Utrabo, Carlos Alberto Lima; Czeczko, Nicolau Gregori; Busato, Cesar Roberto; Montemor-Netto, Mario Rodrigues; Malafaia, Osvaldo; Dietz, Ulrich Andreas

    2012-04-01

    To evaluate the healing process of a defect in the ventral abdominal wall of rats, comparing the polypropylene and polypropylene/poliglecaprone meshes on the 30(th) and 60(th) postoperative day. Thirty two Wistar rats were submitted to a ventral abdominal wall defect, with integrity of the parietal peritoneum. In the repair, were used polypropylene (group A) and polypropylene/poliglecaprone (group B) meshes. The groups were subdivided into four subgroups of eight animals euthanized on the 30(th) (A30 and B30) and 60(th) postoperative day (A60 and B60). Fragments of the abdominal wall of the animals were submitted to macroscopic, tensiometric and histological evaluations. The tensiometry on subgroup A30 showed a mean average break point of 0.78 MPa and in A60, 0.66 Mpa. In subgroup B30 it was 0.84 MPa and in B60, 1.27 Mpa. The score of the inflammatory process showed subacute phase on A30 and B30 sub-groups and chronic inflammatory process in subgroups A30 and 60B. The tensile strength was higher on the wall repaired by polypropylene/poliglecaprone mesh in the 60(th) post-operative day. Histology showed higher concentration of fibrosis on the surface of the polypropylene mesh with a tendency to encapsulation. In polypropylene/poliglecaprone subgroups the histology showed higher concentration of fibrosis on the surface of mesh filaments.

  12. A giant inguinoscrotal hernia associated with other abdominal wall defects A case report.

    Science.gov (United States)

    Iovino, Francesco; Auriemma, Pasquale Pio; Dani, Luca; Giordano, Giovanni; Barbarisi, Alfonso

    2016-04-29

    Giant inguinoscrotal hernias are unusual in developed countries and rarely associated with other wall hernias, such as controlateral inguinal hernia, umbilical hernia. The presence of more parietal defects can facilitate reinstatement of giant hernia content without respiratory and circulatory compromise, but the risk of occlusion and bowel strangulation results increased. Here, we report an unusual case of an asymptomatic giant inguinal hernia associated with controlateral inguinal and umbilical hernia in a 60 years old Caucasian male treated with sequential surgical approach. In particular, the Lichtenstein's technique under spinal anesthesia was performed and it could be considered the gold standard for this disease. Giant inguinal hernia and abdomen wall defects should not be repaired at the same time. It is more useful to be less aggressive, monitoring the progressive and natural adaptation of the viscera into the abdomen. Anyway, thereby literature results very poor and additional reports are required. Giant inguinoscrotal hernia, Hernia, Hernia treatment, Wall defects.

  13. Laparoscopic-assisted surgical reconstruction of a rare congenital abdominal wall defect in two children misdiagnosed with prune-belly syndrome.

    Science.gov (United States)

    Fishman, Andrew I; Franco, Israel

    2013-08-01

    Abdominal wall laxity is typically associated with prune-belly syndrome (PBS). Incomplete forms of PBS have been rarely reported with only the abdominal wall laxity. Herein, we describe a rare congenital abdominal wall defect that has been confused with PBS and illustrate the laparoscopic-assisted surgical technique used for reconstruction. Two boys with symmetrical, bilateral absence or hypoplasia of the internal and external oblique muscles and no genitourinary abnormalities underwent a laparoscopic-assisted abdominal wall reconstruction utilizing the technique previously described by Firlit. Each patient had a Ct scan which confirmed the absence of the oblique muscles. In one patient EMG data confirmed no electrical activity of the obliques. Radiologic evaluation of the urinary tracts revealed no abnormalities. The abdominal wall was plicated utilizing bilateral subcostal incisions. Both patients had excellent cosmetic and functional results with no weakness or bulging of the lateral abdominal wall and improvement of associated symptoms. We believe these two cases and their congenital abdominal wall defects are a rare and often misdiagnosed muscular deficiency separate from PBS. The novel laparoscopic-assisted surgical technique illustrated is feasible and highly successful for these and possible other patients with similar rare congenital abdominal wall defects. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  14. A successful early gore-tex reconstruction of an abdominal wall defect in a neonate with Cantrell pentalogy: a case report and literature review.

    Science.gov (United States)

    Divkovic, Dalibor; Kvolik, Slavica; Sipl, Mirna; Sego, Krunoslav; Puseljic, Silvija; Rakipovic-Stojanovic, Andreja; Kovacic, Borna

    2015-01-01

    A surgical technique, materials used for abdominal wall reconstruction, and postoperative care are important for patient outcomes. We report the first case of neonate with Cantrell's pentalogy surviving early reconstruction of abdominal, diaphragmal and pericardial defects. Several recent investigations suggest that intraabdominal pressure monitoring may improve outcomes in this patient category.

  15. Mesh repair of hernias of the abdominal wall

    NARCIS (Netherlands)

    W.W. Vrijland (Wietske)

    2003-01-01

    textabstractA hernia of the abdominal wall is a permanent or intermittent protrusion of abdominal contents outside the abdominal cavity through a defect in the abdominal wall. Approximately 75% of all hernias occur in the inguinal region. Other types of hernias of the ventral abdominal wall are

  16. Endometriosis Abdominal wall

    International Nuclear Information System (INIS)

    Alvarez, M.; Carriquiry, L.

    2003-01-01

    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

  17. [Post traumatic anterior abdominal wall hernia].

    Science.gov (United States)

    Mzoughi, Zeineb; Bayar, Rached; Khmiri, Hamdi; Gharbi, Lassad; Khalfallah, Mohamed Taher

    2016-01-01

    Post traumatic anterior abdominal wall hernia can be ignored in emergency settings. We here report the case of a 32-year-old patient with a BMI of 30 kg/m 2 , suffering from anterior abdominal wall hernia as a result of a road accident. This lesion wasn't detected during clinical examination. Abdominal tomodensitometry showed a defect of 8 cm in the anterior abdominal wall. The patient underwent surgery during which a musculoaponeurotic defect of 12 cm was detected. The repair was carried out using interrupted suture. The postoperative course was marked by a secondarily infected skin necrosis. The evolution was satisfactory after directed cicatrization. At 3 months postoperatively the patient was doing well with a healed wound and a strong abdominal wall.

  18. Reconstruction of an abdominal wall defect with biologic mesh after resection of a desmoid tumor in a patient with a Gardner's syndrome.

    Science.gov (United States)

    Hammer, Jennifer; Léonard, Daniel; Chateau, François; Abbes Orabi, Nora; Ciccarelli, Olga; Bachmann, Radu; Remue, Christophe; Lengelé, Benoît; Kartheuser, Alex

    2017-02-01

    Desmoid tumors are rare proliferative and invasive benign lesions. They can be sporadic, but in most instances, desmoid tumors develop in the context of Gardner's syndrome with principal localization in the abdominal cavity and abdominal wall. We report the case of a 24-year-old female presenting Gardner's syndrome with a symptomatic abdominal wall desmoid tumor. Lack of response to medical treatment led to surgical management consisting in a complete resection and parietal reconstruction with a biologic mesh. Postoperative course was uneventful and there was no evidence of recurrence at 12 months of follow-up. Conventional treatment of abdominal wall desmoid tumors consists in a wide and radical resection. However, complete resection is not always feasible because of difficulty to differentiate the desmoid tumor from adjacent tissues. The surgical approach may require different techniques to repair the parietal defect including prosthetic material such as synthetic or biologic meshes. Biological mesh is an ideal alternative to synthetic graft, mainly in case of infection. We have encountered a case of a symptomatic growing desmoid tumor of the abdominal wall in a young patient with Gardner's syndrome, successfully treated by complete resection and reconstruction with a biologic mesh to correct the parietal defect.

  19. Behaviour of a new composite mesh for the repair of full-thickness abdominal wall defects in a rabbit model.

    Directory of Open Access Journals (Sweden)

    Gemma Pascual

    Full Text Available INTRODUCTION: Composite biomaterials designed for the repair of abdominal wall defects are composed of a mesh component and a laminar barrier in contact with the visceral peritoneum. This study assesses the behaviour of a new composite mesh by comparing it with two latest-generation composites currently used in clinical practice. METHODS: Defects (7x5cm created in the anterior abdominal wall of New Zealand White rabbits were repaired using a polypropylene mesh and the composites: Physiomesh(TM; Ventralight(TM and a new composite mesh with a three-dimensional macroporous polyester structure and an oxidized collagen/chitosan barrier. Animals were sacrificed on days 14 and 90 postimplant. Specimens were processed to determine host tissue incorporation, gene/protein expression of neo-collagens (RT-PCR/immunofluorescence, macrophage response (RAM-11-immunolabelling and biomechanical resistance. On postoperative days 7/14, each animal was examined laparoscopically to quantify adhesions between the visceral peritoneum and implant. RESULTS: The new composite mesh showed the lowest incidence of seroma in the short term. At each time point, the mesh surface covered with adhesions was greater in controls than composites. By day 14, the implants were fully infiltrated by a loose connective tissue that became denser over time. At 90 days, the peritoneal mesh surface was lined with a stable mesothelium. The new composite mesh induced more rapid tissue maturation than Physiomesh(TM, giving rise to a neoformed tissue containing more type I collagen. In Ventralight(TM the macrophage reaction was intense and significantly greater than the other composites at both follow-up times. Tensile strengths were similar for each biomaterial. CONCLUSIONS: All composites showed optimal peritoneal behaviour, inducing good peritoneal regeneration and scarce postoperative adhesion formation. A greater foreign body reaction was observed for Ventralight(TM. All composites induced

  20. Submucosa de intestino delgado no reparo de defeito em parede abdominal de ratos Small intestinal submucosa to repair anterior abdominal wall defect in rats

    Directory of Open Access Journals (Sweden)

    Fernando Hintz Greca

    2004-10-01

    defect involving the entire anterior abdominal wall of rats. METHODS:Twenty Wistar rats were allocated in 2 groups of 10 animals each. In the group 1 the defect was repaired with SIS and in the group2 it was repaired with polypropylene mesh. On the 30th post-operative day the animals were sacrificed for macroscopic , histological and tensiometric evaluation. RESULTS: Adhesions were present in the animals of both group , but in the polypropylene mesh group the intestinal adhesions were more frequent than in the SID group. The maximum tensile strength was greater in the polypropylene group, however is we consider the thickness of the implants, the tensile strength of submucosa was significantly greater. The mesothelium coverage and the collagen deposition was greater in the SID group. The foreign body reaction and the chronic inflammatory process was higher in the SID group. The percentage of mature collagen was significantly greater in the SIS group. CONCLUSION: We concluded that SIS can be an alternative to synthetic meshes when used to repair the defects of abdominal wall.

  1. Use of small intestinal submucosal and acellular dermal matrix grafts in giant omphaloceles in neonates and a rabbit abdominal wall defect model.

    Science.gov (United States)

    Jiang, Weiwei; Zhang, Jie; Lv, Xiaofeng; Lu, Changgui; Chen, Huan; Xu, Xiaoqun; Tang, Weibing

    2016-03-01

    The described surgical strategies for the management of omphalocele include primary closure, staged closure, and delayed closure. A primary repair is not suitable for all giant omphaloceles. We implanted two grafts, small intestinal submucosal (SIS) and acellular dermal matrix (ADM) onto abdominal wall defects in neonates to study the safety and efficacy of SIS and ADM graft techniques for initial closure of giant omphaloceles in infants, and we also implanted these grafts onto abdominal wall defects in an animal model. Twenty-four patients with giant omphaloceles were divided into two groups (ADM group, 12 patients; SIS group, 12 patients). The operative time, skin healing time postoperatively, and the incidence of skin infections, and abdominal wall hernias were observed. In the rabbit animal model, bilateral full-thickness incisions were made through the rabbit rectus abdominus muscles and a 2×4cm longitudinal whole layer defect was created on either the left or right lateral anterior abdominal wall. A four-layered variant of the SIS graft was used to repair the right abdominal defect; ADM was used to repair the left. Tensile strength was measured using an Instron tensiometer. Electron scanning and light microscopy were used to evaluate neovascularization, collagen deposition, and muscle fibers at 2, 4, 8, and 16weeks postimplantation. In the neonatal patients, there was no statistically significant difference between the two groups with respect to operative time, skin healing time postoperatively, the incidence of skin infections, or abdominal wall hernias. In the SIS group, only one patient developed a skin infection, which led to skin necrosis and sloughing. In the ADM group, four patients developed skin infection postoperatively, and the patch was gradually removed. In the animal study, there was no significant difference between the mean breaking strength of ADM versus SIS repairs. Scanning electron and light microscopy showed collagen deposition

  2. Acute traumatic abdominal wall hernia

    OpenAIRE

    Hartog, Dennis; Tuinebreijer, Wim; Oprel, Pim; Patka, Peter

    2011-01-01

    textabstractAlthough blunt abdominal trauma is frequent, traumatic abdominal wall hernias (TAWH) are rare. We describe a large TAWH with associated intra-abdominal lesions that were caused by high-energy trauma. The diagnosis was missed by clinical examination but was subsequently revealed by a computed tomography (CT) scan. Repair consisted of an open anatomical reconstruction of the abdominal wall layers with reinforcement by an intraperitoneal composite mesh. The patient recovered well and...

  3. The in vivo evaluation of tissue-based biomaterials in a rat full-thickness abdominal wall defect model.

    Science.gov (United States)

    Bryan, Nicholas; Ahswin, Helen; Smart, Neil; Bayon, Yves; Wohlert, Stephen; Hunt, John A

    2014-05-01

    Hernias are defects in which an anatomical fascia is breached resulting in ectopic positioning of an organ into an orifice which routinely does not contain it. Intervention often involves repositioning translocated organs and repair of damaged fascia using exogenous grafts. Despite hernia prevalence, repairs can still fail due to postoperative complications, such as chronic pain and decreased mobility. This study compared repair capacities and characterized the foreign body response elicited by a number of hernia repair grafts to deduce their bulk inflammatory properties while also concluding the point in their fabrication when these are inferred. Materials derived from human dermis (Alloderm(®) ), porcine dermis (Permacol™, patch A, patch D and Strattice(®) ), porcine small-intestinal submucosa (Surgisis™) and a synthetic (multifilament Surgipro™) were implanted into a rat full-thickness abdominal wall excision model, incubated for up to 2 years and characterized histopathologically. Surgisis™ resorbed the fastest of the materials tested (1-3 months) resulting in a mechanically stable parietal peritoneum. Decellularization using sodium dodecyl sulfate (patch A) stimulated a large early inflammatory response which ultimately may have contributed to increased resorption of porcine dermal matrix however the remaining materials typically persisted throughout the 2-year incubation. Cross-linking porcine dermis using 1,6-hexamethylene disocyanate (vs. an identical noncross-linked counterpart) showed no difference in cell recruitment or material integration over 2 years. Typically Strattice(®) and Alloderm(®) recruited larger early populations of cells than Permacol™; however, over extended periods of time in vivo this response normalized. Copyright © 2013 Wiley Periodicals, Inc.

  4. Congenital Abdominal Wall Defects

    DEFF Research Database (Denmark)

    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...

  5. Abdominal wall hernias

    DEFF Research Database (Denmark)

    Henriksen, Nadia A; Mortensen, Joachim H; Lorentzen, Lea

    2016-01-01

    that abdominal wall hernia formation is associated with altered collagen metabolism. The aim of this study was to evaluate biomarkers for type IV and V collagen turnover in patients with multiple hernias and control subjects without hernia. METHODS: Venous blood was collected from 88 men (mean age, 62 years......) with a history of more than 3 hernia repairs and 86, age-matched men without hernias. Biomarkers for synthesis of collagen type IV (P4NP) and type V (P5CP) as well as breakdown (C4M and C5M) were measured in serum by validated, solid-phase, competitive assays. Collagen turnover was indicated by the ratio between...... the biomarker for synthesis and breakdown. RESULTS: Type IV collagen turnover was 1.4-fold increased in patients with multiple hernias compared to control subjects (P turnover was 1.7-fold decreased (P

  6. Acute traumatic abdominal wall hernia

    NARCIS (Netherlands)

    D. den Hartog (Dennis); W.E. Tuinebreijer (Wim); P.P. Oprel (Pim); P. Patka (Peter)

    2011-01-01

    textabstractAlthough blunt abdominal trauma is frequent, traumatic abdominal wall hernias (TAWH) are rare. We describe a large TAWH with associated intra-abdominal lesions that were caused by high-energy trauma. The diagnosis was missed by clinical examination but was subsequently revealed by a

  7. Economics of abdominal wall reconstruction.

    Science.gov (United States)

    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. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. One-year outcome of biological and synthetic bioabsorbable meshes for augmentation of large abdominal wall defects in a rabbit model.

    Science.gov (United States)

    Peeters, Ellen; van Barneveld, Kevin W Y; Schreinemacher, Marc H; De Hertogh, Gert; Ozog, Yves; Bouvy, Nicole; Miserez, Marc

    2013-04-01

    Long-term efficacy of biological and synthetic bioabsorbable meshes for large hernia repair is currently unclear. This rabbit study is aimed at investigating 1-y outcome of biological and synthetic bioabsorbable meshes for augmentation of large abdominal wall defects. In 46 rabbits, an 11 × 4 cm, full-thickness abdominal wall defect was repaired primarily, or with cross-linked (Permacol, Collamend) or non-cross-linked (Surgisis 4-ply, Surgisis Biodesign) biological, synthetic bioabsorbable (GORE BIO-A Tissue Reinforcement [TR], TIGR Matrix Surgical Mesh [MSM]), or polypropylene (Bard Mesh) meshes, using the underlay augmentation technique. One year after surgery, primary outcome was recurrence; secondary outcomes were tensile strength, histologic degree of tissue remodeling, and intraabdominal adhesion formation. Only two Surgisis 4-ply animals (50%) presented with a recurrent hernia. All GORE BIO-A TR meshes were completely resorbed and, as after primary repair, well-organized connective tissue without inflammation was present, with moderate adhesion formation and sufficient tensile strength. Cross-linked biological and TIGR MSM meshes demonstrated highest tensile strength but were only partially incorporated, with similar foreign body reaction and adhesion formation as polypropylene meshes in the TIGR MSM group, and minimal degradation and moderate adhesion formation in the cross-linked biological group. In the non-cross-linked biological group sufficient tensile strength and moderate adhesion formation were found, with pronounced inflammation if mesh remnants were present. Synthetic bioabsorbable GORE BIO-A TR meshes were associated with optimal tissue remodeling, with complete resorption, presence of well-organized tissue, and no inflammation. However, mesh augmentation had no advantages regarding recurrence rate versus primary repair of large abdominal wall defects. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Enhancement of abdominal wall defect repair using allogenic platelet-rich plasma with commercial polyester/cotton fabric (Damour) in a canine model

    Science.gov (United States)

    ABOUELNASR, Khaled; HAMED, Mohamed; LASHEN, Samah; EL-ADL, Mohamed; ELTAYSH, Rasha; TAGAWA, Michihito

    2017-01-01

    Platelet-rich plasma (PRP) has an important role in musculoskeletal surgery; however, it has been underutilized for accelerating the healing of abdominal wall defects in veterinary practice. Therefore, the aim of this study was to evaluate the use of commercial polyester/cotton fabric (Damour) as a new composite mesh for the repair of experimentally induced abdominal wall defects in canine models, and to investigate the possible role of PRP for improving such repair and reducing allied complications. For this purpose, abdominal wall defects were created in 24 healthy mongrel dogs and then repaired with mesh alone (control group) or mesh and allogenic PRP (PRP group). Dogs were euthanized after 2 or 4 months for gross examination of implantation site, detection of adhesion score and hernia recurrence. Moreover, tissue samples were collected for histological and gene expression analyses for neovascularization, collagen formation and tissue incorporation. Hernia recurrence was not recorded in PRP-treated dogs that also displayed significantly more neovascularization and less severe adhesion to the underlings (1.08 ± 0.51) in comparison to control group (2.08 ± 0.99). Histological and molecular evaluation confirmed the gross findings that collagen deposition, new vessel formation, and overexpression of angiogenic and myofibroplastic genes (COL1α1, COL3α1, VEGF and TGFβ1) were observed more frequently in the PRP group, at both time points. In conclusion, we found that addition of allogenic PRP to Damour mesh enhanced neovessel formation, and increased tissue deposition and incorporation, with subsequent reduction of peritoneal adhesion and recurrence rate. PMID:28603214

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Non-traumatic lateral abdominal wall hernia.

    Science.gov (United States)

    Castillo-Sang, M; Gociman, B; Almaroof, B; Fath, J; Cason, F

    2009-06-01

    A rare lateral abdominal wall hernia is described in an adult patient. This was diagnosed in a patient with a prominent right lateral abdominal wall deformity. The patient had been experiencing pain that increased progressively in severity over time. A computerized tomography (CT) scan of the abdomen revealed the location of the lateral abdominal wall defect. The hernia defect was through the transversus abdominis and the internal oblique, with the inferior aspect of the 11th rib forming part of the superior border of the defect. A 4-cm bony spur from the inferior aspect of the rib formed part of the lateral margin of the defect. The hernia sac was contained within a space underneath the external oblique muscle. The association of the hernia defect with a bony spur was highly suggestive of a congenital etiology. The hernia was successfully repaired laparoscopically with Parietex mesh (Sofradim, Lyons, France), and the patient had resolution of the symptoms on discharge and follow-up visits.

  12. Endometrioma de parede abdominal Abdominal wall endometrioma

    Directory of Open Access Journals (Sweden)

    Italo Accetta

    2011-03-01

    Full Text Available RACIONAL: A incidência exata da endometriose na população geral é desconhecida. A confirmação desta doença só é possível através da análise histopatológica de um fragmento obtido por algum procedimento invasivo, pois não existe até o momento, nenhum marcador clínico seguro. OBJETIVO: Relatar a experiência com as manifestações clínicas e o tratamento cirúrgico em pacientes com endometrioma de parede abdominal. MÉTODO: Análise retrospectiva das pacientes operadas por endometrioma de parede abdominal, dando ênfase aos dados relativos à idade, sintomas, cesariana prévia, relação dos sintomas com o ciclo menstrual, exames físicos e complementares, tratamento cirúrgico, evolução pósoperatória e resultado histopatológico dos espécimes. RESULTADOS: Foram operadas 14 pacientes no período estudado, com idade entre 28 e 40 anos. A presença de massa e dor local que piorava durante a menstruação foram as queixas principais. Ultrassonografia e tomografia computadorizada foram exames importantes em localizar precisamente a doença. O tratamento cirúrgico foi exérese ampla da tumoração e dos tecidos comprometidos. As pacientes evoluíram satisfatoriamente e o histopatológico confirmou a suspeita de endometrioma de parede abdominal em todos os casos. CONCLUSÂO: Foi nítida a relação entre cesariana prévia e endometrioma de parede abdominal e estudos ultrassonográficos e tomográficos auxiliaram a planejar a abordagem cirúrgica permitindo a exérese da tumoração e de todos os tecidos adjacentes comprometidos.BACKGROND: The exact incidence of endometriosis in the general population is unknown. Confirmation of this disease is only possible by histopathological analysis of a fragment obtained by some invasive procedure, because there is so far, no clinical secure marker. AIM: To report the experience with the clinical manifestations and surgical treatment in patients with abdominal wall endometrioma. METHODS

  13. Abdominal wall hernia and pregnancy

    DEFF Research Database (Denmark)

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

    2015-01-01

    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......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 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...

  14. Abdominal wall blocks in adults

    DEFF Research Database (Denmark)

    Neimann, Jens Dupont Børglum; Gögenür, Ismail; Bendtsen, Thomas F.

    2016-01-01

    Purpose of review Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research.  Rec...

  15. Recovery after abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim

    2017-01-01

    after abdominal wall reconstruction, while no other significant changes were found in objective or subjective measures at one-year follow-up in both groups of patients. Lastly, study IV examined the abdominal wall- and extremity function, as well as overall and disease specific quality of life. We found...... hernia repair were found. The most commonly used questionnaire was the generic Short-Form 36, which assesses overall health-related quality of life, addressing both physical and mental health. The second-most common questionnaire was the Carolinas Comfort Scale, which is a disease specific questionnaire...... addressing pain, movement limitation and mesh sensation in relation to a current or previous hernia. In total, eight different questionnaires were used at varying time points in the 26 studies. In conclusion, standardization of timing and method of quality of life assessment after incisional hernia repair...

  16. Distinct defects in collagen microarchitecture underlie vessel-wall failure in advanced abdominal aneurysms and aneurysms in Marfan syndrome

    NARCIS (Netherlands)

    Lindeman, J.H.N.; Ashcroft, B.A.; Beenakker, J.-W.M.; Es, M. van; Koekkoek, N.B.R.; Prins, F.A.; Tielemans, J.F.; Abdul-Hussien, H.; Bank, R.A.; Oosterkamp, T.H.

    2010-01-01

    An aneurysm of the aorta is a common pathology characterized by segmentalweakeningof the artery.Althoughit isgenerally accepted that the vessel-wall weakening is caused by an impaired collagen metabolism, a clear association has been demonstrated only for rare syndromes such as the vascular type

  17. ADULT ABDOMINAL WALL HERNIA IN IBADAN.

    African Journals Online (AJOL)

    INTRODUCTION. Abdominal wall hernia repair accounts, in the average surgical unit, for 15-18% of all surgical procedures1,2. Indeed hernias are a leading cause of morbidity and mortality in various parts of Africa1,3,4,5,6. Approximately 7 in 10 cases of all abdominal wall hernias occur in the groin, thus making inguinal ...

  18. Post caesarean section anterior abdominal wall endometriosis ...

    African Journals Online (AJOL)

    Abdominal wall endometriosis is a likely sequelae of caesarean section as viable endometrial tissue are deposited in the peritoneal cavity or anterior abdominal wall. One such case to sensitize clinicians of this rare presentation of the disease is presented. The patient was a 48 year old woman who presented with a lesion ...

  19. Synovial sarcoma of the abdominal wall

    International Nuclear Information System (INIS)

    Matushita, J.P.K.; Matushita, J.S.

    1989-01-01

    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) [pt

  20. Connective tissue alteration in abdominal wall hernia

    DEFF Research Database (Denmark)

    Henriksen, N A; Yadete, D H; Sørensen, Lars Tue

    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 abdominal wall hernia formation....

  1. The extended abdominal wall flap for transplantation.

    Science.gov (United States)

    Hollenbeck, S T; Senghaas, A; Turley, R; Ravindra, K V; Zenn, M R; Levin, L S; Erdmann, D

    2011-06-01

    Patients with extensive loss of the abdominal wall tissue have few options for restoring the abdominal cavity. Composite tissue allotransplantation has been used for limited abdominal wall reconstruction in the setting of visceral transplantation, yet replacement of the entire abdominal wall has not been described. The purpose of this study was to determine the maximal abdominal skin surface available through an external iliac/femoral cuff-based pedicle. Five human cadaveric abdominal walls were injected with methylene blue to analyze skin perfusion based on either the deep inferior epigastric artery (DIEA; n = 5) or a cuff of external iliac/femoral artery (n = 5) containing the deep circumflex iliac, deep inferior epigastric, and superficial inferior epigastric, and superficial circumflex iliac arteries. Abdominal wall flaps were taken full thickness from the costal margin to the midaxillary line and down to the pubic tubercle and proximal thigh. In all specimens, the deep inferior epigastric, deep circumflex iliac, superficial inferior epigastric, and superficial circumflex iliac arteries were found to originate within a 4-cm cuff of the external iliac/femoral artery. Abdominal wall flaps injected through a unilateral external iliac/femoral segment had a significantly greater degree of total flap perfusion than those injected through the DIEA alone (76.5% ± 4% vs 57.2% ± 5%; Student t test, P DIEA vessel alone. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Traumatic abdominal wall hernia: A case report and literature review.

    Science.gov (United States)

    Al Beteddini, Osama S; Abdulla, Samir; Omari, Osama

    2016-01-01

    Traumatic abdominal wall hernia is a rare but serious diagnosis resulting from blunt abdominal trauma. The clinical diagnosis is not usually straightforward and the hernia is often discovered at the time of the surgical exploration for intra-abdominal injuries or by imaging studies. A 25-year-old obese, restraint, male patient was the victim of a high-speed road traffic accident. Among other injuries, he showed extensive skin maceration and bruising over the lower abdomen and flanks upon presentation, however he did not need any surgical intervention. Contrast-enhanced computed tomography scan of the abdomen and pelvis demonstrated extensive abdominal wall muscular disruption over both flanks with herniation of the right colon. Counselled to follow up in 4-6 weeks to have the hernia surgically repaired, he showed up after 8 months with a large muscular defect resulting in a large hernia containing small and large bowel loops. The timing and type of the surgical repair of traumatic abdominal wall hernia depends upon the size of the hernia defect and the presence of associated intra-abdominal injuries. Delayed repair; however, may result in a large defect making primary, non-prosthetic repair impossible and increases the risk of abdominal compartment syndrome after surgical correction. Traumatic abdominal wall hernia presents a diagnostic as well as a therapeutic challenge. The therapeutic approach is governed by a multitude of factors emphasizing the need of a patient-tailored, case by case management plan. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Abdominal Wall Surgery : Management of frail patients

    NARCIS (Netherlands)

    B. de Goede (Barry)

    2017-01-01

    textabstractThis thesis focusses on the management of abdominal wall hernias (e.g. inguinal, umbilical and incisional hernias) in elderly patiens, premature born infants, and patiens with liver cirrhosis - pre-, during and post liver transplantation.

  4. Don't Forget the Abdominal Wall: Imaging Spectrum of Abdominal Wall Injuries after Nonpenetrating Trauma.

    Science.gov (United States)

    Matalon, Shanna A; Askari, Reza; Gates, Jonathan D; Patel, Ketan; Sodickson, Aaron D; Khurana, Bharti

    2017-01-01

    Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury). These injuries are often overlooked clinically because of (a) a lack of findings at physical examination or (b) distraction by more-severe associated injuries. However, these injuries are important to detect because they are highly associated with potentially grave visceral and vascular injuries, such as aortic injury, and because their detection can lead to the diagnosis of these more clinically important grave traumatic injuries. Failure to make a timely diagnosis can result in delayed complications, such as bowel hernia with potential for obstruction or strangulation, or misdiagnosis of an abdominal wall neoplasm. Groin injuries, such as athletic pubalgia, and inferior costochondral injuries should also be considered in patients with abdominal pain after nonpenetrating trauma, because these conditions may manifest with referred abdominal pain and are often included within the field of view at cross-sectional abdominal imaging. Radiologists must recognize and report acute abdominal wall injuries and their associated intra-abdominal pathologic conditions to allow appropriate and timely treatment. © RSNA, 2017.

  5. Biomechanical abdominal wall model applied to hernia repair.

    Science.gov (United States)

    Lyons, M; Mohan, H; Winter, D C; Simms, C K

    2015-01-01

    Most surgical innovations require extensive preclinical testing before employment in the operative environment. There is currently no way to develop and test innovations for abdominal wall surgery that is cheap, repeatable and easy to use. In hernia repair, the required mesh overlap relative to defect size is not established. The aims of this study were to develop a biomechanical model of the abdominal wall based on in vivo pressure measurements, and to apply this to study mesh overlap in hernia repair. An observational study of intra-abdominal pressure (IAP) levels throughout abdominal surgery was conducted to identify the peak perioperative IAP in vivo. This was then applied in the development of a surrogate abdominal wall model. An in vitro study of mesh overlap for various defect sizes was then conducted using this clinically relevant surrogate abdomen model. The mean peak perioperative IAP recorded in the clinical study was 1740 Pa, and occurred during awakening from anaesthesia. This was reproduced in the surrogate abdomen model, which was also able to replicate incisional hernia formation. Using this model, the mesh overlap necessary to prevent hernia formation up to 20 kPa was found, independent of anatomical variations, to be 2 × (defect diameter) + 25 mm. This study demonstrated that a surgically relevant surrogate abdominal wall model is a useful translational tool in the study of hernia repair. Surgical relevance This study examined the mesh overlap requirements for hernia repair, evaluated in a biomechanical model of the abdomen. Currently, mesh size is selected based on empirical evidence and may underpredict the requirement for large meshes. The study proposes a relationship between the defect size and mesh size to select the appropriate mesh size. Following further trials and investigations, this could be used in clinical practice to reduce the incidence of hernia recurrence. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  6. Abdominal Wall Hernias: Various Imaging Features Correlated with the Anatomy of Abdominal Wall at MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Shin Young; Shin, Hyeong Cheol; Kim, Sang Won; Kim, Il Young; Kim, Young Tong [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2009-07-15

    Abdominal wall hernias are a common condition. However, they may develop acute complications and require surgical correction in most cases. Hence, the correct radiological examination is requisite for an accurate diagnosis. A multi-detector row CT (MDCT) provides an accurate identification of the anatomy of the abdominal wall, precise hernia type, and helps in the detection of early signs of complication. We report various imaging features of abdominal wall hernias via a MDCT.

  7. Ultrasonography of anterior abdominal wall lesion

    Energy Technology Data Exchange (ETDEWEB)

    Lee, K.N.; Lee, S. K.; Park, H. Y.; Kim, Y. S.; Park, B. H. [Maryrnoll Hospital, Busan (Korea, Republic of)

    1983-12-15

    The anterior abdominal wall has received little attention in the ultrasonic evaluation. However recently the improved resolution of ultrasound scanning devices has made possible routine examination of the anterior abdominal wall. The authors evaluated ultrasonographic findings of anterior abdominal wall lesions in 27 cases for 1 year(from July '82 to Aug. '83), which were finally diagnosed pathologically and clinically. The results were as follows: 1. Well defined peritoneal line and layers of the anterior abdominal wall made it possible to localize the lesions accurately from adjacent structures. 2. Abscess and hematoma were lower in echogenecity than adjacent tissues, such as muscle layer or subcutaneous fat space and were well delineated from normal structures. 3. In hernia, easy differentiation was made due to oval shape, poor or decreased echo pattern and protrustion from skin layer. Conclusively, in the doubtful cases of palpable mass in the abdominal wall, postoperative complications of sequele, such as accurately but also the guide of treatment. Ultrasonography of anterior abdominal wall is useful to demonstrate the exact location, extent of the lesions and to decrease the frequency of useless laparatomy

  8. Radiologic findings of abdominal wall endometriosis

    International Nuclear Information System (INIS)

    Seo, Jung Wook

    2003-01-01

    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

  9. Radiologic findings of abdominal wall endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. REHERNIATION AFTER REPAIR OF THE ABDOMINAL-WALL WITH EXPANDED POLYTETRAFLUOROETHYLENE

    NARCIS (Netherlands)

    SIMMERMACHER, RKJ; SCHAKENRAAD, JM; BLEICHRODT, RP

    Defects of the abdominal wall that are not amenable to primary closure have to be bridged by synthetic materials. The use of a nonabsorbable expanded polytetrafluoroethylene (ePTFE) soft-tissue patch is advocated for this purpose. To investigate the suitability of the ePTFE patch, abdominal wall

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

    Directory of Open Access Journals (Sweden)

    Ersin Dumlu

    2014-06-01

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

  12. Lower abdominal wall reconstructions with pedicled rectus femoris flaps

    International Nuclear Information System (INIS)

    Arashiro, Ken; Nishizeki, Osamu; Ishida, Kunihiro

    2003-01-01

    During the past 10 years, seven pedicled rectus femoris muscle or musculocutaneous flaps were used to repair lower abdominal defects; three recalcitrant incisional hernias with previous radiotherapy, two long-standing wound infections after synthetic mesh reconstruction, one posttraumatic wall defect and one metastatic tumor. There were two flap complications, one skin paddle necrosis and one wound infection. There was no significant disability of the donor limb encountered. During the two-year and seven month average follow-up, there was no recurrence of the problems except for one minor fascial dehiscence in the patient with metastatic abdominal wall tumor. Easy approach, rapid harvest, relatively large and reliable overlying fascia lata, a single dominant neurovascular pedicle, easy primary closure of the donor site, and minimal donor site morbidity all make the rectus femoris flap a good alternative flap for lower abdominal wall reconstruction. It is especially useful in a condition where synthetic mesh would be unsuitable for defects with infection or recurrent incisional hernia after radiotherapy. (author)

  13. Abdominal wall hernias: imaging with spiral CT

    International Nuclear Information System (INIS)

    Stabile Ianora, A.A.; Midiri, M.; Vinci, R.; Rotondo, A.; Angelelli, G.

    2000-01-01

    Computed tomography is an accurate method of identifying the various types of abdominal wall hernias, especially if they are clinically occult, and of distinguishing them from other diseases such as hematomas, abscesses and neoplasia. In this study we examined the CT images of 94 patients affected by abdominal wall hernias observed over a period of 6 years. Computed tomography clearly demonstrates the anatomical site of the hernial sac, the content and any occlusive bowel complications due to incarceration or strangulation. Clinical diagnosis of external hernias is particularly difficult in obese patients or in those with laparotic scars. In these cases abdominal imaging is essential for a correct preoperative diagnosis and to determine the most effective treatment. (orig.)

  14. Laparoscopic surgery in children: abdominal wall complications

    Directory of Open Access Journals (Sweden)

    Vaccaro S.

    2017-06-01

    Full Text Available Minimal invasive surgery has become the standard of care for operations involving the thoracic and abdominal cavities for all ages. Laparoscopic complications can occur as well as more invasive surgical procedures and we can classify them into non-specific and specific. Our goal is to analyze the most influential available scientific literature and to expose important and recognized advices in order to reduce these complications. We examined the mechanism, risk factors, treatment and tried to outline how to prevent two major abdominal wall complications related to laparoscopy: bleeding and port site herniation .

  15. [Abdominal wall closure in laparotomy].

    Science.gov (United States)

    Bellón-Caneiro, Juan M

    2005-03-01

    The midline laparotomy is among the most common ways of accessing the peritoneal cavity. This approach is not only used for surgery of the digestive tract but is also extensively applied in vascular, gynecology and urological surgery. When this surgical procedure is conducted in an emergency setting, and depending on the type of surgery (clean and /or contaminated), the incidence of complications may be particularly high, especially when acute dehiscence of the wall occurs (evisceration). Furthermore, the rate of herniation related to midline laparotomy is still high at approximately 16% of cases. Despite efforts to evaluate different suture techniques, suture threads (reabsorbable or non-reabsorbable) and general factors that may interfere with the repair process, the incidence of complications associated with this approach has not been reduced. After multiple studies including meta-analyses, the outcome of laparotomy closure has not essentially improved. We should therefore consider the use of new ways of closing the abdomen in selected patients that might somehow reinforce the surgical wound and notably reduce the incidence of short- and medium-term complications. One such method could perhaps be the use of a biomaterial to support and strengthen conventional sutures.

  16. Recurrent desmoid tumor of the abdominal wall | Toughrai | Pan ...

    African Journals Online (AJOL)

    Desmoid tumors most often occur in abdominal wall. Their tendency to recur lead to repeated operations which can make the abdominal wall reconstruction difficult. We report a 28-year-old female history. The patient was referred to our hospital for a recurrent desmoid tumor of the abdominal wall. The tumor was totally ...

  17. Soft-tissue masses in the abdominal wall

    International Nuclear Information System (INIS)

    Bashir, U.; Moskovic, E.; Strauss, D.; Hayes, A.; Thway, K.; Pope, R.; Messiou, C.

    2014-01-01

    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

  18. Traumatic abdominal wall hernia secondary to motorcycle handle bar injury

    Directory of Open Access Journals (Sweden)

    R S Jamabo

    2011-01-01

    Conclusion: We recommend a high level of clinical suspicion for traumatic abdominal wall herniation in all patients with traumatic abdominal wall injuries. It is instructive that the area be explored with primary repair of the hernia and other tissue planes of the abdominal wall.

  19. ADULT ABDOMINAL WALL HERNIA IN IBADAN.

    Science.gov (United States)

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

    2015-12-01

    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. To describe the clinical profile of anterior abdominal wall hernias and our experience in the surgical management of identified hernias. The project was a retrospective study of all patients with abdominal wall hernia presenting into surgical divisions of University College Hospital Ibadan during a 6 year period (January 2008 to December 2013). Relevant information was retrieved from their case notes and analysed. The case records of 1215 (84.7%) patients out of 1435 were retrieved. Elective surgery was done in 981(80.7%) patients while 234 (19.3%) patients had emergency surgery. There were 922 (84.8%) groin hernias and post-operative incisional hernia accounted for 9.1% (111) of the patients. About half (49.1%) of those with incisional hernia were post obstetric and gynaecologic procedure followed by post laparotomy incisional hernias 16 (14%) and others (23.5%). The ratio of inguinal hernia to other types in this study is 3:1. Hollow viscus resection and emergency surgery were predictors of wound infection statistically significant in predicting wound infection (P < 0.001). Peri-operative morbidity/mortality at 28 days post operation was documented in 113 patients (12.1%). One year recurrence rate of groin hernia was 2.1%. The pattern of presentation and management of anterior wall hernias are still the same compared with the earlier study in this hospital. New modality of treatment should be adopted as the standard choice of care. Abdominal wall hernias are very common clinical presentation. Modified Bassini repair was the preferred method of repair due to its simplicity. Mesh repair is becoming more common in recent time but high cost and initial non-availability of the mesh limit its use in our centre.

  20. Abdominal wall necrotizing fasciitis from dislodged percutaneous endoscopic gastrostomy tubes: a case series.

    Science.gov (United States)

    MacLean, Alexandra A; Miller, George; Bamboat, Zubin M; Hiotis, Karen

    2004-09-01

    We report three cases of abdominal wall necrotizing fasciitis that occurred as a result of leakage from displaced percutaneous endoscopic gastrostomy tubes. This is the first report of such a series. Patients underwent extensive operative excisions of their abdominal walls down to their posterior fascia. All patients tolerated their initial surgery, however, two patients ultimately expired from respiratory complications. The surviving patient underwent multiple repeat debridements and reconstructive abdominal wall surgery. We review the epidemiology of patients at risk for this complication and discuss its presentation, as well as the appropriate workup and management. We also address the issues of closure of large abdominal wall defects and future alimentation in this patient group. Finally, abdominal wall necrotizing faciitis from gastrostomy tube leakage is a devastating complication, and the development of preventative strategies for patients at risk is of paramount importance.

  1. Laparoscopic assisted modification of the firlit abdominal wall plication.

    Science.gov (United States)

    Franco, Israel

    2005-07-01

    We describe a modification of the Firlit abdominal wall plication procedure for abdominal wall reconstruction in the prune-belly syndrome. Five boys with the prune-belly syndrome and 1 with congenital atrophy or hypotrophy of the internal and external oblique muscles underwent laparoscopic assisted abdominal wall reconstruction. All 6 patients had excellent cosmetic results, with no weakness or sagging of the abdominal wall. Laparoscopy appears to add to the Firlit procedure an increased measure of safety and a possible decrease in morbidity associated with opening the abdomen, and improved precision that enhances the results achieved with the original procedure and other abdominal wall repairs.

  2. An enigma of spontaneous combined transdiaphragmatic, intercostal and abdominal wall hernia.

    Science.gov (United States)

    Abu-Gazala, M; Ratnayake, A; Abu-Gazala, S; Bala, M

    2013-06-01

    Cough can be associated with many complications. We present a 59-year-old male patient with a very rare combination of a cough-related stress fracture of the ninth rib and herniation through the diaphragm and abdominal wall to the subcutaneous tissue of the chest wall. We suggest thoracotomy through the affected intercostal defect as a surgical approach. The diaphragm, chest wall and abdominal tears were repaired separately, and the abdominal wall was reinforced with mesh. Technical aspects were discussed. Though each individual injury is well documented in the literature, this is a rare combination of defects, requiring early recognition to provide repair before incarceration and further enlargement of the defects occur.

  3. Herniography in anterior abdominal wall hernia

    International Nuclear Information System (INIS)

    Ekberg, O.; Fork, F.T.; Aspelin, P.

    1985-01-01

    The clinical diagnosis of anterior abdominal wall hernia is difficult in patients with a negative or inconclusive physical examination. These hernias are often of an interparietal type which hampers their detection. Herniography may contribute to the clinical workup in patients with Spigelian, incisional, and umbilical hernias. As the clinical presentation may be spurious, herniography should be used on wide indications. Ther herniographic appearance and differential diagnosis of these hernias are reported. The additional use of ultrasonography in this setting is illustrated and discussed. (orig.) [de

  4. Herniography in anterior abdominal wall hernia

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Fork, F.T.; Aspelin, P.

    1985-11-01

    The clinical diagnosis of anterior abdominal wall hernia is difficult in patients with a negative or inconclusive physical examination. These hernias are often of an interparietal type which hampers their detection. Herniography may contribute to the clinical workup in patients with Spigelian, incisional, and umbilical hernias. As the clinical presentation may be spurious, herniography should be used on wide indications. Ther herniographic appearance and differential diagnosis of these hernias are reported. The additional use of ultrasonography in this setting is illustrated and discussed. (orig.).

  5. Isolated Abdominal Wall Metastasis of Endometrial Carcinoma

    Directory of Open Access Journals (Sweden)

    Rita Luz

    2014-01-01

    Full Text Available A woman in her mid-60s presented with a bulky mass on the anterior abdominal wall. She had a previous incidental diagnosis of endometrial adenocarcinoma FIGO stage IB following a vaginal hysterectomy. Physical exam and imaging revealed a well circumscribed bulging tumour at the umbilical region, measuring 10 × 9 × 9 cm, with overlying intact skin and subcutaneous tissue. Surgical resection was undertaken, and histological examination showed features of endometrial carcinoma. She began chemotherapy and is alive with no signs of recurrent disease one year after surgery. This case brings up to light an atypical location of a solitary metastasis of endometrial carcinoma.

  6. [Abdominal wall prostheses. Biomechanic and histological study].

    Science.gov (United States)

    Rath, A M; Zhang, J; Amouroux, J; Chevrel, J P

    1996-01-01

    The best prosthetic material is one which provides the best mechanical resistance with the best biological tolerance. In order to assess the mechanical and histological properties of abdominal wall prostheses, we performed experimental tests in animal models comparing four materials: polypropylene, dacron, polyglactine 910 and a dacron-polyglactine 910 composite. One hundred thirty rabbits were used including 10 controls and 120 test animals. A medial laparotomy was closed with an antemuscular aponevrotic prosthesis in the test animals. Animals were sacrificed at one, two and three months after the operation. Abdominal wall and prosthesis samples were tested to determine resistance to pressure and extension, deformability and elasticity. Histology tests were also done to determine resistance quality and biological tolerance. Dacron was tolerated best and was less resistant than polypropylene, though resistance was satisfactory. There was no advantage with polyglactine compared with non-resorbable prostheses; its only indication would be a septic site. The composite material tested had a resistance comparable with that of dacron but was less well tolerated.

  7. [Successful laparoscopic repair of delayed traumatic abdominal wall hernia].

    Science.gov (United States)

    Hiroshige, Shoji; Kubo, Nobuhide; Orita, Hiroyuki; Saeki, Hiroshi; Kawanaka, Hirofumi; Tomikawa, Morimasa; Uchiyama, Hideaki; Ikeda, Tetsuo; Yano, Tokujirou; Mutou, Youichi; Maehara, Yoshihiko

    2013-12-01

    The occurrence of traumatic abdominal wall hernia secondary to blunt trauma is uncommon, and laparoscopic repair of such hernias is very rare. A 53-year-old man, who had sustained injuries to his right thigh and right abdomen 8 months previously, visited a hospital because of a bulge in the right lateral abdomen. An abdominal computed tomography scan revealed a rupture in the lateral abdominal muscle and herniation of the cecum into the subcutaneous space. Accordingly, delayed traumatic abdominal wall hernia was diagnosed, which was successfully repaired laparoscopically. Thus, a laparoscopic tension-free mesh repair was safely and effectively performed for delayed traumatic abdominal wall hernia.

  8. [Pain originating from the abdominal wall: a forgotten diagnostic option].

    Science.gov (United States)

    Rivero Fernández, Miguel; Moreira Vicente, Víctor; Riesco López, José María; Rodríguez Gandía, Miguel Angel; Garrido Gómez, Elena; Milicua Salamero, José María

    2007-04-01

    Chronic abdominal pain is a common clinical problem in primary care, and is usually referred to gastroenterologists or general surgeons. Although up to 20% of cases of idiopathic abdominal pain arise in structures of the abdominal wall, this is frequently overlooked as a possible cause. It includes pain arising from structures of the abdominal wall including skin, parietal peritoneum, cellular subcutaneous tissue, aponeuroses, abdominal muscles and somatosensorial innervation from lower dorsal roots. The diagnosis is based on anamnesis and physical examination. Carnett's sign is a simple maneuver that discriminates between parietal and visceral pain. Management with topical anesthesia is effective in a majority of patients and can help to confirm the diagnosis.

  9. Adult abdominal wall hernia in Ibadan | Ayandipo | Annals of Ibadan ...

    African Journals Online (AJOL)

    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 ...

  10. Pattern of abdominal wall herniae in females: a retrospective analysis

    African Journals Online (AJOL)

    Background: Gender differences are expected to influence the pattern and outcome of management of abdominal wall hernias. Some of these are left to speculations with few published articles on hernias in females. Objectives: To describe the clinical pattern of abdominal wall hernias in females. Method: A 5 year ...

  11. Cold Abscess of the Anterior Abdominal Wall: An Unusual Primary ...

    African Journals Online (AJOL)

    abdominal wall for the last three years. There were no other symptoms and the patient did not have any other past medical history suggestive of tuberculosis. Physical examination revealed a nontender swelling (7 cm × 5 cm) on the anterior abdominal wall to left of midline which extended from left hypochondrium above to ...

  12. Abdominal wall closure in bladder exstrophy complex repair by ...

    African Journals Online (AJOL)

    Background and Objectives: The Exstrophy Complex (EC) is a serious malformation of midline abdominal wall. Wide pubis prevents approximating the lateralized rectus muscle and leads to dehiscence and fi stula formation. Our aim was to recommend an easier method for abdominal wall closure in the Bladder Exstrophy ...

  13. Pattern of abdominal wall herniae in females: a retrospective analysis.

    African Journals Online (AJOL)

    Abstract. Background: Gender differences are expected to influence the pattern and outcome of management of abdominal wall hernias. Some of these are left to speculations with few published articles on hernias in females. Objectives: To describe the clinical pattern of abdominal wall hernias in females. Method: A 5 year ...

  14. Abdominal wall tumour: An unusual presentation of endometriosis ...

    African Journals Online (AJOL)

    The association between endometriosis and abdominal wall lesion is rare. Since its first description by Brew in 1954 only a few sporadic cases have been reported in the literature. We report a case of extensive painfall abdominal wall tumours that occur possibly as a consequence of a previous caesarian section.

  15. Tensor fascia lata musculocutaneous flap for abdominal wall reconstruction

    International Nuclear Information System (INIS)

    Peled, I.J.; Kaplan, H.Y.; Herson, M.; Wexler, M.R.

    1983-01-01

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

  16. Abdominal Wall Reconstruction in Patients with Digestive Tract Fistulas

    OpenAIRE

    Johnson, Eric K.; Tushoski, Pamela L.

    2010-01-01

    Abdominal wall reconstruction in the digestive tract fistula patient is a complex issue. The authors review the available data and present information regarding the timing of surgery, techniques of abdominal wall reconstruction, hernia repair, and discuss pitfalls associated with the various options. A simple and basic approach to this problem is described.

  17. Abdominal wall reconstruction using De-epithelialized dermal flap: A ...

    African Journals Online (AJOL)

    Abdominal wall reconstruction using De-epithelialized dermal flap: A new technique. ... Journal of Surgical Technique and Case Report ... Background: Although autogenous materials have been used in abdominal wall hernioplasty for a long time, the introduction of prosthetic materials diminished their popularity. However ...

  18. Abdominal Wall Hernia: new perspectives for clinical research

    NARCIS (Netherlands)

    H.H. Eker (Hasan)

    2014-01-01

    markdownabstract__Abstract__ Abdominal wall surgery is a broad term, covering different treatment strategies for all different types of abdominal wall hernias. For example, an inguinal hernia is a totally different entity than an incisional hernia and requires a different treatment strategy.

  19. Tensor fascia lata musculocutaneous flap for abdominal wall reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Peled, I.J.; Kaplan, H.Y.; Herson, M.; Wexler, M.R.

    1983-08-01

    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.

  20. Comparative study between polypropylene and polypropylene/poliglecaprone meshes used in the correction of abdominal wall defect in rats Estudo comparativo entre as telas de polipropileno e polipropileno/poliglecaprone utilizadas na correção de defeito na parede abdominal ventral de ratos

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Lima Utrabo

    2012-04-01

    Full Text Available PURPOSE: To evaluate the healing process of a defect in the ventral abdominal wall of rats, comparing the polypropylene and polypropylene/poliglecaprone meshes on the 30th and 60th postoperative day. METHODS: Thirty two Wistar rats were submitted to a ventral abdominal wall defect, with integrity of the parietal peritoneum. In the repair, were used polypropylene (group A and polypropylene/poliglecaprone (group B meshes. The groups were subdivided into four subgroups of eight animals euthanized on the 30th (A30 and B30 and 60th postoperative day (A60 and B60. Fragments of the abdominal wall of the animals were submitted to macroscopic, tensiometric and histological evaluations. RESULTS: The tensiometry on subgroup A30 showed a mean average break point of 0.78 MPa and in A60, 0.66 Mpa. In subgroup B30 it was 0.84 MPa and in B60, 1.27 Mpa. The score of the inflammatory process showed subacute phase on A30 and B30 sub-groups and chronic inflammatory process in subgroups A30 and 60B. CONCLUSIONS: The tensile strength was higher on the wall repaired by polypropylene/poliglecaprone mesh in the 60th post-operative day. Histology showed higher concentration of fibrosis on the surface of the polypropylene mesh with a tendency to encapsulation. In polypropylene/poliglecaprone subgroups the histology showed higher concentration of fibrosis on the surface of mesh filaments.OBJETIVO: Avaliar a cicatrização de um defeito, na parede abdominal ventral de ratos, comparando-se as telas de polipropileno e polipropileno/poliglecaprone no 30º e 60º dia do pós-operatório. MÉTODOS: Trinta e dois ratos Wistar foram submetidos à produção de defeito na parede abdominal ventral, com integridade do peritônio parietal. Na correção foram utilizadas as telas de polipropileno (grupo A e polipropileno/poliglecaprone (grupo B. Houve subdivisão em quatro subgrupos (A30, A60, B30 e B60 de oito animais que foram submetidos à eutanásia no 30º e 60º dia do p

  1. Classification of primary and incisional abdominal wall hernias.

    Science.gov (United States)

    Muysoms, F E; Miserez, M; Berrevoet, F; Campanelli, G; Champault, G G; Chelala, E; Dietz, U A; Eker, H H; El Nakadi, I; Hauters, P; Hidalgo Pascual, M; Hoeferlin, A; Klinge, U; Montgomery, A; Simmermacher, R K J; Simons, M P; Smietański, M; Sommeling, C; Tollens, T; Vierendeels, T; Kingsnorth, A

    2009-08-01

    A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable. Several members of the EHS board and some invitees gathered for 2 days to discuss the development of an EHS classification for primary and incisional abdominal wall hernias. To distinguish primary and incisional abdominal wall hernias, a separate classification based on localisation and size as the major risk factors was proposed. Further data are needed to define the optimal size variable for classification of incisional hernias in order to distinguish subgroups with differences in outcome. A classification for primary abdominal wall hernias and a division into subgroups for incisional abdominal wall hernias, concerning the localisation of the hernia, was formulated.

  2. Abdominal wall reconstruction for large incisional hernia restores expiratory lung function.

    Science.gov (United States)

    Jensen, Kristian K; Backer, Vibeke; Jorgensen, Lars N

    2017-02-01

    Respiratory complications secondary to intermittent intra-abdominal hypertension and/or atelectasis are common after abdominal wall reconstruction for large incisional hernias. It is unknown if the respiratory function of this patient group is affected long term or impairs activities of daily living. We hypothesized that abdominal wall reconstruction for large incisional hernia would not lead to improved, long-term pulmonary function or respiratory quality of life. Eighteen patients undergoing open abdominal wall reconstruction with mesh for a large incisional hernia (horizontal fascial defect width >10 cm) were compared with 18 patients with an intact abdominal wall who underwent colorectal resection. Patients were examined pre- and 1-year postoperatively. Examined measures included forced vital capacity, forced expiratory volume in first second, peak expiratory flow, maximal in- and expiratory mouth pressure, and 2 validated questionnaires on respiratory quality of life. In order to decrease heterogeneity, objectively examined parameters were presented relative to the predicted values, which were normality adjusted pulmonary measures. At 1-year follow-up, the abdominal wall reconstruction group showed significant improvement in percent predicted peak expiratory flow and maximal expiratory mouth pressure, whereas all other measurements of lung function remained unchanged. Respiratory quality of life did not change significantly. Patients who underwent abdominal wall reconstruction showed a significantly greater improvement of percent predicted peak expiratory flow compared with patients undergoing colorectal resection. Abdominal wall reconstruction for large incisional hernia improved long-term expiratory lung function. Respiratory quality of life did not change significantly after abdominal wall reconstruction. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Giant Desmoid Tumor of the Anterior Abdominal Wall in a Young Female: A Case Report

    Directory of Open Access Journals (Sweden)

    Mahim Koshariya

    2013-01-01

    Full Text Available Desmoid tumors (also called desmoids fibromatosis are rare slow growing benign and musculoaponeurotic tumors. Although these tumors have a propensity to invade surrounding tissues, they are not malignant. These tumors are associated with women of fertile age, especially during and after pregnancy. We report a young female patient with a giant desmoid tumor of the anterior abdominal wall who underwent primary resection. The patient had no history of an earlier abdominal surgery. Preoperative evaluation included abdominal ultrasound, computed tomography, and magnetic resonance imaging. The histology revealed a desmoid tumor. Primary surgical resection with immediate reconstruction of abdominal defect is the best management of this rarity. To the best of our knowledge and PubMed search, this is the first case ever reported in the medical literature of such a giant desmoid tumor arising from anterior abdominal wall weighing 6.5 kg treated surgically with successful outcome.

  4. Incorporation by host tissue of two biomaterials used as repair of defects produced in abdominal wall of rats Incorporação por tecido do hospedeiro de dois biomateriais usados como reparo de defeitos produzido em parede abdominal de ratos

    Directory of Open Access Journals (Sweden)

    Suyiene Cordeiro Falcão

    2008-02-01

    Full Text Available PURPOSE: Biomaterials may be used as treatment of great abdominal wall defects to avoid tension during repair. In the present research we intended to investigate incorporation type by host tissue of membranes of microbial cellulose (MC, produced by the bacteria Zoogloea sp., and of polytetrafluoroethylene (ePTFE in abdominal wall defects of rats. METHODS: Sixty male rats Wistar, anesthetized by ketamine (5mg/100g and xylazine (2mg/100g, were submitted to a rectangular excision (2x3cm of the abdominal wall, including fascia, muscles and peritoneum and further treated with implants of microbial cellulose (MC Group - 30 animals or expanded polytetrafluoroethylene ( ePTFE Group- 30 animals. Each group was subdivided in 14th DPO, 28th DPO and 60th DPO Subgroups. RESULTS: Incorporation of biomaterials was observed by wrapping and infiltration by host tissue. It has been found that wrapping associated to infiltration of host connective tissue in implants of ePTFE were present in 100% of the observed samples, and this may be responsible for increase resistance to traction. Inversely, wrapping without host tissue infiltration was seen in 100% of examined specimens of MC implants. CONCLUSION: Wrapping and host tissue infiltration is seen only in ePTFE implants.OBJETIVO: Biomateriais podem ser usados como tratamento de grandes defeitos da parede abdominal para evitar tensão durante reparo. Na presente pesquisa pretendeu-se investigar o tipo de incorporação pelo tecido do hospedeiro de membranas de celulose microbiana (CM, produzidas pela bactérias Zoogloea sp., e de politetrafluoretileno (PTFEe em defeitos da parede abdominal de ratos. MÉTODOS: Sessenta ratos machos Wistar, anestesiados através de cetamina (5mg/100g e xilazina (2mg/100g, foram submetidos a uma excisão retangular (2x3cm da parede abdominal, incluindo fascia, músculos e peritoneum e posteriormente tratadas com implantes de celulose microbiana (Groupo CM - 30 animais ou

  5. WITHDRAWN: The extended abdominal wall flap for transplantation.

    Science.gov (United States)

    Hollenbeck, S T; Senghaas, A; Turley, R; Ravindra, K V; Zenn, M R; Levin, L S; Erdmann, D

    2011-11-01

    Patients with extensive loss of abdominal wall tissue have few options for restoring the abdominal cavity. Composite tissue allotransplantation has been used for limited abdominal wall reconstruction in the setting of visceral transplantation, yet replacement of the entire abdominal wall has not been described. The purpose of this study was to determine the maximal abdominal skin surface available through an external iliac/femoral cuff-based pedicle. Five human cadaver abdominal walls were injected with methylene blue to analyze skin perfusion based on either the deep inferior epigastric artery (DIEA; n = 5) or a cuff of external iliac/femoral artery (n = 5) containing the deep circumflex iliac, deep inferior epigastric, superficial inferior epigastric, and the superficial circumflex iliac arteries. Abdominal wall flaps were taken full thickness from the costal margin to the mid-axial line and down to the pubic tubercle and proximal thigh. In all specimens, the deep inferior epigastric, deep circumflex iliac, superficial inferior epigastric, and the superficial circumflex iliac arteries were found to originate within a 4-cm cuff of the external iliac/femoral artery. Abdominal wall flaps injected through a unilateral external iliac/femoral segment had a significantly greater degree of total flap perfusion than those injected through the DIEA alone (76.5 +/- 4% versus 57.2 +/- 5%; Student t test, P DIEA vessel alone. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Abdominal wall reconstruction for large incisional hernia restores expiratory lung function

    DEFF Research Database (Denmark)

    Jensen, Kristian K; Backer, Vibeke; Jorgensen, Lars N

    2017-01-01

    (horizontal fascial defect width >10 cm) were compared with 18 patients with an intact abdominal wall who underwent colorectal resection. Patients were examined pre- and 1-year postoperatively. Examined measures included forced vital capacity, forced expiratory volume in first second, peak expiratory flow...

  7. Huge desmoid tumor of the anterior abdominal wall mimicking an ...

    African Journals Online (AJOL)

    Huge desmoid tumor of the anterior abdominal wall mimicking an intraabdominal mass in a postpartum woman: a case report. Khaled Trigui, Mahdi Bouassida, Houda Kilani, Mohamed Mongi Mighri, Selim Sassi, Fathi Chebbi, Hassen Touinsi, Sadok Sassi ...

  8. Bullhorn Hernia: A Rare Traumatic Abdominal Wall Hernia

    African Journals Online (AJOL)

    Traumatic abdominal wall hernia (TAWH) is uncommonly encountered despite the high prevalence of blunt abdominal trauma.[1] Bullhorn hernia is a rare, TAWH caused by direct trauma by the horn of a bull. TAWH is described as herniation through disrupted musculature and fascia associated with adequate trauma ...

  9. An abdominal wall jig for surgical craft workshops.

    Science.gov (United States)

    Hill, J.; Kiff, E. S.

    1990-01-01

    An improved jig simulating the abdominal wall and peritoneal cavity is described. It can be used to teach the techniques of abdominal wound closure and stoma formation. It has proved to be a valuable addition to our anastomosis workshops. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:2146917

  10. Meleney's Ulcer; A Rare but Fatal Abdominal Wall Disease ...

    African Journals Online (AJOL)

    Meleney's ulcer or post operative synergistic bacterial gangrene is a rare form of abdominal wall gangrene but has well documented clinical entity. It develops following intra abdominal surgery in the immediate vicinity of the surgical wound. It is caused by synergistic interaction between microaerophilic nonhemolytic ...

  11. Bullhorn Hernia: A Rare Traumatic Abdominal Wall Hernia

    African Journals Online (AJOL)

    laparotomy. Finally, occult hernias may be managed expectantly. Traumatic abdominal wall hernia caused by bullhorn is commonly found in the lower abdomen such as inguinal region.[9] However, in our case the hernia was in the upper abdomen. Clinically, abdominal pain and locally bulging soft tissue at the ecchymotic.

  12. Abdominal wall hernia and pregnancy: a systematic review.

    Science.gov (United States)

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

    2015-10-01

    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. A literature search was undertaken in PubMed and Embase in combination with a cross-reference search of eligible papers. 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 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 in 102 patients without major complications. The literature on abdominal wall hernia and pregnancy is sparse. Abdominal wall hernia repair with suture or mesh may cause pain in the last trimester of a subsequent pregnancy. Hernia repair in conjunction with cesarean section appear as the optimal treatment of a pregnant patient with a symptomatic abdominal wall hernia.

  13. Giant ventral hernia-relationship between abdominal wall muscle strength and hernia area.

    Science.gov (United States)

    Strigård, K; Clay, L; Stark, B; Gunnarsson, U; Falk, P

    2016-08-02

    Symptoms arising from giant ventral hernia have been considered to be related to weakening of the abdominal muscles. The aim of this study was to investigate the relationship between the area of the abdominal wall defect and abdominal wall muscle strength measured by the validated BioDex system together with a back/abdominal unit. Fifty-two patients with giant ventral hernia (>10 cm wide) underwent CT scan, clinical measurement of hernia size and BioDex measurement of muscle strength prior to surgery. The areas of the hernia derived from CT scan and from clinical measurement were compared with BioDex forces in the modalities extension, flexion and isometric contraction. The Spearman rank test was used to calculate correlations between area, BMI, gender, age, and muscle strength. The hernia area calculated from clinical measurements correlated to abdominal muscle strength measured with the Biodex for all modalities (p-values 0.015-0.036), whereas no correlation was seen with the area calculated by CT scan. No relationship was seen between BMI, gender, age and the area of the hernia. The inverse correlation between BioDex abdominal muscle strength and clinically assessed hernia area, seen in all modalities, was so robust that it seems safe to conclude that the area of the hernia is an important determinant of the degree of loss of abdominal muscle strength. Results using hernia area calculated from the CT scan showed no such correlation and this would seem to concur with the results from a previous study by our group on patients with abdominal rectus diastasis. In that study, defect size assessed clinically, but not that measured by CT scan, was in agreement with the size of the diastasis measured intra-operatively. The point at which the area of a hernia begins to correlate with loss of abdominal wall muscle strength remains unknown since this study only included giant ventral hernias.

  14. Rives-Stoppa incisional hernia repair combined with laparoscopic separation of abdominal wall components: a novel approach to complex abdominal wall closure.

    Science.gov (United States)

    Cox, T C; Pearl, J P; Ritter, E M

    2010-12-01

    The Rives-Stoppa incisional hernia repair is the gold standard for mesh repair of complex incisional hernias. The risk of infection can be reduced if fascia is closed over the prosthetic mesh. Fascial closure in large defects may require extensive dissection and can result in devascularization of the overlying skin and denervation of the abdominal wall musculature. Laparoscopic components separation minimizes these risks while facilitating anterior fascial closure. The combined technique of Rives-Stoppa repair augmented by laparoscopic separation of abdominal wall components has not previously been reported. We retrospectively reviewed our initial experience with this combined technique for incisional hernia repair. A Rives-Stoppa incisional hernia repair is performed with mesh placed in the retromuscular position. If the anterior fascia cannot be closed, a laparoscopic separation of abdominal wall components is performed to facilitate fascial closure without creation of skin flaps. Six patients were identified. Three patients developed hernias following laparotomy from severe injuries sustained during combat. The other patients included hernia after esophagectomy, retroperitoneal liposarcoma resection, and complicated diverticulitis. Average defect size was 270 cm(2). Complete primary fascial closure anterior to the mesh was achieved in 66% of the patients. No mortalities occurred and at short term follow-up no incisional hernia recurrences have developed. Early post operative complications included a superficial skin infection not involving mesh and a recurrent enterocutaneous fistula. The authors conclude that Rives-Stoppa repair augmented by laparoscopic components separation is an innovative method for reconstruction of complex abdominal wall defects. Laparoscopic components separation allows fascial closure to be achieved anterior to the mesh in large incisional hernias, which may reduce wound infection rates.

  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

    Directory of Open Access Journals (Sweden)

    Marcia Regina Zanello Pundek

    2010-06-01

    Full Text Available RACIONAL: O uso de telas cirúrgicas para a correção de defeitos da parede abdominal vem ocupando cada vez mais espaço nas operações no mundo todo. OBJETIVO: Estudar duas telas cirúrgicas distintas (Proceed® e Ultrapro® na cicatrização de defeito produzido em parede abdominal de ratos avaliando-se macroscopia, tensiometria e microscopia. MÉTODO: A amostra foi constituída por 32 ratos Wistar, divididos em dois grupos de 16 animais e quatro subgrupos de oito, submetidos à eutanásia com 15 dias e 30 dias para avaliação. As variáveis macroscópicas foram: presença de hematoma nos bordos da sutura da tela cirúrgica na parede abdominal, união entre a tela e a borda da ferida, presença de infecção no sítio cirúrgico, presença de fístulas de vísceras com a tela cirúrgica, presença de aderências dentro da cavidade abdominal e presença de hérnia incisional. Na microscopia avaliaram-se as fases do processo inflamatório da cicatrização, e na tensiometria a força tênsil necessária para ruptura do material. RESULTADOS: A união entre a tela cirúrgica e a borda da ferida foi melhor no subgrupo Ultrapro 15 dias que no Proceed 15 dias; com 30 dias foi igual nos dois subgrupos. Não houve diferença significativa quanto às demais variáveis da macroscopia. Os dois grupos nos dois momentos tiveram a mesma proporção de casos com processo inflamatório crônico, mas houve maior escore de inflamação do Ultrapro 15 dias que do Ultrapro 30 dias. O subgrupo Ultrapro 15 dias mostrou força de ruptura maior que o subgrupo Proceed 15 dias, mas em 30 dias não houve diferença. Ultrapro mostrou força de ruptura igual para os dois momentos, mas Proceed 30 dias mostrou força de ruptura maior que Proceed 15 dias. CONCLUSÃO: As telas são semelhantes nas variáveis analisadas.BACKGROUND: The use of surgical meshes for the repair of abdominal wall defects has been increasing its share in surgeries worldwide. AIM: To study two

  16. Wandering ascaris coming out through the abdominal wall

    Directory of Open Access Journals (Sweden)

    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.

  17. [A case of sigmoid colon cancer with abdominal wall abscess].

    Science.gov (United States)

    Yamamoto, Yuji; Shimizu, Shinichiro; Maruyama, Takashi; Tanaka, Hajime; Matsuzaki, Hiroshi; Natsume, Toshiyuki; Miyazaki, Akinari; Satoh, Yayoi; Satsuka, Tetsutaro; Yoshioka, Takafumi; Kanada, Yoko; Otsuka, Ryota; Yanagihara, Akitoshi; Yokoyama, Masaya; Kobayashi, Takushi

    2014-11-01

    A 63-year-old man was admitted for an abdominal mass. Computed tomography revealed an abscess (21 × 20 cm) in the abdominal wall and a tumor in the sigmoid colon. Thus, cancer of the sigmoid colon complicated by an abscess of the abdominal wall was diagnosed. The abscess was drained and transverse colostomy was performed with curative intent. After the intervention, chemotherapy (XELOX×3) was administered. Three months later, sigmoidectomy was performed and the stoma was closed. Macroscopic and microscopic examination of the resected specimen detected no remnants of cancer. In patients with advanced colon cancer and abdominal wall involvement, a two-stage operation and preoperative chemotherapy may be considered essential when curative resection is performed.

  18. Anterior abdominal wall endometriosis following Caesarean Section ...

    African Journals Online (AJOL)

    ... her monthly menstruation, in whom abdominal examination revealed a midline subumbilical scar with a sinus surrounded by area of induration discharging menstrum. A wide excision of the lesion was performed and history confirmed endometriosis. Keywords: Caesarean section, scar endometriosis, polypropylene mesh ...

  19. Colonic diverticulosis is associated with abdominal wall hernia

    DEFF Research Database (Denmark)

    Oma, E.; Jorgensen, L. N.; Meisner, S.

    2017-01-01

    Purpose: Colonic diverticulosis and abdominal wall hernia are common pathologies. Studies have suggested that connective tissue alterations play a role in the formation of both diverticulosis and abdominal wall hernia. The aim of this cohort study was to evaluate the association between...... diverticulosis and abdominal wall hernia in a large cohort of patients undergoing colonoscopy. Methods: All consecutive patients who underwent colonoscopy between 2001 and 2013 at Bispebjerg Hospital were eligible for inclusion. The endoscopists prospectively registered the findings of diverticulosis......: A total of 13,855 patients were included, 3685 (26.6%) of whom were diagnosed with diverticulosis. Diverticulosis was independently associated with direct inguinal, OR 1.33, 95% CI 1.00–1.76, P = 0.049, and umbilical/epigastric hernia repair, OR 1.74, 95% CI 1.16–2.63, P = 0.008. Conclusions: Colonic...

  20. [Abdominal wall actinomycosis. A report of a case].

    Science.gov (United States)

    Rojas Pérez-Ezquerra, Beatriz; Guardia-Dodorico, Lorena; Arribas-Marco, Teresa; Ania-Lahuerta, Aldonza; González Ballano, Isabel; Chipana-Salinas, Margot; Carazo-Hernández, Belén

    2015-01-01

    Abdominal wall Actinomycosis is a rare disease associated with the use of intrauterine device and as a complication of abdominal surgery. Diagnosis is difficult because it is unusual and behaves like a malignant neoplasm. A case report is presented of a patient who had used an intrauterine device for four years and developed a stony tumour in the abdominal wall associated with a set of symptoms that, clinically and radiologically, was simulating a peritoneal carcinomatosis associated with paraneoplastic syndrome, even in the course of an exploratory laparotomy. The patient attended our hospital with a two-month history of abdominal pain and symptoms that mimic a paraneoplastic syndrome. The diagnosis of abdominal actinomycosis was suspected by the finding of the microorganism in cervical cytology together with other cultures and Actinomyces negative in pathological studies, confirming the suspicion of a complete cure with empirical treatment with penicillin. Actinomycosis should be considered in patients with pelvic mass or abdominal wall mass that mimics a malignancy. Antibiotic therapy is the first treatment choice and makes a more invasive surgical management unnecessary. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  1. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    Directory of Open Access Journals (Sweden)

    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.

  2. Rare abdominal wall hernias in South Sudan

    African Journals Online (AJOL)

    1. Ordinary direct inguinal hernias which are less frequent in Africa and seldom strangulate (as one has in Figure 6). They may cause no symptoms, remain the same size for long periods and may not need surgery. 2. The BH which is caused by a narrow defect in the conjoint tendon or transversalis fascia and consequently.

  3. [A Case of Abdominal Wall Hernia Rupture during Bevacizumab Treatment].

    Science.gov (United States)

    Sugimoto, Satoshi; Miyazaki, Yasuaki; Hirose, Sou; Michiura, Toshiya; Fujita, Shigeo; Yamabe, Kazuo; Miyazaki, Satoru; Nagaoka, Makio

    2015-11-01

    A 78 -year-old man with rectal cancer underwent abdominoperineal resection of the rectum. In the postoperative period, the patient experienced wound infection, leading to an abdominal wall hernia. Two years following surgery, a rise in the serum CEA level was seen. A metastatic tumor was detected in the right lung on chest CT. VATS right lung inferior lobe segmental resection was performed. After lobectomy, the serum CEA level continued to increase. Another metastatic tumor was detected in the right lung on chest CT. Chemotherapy with capecitabine, oxaliplatin, and bevacizumab was commenced. The erosive part of the abdominal wall scar hernia extended during the nine weeks of chemotherapy. The chemotherapy was then discontinued. In the follow-up CT scan, a right pleural recurrence, local recurrence in the pelvis, and a liver metastasis were detected. Chemotherapy was re-introduced 3 years after surgery. The erosive part of the abdominal wall hernia again began to spread with chemotherapy recommencement. Four months after restarting chemotherapy, the hernia ruptured, with a loop of the small intestine protruding out of it. The patient covered this with a sheet of vinyl and was taken by the ambulance to our hospital. The erosive part of the abdominal wall hernia had split by 10 cm, and a loop of the small intestine was protruding. As ischemia of the small intestine was not observed, we replaced it into the abdominal cavity, and performed a temporary suture repair of the hernia sac. Following this, bevacizumab was discontinued, and the erosive part reduced. We performed a radical operation for abdominal wall scar hernia repair 11 weeks after the discontinuation of bevacizumab.

  4. Anterior Abdominal wall Rhabdomyoma mimicking fibroid: A Case ...

    African Journals Online (AJOL)

    We report a case of a 27 year old Para 1+O house wife who presented with a four months history of a rapidly increasing tumor of the anterior abdominal wall. The abdomen was swollen to the size of a 16 weeks gravid uterus. At laparatomy a tumor measured 15cm by 10cm attached to the posterior aspect of the rectus ...

  5. Abdominal Wall Hernias as seen in LAUTECH Teaching Hospital ...

    African Journals Online (AJOL)

    A prospective survey of Abdominal Wall Hernia patients was done in LAUTECH Teaching Hospital, Osogbo, from November 2000 to February 2002. The objective is to determine the pattern, management and outcome in a 101 patients with 110 hernias. Males accounted for 88.1% of the patients with mean age of 51.1 ...

  6. External abdominal wall hernias in Abia State University teaching ...

    African Journals Online (AJOL)

    Background: External abdominal wall hernias are common surgical conditions worldwide. In Africa, they not only make up a significant part of the surgeons workload, but are a major cause of mechanical intestinal obstruction. They are a leading cause of work loss and disability with lethal complications at times. Knowledge ...

  7. Abdominal wall reconstruction using De-epithelialized dermal flap: A ...

    African Journals Online (AJOL)

    Background: Although autogenous materials have been used in abdominal wall hernioplasty for a long time, the introduction of prosthetic materials diminished their popularity. However, these materials may be expensive, inappropriate or unavailable. The aim of this study is to determine the place of de-epithelialized dermal ...

  8. Cold Abscess of the Anterior Abdominal Wall: An Unusual Primary ...

    African Journals Online (AJOL)

    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 ...

  9. Vulva cellulitis and abscess with extension to anterior abdominal wall

    African Journals Online (AJOL)

    Background: Abscesses occur commonly in our environment. However abscesses of the vulva in children are not often seen but they do occur periodically, and there is a paucity of data on its prevalence in our environment. Aim: To present a case of vulva cellulitis and abscess with extension to anterior abdominal wall ...

  10. Colonic diverticulosis is associated with abdominal wall hernia.

    Science.gov (United States)

    Oma, E; Jorgensen, L N; Meisner, S; Henriksen, N A

    2017-08-01

    Colonic diverticulosis and abdominal wall hernia are common pathologies. Studies have suggested that connective tissue alterations play a role in the formation of both diverticulosis and abdominal wall hernia. The aim of this cohort study was to evaluate the association between diverticulosis and abdominal wall hernia in a large cohort of patients undergoing colonoscopy. All consecutive patients who underwent colonoscopy between 2001 and 2013 at Bispebjerg Hospital were eligible for inclusion. The endoscopists prospectively registered the findings of diverticulosis in a database. Data were merged with the Danish Hernia Database identifying patients who underwent groin and ventral hernia repair. Calculated odds ratios (ORs) were used to describe the extent of association and multivariable logistic regression models were utilized to adjust for age and gender. A total of 13,855 patients were included, 3685 (26.6%) of whom were diagnosed with diverticulosis. Diverticulosis was independently associated with direct inguinal, OR 1.33, 95% CI 1.00-1.76, P = 0.049, and umbilical/epigastric hernia repair, OR 1.74, 95% CI 1.16-2.63, P = 0.008. Colonic diverticulosis was associated with direct inguinal and umbilical/epigastric hernia repair suggesting that connective tissue alterations, herniosis, could be a common etiologic factor of colonic diverticulosis and these abdominal wall hernias.

  11. Classification of primary and incisional abdominal wall hernias

    NARCIS (Netherlands)

    F.E. Muysoms (Filip); M. Miserez; F. Berrevoet; G. Campanelli (Giampiero); G.G. Champault; E. Chelala; U.A. Dietz; H.H. Eker (Hasan); I. El Nakadi; P. Hauters; M. Hidalgo Pascual; A. Hoeferlin; U. Klinge; A. Montgomery; R.K.J. Simmermacher; M.P. Simons; M. Śmietański; C. Sommeling; T. Tollens; T. Vierendeels; A. Kingsnorth

    2009-01-01

    textabstractPurpose: A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable. Methods: Several membersof the EHS

  12. Criteria for definition of a complex abdominal wall hernia

    NARCIS (Netherlands)

    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

  13. A New Rat Model for Orthotopic Abdominal Wall Allotransplantation

    Directory of Open Access Journals (Sweden)

    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.

  14. Transversus abdominal plane block as a sole anesthetic technique for abdominal wall hematoma drainage.

    Science.gov (United States)

    Varela, N; Golvano, M; Monedero, P

    2016-10-01

    Transversus abdominal plane (TAP) block is a known and useful technique, widely used for postoperative pain management of abdominal wall incisions. During the past years, and following the expansion of ultrasound guided techniques, its use has even gained more adepts. It is usually used as an adjuvant technique, primarily in order to control postoperative pain and reduce opioids consumption. We report the case of an 82 years old patient admitted for drainage of a postoperative abdominal wall hematoma after correction of a McBurney incisional hernia. The corrective surgery had gone on without incident, under general anesthesia with laryngeal mask. Two weeks later, the patient came back to our emergency department with a clear hematoma of the abdominal wall. Surgery was decided. A sole local anesthetic technique was achieved, using a TAP block. The block was performed under ultrasound guidance, using a subcostal approach. The surgery went on without complications. Therefore, TAP block offers a hemodynamic stability, appropriate intra-operative anesthesia and post-surgical analgesia of the abdominal wall. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Reconstruction of complex thoraco-abdominal defects with extended anterolateral thigh flap

    Directory of Open Access Journals (Sweden)

    Yadav Prabha

    2010-01-01

    Full Text Available Background: The reconstruction of complex thoraco-abdominal defects following tumour ablative procedures has evolved over the years from the use of pedicle flaps to free flaps. The free extended anterolateral thigh flap is a good choice to cover large defects in one stage. Materials and Methods: From 2004 to 2009, five patients with complex defects of the thoracic and abdominal wall following tumour ablation were reconstructed in one stage and were studied. The commonest tumour was chondrosarcoma. The skeletal component was reconstructed with methylmethacrylate bone cement and polypropylene mesh and the soft tissue with free extended anterolateral thigh flap. The flaps were anastomosed with internal mammary vessels. The donor sites of the flaps were covered with split-skin graft. Result: All the flaps survived well. One flap required re-exploration for venous congestion and was successfully salvaged. Two flaps had post operative wound infection and were managed conservatively. All flap donor sites developed hyper-pigmentation, contour deformity and cobble stone appearance. Conclusion: Single-stage reconstruction of the complex defects of the thoraco-abdominal region is feasible with extended anterolateral thigh flap and can be adopted as the first procedure of choice.

  16. Management of stab wounds to the anterior abdominal wall

    Directory of Open Access Journals (Sweden)

    João Baptista Rezende-Neto

    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.

  17. [Progressive preoperative pneumoperitoneum in patients with giant hernias of the abdominal wall].

    Science.gov (United States)

    López Sanclemente, María Clara; Robres, Joaquim; López Cano, Manuel; Barri, Joan; Lozoya, Roberto; López, Sergio; Vasco, M Angeles; Buqueras, M Carmen; Subirana, Helena; Jorba, Rosa

    2013-01-01

    Patients with giant hernias with loss of domain require proper planning of surgical repair, because of the high associated comorbidity. The progressive preoperative pneumoperitoneum technique described by Goñi Moreno allows a more physiological adaptation of the patient and the abdominal cavity to the reinstatement of the viscera to the abdomen, enabling adequate surgical repair. The objective of this study was to analyze our experience in the treatment of this type of hernia. We carried out a retrospective study that included 11 patients with major abdominal wall defects and loss of domain who were treated with this technique in 2 centers between 2005 and 2010. Eight patients had abdominal hernias and 3 had inguinal hernias. The average insufflation time was 2 weeks and the total amount of air was between 6.6 and 18 l. In 2 patients who showed pulmonary disease decompensation, insufflation had to be temporarily postponed. A further 2 patients had subcutaneous emphysema during the last few days of insufflation, which resolved spontaneously without sequelae. The open mesh repair technique was used in ventral hernias and the preperitoneal technique in all inguinal hernias. There was one recurrence during the 1-year follow-up. Goñi Moreno's technique remains safe to prepare patients with giant hernias with loss of domain. This procedure can reduce the morbidity caused by the increase in abdominal pressure after abdominal wall repair. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  18. A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report

    Directory of Open Access Journals (Sweden)

    Opeya Collins JO

    2011-03-01

    Full Text Available Abstract Introduction Desmoid tumors are benign but locally aggressive tumors of mesenchymal origin which are poorly circumscribed, infiltrate the surrounding tissue, lack a true capsule and are composed of abundant collagen. History of trauma to the site of tumor origin is elicited in up to 1 in 4 cases and they most commonly develop in the anterior abdominal wall and shoulder girdle but they can arise in any skeletal muscle. The clinical behavior and natural history of desmoid tumors are unpredictable and management is difficult with many issues remaining controversial, mainly regarding early detection, the role, type and timing of surgery and the value of non-operative therapies. Case presentation We report a case of a 23 year old male referred from a district hospital to a national referral hospital in Kenya, after developing a huge abdominal wall desmoid tumor following laparotomy for a blunt abdominal injury fourteen months earlier. The tumor was successfully excised and the abdominal wall defect reconstructed using a vicryl/prolene mesh and a unilateral groin flap. The patient had a non-eventful recovery and was discharged through radiotherapy clinic. Conclusion Wide margin tumor excision alone is a reasonable option in the management of desmoid tumors.

  19. TISSUE REGENERATING CAPACITY OF CARBODIIMIDE-CROSS-LINKED DERMAL SHEEP COLLAGEN DURING REPAIR OF THE ABDOMINAL-WALL

    NARCIS (Netherlands)

    VANWACHEM, PB; VANLUYN, MJA; DAMINK, LHHO; DIJKSTRA, PJ; FEIJEN, J; NIEUWENHUIS, P

    In future, the function of collagen-based biomaterials as temporary scaffolds for the generation of new tissue may be emphasized. In this study the function of dermal sheep collagen (DSC) crosslinked with carbodiimide (ENDSC) as repair material for abdominal wall defects in rats was compared with

  20. Clear Cell Adenocarcinoma Arising from Abdominal Wall Endometriosis

    Directory of Open Access Journals (Sweden)

    Thouraya Achach

    2008-01-01

    Full Text Available Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.

  1. [Prospects of hernia and abdominal wall surgery in China].

    Science.gov (United States)

    Tang, J X; Huang, L; Li, S J; Hu, X C

    2017-01-01

    In recent 20 years, hernia and abdominal wall surgery has made great progress in China. However, what we've done still leaves much to be desired. Related guidelines of hernia disease had been conducted, but China is short of multi-center, prospective, and large-sample research evidence. These guidelines are still with low evidence level, and contents need additional modified to well meet Chinese real situation. In terms of treatment of inguinal and abdominal wall incisional hernia, some consensus has been reached from certain key issues globally, but further exploration are still needed. To stand at top of the world, we are a long distance. We should not only strengthen training and quality control but also establish patient registration system and overall management process.

  2. Prosthetic mesh repair of abdominal wall hernias in horses.

    Science.gov (United States)

    Tóth, Ferenc; Schumacher, Jim

    2018-02-05

    Repair of hernias of the abdominal wall of horses is often augmented by inserting a prosthetic mesh. In this review, we describe the various characteristics of prosthetic meshes used for hernia repair and present 2 systems that are used by surgeons in the human medical field to classify techniques of prosthetic mesh herniorrhaphy. Both of these classification systems distinguish between onlay, inlay, sublay, and underlay placements of mesh, based on the location within the abdominal wall in which the prosthetic mesh is inserted. We separate the published techniques of prosthetic mesh herniorrhaphy of horses using this classification system, ascribing names to the techniques of herniorrhaphy where none existed, and report the success rates and complications associated with each technique. By introducing a classification system widely used in the human medical field and illustrating each technique in a figure, we hope to clarify inconsistent nomenclature associated with prosthetic mesh herniorrhaphy performed by veterinary surgeons. © 2018 The American College of Veterinary Surgeons.

  3. Revascularization of human acellular dermis in full-thickness abdominal wall reconstruction in the rabbit model.

    Science.gov (United States)

    Menon, Nathan G; Rodriguez, Eduardo D; Byrnes, Colman K; Girotto, John A; Goldberg, Nelson H; Silverman, Ronald P

    2003-05-01

    This study investigates whether human acellular dermis (Alloderm; LifeCell, Branchburg, NJ) revascularizes when used to reconstruct abdominal wall defects in rabbits. This could prove useful in infected situations in which prosthetic mesh is suboptimal. Twenty-five rabbits were randomly assigned to one of three groups: primary closure (n = 5), expanded polytetrafluoroethylene (GoreTex; W.L. Gore, Flagstaff, AZ) repair (n = 10), or AlloDerm (LifeCell) repair (n = 10). The rabbits in the primary closure group received a 7 cm x 0.5 cm full-thickness abdominal wall defect that was closed primarily. A 7 cm x 3 cm full-thickness abdominal wall defect was created in the other two groups. The defects were repaired with a GoreTex Mycromesh (W.L. Gore), or AlloDerm (LifeCell) patch. At 30 days, the following endpoints were evaluated: (1) incidence of herniation; (2) presence of intra-abdominal adhesions; (3) the breaking strength of the patch-fascial interface; and (4) evaluation of graft vascularization by fluorescein dye infusion and histological analysis. There was no incidence of herniation in any of the rabbits. Visceral adhesions to the patch were found in all animals in the Gore-Tex (W.L. Gore) group but in none in the AlloDerm (LifeCell) group. The size of the patch was unchanged in all the rabbits except for two rabbits in the AlloDerm (LifeCell) group that stretched 1 cm in the transverse dimension. The change in size was not statistically significant (p = 0.17) when compared with the change in size in the Gore-Tex (W.L. Gore) group. The mean breaking strength of the primary closure group was significantly higher (521.2 N/mm2 +/- 223.0) than that of the two patch-repair groups (p Gore-Tex (W.L. Gore) fascial interface (337.0 N/mm2 +/- 141.2). Fluorescein dye infusion and histological analysis confirmed vascularization of the AlloDerm (LifeCell) graft. This study demonstrates that AlloDerm (LifeCell) does become vascularized when used as a fascial interposition

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    Choi, Young Ho; Koh, Young Hwan; Han, Dae Hee; Kim, Ji Hoon; Cha, Joo Hee; Lee, Eun Hye; Song, Chi Sung

    2008-01-01

    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

  6. Abdominal wall reconstruction for incisional hernia optimizes truncal function and quality of life

    DEFF Research Database (Denmark)

    Jensen, Kristian K.; Munim, Kanzah; Kjaer, Michael

    2017-01-01

    Objective: The aim of the study was to examine abdominal wall function in patients undergoing abdominal wall reconstruction (AWR) for incisional hernia. Background: The literature on abdominal wall function in patients with incisional hernia is sparse. It has been suggested that AWR leads...... to improvement in function, but it is unknown whether this is specific to the abdominal wall or due to an improvement in overall physical fitness. Methods: We performed a prospective case-control study of 18 consecutive patients with large incisional hernia undergoing AWR with linea alba restoration. Truncal...... and truncal extension. Conclusions: AWR for incisional hernia specifically improved long-term abdominal wall muscular function and quality of life....

  7. Distribution of Wall Stress in Abdominal Aortic Aneurysm (AAA)

    Science.gov (United States)

    Lasheras, Juan

    2005-11-01

    Abdominal aortic aneurysm (AAA) rupture is believed to occur when the mechanical stress acting on the wall exceeds the strength of the wall tissue. Therefore, knowledge of the AAA wall stress distribution could be useful in assessing its risk of rupture. In our research, a finite element analysis was used to determine the wall stresses both in idealized models and in a real clinical model in which the aorta was considered isotropic with nonlinear material properties and was loaded with a given pressure. In the idealized models, both maximum diameter and asymmetry were found to have substantial influence on the distribution of the wall stress. The thrombus inside the AAA was also found to help protecting the walls from high stresses. Using CT scans of the AAA, the actual geometry of the aneurysm was reconstructed and we found that wall tension increases on the flatter surface (typically corresponds to the posterior surface) and at the inflection points of the bulge. In addition to the static analysis, we also performed simulations of the effect of unsteady pressure wave propagation inside the aneurysm.

  8. Acute acalculous cholecystitis after abdominal wall repair (Rives-Stoppa)

    DEFF Research Database (Denmark)

    Reurings, Jurrian C; Diaz, Ruben P D; Penninga, Luit

    2014-01-01

    Acute acalculous cholecystitis (AAC) is a rare condition normally occurring in critically ill patients. Compared to acute calculous cholecystitis, AAC is associated with complications and has a worse outcome. Hence, knowledge of this condition is very important. We describe a case of a 31-year......-old man who developed AAC after abdominal wall repair with mesh (Rives-Stoppa procedure) 1 day after discharge from the hospital. To the best of our knowledge, this is the first paper to report AAC after abdominal incisional hernia repair. Although it is known to be more common in critically ill patients......, AAC can also occur postoperatively in outpatients. Early recognition and treatment of AAC may improve outcome....

  9. Anterior Abdominal Wall Desmoids Tumor in a Five Year Old Girl – A ...

    African Journals Online (AJOL)

    xp

    ABSTRACT: Desmoid tumors are rare, slow – growing, mesenchymal monoclinic proliferation. It may occur as intra-abdominal tumor usually affecting the mesentery of the intestine or it could be extra-abdominal in which they may affect the popliteal region, the chest wall or the anterior abdominal wall. Reports in children ...

  10. Anterior Abdominal Wall Desmoids Tumor in a Five Year Old Girl – A ...

    African Journals Online (AJOL)

    Desmoid tumors are rare, slow – growing, mesenchymal monoclinic proliferation. It may occur as intra-abdominal tumor usually affecting the mesentery of the intestine or it could be extra-abdominal in which they may affect the popliteal region, the chest wall or the anterior abdominal wall. Reports in children less than 10 ...

  11. Criteria for definition of a complex abdominal wall hernia.

    Science.gov (United States)

    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; van Geffen, E; Conze, J; van Goor, H

    2014-02-01

    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 allow comparison of different surgical approaches. The aim of this study was to reach consensus on criteria used to define a patient with "complex" hernia. Three consensus meetings were convened by surgeons with expertise in complex abdominal wall hernias, aimed at laying down criteria that can be used to define "complex hernia" patients, and to divide patients in severity classes. To aid discussion, literature review was performed to identify hernia classification systems, and to find evidence for patient and hernia variables that influence treatment and/or prognosis. Consensus was reached on 22 patient and hernia variables for "complex" hernia criteria inclusion which were grouped under four categories: "Size and location", "Contamination/soft tissue condition", "Patient history/risk factors", and "Clinical scenario". These variables were further divided in three patient severity classes ('Minor', 'Moderate', and 'Major') to provide guidance for peri-operative planning and measures, the risk of a complicated post-operative course, and the extent of financial costs associated with treatment of these hernia patients. Common criteria that can be used in defining and describing "complex" (abdominal wall) hernia patients have been identified and divided under four categories and three severity classes. Next step would be to create and validate treatment algorithms to guide the choice of surgical technique including mesh type for the various complex hernias.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Sung Kyu Bae

    2013-01-01

    Full Text Available BackgroundIf 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.MethodsFrom 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 after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction.ResultsUpon 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 terms of function and esthetics at 3 to 6 months post-surgery.ConclusionsUsing a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.

  14. Management of abdominal wall defects (gastroschisis and omphalocele at Hospital Universitario San Vicente de Paúl, in Medellín, Colombia, 1998-2006 Tratamiento de los defectos de la pared abdominal (gastrosquisis y onfalocele en el Hospital Universitario San Vicente de Paúl, Medellín, 1998-2006

    Directory of Open Access Journals (Sweden)

    Mirian Natalia Herrera Toro

    2010-08-01

    Full Text Available

    Introduction: Gastroschisis and omphalocele are neonatal malformations of the abdominal wall. Despite their great differences, both are severe diseases characterized by herniation of viscera through the defect in the abdominal wall. Children with these defects present as surgical emergencies that pose a difficult challenge to the attending surgeon. Even with appropriate management, the mortality rate is between 20-40%. Omphalocele and, to a lesser degree gastroschisis, are associated with a wide range of malformations.

    Objective: The aim of this retrospective review was to describe the management of children with gastroschisis or omphalocele, and the results obtained with it, at the

    Pediatric Surgery Section, Hospital Universitario San Vicente de Paúl, in Medellin, Colombia.

    Abdominal wall desmoid tumor mimicking a subserosal uterine leiomyoma

    Directory of Open Access Journals (Sweden)

    Al-Jefout M

    2011-06-01

    Full Text Available Moamar Al-Jefout1,2, Alabed Walid2, Abomayale Esam2, Alqaisi Amin2, Hawa Nather1,2, Nawayse Sultan2, Khadra Maysa31Department of Obstetrics and Gynaecology, Mutah Medical Faculty, Mutah University, Karak; 2Karak Hospital, Ministry of Health, Karak; 3University of Jordan, Amman, JordanAbstract: Desmoid tumors are cytologically bland fibrous neoplasms originating from musculoaponeurotic structures throughout the body. The cause of desmoid tumors is uncertain, but may be related to trauma or hormonal factors, or may have a genetic association. These tumors can be found in some young women during pregnancy or just after giving birth. We report herein a case of desmoid tumor on the inner aspect of the abdominal wall that mimicked a large subserosal uterine leiomyoma. Initial clinical examination of the patient suggested a large abdominal wall tumor, while the imaging techniques including transabdominal ultrasound and magnetic resonance imaging suggested a large subserosal uterine leiomyoma as the initial diagnosis. This case emphasizes the importance of clinical examination during the diagnostic process.Keywords: diagnosis, lesion, ultrasound

  15. Evaluation of cutaneous abdominal wall sensibility after abdominoplasty.

    Science.gov (United States)

    Fels, Klaus Werner; Cunha, Marcelo Sacramento; Sturtz, Gustavo Pinó; Gemperli, Rolf; Ferreira, Marcus Castro

    2005-01-01

    Changes in cutaneous sensibility are common after diverse plastic surgical procedures. Although prior studies examined aesthetic results, combined procedures, and new abdominoplasty techniques, few examined the effect of undermining on cutaneous sensibility. This study aimed to analyze and quantify cutaneous sensibility after classic abdominoplasty. Two groups of patients were studied: a control group of 10 patients without surgery and another group of 25 patients who had undergone classic abdominoplasty. The abdominal wall surface was divided into nine regions. Pain sensibility was evaluated by tests with needles, and thermal sensibility by test tubes containing hot and cold water. Superficial tactile sensibility was tested using the Pressure-Specified Sensory Device (PSSD), which is capable of determining the cutaneous pressure threshold. Statistical analysis was conducted using Student's 't-test'. The results showed a decrease in the three types of sensibility. Statistical analysis showed a significant difference (p < 0.05) between the groups for all regions tested. The centermost regions of the abdominal wall presented the highest index of analgesia and thermal anesthesia, as well as higher cutaneous pressure thresholds.

  16. An abdominal wall simulator for testing suprapubic urinary catheters.

    Science.gov (United States)

    Coveney, V A; Gröver, D

    2001-08-01

    Urinary catheters (drainage tubes) are in widespread use. The most common type of long-term catheter is the Foley, which is made from natural or synthetic rubber. Foley catheters are passed into the bladder via the urethra or the suprapubic puncture channel (through the abdominal wall). A simulator for the abdominal wall has been developed to simulate aspects of the interaction between it and a suprapubic catheter. The simulator is based on a slab of ultrasoft elastomer with tensionable reinforcing polyamide filaments. The behaviour of the simulator has been compared with data published. A soft membrane (contact pressure) transducer (SMT) was used and novel instrumented 'tongs' for lateral indentation of the puncture track giving indentation stiffness. Slab materials were used with shear moduli of 0.1 and 0.021 MPa. Two filament-tensioning methods were used: by clamping to a winding mechanism and by weights. The combination of the softer slab material and tensioning by weights gave good conformity to physiological data; other combinations did not.

  17. Results of surgical treatment of anterior abdominal wall desmoid tumours : 13 cases reviewed with literature.

    Science.gov (United States)

    Yabanoglu, H; Karagulle, E; Aytac, H O; Caliskan, K; Canpolat, T; Koc, Z; Akdur, A C; Moray, G; Haberal, M

    2014-01-01

    We retrospectively evaluated the results of surgical treatment for anterior abdominal wall -desmoid tumours. Records for 13 patients operated on for desmoid tumours from 1997-2013 were searched for age, gender, abdominal/pelvic surgical history, pregnancy, Gardner's syndrome, pre-operative radiological examinations, tumour size, multifocality, surgical procedure, tumour presence at surgical margins, recurrence, morbidity, and mortality. Local recurrence-free survival probabilities were estimated by the Kaplan-Meier method and stratified by various clinicopathological variables. There were 11 female (84,6%) and 2 male (15,4%) patients with a median age of 36 years. Seven (53,8%) -patients had previous abdominal/pelvic surgery, five (38,5%) had a history of pregnancy, and one (7,6%) had Gardner's Syndrome. Two (15,3%) patients had multifocality on their pre-operative radiological examinations. Mean tumour -diameter was 4,6 cm (SD 3,2 cm ; range 2-12 cm). After the excision of the masses in five (38,5%) patients, synthetic materials were used to close the abdominal wall defects. Two (15,3%) patients with positive surgical margins after -surgery were re-operated. Three (23%) patients required a second surgical intervention after the mass excisions were performed. Mean follow-up time was 56,7 months. Recurrence was observed in three patients during follow-up. Increased tumour size, history of previous abdominal/pelvic surgery, and the presence of multifocality had a negative effect on local recurrence-free survival. There was no mortality during follow-up. Desmoid tumours are characterized by high recurrence, even after proper surgical excisions. Preoperative differential diagnoses of these tumours should be done and a post-operative follow-up protocol should be followed. Copyright© Acta Chirurgica Belgica.

  18. Reconstruction of the full thickness chest wall defect

    International Nuclear Information System (INIS)

    Moriguchi, Takahiko; Sano, Susumu; Ogawa, Yutaka; Fujimori, Yoshisuke; Abe, Ryuji.

    1977-01-01

    To treat the chest wall defect following the postoperative radiotherapy for breast cancer, we used an island flap prepared from the opposite mammary region preserving the perforating vessels from the internal thoracic artery. (auth.)

  19. Recurrence of Pelvic Chondrosarcoma through Fascial Defect into Abdominal Cavity

    Directory of Open Access Journals (Sweden)

    Kemal Gökkuş

    2014-01-01

    Full Text Available Our patient was a 76-year-old female who has been operated on 2 times in 8 years for pelvic chondrosarcoma. The patient came to our clinic with a large mass in left iliac region which extended into the paravertebral area. Physical examination and preoperative imagining studies revealed a mass at the left iliac area that infiltrated sciatic notch and extended from posterior iliac region towards the anterior side of iliac bone through the sciatic notch and an incisional hernia including descending colon. The mass was also penetrating the abdominal cavity through the hernia. Surgical intervention was planned. Since the tumor infiltrated the sciatic nerve, hemipelvectomy was indicated. Patient refused hemipelvectomy. Therefore, palliative debulking surgery was considered. We treated the case with marginal excision and abdominal wall reconstruction employing prolene and vicryl suture materials in order to prevent a postoperative visceral herniation and local invasion. At the latest follow-up appointment in 2 years, the patient still had no signs of tumor recurrence. This case showed us that an incisional hernia can serve as a pathway for the recurrence invasion of the chondrosarcoma.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  3. Hydraulic structures with defective sheet pile walls

    OpenAIRE

    Ahmed, Ashraf A.; Johnston, Harold T.; Oyedele, Lukumon

    2013-01-01

    A sheet pile wall driven to form a barrier wall below the floor of a hydraulic structure is frequently assumed to be watertight. Although the leakage through the interlocks of the sheet piles is usually small, damage and other factors can result in significant leakage. Consequently, this assumption is rarely, if ever, satisfied in reality. The present study used a finite-element model to investigate the effect of leaks through sheet piles driven under the floor of a hydraulic structure on see...

  4. Abdominal wall fibromatosis associated with previous laparoscopic hernia repair.

    Science.gov (United States)

    Brown, S B F; MacDuff, E; O'Dwyer, P J

    2013-10-01

    Two cases of desmoid-type fibromatosis developing after laparoscopic hernia repair are described: one in a young male 3 years after laparoscopic umbilical hernia repair and the other in a young female 1 year after laparoscopic incisional hernia repair. The male patient presented with a slowly enlarging non-tender firm abdominal wall mass; the female patient had similar findings. Excision biopsy in the male and core biopsy in the female were consistent with fibromatosis. The young male patient underwent resection of the fibromatosis, and the female patient has been managed conservatively. These are the first documented cases of fibromatosis developing after laparoscopic hernia surgery. Whilst the safety of hernia meshes has been assessed in animal studies, it may be that more detailed study of intraperitoneal placement of these meshes is required.

  5. Mechanical behavior of surgical meshes for abdominal wall repair: In vivo versus biaxial characterization.

    Science.gov (United States)

    Simón-Allué, R; Ortillés, A; Calvo, B

    2018-03-14

    Despite the widespread use of synthetic meshes in the surgical treatment of the hernia pathology, the election criteria of a suitable mesh for specific patient continues to be uncertain. Thus, in this work, we propose a methodology to determine in advance potential disadvantages on the use of certain meshes based on the patient-specific abdominal geometry and the mechanical features of the certain meshes. To that purpose, we have first characterized the mechanical behavior of four synthetic meshes through biaxial tests. Secondly, two of these meshes were implanted in several New Zealand rabbits with a total defect previously created on the center of the abdominal wall. After the surgical procedure, specimen were subjected to in vivo pneumoperitoneum tests to determine the immediate post-surgical response of those meshes after implanted in a healthy specimen. Experimental performance was recorded by a stereo rig with the aim of obtaining quantitative information about the pressure-displacement relation of the abdominal wall. Finally, following the procedure presented in prior works (Simón-Allué et al., 2015, 2017), a finite element model was reconstructed from the experimental measurements and tests were computationally reproduced for the healthy and herniated cases. Simulations were compared and validated with the in vivo behavior and results were given along the abdominal wall in terms of displacements, stresses and strain. Mechanical characterization of the meshes revealed Surgipro TM as the most rigid implant and Neomesh SuperSoft® as the softer, while other two meshes (Neomesh Soft®, Neopore®) remained in between. These two meshes were employed in the experimental study and resulted in similar effect in the abdominal wall cavity and both were close to the healthy case. Simulations confirmed this result while showed potential objections in the case of the other two meshes, due to high values in stresses or elongation that may led to discomfort in real

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Anterior abdominal wall hernias in a rural practice in Rivers State ...

    African Journals Online (AJOL)

    Background: Abdominal wall hernias constitute the most common of all surgical problems and can be fatal when complicated. Aim: To determine the pattern of presentation of anterior abdominal wall hernias in a rural community in Rivers State of Nigeria. Methods: The study was conducted in Bethesda Clinic, a rural clinic in ...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: The material and the surgical technique used to close an abdominal wall incision are important determinants of the risk of developing an incisional hernia. Optimising closure of abdominal wall incisions holds a potential to prevent patients suffering from incisional hernias and for im...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Evaluation of healing prosthetic materials polyester mesh resorbable film and collagen elastin matrix /polypropylene used in rabbits abdominal wall defects Avaliação da cicatrização da tela de poliéster com lâmina absorvível e a tela de colágeno-elastina/polipropileno utilizadas no reparo de lesões da parede abdominal de coelhos

    Directory of Open Access Journals (Sweden)

    Danielle Duck Schulz

    2009-12-01

    Full Text Available PURPOSE: To compare polyester with absorbable layer prosthesis with collagen-elastin/polypropylene prosthesis in the repair of abdominal wall defects. METHODS: The 16 studied rabbits were divided in groups A and B (euthanized on the 30th and 60th days, after the implant of the mesh. The animals underwent laparotomy and received a 2cm wall "defect" on each side of the Alba linea. The repair was made with the suture of a polyester mesh with absorbable film on the left side of the Alba Linea and with collagen-elastin/polypropylene mesh on the right side. Adherences were classified according to Nair Score and microscopic evaluation observing types I and III collagen formation and other immunohistochemical analyses. RESULTS: There were no significant differences in adhesion formation. The collagen type I showed higher deposition in polyester with absorbable layer. In group B, the difference between the meshes was significant, with higher collagen III deposition in polyester with absorbable layer (60º P.O.. About the metalloproteinases, the presence of MMP -1 and MMP-8 were about the same; the expression of MMP-13 increased near to the 60th day. CONCLUSIONS: There is no significant difference between the two meshes in adhesion formation and immunohystochemical evaluation. The polyester mesh resorbable film presented a higher deposition of collagen.OBJETIVO: Comparar a tela poliéster com lâmina absorvível e a confeccionada pela aposição da tela de colágeno-elastina/polipropileno no reparo de lesões da parede abdominal. MÉTODOS: Foram avaliados 16 coelhos, divididos aleatoriamente em dois grupos e submetidos a eutanásia no 30º e no 60º dia P.O. Os animais foram submetidos à laparotomia e confecção de dois defeitos triangulares de 2 cm, de espessura total, na parede abdominal ventral. A correção foi realizada através de fixação, na metade esquerda da linha alba, da tela de poliéster com lâmina absorvível e na direita, tela composta

  12. Grey Turner's and Cullen's signs induced by spontaneous hemorrhage of the abdominal wall after coughing.

    Science.gov (United States)

    Fan, Zhe; Zhang, Yingyi

    2017-08-01

    Grey Turner's and Cullen's signs are rare clinical signs, which most appear in patients with severe acute pancreatitis. The present patient complained of abdominal pain after coughing. However, contrast-enhanced CT revealed a hemorrhage of the abdominal wall. Therefore, spontaneous hemorrhage of the abdominal wall was diagnosed. The patient recovered through immobilization and hemostasis therapy. This case report and literature review aims to remind clinicians of manifestations and treatment of spontaneous hemorrhage.

  13. A clinically relevant in vivo model for the assessment of scaffold efficacy in abdominal wall reconstruction

    Directory of Open Access Journals (Sweden)

    Jeffrey CY Chan

    2016-12-01

    Full Text Available An animal model that allows for assessment of the degree of stretching or contraction of the implant area and the in vivo degradation properties of biological meshes is required to evaluate their performance in vivo. Adult New Zealand rabbits underwent full thickness subtotal unilateral rectus abdominis muscle excision and were reconstructed with the non-biodegradable Peri-Guard®, Prolene® or biodegradable Surgisis® meshes. Following 8 weeks of recovery, the anterior abdominal wall tissue samples were collected for measurement of the implant dimensions. The Peri-Guard and Prolene meshes showed a slight and obvious shrinkage, respectively, whereas the Surgisis mesh showed stretching, resulting in hernia formation. Surgisis meshes showed in vivo biodegradation and increased collagen formation. This surgical rabbit model for abdominal wall defects is advantageous for evaluating the in vivo behaviour of surgical meshes. Implant area stretching and shrinkage were detected corresponding to mesh properties, and histological analysis and stereological methods supported these findings.

  14. Abdominal wall dynamics after component separation hernia repair.

    Science.gov (United States)

    Lisiecki, Jeffrey; Kozlow, Jeffrey H; Agarwal, Shailesh; Ranganathan, Kavitha; Terjimanian, Michael N; Rinkinen, Jacob; Brownley, R Cameron; Enchakalody, Binu; Wang, Stewart C; Levi, Benjamin

    2015-01-01

    The component separation technique (CST) is an important technique now used frequently in complex ventral hernia repair (VHR). Although this technique has demonstrated superior success rates, there is a paucity of research describing how release of the external obliques coupled with rectus myofascial advancement alters the morphology of the abdominal architecture. In this study, we apply the new concept of analytic morphomics to describe the immediate changes in morphology of the abdomen that take place after VHR by CST. We identified 21 patients who underwent VHR by CST and received both preoperative and postoperative computed tomography scans between 2004 and 2009 in our clinical database. The surgical technique involved incisional release of the external oblique muscle lateral to the linea semilunaris with rectus abdominis myofascial advancement in all patients. Using semiautomated morphomic analysis, we measured the pre- and post-operative dimensions of the abdominal wall including the anterior-posterior distance from the anterior vertebra-to-skin and fascia along with the circumferential area of the skin and fascial compartments. Paired Student t-tests were used to compare pre- and post-operative values. After hernia repair, there was a decrease in the anterior vertebra-to-skin distance (16.6 cm-15.8 cm, P = 0.007). There were also decreases in total body area (968.0 cm(2)-928.6 cm(2), P = 0.017) and total body circumference (113.6 cm-111.4 cm, P = 0.016). The distance from fascia to skin decreased as well, almost to the point of statistical significance (3.3 cm-2.9 cm, P = 0.0505). Interestingly, fascia area and circumference did not decrease significantly after the operation (578.2 cm(2)-572.5 cm(2), P = 0.519, and 89.1 cm-88.6 cm, P = 0.394, respectively). Morphomic analysis can be used to compare and pre- and post-operative changes in patients undergoing abdominal surgery. Our study demonstrates that component separation affects

  15. Is abdominal wall contraction important for normal voiding in the female rat?

    Directory of Open Access Journals (Sweden)

    Boone Timothy B

    2007-03-01

    Full Text Available Abstract Background Normal voiding behavior in urethane-anesthetized rats includes contraction of the abdominal wall striated muscle, similar to the visceromotor response (VMR to noxious bladder distension. Normal rat voiding requires pulsatile release of urine from a pressurized bladder. The abdominal wall contraction accompanying urine flow may provide a necessary pressure increment for normal efficient pulsatile voiding. This study aimed to evaluate the occurrence and necessity of the voiding-associated abdominal wall activity in urethane-anesthetized female rats Methods A free-voiding model was designed to allow assessment of abdominal wall activity during voiding resulting from physiologic bladder filling, in the absence of bladder or urethral instrumentation. Physiologic diuresis was promoted by rapid intravascular hydration. Intercontraction interval (ICI, voided volumes and EMG activity of the rectus abdominis were quantified. The contribution of abdominal wall contraction to voiding was eliminated in a second group of rats by injecting botulinum-A (BTX, 5 U into each rectus abdominis to induce local paralysis. Uroflow parameters were compared between intact free-voiding and BTX-prepared animals. Results Abdominal wall response is present in free voiding. BTX preparation eliminated the voiding-associated EMG activity. Average per-void volume decreased from 1.8 ml to 1.1 ml (p Conclusion The voiding-associated abdominal wall response is a necessary component of normal voiding in urethane anesthetized female rats. As the proximal urethra may be the origin of the afferent signaling which results in the abdominal wall response, the importance of the bladder pressure increment due to this response may be in maintaining a normal duration intermittent pulsatile high frequency oscillatory (IPHFO/flow phase and thus efficient voiding. We propose the term Voiding-associated Abdominal Response (VAR for the physiologic voiding-associated EMG/abdominal

  16. Reconstruction of Thoracic Wall Defect with Polytetrafluoroethylene Graft

    Directory of Open Access Journals (Sweden)

    Erkan Akar

    2014-03-01

    The most common causes of major thoracic traumas are stabwounds, traffic accidents and gunshot wounds. Thoracic wall defects developing due to these injuries should be repaired if they lead to paradoxal respiration. We repaired the thoracic wall defect of the 25-year-old male patient who was admitted to our clinic with gunshot wound with Polytetrafluoroethylene graft as expansion dysfunction and paradoxal respiration developed. No complications developed and he was discharged with recovery.  In conclusion, Polytetrafluoroethylene graft is a good reconstruction tool at present because it prevents paradoxal respiration successfully, applied easily and cosmetic. 

  17. Induced Magnetic Moment in Defected Single-Walled Carbon Nanotubes

    International Nuclear Information System (INIS)

    Liu Hong

    2006-01-01

    The existence of a large induced magnetic moment in defect single-walled carbon nanotube(SWNT) is predicted using the Green's function method. Specific to this magnetic moment of defect SWNT is its magnitude which is several orders of magnitude larger than that of perfect SWNT. The induced magnetic moment also shows certain remarkable features. Therefore, we suggest that two pair-defect orientations in SWNT can be distinguished in experiment through the direction of the induced magnetic moment at some Specific energy points

  18. The Many Guises of Endometriosis: Giant Abdominal Wall Endometriosis Masquerading as An Incisional Hernia

    Directory of Open Access Journals (Sweden)

    Chiara Petrosellini

    2017-10-01

    Full Text Available Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterine cavity. Although it is a leading cause of chronic pelvic pain and infertility, its clinical presentation can vary, resulting in diagnostic and therapeutic challenges. Extrapelvic endometriosis is particularly difficult to diagnose owing to its ability to mimic other conditions. Endometrial tissue in a surgical scar is uncommon and often misdiagnosed as a granuloma, abscess, or malignancy. Cyclical hemorrhagic ascites due to peritoneal endometriosis is exceptionally rare. We report the case of a pre-menopausal, nulliparous 44-year-old woman who presented with ascites and a large abdominal mass that arose from the site of a lower midline laparotomy scar. Five years previously, she had undergone open myomectomy for uterine fibroids. Soon after her initial operation she developed abdominal ascites, which necessitated percutaneous drainage on multiple occasions. We performed a laparotomy with excision of the abdominal wall mass through an inverted T incision. The extra-abdominal mass consisted of mixed cystic and solid components, and weighed 1.52 kg. It communicated with the abdominopelvic cavity through a 2 cm defect in the linea alba. The abdomen contained a large amount of odourless, brown fluid which drained into the mass. There was a large capsule that covered the small and large bowel, liver, gallbladder, and stomach. Final histology reported a 28×19×5 cm mass of endometrial tissue with no evidence of malignant transformation. The patient recovered well post-operatively and has remained asymptomatic. Our case illustrates that, despite being a common disease, endometriosis can masquerade as several other conditions and be missed or diagnosed late. Delay in diagnosis will not only prolong symptoms but can also compromise reproductive lifespan. It is therefore paramount that endometriosis is to be considered early in the management of premenopausal women

  19. Appearance of abdominal wall endometriosis on MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  20. Functional residual capacity increase during laparoscopic surgery with abdominal wall lift

    Directory of Open Access Journals (Sweden)

    Hiroshi Ueda

    Full Text Available Abstract Background and objectives: The number of laparoscopic surgeries performed is increasing every year and in most cases the pneumoperitoneum method is used. One alternative is the abdominal wall lifting method and this study was undertaken to evaluate changes of functional residual capacity during the abdominal wall lift procedure. Methods: From January to April 2013, 20 patients underwent laparoscopic cholecystectomy at a single institution. All patients were anesthetized using propofol, remifentanil and rocuronium. FRC was measured automatically by Engstrom Carestation before the abdominal wall lift and again 15 minutes after the start of the procedure. Results: After abdominal wall lift, there was a significant increase in functional residual capacity values (before abdominal wall lift 1.48 × 103 mL, after abdominal wall lift 1.64 × 103 mL (p < 0.0001. No complications such as desaturation were observed in any patient during this study. Conclusions: Laparoscopic surgery with abdominal wall lift may be appropriate for patients who have risk factors such as obesity and respiratory disease.

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

    Science.gov (United States)

    Muysoms, F E; Antoniou, S A; Bury, K; Campanelli, G; Conze, J; Cuccurullo, D; de Beaux, A C; Deerenberg, E B; East, B; Fortelny, R H; Gillion, J-F; Henriksen, N A; Israelsson, L; Jairam, A; Jänes, A; Jeekel, J; López-Cano, M; Miserez, M; Morales-Conde, S; Sanders, D L; Simons, M P; Śmietański, M; Venclauskas, L; Berrevoet, F

    2015-02-01

    The material and the surgical technique used to close an abdominal wall incision are important determinants of the risk of developing an incisional hernia. Optimising closure of abdominal wall incisions holds a potential to prevent patients suffering from incisional hernias and for important costs savings in health care. The European Hernia Society formed a Guidelines Development Group to provide guidelines for all surgical specialists who perform abdominal incisions in adult patients on the materials and methods used to close the abdominal wall. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and methodological guidance was taken from Scottish Intercollegiate Guidelines Network (SIGN). The literature search included publications up to April 2014. The guidelines were written using the AGREE II instrument. An update of these guidelines is planned for 2017. For many of the Key Questions that were studied no high quality data was detected. Therefore, some strong recommendations could be made but, for many Key Questions only weak recommendations or no recommendation could be made due to lack of sufficient evidence. To decrease the incidence of incisional hernias it is strongly recommended to utilise a non-midline approach to a laparotomy whenever possible. For elective midline incisions, it is strongly recommended to perform a continuous suturing technique and to avoid 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 method of fascial closure. Currently, no recommendations can be given on the optimal technique to close emergency laparotomy incisions. Prophylactic mesh augmentation appears effective and safe and can be suggested in high

  2. Exercise-Induced Abdominal Wall Muscle Injury Resulting in Rhabdomyolysis and Mimicking an Acute Abdomen.

    Science.gov (United States)

    Echague, Charlene G; Csokmay, John M

    2018-03-01

    Rhabdomyolysis is characterized by muscle necrosis and release of intracellular constituents, causing muscle pain, weakness, and myoglobinuria. This can be attributed to muscle injury after strenuous exercise. If the abdominal wall is involved, clinical presentation may resemble an acute abdomen. A 27-year-old woman, gravida 4 para 2, presented with swelling and pain of the mons pubis and abdominal pain after intense powerlifting 2 days prior. A computed tomography scan was performed, revealing abdominal wall inflammation. Although myoglobinuria was absent, there was high suspicion for rhabdomyolysis, which was confirmed by an elevated creatine kinase level. The patient improved after receiving intravenous fluids and abstaining from physical activity. Abdominal wall muscle injury resulting in rhabdomyolysis can imitate an acute abdomen in a healthy woman presenting with abdominal pain and swelling.

  3. Influence of the abdominal wall on the nonlinear propagation of focused therapeutic ultrasound

    International Nuclear Information System (INIS)

    Zhen-Bo, Liu; Ting-Bo, Fan; Dong, Zhang; Xiu-Fen, Gong

    2009-01-01

    This article theoretically studies the influence of inhomogeneous abdominal walls on focused therapeutic ultrasound based on the phase screen model. An inhomogeneous tissue is considered as a combination of a homogeneous medium and a phase aberration screen. Variations of acoustic parameters such as peak positive pressure, peak negative pressure, and acoustic intensity are discussed with respect to the phase screen statistics of human abdominal walls. Results indicate that the abdominal wall can result in energy loss of the sound in the focal plane. For a typical human abdominal wall with correlation length of 7.9 mm and variance of 0.36, the peak acoustic intensity radiated from a 1 MHz transmitter with a radius of 30 mm can be reduced by about 14% at the focal plane. (classical areas of phenomenology)

  4. Abdominal wall Hydatid cyst: A review a literature with a case report

    Directory of Open Access Journals (Sweden)

    Abdulwahid M. Salih

    2017-01-01

    Conclusion: HC should be put in the differential diagnosis of the abdominal wall masses. Its pre-operative diagnosis is important to prevent rupture with subsequent anaphylaxis and recurrence. Surgery is the main modality of treatment.

  5. Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases

    NARCIS (Netherlands)

    N.D. Kannekens-Bouvy (Nicole); R.L. Marquet (Richard); H.J. Bonjer (Jaap); J. Jeekel (Hans)

    1996-01-01

    textabstractOBJECTIVE: A tumor model in the rat was used to study peritoneal tumor growth and abdominal wall metastases after carbon dioxide (CO2) pneumoperitoneum, gasless laparoscopy, and laparotomy. SUMMARY BACKGROUND DATA: The role of laparoscopic resection of

  6. Incisional subcutaneous endometrioma of the abdominal wall: report of two cases

    International Nuclear Information System (INIS)

    Merran, S.; Karila-Cohen, P.

    2004-01-01

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

  7. Traumatic abdominal wall hernia - four cases and a review of the ...

    African Journals Online (AJOL)

    Objective: To review blunt traumatic abdominal wall hernias (TAWHs) in our institution. Method: Retrospective review of blunt abdominal trauma cases over a 6-month period. Results: Four patients with TAWH were identified. The mean age was 36 years. Three had been involved in vehicular collisions, and 1 had been ...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    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....

  9. Actinomycosis of the abdominal wall after cholecystectomy: transferral theory

    NARCIS (Netherlands)

    Kooi, E.-J.; de Vries, P. J.; van Geloven, A. W. W.; Stel, H. V.; Kingma, P. J.

    2016-01-01

    Abdominal actinomycosis is a rare disease caused by Gram-positive anaerobic Actinomyces bacteria. Here, we present a patient with an intrauterine contraceptive device who developed a long lasting and unexplained recurrent, painful abdominal swelling a few months after a laparoscopic cholecystectomy

  10. Abdominal wall hernias in upper Egypt: A different spectrum ...

    African Journals Online (AJOL)

    Background: Hernia is a very common surgical condition affecting all ages and both sexes. To describe and find the possible differences in the spectrum of abdominal hernias and document trends in their management, we carried out a descriptive study of all patients with abdominal hernias admitted to a single tertiary ...

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

    Directory of Open Access Journals (Sweden)

    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

  12. Reconstruction of a complex anterior abdominal wall defect with ...

    African Journals Online (AJOL)

    Nigerian Journal of Plastic Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 7, No 2 (2011) >. Log in or Register to get access to full text downloads.

  13. Abdominoplasty in prune belly syndrome: Modifications in Monfort technique to address variable patterns of abdominal wall weakness.

    Science.gov (United States)

    Smith, Edwin A; Srinivasan, Arun; Scherz, Hal C; Tracey, Anthony J; Broecker, Bruce; Kirsch, Andrew J

    2017-10-01

    Abdominoplasty is an important component of the management of children with prune belly syndrome (PBS). While there are features of the abdominal defect in PBS which are common to all patients, there will be differences unique to each patient that should be taken into consideration in surgical planning. Specifically, we have come to realize that although the Monfort procedure assumes a symmetric pattern of abdominal wall laxity, this symmetry is rarely present. The aim of this report is to describe our modifications and review our outcomes for the Monfort procedure which more completely address correction of the abdominal wall laxity including both common and uncommon features while positioning the umbilicus to a more anatomically correct position (Figure). Sixteen male patients with PBS and one female pseudoprune belly syndrome patient, aged 2-9 years, were treated at our institution between 2003 and 2014. Modifications incorporated into the abdominoplasty procedure for PBS applied to this study group included: 1) use of diagnostic laparoscopy to define the topography of the abdominal wall defect, 2) initial midline rather than elliptical skin incision to defer retailoring of the skin coverage until the final step of the procedure, 3) varying the width of the central plate to correct side to side asymmetry in redundancy, 4) plication of the central plate to reduce vertical redundancy and reposition the umbilicus, and 5) plication of focal areas of fascial weakness, most often in the flank region. All patients have improved abdominal wall contour with a more uniform correction of areas of weakness at a mean follow-up of 5.5 years (range 18 months-11.5 years). All patients and parents indicate that they are very satisfied with the outcome of their procedures without any revisions being performed. This study is descriptive in nature and retrospective, with the patient population treated in a relatively uniform fashion that does not allow direct comparison with other

  14. Complicated acute appendicitis presenting as an abscess in the abdominal wall in an elderly patient: A case report

    Directory of Open Access Journals (Sweden)

    Ibrahim Massuqueto Andrade Gomes de Souza

    Full Text Available Introduction: Appendicitis is a common cause of acute abdomen; however, the classic clinical signs are not often present, and it has unusual presentations. Thus, its diagnosis can be challenging. PRESENTATION OF CASE: We describe the case of an elderly man who presented with right abdominal wall abscess with spontaneous drainage in the emergency department. Since we suspected a subjacent abdominal pathology, we performed surgery, and intraoperatively, we observed that the Appendix tip had invaded the abdominal wall. Discussion: This patient had a challenging diagnostic process and surgical visualization of the appendicular tip invading the abdominal wall was an important characteristic in proving the cause of the abdominal wall abscess. Conclusion: The onset of an abdominal wall abscess without a known cause needs to be thoroughly investigated, with consideration of a subjacent abdominal cause and appendicitis necessitatis. Keywords: Appendicitis, Abdominal abscess, Appendicitis necessitatis, Case report

  15. Contraction of Abdominal Wall Muscles Influences Incisional Hernia Occurrence and Size

    Science.gov (United States)

    Lien, Samuel C.; Hu, Yaxi; Wollstein, Adi; Franz, Michael G.; Patel, Shaun P.; Kuzon, William M.; Urbanchek, Melanie G.

    2015-01-01

    Background Incisional hernias are a complication in 10% of all open abdominal operations and can result in significant morbidity. The purpose of this study is to determine if inhibiting abdominal muscle contraction influences incisional hernia formation during laparotomy healing. We hypothesize that reducing abdominal musculature deformation reduces incisional hernia occurrence and size. Study Design Using an established rat model for incisional hernia, a laparotomy through the linea alba was closed with one mid-incision, fast-absorbing suture. Three groups were compared: a SHAM group (SHAM; n = 6) received no laparotomies while the Saline Hernia (SH; n = 6) and Botox Hernia (BH; n = 6) groups were treated once with equal volume saline or Botulinum Toxin (Botox®, Allergan) before the incomplete laparotomy closure. On post-operative day 14, the abdominal wall was examined for herniation and adhesions and contractile forces were measured for abdominal wall muscles. Results No hernias developed in SHAM rats. Rostral hernias developed in all SH and BH rats. Caudal hernias developed in all SH rats, but in only 50% of the BH rats. Rostral hernias in the BH group were 35% shorter and 43% narrower compared to those in the SH group (p abdominal muscles compared to the SHAM and SH groups (p abdominal muscles reduces the number and size of incisional hernias. These results confirm abdominal wall muscle contractions play a significant role in the pathophysiology of incisional hernia formation. PMID:25817097

  16. Computed tomography of traumatic abdominal wall hernia and associated deceleration injuries

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, N.A.; Ryan, M.F.; Hamilton, P.A.; Bloom, C.; Murphy, J.P. [Sunnybrook and Women' s College Health Sciences Centre, Univ. of Toronto, Dept. of Medical Imaging, Toronto, Ontario (Canada); Brenneman, F. [Sunnybrook and Women' s College Health Sciences Centre, Univ. of Toronto, Dept. of Surgery, Toronto, Ontario (Canada)

    2002-06-01

    We retrospectively reviewed the computed tomographic CT examinations of 15 cases of abdominal wall hernia due to abdominal trauma; 13 patients had been injured in motor vehicle accidents (11 of those were belted in). All hernias were correctly identified on CT and confirmed intraoperatively. Traumatic abdominal wall hernia proved an important indicator of associated visceral injury, especially to the bowel (n = 6) and mesentery (n = 10). Careful review of the bowel and mesentery should thus be undertaken when disruption of the abdominal wall is documented. Radiologists should be aware, however, that CT findings may correlate poorly with severity of injury in these areas. In these instances, close clinical correlation and, sometimes, rescanning may be necessary. (author)

  17. Excision of a large abdominal wall lipoma improved bowel passage in a Proteus syndrome patient

    Science.gov (United States)

    Nakayama, Yoshifumi; Kusuda, Shinichi; Nagata, Naoki; Yamaguchi, Koji

    2009-01-01

    Proteus syndrome is an extremely rare congenital disorder that produces multifocal overgrowth of tissue. This report presents a surgical case of a large lipoma in the abdominal wall of a patient with Proteus syndrome. She was diagnosed with Proteus syndrome based on certain diagnostic criteria. The neoplasm increased in size gradually, producing hemihypertrophy of her left lower extremity and trunk, and spread to her retroperitoneum and her left abdominal wall. She experienced gradually progressive constipation, nausea, vomiting, and abdominal pain. Computed tomography (CT) of the abdomen demonstrated a large mass in the subcutaneous adipose tissue of the left lower abdominal wall which measured 12 cm × 8 cm x 6 cm in diameter and encased the left colon. This mass in the abdominal wall was excised. The weight of the excised mass was 1550 g. The histopathological diagnosis of this mass was lipoma. After surgery, the encasement of the left colon was improved, and the patient was able to move her bowels twice per day. The excision of the large lipoma in the abdominal wall contributed to the improved bowel passage in this patient with Proteus syndrome. PMID:19598310

  18. Heterotopic intra-abdominal ossification in a complex ventral hernia defect.

    Science.gov (United States)

    Obeid, A; Sarhane, Ka; Berjaoui, T; Abiad, F

    2014-02-01

    Heterotopic ossification, an entity common in orthopaedic practice frequently involving the hip, knee or other joints, is rarely encountered in abdominal wounds and mesentery. This unusual condition, referred to as mesenteric ossification, is typically associated with intra-abdominal catastrophes. Surgical repair following such catastrophes has always been a challenge as the abdominal wall architecture is frequently distorted by the multiple laparotomies previously performed. In addition, the presence of several enterocutaneous fistulae further compounds the reconstruction approach, especially when mesh material is planned for use. We report a case of intra-abdominal heterotopic ossification with mesenteric involvement after a penetrating injury to the abdomen, followed by multiple laparotomies that ended in a complex abdominal wall hernia with major loss of domain, and multiple enterocutaneous fistulae. The patient was treated with resection of the bony deposits from the abdominal wound and cavity, along with excision of the fistula sites. This was followed by a component separation technique and the use of a biologic mesh graft to reconstruct the abdominal wall.

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

    Directory of Open Access Journals (Sweden)

    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. WSES guidelines for emergency repair of complicated abdominal wall hernias

    NARCIS (Netherlands)

    M. Sartelli (Massimo); F. Coccolini (Federico); G.H. van Ramshorst (Gabrielle); G. Campanelli (Giampiero); V. Mandala; L. Ansaloni (Luca); E.E. Moore (Ernest); A. Peitzman (Andrew); G.C. Velmahos (George ); F.A. Moore (Fredrick); A. Leppaniemi (Ari); C.C. Burlew (Clay); W.L. Biffl (Walter); K. Koike (Kaoru); Y. Kluger (Yoram); G.P. Fraga (Gustavo); C.A. Ordonez (Carlos); S. Di Saverio (Salomone); F. Agresta; B. Sakakushev (Boris); I. Gerych (Igor); I. Wani (Imtiaz); M.D. Kelly (Michael ); C.A. Gomes (Carlos); M.P. Faro Jr (Mario); K. Taviloglu (Korhan); Z. Demetrashvili (Zaza); J.G. Lee (Jeong ); N. Vettoretto (Nereo); G. Guercioni (Gianluca); C. Tranà (Cristian); Y. Cui (Yijun); K.Y.Y. Kok (Kenneth); W.M. Ghnnam (Wagih); A.E.S. Abbas (Ashraf El-Sayed); N. Sato (Norio); S. Marwah (Sanjay); M. Rangarajan (Muthukumaran); O. Ben-Ishay (Offir); A.R.K. Adesunkanmi (Abdul Rashid); H.A. Segovia Lohse (Helmut); J. Kenig (Jakub); V. Mandalà (Vincenzo); A. Patrizi (Andrea); R. Scibé (Rodolfo); F. Catena (Fausto)

    2013-01-01

    textabstractEmergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of

  1. Intra-abdominal pressure and abdominal wall muscular function: Spinal unloading mechanism.

    Science.gov (United States)

    Stokes, Ian A F; Gardner-Morse, Mack G; Henry, Sharon M

    2010-11-01

    The roles of antagonistic activation of abdominal muscles and of intra-abdominal pressurization remain enigmatic, but are thought to be associated with both spinal unloading and spinal stabilization in activities such as lifting. Biomechanical analyses are needed to understand the function of intra-abdominal pressurization because of the anatomical and physiological complexity, but prior analyses have been over-simplified. To test whether increased intra-abdominal pressure was associated with reduced spinal compression forces for efforts that generated moments about each of the principal axis directions, a previously published biomechanical model of the spine and its musculature was modified by the addition of anatomically realistic three-layers of curved abdominal musculature connected by fascia to the spine. Published values of muscle cross-sectional areas and the active and passive stiffness properties were assigned. The muscle activations were calculated assuming minimized muscle stress and stretch for the model loaded with flexion, extension, lateral bending and axial rotation moments of up to 60 Nm, along with intra-abdominal pressurization of 5 or 10 kPa (37.5 or 75 mm Hg) and partial bodyweight (340 N). The analysis predicted a reduction in spinal compressive force with increase in intra-abdominal pressurization from 5 to 10 kPa. This reduction at 60 Nm external effort was 21% for extension effort, 18% for flexion effort, 29% for lateral bending and 31% for axial rotation. This analysis predicts that intra-abdominal pressure produces spinal unloading, and shows likely muscle activation patterns that achieve this. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Long-term follow-up of total abdominal wall reconstruction for prune belly syndrome.

    Science.gov (United States)

    Lesavoy, Malcolm A; Chang, Eric I; Suliman, Ahmed; Taylor, Jason; Taylor, James; Kim, Sara E; Ehrlich, Richard M

    2012-01-01

    Prune belly syndrome is a rare, congenital condition that consists of a major deficiency or hypoplasia of the abdominal wall musculature, bilateral cryptorchidism, and genitourinary tract malformations. Reconstruction of the abdominal wall in these patients has presented a challenge to plastic surgeons throughout the years. The authors previously described a technique for total abdominal wall reconstruction that permitted simultaneous urinary tract reconstruction and bilateral orchiopexy. This innovative procedure used medial advancement of the fascia in a "double-breasted" fashion with preservation of the umbilicus. The authors reviewed their experience with this particular technique in one of the largest series of patients in the literature and the series with the longest follow-up. Twenty patients underwent total abdominal wall reconstruction with simultaneous urinary tract reconstruction and orchiopexy with a mean follow-up of 20.4 years. There were no major complications noted during this period, and all patients were extremely satisfied with their postoperative result. Total abdominal wall reconstruction using the double-breasted technique in patients with prune belly syndrome is a safe and durable procedure that achieves excellent cosmetic results. Therapeutic, IV.

  3. [Hernia recurrence long term follow-up after open procedures of abdominal wall plasty-prospective study including 142 patients].

    Science.gov (United States)

    Mureşan, Mircea; Mureşan, Simona; Bara, Tivadar; Neagoe, Radu; Sala, Daniela; Suciu, Bogdan

    2016-01-01

    The incisional hernia continues to be a frequent complication of laparotomies. The purpose of study is the analysis of hernia disease relapse after one year after different open plasties methods of the abdominal wall. A prospective longitudinal study was performed that included 142 patients. An analysis was performed on the individual data, the level of obesity, intra-surgical variations in intra-abdominal pressure, the intensity of post-surgical pain, the post-surgical complications, and the types of plasties of abdominal wall, simple and with polypropylene mesh. The analysis of studied group showed a general rate of relapse of 16.9%, and within the 4 procedures, 40.74% in the case of simple plasties, of 16.07% after the only plasties, 6.97% after the retro-muscular plasties, and 6.25% after the full substitution of parietal defect. On analysing the collected, hernia relapse was statistically significantly related to the level of obesity, variations in intra-abdominal pressure, post-surgical pain, and the type of procedure performed. Hernia is a frequent complication of laparotomies. Hernia relapse was more frequent in the case of simple plasties. Among the mesh procedures, the onlay plasty showed a higher rate of relapse and post-surgical complications. Hernia relapse was more frequent in the case of variations of intra-abdominal pressure, and with increased post-surgical pain. The use of an echography examination may increase the accuracy of the presence of hernia disease. Copyright © 2015 Academia Mexicana de Cirugía A.C. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. A Case of Urachal Carcinoma of the Abdominal Wall in a Kidney Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Takuya Yamazaki

    2017-01-01

    Full Text Available Urachal carcinoma is an extremely rare malignant tumor arising from the urachus in the fetus. We report a patient who developed urachal carcinoma 18 years after kidney transplantation. A 59-year-old man was admitted because of abdominal pain and massive ascites. He had undergone kidney transplantation 18 years earlier and had end-stage renal disease requiring dialysis. Abdominal CT showed massive ascites and an abdominal wall cystic mass separated from the peritoneal cavity. Hemodialysis was started, and paralytic ileus was diagnosed and treated. His ileus symptoms improved temporarily, but he died of myocardial infarction. An autopsy was performed, which revealed cystadenocarcinoma in the abdominal wall mass, leading to a diagnosis of urachal carcinoma.

  6. Late metastatic endometrial carcinoma at the repair site of an abdominal wall incisional hernia.

    Science.gov (United States)

    Meshikhes, Abdul-Wahed N; Al-Badr, Suha H; Sulais, Ehsan A; Al-Qudaihi, Hibba M

    2017-05-01

    The abdominal wall is a very rare site for endometrial cancer metastases. Its appearance generally indicates advanced cancer with poor prognosis. We report a case of a 55-year-old female who presented with an incisional hernia 4 years after abdominal panhysterectomy for endometrioid adenocarcinoma in 2009. Open hernia mesh repair was performed but on follow-up, she complained of pain and a swelling at the repair site. This was radiologically diagnosed as fibromatosis, but tru-cut biopsy confirmed presence of fibromatosis as well as a metastatic endometrial carcinoma. She was started on neoadjuvant chemotherapy, but had poor response, and therefore, radical excision was performed. She remained well with no metastatic recurrence at 12-month follow-up. This case illustrates late appearance of abdominal wall metastasis from abdomino-pelvic malignancies and highlights the need to exclude the presence of recurrence or metastases prior to surgical repair of incisional hernia occurring after the resection of abdominal or pelvic malignancy.

  7. Point-of-Care Ultrasound Diagnosis of Traumatic Abdominal Wall Hernia.

    Science.gov (United States)

    Bjork, Lori B; Bellew, Shawna D; Kummer, Tobias

    2017-05-01

    Traumatic abdominal wall hernias due to blunt abdominal trauma in pediatric patients can pose a diagnostic challenge because of spontaneous hernia reduction. Ultrasonography may be superior to computed tomography for this indication in some cases because of the ability to dynamically and repeatedly assess the area of injury. Herniation can be induced or exaggerated via Valsalva maneuvers, which can facilitate its detection during dynamic assessment. We present the case of a 3-year-old boy who sustained blunt abdominal trauma, with a resultant abdominal wall hernia that was diagnosed using point-of-care ultrasound imaging. This hernia was not visualized with computed tomography, and point-of-care ultrasonography expedited admission for operative repair.

  8. Lipedema complicated by lymphedema of the abdominal wall and lower limbs.

    Science.gov (United States)

    Zelikovski, A; Haddad, M; Koren, A; Avrahami, R; Loewinger, J

    2000-06-01

    We describe a 52 year-old woman in whom lymphedema primarily of the abdominal wall was superimposed on lipedema resulting in an abdomen of enormous dimensions with marked impairment of ambulation. Treatment consisted of preoperative compression of the legs by an external pneumatic device (Lympha-Press) followed by excision of the lymphedematous abdominal fat pad in conjunction with "debulking" of the right leg. The patient illustrates the extremes of lipedema complicated by lymphedema and the technical difficulties associated with its management.

  9. Texture analysis improves level set segmentation of the anterior abdominal wall

    International Nuclear Information System (INIS)

    Xu, Zhoubing; Allen, Wade M.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Landman, Bennett A.

    2013-01-01

    Purpose: The treatment of ventral hernias (VH) has been a challenging problem for medical care. Repair of these hernias is fraught with failure; recurrence rates ranging from 24% to 43% have been reported, even with the use of biocompatible mesh. Currently, computed tomography (CT) is used to guide intervention through expert, but qualitative, clinical judgments, notably, quantitative metrics based on image-processing are not used. The authors propose that image segmentation methods to capture the three-dimensional structure of the abdominal wall and its abnormalities will provide a foundation on which to measure geometric properties of hernias and surrounding tissues and, therefore, to optimize intervention.Methods: In this study with 20 clinically acquired CT scans on postoperative patients, the authors demonstrated a novel approach to geometric classification of the abdominal. The authors’ approach uses a texture analysis based on Gabor filters to extract feature vectors and follows a fuzzy c-means clustering method to estimate voxelwise probability memberships for eight clusters. The memberships estimated from the texture analysis are helpful to identify anatomical structures with inhomogeneous intensities. The membership was used to guide the level set evolution, as well as to derive an initial start close to the abdominal wall.Results: Segmentation results on abdominal walls were both quantitatively and qualitatively validated with surface errors based on manually labeled ground truth. Using texture, mean surface errors for the outer surface of the abdominal wall were less than 2 mm, with 91% of the outer surface less than 5 mm away from the manual tracings; errors were significantly greater (2–5 mm) for methods that did not use the texture.Conclusions: The authors’ approach establishes a baseline for characterizing the abdominal wall for improving VH care. Inherent texture patterns in CT scans are helpful to the tissue classification, and texture

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Phacomatosis pigmentokeratotica associated with hemihypertrophy and a rhabdomyosarcoma of the abdominal wall.

    Science.gov (United States)

    Gruson, Lisa M; Orlow, Seth J; Schaffer, Julie V

    2006-08-01

    Phacomatosis pigmentokeratotica (PPK) represents a specific "twin nevus" syndrome in which a speckled lentiginous nevus (SLN) is associated with an organoid nevus with sebaceous differentiation. A boy with a large nevus sebaceus on the left face and upper part of the trunk, a giant segmental SLN extending from the abdomen to the feet bilaterally, and right hemihypertrophy developed an embryonal rhabdomyosarcoma of the right abdominal wall at age 6 months. A variety of musculoskeletal, neurologic, and ocular anomalies have been observed in patients with PPK, reflecting the individual manifestations of both SLN and Schimmelpenning syndromes. This report adds hemihypertrophy to the spectrum of extracutaneous manifestations of PPK and, to our knowledge, represents the first observation of a rhabdomyosarcoma arising in contiguity with an SLN in a patient with PPK. The development of a rhabdomyosarcoma in our patient likely reflects both increased propensity for growth (as evidenced by the hemihypertrophy) and the pluripotent nature of neural-crest derived cells within the field defect that underlies an SLN.

  12. Unusual Presentations of Actinomycosis; Anterior Abdominal Wall and Appendix: Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Faruk Karateke

    2013-09-01

    Full Text Available Background: Primary actinomycosis of the anterior abdominal wall and appendix are very rare clinical entities. An accurate diagnosis is generally obtained by histological examination, and treatment often requires surgical resection. Case Report: In this study we presented two cases of primary actinomycosis involving the anterior abdominal wall and a third one located in the appendix. Conclusion: Actinomyces Israelii can involve all anatomic structures of the abdomen. Although preoperative diagnosis is difficult, the combination of surgery and antibiotic treatment results in complete treatment in the majority of cases.

  13. [Spontaneous rupture of the abdominal wall in cirrhotic patients with ascites].

    Science.gov (United States)

    Castellote, J; Xiol, X; Fernández Esparrach, G; Baliellas, C; Rota Roca, R; Casais, L

    1991-06-01

    The abdominal wall hernia is a common finding in cirrhotic patients. Spontaneous disruption of the abdominal wall through these herniae is an uncommon complication, is associated with a high mortality and should be considered a gastroenterologic emergency. It occurs through a skin ulceration over the hernia in the 70% of all cases. Intravascular expansion plus long antibiotic prophylaxis with anti-staphylococcal agents are the mainstays of medical therapy. The definitive treatment must be surgical. Each case must be evaluated individually to determine the optimal surgical management, not necessarily on an emergent basis. We report three new cases surviving this complication.

  14. Semiautomatic vessel wall detection and quantification of wall thickness in computed tomography images of human abdominal aortic aneurysms

    International Nuclear Information System (INIS)

    Shum, Judy; DiMartino, Elena S.; Goldhammer, Adam; Goldman, Daniel H.; Acker, Leah C.; Patel, Gopal; Ng, Julie H.; Martufi, Giampaolo; Finol, Ender A.

    2010-01-01

    Purpose: Quantitative measurements of wall thickness in human abdominal aortic aneurysms (AAAs) may lead to more accurate methods for the evaluation of their biomechanical environment. Methods: The authors describe an algorithm for estimating wall thickness in AAAs based on intensity histograms and neural networks involving segmentation of contrast enhanced abdominal computed tomography images. The algorithm was applied to ten ruptured and ten unruptured AAA image data sets. Two vascular surgeons manually segmented the lumen, inner wall, and outer wall of each data set and a reference standard was defined as the average of their segmentations. Reproducibility was determined by comparing the reference standard to lumen contours generated automatically by the algorithm and a commercially available software package. Repeatability was assessed by comparing the lumen, outer wall, and inner wall contours, as well as wall thickness, made by the two surgeons using the algorithm. Results: There was high correspondence between automatic and manual measurements for the lumen area (r=0.978 and r=0.996 for ruptured and unruptured aneurysms, respectively) and between vascular surgeons (r=0.987 and r=0.992 for ruptured and unruptured aneurysms, respectively). The authors' automatic algorithm showed better results when compared to the reference with an average lumen error of 3.69%, which is less than half the error between the commercially available application Simpleware and the reference (7.53%). Wall thickness measurements also showed good agreement between vascular surgeons with average coefficients of variation of 10.59% (ruptured aneurysms) and 13.02% (unruptured aneurysms). Ruptured aneurysms exhibit significantly thicker walls (1.78±0.39 mm) than unruptured ones (1.48±0.22 mm), p=0.044. Conclusions: While further refinement is needed to fully automate the outer wall segmentation algorithm, these preliminary results demonstrate the method's adequate reproducibility and

  15. Abdominal wall reconstruction in the prune belly syndrome.

    Science.gov (United States)

    Randolph, J; Cavett, C; Eng, G

    1981-12-01

    In our institution, 12 patients have been encountered with prune belly syndrome. Eight children have undergone evaluation of their abdominal musculature by electromyography. Results of their studies show that major functioning or recoverable muscle exists in the lateral and upper sector of the abdomen, but that little or no muscle exists in the lower central abdomen. Based in part on these findings, an operation has been devised which spares all potentially functioning musculature and corresponding motor nerves, and disposes of nonfunctioning and nonrecoverable muscle. In terms of cosmetic appearance and gross motor testing, these growing boys show significant improvement.

  16. The cutaneous arteries of the anterior abdominal wall: a three-dimensional study.

    Science.gov (United States)

    Tregaskiss, Ashley P; Goodwin, Adam N; Acland, Robert D

    2007-08-01

    Abdominal perforator flaps represent a natural progression in the quest to minimize abdominal wall morbidity. Their one disadvantage is the significant rate of vascular complications to which they are subject in some series. The authors examined the vascular anatomy of the abdominal integument, to determine why such complications occur and how they may be prevented. In 10 fresh cadavers, major arteries supplying the abdominal wall were injected with a lead-based contrast medium. The abdominal integument of each cadaver was imaged using a 16-slice spiral computed tomography scanner, to produce three-dimensional reconstructions of the arterial anatomy. Reconstructions were observed for orientation, course, and morphology of the major perforators within the abdominal integument. Perforators of the deep inferior epigastric artery (DIEA) varied markedly in their orientation, course, and morphology among specimens. By contrast, perforators of the superior epigastric artery (SEA) were relatively consistent in their morphology and orientation. In eight of 10 specimens, SEA perforators with extensive anatomical "territories" orientated toward the umbilicus were present. These SEA perforators pierced the rectus sheath within 4 cm of the costal margin and were present bilaterally in seven of eight specimens. The unpredictable orientation and course of DIEA perforators indicate that the blood supply of abdominal perforator flaps, raised without clear knowledge of their unique vascular anatomy, may often be more random than axial. This may account for much of the ischemia-related morbidity observed with DIEA-based perforator flaps. Preservation of SEA perforators adjacent to the costal margin during abdominoplasty will likely improve abdominal wall perfusion and reduce donor-site morbidity.

  17. Contraction of abdominal wall muscles influences size and occurrence of incisional hernia.

    Science.gov (United States)

    Lien, Samuel C; Hu, Yaxi; Wollstein, Adi; Franz, Michael G; Patel, Shaun P; Kuzon, William M; Urbanchek, Melanie G

    2015-07-01

    Incisional hernias are a complication in 10% of all open abdominal operations and can result in substantial morbidity. The purpose of this study was to determine whether inhibiting abdominal muscle contraction influences incisional hernia formation during the fascial healing after laparotomy. We hypothesized that decreasing the deformation of the abdominal musculature would decrease the size or occurrence of an incisional hernia. Using an established rat model for incisional hernia, a laparotomy through the linea alba was closed with 1 mid-incision, fast-absorbing suture. Three groups were compared: a sham group (sham; n = 6) received no laparotomy, and the saline hernia (SH; n = 6) and Botox hernia (BH; n = 6) groups were treated once with equal volumes of saline or botulinum toxin (Botox, Allergan) before the incomplete laparotomy closure. On postoperative day 14, the abdominal wall was examined for herniation and adhesions, and contractile forces were measured for abdominal wall muscles. No hernias developed in the sham rats. Rostral hernias developed in all SH and BH rats. Caudal hernias developed in all SH rats, but in only 50% of the BH rats. Rostral hernias in the BH group were 35% shorter and 43% narrower compared with those in the SH group (P abdominal muscles compared with the sham and SH groups (P abdominal muscles decreases the number and size of incisional hernias. These results suggest that contractions of the abdominal wall muscle play a role in the pathophysiology of the formation of incisional hernias. Published by Elsevier Inc.

  18. Abdominal wall CT angiography: a detailed account of a newly established preoperative imaging technique.

    Science.gov (United States)

    Phillips, Timothy J; Stella, Damien L; Rozen, Warren M; Ashton, Mark; Taylor, G Ian

    2008-10-01

    Institutional review board approval was obtained for this study, and all patients gave written informed consent. Autologous surgical breast reconstruction with use of abdominal wall donor flaps based on the deep inferior epigastric artery (DIEA) and one or more of its anterior musculocutaneous perforating branches (DIEA perforator flap) is being used with increasing frequency instead of breast reconstruction with use of traditional transverse rectus abdominus musculocutaneous and modified muscle-sparing flaps. Preoperative mapping of the DIEA perforators with abdominal wall computed tomographic (CT) angiography may improve patient care by providing the surgeon with additional information that will lead to optimization of the surgical technique, shorter procedure time, and reduction in the frequency of surgical complications. The branching patterns of the DIEA, the segmental anatomy of the anterior adipocutaneous perforating branches of the DIEA, and the importance of these features in pre- and intraoperative surgical planning necessitate a different approach to abdominal wall CT angiography than that used with other abdominal CT angiographic techniques. In abdominal wall CT angiography, the common femoral artery is used as the bolus trigger, CT scanning is performed in the caudocranial direction, the automatic exposure control feature is disabled, a scaled grid overlay tool is used to present information to the surgeons, and radiation dose is minimized (average dose, 6 mSv). The anatomic accuracy of abdominal wall CT angiography has been investigated in cadaveric and surgical studies, with sensitivity of 96%-100% and specificity of 95%-100%. This detailed description will allow other radiologists and surgeons interested in free DIEP flap surgery to incorporate this useful tool into their practice. (c) RSNA, 2008.

  19. Automated segmentation and recognition of abdominal wall muscles in X-ray torso CT images and its application in abdominal CAD

    International Nuclear Information System (INIS)

    Zhou, X.; Kamiya, N.; Hara, T.; Fujita, H.; Chen, H.; Yokoyama, R.; Hoshi, H.

    2007-01-01

    The information of abdominal wall is very important for the planning of surgical operation and abdominal organ recognition. In research fields of computer assisted radiology and surgery and computer-aided diagnosis, the segmentation and recognition of the abdominal wall muscles in CT images is a necessary pre-processing step. Due to the complexity of the abdominal wall structure and indistinctive in CT images, the automated segmentation of abdominal wall muscles is a difficult issue and has not been solved completely. We propose an approach to segment the abdominal wall muscles and divide it into three categories (front abdominal muscles including rectus abdominis; left and right side abdominal muscles including external oblique, internal oblique and transversus abdominis muscles) automatically. The approach, first, makes an initial classification of bone, fat, and muscles and organs based on the CT number. Then a layer structure is generated to describe the 3-D anatomical structures of human torso by stretching the torso region onto a thin-plate for easy recognition. The abdominal wall muscles are recognized on the layer structures using the spatial relations to the skeletal structure and CT numbers. Finally, the recognized regions are mapped back to the 3-D CT images using an inverse transformation of the stretching process. This method is applied to 20 cases of torso CT images and evaluations are based on visual comparison of the recognition results and the original CT images by an expert in anatomy. The results show that our approach can segment and recognize abdominal wall muscle regions effectively. (orig.)

  20. Automated segmentation and recognition of abdominal wall muscles in X-ray torso CT images and its application in abdominal CAD

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, X.; Kamiya, N.; Hara, T.; Fujita, H. [Dept. of Intelligent Image Information, Div. of Regeneration and Advanced Medical Sciences, Graduate School of Medicine, Gifu Univ., Gifu (Japan); Chen, H. [Dept. of Anatomy, Graduate School of Medicine, Gifu Univ., Gifu (Japan); Yokoyama, R.; Hoshi, H. [Dept. of Radiology, Gifu Univ. Graduate School of Medicine and Univ. Hospital, Gifu (Japan)

    2007-06-15

    The information of abdominal wall is very important for the planning of surgical operation and abdominal organ recognition. In research fields of computer assisted radiology and surgery and computer-aided diagnosis, the segmentation and recognition of the abdominal wall muscles in CT images is a necessary pre-processing step. Due to the complexity of the abdominal wall structure and indistinctive in CT images, the automated segmentation of abdominal wall muscles is a difficult issue and has not been solved completely. We propose an approach to segment the abdominal wall muscles and divide it into three categories (front abdominal muscles including rectus abdominis; left and right side abdominal muscles including external oblique, internal oblique and transversus abdominis muscles) automatically. The approach, first, makes an initial classification of bone, fat, and muscles and organs based on the CT number. Then a layer structure is generated to describe the 3-D anatomical structures of human torso by stretching the torso region onto a thin-plate for easy recognition. The abdominal wall muscles are recognized on the layer structures using the spatial relations to the skeletal structure and CT numbers. Finally, the recognized regions are mapped back to the 3-D CT images using an inverse transformation of the stretching process. This method is applied to 20 cases of torso CT images and evaluations are based on visual comparison of the recognition results and the original CT images by an expert in anatomy. The results show that our approach can segment and recognize abdominal wall muscle regions effectively. (orig.)

  1. Abdominal Wall Metastasis from an Invasive Lobular Carcinoma of the Breast: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hana; Son, Eun Ju; Youk, Ji Hyun; Chung, Jin [Dept. of Radiology, Gangnam Severance Hospital, Yensei University College of Medicine, Seoul (Korea, Republic of); Noh, Song Mi; Jung, Woo Hee [Dept. of Diagnostic Pathology, Gangnam Severance Hospital, Yensei University College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    Breast cancer is one of the most common malignancies in women. Breast cancer frequently metastasizes to the bones, lungs, and liver. However, the recurrence of distant soft-tissue metastasis except to the chest wall is extremely rare. Here, we describe our experience with a patient in whom invasive lobular carcinoma of the breast with metastasis to the abdominal wall presented as subcutaneous nodules without local recurrence.

  2. Abdominal Wall Metastasis from an Invasive Lobular Carcinoma of the Breast: A Case Report

    International Nuclear Information System (INIS)

    Kim, Hana; Son, Eun Ju; Youk, Ji Hyun; Chung, Jin; Noh, Song Mi; Jung, Woo Hee

    2011-01-01

    Breast cancer is one of the most common malignancies in women. Breast cancer frequently metastasizes to the bones, lungs, and liver. However, the recurrence of distant soft-tissue metastasis except to the chest wall is extremely rare. Here, we describe our experience with a patient in whom invasive lobular carcinoma of the breast with metastasis to the abdominal wall presented as subcutaneous nodules without local recurrence.

  3. Relationship between ventral hernia defect area and intra-abdominal pressure: dynamic in vivo measurement.

    Science.gov (United States)

    Qandeel, Haitham; O'Dwyer, Patrick J

    2016-04-01

    It is an acceptable concept that the ventral hernia defect area will increase with a rise in intra-abdominal pressure (IAP). The literature lacks the evidence about how much this increase is in vivo. The aim of this study was to objectively measure the change in the ventral hernia defect area with increasing intra-abdominal pressure. In a prospective study of laparoscopic ventral hernia repair, the area of hernia defect was measured from inside the abdomen using a sterile paper ruler. The horizontal (width) and vertical (length) measurements of the defect were taken at two pressure points: (IAP = 8 mmHg) and (IAP = 15 mmHg). The hernia defect area was calculated as an oval shape using a standard formula. Eighteen consecutive patients with a ventral hernia were included in this study (8 males: 10 females). Median age was 60 years (30-81), body mass index (BMI) was 29.9 (22.6-37.6). Changing the IAP significantly, (P hernia defect. The median calculated defect area, as an oval shape, was 5.6 cm(2) (Q1-Q3 = 3.5-15.5) and 6.9 cm(2) (Q1-Q3 = 4.5-18.7) at 8 and 15 mmHg IAP, respectively. The calculated area of mesh required to cover the defect with a 5 cm overlap increased by a median of 5% (Q1-Q3 = 3-6%). The change in defect area did not differ significantly between obese and non-obese patients (P = 0.5). Dynamic, rather than static, measurements of ventral hernia area during laparoscopy provide a simple way of in vivo objective measurement that helps the surgeon choose the appropriate area of mesh. When choosing mesh area, we support the trend toward a larger overlap of at least 5 cm if less precise methods of measuring defect area are been used.

  4. Establishing the case for CT angiography in the preoperative imaging of abdominal wall perforators.

    Science.gov (United States)

    Rozen, W M; Ashton, M W; Grinsell, D; Stella, D L; Phillips, T J; Taylor, G I

    2008-01-01

    Preoperative imaging of the donor site vasculature for deep inferior epigastric artery (DIEA) perforator flaps and other abdominal wall reconstructive flaps has become more commonplace. Abdominal wall computed tomography angiography (CTA) has been described as the most accurate and reproducible modality available for demonstrating the location, size, and course of individual perforators. We drew on our experience of 75 consecutive patients planned for DIEA-based flap surgery undertaking CTA at a single institution. Seven of these cases have been reported to highlight the utility of CTA for preoperative planning, emphasizing the unique information supplied by CTA that may influence operative outcome. Among all cases that underwent preoperative imaging with CTA, there was 100% flap survival, with no partial or complete flap necrosis. We found that in three of the cases described, the choice of operation was necessarily selected based on CTA findings (DIEA perforator flap, transverse rectus abdominis myocutaneous flap, and superficial superior epigastric artery flap). In addition, three cases demonstrate that CTA findings may dictate the decision to operate at all, and one case demonstrates the utility of CTA for evaluating the entire abdominal contents for comorbid conditions. Our experience with CTA for abdominal wall perforator mapping has been highly beneficial. CTA may guide operative technique and improve perforator selection in uncomplicated cases, and in difficult cases it can guide the most appropriate operation or indeed if an operation is appropriate at all. This is particularly the case in the setting of comorbidities or previous abdominal surgery.

  5. Abdominal wall muscle elasticity and abdomen local stiffness on healthy volunteers during various physiological activities.

    Science.gov (United States)

    Tran, D; Podwojewski, F; Beillas, P; Ottenio, M; Voirin, D; Turquier, F; Mitton, D

    2016-07-01

    The performance of hernia treatment could benefit from more extensive knowledge of the mechanical behavior of the abdominal wall in a healthy state. To supply this knowledge, the antero-lateral abdominal wall was characterized in vivo on 11 healthy volunteers during 4 activities: rest, pullback loading, abdominal breathing and the "Valsalva maneuver". The elasticity of the abdominal muscles (rectus abdominis, obliquus externus, obliquus internus and transversus abdominis) was assessed using ultrasound shear wave elastography. In addition, the abdomen was subjected to a low external load at three locations: on the midline (linea alba), on the rectus abdominis region and on lateral muscles region in order to evaluate the local stiffness of the abdomen, at rest and during "Valsalva maneuver". The results showed that the "Valsalva maneuver" leads to a statistically significant increase of the muscle shear modulus compared to the other activities. This study also showed that the local stiffness of the abdomen was related to the activity. At rest, a significant difference has been observed between the anterior (0.5N/mm) and the lateral abdomen locations (1N/mm). Then, during the Valsalva maneuver, the local stiffness values were similar for all locations (ranging from 1.6 to 2.2N/mm). This work focuses on the in vivo characterization of the mechanical response of the human abdominal wall and abdomen during several activities. In the future, this protocol could be helpful for investigation on herniated patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Safety assessment of pipes with multiple local wall thinning defects under pressure and bending moment

    International Nuclear Information System (INIS)

    Peng Jian; Zhou Changyu; Xue Jilin; Dai Qiao; He Xiaohua

    2011-01-01

    The safety assessment of pipes with local wall thinning defects is highly important in engineering. Most attention has been paid on the safety assessment of pipe with single local wall thinning defect, while the studies about multiple local wall thinning defects are not nearly enough. However, the interaction of multiple local wall thinning defects in some conditions is great, and may have a great impact on the safety assessment. In the present standard API 579/ASME FFS, the safety assessment of pipes with multiple local wall thinning defects is given, while as well as the influence of load condition, the influences of arrangement and relative depth of defects are ignored, which may influence the safety assessment considerably. In this paper, the influence of the interaction between multiple local wall thinning defects on the remaining strength of pipes at different arrangements and depths of defects under different load conditions (pressure, tension-bending moment and compression-bending moment) are studied. A quantified index is defined to describe the interaction between defects quantitatively. For different arrangements and relative depths of defects, based on a limit value 0.05 of the quantified index of the interaction between defects, a relatively systematic safety assessment of pipes with multiple local wall thinning defects under different load conditions has been proposed.

  7. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias.

    LENUS (Irish Health Repository)

    Birindelli, Arianna

    2017-01-01

    Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.

  8. Closed incision prophylactic negative pressure wound therapy in patients undergoing major complex abdominal wall repair

    NARCIS (Netherlands)

    de Vries, F. E. E.; Atema, J. J.; Lapid, O.; Obdeijn, M. C.; Boermeester, M. A.

    2017-01-01

    Purpose To evaluate if incisional prophylactic negative pressure wound therapy (pNPWT) reduces wound infections and other wound complications in high-risk patients undergoing major complex ventral abdominal wall repair. Methods Retrospective before-after comparison nested in a consecutive series of

  9. Mechanical properties of the abdominal wall and biomaterials utilized for hernia repair.

    Science.gov (United States)

    Deeken, Corey R; Lake, Spencer P

    2017-10-01

    Abdominal wall hernias are one of the most common and long-standing surgical applications for biomaterials engineering. Yet, despite over 50 years of standard use of hernia repair materials, revision surgery is still required in nearly one third of patients due to hernia recurrence. To date, hernia mesh designs have focused on maximizing tensile strength to prevent structural failure of the implant. However, most recurrences occur at the biomaterial-tissue interface. There is a fundamental gap in understanding the degree to which a mechanical mismatch between hernia repair materials and host tissue contributes to failure at this interface. This review summarizes the current literature related to the anatomy and mechanics of both human and animal abdominal wall tissues, as well as the mechanical properties of many commonly-utilized hernia repair materials. The studies reviewed here reported greater compliance of the linea alba, larger strains for the intact abdominal wall, and greater stiffness for the rectus sheath and umbilical fascia when the tissues were loaded in the longitudinal direction compared to transverse. Additionally, greater stresses were observed in the linea alba when loaded in the transverse direction compared to longitudinal. Given these trends, a few recommendations can be made regarding orientation of mesh. The most compliant axis of the biomaterial should be oriented in the cranio-caudal (longitudinal) direction, and the strongest axis of the biomaterial should be oriented in the medial-lateral (transverse) direction. The human abdominal wall is also anisotropic, with anisotropy ratios as high as 8-9 reported for the human linea alba. Current biomaterial designs exhibit anisotropy ratios in the range of 1-3, and it is unclear whether an ideal ratio exists for optimal match between mesh and tissue. This is likely dependent on implantation location as the linea alba, rectus sheath, and other tissues of the abdominal wall exhibit different

  10. Mesh fixation with a barbed anchor suture results in significantly less strangulation of the abdominal wall.

    Science.gov (United States)

    Lyons, Calvin; Joseph, Rohan; Salas, Nilson; Reardon, Patrick R; Bass, Barbara L; Dunkin, Brian J

    2012-05-01

    Laparoscopic ventral hernia repair using an underlay mesh frequently requires suture fixation across the abdominal wall, which results in significant postoperative pain. This study investigates the utility of a novel mesh fixation technique to reduce the strangulation force on the abdominal wall. Multiple 2-cm(2) pieces of polyester mesh (Parietex Composite, Covidien) were placed as an underlay against a porcine abdominal wall. Fixation was accomplished using either the standard 0-polyglyconate or the 0-polyglyconate barbed anchor suture designed to hold in tissue without the need to tie a knot (V-Loc 180; Covidien). Suture fixation began with a stab wound incision in the skin. A suture-passing device then was used to pass the suture across the abdominal wall and through the mesh. The suture passer was removed and reintroduced through the same stab wound incision but at a different fascial entry point 1.5 cm away. The tail of the suture was grasped and pulled up through both the mesh and the abdominal wall, creating a full-thickness U-stitch. One tail of the suture was attached to a tensiometer, and the strangulation force on the abdominal wall was measured while the suture was tied (standard) or looped (barbed). To compare pullout force, the tensiometer was attached to either the mesh or the suture, and traction was applied until material failure or suture pull through. Results are expressed as mean ± standard deviation. Comparisons were performed using Student's t-test. Eight pieces of mesh were placed for each suture. The average force required to secure the barbed suture (0.59 ± 0.08 kg) was significantly less than the force needed to secure the standard suture (2.17 ± 0.58 kg) (P < 0.0001). Table 1 compares the suture pullout forces with the mesh failure forces. Although the pullout force for the standard suture is significantly greater than for the barbed suture, both sutures have a pullout strength significantly greater than the mesh failure force. Table

  11. Indications and outcomes of the components separation technique in the repair of complex abdominal wall hernias: experience from the cambridge plastic surgery department.

    Science.gov (United States)

    Adekunle, Shola; Pantelides, Nicholas M; Hall, Nigel R; Praseedom, Raaj; Malata, Charles M

    2013-01-01

    The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    Shao, Zhi Hong; Gao, Xiao Long; Yi, Xiang Hua; Wang, Pei Jun

    2011-01-01

    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. A novel technique for reconstruction of the abdominal wall in the prune belly syndrome.

    Science.gov (United States)

    Monfort, G; Guys, J M; Bocciardi, A; Coquet, M; Chevallier, D

    1991-08-01

    There is currently widespread enthusiasm for abdominal wall reconstruction in patients with the prune belly syndrome. We have devised an operation that appears to offer some advantages over those proposed by Ehrlich and Randolph. The technique preserves the umbilicus, and thickens and strengthens the anterior abdominal wall. By narrowing the waist, it also produces a better cosmetic appearance. After full thickness resection of a varying amount of skin from the central abdomen, the anterior wall is sutured in double-breasted fashion, thus, preserving all vascularization and the umbilicus. Since 1969 we have successfully performed this procedure on 9 prune belly patients including 1 girl. The results were excellent in terms of duration and cosmetic appearance.

  15. Unexpected granular cell tumor in abdominal wall: case report and literature review.

    Science.gov (United States)

    Panunzi, Andrea; D'Orazi, Valerio; Toni, Francesca; Coppola, Giovanni Andrea; D'Alessandro, Valentina; Pontone, Stefano; Pironi, Daniele; Ortensi, Andrea

    2012-01-01

    Granular cell tumors (GCTs) are uncommon benign neoplasms deriving from Schwann cells of the peripheral nerve fibers. Although these tumors can be found anywhere in the body, the most frequent site is the tongue, followed by the chest wall and the arm. The abdominal wall is an extremely rare site for GCTs. These tumors are generally asymptomatic and have a slow growth rate. Today, thanks to their immunoreactivity to S-100 and CD68, the differential diagnosis is more straightforward than in the past. We report on a young patient affected by a GCT located in the upper third of the right rectus abdominis muscle. En bloc excision through a diamond-shaped skin incision allowed us to make a correct histological diagnosis, which was confirmed by the immunohistochemical findings. GCT, which is very rare in abdominal wall muscles, should be considered in the differential diagnosis, and surgical excision is the treatment of choice.

  16. Fluid-structure interaction in abdominal aortic aneurysms: effects of asymmetry and wall thickness

    Directory of Open Access Journals (Sweden)

    Muluk Satish C

    2005-11-01

    Full Text Available Abstract Background Abdominal aortic aneurysm (AAA is a prevalent disease which is of significant concern because of the morbidity associated with the continuing expansion of the abdominal aorta and its ultimate rupture. The transient interaction between blood flow and the wall contributes to wall stress which, if it exceeds the failure strength of the dilated arterial wall, will lead to aneurysm rupture. Utilizing a computational approach, the biomechanical environment of virtual AAAs can be evaluated to study the affects of asymmetry and wall thickness on this stress, two parameters that contribute to increased risk of aneurysm rupture. Methods Ten virtual aneurysm models were created with five different asymmetry parameters ranging from β = 0.2 to 1.0 and either a uniform or variable wall thickness to study the flow and wall dynamics by means of fully coupled fluid-structure interaction (FSI analyses. The AAA wall was designed to have a (i uniform 1.5 mm thickness or (ii variable thickness ranging from 0.5 – 1.5 mm extruded normally from the boundary surface of the lumen. These models were meshed with linear hexahedral elements, imported into a commercial finite element code and analyzed under transient flow conditions. The method proposed was then compared with traditional computational solid stress techniques on the basis of peak wall stress predictions and cost of computational effort. Results The results provide quantitative predictions of flow patterns and wall mechanics as well as the effects of aneurysm asymmetry and wall thickness heterogeneity on the estimation of peak wall stress. These parameters affect the magnitude and distribution of Von Mises stresses; varying wall thickness increases the maximum Von Mises stress by 4 times its uniform thickness counterpart. A pre-peak systole retrograde flow was observed in the AAA sac for all models, which is due to the elastic energy stored in the compliant arterial wall and the expansion

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Chowbey Pradeep

    2006-01-01

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

  19. Handlebar hernia: a case report and literature review on traumatic abdominal wall hernia in children.

    Science.gov (United States)

    van Bemmel, A J M; van Marle, A G J; Schlejen, P M; Schmitz, R F

    2011-08-01

    A rare case of abdominal trauma, a handlebar hernia, is described, as well as a review of the pertinent literature. A 7-year-old boy presented to our emergency room after sustaining blunt force to the abdomen; he fell on the handlebar of his bicycle. Immediately after the accident, a bulge was noticeable at the point of impact. Handlebar hernia is a diagnosis that is easily missed, which can lead to strangulation and incarceration of the bowel. With this case report, we hope to augment the knowledge on traumatic abdominal wall hernia, hopefully leading to early diagnosis and treatment.

  20. Early results on the use of biomaterials as adjuvant to abdominal wall closure following cytoreduction and hyperthermic intraperitoneal chemotherapy

    Directory of Open Access Journals (Sweden)

    Boutros Cherif

    2010-08-01

    Full Text Available Abstract Background Hyperthermic chemotherapy applies thermal energy to both abdominal wall as well as the intra-abdominal viscera. The combination of the hyperthemia, chemotherapy and cytoreductive surgery (CRS is associated with a defined risk of abdominal wall and intestinal morbidity reported to be as high as 15%, respectively to date, no studies have evaluated the use of biomaterial mesh as adjuvant to abdominal wall closure in this group of patients. In the present report, we hypothesized that post HIPEC closure with a biomaterial can reduce abdominal wall morbidity after CRS and hyperthermic intraperitoneal chemotherapy. Materials and methods All patients treated with HIPEC in a tertiary care center over 12 months (2008-2009 period were included. Eight patients received cytoreductive surgery followed by HIPEC for 90 minutes using Mitomycin C (15 mg q 45 minutes × 2. Abdominal wall closure was performed using Surgisis (Cook Biotech. mesh in an underlay position with 3 cm fascial overlap-closure. Operative time, hospital length of stay (LOS as well as postoperative outcome with special attention to abdominal wall and bowel morbidity were assessed. Results Eight patients, mean age 59.7 ys (36-80 were treated according to the above protocol. The primary pathology was appendiceal mucinous adenocarcinoma (n = 3 colorectal cancer (n = 3, and ovarian cancer (n = 2. Four patients (50% presented initially with abdominal wall morbidity including incisional ventral hernia (n = 3 and excessive abdominal wall metastatic implants (n = 1. The mean peritoneal cancer index (PCI was 8.75. Twenty eight CRS were performed (3.5 CRS/patient. The mean operating time was 6 hours. Seven patients had no abdominal wall or bowel morbidity, the mean LOS for these patients was 8 days. During the follow up period (mean 6.3 months, one patient required exploratory laparotomy 2 weeks after surgery and subsequently developed an incisional hernia and enterocutaneous

  1. Concomitant Panniculectomy Affects Wound Morbidity but Not Hernia Recurrence Rates in Abdominal Wall Reconstruction: A Propensity Score Analysis.

    Science.gov (United States)

    Giordano, Salvatore; Garvey, Patrick B; Baumann, Donald P; Liu, Jun; Butler, Charles E

    2017-12-01

    Studies of abdominal wall reconstruction with concurrent panniculectomy have reported contradictory results. The authors hypothesized that patients undergoing abdominal wall reconstruction with concurrent panniculectomy experience more wound healing complications but similar rates of hernia recurrence compared with abdominal wall reconstruction alone. Of 548 consecutive patients, 305 patients (55.7 percent) underwent abdominal wall reconstruction alone and 243 (44.3 percent) underwent abdominal wall reconstruction with concurrent panniculectomy. Mean follow-up was 30 months. The authors compared these two groups' postoperative complications and outcomes before and after propensity score analysis. Abdominal wall reconstruction with concurrent panniculectomy patients had a significantly higher overall complication rate (38.3 percent versus 29.2 percent; p = 0.025) and a trend toward a higher surgical-site occurrence rate (27.6 percent versus 20.7 percent; p = 0.06) compared with abdominal wall reconstruction alone. There were significantly higher incidences of skin dehiscence (19.3 percent versus 12.5 percent; p = 0.032), fat necrosis (10.7 percent versus 3.6 percent; p = 0.002), and infection abscess (9.5 percent versus 4.3 percent; p = 0.023) but no significant difference in hernia recurrence (6.9 percent versus 11.5 percent; p = 0.27) at long-term follow-up. Propensity score analysis yielded 188 pairs of matched patients with no significant differences in overall complication and hernia recurrence rates. Significantly higher rates of fat necrosis (9.6 percent versus 4.3 percent; p = 0.041) and abscess (10.1 percent versus 3.2 percent; p = 0.007) were observed in the abdominal wall reconstruction with concurrent panniculectomy group. Abdominal wall reconstruction with concurrent panniculectomy is associated with higher wound morbidity but similar surgical-site occurrence and hernia recurrence rates at long-term follow-up. The authors believe that panniculectomy can

  2. Fine-needle Aspiration Cytology of Abdominal Wall Endometriosis: 
A Meaningful Adjunct to Diagnosis.

    Science.gov (United States)

    Ail, Divya A; Joshi, Avinash R; Manzoor, Irmeen; Patil, Sukhada; Kulkarni, Maithili

    2018-01-01

    Fine-needle aspiration cytology (FNAC) is a simple, non-invasive diagnostic modality which can be performed with ease on any superficially palpable lesion. Surgical scar endometriosis is a rare entity which presents as an abdominal lump in women of reproductive age. It is often a diagnostic pitfall for clinicians due to its nonspecific symptoms. It displays characteristic morphology, which needs to be identified and recognized by a cytopathologist for accurate diagnosis. FNAC can be used as a key diagnostic tool in cases of abdominal wall mass for appropriate patient management, thereby avoiding unnecessary diagnostic procedures. Here, we report the case of a 35-year-old woman who presented with an abdominal lump where FNAC played a vital role in the patient's management.

  3. Fine-needle Aspiration Cytology of Abdominal Wall Endometriosis: A Meaningful Adjunct to Diagnosis

    Directory of Open Access Journals (Sweden)

    Divya A. Ail

    2018-01-01

    Full Text Available Fine-needle aspiration cytology (FNAC is a simple, non-invasive diagnostic modality which can be performed with ease on any superficially palpable lesion. Surgical scar endometriosis is a rare entity which presents as an abdominal lump in women of reproductive age. It is often a diagnostic pitfall for clinicians due to its nonspecific symptoms. It displays characteristic morphology, which needs to be identified and recognized by a cytopathologist for accurate diagnosis. FNAC can be used as a key diagnostic tool in cases of abdominal wall mass for appropriate patient management, thereby avoiding unnecessary diagnostic procedures. Here, we report the case of a 35-year-old woman who presented with an abdominal lump where FNAC played a vital role in the patient’s management.

  4. Isometric abdominal wall muscle strength assessment in individuals with incisional hernia: a prospective reliability study

    DEFF Research Database (Denmark)

    Jensen, K. K.; Kjær, Michael; Jorgensen, L. N.

    2016-01-01

    Purpose To determine the reliability of measurements obtained by the Good Strength dynamometer, determining isometric abdominal wall and back muscle strength in patients with ventral incisional hernia (VIH) and healthy volunteers with an intact abdominal wall. Methods Ten patients with VIH and ten...... and extension showed excellent test–retest reliability for both patients with VIH (ICC 0.91 and 0.99) and healthy controls (ICC 0.97 and 0.96). Bland and Altman plots showed that no systematic bias was present for neither truncal flexion nor extension when assessing reliability. For patients with VIH...... and IPAQ was found. Conclusions The Good Strength dynamometer provided a reliable, low-cost measure of truncal flexion and extension in patients with VIH....

  5. Desmoid Tumor of the Anterior Abdominal Wall in Female Patients: Comparison with Endometriosis

    Directory of Open Access Journals (Sweden)

    H. Krentel

    2012-01-01

    Full Text Available In female patients presenting a tumor of the lower abdominal wall especially after cesarian section, an endometriotic tumor as well as an aggressive desmoid tumor should be considered. Symptoms in correlation with the monthly period can facilitate the presurgical differentiation between endometriosis and fibromatosis. Ultrasound reveals the typical location of both tumors and its remarkable sonographic appearance. In the clinical practice, the desmoid fibromatosis of the lower abdominal wall is a very rare disease. We present a case of a 25-year-old pregnant and discuss diagnostic and therapeutic options by a PubMed literature review. With the knowledge of the prognosis of the desmoid fibromatosis and the respective treatment options including wait and see, complete surgical resection with macroscopically free margins and adjuvant approaches is essential to avoid further interventions and progression of the locally destructive tumor.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Povidone-iodine spray technique versus traditional scrub-paint technique for preoperative abdominal wall preparation.

    Science.gov (United States)

    Moen, Michael D; Noone, Michael B; Kirson, Inbar

    2002-12-01

    The study was conducted to compare povidone-iodine spray and traditional scrub-paint techniques in reducing abdominal wall bacteria during preoperative preparation. Sixty patients scheduled to undergo vaginal surgery were recruited for study. Cultures of the abdominal skin were performed before and after preparation with two techniques: A traditional 5-minute iodophor soap scrub-paint on one half and povidone-iodine aqueous spray on the other. Multiple pairwise comparisons were performed with the Wilcoxon signed rank test. A P value of.05 was considered statistically significant in all analyses. The mean number of colonies for spray after 1 minute was 1.83 +/- 3.16, for spray after 3 minutes was 0.40 +/- 1.15, and after 5-minute scrub was 0.87 +/- 2.97. Both techniques, the spray after 3 minutes and the 5-minute scrub, were statistically more effective at reducing bacterial counts than the spray after 1 minute. There was no statistically significant difference between the spray after 3 minutes and the scrub techniques. Povidone-iodine applied as a spray and left to dry for 3 minutes appears as effective as the traditional scrub-paint technique in reducing abdominal wall bacteria before abdominal surgery.

  8. Late metastatic endometrial carcinoma at the repair site of an abdominal wall incisional hernia

    Directory of Open Access Journals (Sweden)

    Abdul-Wahed N. Meshikhes

    2017-05-01

    Full Text Available The abdominal wall is a very rare site for endometrial cancer metastases. Its appearance generally indicates advanced cancer with poor prognosis. We report a case of a 55-year-old female who presented with an incisional hernia 4 years after abdominal panhysterectomy for endometrioid adenocarcinoma in 2009. Open hernia mesh repair was performed but on follow-up, she complained of pain and a swelling at the repair site. This was radiologically diagnosed as fibromatosis, but tru-cut biopsy confirmed presence of fibromatosis as well as a metastatic endometrial carcinoma. She was started on neoadjuvant chemotherapy, but had poor response, and therefore, radical excision was performed. She remained well with no metastatic recurrence at 12-month follow-up. This case illustrates late appearance of abdominal wall metastasis from abdomino-pelvic malignancies and highlights the need to exclude the presence of recurrence or metastases prior to surgical repair of incisional hernia occurring after the resection of abdominal or pelvic malignancy.

  9. Importance of Defect Detectability in Positron Emission Tomography Imaging of Abdominal Lesions

    International Nuclear Information System (INIS)

    Yamashita, Shozo; Yokoyama, Kunihiko; Onoguchi, Masahisa; Yamamoto, Haruki; Nakaichi, Tetsu; Tsuji, Shiro; Nakajima, Kenichi

    2015-01-01

    This study was designed to assess defect detectability in positron emission tomography (PET) imaging of abdominal lesions. A National Electrical Manufactures Association International Electrotechnical Commission phantom was used. The simulated abdominal lesion was scanned for 10 min using dynamic list-mode acquisition method. Images, acquired with scan duration of 1-10 min, were reconstructed using VUE point HD and a 4.7 mm full-width at half-maximum (FWHM) Gaussian filter. Iteration-subset combinations of 2-16 and 2-32 were used. Visual and physical analyses were performed using the acquired images. To sequentially evaluate defect detectability in clinical settings, we examined two middle-aged male subjects. One had a liver cyst (approximately 10 mm in diameter) and the other suffered from pancreatic cancer with an inner defect region (approximately 9 mm in diameter). In the phantom study, at least 6 and 3 min acquisition durations were required to visualize 10 and 13 mm defect spheres, respectively. On the other hand, spheres with diameters ≥17 mm could be detected even if the acquisition duration was only 1 min. The visual scores were significantly correlated with background (BG) variability. In clinical settings, the liver cyst could be slightly visualized with an acquisition duration of 6 min, although image quality was suboptimal. For pancreatic cancer, the acquisition duration of 3 min was insufficient to clearly describe the defect region. The improvement of BG variability is the most important factor for enhancing lesion detection. Our clinical scan duration (3 min/bed) may not be suitable for the detection of small lesions or accurate tumor delineation since an acquisition duration of at least 6 min is required to visualize 10 mm lesions, regardless of reconstruction parameters. Improvements in defect detectability are important for radiation treatment planning and accurate PET-based diagnosis

  10. Laparoscopic Cholecystectomy: Incidental Carcinoma of the Gallbladder with Abdominal Wall and Axillary Node Metastasis

    Directory of Open Access Journals (Sweden)

    Richard C. Johnson

    1997-01-01

    Full Text Available A case report is presented of intra-mural gallbladder carcinoma discovered incidentally after laparoscopic cholecystectomy who subsequently developed abdominal wall recurrence at the epigastric exit port, and axillary lymph node metastases. Possible preventative steps for tumour dissemination and a management plan if incidental carcinoma is diagnosed is discussed. The use of a non-porous retrieval bag, early recognition of the carcinoma and excision of the exit wound are advocated.

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

    International Nuclear Information System (INIS)

    Da Ines, David; Montoriol, Pierre Francois; Petitcolin, Virginie; Garcier, Jean-Marc; Bourdel, Nicolas; Canis, Michel; Charpy, Cecile

    2011-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  13. Pilot study on objective measurement of abdominal wall strength in patients with ventral incisional hernia.

    Science.gov (United States)

    Parker, Michael; Goldberg, Ross F; Dinkins, Maryane M; Asbun, Horacio J; Daniel Smith, C; Preissler, Susanne; Bowers, Steven P

    2011-11-01

    Outcomes after ventral incisional hernia (VIH) repair are measured by recurrence rate and subjective measures. No objective metrics evaluate functional outcomes after abdominal wall reconstruction. This study aimed to develop testing of abdominal wall strength (AWS) that could be validated as a useful metric. Data were prospectively collected during 9 months from 35 patients. A total of 10 patients were evaluated before and after VIH repair, for a total of 45 encounters. The patients were tested simultaneously or in succession by two of three examiners. Data were collected for three tests: double leg lowering (DLL), trunk raising (TR), and supine reaching (SR). Raw data were compared and tested for validity, and continuous data were transformed to categorical data. Agreement was measured using the intraclass correlation coefficient (ICC) for DLL and using kappa for the ordinal measures. Simultaneous testing yielded the following interobserver reliability: DLL (0.96 and 0.87), TR (1.00 and 0.95), and SR (0.76). Reproducibility was assessed by consecutive tests, with correlation as follows: DLL (0.81), TR (0.81), and RCH (0.21). Due to poor interobserver reliability for the SR test compared with the DLL and TR tests, the SR test was excluded from calculation of an overall score. Based on raw data distribution from the DLL and TR tests, the DLL data were categorized into 10º increments, allowing construction of a 10-point score. The median AWS score was 5 (interquartile range [IQR], 4-7), and there was agreement within 1 point for 42 of the 45 encounters (93%). The findings from this study demonstrate that the 10-point AWS score may measure AWS in an accurate and reproducible fashion, with potential for objective description of abdominal wall function of VIH patients. This score may help to identify patients suited for abdominal wall reconstruction while measuring progress after VIH repair. Further longitudinal outcomes studies are needed.

  14. Methods of abdominal wall expansion for repair of incisional herniae: a systematic review.

    Science.gov (United States)

    Alam, N N; Narang, S K; Pathak, S; Daniels, I R; Smart, N J

    2016-04-01

    To systematically review the available literature regarding methods for abdominal wall expansion and compare the outcome of primary fascial closure rates. A systematic search of Pubmed and Embase databases was conducted using the search terms "Abdominal wall hernia", "ventral hernia", "midline hernia", "Botulinum toxin", "botox", "dysport", "progressive preoperative pneumoperitoneum", and "tissue expanders". Study quality was assessed using the Methodological Index for Non-Randomised Studies. 21 of the 105 studies identified met the inclusion criteria. Progressive preoperative pneumoperitoneum (PPP) was performed in 269 patients across 15 studies with primary fascial closure being achieved in 226 (84%). 16 patients had a recurrence (7.2%) and the complication rate was 12% with 2 reported mortalities. There were 4 studies with 14 patients in total undergoing abdominal wall expansion using tissue expanders with a fascial closure rate of 92.9% (n = 13). A recurrence rate of 10.0% (n = 1) was reported with 1 complication and no mortalities. Follow up ranged from 3 to 36 months across the studies. There were 2 studies reporting the use of botulinum toxin with 29 patients in total. A primary fascial closure rate of 100% (n = 29) was demonstrated although a combination of techniques including component separation and Rives-Stoppa repair were used. There were no reported complications related to the use of Botulinum Toxin. However, the short-term follow up in many cases and the lack of routine radiological assessment for recurrence suggests that the recurrence rate has been underestimated. PPP, tissue expanders and Botulinum toxin are safe and feasible methods for abdominal wall expansion prior to incisional hernia repair. In combination with existing techniques for repair, these methods may help provide the crucial extra tissue mobility required to achieve primary closure.

  15. Laparoscopic Removal of An Ectopic Intrauterine Device From The Anterior Abdominal Wall

    Directory of Open Access Journals (Sweden)

    Yaprak Engin Üstün

    2006-12-01

    Full Text Available The intrauterine devices (IUDs have been used widely by women of childbearing years. In this report, we presented a case of a 25-year-old gravida 4, parity 3 woman with an abdominal wall penetration by an IUD. She had an IUD (TCu-380A inserted immediately after dilatation & curettage. The IUD was removed laparoscopically.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    Sabate, J.M.; Fernandez, A.; Torrubia, S.; Villanueva, A.; Monill, J.M.

    1999-01-01

    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.)

  18. [Effects of tenoxicam on abdominal wall healing: experimental study in rats].

    Science.gov (United States)

    Watanabe, André Luís Conde; Watanabe, Luís Massaro

    2005-01-01

    To analyse the effect of tenoxicam, a nonsteroidal anti-inflammatory, on the abdominal wall healing in rats. It was used 40 rats, submitted to longitudinal laparotomies, and allocated, randomly, in one control group (C), consisted of 20 rats treated with saline solution; and one test group (T), consisted of 20 rats treated with tenoxicam. The animals of each group were divided, according to their sacrifice day, into subgroups of 10 animals, named as C7, C14, T7 and T14. The numbers 7 and 14 indicated that the animal would be sacrificed on the 7th and 14th postoperative day, respectively. The tenoxicam (1 mg/ml) and saline solution (NaCl 0.9%) were administrated by intramuscular injections, at the dose of 0.6 ml/kg/day, immediately after surgery and continued for 4 days. In the sacrifice day, two segments of the abdominal wall (1 cm x 3 cm) were prepared and submitted to breaking strength measurement and hydroxyproline determination. No complications were observed in the four subgroups, including infection or dehiscence. There were no significant differences in the breaking strength measurement (p=0.262) and the hydroxyproline levels (p=0.392) among the four subgroups. The tenoxicam, administered intramuscularly, does not interfere on the abdominal wall healing of rats.

  19. CT in the diagnosis of abdominal wall hernias: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Hoejer, A.M.; Jess, P. [Department of Surgery, Roskilde County Hospital Koege, DK-4600 Koege (Denmark); Rygaard, H. [Department of Radiology, Roskilde County Hospital Koege, DK-4600 Koege (Denmark)

    1997-12-01

    The aim of the study was to estimate the value of CT in the diagnosis of abdominal wall hernias and at the same time to create a standard for this CT investigation. Twenty-four patients with suspected hernia of the abdominal wall were examined. All were operated on. The CT scans were assessed by two radiologists to estimate the interobserver variation. The CT diagnoses made by the two radiologists were correct in 83 % and 79 % of cases, respectively. The sensitivity was 0.83 in both CT evaluations and the specificity was 0.83 and 0.67, respectively. The predictive value of a positive CT finding was 0.94 and 0.88, while the predictive value of a negative CT finding was 0.63 and 0.57, respectively. The interobserver variation (kappa) was 0.87. The study therefore indicates that a positive CT finding of abdominal wall hernia is reliable, while a negative finding does not exclude the diagnosis. The interobserver variation of the CT diagnoses is acceptable. To achieve the highest diagnostic accuracy, it is recommended to always use the Valsalva manoeuvre, oral intake of contrast and 10/10 mm CT slices. (orig.) With 3 figs., 1 tab., 7 refs.

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

    Directory of Open Access Journals (Sweden)

    Daniela Ulrich

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

  1. Risk Assessment of Abdominal Wall Thickness Measured on Pre-Operative Computerized Tomography for Incisional Surgical Site Infection after Abdominal Surgery.

    Science.gov (United States)

    Tongyoo, Assanee; Chatthamrak, Putipan; Sriussadaporn, Ekkapak; Limpavitayaporn, Palin; Mingmalairak, Chatchai

    2015-07-01

    The surgical site infection (SSI) is a common complication of abdominal operation. It relates to increased hospital stay, increased healthcare cost, and decreased patient's quality of life. Obesity, usually defined by BMI, is known as one of the risks of SSI. However, the thickness of subcutaneous layers of abdominal wall might be an important local factor affecting the rate of SSI after the abdominal operations. The objective of this study is to assess the importance of the abdominal wall thickness on incisional SSI rate. The subjects of the present study were patients who had undergone major abdominal operations at Thammasat University Hospital between June 2013 and May 2014, and had been investigated with CT scans before their operations. The demographic data and clinical information of these patients were recorded. The thickness ofsubcutaneous fatty tissue from skin down to the most superficial layer of abdominal wall muscle at the surgical site was measured on CT images. The wound infectious complication was reviewed and categorized as superficial and deep incisional SSIfollowing the definition from Centersfor Disease Control and Prevention (CDC) guidelines. The significance ofeach potentialfactors on SSI rates was determined separately with student t-test for quantitative data and χ2-test for categorical data. Then all factors, which had p operative CTscans. Post-operative SSI was 25.2% (35/139), superficial and deep types in 27 and 8 patients, respectively. The comparison of abdominal wall thickness between patients with and without infection was significantly different (20.0 ± 8.4 mm and 16.0 ± 7.2 mm, respectively). When the thickness at 20 mm was used as the cut-off value, 43 of 139 patients had abdominal wall thickness ≥ 20 mm. The incidence of SSI of the thickness ±20 mm group was 37.2% (16/43) and of the less thickness group was 19.8% (19/96), with p operation. However, only abdominal wall thickness and wound classification were still significant

  2. Analgesic effect of bupivacaine eluting porcine small intestinal submucosa (SIS) in ferrets undergoing acute abdominal hernia defect surgery.

    Science.gov (United States)

    Johnson, Brenda M; Ko, Jeff C; Hall, Paul J; Saunders, Alan T; Lantz, Gary C

    2011-05-15

    Porcine small intestinal submucosa (SIS) is used as a biological implant for abdominal wall hernia repair to facilitate wound healing and augment local tissue strength. This prospective, randomized, blinded study evaluated local pain control provided by bupivacaine adsorbed to SIS for repair of acutely created abdominal wall full thickness muscle/fascial defects in ferrets. Eighteen healthy ferrets were randomly and equally assigned to three groups: (1) SIS with bupivacaine subjected to surgery, (2) SIS with no bupivacaine subjected to surgery, and (3) anesthesia only control group. Ferrets in groups 1 and 2 were anesthetized with butorphanol and sevoflurane for the surgery. Control ferrets were anesthetized in the same fashion for the same duration without surgery. Behavior and pain were evaluated in all ferrets by behavioral observation, algometer, and palpometer measurements, and heart and respiratory rates each obtained before surgery and at various intervals for 96 h after surgery. When pain reached a predetermined threshold, buprenorphine was used as a rescue analgesic. The serum and combined tissue concentrations of bupivacaine were analyzed. Overall, the palpometer testing was better tolerated in the bupivacaine treated SIS group than by the untreated SIS group (P = 0.04). There was an observed physiologically significant difference in algometer and other palpometer readings as well as heart and respiratory rates. All ferrets in the untreated SIS group were rescued while 33% of the SIS-bupivacaine groups were rescued (P pain relief over 2-4 days with no clinical adverse effects observed in the ferrets. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. The ‘AbdoMAN’ : An artificial abdominal wall simulator for biomechanical studies on laparotomy closure techniques

    NARCIS (Netherlands)

    Kroese, Leonard F.; Harlaar, JJ; Ordrenneau, C.; Verhelst, JM; Guérin, G.; Turquier, F.; Goossens, R.H.M.; Kleinrensink, GJ; Jeekel, J; Lange, Johan F.

    2017-01-01

    Purpose: Incisional hernia remains a frequent complication after abdominal surgery associated with significant morbidity and high costs. Animal and clinical studies have exhibited some limitations. The purpose of this study was to develop an artificial human abdominal wall (AW) simulator in order

  4. The ‘AbdoMAN’: an artificial abdominal wall simulator for biomechanical studies on laparotomy closure techniques

    NARCIS (Netherlands)

    L.F. Kroese (Leonard); J.J. Harlaar (Joris Jan); Ordrenneau, C.; J. Verhelst (Joost); Guérin, G.; Turquier, F.; R.H.M. Goossens (Richard); G.J. Kleinrensink (Gert Jan); J. Jeekel (Hans); J.F. Lange (Johan)

    2017-01-01

    textabstractPurpose: Incisional hernia remains a frequent complication after abdominal surgery associated with significant morbidity and high costs. Animal and clinical studies have exhibited some limitations. The purpose of this study was to develop an artificial human abdominal wall (AW) simulator

  5. [SCARPA FASCIA AND ABDOMINAL WALL DEEP ADIPOSE COMPARTMENT PRESERVATION IN ABDOMINOPLASTY - CURRENT CLINICAL AND ANATOMICAL REVIEW].

    Science.gov (United States)

    Har-Shai, Lior; Hayun, Yehiel; Barel, Eric; Ad-El, Dean D

    2018-02-01

    During the last two decades, in parallel to the increased prevalence of bariatric procedures, there has been a marked increase in the prevalence of abdominoplasty surgery in the United States, and in accordance an increase in the scientific and clinical research related to all aspects of this technique. The most common complication of abdominoplasty is the formation of post-operative seroma. Various theories have been raised regarding the pathophysiology of seroma formation, and numerous methods for seroma prevention have been employed and tested. In the early 90's, a new theory argued that post-operative seroma formation is secondary to damage caused to the abdominal wall's lymphatic drainage during flap undermining. In light of this theory, a new surgical technique was suggested to execute the flap undermining in a more superficial plane. This enabled the preservation of the scarpa fascia and the deep adipose compartment, which preserved the integrity of the abdominal wall lymphatic collectors. This method was successful in reducing the rate of postoperative seroma formation. Recent studies have shed new light on the anatomy of the abdominal lymphatic collectors, pathophysiology of seroma formation and methods of its prevention. This new data undermines the foundations of the scarpa fascia preservation theory, and the surgical technique that was derived from it. A new theory that tries to settle the contradiction between the clinical success of the technique in reducing seromas and the new findings regarding abdominal wall's lymphatic collectors anatomy, is the presence of a 'sticky interface' between the deep adipose compartment and the flap.

  6. Abdominal Wall Reconstruction for Incisional Hernia Optimizes Truncal Function and Quality of Life: A Prospective Controlled Study.

    Science.gov (United States)

    Jensen, Kristian K; Munim, Kanzah; Kjaer, Michael; Jorgensen, Lars N

    2017-06-01

    The aim of the study was to examine abdominal wall function in patients undergoing abdominal wall reconstruction (AWR) for incisional hernia. The literature on abdominal wall function in patients with incisional hernia is sparse. It has been suggested that AWR leads to improvement in function, but it is unknown whether this is specific to the abdominal wall or due to an improvement in overall physical fitness. We performed a prospective case-control study of 18 consecutive patients with large incisional hernia undergoing AWR with linea alba restoration. Truncal flexion and extension strength, hand grip strength, leg extension power, and quality of life (SF-36 and Carolinas Comfort Scale) were assessed preoperatively and 1 year postoperatively. Patients were compared with a control group of patients with an intact abdominal wall undergoing colorectal resection (n = 18). The study was registered at ClinicalTrials.gov (NCT02011048). Compared with preoperative measurements, 1-year follow-up after AWR demonstrated an increase of both truncal flexion strength (from mean 505.6 N to 572.3 N, P hernia specifically improved long-term abdominal wall muscular function and quality of life.

  7. Detecting defects in diaphragm walls prior to excavation

    NARCIS (Netherlands)

    Spruit, R.; Hopman, V.; Van Tol, A.F.; Broere, W.

    2011-01-01

    Recent incidents with leaking diaphragm walls during construction of subway lines in Amsterdam and Rotterdam (Netherlands) have led to reconsideration of the diaphragm wall as a retaining wall construction for deep excavations. In our opinion the joints between the panels are the weak spot. During

  8. Polypropylene-based composite mesh versus standard polypropylene mesh in the reconstruction of complicated large abdominal wall hernias: a prospective randomized study.

    Science.gov (United States)

    Kassem, M I; El-Haddad, H M

    2016-10-01

    To compare polypropylene mesh positioned onlay supported by omentum and/or peritoneum versus inlay implantation of polypropylene-based composite mesh in patients with complicated wide-defect ventral hernias. This was a prospective randomized study carried out on 60 patients presenting with complicated large ventral hernia in the period from January 2012 to January 2016 in the department of Gastrointestinal Surgery unit and Surgical Emergency of the Main Alexandria University Hospital, Egypt. Large hernia had an abdominal wall defect that could not be closed. Patients were divided into two groups of 30 patients according to the type of mesh used to deal with the large abdominal wall defect. The study included 38 women (63.3 %) and 22 men (37.7 %); their mean age was 46.5 years (range, 25-70). Complicated incisional hernia was the commonest presentation (56.7 %).The operative and mesh fixation times were longer in the polypropylene group. Seven wound infections and two recurrences were encountered in the propylene group. Mean follow-up was 28.7 months (2-48 months). Composite mesh provided, in one session, satisfactory results in patients with complicated large ventral hernia. The procedure is safe and effective in lowering operative time with a trend of low wound complication and recurrence rates.

  9. Trace elements in the wall of abdominal aortic aneurysms with and without coexisting iliac artery aneurysms.

    Science.gov (United States)

    Ziaja, Damian; Chudek, Jerzy; Sznapka, Mariola; Kita, Andrzej; Biolik, Grzegorz; Sieroń-Stołtny, Karolina; Pawlicki, Krzysztof; Domalik, Jolanta; Ziaja, Krzysztof

    2015-06-01

    Iliac artery aneurysms (IAA) and abdominal aortic aneurysms (AAA) frequently coexist. It remains unknown whether the content of trace elements in AAA walls depends on the coexistence of IAAs. The aim of this study was to compare the content of selected trace elements in AAA walls depending on the coexistence of IAAs. The content of trace elements was assessed in samples of AAA walls harvested intraoperatively in 19 consecutive patients. In the studied group, coexisting IAAs were diagnosed in 11 out of the 19 patients with AAA. The coexistence of IAAs was associated with a slightly lower content of nickel (0.28 (0.15-0.40) vs. 0.32 (0-0.85) mg/g; p = 0.09) and a significantly higher content of cadmium (0.71 (0.26-1.17) vs. 0.25 (0.20-0.31) mg/g; p = 0.04) in AAA walls. The levels of the remaining studied elements, copper, zinc, manganese, magnesium and calcium, were comparable. The elevated levels of cadmium in the walls of AAA coexisting with IAAs may suggest an impact of the accumulation of this trace element on the greater damage of the iliac artery wall.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Fournier?s gangrene - delayed pedicle flap based upon the anterior abdominal wall

    Directory of Open Access Journals (Sweden)

    Ania Sliwinski

    2014-06-01

    Full Text Available Introduction Fournier’s gangrene is a poly-microbial necrotizing fasciitis that involves the perineum and/or external genitalia. Urgent surgical debridement is well recognized as essential acute treatment yet unique challenges arise for plastic surgical reconstruction to obtain a complete functional recovery. This case describes a successful delayed pedicle flap repair based upon the anterior abdominal wall. Case description A 24 year old man was admitted to ICU ten days after elective circumcision with Fournier’s gangrene. He underwent a number of surgical debridements, and was referred for plastic surgical management. He had penile reconstruction using a random pattern abdominal flap, which was performed as a three stage procedure including flap vascular delay technique. Discussion Perineal and penile skin loss can be significant and is difficult to repair. Various techniques have been used to reconstruct lost tissue: skin grafts, transposition of the testes and spermatic cords to the thigh, flaps, and other types of pediculated myocutaneous flaps. Muscle flap reconstruction provides an environment that allows for complete regeneration of the urethral epithelium but is bulky and unsightly. Skin grafts contract and may produce painful and dysfunctional reconstructions. This novel technique produces a functional, and aesthetic reconstruction. Conclusion Penile skin recovery following Fournier’s gangrene recovery is problematic. This case demonstrates the functionality of a delayed flap repair using the anterior abdominal wall.

  12. Latissimus dorsi free flap reconstruction of major abdominal defect in treatment of giant Marjolin's ulcer

    DEFF Research Database (Denmark)

    Steffensen, Signe Muus; Thomassen, Anders; Jensen, Jesper Poul Naested

    2014-01-01

    We present a case of a 56-year-old man with a giant carcinoma in the abdominal wall. Based on positron emission tomography/computed tomography (PET/CT) scan there were FDG-avid lymph nodes in the ipsilateral axillary and groin, suspicious for metastases. At contrast-enhanced CT the parietal...... peritoneum seemed free of tumor invasion, which was essential to radical surgery planning. The tumor was completely removed with clear margins of resection and no metastasis in the resected lymph nodes. The PET/CT scan was repeated after 4 months, showing no signs of recurrence....

  13. Abdominal wall injuries occurring after blunt trauma: incidence and grading system.

    Science.gov (United States)

    Dennis, Ryan W; Marshall, Andre; Deshmukh, Harshal; Bender, Jeffrey S; Kulvatunyou, Narong; Lees, Jason S; Albrecht, Roxie M

    2009-03-01

    Traumatic abdominal wall injuries (AWIs) are being increasingly recognized after blunt force injury. All available abdominal/pelvic computed axial tomography (CAT) scans of blunt trauma patients evaluated at our level I trauma center from January 2005 to August 2006 were reviewed for the presence of AWI. AWI was graded using a severity-based numeric system. AWI grade was then compared with variables from a prospectively maintained trauma registry. Of 1,549 reviewed CAT scans, 9% showed AWI (grade I = 53%, grade II = 28%, grade III = 9%, grade IV = 8%, and grade V = 2%). There was no association between AWI and seatbelt use, Injury Severity Score, weight, or need for abdominal surgery. AWI occurs in 9% of blunt trauma patients undergoing abdominal/pelvic CAT scans. The incidence of herniation on CAT at presentation after blunt trauma is .2%, and the incidence of patients at risk of future hernia formation is 1.5%. AWI can be effectively cataloged using a straightforward numeric grading system.

  14. Metastasectomy of Abdominal Wall Lesions due to Prostate Cancer Detected Through PET/CT Gallium 68-PMSA: First Case Report

    Directory of Open Access Journals (Sweden)

    Claudia Ochoa

    2017-05-01

    Full Text Available Introducing the topic of abdominal wall metastasis secondary to prostate cancer with a reminder of the disease's rarity, being the first published case. This article is about a 66 year old patient diagnosed with prostate cancer [cT2aNxMx iPSA: 5,6 ng/ml Gleason 3+3, (Grade 1 Group], treated with radical prostatectomy as well as accompanied with amplified pelvic lymphadenectomy, who subsequently presented metastatic lesions to the abdominal wall diagnosed with PET/CT Gallium 68-PMSA technique and treated with abdominal metastasectomy with adequate short term results.

  15. What we know about management of traumatic abdominal wall hernia: review of the literature and case report.

    Science.gov (United States)

    Hamidian Jahromi, Alireza; Skweres, Justin; Sangster, Guillermo; Johnson, Lester; Samra, Navdeep

    2015-02-01

    Traumatic abdominal wall hernia (TAWH) is an uncommon form of hernia caused by blunt traumatic disruption of the abdominal wall musculature/fascia and abdominal organ herniation. Diagnosis of TAWH is challenging and requires a high level of suspicion. This form of hernia seems to be underrepresented in the English-language medical literature. There is currently no consensus on the optimal management for TAWH. In this article, we discuss the management of a 36-year-old motorcycle driver who was involved in a road traffic accident. On evaluation at our trauma center, he was found to have TAWH. Diagnostic criteria, imaging modalities and different management options for TAWH will be discussed.

  16. Metastasectomy of Abdominal Wall Lesions due to Prostate Cancer Detected Through PET/CT Gallium 68-PMSA: First Case Report.

    Science.gov (United States)

    Ochoa, Claudia; Ramirez, Angie; Varela, Rodolfo; Godoy, Fabian; Vargas, Rafael; Forero, Jorge; Rojas, Andres; Roa, Carmen; Céspedes, Carlos; Ramos, Jose; Cabrera, Marino; Calderon, Andres

    2017-05-01

    Introducing the topic of abdominal wall metastasis secondary to prostate cancer with a reminder of the disease's rarity, being the first published case. This article is about a 66 year old patient diagnosed with prostate cancer [cT2aNxMx iPSA: 5,6 ng/ml Gleason 3+3, (Grade 1 Group)], treated with radical prostatectomy as well as accompanied with amplified pelvic lymphadenectomy, who subsequently presented metastatic lesions to the abdominal wall diagnosed with PET/CT Gallium 68-PMSA technique and treated with abdominal metastasectomy with adequate short term results.

  17. Repair of recurrent hernia after biologic mesh failure in abdominal wall reconstruction.

    Science.gov (United States)

    Purnell, Chad A; Souza, Jason M; Park, Eugene; Dumanian, Gregory A

    2014-11-01

    Biologic mesh is commonly used in abdominal wall reconstruction but may result in increased hernia recurrence. There are minimal data on repair of these recurrent hernias. We conducted a retrospective chart review of 24 patients presenting to a single surgeon with recurrent ventral hernia, previously repaired with biologic mesh. Seventeen of 24 study patients underwent open repair, including 5 revisions of incomplete external oblique release. Mesh was polypropylene in 11 patients and fenestrated condensed polytetrafluoroethylene in 3 patients. In 1 patient, no mesh was used. In 2 patients, bridged biologic mesh was used because of risk of exposure. All biologic repairs have since recurred. Complications occurred in 3 of 15 prosthetic mesh patients and in all biologic mesh patients. Prior components release can be repeated if computed tomography scan reveals incomplete release. Recurrence is common after bridged biologic mesh repair. Conventional mesh can be used safely in many recurrent abdominal hernias after biologic mesh failure. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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. [Implantation of synthetic mesh for the closing of abdominal wall ruptures in the ventral flank of cows: a retrospective study of 16 cases].

    Science.gov (United States)

    Koller, U; Lischer, C L; Auer, J A

    2001-07-01

    In this paper the technique and long-term results for abdominal wall ruptures in the ventral flank are described in 16 cows that underwent surgery between January 1990 and October 1999. Most injuries were caused by a horn of another cow. In three cases the rupture was repaired longer than 6 weeks after traumatic injury. The other defects were treated surgically 6.4 (0-25) days after they occurred. The muscle defects were closed layer by layer with simple continuous sutures (polyglactin 910, 6 metric) under general anesthesia in lateral recumbency and the sutured defect was reinforced with a synthetic mesh (polyester or polyglactin 910) fixed to the outside of the external oblique abdominal muscle. The most frequent postoperative complication was subcutaneous seroma. It was treated successfully by incision and drainage. All patients were released 11.6 +/- 5.5 (6-23) days after surgery. A telephone survey 53 +/- 26 (7-106) months after surgery revealed that the patients had an average survival time of 30 (2-104) months, had born one to seven calves without any complications and that only one cow had had an unsatisfactory milk yield. One cow had to be slaughtered 2 months after surgery because of a relapse. Synthetic mesh was used successfully to close the defect in 15 animals. The functional as well as the cosmetic result of the described operation was good to excellent.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Theoretical analysis of the influence of flexoelectric effect on the defect site in nematic inversion walls

    International Nuclear Information System (INIS)

    Zheng Gui-Li; Xuan Li; Zhang Hui; Ye Wen-Jiang; Zhang Zhi-Dong; Song Hong-Wei

    2016-01-01

    Based on the experimental phenomena of flexoelectric response at defect sites in nematic inversion walls conducted by Kumar et al., we gave the theoretical analysis using the Frank elastic theory. When a direct-current electric field normal to the plane of the substrate is applied to the parallel aligned nematic liquid crystal cell with weak anchoring, the rotation of ±1 defects in the narrow inversion walls can be exhibited. The free energy of liquid crystal molecules around the +1 and –1 defect sites in the nematic inversion walls under the electric field was formulated and the electric-field-driven structural changes at the defect site characterized by polar and azimuthal angles of the local director were simulated. The results reveal that the deviation of azimuthal angle induced by flexoelectric effect are consistent with the switching of extinction brushes at the +1 and −1 defects obtained in the experiment conducted by Kumar et al. (paper)

  4. When Closure Fails: What the Radiologist Needs to Know About the Embryology, Anatomy, and Prenatal Imaging of Ventral Body Wall Defects.

    Science.gov (United States)

    Torres, Ulysses S; Portela-Oliveira, Eduardo; Braga, Fernanda Del Campo Braojos; Werner, Heron; Daltro, Pedro Augusto Nascimento; Souza, Antônio Soares

    2015-12-01

    Ventral body wall defects (VBWDs) are one of the main categories of human congenital malformations, representing a wide and heterogeneous group of defects sharing a common feature, that is, herniation of one or more viscera through a defect in the anterior body wall. Gastroschisis and omphalocele are the 2 most common congenital VBWDs. Other uncommon anomalies include ectopia cordis and pentalogy of Cantrell, limb-body wall complex, and bladder and cloacal exstrophy. Although VBWDs are associated with multiple abnormalities with distinct embryological origins and that may affect virtually any system organs, at least in relation to anterior body wall defects, they are thought (except for omphalocele) to share a common embryologic mechanism, that is, a failure involving the lateral body wall folds responsible for closing the thoracic, abdominal, and pelvic portions of the ventral body wall during the fourth week of development. Additionally, many of the principles of diagnosis and management are similar for these conditions. Fetal ultrasound (US) in prenatal care allows the diagnosis of most of such defects with subsequent opportunities for parental counseling and optimal perinatal management. Fetal magnetic resonance imaging may be an adjunct to US, providing global and detailed anatomical information, assessing the extent of defects, and also helping to confirm the diagnosis in equivocal cases. Prenatal imaging features of VBWDs may be complex and challenging, often requiring from the radiologist a high level of suspicion and familiarity with the imaging patterns. Because an appropriate management is dependent on an accurate diagnosis and assessment of defects, radiologists should be able to recognize and distinguish between the different VBWDs and their associated anomalies. In this article, we review the relevant embryology of VBWDs to facilitate understanding of the pathologic anatomy and diagnostic imaging approach. Features will be illustrated with prenatal US

  5. What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

    Science.gov (United States)

    Köckerling, F; Alam, N N; Antoniou, S A; Daniels, I R; Famiglietti, F; Fortelny, R H; Heiss, M M; Kallinowski, F; Kyle-Leinhase, I; Mayer, F; Miserez, M; Montgomery, A; Morales-Conde, S; Muysoms, F; Narang, S K; Petter-Puchner, A; Reinpold, W; Scheuerlein, H; Smietanski, M; Stechemesser, B; Strey, C; Woeste, G; Smart, N J

    2018-04-01

    Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations. A European working group, "BioMesh Study Group", composed of invited surgeons with a special interest in surgical meshes, formulated key questions, and forwarded them for processing in subgroups. In January 2016, a workshop was held in Berlin where the findings were presented, discussed, and voted on for consensus. Findings were set out in writing by the subgroups followed by consensus being reached. For the review, 114 studies and background analyses were used. The cumulative data regarding biologic mesh under contaminated conditions do not support the claim that it is better than synthetic mesh. Biologic mesh use should be avoided when bridging is needed. In inguinal hernia repair biologic and biosynthetic meshes do not have a clear advantage over the synthetic meshes. For prevention of incisional or parastomal hernias, there is no evidence to support the use of biologic/biosynthetic meshes. In complex abdominal wall hernia repairs (incarcerated hernia, parastomal hernia, infected mesh, open abdomen, enterocutaneous fistula, and component separation technique), biologic and biosynthetic meshes do not provide a superior alternative to synthetic meshes. The routine use of biologic and biosynthetic meshes cannot be recommended.

  6. Isometric abdominal wall muscle strength assessment in individuals with incisional hernia: a prospective reliability study.

    Science.gov (United States)

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

    2016-12-01

    To determine the reliability of measurements obtained by the Good Strength dynamometer, determining isometric abdominal wall and back muscle strength in patients with ventral incisional hernia (VIH) and healthy volunteers with an intact abdominal wall. Ten patients with VIH and ten healthy volunteers with an intact abdominal wall were each examined twice with a 1 week interval. Examination included the assessment of truncal flexion and extension as measured with the Good Strength dynamometer, the completion of the International Physical Activity Questionnaire (IPAQ) and the self-assessment of truncal strength on a visual analogue scale (SATS). The test-retest reliability of truncal flexion and extension was assessed by interclass correlation coefficient (ICC), and Bland and Altman graphs. Finally, correlations between truncal strength, and IPAQ and SATS were examined. Truncal flexion and extension showed excellent test-retest reliability for both patients with VIH (ICC 0.91 and 0.99) and healthy controls (ICC 0.97 and 0.96). Bland and Altman plots showed that no systematic bias was present for neither truncal flexion nor extension when assessing reliability. For patients with VIH, no significant correlations between objective measures of truncal strength and IPAQ or SATS were found. For healthy controls, both truncal flexion (τ 0.58, p = 0.025) and extension (τ 0.58, p = 0.025) correlated significantly with SATS, while no other significant correlation between truncal strength measures and IPAQ was found. The Good Strength dynamometer provided a reliable, low-cost measure of truncal flexion and extension in patients with VIH.

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

    International Nuclear Information System (INIS)

    Bossi, Alberto; De Wever, Ivo; Van Limbergen, Erik; Vanstraelen, Bianca

    2007-01-01

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

  8. Hybrid NOTES transvaginal intraperitoneal onlay mesh in abdominal wall hernias: an alternative to traditional laparoscopic procedures.

    Science.gov (United States)

    Descloux, Alexandre; Pohle, Sebastian; Nocito, Antonio; Keerl, Andreas

    2015-12-01

    Abdominal wall hernias are increasingly treated by laparoscopic placement of an intraperitoneal onlay mesh (IPOM). We present an alternative technique for women: the laparoscopic-assisted transvaginal IPOM. Before surgery, all patients underwent a gynecological examination. The patients agreed to IPOM repair via a transvaginal approach, and written informed consent for surgery was obtained. Pneumoperitoneum was established with a Veress needle at the umbilicus. This access was subsequently dilated to 5 mm (VersaStep), and a 5-mm laparoscope was inserted. Under laparoscopic view, the transvaginal trocars (12-mm VersaStep and 5-mm flexible accesses) were safely inserted after lifting the uterus with a uterus manipulator. After preparation of the falciform ligament, the ligamentum teres and the preperitoneal fat, a lightweight composite mesh was introduced through the transvaginal access and fixed with absorbable tacks using the double-crown technique. From September 2011 to December 2012, we performed six laparoscopic-assisted transvaginal IPOM procedures (one epigastric, three umbilical, two combined epigastric and umbilical hernias; all were primary hernias). In the initial phase, only patients with small or medium primary abdominal wall hernia were selected (max. 3 cm diameter). Median hospital stay was 3 days (range 2-6 days). One minor complication occurred perioperatively (second-degree skin burn to the labia majora). At 1-year follow-up, we identified one recurrence in a high-risk patient with a body mass index higher than 35 kg/m(2). No infection and no mortality were observed. Although no final conclusion can be made regarding the presumed non-inferiority of this technique in terms of recurrence and mesh infection compared with traditional laparoscopic IPOM, laparoscopic-assisted transvaginal IPOM is a feasible alternative to treat abdominal wall hernias.

  9. Skin as marker for collagen type I/III ratio in abdominal wall fascia.

    Science.gov (United States)

    Peeters, E; De Hertogh, G; Junge, K; Klinge, U; Miserez, M

    2014-08-01

    An altered collagen metabolism could play an important role in hernia development. This study compared collagen type I/III ratio and organisation between hernia and control patients, and analysed the correlation in collagen type I/III ratio between skin and abdominal wall fascia. Collagen organisation was analysed in Haematoxylin-Eosin sections of anterior rectus sheath fascia, and collagen type I/III ratio, by crosspolarisation microscopy, in Sirius-Red sections of skin and anterior rectus sheath fascia, of 19 control, 10 primary inguinal, 10 recurrent inguinal, 13 primary incisional and 8 recurrent incisional hernia patients. Compared to control patients [7.2 (IQR = 6.8-7.7) and 7.2 (IQR = 5.8-7.9)], collagen type I/III ratio was significantly lower in skin and anterior rectus sheath fascia of primary inguinal [5.2 (IQR = 3.8-6.3) and 4.2 (IQR = 3.8-4.7)], recurrent inguinal [3.2 (IQR = 3.1-3.6) and 3.3 (IQR = 3-3.7)], primary incisional [3.5 (IQR = 3-3.9) and 3.4 (IQR = 3.3-3.6)] and recurrent incisional hernia [3.2 (IQR = 3.1-3.9) and 3.2 (IQR = 2.9-3.2)] patients; also incisional and recurrent inguinal hernia had lower ratio than primary inguinal hernia patients. Furthermore, collagen type I/III ratio was significantly correlated (r = 0.81; P fascia. Finally, collagen organisation was comparable between hernia and control patients. Furthermore, in both skin and abdominal wall fascia of hernia patients, collagen type I/III ratio was lower compared to control patients, with more pronounced abnormalities in incisional and recurrent inguinal hernia patients. Importantly, collagen type I/III ratio in skin was representative for that in abdominal wall fascia.

  10. The future of stem cell therapy in hernia and abdominal wall repair.

    Science.gov (United States)

    Petter-Puchner, A H; Fortelny, R H; Gruber-Blum, S; Redl, H; Dietz, U

    2015-02-01

    Stem cell therapies have been proposed in preclinical trials as new treatment options in abdominal wall repair. This work lists sources of feasible cell lines and the current status of literature and provides a cautious outlook into future developments. Special attention was paid to translational issues and practicabilty in a complex field. Cell-based therapies will play a role in the clinical setting in the future. Regulatory and ethical issues need to be addressed as well as the proof of cost-effectiveness.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  12. Acute incarcerated external abdominal hernia

    OpenAIRE

    Yang, Xue-Fei; Liu, Jia-Lin

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surg...

  13. Acutely incarcerated abdominal wall hernia: what if it is a consequence?

    Science.gov (United States)

    Gonenc, M; Bozkurt, M A; Kapan, S; Aras, A; Surek, A; Alis, H

    2014-01-01

    The aim of this study was to emphasize the importance of differential diagnosis in patients with acutely incarcerated abdominal wall hernia (AWH). The medical records of patients who underwent emergency surgery with preoperative diagnosis of acutely incarcerated AWH and in whom acutely incarcerated AWH was the consequence of increased intraabdominal pressure due to other abdominal emergencies were reviewed. The following data were collected: demographics, the duration between the onset of symptoms and admission, clinical findings, biochemical test results that were abnormal, radiological findings, preoperative and intraoperative diagnosis, operative findings, surgical procedure, different diagnosis made in the postoperative period, reoperation, morbidity, mortality, and the length of hospital stay. Ten patients were included to the study. The primary pathology was found to be perforated peptic ulcer disease in three, bowel obstruction due to neoplastic mass in three, complicated appendicitis in two, acute mesenteric ischemia in one, and acute diverticulitis in one. The correct diagnosis was made during emergency surgery for hernia repair, whereas the primary pathology was identified postoperatively in two patients. Patients who are diagnosed to have acutely incarcerated AWH preoperatively should undergo further diagnostic workup, if any level of clinical suspicion for differential diagnosis is present. Moreover, the surgeon should consider general abdominal exploration if contradictory findings are encountered during the exploration of the hernia sac, even if preoperative diagnostic studies reveal no gross pathology or non-specific findings.

  14. Stress adapted embroidered meshes with a graded pattern design for abdominal wall hernia repair

    Science.gov (United States)

    Hahn, J.; Bittrich, L.; Breier, A.; Spickenheuer, A.

    2017-10-01

    Abdominal wall hernias are one of the most relevant injuries of the digestive system with 25 million patients in 2013. Surgery is recommended primarily using allogenic non-absorbable wrap-knitted meshes. These meshes have in common that their stress-strain behaviour is not adapted to the anisotropic behaviour of native abdominal wall tissue. The ideal mesh should possess an adequate mechanical behaviour and a suitable porosity at the same time. An alternative fabrication method to wrap-knitting is the embroidery technology with a high flexibility in pattern design and adaption of mechanical properties. In this study, a pattern generator was created for pattern designs consisting of a base and a reinforcement pattern. The embroidered mesh structures demonstrated different structural and mechanical characteristics. Additionally, the investigation of the mechanical properties exhibited an anisotropic mechanical behaviour for the embroidered meshes. As a result, the investigated pattern generator and the embroidery technology allow the production of stress adapted mesh structures that are a promising approach for hernia reconstruction.

  15. How to operate safely steam generators with multiple tube through-wall defects

    International Nuclear Information System (INIS)

    Hernalsteen, P.

    1993-01-01

    For a Nuclear Power Plant (NPP) of the Pressurized Water Reactor (PWR) type, the Steam Generator (SG) tube bundle represents the major but also the thinnest part of the primary pressure boundary. To the extent that no tube material has yet been identified to be immune to corrosion, defects may initiate in service and easily propagate through wall. While not a desirable feature, a Through Wall Deep (TWD) defect does not necessarily pose a threat to either the structural integrity or leaktightness and this paper shows how SG can (and indeed, do) operate safely and reliably while having many tubes affected by deep and even TWD defects

  16. Pain pressure threshold algometry of the abdominal wall in healthy women

    Directory of Open Access Journals (Sweden)

    M.L.L.S. Montenegro

    2012-07-01

    Full Text Available The objective of this study was to determine the inter- and intra-examiner reliability of pain pressure threshold algometry at various points of the abdominal wall of healthy women. Twenty-one healthy women in menacme with a mean age of 28 ± 5.4 years (range: 19-39 years were included. All volunteers had regular menstrual cycles (27-33 days and were right-handed and, to the best of our knowledge, none were taking medications at the time of testing. Women with a diagnosis of depression, anxiety or other mood disturbances were excluded. Women with previous abdominal surgery, any pain condition or any evidence of inflammation, hypertension, smoking, alcoholism, or inflammatory disease were also excluded. Pain perception thresholds were assessed with a pressure algometer with digital traction and compression and a measuring capacity for 5 kg. All points were localized by palpation and marked with a felt-tipped pen and each individual was evaluated over a period of 2 days in two consecutive sessions, each session consisting of a set of 14 point measurements repeated twice by two examiners in random sequence. There was no statistically significant difference in the mean pain threshold obtained by the two examiners on 2 diferent days (examiner A: P = 1.00; examiner B: P = 0.75; Wilcoxon matched pairs test. There was excellent/good agreement between examiners for all days and all points. Our results have established baseline values to which future researchers will be able to refer. They show that pressure algometry is a reliable measure for pain perception in the abdominal wall of healthy women.

  17. Pain pressure threshold algometry of the abdominal wall in healthy women.

    Science.gov (United States)

    Montenegro, M L L S; Braz, C A; Mateus-Vasconcelos, E L; Rosa-e-Silva, J C; Candido-dos-Reis, F J; Nogueira, A A; Poli-Neto, O B

    2012-07-01

    The objective of this study was to determine the inter- and intra-examiner reliability of pain pressure threshold algometry at various points of the abdominal wall of healthy women. Twenty-one healthy women in menacme with a mean age of 28 ± 5.4 years (range: 19-39 years) were included. All volunteers had regular menstrual cycles (27-33 days) and were right-handed and, to the best of our knowledge, none were taking medications at the time of testing. Women with a diagnosis of depression, anxiety or other mood disturbances were excluded. Women with previous abdominal surgery, any pain condition or any evidence of inflammation, hypertension, smoking, alcoholism, or inflammatory disease were also excluded. Pain perception thresholds were assessed with a pressure algometer with digital traction and compression and a measuring capacity for 5 kg. All points were localized by palpation and marked with a felt-tipped pen and each individual was evaluated over a period of 2 days in two consecutive sessions, each session consisting of a set of 14 point measurements repeated twice by two examiners in random sequence. There was no statistically significant difference in the mean pain threshold obtained by the two examiners on 2 different days (examiner A: P = 1.00; examiner B: P = 0.75; Wilcoxon matched pairs test). There was excellent/good agreement between examiners for all days and all points. Our results have established baseline values to which future researchers will be able to refer. They show that pressure algometry is a reliable measure for pain perception in the abdominal wall of healthy women.

  18. Outcome of patients with chronic mesh infection following abdominal wall hernia repair.

    Science.gov (United States)

    Chung, L; Tse, G H; O'Dwyer, P J

    2014-10-01

    Mesh infection following incisional hernia repair has been reported at around 6-10 %. The aim of this study is to assess the outcome of patients following treatment for chronically infected mesh after repair of an abdominal wall hernia. Data were gathered on all patients with chronically infected mesh following failed conservative management treated under the care of one surgeon between January 2004 and December 2010. This included patient demographics, reason for first operation, number of previous operations and the number of previous hernia repairs. In addition, the type of mesh removed was recorded as was the organism cultured from the wound. Patients were followed up in a clinic at 1 month, 3 months and 1 year after surgery. 15 patients had 18 operations under general anaesthesia for infected mesh (10 partial and 8 complete mesh excisions). The interval between the last mesh implantation or abdominal operation and re-operation for infection was a median of 17 months (range 7-49 months). All patients who had complete mesh removal had complete healing of their wound at 3 months compared with four in the partial excision group (P = 0.011). At a median follow-up of 19 months, only five in the complete and three in the partial excision group had complete wound healing (P = 0.184). The outcome of patients treated for chronic mesh infection is unsatisfactory with high risk of recurrent herniation and development of further chronic abdominal wall sepsis; therefore, every effort should be made to prevent this problem in the first instance.

  19. [Case report: Rapidly growing abdominal wall giant desmoid tumour during pregnancy].

    Science.gov (United States)

    Palacios-Zertuche, Jorge Tadeo; Cardona-Huerta, Servando; Juárez-García, María Luisa; Valdés-Flores, Everardo; Muñoz-Maldonado, Gerardo Enrique

    Desmoid tumours are one of the rarest tumours worldwide, with an estimated yearly incidence of 2-4 new cases per million people. They are soft tissue monoclonal neoplasms that originate from mesenchymal stem cells. It seems that the hormonal and immunological changes occurring during pregnancy may play a role in the severity and course of the disease. The case is presented on 28-year-old female in her fifth week of gestation, in whom an abdominal wall tumour was found attached to left adnexa and uterus while performing a prenatal ultrasound. The patient was followed up under clinical and ultrasonographic surveillance. When she presented with abnormal uterine activity at 38.2 weeks of gestation, she was admitted and obstetrics decided to perform a caesarean section. Tumour biopsy was taken during the procedure. Histopathology reported a desmoid fibromatosis. A contrast enhanced abdominal computed tomography scan was performed, showing a tumour of 26×20.5×18cm, with well-defined borders in contact with the uterus, left adnexa, bladder and abdominal wall, with no evidence of infiltration to adjacent structures. A laparotomy, with tumour resection, hysterectomy and left salpingo-oophorectomy, components separation techniques, polypropylene mesh insertion, and drainage was performed. The final histopathology report was desmoid fibromatosis. There is no evidence of recurrence after 6 months follow-up. Desmoid tumours are locally aggressive and surgical resection with clear margins is the basis for the treatment of this disease, using radiotherapy, chemotherapy and hormone therapy as an adjunct in the treatment. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  20. Ising lines: natural topological defects within ferroelectric Bloch walls

    Czech Academy of Sciences Publication Activity Database

    Stepkova, Vilgelmina; Márton, Pavel; Hlinka, Jiří

    2015-01-01

    Roč. 92, č. 9 (2015), "094106-1"-"094106-5" ISSN 1098-0121 R&D Projects: GA ČR GA15-04121S Institutional support: RVO:68378271 Keywords : ferroelectrics * Ginzburg-Landau-Devonshire model * domain structure * topological defects Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 3.736, year: 2014

  1. One year experience of swine dermal non-crosslinked collagen prostheses for abdominal wall repairs in elective and emergency surgery.

    Science.gov (United States)

    Montori, Giulia; Coccolini, Federico; Manfredi, Roberto; Ceresoli, Marco; Campanati, Luca; Magnone, Stefano; Pisano, Michele; Poiasina, Elia; Nita, Gabriela; Catena, Fausto; Ansaloni, Luca

    2015-01-01

    The approach to the abdominal wall surgical repair is dramatically changed in the last years. This study evaluates our institutional outcomes about the usage of biological meshes for abdominal wall repair in different setting: in elective surgery, in emergency surgery and in abdominal wall repair following open abdomen (OA) procedure. A database was prospectively conducted (January-December 2014) and data were reviewed for patients who underwent to an abdominal wall reconstruction with swine dermal non-cross linked collagens prostheses either in elective or emergency setting, and following OA/laparostomy procedure. Demographic data, co-morbidities, indications for surgery, intra-operative details, post-operative complications and outcome (peri-operative, 3, 6, 9-months) were analyzed. A total of 30 cases were reported: 9 in elective surgery (Group 1), 4 in emergency surgery (Group 2) and 17 with abdominal wall closure following OA management (Group 3). Two meshes were removed: 1 in the Group 1 and 1 in the Group 3. During follow-up only one patient in the Group 3 had a recurrence of the incisional hernia. Mortality rate was 11.1 % at 3 months in Group 1, 0 % in the Group 2, and 29.4 % in peri-operative period in the Group 3. The use of non-cross linked biological meshes can be safe and versatile in different situations from elective to emergency surgery, and also for the reconstruction of the abdominal wall after OA procedure, with an acceptable recurrence and mortality rate.

  2. Functional electrical stimulation to the abdominal wall muscles synchronized with the expiratory flow does not induce muscle fatigue.

    Science.gov (United States)

    Okuno, Yukako; Takahashi, Ryoichi; Sewa, Yoko; Ohse, Hirotaka; Imura, Shigeyuki; Tomita, Kazuhide

    2017-03-01

    [Purpose] Continuous electrical stimulation of abdominal wall muscles is known to induce mild muscle fatigue. However, it is not clear whether this is also true for functional electrical stimulation delivered only during the expiratory phase of breathing. This study aimed to examine whether or not intermittent electrical stimulation delivered to abdominal wall muscles induces muscle fatigue. [Subjects and Methods] The subjects were nine healthy adults. Abdominal electrical stimulation was applied for 1.5 seconds from the start of expiration and then turned off during inspiration. The electrodes were attached to both sides of the abdomen at the lower margin of the 12th rib. Abdominal electrical stimulation was delivered for 15 minutes with the subject in a seated position. Expiratory flow was measured during stimulus. Trunk flexor torque and electromyography activity were measured to evaluate abdominal muscle fatigue. [Results] The mean stimulation on/off ratio was 1:2.3. The declining rate of abdominal muscle torque was 61.1 ± 19.1% before stimulus and 56.5 ± 20.9% after stimulus, not significantly different. The declining rate of mean power frequency was 47.8 ± 11.7% before stimulus and 47.9 ± 10.2% after stimulus, not significantly different. [Conclusion] It was found that intermittent electrical stimulation to abdominal muscles synchronized with the expiratory would not induce muscle fatigue.

  3. Does a muscle flap accelerate wound healing of gastric wall defects compared with an omental flap?

    Science.gov (United States)

    Hishida, Masashi; Toriyama, Kazuhiro; Yagi, Shunjiro; Ebisawa, Katsumi; Morishita, Tsuyoshi; Takanari, Keisuke; Kamei, Yuzuru

    2015-06-01

    Most often used for reconstruction at superficial sites, a muscle flap recently was reported to promote clinical wound healing in a duodenal defect. We therefore examined whether a muscle flap could promote wound healing comparably to an omental flap in rats with gastric wall defects. After perforation of the centre of the anterior gastric wall, rats were divided into 2 groups. In the muscle group, a muscle flap was fixed to the defect; in the omentum group, an omental flap was placed over the defect. We histopathologically compared tissue responses during gastric wall healing. While stratified villi had completely covered the defect by day 7 in both groups, scar maturation differed. Scar tissue persisted in the muscle group, but was gradually replaced by adipose tissue in the omentum group. Both muscle and omental flaps accelerated gastric wall wound healing. A muscle flap is an excellent alternative for repair of gastric defects when no omental flap is available. Copyright © 2015. Published by Elsevier Ltd.

  4. Three-Dimensional Custom-Made Titanium Ribs for Reconstruction of a Large Chest Wall Defect.

    Science.gov (United States)

    Simal, Isabel; García-Casillas, Maria Antonia; Cerdá, Julio Arturo; Riquelme, Óscar; Lorca-García, Concepción; Pérez-Egido, Laura; Fernández-Bautista, Beatriz; Torre, Manuel de la; de Agustín, Juan Carlos

    2016-12-01

    Reconstruction of large chest wall defects always demand surgeons of having lots of means available (both materials and resourceful) to apply a cover to chest wall defects which can range from a few centimeters to the lack of a few entire ribs. In this study, we present the case of a teenager who suffered from a complete resection of three ribs because of Ewing sarcoma dependent on the sixth rib. Given the size of the defect, a multidisciplinary approach was chosen to provide rigid and soft tissue coverage and minimal functional and aesthetic impact. Custom-made titanium implants were designed based on three-dimensional computed tomography scan reconstruction. The surgical specimen via a left lateral thoracotomy (fifth, sixth, and seventh entire ribs) was resected, leaving a defect of 35 × 12 × 6 cm. A Gore-Tex patch (W. L. Gore & Associates, Arizona, United States) was placed and, after that, the implants were anchored to the posterior fragment of the healthy ribs and to the costal cartilage anteriorly. Finally, the surgical site was covered with a latissimus dorsi flap. The postoperative course was uneventful. After 9 months of follow-up, the patient has full mobility. This case shows that the implant of custom-made ribs, combined with other techniques, is a good surgical choice for reconstruction of large chest wall defects. The implant of custom-made ribs, combined with other techniques, is a good surgical choice for reconstruction of large chest wall defects.

  5. The value of intra-abdominal pressure monitoring through ...

    African Journals Online (AJOL)

    Introduction Gastroschisis and omphalocele are most common congenital abdominal wall defects (AWDs). Surgical management aims to reduce the evisceration safely, close the defect with a cosmetically acceptable outcome under guidance of intraoperative monitoring of intra-abdominal pressure (IAP). Intravesical ...

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

    Science.gov (United States)

    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.

  7. Abdominal wall healing in incisional hernia using different biomaterials in rabbits

    Directory of Open Access Journals (Sweden)

    Ana Letícia Gomes Aramayo

    2013-04-01

    Full Text Available PURPOSE: To investigate abdominal wound healing using specific biomaterials in incisional hernias. METHODS: Incisional hernias were produced in 40 rabbits, after that they were reoperated with or without the use of meshes: PREMILENE® (PPL, ULTRAPRO® (UP, PROCEED® (PCD or repairing without mesh (TRANSPALB. After 30 days a macroscopic and microscopic study of the part withdrawn from the abdominal wall was performed. RESULTS: Macroscopic: adhesion Area: PPL> UP and PCD (p = 0.031. Vascularization: PPL> UP and PCD (p = 0.001. PPL groups (p = 0.032 and PCD (p PPL, UP and TRANSPALB (p = 0.010; eosinophils: PPL> UP, and TRANSPALB PCD (p = 0.010; granulation tissue: PPL and PCD> UP and TRANSPALB (p TRANSPALB (p UP (p = 0.009 and TRANSPALB (p TRANSPALB (p PCD and TRANSPALB (p <0.001. CONCLUSION: All types of meshes caused the formation of adhesions. The UP and PCD groups showed lower area and vascularization of the adhesions. The PPL and PCD groups showed higher meshes shrinkage and there was a predominance of acute inflammatory process in the PCD group.

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Specific improvement measures to reduce complications and mortality after urgent surgery in complicated abdominal wall hernia.

    Science.gov (United States)

    Martínez-Serrano, M A; Pereira, J A; Sancho, J; Argudo, N; López-Cano, M; Grande, L

    2012-04-01

    Morbidity and mortality are increased after urgent surgery for complicated abdominal wall hernia. We analysed prospectively early morbidity and mortality after implementing specific management measures in patients undergoing urgent hernia repair. The study population included 244 patients with complicated abdominal wall hernia requiring surgical repair on an emergency basis over 1-year period. Patients were managed according to a protocol that included specific actions to be implemented in the pre-, intra- and postoperative periods. Outcomes of these patients were compared with those of 402 undergoing similar operations before development of the protocol. Patients in whom acute complication was the first hernia symptom had higher mortality (7.2% vs 2.5%; P = 0.07) and were consulted later than 24 h (49.4% vs 36%; P = 0.044). Patients consulting later than 24 h had higher mortality (8.1% vs 1.4%, P = 0.017). Femoral hernias exhibited specific characteristics and were associated with higher mortality (13% vs 1.6%; P = 0.001). Overall, both groups had similar mortality (4.5% vs 4.1%; P = 0.8); complications (38.8% vs 37.7%; P = 0.2), and bowel resection rates (12.2% vs 11.5%; P = 0.8). Excluding the group of femoral hernias, the measures achieved a lower rate of severe complications (21.2% vs 10.3%; P = 0.04) and a decrease in mortality (2.9% vs 0.6%; P = 0.05) after bowel resection. Specific measures for improvement of management and prevention of complications and mortality were effective in patients without femoral hernia. To reduce mortality, the best applicable measure is early detection and to prioritize the scheduled operation of femoral hernias and those affecting high risk patients. The implementation of preventive and educational programs in high risk patients is essential.

  10. "Choke" vessels between vascular territories of the abdominal wall: literature review and rare case of Leriche's syndrome.

    Science.gov (United States)

    Ye, Xuan; Rozen, Warren M; Alonso-Burgos, Alberto; Ashton, Mark W

    2012-11-01

    We undertook a review of the anatomical changes of "choke" vessels between the internal thoracic artery (ITA) and deep inferior epigastric artery (DIEA), as highlighted by a case of aortoiliac occlusive disease (Leriche's syndrome), and discuss the physiological concepts observed with regard to surgical delay procedures within the abdominal wall performed prior to abdominal cutaneous free flaps and coronary artery bypass grafting. Computed tomographic angiography (CTA) was undertaken on a patient with a rare case of Leriche's syndrome and a literature review of over 200 references on the anatomy, physiology and clinical uses of choke vessels in the abdominal wall was undertaken. The CTA demonstrated that in patients with Leriche's syndrome, there is a marked dilatation of all ITA-DIEA pathways and increased flow through choke vessels. If these changes can be surgically replicated in the form of a delay procedure for patients seeking to undergo autologous breast construction, this could improve the outcomes of abdominal cutaneous free flaps and coronary artery bypass grafting. We accordingly propose three surgical methods for augmenting blood flow to the abdominal wall: a) ligation of the DIEA; b) ligation of the distal ITA; and c) creation of an arterio-venous fistulae in the DIEA. Our review of the literature confirmed the viability of these propositions. The dilatation of choke vessels in response to increased haemodynamic stress may thus be utilised to enhance blood supply to tissues prior to transfer and can be achieved through simple and minimally invasive methods. Copyright © 2012 Wiley Periodicals, Inc.

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

    Directory of Open Access Journals (Sweden)

    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

  12. Defects in individual semiconducting single wall carbon nanotubes: Raman spectroscopic and in situ Raman spectroelectrochemical study.

    Science.gov (United States)

    Kalbac, Martin; Hsieh, Ya-Ping; Farhat, Hootan; Kavan, Ladislav; Hofmann, Mario; Kong, Jing; Dresselhaus, Mildred S

    2010-11-10

    Raman spectroscopy and in situ Raman spectroelectrochemistry have been used to study the influence of defects on the Raman spectra of semiconducting individual single-walled carbon nanotubes (SWCNTs). The defects were created intentionally on part of an originally defect-free individual semiconducting nanotube, which allowed us to analyze how defects influence this particular nanotube. The formation of defects was followed by Raman spectroscopy that showed D band intensity coming from the defective part and no D band intensity coming from the original part of the same nanotube. It is shown that the presence of defects also reduces the intensity of the symmetry-allowed Raman features. Furthermore, the changes to the Raman resonance window upon the introduction of defects are analyzed. It is demonstrated that defects lead to both a broadening of the Raman resonance profile and a decrease in the maximum intensity of the resonance profile. The in situ Raman spectroelectrochemical data show a doping dependence of the Raman features taken from the defective part of the tested SWCNT.

  13. Proteins associated with the size and expansion rate of the abdominal aortic aneurysm wall as identified by proteomic analysis

    DEFF Research Database (Denmark)

    Urbonavicius, Sigitas; Lindholt, Jes Sanddal; Delbosc, Sandrine

    2010-01-01

    Identification of biomarkers for the natural history of abdominal aortic aneurysms (AAA) holds the key to non-surgical intervention and improved selection for AAA repair. We aimed to associate the basic proteomic composition of AAA wall tissue with the expansion rate and size in patients with AAA....

  14. Fixity of ports to the abdominal wall during laparoscopic surgery: a randomized comparison of cutting versus blunt trocars.

    Science.gov (United States)

    Hamade, A M; Issa, M E; Haylett, K R; Ammori, B J

    2007-06-01

    Dislodgement of ports from the abdominal wall is a common problem during laparoscopic surgery. The aim of this study was to evaluate port stability using either cutting or blunt-tipped trocars. Patients undergoing laparoscopic surgery were randomized to have the secondary ports inserted using either cutting or blunt-tipped trocars. The fixity of ports to the abdominal wall was evaluated at the start and completion of surgery by measuring the total traction force required to displace the ports. Similarly, the friction forces required to displace instruments within the ports were measured. Thirty patients were randomized into two groups (15 patients in each group), and a total of 114 ports (cutting, n = 51; blunt, n = 63) were evaluated. The groups were comparable in age, gender, body mass index, and operating time. The total traction forces needed to displace the 5-mm and 10-mm ports were significantly lower when cutting trocars were used at both the beginning (2.6 vs. 11.8 N, p fixity to the abdominal wall during laparoscopic surgery declines with time. The insertion of ports using a blunt-tipped trocar is associated with significantly greater stability and fixity of the port to the abdominal wall. The use of blunt-tipped trocars is recommended for routine practice in laparoscopic surgery.

  15. Abdominal wall phlebitis due to Prevotella bivia following renal transplantation in a patient with an occluded inferior vena cava

    NARCIS (Netherlands)

    Janssen, S.; van Donselaar-van der Pant, K. A. M. I.; van der Weerd, N. C.; Develter, W.; Bemelman, F. J.; Grobusch, M. P.; Idu, M. M.; ten Berge, I. J. M.

    2013-01-01

    Pre-existing occlusion of the inferior vena cava may complicate renal transplantation. Suppurative abdominal wall phlebitis following renal transplantation was diagnosed in a patient with pre-existing thrombosis of the inferior vena cava of unknown cause. The phlebitis developed in the subcutaneous

  16. Radiologic analysis of cecal filling defects and local wall displacement

    International Nuclear Information System (INIS)

    Kim, D. I.; Suh, J. S.; Kim, G. E.; Park, C. Y.

    1981-01-01

    It has long been accepted that cecum and ileocecal valve are prime important area in GI roentgenology because of variety and frequency of primary and secondary disease involvement. However, precise preoperative diagnosis is still debatable roentrenologically. It is necessary to use the more descriptive terms and systemic approach for roentgenologic diagnosis in this area. Authors analyzed pathologically verified 54 cases of cecal lesion by double contrast colon examination at Yonsei University Medical College Severance Hospital from January '75 to September '80. Of the distribution of diseases, pericecal abscess (16/54; 29.6%) was most common, and followed by intestinal tuberculosis (9/54; 16.6%), and carcinoma (9/54; 16.6%) etc. The ratio of male and female was 2.18: 1 and peak incidence was above 4th decade. The majority of cases show right lower quadrant pain and palpable mass as clinical manifestation. Of the radiologic findings, abnormality in appendix such as nonfilling or irregular filling of barium suggest pericecal abscess, mucocele and less frequently adenocarcinoma of cecum, and characteristically pericecal abscess show rather smooth displacement of medial wall of cecum, but abrupt transition of lesion is shown in adenocarcinoma. Irritability and shortening of cecum, and fixation and speculation of terminal ileum were frequently found in inflammatory conditions such as pericecal abscess, intestinal tuberculosis and chronic nonspecific inflammation. Cecal lesion associated with involvement of ileocecal value were noted in intestinal tuberculosis, lymphoma and adenocarcinoma

  17. ON-POWER DETECTION OF PIPE WALL-THINNED DEFECTS USING IR THERMOGRAPHY IN NPPS

    Directory of Open Access Journals (Sweden)

    JU HYUN KIM

    2014-04-01

    Full Text Available Wall-thinned defects caused by accelerated corrosion due to fluid flow in the inner pipe appear in many structures of the secondary systems in nuclear power plants (NPPs and are a major factor in degrading the integrity of pipes. Wall-thinned defects need to be managed not only when the NPP is under maintenance but also when the NPP is in normal operation. To this end, a test technique was developed in this study to detect such wall-thinned defects based on the temperature difference on the surface of a hot pipe using infrared (IR thermography and a cooling device. Finite element analysis (FEA was conducted to examine the tendency and experimental conditions for the cooling experiment. Based on the FEA results, the equipment was configured before the cooling experiment was conducted. The IR camera was then used to detect defects in the inner pipe of the pipe specimen that had artificially induced defects. The IR thermography developed in this study is expected to help resolve the issues related to the limitations of non-destructive inspection techniques that are currently conducted for NPP secondary systems and is expected to be very useful on the NPPs site.

  18. Evaluation of antibiotic pressurized pulse lavage for contaminated retromuscular abdominal wall reconstruction.

    Science.gov (United States)

    Majumder, Arnab; Miller, Heidi J; Patel, Parita; Wu, Yuhsin V; Elliott, Heidi L; Novitsky, Yuri W

    2017-07-01

    Despite patient risk factors such as diabetes and obesity, contamination during surgery remains a significant cause of infections and subsequent wound morbidity. Pressurized pulse lavage (PPL) has been utilized as a method to reduce bacterial bioburden with promising results in many fields. Although existing methods of lavage have been utilized during abdominal operations, no studies have examined the use of PPL during complex hernia repair. Patients undergoing abdominal wall reconstruction (AWR) in clean-contaminated or contaminated fields with antibiotic PPL, from January 2012 to May 2013, were prospectively evaluated. Primary outcome measures studied were conversion of retrorectus space culture from positive to negative after PPL and 30-day surgical site infection (SSI) rate. A total of 56 patients underwent AWR, with 44 patients (78.6 %) having clean-contaminated fields and 12 patients (21.4 %) having contaminated ones. Twenty-two patients (39.3 %) had positive pre-PPL cultures, 18 of which (81.8 %) converted to negative cultures after PPL. Eleven patients (19.6 %) developed SSIs. Those with persistently positive cultures after PPL had the highest rate of SSI, where two out of four patients (50.0 %) developed an SSI. Contrastingly, only 5 of 18 patients (27.8 %) who converted from a positive to negative culture after PPL developed an SSI. Our findings demonstrate that antibiotic PPL is an effective method to reduce bacterial bioburden during AWR in clean-contaminated and contaminated fields. While complete conversion and eradication of SSI were not achieved, we believe that PPL may be a useful adjunct to standard operative asepsis in preventing prosthetic contamination during contaminated AWR.

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

    Directory of Open Access Journals (Sweden)

    Tanasković Irena

    2010-01-01

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

  20. Factors affecting outcome of emergency paediatric abdominal surgery

    African Journals Online (AJOL)

    , 6 (2.4%) anterior abdominal wall defects and 5 (2.0%) each of infantile hypertrophic pyloric stenosis and primary peritonitis. Postoperative complications were observed in 85 (33.9%) of patients. The commonest complications were wound ...

  1. A pregnant woman with a surgical site infection after mesh repair of an abdominal wall incisional hernia: a case report.

    Science.gov (United States)

    Ozaki, Kana; Tanimura, Kenji; Ebina, Yasuhiko; Kanemitsu, Kiyonori; Yamada, Hideto

    2017-03-11

    Surgical meshes are widely used in incisional hernia repair. However, there are no reports of pregnancies complicated by infection of surgical meshes used for hernia repair. This is the first case report of a pregnant woman who experienced surgical site infection associated with surgical mesh used for repair of an abdominal wall incisional hernia. We report a case of a 41-year-old pregnant Japanese woman with surgical site infection after mesh repair of an abdominal wall incisional hernia. She was diagnosed with an abdominal wall incisional hernia at 3 months after her third cesarean section, and she underwent an operation of hernia repair with use of monofilament polypropylene mesh 7 months after the third cesarean section. However, a surgical site infection associated with surgical mesh occurred. During antibiotic treatment, she was found to be pregnant. She was referred to our hospital at 13 weeks and 2 days of gestation. The surgeons removed the infected mesh at 16 weeks and 3 days of gestation. Neither the hernia nor infection at the surgical site recurred throughout pregnancy. We planned a cesarean section using a transverse uterine fundal incision method with an upper abdominal incision. The patient delivered a 2478-g healthy female infant. The present report shows that removal of mesh can safely control surgical site infection during pregnancy.

  2. Diffusion-weighted imaging in the evaluation of hormonal cyclic changes in abdominal wall endometriomas

    International Nuclear Information System (INIS)

    Genç, B.; Solak, A.; Şahin, N.; Genç, M.; Oğul, H.; Sivrikoz, O. Nermin; Kantarcı, M.

    2014-01-01

    Aim: To investigate the utility of diffusion-weighted (DW) magnetic resonance imaging (MRI) in the diagnosis of abdominal wall endometrioma (AWE) and to compare the ADC (apparent diffusion coefficient) values of AWE with those of the uterine endometrium during two different phases of the menstrual cycle. Materials and methods: A total of 22 women aged between 27 and 42 years (mean 32.8 years) and who had regular menstrual cycles were included in the study. These patients had a total of 25 AWE lesions. The mean and standard deviation of the ADC values of the normal endometrium/AWE were calculated for the menstrual and luteal phases. All examinations were performed using a 1.5 T magnet (b-values of 50, 400, and 800 mm/s 2 ). The results were analysed using the Shapiro–Wilk test, the Pearson correlation test, the analysis of variance (ANOVA) test, and the paired sample t-test. Results: The ADC values of the endometrium were different in the two phases of the menstrual cycle (menstrual phase: 0.924 ± 0.171; luteal phase: 1.171 ± 0.135). Similarly, the ADC values of the AWE were different in these phases (menstrual phase: 0.937 ± 0.256, luteal phase: 1.256 ± 0.215). In both AWE and the uterine endometrium, the ADC measurements were significantly lower in the menstrual phase than during the luteal phase. This difference was statistically significant (p < 0.05). There was no significant difference in the ADC values between the endometrial layer and AWE during the same phase (p = 0.216 for menstrual phase, p = 0.104 for luteal phase, paired sample t-test). Conclusion: The present study demonstrated that in all patients, the DWI features of AWEs were significantly similar to those of the uterine endometrial tissue. Additionally, the ADC measurements of the patients showed similar cyclical changes. These results suggest that the ADC values of a lesion close to the uterine endometrium may be used to differentiate AWE from the other disease entities of the abdominal wall

  3. Abdominal Wall Reconstruction with Concomitant Ostomy-Associated Hernia Repair: Outcomes and Propensity Score Analysis.

    Science.gov (United States)

    Mericli, Alexander F; Garvey, Patrick B; Giordano, Salvatore; Liu, Jun; Baumann, Donald P; Butler, Charles E

    2017-03-01

    The optimal strategy for abdominal wall reconstruction in the presence of a stomal-site hernia is unclear. We hypothesized that the rate of ventral hernia recurrence in patients undergoing a combined ventral hernia repair and stomal-site herniorraphy would not differ clinically from the ventral hernia recurrence rate in patients undergoing an isolated ventral hernia repair. We also hypothesized that bridged ventral hernia repairs result in worse outcomes compared with reinforced repairs, regardless of stomal hernia. We retrospectively reviewed prospectively collected data from consecutive abdominal wall reconstructions performed with acellular dermal matrix (ADM) at a single center between 2000 and 2015. We compared patients who underwent a ventral hernia repair alone (AWR) and those who underwent both a ventral hernia repair and ostomy-associated herniorraphy (AWR+O). We conducted a propensity score matched analysis to compare the outcomes between the 2 groups. Multivariable Cox proportional hazards and logistic regression models were used to study associations between potential predictive or protective reconstructive strategies and surgical outcomes. We included 499 patients (median follow-up 27.2 months; interquartile range [IQR] 12.4 to 46.6 months), 118 AWR+O and 381 AWR. After propensity score matching, 91 pairs were obtained. Ventral hernia recurrence was not statistically associated with ostomy-associated herniorraphy (adjusted hazard ratio [HR] 0.7; 95% CI 0.3 to 1.5; p = 0.34). However, the AWR+O group experienced a significantly higher percentage of surgical site occurrences (34.1%) than the AWR group (18.7%; adjusted odds ratio 2.3; 95% CI 1.4 to 3.7; p hernia recurrences when the repair was reinforced compared with bridged (5.3% vs 38.5%; p hernia recurrence between the AWR and AWR+O groups. Bridging was associated with an increased rate of hernia recurrence and should be avoided if possible. Copyright © 2016 American College of Surgeons

  4. Effects of Chitosan Coatings on Polypropylene Mesh for Implantation in a Rat Abdominal Wall Model

    Science.gov (United States)

    Udpa, Natasha; Iyer, Shama R.; Rajoria, Rohit; Breyer, Kate E.; Valentine, Helen; Singh, Bhupinder; McDonough, Sean P.; Brown, Bryan N.; Bonassar, Lawrence J.

    2013-01-01

    Hernia repair and pelvic floor reconstruction are usually accompanied with the implantation of a surgical mesh, which frequently results in a foreign body response with associated complications. An ideal surgical mesh that allows force generation of muscle tissues without significant granulation tissue and/or fibrosis is of significant clinical interest. The objective of the present study was to evaluate the in vitro and in vivo responses of a chitosan coating on polypropylene mesh (Ch-PPM) in comparison with commercially available meshes. We found that application of a 0.5% (w/v) Ch-PPM elicited preferential attachment of myoblasts over fibroblast attachment in vitro. Therefore, we test the hypothesis that 0.5% Ch-PPM will encourage skeletal muscle tissue ingrowth and decrease fibrosis formation in vivo. We implanted 0.5% Ch-PPM, collagen-coated polypropylene mesh (Pelvitex™; C.R. Bard), and polypropylene (Avaulta Solo®; C.R. Bard) alone using a rat abdominal defect model. Force generation capacity and inflammatory response of each mesh were evaluated 2, 4, and 12 weeks postimplantation. We found that chitosan coating is associated with the restoration of functional skeletal muscle with histomorphologic characteristics that resemble native muscle and an early macrophage phenotypic response that has previously been shown to lead to more functional outcomes. PMID:23859182

  5. The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair: a single institutional review and derived cost analysis.

    Science.gov (United States)

    Azoury, S C; Rodriguez-Unda, N; Soares, K C; Hicks, C W; Baltodano, P A; Poruk, K E; Hu, Q L; Cooney, C M; Cornell, P; Burce, K; Eckhauser, F E

    2015-12-01

    The authors evaluated the ability of a fibrin sealant (TISSEEL™: Baxter Healthcare Corp, Deerfield, IL, USA) to reduce the incidence of post-operative seroma following abdominal wall hernia repair. We performed a 4-year retrospective review of patients undergoing abdominal wall hernia repair, with and without TISSEEL, by a single surgeon (FEE) at The Johns Hopkins Hospital. Demographics, surgical risk factors, operative data and 30-day outcomes, including wound complications and related interventions, were compared. The quantity and cost of Tisseel per case was reviewed. A total of 250 patients were evaluated: 127 in the TISSEEL group and 123 in the non-TISSEEL control group. The average age for both groups was 56.6 years (P = 0.97). The majority of patients were female (TISSEEL 52.8%, non-TISSEEL 56.1%, P = 0.59) and ASA Class III (TISSEEL 56.7%, non-TISSEEL 58.5%, P = 0.40). There was no difference in the average defect size for both groups (TISSEEL 217 ± 187.6 cm(2), non-TISSEEL 161.3 ± 141.5 cm(2), P = 0.36). Surgical site occurrences occurred in 18.1% of the TISSEEL and 13% of the non-TISSEEL group (P = 0.27). There was a trend towards an increased incidence of seroma in the TISSEEL group (TISSEEL 11%, non-TISSEEL 4.9%, P = 0.07). A total of $124,472.50 was spent on TISSEEL, at an average cost of $995.78 per case. In the largest study to date, TISSEEL™ application offered no advantage for the reduction of post-operative seroma formation following complex abdominal hernia repair. Moreover, the use of this sealant was associated with significant costs.

  6. Effects of weight reduction surgery on the abdominal wall fascial wound healing process.

    Science.gov (United States)

    Krpata, David M; Criss, Cory N; Gao, Yue; Sadava, Emmanuel E; Anderson, James M; Novitsky, Yuri W; Rosen, Michael J

    2013-09-01

    Bariatric surgery patients enter into a catabolic state postoperatively, which can lead to an aberrant wound healing process. To improve the future treatment of morbidly obese patients, the aim of our study was to understand the link between bariatric surgery and alterations in the wound healing processes. A total of 18 morbidly obese Zucker rats were separated into three groups and underwent one of three surgical procedures: Roux-en-Y gastric bypass (RYGB; n = 6); sleeve gastrectomy (GS; n = 6); or midline laparotomy only (n = 6). The rats were weighed on postoperative day 0, 3, 7, and 14. On day 14, the abdominal wall was harvested and underwent histologic and biomechanical evaluation. A significant difference was found in the weight gain between the laparotomy control group (LC) and bariatric surgical groups at 7 and 14 d. By postoperative day 7, the GS and RYGB rats weighed significantly less than the LC group, losing, on average, 7% and 6% of their initial body weight, respectively, and the LC gained 4% of their weight (P gained 20% of their original weight, and the two bariatric groups both weighed significantly less (P bariatric surgery negatively affects wound healing both histologically and biomechanically compared with nonbariatric models. Although obesity remains a significant factor in the wound healing process, understanding the link between bariatric surgery and alterations in wound healing is imperative before advocating simultaneous repair of ventral hernias during concomitant bariatric surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Unexpected Abscess Localization of the Anterior Abdominal Wall in an ADPKD Patient Undergoing Hemodialysis

    Directory of Open Access Journals (Sweden)

    Nikos Sabanis

    2015-01-01

    Full Text Available Autosomal Dominant Polycystic Kidney Disease (ADPKD is one of the most common monogenic disorders and the leading inheritable cause of end-stage renal disease worldwide. Cystic and noncystic extrarenal manifestations are correlated with variable clinical presentations so that an inherited disorder is now considered a systemic disease. Kidney and liver cystic infections are the most common infectious complications in ADPKD patients. Furthermore, it is well known that ADPKD is commonly associated with colonic diverticular disease which recently has been reported to be linked to increased risk of infection on hemodialysis patients. Herein, we present a case of anterior abdominal wall abscess caused by Enterococcus faecalis in a patient with ADPKD undergoing hemodialysis. Although the precise pathway of infection remains uncertain, the previous medical history as well as the clinical course of our patient led us to hypothesize an alternative route of infection from the gastrointestinal tract through an aberrant intestinal barrier into the bloodstream and eventually to an atypical location.

  9. Machine Learning Approach for Predicting Wall Shear Distribution for Abdominal Aortic Aneurysm and Carotid Bifurcation Models.

    Science.gov (United States)

    Jordanski, Milos; Radovic, Milos; Milosevic, Zarko; Filipovic, Nenad; Obradovic, Zoran

    2018-03-01

    Computer simulations based on the finite element method represent powerful tools for modeling blood flow through arteries. However, due to its computational complexity, this approach may be inappropriate when results are needed quickly. In order to reduce computational time, in this paper, we proposed an alternative machine learning based approach for calculation of wall shear stress (WSS) distribution, which may play an important role in mechanisms related to initiation and development of atherosclerosis. In order to capture relationships between geometric parameters, blood density, dynamic viscosity and velocity, and WSS distribution of geometrically parameterized abdominal aortic aneurysm (AAA) and carotid bifurcation models, we proposed multivariate linear regression, multilayer perceptron neural network and Gaussian conditional random fields (GCRF). Results obtained in this paper show that machine learning approaches can successfully predict WSS distribution at different cardiac cycle time points. Even though all proposed methods showed high potential for WSS prediction, GCRF achieved the highest coefficient of determination (0.930-0.948 for AAA model and 0.946-0.954 for carotid bifurcation model) demonstrating benefits of accounting for spatial correlation. The proposed approach can be used as an alternative method for real time calculation of WSS distribution.

  10. Cloacal Exstrophy : An Epidemiologic Study From the International Clearinghouse for Birth Defects Surveillance and Research

    NARCIS (Netherlands)

    Feldkamp, Marcia L.; Botto, Lorenzo D.; Amar, Emmanuelle; Bakker, Marian K.; Bermejo-Sanchez, Eva; Bianca, Sebastiano; Canfield, Mark A.; Castilla, Eduardo E.; Clementi, Maurizio; Csaky-Szunyogh, Melinda; Leoncini, Emanuele; Li, Zhu; Lowry, R. Brian; Mastroiacovo, Pierpaolo; Merlob, Paul; Morgan, Margery; Mutchinick, Osvaldo M.; Rissmann, Anke; Ritvanen, Annukka; Siffel, Csaba; Carey, John C.

    2011-01-01

    Cloacal exstrophy presents as a complex abdominal wall defect thought to result from a mesodermal abnormality. Anatomically, its main components are Omphalocele, bladder Exstrophy and Imperforate anus. Other associated malformations include renal malformations and Spine defects (OEIS complex).

  11. Clinical experience with titanium mesh in reconstruction of massive chest wall defects following oncological resection

    Science.gov (United States)

    Yang, Haitang; Tantai, Jicheng

    2015-01-01

    Objectives To present our experience of reconstructing wide defects with porously titanium mesh after radical resection of malignant chest wall tumors. Methods A retrospective review of surgical reconstruction for large chest wall resections with titanium mesh was conducted from January 2009 to August 2014 in Shanghai Chest Hospital. Results A total of 27 patients underwent major chest wall reconstructions with titanium mesh, following oncological resections. Chest wall sarcomas were the most frequent (63.0%). The mean tumor size was 72.4 (range, 36-140) cm2. The average size of the applied porously titanium mesh was 140.9 (range, 80-225) cm2. Mean postoperative length of stay was 7.1 (range, 4-14) days. There were no perioperative mortalities. Four (14.8%) patients experienced treatable complications. All had a resection of at least 3 ribs (median 3, mean 3.5 ribs). A total of 22 patients underwent ribs without sternal resections, and five patients underwent partial sternal resections with adjacent costal cartilage. Anterior chest wall resections were performed in 13 patients while lateral chest wall resections were performed in 9 patients. Three patients had extended resections beyond the chest wall in patients with primary chest wall malignancies, including two with wedge resections of lung and one with partial resection of pericardium. No patient was lost to follow-up. Mean follow-up was 30.7 months. Neither chest wall instability nor wound infection/necrosis was observed. Of these, 23 patients (85.2%) were alive at the last follow-up. Local recurrence was detected in three cases. The 5-year disease-free and overall survivals of primary chest tumors were 72.1% and 80.8%, respectively. Conclusions Our results showed that chest wall reconstruction utilizing synthetic titanium meshes following extensive resections of the chest wall malignant tumors allowed adequate resection size, with acceptable complications and survival benefits. PMID:26380739

  12. Malignant granular cell tumor of the abdominal wall mimicking desmoid tumor: A case report with CT imaging findings and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Je Hong; Ahn, Sung Eun; Lee, Dong Ho; Park, Seong Jin; Moon, Sung Kyoung; Lim, Joo Won [Dept. Radiology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2016-08-15

    Granular cell tumors (GCTs) are extremely rare mesenchymal neoplasms of Schwann cell origin. Malignant GCTs (MGCTs) comprise 0.5-2% of all GCTs. In the present report, we describe a case of a 66-year-old man with MGCT of the abdominal wall. The patient visited our hospital due to a recently growing palpable soft tissue mass in the abdominal wall. Computed tomography scan revealed a 4.3 × 4.1 × 2.9 cm sized mass arising from the left abdominal wall, which was contemplated as a desmoid tumor before surgical excision. Histopathological examination confirmed MGCT.

  13. Individual design and rapid prototyping in reconstruction of orbital wall defects.

    Science.gov (United States)

    Tang, Wei; Guo, Lijuan; Long, Jie; Wang, Hang; Lin, Yunfeng; Liu, Lei; Tian, Weidong

    2010-03-01

    We examined the application of individual digital design and rapid prototyping in the reconstruction of orbital wall defects for different stages of orbital volume (OV) changes. Patients with unilateral post-traumatic orbital defects underwent individual digital design and rapid prototyping to manufacture specific titanium mesh implants to create ideal OV recovery. Features of orbital wall fracture deformities and OV changes were analyzed and measured with 3-Dimensional Medical Surface Rendering image software system. Most cases involving enophthalmos and diplopia were rectified, except for 5 cases of enophthalmos and 2 cases of diplopia with fresh fractures and 11 cases of enophthalmos and 7 cases of diplopia cases with old fractures. Ocular movements and facial malformations were improved. The OV values between the uninjured and injured sides had a significant deviation (P orbital wall fractures can be diagnosed in early fracture stages and that the degree of long-term enophthalmos can be predicted with 3-Dimensional Medical Surface Rendering software. Our results suggest that early-stage orbital wall fractures should recover OV as early as possible, and that advanced stage orbital wall fractures should overcorrect OV. The degree of accuracy and rational of OV reconstruction can be improved by appropriate individual digitalization design and rapid prototyping technology. Copyright (c) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  14. MULTIMODALITY THERAPY FOR OSTEOSARCOMA OF THE STERNUM WITH RECONSTRUCTION OF COMPLEX CHEST WALL DEFECTS

    Directory of Open Access Journals (Sweden)

    V. E. Ivanov

    2017-01-01

    Full Text Available Background. Osteosarcoma is a high-grade malignant bone tumor that accounts for up to 6 % of all bone neoplasms. There are only a few published cases of primary sternal osteosarcomas, reflecting the rarity of these tumors. Recently, there has been a growing interest in performing radical excisions of chest wall tumors followed by combined single-stage reconstruction of the rib cage with implants made of biologically compatible materials. Material and methods. We present the case of a 49-year-old woman diagnosed with osteosarcoma of the sternum. The patient received a combined modality treatment including chemotherapy, radiotherapy and surgery. Titanium nickelid implants were used for the reconstruction of chest wall defects. Results. The multimodality treatment with reconstruction of postoperative chest wall defects allowed the achievement of the optimal quality of life for 21 months in the patient with very poor prognosis. Conclusion. The chest wall reconstruction using biocompatible materials from titanium nickelid appeared to be an effective and safe technique for the treatment of chest wall tumors.

  15. Gasless laparoscopic surgery plus abdominal wall lifting for giant hiatal hernia-our single-center experience.

    Science.gov (United States)

    Yu, Jiang-Hong; Wu, Ji-Xiang; Yu, Lei; Li, Jian-Ye

    2016-12-01

    Giant hiatal hernia (GHH) comprises 5% of hiatal hernia and is associated with significant complications. The traditional operative procedure, no matter transthoracic or transabdomen repair of giant hiatal hernia, is characteristic of more invasion and more complications. Although laparoscopic repair as a minimally invasive surgery is accepted, a part of patients can not tolerate pneumoperitoneum because of combination with cardiopulmonary diseases or severe posterior mediastinal and neck emphesema during operation. The aim of this article was to analyze our experience in gasless laparoscopic repair with abdominal wall lifting to treat the giant hiatal hernia. We performed a retrospective review of patients undergoing gasless laparoscopic repair of GHH with abdominal wall lifting from 2012 to 2015 at our institution. The GHH was defined as greater than one-third of the stomach in the chest. Gasless laparoscopic repair of GHH with abdominal wall lifting was attempted in 27 patients. Mean age was 67 years. The results showed that there were no conversions to open surgery and no intraoperative deaths. The mean duration of operation was 100 min (range: 90-130 min). One-side pleura was injured in 4 cases (14.8%). The mean postoperative length of stay was 4 days (range: 3-7 days). Median follow- up was 26 months (range: 6-38 months). Transient dysphagia for solid food occurred in three patients (11.1%), and this symptom disappeared within three months. There was one patient with recurrent hiatal hernia who was reoperated on. Two patients still complained of heartburn three months after surgery. Neither reoperation nor endoscopic treatment due to signs of postoperative esophageal stenosis was required in any patient. Totally, satisfactory outcome was reported in 88.9% patients. It was concluded that the gasless laparoscopic approach with abdominal wall lifting to the repair of GHH is feasible, safe, and effective for the patients who cannot tolerate the pneumoperitoneum.

  16. Reduced Chest and Abdominal Wall Mobility and Their Relationship to Lung Function, Respiratory Muscle Strength, and Exercise Tolerance in Subjects With COPD.

    Science.gov (United States)

    Kaneko, Hideo; Shiranita, Shuichi; Horie, Jun; Hayashi, Shinichiro

    2016-11-01

    Advanced air-flow limitation in patients with COPD leads to a reduction in vital capacity, respiratory muscle strength, and exercise capacity. However, its impact on chest and abdominal wall mobility is unknown. This study aimed to ascertain the prevalence of patients with COPD with reduced chest and abdominal wall mobility and to investigate the effect of reduced chest and abdominal wall mobility on pulmonary function, respiratory muscle strength, and exercise capacity. In 51 elderly male subjects with COPD, chest and abdominal wall mobility, FVC, FEV 1 , FEV 1 /FVC, maximal inspiratory pressure (P Imax ), maximal expiratory pressure (P Emax ), and the 6-min walk distance (6MWD) were assessed. Chest and abdominal wall mobility were measured using the breathing movement scale (0-8) at the 3 regions (upper chest, lower chest, and abdomen). Reduced mobility was defined as a value lower than the lower limit of the normal scale. The unpaired t test, Mann-Whitney test, and multiple regression analysis were performed. The percentages of subjects with reduced mobility were 78% for the upper chest, 76% for the lower chest, and 53% for the abdomen. The subjects with reduced mobility had significantly low FVC, FEV 1 , and 6MWD in each region and significantly low FEV 1 /FVC, P Imax , and P Emax in the abdominal region compared with those with nonreduced mobility. FVC and 6MWD were independently associated with the scale values in each region and with the abdominal scale value, respectively. The majority of subjects with COPD had reduced chest and abdominal wall mobility, which was independently associated with FVC. Even though abdominal wall mobility was relatively preserved compared with chest wall mobility, it was also independently associated with 6MWD. Copyright © 2016 by Daedalus Enterprises.

  17. Imaging observations of a schwannoma of low malignant potential in the anterior abdominal wall: A case report.

    Science.gov (United States)

    Liu, Yongkang; Chen, Xiao; Wang, Tianyao; Wang, Zhongqiu

    2014-09-01

    Neurilemmoma, also known as schwannoma, is an uncommon benign neoplasm that is most commonly found in the trunk and head and neck regions. The present study reports the case of a 67-year-old female with schwannoma localized in the anterior abdominal wall and analyzes the ultrasound and computed tomography (CT) imaging observations of the schwannoma. A dynamic time-intensity curve was also recorded in the study. A well-defined, elliptic low echo level, heterogeneous mass was observed during ultrasound examination. The CT scan revealed a solid, heterogeneous, low-density mass in the abdominal wall. Contrast-enhanced scans showed a heterogeneously enhanced mass during the arterial and venous phase. Centripetal fill-in was demonstrated and the mass was markedly, homogenously enhanced relative to the muscles during the delayed phase. Peak enhancement was observed during the venous phase and then slowly declined. However, the mass was hyperattenuated during the delayed phase. The lesion was completely excised and no evidence of recurrence has been identified during the 3 months of follow-up. The present study suggested that a diagnosis of schwannoma should be considered for certain patients with masses in the abdominal wall. Peripheral enhancement during the arterial and venous phases and homogeneous enhancement in the delayed phase are the significant imaging findings of a schwannoma.

  18. The venous anatomy of the abdominal wall for Deep Inferior Epigastric Artery (DIEP) flaps in breast reconstruction

    Science.gov (United States)

    Ashton, Mark W

    2012-01-01

    Background Despite improving outcomes, venous problems in the harvest of deep inferior epigastric artery perforator (DIEP) flaps remain the more common vascular complications. However, it is apparent that the venous anatomy of the anterior abdominal wall has not been described to the same extent as the arterial anatomy. Cadaveric dissection studies of venous anatomy frequently lack the detail of their arterial counterparts. Venous valves complicate retrograde injection, resulting in poor quality studies with limited anatomical information. Methods The current manuscript comprises a review of the literature, highlighting key features of the anatomy of the venous drainage of the abdominal wall integument, with particular pertinence to DIEP flaps. Both cadaveric and clinical studies are included in this review. Our own cadaveric and in-vivo studies were undertaken and included in detail in this manuscript, with the cadaveric component utilizing direct catheter venography and the in-vivo studies were undertaken using preoperative computed tomographic angiography (CTA), mapping in-vivo venous flow. Results Several key features of the venous anatomy of the abdominal wall render it different to other regions, and are of particular importance to DIEP flap transfer. Conclusions The cause of venous compromise is multi-factorial, with perforator diameter, midline crossover, and deep-superficial venous communications all important. Venous cadaveric studies as well as clinical CTA preoperatively can identify these anomalies. PMID:25083432

  19. Reconstruction of Large Full Thickness Chest Wall Defects Following Resection of Malignant Tumors

    International Nuclear Information System (INIS)

    Khalil, E.A.; El-Zohairy, M.A.; Bukhari, M.

    2010-01-01

    Full-thickness chest wall resection is the well-established treatment for primary or metastatic chest wall tumors. Adequate surgery with large resections is always needed to achieve a radical resection in healthy tissues, leading to optimal local control of the disease. The purpose of this study is to present our experience in chest wall reconstruction after major tumor resection. Patients and Methods: Between January 2006 and January 2010, 18 consecutive patients who underwent major chest wall resections for primary or metastatic chest wall tumors were studied. All had resection of at least three ribs and immediate reconstruction. Surgical procedures, extent of the resection, resulting defects and postoperative morbidity and mortality were discussed. Results: Surgical indications included primary, recurrent and metastatic chest wall neoplasms, sarcoma and recurrent breast cancer were the most frequent diagnoses. Resection of 3 ribs was performed in 8 patients, while resection of more than 3 ribs was performed in 10 patients. Resection of sternum and adjacent costal cartilages was performed in one patient, right chest wall resections were performed in 7 patients while left chest wall resections were performed in 10 patients. Immediate repair of the defects was performed in all cases, all patient had placement of prosthesis either polypropylene or polytetrafluoroethylene, 3 patients had methylacrylate in addition to the prosthesis. Coverage w as achieved using myocutaneous flaps in 7 patients. Mechanical ventilation was needed in 11 patients with a mean duration of ventilation 2.211.8 days (range between 1- 6 days). No 30-days mortality was recorded. Four patients 22.2% developed complications, 2 patients need prolonged mechanical ventilation for respiratory insufficiency and 2 patients had partial flap necrosis and wound infection. Mean hospital stay was 10.1±3.2 days. Conclusion: Immediate reconstruction of large full thickness chest wall defects following

  20. Motorbike-handlebar hernia - a rare traumatic abdominal wall hernia: a case report and review of the literature.

    Science.gov (United States)

    Tianyi, Frank-Leonel; Agbor, Valirie Ndip; Njim, Tsi

    2017-03-31

    Handlebar hernias are very rare and arise following a sudden force from a handle-like object impacting a focal area of the abdomen, which results in a disruption of the underlying abdominal muscle and fascia without necessarily disrupting the overlying skin. Other than a reducible swelling on the abdominal wall, the physical examination of such patients is usually unremarkable and the diagnosis could easily be missed. An 8-year-old Cameroonian boy with no significant past history presented to our emergency service with a tender left flank swelling following a road traffic accident. He was knocked down by a motorbike with resulting impact of the handlebar on his abdomen. A handlebar hernia was diagnosed on the basis of a reducible abdominal swelling with a positive cough impulse. A herniorrhaphy was done the following day after resuscitation and his postoperative period was uneventful. Handlebar hernias, although rare, should be suspected when patients present with an abdominal swelling following blunt abdominal trauma involving a handlebar-like object. A good history and physical examination are usually enough to pose an early diagnosis of handlebar hernia. Management typically involves surgical intervention to prevent complications. The timing and surgical approach should be decided on a case-by-case basis.

  1. Electromyographic activity of the anterolateral abdominal wall muscles during the vesical filling and evacuation

    Directory of Open Access Journals (Sweden)

    Ahmed Shafik

    2007-06-01

    Full Text Available

    BACKGROUND: The role of the anterolateral abdominal wall muscles (AAWMs during the vesical filling and evacuation has not been sufficiently addressed in the literature. We have investigated the hypothesis that the AAWMs exhibit the increased electromyographic (EMG activity on the vesical distension and contraction which presumably assists vesical evacuation.

    METHODS: The effects of the vesical balloon distension on the vesical pressure (VP, vesical neck (VNP pressures and the AAWMs' EMG activity were studied in 28 healthy volunteers aged 40.7 ± 9.7 years (18 men, 10 women. These effects were tested after the individual anesthetization of the bladder and AAWMs and after saline infiltration.

    RESULTS: The VP and the VNP showed a gradual increase upon the incremental vesical balloon distension which started at a distending volume of 120–140 ml. At a mean volume of 364.6 ± 23.8 ml, the VP increased to a mean of 36.6 ± 3.2 cmH2O, the VNP decreased to 18.4 ± 2.4 cmH2O, and the AAWMs EMG registered a significant increase. This effect disappeared in the individual bladder and in the AAWMs' anesthetization. However, it did not disappear in the saline administration.

    CONCLUSIONS: The AAWMs appear to contract simultaneously with vesical contraction. This action presumably increases the IAP and it

  2. Effect of botulinum toxin type A in lateral abdominal wall muscles thickness and length of patients with midline incisional hernia secondary to open abdomen management.

    Science.gov (United States)

    Ibarra-Hurtado, T R; Nuño-Guzmán, C M; Miranda-Díaz, A G; Troyo-Sanromán, R; Navarro-Ibarra, R; Bravo-Cuéllar, L

    2014-10-01

    Abdominal wall hernia secondary to open abdomen management represents a surgical challenge. The hernia worsens due to lateral muscle retraction. Our objective was to evaluate if Botulinum Toxin Type A (BTA) application in lateral abdominal wall muscles modifies its thickness and length. A clinical trial of male trauma patients with hernia secondary to open abdomen management was performed from January 2009 to July 2011. Thickness and length of lateral abdominal muscles were measured by a basal Computed Tomography and 1 month after BTA application. A dosage of 250 units of BTA was applied at five points at each side between the external and internal oblique muscles under ultrasonographic guidance. Statistical analysis for differences between basal and after BTA application measures was performed by a paired Student's t test (significance: p abdominal muscles decreases its thickness and increases its length in abdominal wall hernia patients secondary to open abdomen management.

  3. Cyclodextrin and maltodextrin finishing of a polypropylene abdominal wall implant for the prolonged delivery of ciprofloxacin.

    Science.gov (United States)

    Laurent, T; Kacem, I; Blanchemain, N; Cazaux, F; Neut, C; Hildebrand, H F; Martel, B

    2011-08-01

    The aim of this work was to develop a polypropylene (PP) artificial abdominal wall implant for the prolonged release of ciprofloxacin (CFX). This sustained release effect was obtained by functionalization of the textile mesh with citric acid and hydroxypropyl-γ-cyclodextrin (HPγCD) or maltodextrin (MD). In both cases the textile finishing reaction yielded a cyclo- or malto-dextrin crosslinked polymer coating the fibers. The modified supports were characterized by thermogravimetric analysis (TGA), differential scanning calorimetry and scanning electron microscopy. The sorption capacities and the kinetics of CFX release were studied by batch tests coupled with spectrophotometric assays. Microbiological assays were carried out on Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli, while proliferation and viability tests used fibroblasts. The main results were as follows. (i) Due to the differences between the range of temperature of thermal degradation of the (cyclo)dextrins polymers and of the PP fibers TGA was a reliable method for quantifying the degree of functionalization of the textiles. (ii) Both modified supports showed improved sorption/desorption capacities for CFX, compared with the virgin mesh. The HPγCD-finished support showed an increased sorption capacity and a lower release rate of CFX compared with the MD modified support. (iii) Microbiological assays confirmed the latter result, with greater sustained antibacterial activity of the HPγCD treated support. These experiments have demonstrated the role of the cyclodextrin cavity in interactions with CFX: the antibiotic was not only adsorbed via hydrogen and acid-base interactions with the polyCTR-HPγCD network, but also via host-guest complexation. (iv) Biological tests revealed a slight decrease in fibroblast proliferation after 6 days on the modified supports, but cell viability tests showed that this was not due to toxicity of the (cyclo)dextrin polymer coatings. Copyright

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Use of intraoperative indocyanin-green angiography to minimize wound healing complications in abdominal wall reconstruction.

    Science.gov (United States)

    Patel, Ketan M; Bhanot, Parag; Franklin, Brenton; Albino, Frank; Nahabedian, Maurice Y

    2013-12-01

    Complication rates following abdominal wall reconstruction (AWR) remain high. Early complications are related to skin necrosis and delayed healing, whereas late complications are related to recurrence. When concomitant body contouring procedures are performed, complication rates can be further increased. It is hypothesised that fluorescent angiography using indocyanin green (ICG) can identify poorly perfused tissues and thus reduce the incidence of delayed healing. A retrospective review was conducted of all patients who underwent AWR with concomitant panniculectomy from 2007-2012. Intraoperative ICG angiography with the SPY system (LifeCell Corp.) was used to determine the amount of resection for body contouring in patients who underwent reconstruction in a cohort of patients. SPY-Q was used to assess relative perfusion of analysed areas. Preoperative, postoperative, and operative details were analyzed. Seventeen patients met inclusion criteria, 12 patients were included in the non-ICG cohort, while five patients were included in the ICG cohorts. Wound-healing complications occurred in 5/12 (42%) patients in the non-ICG cohort vs 1/5 (20%) of the ICG cohorts. A description of the sole patient with complications in the ICG cohort is illustrated. Operative debridement and wound infection development occurred more frequently in the non-ICG cohort compared with the ICG cohort (17%, 17% vs 0%, 0%, respectively). Average time to wound healing was 41.1 days. Intraoperative ICG angiography can accurately detect perfusion abnormalities and can decrease wound healing related complications in complex hernia repair with concomitant panniculectomy. Assessing and ensuring skin viability can decrease the need for operative debridement.

  6. Purity and Defect Characterization of Single-Wall Carbon Nanotubes Using Raman Spectroscopy

    Directory of Open Access Journals (Sweden)

    Yasumitsu Miyata

    2011-01-01

    Full Text Available We investigated the purity and defects of single-wall carbon nanotubes (SWCNTs produced by various synthetic methods including chemical vapor deposition, arc discharge, and laser ablation. The SWCNT samples were characterized using scanning electron microscopy (SEM, thermogravimetric analysis (TGA, and Raman spectroscopy. Quantitative analysis of SEM images suggested that the G-band Raman intensity serves as an index for the purity. By contrast, the intensity ratio of G-band to D-band (G/D ratio reflects both the purity and the defect density of SWCNTs. The combination of G-band intensity and G/D ratio is useful for a quick, nondestructive evaluation of the purity and defect density of a SWCNT sample.

  7. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  8. Measurement of defect size and location of wall thinned pipe using ESPI and shearography

    Science.gov (United States)

    Kim, Kyeongsuk; Jung, Dukwoon; Chang, Hosub; Jung, Hyunchul

    2010-03-01

    To keep the safety of the nuclear reactor and prevent the destruction of the environment, it is important to evaluate integrity of piping used in the nuclear power plant. Many kinds of the non-destructive testing methods for the nuclear components have been developed. Especially, measurement techniques using laser provide the high accuracy, the high speed, and the convenience. ESPI and shearography are well known techniques as the optic-based non-destructive measurement method. The goal of this paper is to present the standard of measurement technique using laser for the wall-thinned pipes. In order to achieve this goal, the out-of-plane deformation of the wall-thinned pipes is quantitatively measured by using ESPI and shearography and the results are compared each other. Various kinds of specimen which have respect to the minimum thickness, the width, and the length of a wall-thinning defect are prepared. The size and the shape of a wall-thinning defect are measured by using ESPI and shearography. According to the comparison results, the applicability for the piping used in the nuclear power plant is verified and the measurable range is analyzed.

  9. Clinical anatomy of the inferior epigastric artery with special relevance to invasive procedures of the anterior abdominal wall

    Directory of Open Access Journals (Sweden)

    Praisy Joy

    2017-01-01

    Full Text Available Introduction: Injury to the inferior epigastric artery (IEA has been reported following lower abdominal wall surgical incisions, abdominal peritoneocentesis and trocar placements at laparoscopic port sites, resulting in the formation of abdominal wall haematomas that may expand considerably due to lack of tissue resistance. The aim of this study was to localise its course in relation to standard anatomic landmarks and suggest safe areas for performance of invasive procedures. Materials and Methods: Sixty IEAs of 30 adult cadavers (male = 19; female = 11 were dissected and the course of the IEA noted in relation to the mid-inguinal point, anterior superior iliac spine (ASIS and umbilicus. Results: The mean distance of the IEA from the midline was 4.45 ± 1.42 cm at the level of the mid-inguinal point, 4.10 ± 1.15 cm at the level of ASIS and 4.49 ± 1.15 cm at the level of umbilicus. There was an average of 3.3 branches per IEA with more branches arising from its lateral aspect. The IEA was situated within one-third (32% of the distance between the midline and the sagittal plane through ASIS at all levels. Conclusion: To avoid injury to IEA, trocars can be safely inserted 5.5 cm [mean + 1 standard deviation (SD] away from the midline (or slightly more than one-third of the distance between the midline and a sagittal plane running through ASIS. These findings may be useful not only for laparoscopic procedures but also for image-guided biopsy, abdominal paracentesis, and placement of abdominal drains.

  10. Chest wall mechanics and abdominal pressure during general anaesthesia in normal and obese individuals and in acute lung injury.

    Science.gov (United States)

    Pelosi, Paolo; Luecke, Thomas; Rocco, Patricia R M

    2011-02-01

    This article discusses the methods available to evaluate chest wall mechanics and the relationship between intraabdominal pressure (IAP) and chest wall mechanics during general anaesthesia in normal and obese individuals, as well as in acute lung injury/acute respiratory distress syndrome. The interactions between the abdominal and thoracic compartments pose a specific challenge for intensive care physicians. IAP affects respiratory system, lung and chest wall elastance in an unpredictable way. Thus, transpulmonary pressure should be measured if IAP is more than 12 mmHg or if chest wall elastance is compromised for other reasons, even though the absolute values of pleural and transpulmonary pressures are not easily obtained at bedside. We suggest defining intraabdominal hypertension (IAH) as IAP at least 20 mmHg and abdominal compartment syndrome (ACS) as IAP at least 20 mmHg associated with failure of one or more organs, although further studies are required to confirm this hypothesis. Additionally, in the presence of IAH, controlled mechanical ventilation should be applied and positive end-expiratory pressure individually titrated. Prophylactic open abdomen should be considered in the presence of ACS. Increased IAP markedly affects respiratory function and complicates patient management. Frequent assessment of IAP is recommended.

  11. Tensile Characterization of Single-Walled Carbon Nanotubes with Helical Structural Defects.

    Science.gov (United States)

    Jhon, Young I; Kim, Chulki; Seo, Minah; Cho, Woon Jo; Lee, Seok; Jhon, Young Min

    2016-02-04

    Recently, evidence was presented that certain single-walled carbon nanotubes (SWNTs) possess helical defective traces, exhibiting distinct cleaved lines, yet their mechanical characterization remains a challenge. On the basis of the spiral growth model of SWNTs, here we present atomic details of helical defects and investigate how the tensile behaviors of SWNTs change with their presence using molecular dynamics simulations. SWNTs have exhibited substantially lower tensile strength and strain than theoretical results obtained from a seamless tubular structure, whose physical origin cannot be explained either by any known SWNT defects so far. We find that this long-lasting puzzle could be explained by assuming helical defects in SWNTs, exhibiting excellent agreement with experimental observation. The mechanism of this tensile process is elucidated by analyzing atomic stress distribution and evolution, and the effects of the chirality and diameter of SWNTs on this phenomenon are examined based on linear elastic fracture mechanics. This work contributes significantly to our understanding of the growth mechanism, defect hierarchies, and mechanical properties of SWNTs.

  12. Analysis of Side-Wall Structure of Grown-in Twin-Type Octahedral Defects in Czochralski Silicon

    Science.gov (United States)

    Ueki, Takemi; Itsumi, Manabu; Takeda, Tadao

    1998-04-01

    We analyzed the side-wall structure of grown-in octahedral defects in Czochralski silicon standard wafers for large-scale integrated circuits. There are two types of twin octahedral defects: an overlapping type and an adjacent type. In the twin octahedral defects of the overlapping type, a hole is formed in the connection part. The side-wall layer in the hole part is formed continually and is the same thickness as the side-wall layers of both octahedrons. In the twin octahedral defects of the adjacent type, a partition layer is formed in the connection part. Our electron energy-loss spectroscopy analyses identified that the side-wall layer includes SiO2.

  13. Evaluation of cell sheet application on one wall bone defect in Macaca nemestrina through periostin expression

    Science.gov (United States)

    Tamin, R. Y.; Soeroso, Y.; Amir, L.; Idrus, E.

    2017-08-01

    Chronic periodontitis is an oral disease in which the destruction of periodontal tissue leads to tooth loss. Regenerative therapy for attachment cannot be applied to one wall bone defects owing to the minimal existing healthy bone. Tissue engineering in the form of cell sheets has been developed to overcome this limitation. In a previous study, cell sheet application to a one wall bone defect in Macaca nemestrina showed good clinical results. To evaluate the effectiveness of cell sheet application histologically, the level of periostin expression in the gingival crevicular fluid (GCF) of M. nemestrina was determined. Periostin is a 90-kDa protein that regulates coordination and interaction for regeneration and tissue repair. A laboratory observation study was performed to see the differences in periostin levels in samples collected from M. nemestrina’s GCF, where a cell sheet was applied to the bone defect. Gel electrophoresis with SDS-PAGE was performed to detect periostin expression based on its molecular weight and to compare the expression band between the cell sheet and the control at 1, 2, and 3 weeks after treatment. The gel electrophoresis result shows different thicknesses of the protein band around the molecular weight of periostin between the cell sheet groups.

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

    Directory of Open Access Journals (Sweden)

    Ilhan Bali

    2015-04-01

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

  15. Erosion of small intestine with necrotising fasciitis of over lying abdominal wall after expanded poly-tetrafluoroethylene mesh implantation: A rare complication after laparoscopic incisional hernia repair

    Directory of Open Access Journals (Sweden)

    Ashish Shrivastava

    2013-01-01

    Full Text Available Complications such as bowel erosions, enterocutaneous fistulae are rare with the use of expandedpoly-tetrafluoroethylene (ePTFE mesh in laparoscopic incisional hernia repair (LIHR. This unusual case patient presented to us with necrotising fasciitis of overlying anterior abdominal wall with peritonitis withsepticaemia and underwent aLIHR6 weeks before, which has not been reported till yet. We report a case of LIHR, presented to us with necrotising fasciitis of overlying anterior abdominal wall, peritonitis and septicaemia which was managed by small bowel segmental resection and exteriorisation of the ends, debridement of overlying anterior abdominal wall and maximum resection of implanted mesh. This case is unusual secondary to long experience with ePTFE mesh and the lack of published cases similar to this one. A brief review of relevant literature has been included in the article. We recommend pre-peritoneal placement of dual mesh fixed preferably by trans-abdominal polypropylene suture in LIHR.

  16. Interplay between collective pinning and artificial defects on domain wall propagation in Co/Pt multilayers

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez-Rodriguez, G; Hierro-Rodriguez, A; Perez-Junquera, A; Montenegro, N; Alameda, J M; Velez, M [Dept. Fisica, Universidad de Oviedo-CINN, 33007 Oviedo (Spain); Menendez, J L [Centro de Investigacion en Nanomateriales y Nanotecnologia (CINN). Principado de Asturias-Consejo Superior de Investigaciones Cientificas (CSIC)-Univ. Oviedo -UO, Parque Tecnologico de Asturias, 33428 Llanera (Spain); Ravelosona, D, E-mail: mvelez@uniovi.e [Institut d' Electronique Fondamentale, UMR CNRS 8622, Univ. Paris Sud, 91405 Orsay Cedex (France)

    2010-08-04

    The interplay between collective pinning on intrinsic structural defects and artificial pinning at a patterned hole is studied in magnetic multilayers with perpendicular anisotropy. The pinning strength of a patterned hole is measured through its efficiency to stop domain wall (DW) propagation into a consecutive unpatterned nanowire section (using antisymmetric magnetoresistance to detect the direction of DW propagation) whereas collective pinning is characterized by the field dependence of DW velocity. Close to room temperature, collective pinning becomes weaker than artificial pinning so that pinning at the hole compensates nucleation-pad geometry, blocking DW propagation across the nanowire.

  17. Defects in Individual Semiconducting Single Wall Carbon Nanotubes: Raman Spectroscopic and in Situ Raman Spectroelectrochemical Study

    Czech Academy of Sciences Publication Activity Database

    Kalbáč, Martin; Hsieh, Y. P.; Farhat, H.; Kavan, Ladislav; Hofmann, M.; Kong, J.; Dresselhaus, M. S.

    2010-01-01

    Roč. 10, č. 11 (2010), s. 4619-4626 ISSN 1530-6984 R&D Projects: GA ČR GC203/07/J067; GA AV ČR IAA400400804; GA AV ČR IAA400400911; GA AV ČR KAN200100801; GA MŠk ME09060 Institutional research plan: CEZ:AV0Z40400503 Keywords : single wall carbon nanotubes * Raman spectroscopy * defects Subject RIV: CG - Electrochemistry Impact factor: 12.186, year: 2010

  18. Interplay between collective pinning and artificial defects on domain wall propagation in Co/Pt multilayers

    International Nuclear Information System (INIS)

    Rodriguez-Rodriguez, G; Hierro-Rodriguez, A; Perez-Junquera, A; Montenegro, N; Alameda, J M; Velez, M; Menendez, J L; Ravelosona, D

    2010-01-01

    The interplay between collective pinning on intrinsic structural defects and artificial pinning at a patterned hole is studied in magnetic multilayers with perpendicular anisotropy. The pinning strength of a patterned hole is measured through its efficiency to stop domain wall (DW) propagation into a consecutive unpatterned nanowire section (using antisymmetric magnetoresistance to detect the direction of DW propagation) whereas collective pinning is characterized by the field dependence of DW velocity. Close to room temperature, collective pinning becomes weaker than artificial pinning so that pinning at the hole compensates nucleation-pad geometry, blocking DW propagation across the nanowire.

  19. Anaesthetic injection versus ischemic compression for the pain relief of abdominal wall trigger points in women with chronic pelvic pain.

    Science.gov (United States)

    Montenegro, Mary L L S; Braz, Carolina A; Rosa-e-Silva, Julio C; Candido-dos-Reis, Francisco J; Nogueira, Antonio A; Poli-Neto, Omero B

    2015-12-01

    Chronic pelvic pain is a common condition among women, and 10 to 30 % of causes originate from the abdominal wall, and are associated with trigger points. Although little is known about their pathophysiology, variable methods have been practiced clinically. The purpose of this study was to evaluate the efficacy of local anaesthetic injections versus ischemic compression via physical therapy for pain relief of abdominal wall trigger points in women with chronic pelvic pain. We conducted a parallel group randomized trial including 30 women with chronic pelvic pain with abdominal wall trigger points. Subjects were randomly assigned to one of two intervention groups. One group received an injection of 2 mL 0.5 % lidocaine without a vasoconstrictor into a trigger point. In the other group, ischemic compression via physical therapy was administered at the trigger points three times, with each session lasting for 60 s, and a rest period of 30 s between applications. Both treatments were administered during one weekly session for four weeks. Our primary outcomes were satisfactory clinical response rates and percentages of pain relief. Our secondary outcomes are pain threshold and tolerance at the trigger points. All subjects were evaluated at baseline and 1, 4, and 12 weeks after the interventions. The study was conducted at a tertiary hospital that was associated with a university providing assistance predominantly to working class women who were treated by the public health system. Clinical response rates and pain relief were significantly better at 1, 4, and 12 weeks for those receiving local anaesthetic injections than ischemic compression via physical therapy. The pain relief of women treated with local anaesthetic injections progressively improved at 1, 4, and 12 weeks after intervention. In contrast, women treated with ischemic compression did not show considerable changes in pain relief after intervention. In the local anaesthetic injection group, pain threshold

  20. [CHOICE OF THE TREATMENT TACTICS IN PATIENTS, SUFFERING POSTOPERATIVE HERNIA OF ANTERIOR ABDOMINAL WALL WITH CONCOMITANT MORBID OBESITY].

    Science.gov (United States)

    Kondratenko, B M

    2015-08-01

    Experience of treatment of 73 patients, suffering postoperative hernia of anterior abdominal wall with concomitant obesity, was presented. In 31 (42.5%) of them in a period of reduction and stabilization of a body mass the allohernioplasty as a second stage after bariatric operation was done, and in 9 (42.5%)--simultant bariatric operations with hernioplasty and dermatolipectomy. During a follow-up period after bariatric operation and hernioplasty the hernia recurrence have occurred in 3 (9.1%) patients, after hernioplasty--in 11 (33.3%), witnessing high efficacy of staged treatment in such patients.

  1. Reconstruction of full-thickness chest wall defects using rectus abdominis musculocutaneous flap: A report of fifteen cases

    International Nuclear Information System (INIS)

    Miyamoto, Y.; Hattori, T.; Niimoto, M.; Toge, T.

    1986-01-01

    In 15 patients chest walls were excised because of recurrent breast cancer, radiation ulcer, or rib tumor. In most cases the full-thickness defect of the chest wall was about 10 x 10 cm. Reconstruction was performed using only a rectus abdominis musculocutaneous flap. No patient developed circulation problems in the flap or severe flail chest, and we had successful results in all our cases. These results show that the rectus abdominis musculocutaneous flap is quite effective and safe to use in the reconstruction of chest wall defects

  2. Study on the influence of inner wall morphology and structure defect on the emission point of microchannel plate

    Science.gov (United States)

    Bo, Tiezhu; Shi, Xiaoxuan; Wang, Chen; Cai, Hua; Lian, Jiao; Cao, Zhenbo; Li, Qing; Liu, Chang; Liu, Hui

    2017-10-01

    The microchannel plate (MCP) as the most important component of image intensifiers and ultraviolet detectors, is avalanche two-dimensional electron multiplier device. The emission point as a pattern noise, which is characterized by a bright or a flickering point at a fixed position of the fluorescent screen, affects the visual quality and reliability of the MCP. Therefore, eliminating the emission point is an effective way to improve the performances of the MCP. In this paper, the inner wall morphology and structure defect of the channel were studied, the MCPs with different inner wall morphlogies were analyzed by SEM, and the emission point were tested by using the photoelectric imaging integrated tester. Using the above-mentioned research methods, a specific relationship between the inner wall morphology and the emission point was established. According to the field emission theory, the mechanism of the emission point was analyzed and discussed. The results show that the inner wall structure defects of the channel are the main reasons for the emission point. Furthermore, the study found that the matching of the thermal physical properties between core glass and clad glass is the main reason for the occurrence of structure defects. The structure defects of the inner wall can be effectively reduced by optimizing the composition of the glass material, make the two glasses have the suitable performance matching, avoid forming residual pores at the interface position, the inner wall of the channel will have a smooth, defect free microstructure, thereby effectively controlling the emission point of the MCP.

  3. Electrospun biodegradable microfibers induce new collagen formation in a rat abdominal wall defect model

    DEFF Research Database (Denmark)

    Tarpø, Cecilie Lærke Glindtvad; Chen, Menglin; Nygaard, Jens Vinge

    2018-01-01

    Half of the female population over age 50 years will experience pelvic organ prolapse. We suggest a new approach based on tissue engineering principles to functionally reconstruct the anatomical structures of the pelvic floor. The aim of this study is to investigate the mechanical performance...

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

    International Nuclear Information System (INIS)

    Solak, Aynur; Şahin, Neslin; Genç, Berhan; Sever, Ali Rıza; Genç, Mine; Sivrikoz, Oya Nermin

    2013-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Spontaneous Expulsion of a Biliary Stent via the abdominal wall: A ...

    African Journals Online (AJOL)

    We report a rare complication of a biliary stent inserted via endoscopic retrograde cholangio-pancreatography (ERCP) for benign biliary disease in a 60 years-old female presented with abdominal pain and a tender left iliac fossa (LIF) mass. She had change of the colour of the skin over the hypogastric region. Crepitus was ...

  7. Critical overview of all available animal models for abdominal wall hernia research

    NARCIS (Netherlands)

    Vogels, R.R.M.; R. Kaufmann (Ruth); L.C.L. van den Hil (Leontine); van Steensel, S.; M.H.F. Schreinemacher (Marc H.F.); J.F. Lange (Johan); N.D. Kannekens-Bouvy (Nicole)

    2017-01-01

    textabstractPurpose: Since the introduction of the first prosthetic mesh for abdominal hernia repair, there has been a search for the “ideal mesh.” The use of preclinical or animal models for assessment of necessary characteristics of new and existing meshes is an indispensable part of hernia

  8. Jejunal metastases from squamous cell carcinoma of the cervix presenting as an abdominal wall abscess

    Directory of Open Access Journals (Sweden)

    Kavita Mardi

    2016-01-01

    Full Text Available Metastatic tumors of the intestinal tract from extra-abdominal sites are rare. In cervical cancer, the liver, lung, and the bones are the most common distant sites of metastases. Metastasis to the small intestine is very rare. We report a rare case of metastasis of cervical squamous cell carcinoma to jejunum after a few months of chemoradiotherapy.

  9. Diagnostic Accuracy of Abdominal wall Ultrasonography and Local Wound Exploration in Predicting the Need for Laparotomy following Stab Wound

    Directory of Open Access Journals (Sweden)

    Ali Vafaei

    2017-01-01

    Full Text Available Introduction: Screening of patients with anterior abdominal penetrating trauma in need for laparotomy is an important issue in management of these cases. This study aimed to compare the accuracy of abdominal wall ultrasonography (AWU and local wound exploration (LWE in this regard.Methods: This diagnostic accuracy study was conducted on ≥ 18 year-old patients presenting to emergency department with anterior abdominal stab wound and stable hemodynamics, to compare the characteristics of AWU and LWE in screening of patients in need of laparotomy.Results: 50 cases with the mean age of 28.44 ± 7.14 years were included (80% male. Sensitivity, specificity and area under the receiver operating characteristic (ROC curve of AWU were 70.58 (95% CI: 44.04 – 88.62, 93.33 (95% CI: 76.49 – 98.83, and 81.96 (95% CI: 69.91 – 94.01, respectively. These measures were 88.23 (62.25 – 97.93, 93.33 (76.49 – 98.83, and 90.78 (95% CI: 81.67 – 99.89 for LWE, respectively. The difference in overall accuracy of the two methods was not statistically significant (p = 0.0641.Conclusion: Based on the findings of the present study, AWU and LWE had the same specificity but different sensitivities in screening of anterior abdominal stab wound patients in need of laparotomy. The overall accuracy of LWE was slightly higher (91.48% versus 85.1%.

  10. Successful three stage repair of a large congenital abdominal region defect

    Directory of Open Access Journals (Sweden)

    Vaidehi Agrawal

    2015-06-01

    Full Text Available We present two infants born with large, right upper quadrant defects which cannot be categorized as either a gastroschisis or omphalocele. We successfully managed one infant with a three stage repair using polytetrafluoroethylene (PTFE patch, porcine urinary bladder matrix (UBM and delayed surgical closure. The second infant passed away due to parental consent care withdrawal.

  11. Evaluation of optical data gained by ARAMIS-measurement of abdominal wall movements for an anisotropic pattern design of stress-adapted hernia meshes produced by embroidery technology

    Science.gov (United States)

    Breier, A.; Bittrich, L.; Hahn, J.; Spickenheuer, A.

    2017-10-01

    For the sustainable repair of abdominal wall hernia the application of hernia meshes is required. One reason for the relapse of hernia after surgery is seen in an inadequate adaption of the mechanical properties of the mesh to the movements of the abdominal wall. Differences in the stiffness of the mesh and the abdominal tissue cause tension, friction and stress resulting in a deficient tissue response and subsequently in a recurrence of a hernia, preferentially in the marginal area of the mesh. Embroidery technology enables a targeted influence on the mechanical properties of the generated textile structure by a directed thread deposition. Textile parameters like stitch density, alignment and angle can be changed easily and locally in the embroidery pattern to generate a space-resolved mesh with mechanical properties adapted to the requirement of the surrounding tissue. To determine those requirements the movements of the abdominal wall and the resulting distortions need to be known. This study was conducted to gain optical data of the abdominal wall movements by non-invasive ARAMIS-measurement on 39 test persons to estimate direction and value of the major strains.

  12. Use of a living dermal equivalent for a refractory abdominal defect after pediatric multivisceral transplantation.

    Science.gov (United States)

    Charles, Carlos A; Kato, Tomoaki; Tzakis, Andreas G; Miller, Barbara N; Kirsner, Robert S

    2004-09-01

    Primary closure is not always possible after pediatric multivisceral transplantation. Reepithelialization may require extended periods of postoperative time, which can be associated with significant morbidity. The objective was to accelerate secondary wound closure thereby minimizing infection or further complications in a pediatric multivisceral transplant patient. Five applications of human fibroblast-derived dermis (Dermagraft, Smith and Nephew) were applied to the postsurgical defect of a pediatric multivisceral transplant patient over the course of 8 months. Routine wound care and observation was performed between human fibroblast-derived dermis applications. Human fibroblast-derived dermis stimulated healing and accelerated reepithelialization. Signs of clinical rejection or infection were not observed. Reepithelialization can be aided in the postoperative period in pediatric multivisceral transplant patients with human fibroblast-derived dermis, thereby helping to deter complications associated with secondary wound closure. We have illustrated the successful use of a human fibroblast-derived dermis as an adjunct for wound healing in a complicated surgical defect.

  13. THORACO - ABDOMINAL FLAP FOR RESURFACING LARGE POST MASTECTOMY DEFECTS IN LOCALLY ADVANCED CA. BREAST

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-02-01

    Full Text Available Covering of large wounds after mastectomy in locally advanced Ca breast with skin that can withstand radiotherapy is a challenge to the surgeon. Here this study we used a local advancement flap from the adjacent area called Thoraco - A bdominal F la p (TA flap for such giant defects. This is based on superficial and lumbar arteries and is thick to with stand consequent RT . MATERIALS AND METHODS: Of the total 107 cases of LABC 32 had post mastectomy defects of larger than 12 cm and could not be closed by simple approximation. Among the 32 cases 17 cases are covered by split thickness skin grafting. 15 cases are covered by TA flap. These cases are assessed for mean operating time, mean blood loss, post - operative stay, flap necrosis and viability of the f lap after radiotherapy. RESULTS: There is minimal extra time or blood loss in these cases . All the flaps healed well except for small edge necrosis in 4 cases. In all the patients we could start radiotherapy in the fourth week of surgery and all the flaps withstood RT well. After further evaluation probably this can be recommended as procedure for giant post mastectomy defects particularly for those who require RT early

  14. Dynamical Analysis of Lower Abdominal Wall in the Human Inguinal Hernia

    OpenAIRE

    Fortuny Anguera, Gerard

    2009-01-01

    En aquesta tesi es construeix un simulador numèric de la paret abdominal inferior, per tal de determinar la gènesis i les causes de les hernies inguinal humanes. Així, un model amb dades reals d'aquesta regió del cos humà (correctament discretitzades) ens permetrà reproduir les propietats dinàmiques de diferents elements de la regió permetent la simulació de la hernia en el moment que te lloc.La simulació muscular en general, ha tingut un paper secundari en la simulació numèrica, ja que en o...

  15. Rapid prototyped patient specific implants for reconstruction of orbital wall defects.

    Science.gov (United States)

    Stoor, Patricia; Suomalainen, Anni; Lindqvist, Christian; Mesimäki, Karri; Danielsson, Daniel; Westermark, Anders; Kontio, Risto K

    2014-12-01

    Defects of orbital walls can be reconstructed using implants. The authors report a safe and accurate method to reconstruct bone defects in the orbital area using patient specific implants. A detailed process description of computer aided design (CAD) reconstructive surgery (CRS) is introduced in this prospective study. The 3D volumetric virtual implant was design using MSCT data and PTCProEngineer™ 3D software. The intact orbital cavity of twelve patients was mirrored to the injured side. Specific ledges steered the implant into correct place. Postoperatively the position was assessed using image fusion. One implant (8%) was rejected due to chemical impurities, two (16%) had a false shape due to incorrect CAD. Data of thin bone did not transfer correctly to CAD and resulted in error. One implant (8%) was placed incorrectly. Duration of the CRS was in average 1.17 h, correspondingly 1.57 h using intraoperative bending technique. The CRS process has several critical stages, which are related to converting data and to incompatibility between software. The CRS process has several steps that need further studies. The data of thin bone may be lost and disturb an otherwise very precise technique. The risk of incorporating impurities into the implant must be carefully controlled. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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. Staged abdominal closure with intramuscular tissue expanders and modified components separation technique of a giant incisional hernia after repair of a ruptured omphalocele

    Directory of Open Access Journals (Sweden)

    Yukihiro Tatekawa

    2016-07-01

    Full Text Available In patients with omphalocele, several different techniques are performed for repair of the abdominal wall defect. We present the case of a staged abdominal closure of a giant incisional hernia after repair of a ruptured omphalocele. At birth, skin flap coverage associated with silo formation occurred, but the abdominal wall defect remained, resulting in a giant abdominal hernia. To expand the layers of the abdominal wall, tissue expanders were placed between the bilateral internal oblique and transverses abdominis muscles. Postoperatively, a modified components separation technique was performed. The abdominal wall was closed in the midline. Upon closure of the skin in the midline, bilateral relaxing incisions were performed, covering the remaining defect with artificial dermis. At the age of one year and 7 months, the patient had no recurrent incisional hernia nor any wound complications.

  18. Satisfaction and perceived quality of life results in patients operated on for primary hernia of the abdominal wall.

    Science.gov (United States)

    de Miguel-Ibáñez, Ricardo; Nahban-Al Saied, Saif Adeen; Alonso-Vallejo, Javier; Escribano Sotos, Francisco

    2015-12-01

    Outpatient surgery is currently the standard procedure in 60-70% of the most prevalent surgical procedures. Minimally invasive models in health care have improved basic aspects such as postoperative pain and hospital stay, but there are few publications related to perceived quality shown by patients, such as the need for informal care at home or delay before surgery. The aim of the study was to determine the global satisfaction perceived by patients undergoing abdominal wall hernia repair. An ad hoc split questionnaire has been completed on satisfaction after a week and postoperative quality a month after intervention by 203 patients operated on for abdominal hernia in a year. Variables included postoperative pain, need for informal care, surgical delay, information supplied, professional management and overall satisfaction. A total of 48.28% of patients needed informal care at home. They were largely attended by women, wives or daughters, for a few days. In 45.81% they were discharged on the same day, and 53.2% in less than 72 h. Overall satisfaction in the program of day surgery and short hospital stay was 94.6%. The overall process of satisfaction was not related to age, sex or educational level of patients, while there was an inverse relationship between satisfaction and days of hospitalization and days of pain that required analgesia at home. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Abdominal wall reconstruction with components separation and mesh reinforcement in complex hernia repair.

    Science.gov (United States)

    Nockolds, Claire L; Hodde, Jason P; Rooney, Paul S

    2014-04-30

    Abdominal closure in the presence of enterocutaneous fistula, stoma or infection can be challenging. A single-surgeon's experience of performing components separation abdominal reconstruction and reinforcement with mesh in the difficult abdomen is presented. Medical records from patients undergoing components separation and reinforcement with hernia mesh at Royal Liverpool Hospital from 2009 to 2012 were reviewed. Patients were classified by the Ventral Hernia Working Group (VHWG) grading system. Co-morbidities, previous surgeries, specific type of reconstruction technique, discharge date, complications and hernia recurrence were recorded. Twenty-three patients' (15 males, 8 females) notes were reviewed. Median age was 57 years (range 20-76 years). Median follow-up at the time of review was 17 months (range 2-48 months). There were 13 grade III hernias and 10 grade IV hernias identified. Synthetic mesh was placed to reinforce the abdomen in 6 patients, cross-linked porcine dermis was used in 3, and a Biodesign® Hernia Graft was placed in 14. Complications included wound infection (13%), superficial wound dehiscence (22%), seroma formation (22%) and stoma complications (9%). To date, hernias have recurred in 3 patients (13%). Components separation and reinforcement with biological mesh is a successful technique in the grade III and IV abdomen with acceptable rate of recurrence and complications.

  20. Suitability of pharmacokinetic models for dynamic contrast-enhanced MRI of abdominal aortic aneurysm vessel wall: a comparison.

    Directory of Open Access Journals (Sweden)

    V Lai Nguyen

    Full Text Available PURPOSE: Increased microvascularization of the abdominal aortic aneurysm (AAA vessel wall has been related to AAA progression and rupture. The aim of this study was to compare the suitability of three pharmacokinetic models to describe AAA vessel wall enhancement using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI. MATERIALS AND METHODS: Patients with AAA underwent DCE-MRI at 1.5 Tesla. The volume transfer constant (K(trans , which reflects microvascular flow, permeability and surface area, was calculated by fitting the blood and aneurysm vessel wall gadolinium concentration curves. The relative fit errors, parameter uncertainties and parameter reproducibilities for the Patlak, Tofts and Extended Tofts model were compared to find the most suitable model. Scan-rescan reproducibility was assessed using the interclass correlation coefficient and coefficient of variation (CV. Further, the relationship between K(trans and AAA size was investigated. RESULTS: DCE-MRI examinations from thirty-nine patients (mean age±SD: 72±6 years; M/F: 35/4 with an mean AAA maximal diameter of 49±6 mm could be included for pharmacokinetic analysis. Relative fit uncertainties for K(trans based on the Patlak model (17% were significantly lower compared to the Tofts (37% and Extended Tofts model (42% (p<0.001. K(trans scan-rescan reproducibility for the Patlak model (ICC = 0.61 and CV = 22% was comparable with the Tofts (ICC = 0.61, CV = 23% and Extended Tofts model (ICC = 0.76, CV = 22%. K(trans was positively correlated with maximal AAA diameter (Spearman's ρ = 0.38, p = 0.02 using the Patlak model. CONCLUSION: Using the presented imaging protocol, the Patlak model is most suited to describe DCE-MRI data of the AAA vessel wall with good K(trans scan-rescan reproducibility.

  1. Characteristic Features of Stone-Wales Defects in Single-Walled Carbon Nanotube; Adsorption, Dispersion, and Field Emission

    Directory of Open Access Journals (Sweden)

    Seungkwang Roh

    2010-01-01

    Full Text Available Adsorption behaviors of dodecanethiol (C12H25SH molecules are investigated on the surface of single-walled carbon nanotubes (SWCNTs with vibrational and X-ray photoelectron spectrometers. The active adsorption sites are proved as Stone-Wales (SW defects (5–7 ring defects. The SW defect-removed SWCNTs formed by reacting nanotubes with allyl acrylate molecules are compared with pristine SWCNTs in dispersion and field emission. The former shows higher dispersion and field emission than the latter.

  2. Evaluation of various boluses in dose distribution for electron therapy of the chest wall with an inward defect

    Science.gov (United States)

    Mahdavi, Hoda; Jabbari, Keyvan; Roayaei, Mahnaz

    2016-01-01

    Delivering radiotherapy to the postmastectomy chest wall can be achieved using matched electron fields. Surgical defects of the chest wall change the dose distribution of electrons. In this study, the improvement of dose homogeneity using simple, nonconformal techniques of thermoplastic bolus application on a defect is evaluated. The proposed phantom design improves the capability of film dosimetry for obtaining dose profiles of a patient's anatomical condition. A modeled electron field of a patient with a postmastectomy inward surgical defect was planned. High energy electrons were delivered to the phantom in various settings, including no bolus, a bolus that filled the inward defect (PB0), a uniform thickness bolus of 5 mm (PB1), and two 5 mm boluses (PB2). A reduction of mean doses at the base of the defect was observed by any bolus application. PB0 increased the dose at central parts of the defect, reduced hot areas at the base of steep edges, and reduced dose to the lung and heart. Thermoplastic boluses that compensate a defect (PB0) increased the homogeneity of dose in a fixed depth from the surface; adversely, PB2 increased the dose heterogeneity. This study shows that it is practical to investigate dose homogeneity profiles inside a target volume for various techniques of electron therapy. PMID:27051169

  3. Evaluation of nano ceramic coating on radiographic defects of thin-walled AL4-4 aluminum alloy sand casting

    Directory of Open Access Journals (Sweden)

    Mansour Borouni

    2016-10-01

    Full Text Available Internal defects are among the problems in gravity casting of aluminum parts. The main internal volumetric defects are gas and shrinkage defects which form during solidification of the melt and drastically reduce the quality of the produced parts. These defects adversely affect the mechanical properties of thin walled castings parts. In this study, ceramic nanoparticles coatings were applied on the sand mold and the effect of mold coatings on the reduction of defects were investigated. X-ray radiography was used to detect defects in sand molds with ceramic nanoparticles coatings. For comparison, this test was performed on molds with micro-ceramic and graffiti coatings and uncoated sand mold. The results showed that the maximum amount of gas and shrinkage defects was observed in casting parts from AL4-1 alloy in uncoated molds. On the other hand, the minimum defects were found in molds coated with ceramic nanoparticles. It seems that the reduced defects in casting parts in molds coated with ceramic nanoparticles may be due to high thermal and chemical stability and higher heat transfer rate of the coating. These results can facilitate the production of high quality aluminum alloys parts using nanotechnology.

  4. Type of incision does not predict abdominal wall outcome after emergency surgery for colonic anastomotic leakage

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Oma, Erling; Harling, Henrik

    2017-01-01

    PURPOSE: Most literature on abdominal incision is based on patients undergoing elective surgery. In a cohort of patients with anastomotic leakage after colonic cancer resection, we analyzed the association between type of incision, fascial dehiscence, and incisional hernia. METHODS: Data were...... extracted from the Danish Colorectal Cancer Group database and merged with information from the Danish National Patient Register. All patients with anastomotic leakage after colonic resection in Denmark from 2001 until 2008 were included and surgical records on re-operations were retrieved. The primary...... for anastomotic leakage were included with a median follow-up of 5.4 years. Incisional hernia occurred in 41 of 227 (15.3%) patients undergoing midline incision compared with 14 of 81 (14.7%) following transverse incision, P = 1.00. After adjusting for confounders, there was no association between the type...

  5. Botulinum Toxin A as an Adjunct to Abdominal Wall Reconstruction for Incisional Hernia

    DEFF Research Database (Denmark)

    Soltanizadeh, Sinor; Helgstrand, Frederik; Jorgensen, Lars N

    2017-01-01

    the literature. Data were sought regarding primary fascial closure with and without CST, safety, hernia recurrence, method of application, and preoperative radiological imaging. RESULTS: Six cohort studies including a total of 133 patients receiving BTA were identified. No randomized or case-control studies were...... found. In total, 83.5% of the patients achieved primary fascial closure. Supplemental CST was necessary in 24.1% of the patients. Two patients developed hernia recurrence during follow-up. No postoperative complications or adverse events were considered related to the administration of BTA, except...... for impairment of postoperative coughing and sneezing. Additionally, radiological imaging showed that BTA increased the length of lateral abdominal muscles before surgery. CONCLUSIONS: Preoperative administration of BTA increases muscle length and may facilitate primary fascial closure. Optimal administration...

  6. Effects of aging on abdominal wall healing in rats Efeitos do envelhecimento na cicatrização da parede abdominal, em ratos

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Pessole Biondo-Simões

    2005-04-01

    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.OBJETIVO: Estudar a cicatrização da parede abdominal em ratos adultos jovens e

  7. Systematic review and meta-analysis of the effectiveness of antibiotic prophylaxis in prevention of wound infection after mesh repair of abdominal wall hernia

    NARCIS (Netherlands)

    Aufenacker, T. J.; Koelemay, M. J. W.; Gouma, D. J.; Simons, M. P.

    2006-01-01

    BACKGROUND: The aim was to determine whether systemic antibiotic prophylaxis prevented wound infection after repair of abdominal wall hernia with mesh. METHODS: This was a systematic review of the available literature identified from multiple databases using the terms 'hernia' and 'antibiotic

  8. EuraHS: The Development of an international online platform for registration and outcome measurement of ventral abdominal wall Hernia repair

    NARCIS (Netherlands)

    F.E. Muysoms (Filip); G. Campanelli (Giampiero); G.G. Champault; A.C. DeBeaux; U.A. Dietz; J. Jeekel (Hans); U. Klinge; F. Köckerling; V. Mandala; A. Montgomery; S. Morales Conde (S.); W. Puppe; R.K.J. Simmermacher; M. Śmietański; M. Miserez

    2012-01-01

    textabstractBackground Although the repair of ventral abdominal wall hernias is one of the most commonly performed operations, many aspects of their treatment are still under debate or poorly studied. In addition, there is a lack of good definitions and classifications that make the evaluation of

  9. The effect of topological defects and oxygen adsorption on the electronic transport properties of single-walled carbon-nanotubes

    International Nuclear Information System (INIS)

    Grujicic, M.; Cao, G.; Singh, R.

    2003-01-01

    Ab initio density functional theory (DFT) calculations of the interactions between isolated infinitely-long semiconducting zig-zag (10, 0) or isolated infinitely-long metallic arm-chair (5, 5) single-walled carbon-nanotubes (SWCNTs) and single oxygen-molecules are carried out in order to determine the character of molecular-oxygen adsorption and its effect on electronic transport properties of these SWCNTs. A Green's function method combined with a nearest-neighbor tight-binding Hamiltonian in a non-orthogonal basis is used to compute the electrical conductance of SWCNTs and its dependence on the presence of topological defects in SWCNTs and of molecular-oxygen adsorbates. The computational results obtained show that in both semiconducting and metallic SWCNTs, oxygen-molecules are physisorbed to the defect-free nanotube walls, but when such walls contain topological defects, oxygen-molecules become strongly chemisorbed. In semiconducting (10, 0) SWCNTs, physisorbed O 2 -molecules are found to significantly increase electrical conductance while the effect of 7-5-5-7 defects is practically annulled by chemisorbed O 2 -molecules. In metallic (5, 5) SWCNTs, both O 2 adsorbates and 7-5-5-7 defects are found to have a relatively small effect on electrical conductance of these nanotubes

  10. Mechanical and geometrical determinants of wall stress in abdominal aortic aneurysms: A computational study.

    Directory of Open Access Journals (Sweden)

    Dara Azar

    Full Text Available An aortic aneurysm (AA is a focal dilatation of the aortic wall. Occurrence of AA rupture is an all too common event that is associated with high levels of patient morbidity and mortality. The decision to surgically intervene prior to AA rupture is made with recognition of significant procedural risks, and is primarily based on the maximal diameter and/or growth rate of the AA. Despite established thresholds for intervention, rupture occurs in a notable subset of patients exhibiting sub-critical maximal diameters and/or growth rates. Therefore, a pressing need remains to identify better predictors of rupture risk and ultimately integrate their measurement into clinical decision making. In this study, we use a series of finite element-based computational models that represent a range of plausible AA scenarios, and evaluate the relative sensitivity of wall stress to geometrical and mechanical properties of the aneurysmal tissue. Taken together, our findings encourage an expansion of geometrical parameters considered for rupture risk assessment, and provide perspective on the degree to which tissue mechanical properties may modulate peak stress values within aneurysmal tissue.

  11. Among 1,706 cases of abdominal wall reconstruction, what factors influence the occurrence of major operative complications?

    Science.gov (United States)

    Fischer, John P; Wink, Jason D; Nelson, Jonas A; Kovach, Stephen J

    2014-02-01

    Abdominal wall reconstruction (AWR) poses a substantial operative challenge, often in the setting of multiple failed attempts at repair in high-risk patients. Our aim was to assess risk factors for major operative morbidity after AWR using the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) patient database. A review of the ACS-NSQIP database of outcomes from 2005 to 2010 was performed to identify patients undergoing AWR utilizing Current Procedural Terminology codes for ventral hernia repair and a concomitant component separation. Independent variables included patient demographics, medical comorbidities, and operative considerations. Major operative complication (deep wound infection, graft or prosthetic loss, or unplanned return to the operating room within 30 days) was used as our dependent variable. Stepwise, multivariate logistic regression was performed to evaluate patient risk factors influencing the occurrence of major operative complications. We identified 1,706 patients with an average age of 55.9 ± 12.8 years with 30.1% undergoing concurrent intra-abdominal procedures and 57.1% undergoing mesh repair. Notable medical comorbidities included obesity (63.4%), smoking (24.9%), hypertension (53.1%), diabetes (19.9%), and anemia (22.6%). Average operative time was 211.7 ± 105.0 minutes. Regression analysis determined that prolonged operative time (odds ratio [OR], 2.7; P 2 (OR, 1.8; P = .009) were positively associated, whereas advanced age (OR, 0.5; P = .005) was negatively associated with the occurrence of major operative complications. Greater operative times and overall patient health are important prognostic factors for individuals undergoing AWR. The increased physiologic stress of a greater operative duration on patients who often have multiple comorbidities seems to play a significant role in predicting negative outcomes after AWR. Copyright © 2014 Mosby, Inc. All rights reserved.

  12. Laparoscopic tension-free repair of anterior abdominal wall incisional and ventral hernias with an intraperitoneal Gore-Tex mesh: prospective study and review of the literature.

    Science.gov (United States)

    Aura, Tamer; Habib, Elias; Mekkaoui, Mrine; Brassier, Didier; Elhadad, Andre

    2002-08-01

    Recurrence rates after repair of incisional and ventral hernias range from 18% to 52%. Prosthetic open repair has decreased this rate, but the wide fascial dissection it requires increases the complication rate. Laparoscopic repair is a safe and effective alternative. A prospective study was performed including 86 patients (63 women and 23 men) with a mean age of 54 years (range 29-79 years) having incisional or ventral hernias who underwent laparoscopic repair in our institution between July 1994 and October 2001. The majority of the patients were obese with a mean body mass index of 31.7 kg/m2. The abdominal wall defect size ranged from 2 X 1 cm to 20 X 13 cm. In all cases, a Gore-Tex mesh (Dual Mesh, W.L. Gore & Associates, Flagstaff, AZ, USA) was used in sizes ranging from 10 X 15 cm to 20 X 30 cm. Nineteen repairs were performed for recurrent hernias (12 incisional and 7 ventral). The mean operative time was 110.3 minutes (range 50-240 minutes). There was one open conversion (1.2%), one intraoperative complication (1.2%), and no deaths. There were no wound or mesh infections. Immediate postoperative complications occurred in 9 patients (10.6%) and late complications occurred in 16 patients (18.8%). The average hospital stay was 4.8 days (range 2-19 days). During a mean follow-up of 37 months (range 6-73 months), there were 6 hernia recurrences (7%). Laparoscopic repair of incisional hernia and ventral hernia appears to be safe, especially with the use of Gore-Tex mesh, and is proving to be effective as it decreases pain, complications, hospital stay, and recurrences.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Effect of length of thinning area on the failure behavior of carbon steel pipe containing a defect of wall thinning

    International Nuclear Information System (INIS)

    Kim, Jin Weon; Park, Chi Yong

    2003-01-01

    The present study performed pipe failure tests using 102 mm-Sch. 80 carbon steel pipe with various simulated wall thinning defects, to investigate the effect of axial length of wall thinning and internal pressure on the failure behavior of pipe thinned by flow accelerated corrosion (FAC). The tests were conducted under loading conditions of four-point bending with and without internal pressure. The results showed that a failure mode of pipe with a defect depended on the magnitude of internal pressure and axial thinning length as well as stress type and thinning depth and circumferential angle. Both load carrying capability (LCC) and deformation capability (DC) were depended on stress type in the thinning area and dimensions of thinning defect. For applying tensile stress to the thinned area, the dependence of LCC on the axial length of wall thinning was determined by circumferential thinning angle, and the DC was proportionally increased with increase in axial length of wall thinning regardless of the circumferential angle. For applying compressive stress to thinned area, however, the LCC was decreased with increase in axial length of the thinned area. Also, the effect of internal pressure on failure behavior was characterized by failure mode of thinned pipe, and it promoted crack occurrence and mitigated a local buckling of the thinned area

  15. Evidence for replacement of an infected synthetic by a biological mesh in abdominal wall hernia repair

    Directory of Open Access Journals (Sweden)

    Agneta eMontgomery

    2016-01-01

    Full Text Available The incidence of deep infection using a synthetic mesh in inguinal hernia repair is low and reported to be well below 1%. This is in contrast to incisional hernia surgery where the reported incidence is 3% respective 13% comparing laparoscopic to open mesh repair reported in a Cochrane review. Main risk factors were long operation time, surgical site contamination and early wound complications. An infected mesh can be preserved using conservative treatment were negative pressure wound therapy (VAC® could play an important role. If strategy fails, the mesh needs to be removed. This review aims to look at evidence for situations were a biological mesh would work as a replacement of a removed infected synthetic mesh. Material and MethodsA literature search of the Medline database was performed using the PubMed search engine. Twenty publications were found relevant for this review.ResultsFor studies reviewed three options are presented: removal of the infected synthetic mesh alone, replacement with either a new synthetic or a new biological mesh. Operations were all performed at specialist centers. Removal of the mesh alone was an option limited to inguinal hernias. In ventral/incisional hernias the use of a biological mesh for replacement resulted in a very high recurrence rate, if bridging was required. Either a synthetic or a biological mesh seems to work as a replacement when fascial closure can be achieved. Evidence is though very low. ConclusionWhen required, either a synthetic or a biological meshes seems to work as a replacement for an infected synthetic mesh if the defect can be closed. It is however not recommended to use a biological mesh for bridging. Mesh replacement surgery is demanding and is recommended to be performed in a specialist center.

  16. Free-breathing black-blood CINE fast-spin echo imaging for measuring abdominal aortic wall distensibility: a feasibility study

    Science.gov (United States)

    Lin, Jyh-Miin; Patterson, Andrew J.; Chao, Tzu-Cheng; Zhu, Chengcheng; Chang, Hing-Chiu; Mendes, Jason; Chung, Hsiao-Wen; Gillard, Jonathan H.; Graves, Martin J.

    2017-05-01

    The paper reports a free-breathing black-blood CINE fast-spin echo (FSE) technique for measuring abdominal aortic wall motion. The free-breathing CINE FSE includes the following MR techniques: (1) variable-density sampling with fast iterative reconstruction; (2) inner-volume imaging; and (3) a blood-suppression preparation pulse. The proposed technique was evaluated in eight healthy subjects. The inner-volume imaging significantly reduced the intraluminal artifacts of respiratory motion (p  =  0.015). The quantitative measurements were a diameter of 16.3  ±  2.8 mm and wall distensibility of 2.0  ±  0.4 mm (12.5  ±  3.4%) and 0.7  ±  0.3 mm (4.1  ±  1.0%) for the anterior and posterior walls, respectively. The cyclic cross-sectional distensibility was 35  ±  15% greater in the systolic phase than in the diastolic phase. In conclusion, we developed a feasible CINE FSE method to measure the motion of the abdominal aortic wall, which will enable clinical scientists to study the elasticity of the abdominal aorta.

  17. Evaluation of the abdominal wall cicatrization of rabbits exposed to nicotine and undergone abdominoplasty using nylon thread or cyanoacrylate.

    Science.gov (United States)

    Costa, Luciano Assis; Jardim, Paulo dos Reis; Macedo, Pedro Henrique Alvares Paiva; Amaral, Vânia da Fonseca; Silva, Alcino Lázaro da; Barbosa, Cirênio de Almeida

    2012-12-01

    To compare the wound healing of the abdominal wall of rabbits exposed to nicotine and submitted to abdominoplasty using 2-octyl cyanoacrylate or nylon thread for the surgery suture. Thirty two rabbits were used. They were divided in subgroups: A1, A2, B1 e B2. Group A received saline 0.9%; group B received nicotine, both groups for 14 days before surgery. We performed an abdominoplasty with a nylon suture into the A1 and B1 subgroups; as for A2 and B2 groups the suture was performed with cyanoacrylate. The euthanasia happened in the 14th post-operative day. After, we evaluated: swollen process, fibroblast proliferation, collagen, neovascularization, and macroscope and microscope epithelization of the scars. We observed the presence of eosinophils in all scars exposed to the cyanoacrylate, and a significant increase of neovascularization in the subgroup B2 comparing to the A2 one (p=0.037). The other variables haven't showed any statistical difference. Nicotine hasn't influenced the swollen process, the fibroblast proliferation, the presence of collagen, neither the epithelialization. The neovascularization showed cicatricial immaturity when comparing group A2 to group B2. The eosinophils in the scars repaired with glue showed that the substance has acted as an allergen.

  18. [Application of acetabular tridimensional memory alloy-fixation system in treatment of old acetabular posterior wall fracture with bone defect].

    Science.gov (United States)

    Cao, Liehu; Bao, Guangquan; Zhang, Chuncai; Liu, Xinwei; Niu, Yunfei; Xu, Shuogui; Su, Jiacan

    2011-12-01

    To investigate the effectiveness of acetabular tridimensional memory alloy-fixation system (ATMFS) combined with autologous iliac bone in the treatment of old acetabular posterior wall fracture with bone defect. Between January 2002 and February 2009, 17 patients with old acetabular posterior wall fracture and bone defect were treated, including 11 males and 6 females with an average age of 41.7 years (range, 20-60 years). The time from fracture to admission was 14-180 days (mean, 63 days). The displacement of the acetabular articular surface was more than or equal to 3 mm. According to the America Association of Orthopedic Surgeon (AAOS) acetabular fracture and defect classification standard, there were 4 cases of type I, 6 cases of type II, 5 cases of type III, and 2 cases of type IV. After the residual fracture fragments of the acetabular posterior wall and soft tissue hyperplasia were removed, the femoral head was reduced, and posterior wall defect was repaired with autologous iliac bone graft; ATMFS was used to fix acetabular posterior wall and artificial capsular ligament to reconstruct the hip so as to prevent re-dislocation of the femoral head. According to Matta imaging assessment standard, the results were excellent in 8 cases, good in 6 cases, fair in 2 cases, and poor in 1 case with an excellent and good rate of 82.3%. All incisions healed by first intention, and no sciatic nerve injury occurred. All patients were followed up 1-8 years (mean, 3.9 years). The mean time of fracture union was 3.6 months (range, 2-6 months). Avascular necrosis of femoral head occurred in 1 case, heterotopic ossification around the acetabulum in 1 case. According to Merle d'Aubigné-Postel scoring system evaluation, the clinical results were excellent in 9 cases, good in 6 cases, fair in 1 case, and poor in 1 case with an excellent and good rate of 88.2%. ATMFS combined with autologous iliac bone graft and artificial ligament reconstruction of the hip joint capsule is a good

  19. Gastric full-thickness suturing during EMR and for treatment of gastric-wall defects (with video).

    Science.gov (United States)

    von Renteln, Daniel; Schmidt, Arthur; Riecken, Bettina; Caca, Karel

    2008-04-01

    The endoscopic full-thickness Plicator device was initially developed to provide an endoscopic treatment option for patients with GERD. Because the endoscopic full-thickness Plicator enables rapid and easy placement of transmural sutures, comparable with surgical sutures, we used the Plicator device for endoscopic treatment or prevention of GI-wall defects. To describe the outcomes and complications of endoscopic full-thickness suturing during EMR and for the treatment of gastric-wall defects. A report of 4 cases treated with the endoscopic full-thickness suturing between June 2006 and April 2007. A large tertiary-referral center. Four subjects received endoscopic full-thickness suturing. The subjects were women, with a mean age of 67 years. Of the 4 subjects, 3 received endoscopic full-thickness suturing during or after an EMR. One subject received endoscopic full-thickness suturing for treatment of a fistula. Primary outcome measurements were clinical procedural success and procedure-related adverse events. The mean time for endoscopic full-thickness suturing was 15 minutes. In all cases, GI-wall patency was restored or ensured, and no procedure-related complications occurred. All subjects responded well to endoscopic full-thickness suturing. The resection of one GI stromal tumor was incomplete. Because of the Plicator's 60F distal-end diameter, endoscopic full-thickness suturing could only be performed with the patient under midazolam and propofol sedation. The durable Plicator suture might compromise the endoscopic follow-up after EMR. The endoscopic full-thickness Plicator permits rapid and easy placement of transmural sutures and seems to be a safe and effective alternative to surgical intervention to restore GI-wall defects or to ensure GI-wall patency during EMR procedures.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  1. Serum antibodies against Chlamydia pneumoniae outer membrane protein cross-react with the heavy chain of immunoglobulin in the wall of abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Støvring, Jette; Østergaard, Lars

    2004-01-01

    Chlamydia pneumoniae (Cp) has been demonstrated in arteries and abdominal aortic aneurysms (AAAs). However, the validity of the methods used is questioned, and antibiotic treatment trials have thus far shown disappointing results. Nevertheless, antibodies against the Cp outer membrane proteins (O...... (OMPs) have been associated with progression of atherosclerosis and AAAs. The aim of this study was to detect Cp OMPs in the wall of AAA patients by use of purified serum antibodies directed against Cp OMP and to assess potential cross-reacting proteins in AAA walls.......Chlamydia pneumoniae (Cp) has been demonstrated in arteries and abdominal aortic aneurysms (AAAs). However, the validity of the methods used is questioned, and antibiotic treatment trials have thus far shown disappointing results. Nevertheless, antibodies against the Cp outer membrane proteins...

  2. Tamoxifen up-regulates catalase production, inhibits vessel wall neutrophil infiltration, and attenuates development of experimental abdominal aortic aneurysms.

    Science.gov (United States)

    Grigoryants, Vladimir; Hannawa, Kevin K; Pearce, Charles G; Sinha, Indranil; Roelofs, Karen J; Ailawadi, Gorav; Deatrick, Kristopher B; Woodrum, Derek T; Cho, Brenda S; Henke, Peter K; Stanley, James C; Eagleton, Matthew J; Upchurch, Gilbert R

    2005-01-01

    Selective estrogen receptor modulators (SERMs), similar to estrogens, possess vasoprotective effects by reducing release of reactive oxygen species. Little is known about the potential effects of SERMs on the pathogenesis of abdominal aortic aneurysms (AAAs). This study's objective was to investigate the growth of experimental AAAs in the setting of the SERM tamoxifen. In the first set of experiments, adult male rats underwent subcutaneous tamoxifen pellet (delivering 10 mg/kg/day) implantation (n = 14) or sham operation (n = 16). Seven days later, all animals underwent pancreatic elastase perfusion of the abdominal aorta. Aortic diameters were determined at that time, and aortas were harvested 7 and 14 days after elastase perfusion for immunohistochemistry, real-time polymerase chain reaction, Western blot analysis, and zymography. In the second set of experiments, a direct irreversible catalase inhibitor, 3-amino-1,2,4-triazole (AT), was administered intraperitoneally (1 mg/kg) daily to tamoxifen-treated (n = 6) and control rats (n = 6), starting on day 7 after elastase perfusion. Aortic diameters were measured on day 14. In a third set of experiments, rats were perfused with catalase (150 mg/kg) after the elastase (n = 5), followed by daily intravenous injections of catalase (150 mg/kg/day) administered for 10 days. A control group of rats (n = 7) received 0.9% NaCl instead of catalase. Mean AAA diameters were approximately 50% smaller in tamoxifen-treated rats compared with sham rats 14 days after elastase perfusion (P = .002). The tamoxifen-treated group's aortas had a five-fold increase in catalase mRNA expression (P = .02) on day 7 and an eight-fold increase in catalase protein on day 14 (P = .04). Matrix metalloprotroteinase-9 activity was 2.4-fold higher (P = .01) on day 7 in the aortas of the controls compared to the tamoxifen-treated group's aortas. Tamoxifen-treated rats had approximately 40% fewer aortic polymorphonuclear neutrophils compared to

  3. Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database.

    Science.gov (United States)

    Chung, P J; Lee, J S; Tam, S; Schwartzman, A; Bernstein, M O; Dresner, L; Alfonso, A; Sugiyama, G

    2017-06-01

    Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. A retrospective analysis of data from the ACS NSQIP from 2005 to 2010 was performed. Patients were selected using Current Procedural Terminology (CPT) and International Classification of Disease 9 Clinical Modification (ICD9) codes for the repair of inguinal, femoral, umbilical, epigastric, ventral, or incisional hernias that were incarcerated, obstructed, strangulated, or gangrenous. Only emergent cases occurring within two days of admission and admitted as inpatients were included. Univariate and multivariable analysis was performed. A risk score was also created. There were 4298 cases of emergent anterior abdominal wall hernia surgery. The most common was inguinal (25.3 %), followed by incisional (23.8 %), umbilical (23.5 %), ventral (12.1 %), femoral (8.8 %), and epigastric (6.5 %) hernias. Multivariable analysis demonstrated six statistically significant predictors of short-term mortality, including history of congestive heart failure (CHF) [odds ratio (OR) 8.24, 95 % confidence interval (CI) 4.05-16.75), age (OR 5.52, 95 % CI 3.48-8.77), history of peripheral vascular disease (PVD) (OR 4.98, 95 % CI 2.08-11.92), presence of ascites (OR 3.16, 95 % CI 1.64-6.08), preoperative blood urea nitrogen (OR 1.35, 95 % CI 1.22-1.49), and preoperative white blood cell count (OR 1.22, 95 % CI 1.02-1.45). The C-statistic for the risk model was 0.858. We present a large study on short-term mortality following emergent anterior abdominal wall hernia repairs based on the ACS NSQIP with a derived risk model that demonstrates excellent discriminative ability.

  4. Acceleration sensors in abdominal wall position as a non-invasive approach to detect early breathing alterations induced by intolerance of increased airway resistance.

    Science.gov (United States)

    Breuer, Thomas; Bruells, Christian S; Rossaint, Rolf; Steffen, Henning; Disselhorst-Klug, Catherine; Czaplik, Michael; Zoremba, Norbert

    2017-11-10

    Early detection of respiratory overload is crucial to mechanically ventilated patients, especially during phases of spontaneous breathing. Although a diversity of methods and indices has been established, there is no highly specific approach to predict respiratory failure. This study aimed to evaluate acceleration sensors in abdominal and thoracic wall positions to detect alterations in breathing excursions in a setting of gradual increasing airway resistance. Twenty-nine healthy volunteers were committed to a standardized protocol of a two-minutes step-down spontaneous breathing on a 5 mm, 4 mm and then 3 mm orally placed endotracheal tube. Accelerator sensors in thoracic and abdominal wall position monitored breathing excursions. 15 participants passed the breathing protocol ("completed" group), 14 individuals cancelled the protocol due to subjective intolerance to the increasing airway resistance ("abandoned" group). Gradual increased respiratory workload led to a significant decrease of acceleration in abdominal wall position in the "abandoned" group compared to the "completed" group (p breathing alterations prior to respiratory failure. EK 309-15; by the Ethics Committee of the Faculty of Medicine, RWTH Aachen, Aachen, Germany. Retrospectively registered 28th of December 2015.

  5. Randomised comparison of three types of continuous anterior abdominal wall block after midline laparotomy for gynaecological oncology surgery.

    Science.gov (United States)

    Cowlishaw, P J; Kotze, P J; Gleeson, L; Chetty, N; Stanbury, L E; Harms, P J

    2017-07-01

    Effective analgesia after midline laparotomy surgery is essential for enhanced recovery programs. We compared three types of continuous abdominal wall block for analgesia after midline laparotomy for gynaecological oncology surgery. We conducted a single-centre, double-blind randomised controlled trial. Ninety-four patients were randomised into three groups to receive two days of programmed intermittent boluses of ropivacaine (18 ml 0.5% ropivacaine every four hours) via either a transversus abdominis plane (TAP) catheter, posterior rectus sheath (PRS) catheter, or a subcutaneous (SC) catheter. All groups received patient-controlled analgesia with morphine, and regular paracetamol and non-steroidal anti-inflammatory medication. Measured outcomes included analgesic and antiemetic usage and visual analog scores for pain, nausea, vomiting, and satisfaction. Eighty-eight patients were analysed (29 SC, 29 PRS and 30 TAP). No differences in the primary outcome were found (median milligrams morphine usage on day two SC 28, PRS 25, TAP 21, P =0.371). There were differences in secondary outcomes. Compared with the SC group, the TAP group required less morphine in recovery (0 mg versus 6 mg, P =0.01) and reported less severe pain on day one (visual analog scores 36.3 mm versus SC 55 mm, P =0.04). The TAP group used fewer doses of tropisetron on day one compared with the PRS group (8 versus 21, P =0.016). Programmed intermittent boluses of ropivacaine delivered via PRS, TAP and SC catheters can be provided safely to patients undergoing midline laparotomy surgery. Initially TAP catheters appear superior, reducing early opioid and antiemetic requirements and severe pain, but these advantages are lost by day two.

  6. Theoretical Investigation on Single-Wall Carbon Nanotubes Doped with Nitrogen, Pyridine-Like Nitrogen Defects, and Transition Metal Atoms

    Directory of Open Access Journals (Sweden)

    Michael Mananghaya

    2012-01-01

    Full Text Available This study addresses the inherent difficulty in synthesizing single-walled carbon nanotubes (SWCNTs with uniform chirality and well-defined electronic properties through the introduction of dopants, topological defects, and intercalation of metals. Depending on the desired application, one can modify the electronic and magnetic properties of SWCNTs through an appropriate introduction of imperfections. This scheme broadens the application areas of SWCNTs. Under this motivation, we present our ongoing investigations of the following models: (i (10, 0 and (5, 5 SWCNT doped with nitrogen (CNxNT, (ii (10, 0 and (5, 5 SWCNT with pyridine-like defects (3NV-CNxNT, (iii (10, 0 SWCNT with porphyrine-like defects (4ND-CNxNT. Models (ii and (iii were chemically functionalized with 14 transition metals (TMs: Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Pd, Ag, Pt and Au. Using the spin-unrestricted density functional theory (DFT, stable configurations, deformations, formation and binding energies, the effects of the doping concentration of nitrogen, pyridine-like and porphyrine-like defects on the electronic properties were all examined. Results reveal that the electronic properties of SWCNTs show strong dependence on the concentration and configuration of nitrogen impurities, its defects, and the TMs adsorbed.

  7. Effects of a tetracycline blended polylactic and polyglycolic acid membrane on the healing of one-wall intrabony defects in beagle dogs

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Il-Young [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Jung, Ui-Won [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Kim, Chang-Sung [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Lee, Yong-Keun [Department and Research Institute of Dental Biomaterials and Bioengineering, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-750 (Korea, Republic of); Cho, Kyoo-Sung [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Chai, Jung-Kiu [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Kim, Chong-Kwan [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Choi, Seong-Ho [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of)

    2007-09-15

    The purpose of this study was to evaluate the regenerative effects of a tetracycline blended polylactic and polyglycolic acid (TC-PLGA) and non-blended polylactic and polyglycolic acid (PLGA) barrier membrane on one-wall intrabony defects in beagle dogs. It can be concluded that when used for guided tissue regeneration TC-PLGA membranes show a beneficial effect on one-wall intrabony defects in beagle dogs.

  8. Effects of a tetracycline blended polylactic and polyglycolic acid membrane on the healing of one-wall intrabony defects in beagle dogs

    International Nuclear Information System (INIS)

    Kim, Il-Young; Jung, Ui-Won; Kim, Chang-Sung; Lee, Yong-Keun; Cho, Kyoo-Sung; Chai, Jung-Kiu; Kim, Chong-Kwan; Choi, Seong-Ho

    2007-01-01

    The purpose of this study was to evaluate the regenerative effects of a tetracycline blended polylactic and polyglycolic acid (TC-PLGA) and non-blended polylactic and polyglycolic acid (PLGA) barrier membrane on one-wall intrabony defects in beagle dogs. It can be concluded that when used for guided tissue regeneration TC-PLGA membranes show a beneficial effect on one-wall intrabony defects in beagle dogs

  9. Abdominal wall surgery

    Science.gov (United States)

    Cosmetic surgery of the abdomen; Tummy tuck; Abdominoplasty ... Most of the time, this surgery is an elective or cosmetic procedure because it is an operation you choose to have. It is not usually needed for health reasons. Cosmetic abdomen repair ...

  10. A case of divided latissimus dorsi flap repair for chest wall defect after wide resection of post-irradiation angiosarcoma

    International Nuclear Information System (INIS)

    Matsubara, Yukiko; Sawaizumi, Masayuki; Imai, Tomohiro; Maeda, Takuma; Fujita, Kazutoshi; Matsumoto, Seiichi; Iwase, Takuji; Motoi, Noriko; Kanda, Hiroaki

    2011-01-01

    We report the case of a 76-year-old woman who had undergone breast-conserving surgery for left breast cancer, followed by irradiation at a total dose of 66 Gy in 2005. When 5 years 1 month had elapsed after the operation, redness of the left chest wall was observed. A biopsy was performed and the histopathological diagnosis was angiosarcoma. Extended resection of the full thickness of the skin was performed. Adequate resection left a massive defect 15 x 18 cm in size. The divided latissimus dorsi flap was designed, and the oval-shaped skin defect was closed with the skin island of this flap. Post-irradiation sarcoma involving the vessels is a rare entity and occurs in 0.07-0.48% of all cases after radiation therapy. It metastasizes to the distant organs in an early stage and has a poor prognosis. No standard therapy for the disease has been established. Early detection and extended resection are considered to contribute to improvement of the prognosis. The divided latissimus dorsi flap is very useful for reconstructing a wide chest wall defect without the need to wide skin graft the donor site. (author)

  11. 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

    Directory of Open Access Journals (Sweden)

    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.

  12. Long-term Observation of Regenerated Periodontium Induced by FGF-2 in the Beagle Dog 2-Wall Periodontal Defect Model.

    Directory of Open Access Journals (Sweden)

    Jun Anzai

    Full Text Available The long-term stability and qualitative characteristics of periodontium regenerated by FGF-2 treatment were compared with normal physiological healing tissue controls in a Beagle dog 2-wall periodontal defect model 13 months after treatment by assessing tissue histology and three-dimensional microstructure using micro-computed tomography (μCT. After FGF-2 (0.3% or vehicle treatment at the defect sites, serial changes in the bone mineral content (BMC were observed using periodic X-ray imaging. Tissues were harvested at 13 months, evaluated histomorphometrically, and the cortical bone volume and trabecular bone structure of the newly formed bone were analyzed using μCT. FGF-2 significantly increased the BMC of the defect area at 2 months compared with that of the control group, and this difference was unchanged through 13 months. The cortical bone volume was significantly increased by FGF-2, but there was no difference between the groups in trabecular bone structure. Bone maturation was occurring in both groups because of the lower cortical volume and denser trabecular bone than what is found in intact bone. FGF-2 also increased the area of newly formed bone as assessed histomorphometrically, but the ratios of trabecular bone in the defect area were similar between the control and FGF-2 groups. These results suggest that FGF-2 stimulates neogenesis of alveolar bone that is of similar quality to that of the control group. The lengths of the regenerated periodontal ligament and cementum, measured as the distance from the defect bottom to the apical end of the gingival epithelium, and height and area of the newly formed bone in the FGF-2 group were larger than those in the control group. The present study demonstrated that, within the limitation of artificial periodontal defect model, the periodontal tissue regenerated by FGF-2 was maintained for 13 months after treatment and was qualitatively equivalent to that generated through the physiological

  13. Theoretical investigation of nerve agent DMMP adsorption onto Stone–Wales defected single-walled carbon nanotube

    International Nuclear Information System (INIS)

    Ahmadian, Nasim; Ganji, Masoud Darvish; Laffafchy, Mozayyan

    2012-01-01

    To find a suitable sensitivity sensor for dimethyl methylphosphonate (DMMP) as nerve agent, we studied the adsorption behavior of DMMP on the exterior surface of defected semiconducting (10,0) single-wall carbon nanotube (SWCNT) by means of first-principles van der Waals density functional (vdW-DF) calculations. The obtained results of adsorption energies reveal that the defect embedded within the (10,0) SWCNT does not promote binding capability in this system. Notably, analyzing the electronic structures and Mulliken population for the energetically most favorable complex supports that the defect changes slightly the electronic properties of SWCNT, indicating there is no considerable hybridization between the corresponding orbitals and the weak interaction obtained quantitatively in terms of binding energies. -- Highlights: ► State of the art ab initio DFT calculations on the Periodic system. ► We have considered the defected CNT for the adsorption capability. ► Full geometrical relaxation has been performed in our work. ► Electronics analysis were carried out for the structures of the considered complexes.

  14. Motion control in double-walled carbon nanotube systems using a Stone-Thrower-Wales defect cluster

    International Nuclear Information System (INIS)

    Liu Ping; Zhang Yongwei

    2010-01-01

    The ability to control the motion of a single molecule will have an important impact in nano-mechanical systems. Multi-walled carbon nanotube systems, which have extremely low intertube friction and strong motion confinement, can form the basis for mechanically based motion control. We devise two molecular motion control units based on double-walled carbon nanotubes embedded with a Stone-Thrower-Wales defect cluster, and perform molecular dynamics simulations to determine the characteristics of these two control units. We show that one of the molecular control units is able to perform a logic operation on one logic input and produce three logic outputs, while the other is able to produce two logic outputs. Potential applications of the motion control units include molecular switches, shuttles and mechanically based logic devices.

  15. Investigation on bonding defects in ITER first wall beryllium armour components by combining analytical and experimental methods

    Energy Technology Data Exchange (ETDEWEB)

    Pérez, Germán, E-mail: german.perez.pichel@gmail.com; Mitteau, Raphaël; Eaton, Russell; Raffray, René

    2015-12-15

    Highlights: • Bonding defects at the ITER first wall beryllium armour are studied. • Experimental and analytical methods are combined. • Models supporting test results interpretation are proposed. • Guidelines for new experimental protocols are suggested. • Contribution to the definition of defects acceptance criteria. - Abstract: The reliability of the plasma facing components (PFCs) is essential for the efficient plasma operation in a fusion machine. This concerns especially the bond between the armour tiles facing the plasma and the heat sink material (copper alloy). The different thermal expansions of the bonded materials cause a stress distribution in the bond, which peaks at the bond edge. Under cyclic heat flux and accounting for the possible presence of bonding defects, this stress could reach a level where the component might be jeopardised. Because of the complexity of describing realistically by analyses and models the stress evolution in the bond, “design by experiments” is the main procedure for defining and qualifying the armour joint. Most of the existing plasma operation know-how on actively cooled PFCs has been obtained with carbon composite armour tiles. In ITER, the tiles of the first wall are made out of beryllium, which means that the know-how is progressively adapted to this specific bimetallic pair. Nonetheless, analyses are still performed for supporting the R&D experimental programme. This paper: explores methods for combining experimental results with finite element and statistical analyses; benchmarks test results; proposes hypothesis and rationales consistent with test results interpretations; suggests guidelines for defining possible further experimental protocols; and contributes to the definition of defects acceptance criteria.

  16. Investigation on bonding defects in ITER first wall beryllium armour components by combining analytical and experimental methods

    International Nuclear Information System (INIS)

    Pérez, Germán; Mitteau, Raphaël; Eaton, Russell; Raffray, René

    2015-01-01

    Highlights: • Bonding defects at the ITER first wall beryllium armour are studied. • Experimental and analytical methods are combined. • Models supporting test results interpretation are proposed. • Guidelines for new experimental protocols are suggested. • Contribution to the definition of defects acceptance criteria. - Abstract: The reliability of the plasma facing components (PFCs) is essential for the efficient plasma operation in a fusion machine. This concerns especially the bond between the armour tiles facing the plasma and the heat sink material (copper alloy). The different thermal expansions of the bonded materials cause a stress distribution in the bond, which peaks at the bond edge. Under cyclic heat flux and accounting for the possible presence of bonding defects, this stress could reach a level where the component might be jeopardised. Because of the complexity of describing realistically by analyses and models the stress evolution in the bond, “design by experiments” is the main procedure for defining and qualifying the armour joint. Most of the existing plasma operation know-how on actively cooled PFCs has been obtained with carbon composite armour tiles. In ITER, the tiles of the first wall are made out of beryllium, which means that the know-how is progressively adapted to this specific bimetallic pair. Nonetheless, analyses are still performed for supporting the R&D experimental programme. This paper: explores methods for combining experimental results with finite element and statistical analyses; benchmarks test results; proposes hypothesis and rationales consistent with test results interpretations; suggests guidelines for defining possible further experimental protocols; and contributes to the definition of defects acceptance criteria.

  17. Latissimus dorsi free flap reconstruction of major abdominal defect in treatment of giant Marjolin’s ulcer: a short report focused on preoperative imaging

    International Nuclear Information System (INIS)

    Steffensen, Signe Muus; Thomassen, Anders; Jensen, Jesper Poul Naested; Soerensen, Jens Ahm

    2014-01-01

    We present a case of a 56-year-old man with a giant carcinoma in the abdominal wall. Based on positron emission tomography/computed tomography (PET/CT) scan there were FDG-avid lymph nodes in the ipsilateral axillary and groin, suspicious for metastases. At contrast-enhanced CT the parietal peritoneum seemed free of tumor invasion, which was essential to radical surgery planning. The tumor was completely removed with clear margins of resection and no metastasis in the resected lymph nodes. The PET/CT scan was repeated after 4 months, showing no signs of recurrence

  18. Comparison between isolated serial clinical examination and computed tomography for stab wounds in the anterior abdominal wall.

    Science.gov (United States)

    Breigeiron, Ricardo; Breitenbach, Tiago Cataldo; Zanini, Lucas Adalberto Geraldi; Corso, Carlos Otavio

    2017-01-01

    to compare abdominal computer tomography (CT) with isolated serial clinical exam (SCE) in the management of anterior abdominal stab wounds. randomized prospective study performed at Hospital de Pronto Socorro de Porto Alegre involving patients with anterior abdominal stab wounds without indication of immediate laparotomy; patients were divided in two groups: CT group and SCE group, In the SCE group, patients were followed up with serial clinical exam every 6 hours, Patients of CT group were submitted to abdominal computer tomography after initial evaluation. 66 patients were studied and 33 were included in each group, Of total, six were submitted to surgery, three of each group, In the SCE group, patients submitted to surgery in media waited 12 hours from arrival to diagnosis without any non-therapeutic surgeries, The remaining 30 patients of this group were discharged from hospital after 24 hours of observation, In the CT group, three patients showed alteration at CT and were submitted to laparotomy, one non-therapeutic, The others were discharged from hospital after 24 hours of observation, Abdominal computer tomography had a positive predictive value (PPV) of 67% and negative predictive value (NPV) of 100%, with 96% of accuracy, Isolated serial clinical exam showed PPV and NPV of 100% and 100% of accuracy. selective management of anterior abdominal stabs is safe, when a rigorous selection of patients is observed, Isolated serial clinical exam may be performed without computer tomography, without increase of hospitalization time or morbidity, reducing costs, exposure to radiation, mortality and morbidity and non-therapeutic laparotomies.

  19. Development of a Flexible Broadband Rayleigh Waves Comb Transducer with Nonequidistant Comb Interval for Defect Detection of Thick-Walled Pipelines

    Science.gov (United States)

    He, Cunfu; Yan, Lyu; Zhang, Haijun

    2018-01-01

    It is necessary to develop a transducer that can quickly detect the inner and outer wall defects of thick-walled pipes, in order to ensure the safety of such pipes. In this paper, a flexible broadband Rayleigh-waves comb transducer based on PZT (lead zirconate titanate) for defect detection of thick-walled pipes is studied. The multiple resonant coupling theory is used to expand the transducer broadband and the FEA (Finite Element Analysis) method is used to optimize transducer array element parameters. Optimization results show that the best array element parameters of the transducer are when the transducer array element length is 30 mm, the thickness is 1.2 mm, the width of one end of is 1.5 mm, and the other end is 3 mm. Based on the optimization results, such a transducer was fabricated and its performance was tested. The test results were consistent with the finite-element simulation results, and the −3 dB bandwidth of the transducer reached 417 kHz. Transducer directivity test results show that the Θ−3dB beam width was equal to 10 °, to meet the defect detection requirements. Finally, defects of thick-walled pipes were detected using the transducer. The results showed that the transducer could detect the inner and outer wall defects of thick-walled pipes within the bandwidth. PMID:29498636

  20. Case Report: Rapid staged abdominal closure using Gore-Tex® mesh as a bridge to primary omphalocele sac closure

    Directory of Open Access Journals (Sweden)

    William C. Kethman

    2016-06-01

    Full Text Available Omphaloceles present an ongoing challenge due to significant variations in presentation and associated co-morbidities. Diverse management strategies have been described to tackle many of the fundamental challenges of closure and reconstruction of the abdominal wall – this fact demonstrates a need for increasingly individualized management options for this complex disease. We describe a novel method of rapid staged abdominal wall closure using Gore-Tex® mesh as a bridge to primary omphalocele closure in an infant with partial Pentalogy of Cantrell and giant ruptured omphalocele. This strategy can be used in management of some of the most complex abdominal wall defects.

  1. Closing the gap between the laparoscopic and open approaches to abdominal wall hernia repair: a trend and outcomes analysis of the ACS-NSQIP database.

    Science.gov (United States)

    Savitch, Samantha L; Shah, Paresh C

    2016-08-01

    To assess trends in utilization and perioperative outcomes of laparoscopic and open abdominal wall hernia repair. Using the ACS-NSQIP database between 2009 and 2012, patients were identified as having an ICD-9 diagnosis of an umbilical, ventral, or incisional hernia as well as a CPT code for a laparoscopic or open abdominal wall hernia repair. A coarsened exact matching procedure was utilized to create a matched cohort to mitigate selection bias. Thirty-day outcomes analysis was done for the aggregate and matched cohorts. Subcategory analysis was performed for inpatient/outpatient status, strangulated/incarcerated hernias, initial/recurrent repairs, and hernia type (umbilical, ventral, incisional). Chi-square analysis was performed to determine the statistical significance of each comparison. In total, 112,074 qualifying patients were identified, 86,566 (77.24 %) open and 25,508 (22.76 %) laparoscopic. Patients undergoing laparoscopic repair were more likely to have preexisting comorbidities, but less likely to experience any postoperative morbidity (11.74 vs. 7.25 %, P hernia repairs (P = 0.0082 vs. P = 0.3172). Patients undergoing laparoscopic repair were still less likely to experience any postoperative (9.57 vs. 4.92 %, P abdominal wall hernia repairs, though utilization increased by 40 % from 2009 to 2012. The laparoscopic approach continues to be safer on many fronts, but not all, and is arguably not better for umbilical or primary hernia repairs on the basis of overall morbidity and length of stay.

  2. The defects influence on domain wall propagation in bistable glass-coated microwires

    Energy Technology Data Exchange (ETDEWEB)

    Rodionova, V. [Magnetism Division, Faculty of Physics, M.V. Lomonosov Moscow State University, Moscow 119991 (Russian Federation); Immanuel Kant Baltic Federal University, Kaliningrad 236041 (Russian Federation); Dpto. Fisica de Materiales, Fac. Quimicas, UPV/EHU, San Sebastian 20018 (Spain); Zhukova, V., E-mail: valentina.zhukova@ehu.es [Dpto. Fisica de Materiales, Fac. Quimicas, UPV/EHU, San Sebastian 20018 (Spain); Ilyn, M.; Ipatov, M. [Dpto. Fisica de Materiales, Fac. Quimicas, UPV/EHU, San Sebastian 20018 (Spain); Perov, N. [Magnetism Division, Faculty of Physics, M.V. Lomonosov Moscow State University, Moscow 119991 (Russian Federation); Zhukov, A. [Dpto. Fisica de Materiales, Fac. Quimicas, UPV/EHU, San Sebastian 20018 (Spain); IKERBASQUE, Basque Foundation for Science, Bilbao 48011 (Spain)

    2012-05-01

    We studied the domain wall (DW) dynamics of magnetically bistable amorphous glass-coated Fe{sub 74}B{sub 13}Si{sub 11}C{sub 2} microwires. In according to our experimental results magnetic field dependences of DW velocity of studied microwires can be divided into two groups: with uniform or uniformly accelerated DW propagation along the microwire. Strong correlation between the type of the magnetic field dependence of domain wall velocity, v(H), and the distribution of the local nucleation fields has been observed. Moreover, we observed abrupt increasing of DW velocity (jump) on the magnetic field dependences of the domain wall velocity, v(H), for the both types of the v(H) dependences. At the same time usual linear increasing of the domain wall velocity with magnetic field persists below these jumps. It was found that the jump height correlates with the location of nucleation place of the new domain wall. We have measured local nucleation field distribution in all the microwires. From local nucleation field distribution we have obtained the DW nucleation locations and estimated the jump height.

  3. The defects influence on domain wall propagation in bistable glass-coated microwires

    International Nuclear Information System (INIS)

    Rodionova, V.; Zhukova, V.; Ilyn, M.; Ipatov, M.; Perov, N.; Zhukov, A.

    2012-01-01

    We studied the domain wall (DW) dynamics of magnetically bistable amorphous glass-coated Fe 74 B 13 Si 11 C 2 microwires. In according to our experimental results magnetic field dependences of DW velocity of studied microwires can be divided into two groups: with uniform or uniformly accelerated DW propagation along the microwire. Strong correlation between the type of the magnetic field dependence of domain wall velocity, v(H), and the distribution of the local nucleation fields has been observed. Moreover, we observed abrupt increasing of DW velocity (jump) on the magnetic field dependences of the domain wall velocity, v(H), for the both types of the v(H) dependences. At the same time usual linear increasing of the domain wall velocity with magnetic field persists below these jumps. It was found that the jump height correlates with the location of nucleation place of the new domain wall. We have measured local nucleation field distribution in all the microwires. From local nucleation field distribution we have obtained the DW nucleation locations and estimated the jump height

  4. Recombinant human bone morphogenetic protein 2-induced heterotopic ossification of the retroperitoneum, psoas muscle, pelvis and abdominal wall following lumbar spinal fusion

    International Nuclear Information System (INIS)

    Shah, Raj K.; Moncayo, Valeria M.; Pierre-Jerome, Claude; Terk, Michael R.; Smitson, Robert D.

    2010-01-01

    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.)

  5. One-stage reconstruction of chest wall defects with greater omentum transplantation

    International Nuclear Information System (INIS)

    Harashina, Takao; Oshiro, Toshio; Sato, Koji.

    1976-01-01

    Reconstructive operation by greater omentum transplantation in two cases of chest wall ulcer due to radiation therapy following an operation of breast cancer was introduced. The exposed dose of one case was not clarified, but that of another case was 5000 rad. This operation method is an excellent one, because operation is completed at one-stage and reconstruction of tissue is great owing to good blood circulation. It was thought that this method must be used more positively in the treatment of chest wall ulcer due to irradiation which is difficult to be treated. (Tsunoda, M.)

  6. Functional evaluation of the grafted wall with porcine-derived small intestinal submucosa (SIS) to a stomach defect in rats.

    Science.gov (United States)

    Ueno, Tomio; de la Fuente, Sebastian G; Abdel-Wahab, Omar I; Takahashi, Toku; Gottfried, Marcia; Harris, Mary B; Tatewaki, Makoto; Uemura, Kenichiro; Lawson, D Curtis; Mantyh, Christopher R; Pappas, Theodore N

    2007-09-01

    Small intestinal submucosa (SIS) represents a novel bio-scaffolding material that may be used to repair hollow-organ defects. However, it is unclear whether neurophysiologic responses return to SIS-grafted areas in the gut. We evaluated the functional recovery of a stomach defect grafted with the porcine-derived SIS. Twelve rats had a full-thickness defect created in the stomach. SIS was secured to the gastric wall. After 6 months, muscle strips were harvested from within the grafted area to perform both a histologic and a functional study. Additional full-thickness muscle strips were harvested from the posterior in the same stomach as controls. A dose response curve was obtained with carbachol (CCH) or sodium nitroprusside (SNP). Activation of intrinsic nerves was achieved by electrical field stimulation (EFS). The response to CCH and amplitude in EFS showed tonic contraction in both controls and SIS strips in a concentration-dependent and frequency-dependent manner. The magnitude after each stimulation was significantly lower in SIS strips compared with controls (P SIS provides a template for nerve migration to the graft in the rodent stomach. Innervations showed a similar distribution to that observed in the controls. The clinical implications of such findings warrant additional investigation.

  7. Successful fertility-preserving management of a case of placenta percreta invading the urinary bladder and anterior abdominal wall: A case report

    Directory of Open Access Journals (Sweden)

    Ahmed M. Abbas

    2018-03-01

    Full Text Available Placenta percreta is defined as abnormal infiltration of placental tissue through the uterine wall with invasion into nearby organs such as bladder or rectum. When placenta precreta is complicated by bladder invasion, mortality rates have been projected as high as 9.5% for the mother and 24% for the fetus. Here we reported a case of 31-year-old female patient G4 P3, pregnant 36 weeks & 4 days, previous 2 cesarean sections with placenta percreta invading the urinary bladder and anterior abdominal wall. Delivery of single living female fetus weight 3100 g with conservative management of the uterus. No placental tissue was left in situ. The patient and her infant were discharged from the hospital in a good health.

  8. 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

    Directory of Open Access Journals (Sweden)

    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.

  9. Image-guided intensity-modulated radiotherapy for refractory bilateral breast cancer in a patient with extensive cutaneous metastasis in the chest and abdominal walls

    Directory of Open Access Journals (Sweden)

    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

  10. Measurement of defects on the wall by use of the inclination angle of laser slit beam and position tracking algorithm of camera

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan; Yoon, Ji Sup; Jung, Jae Hoo; Hong, Dong Hee; Park, Gee Yong

    2001-01-01

    In this paper, a method of measuring the size of defects on the wall and restructuring the defect image is proposed based on the estimation algorithm of a camera orientation which uses the declination angle of the line slit beam. To reconstruct the image, an algorithm of estimating the horizontally inclined angle of CCD camera is presented. This algorithm adopts a 3-dimensional coordinate transformation of the image plane where both the LASER beam and the original image of the defects exist. The estimation equation is obtained by using the information of the beam projected on the wall and the parameters of this equation are experimentally obtained. With this algorithm, the original image of the defect can be reconstructed into the image which is obtained by a camera normal to the wall. From the result of a series of experiment shows that the measuring accuracy of the defect is within 0.5% error bound of real defect size under 30 degree of the horizontally inclined angle. Also, the accuracy is deteriorates with the error rate of 1% for every 10 degree increase of the horizontally inclined angle. The estimation error increases in the range of 30{approx}50 degree due to the existence of dead zone of defect depth, and defect length can not be measured due to the disappearance of image data above 70 degree. In case of under water condition, the measuring accuracy is also influenced due to the changed field of view of both the camera and the laser slit beam caused by the refraction rate in the water. The proposed algorithm provides the method of reconstructing the image taken at any arbitrary camera orientation into the image which is obtained by a camera normal to the wall and thus it enables the accurate measurement of the defect lengths only by using a single camera and a laser slit beam.

  11. Gastrointestinal tract wall visualization and distention during abdominal and pelvic multidetector CT with a neutral barium sulphate suspension: comparison with positive barium sulphate suspension and with water.

    Science.gov (United States)

    Oliva, M R; Erturk, S M; Ichikawa, T; Rocha, T; Ros, P R; Silverman, S G; Mortele, K J

    2012-01-01

    When examining patients with contrast-enhanced multidetector-row CT, we determined if the stomach and small bowel were visualized and distended better with a neutral barium sulphate suspension than with positive barium sulphate suspension or water. After obtaining approval from our institutional review board, 156 patients (women: 84; mean age: 54 yrs) with no history of gastrointestinal tract disease were randomized prospectively to receive orally either 900 ml of neutral (0.1% w/v) barium sulphate suspension (n = 53), 900 ml of positive (2.1% w/v) barium sulphate suspension (n = 53), or 900 ml of water (n = 50), prior to undergoing contrast-enhanced abdominal and pelvic multidetector-row CT. Two independent radiologists evaluated the stomach, and small bowel, for luminal distension and wall visualization, using a five point scale. Results were compared using Kruskal-Wallis and Mann-Whitney U tests. The walls of the stomach, and small bowel were visualized better in patients who were administered neutral barium sulphate suspension than those who were administered either positive barium sulphate suspension (p barium sulphate suspension, the stomach and small bowel were distended better compared to patients administered water (p barium sulphate suspension (p contrast-enhanced abdominal and pelvic multidetector-row CT, orally administered neutral barium sulphate suspension allows the gastrointestinal tract to be visualized and distended better than either positive barium sulphate suspension, or water.

  12. A Rare Case of Giant Basal Cell Carcinoma of the Abdominal Wall: Excision and Immediate Reconstruction with a Pedicled Deep Inferior Epigastric Artery Perforator (DIEP) Flap.

    Science.gov (United States)

    Di Lorenzo, Sara; Zabbia, Giovanni; Corradino, Bartolo; Tripoli, Massimiliano; Pirrello, Roberto; Cordova, Adriana

    2017-12-04

    BACKGROUND Basal cell carcinoma (BCC) greater than 5 cm in diameter is called giant basal cell carcinoma (GBCC), or super giant basal cell carcinoma if it has a diameter larger than 20 cm. Giant BCC only accounts for 0.5% of BCCs and super giant BCC is exceedingly rare. On account of their rarity, there are no established guidelines for GBCC treatment. CASE REPORT We describe a peculiar case of an 82-year-old woman with a GBCC carcinoma of the lower abdominal wall. The tumor was surgically removed with ipsilateral inguinal lymph nodes and the abdominal wall was reconstructed immediately with a pedicled deep inferior epigastric artery perforator (DIEP) flap. CONCLUSIONS Treatment of giant basal cell carcinoma is often difficult, especially in elderly patients with poor general health and multiple pathologies. The pedicled DIEP flap is rotated to cover the loss of substance without tension, and it is easy to harvest and transfer. This flap allowed a good result without local or systemic complication. We present this report as a reminder of the occasional occurrence of extremely aggressive BCCs. We believe that, especially for rare tumors like these, it is very useful for the entire scientific community to publish these cases and the therapeutic strategies used to treat them.

  13. 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

    Directory of Open Access Journals (Sweden)

    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.

  14. Finite Element Implementation of a Structurally-Motivated Constitutive Relation for the Human Abdominal Aortic Wall with and without Aneurysms

    DEFF Research Database (Denmark)

    Enevoldsen, Marie Sand; Henneberg, Kaj-Åge; Lönn, L

    2011-01-01

    The structural integrity of the abdominal aorta is maintained by elastin, collagen, and vascular smooth muscle cells. Changes with age in the structure can lead to develop-ment of aneurysms. This paper presents initial work to capture these changes in a finite element model (FEM) of a structural-ly-motivated...

  15. Beam Expansion of Blind Spot Detection Radar Antennas Using a Radome with Defected Corrugated Inner Wall

    Directory of Open Access Journals (Sweden)

    Hayeon Kim

    2017-01-01

    Full Text Available A beam expanding radome for 76.5 GHz automotive radar antennas is presented whose inner surface is engraved with corrugations. The radar used for blind spot detection (BSD requires a very wide beam width to ensure longer time for tracking out-of-sight objects. It is found that the corrugations modulate the phase velocities of the waves along the surface, which increases beam width in the far field. In addition, defects in the corrugation increase beam width even further. The presented structure satisfies the beam width requirement while keeping a low profile.

  16. Correlation between the 2-Dimensional Extent of Orbital Defects and the 3-Dimensional Volume of Herniated Orbital Content in Patients with Isolated Orbital Wall Fractures

    Directory of Open Access Journals (Sweden)

    Jong Hyun Cha

    2017-01-01

    Full Text Available BackgroundThe purpose of this study was to assess the correlation between the 2-dimensional (2D extent of orbital defects and the 3-dimensional (3D volume of herniated orbital content in patients with an orbital wall fracture.MethodsThis retrospective study was based on the medical records and radiologic data of 60 patients from January 2014 to June 2016 for a unilateral isolated orbital wall fracture. They were classified into 2 groups depending on whether the fracture involved the inferior wall (group I, n=30 or the medial wall (group M, n=30. The 2D area of the orbital defect was calculated using the conventional formula. The 2D extent of the orbital defect and the 3D volume of herniated orbital content were measured with 3D image processing software. Statistical analysis was performed to evaluate the correlations between the 2D and 3D parameters.ResultsVarying degrees of positive correlation were found between the 2D extent of the orbital defects and the 3D herniated orbital volume in both groups (Pearson correlation coefficient, 0.568−0.788; R2=32.2%−62.1%.ConclusionsBoth the calculated and measured 2D extent of the orbital defects showed a positive correlation with the 3D herniated orbital volume in orbital wall fractures. However, a relatively large volume of herniation (>0.9 cm3 occurred not infrequently despite the presence of a small orbital defect (<1.9 cm2. Therefore, estimating the 3D volume of the herniated content in addition to the 2D orbital defect would be helpful for determining whether surgery is indicated and ensuring adequate surgical outcomes.

  17. Is 1p36 deletion associated with anterior body wall defects?

    Science.gov (United States)

    Çöllü, Medis; Yüksel, Şirin; Şirin, Başak Kumbasar; Abbasoğlu, Latif; Alanay, Yasemin

    2016-07-01

    Epispadias and exstrophy of the cloaca, also known as OEIS complex (omphalocele, exstrophy, imperforate anus, spinal defects), respectively constitute the most benign and severe ends of the bladder exstrophy-epispadias complex (BEEC) spectrum. In 2009, El-Hattab et al. reported the first patient with OEIS complex associated with a chromosome 1p36 deletion. Here we report a second patient with 1p36 deletion who also has classic bladder exstrophy, supporting the possible role of genes in this region in the development of BEEC. The absence of omphalocele and imperforate anus in our patient places him toward classic bladder exstrophy while presence of spina bifida and the absence of coccyx suggest an overlap with OEIS complex. An additional differential diagnosis is the pentalogy of Cantrell in our patient as he also has a diaphragmatic hernia and an incomplete sternum. This is the second observation of a ventral midline birth defect in association with 1p36 deletion syndrome, following El-Hattab et al.'s report [2009]. The three genes (NOCL2, DVL1, and MMP23B) discussed as possible candidates are also among the deleted ones in our patient, supporting the possible role of these genes in BEEC spectrum. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Defectos de la pared abdominal

    Directory of Open Access Journals (Sweden)

    Adis L. Peña Cedeño

    2004-03-01

    Full Text Available Se realizó un estudio de los fetos con malformaciones congénitas, dadas por defecto de la pared abdominal (DPA, nacidos en el Hospital Universitario Ginecoobstétrico de Guanabacoa durante los años 1984 al 2000, para determinar la frecuencia de los distintos tipos de defectos de la pared abdominal y las malformaciones asociadas a éstas. Se revisaron los protocolos de necropsias e historias clínicas en este período y se obtuvieron 25 casos con DPA. La malformación más frecuente fue el onfalocele con 14 casos, seguido de la gastrosquisis con 6 casos. Se hallaron malformaciones asociadas en el 68 % de los casos, y se comprobó la efectividad del Programa Nacional de Malformaciones Congénitas, pues en el 80 % de las pacientes se interrumpió precozmente el embarazo.A study of the fetuses with congenital malformations due to defect of the abdominal wall (AWD that were born at the Gynecoobstetric Teaching Hospital of Guanabacoa from 1984 to 2000 was conducted aimed at determining the frequency of the different types of defects of the abdominal wall and the malformations associated with them. The protocosl of necropsies and medical histories corresponding to this period were reviewed and 25 cases with AWD were detected. The most common malformation was omphalocele with 14 cases, followed by gastrosquisis with 6 cases. Associated malformations were found in 68 % of the cases and it was proved the effectiveness of the National Program of Congenital Malformations, since pregnancy was interrupted early in 80 % of the patients.

  19. Defective Pollen Wall is Required for Anther and Microspore Development in Rice and Encodes a Fatty Acyl Carrier Protein Reductase

    Energy Technology Data Exchange (ETDEWEB)

    Shi, J.; Shanklin, J.; Tan, H.; Yu, X.-H.; Liu, Y.; Liang, W.; Ranathunge, K.; Franke, R. B.; Schreiber, L.; Wang, Y.; Kai, G.; Ma, H.; Zhang, D.

    2011-06-01

    Aliphatic alcohols naturally exist in many organisms as important cellular components; however, their roles in extracellular polymer biosynthesis are poorly defined. We report here the isolation and characterization of a rice (Oryza sativa) male-sterile mutant, defective pollen wall (dpw), which displays defective anther development and degenerated pollen grains with an irregular exine. Chemical analysis revealed that dpw anthers had a dramatic reduction in cutin monomers and an altered composition of cuticular wax, as well as soluble fatty acids and alcohols. Using map-based cloning, we identified the DPW gene, which is expressed in both tapetal cells and microspores during anther development. Biochemical analysis of the recombinant DPW enzyme shows that it is a novel fatty acid reductase that produces 1-hexadecanol and exhibits >270-fold higher specificity for palmiltoyl-acyl carrier protein than for C16:0 CoA substrates. DPW was predominantly targeted to plastids mediated by its N-terminal transit peptide. Moreover, we demonstrate that the monocot DPW from rice complements the dicot Arabidopsis thaliana male sterile2 (ms2) mutant and is the probable ortholog of MS2. These data suggest that DPWs participate in a conserved step in primary fatty alcohol synthesis for anther cuticle and pollen sporopollenin biosynthesis in monocots and dicots.

  20. Early laparotomy and timely reconstruction for patients with abdominal electrical injury

    Science.gov (United States)

    Zhang, Pi-Hong; Liu, Zan; Ren, Li-Cheng; Zeng, Ji-Zhang; Huang, Geng-Wen; Xiao, Mu-Zhang; Zhou, Jie; Liang, Peng-Fei; Zhang, Ming-Hua; Huang, Xiao-Yuan

    2017-01-01

    Abstract Introduction: High-tension electricity can cause devastating injuries that may result in abdominal wall loss, visceral damage, and sometimes major threat to life. The visceral organ may be exposed after debridement and require flap cover, but the tensile strength of abdominal wall may be lack even if flap transplanted. Methods: From April 2007 through May 2015, 5 patients with severe abdominal electrical injury were treated at our hospital. Exploratory laparotomy was performed based on their clinical manifestations and debridement findings of abdominal wall at early stage, and decision regarding technique for reconstruction of abdominal wall was based on an assessment of the location and extent of the defect. Medical records were reviewed for these data. Results: Clinical evaluation and debridement findings of the abdomen revealed 4 patients with suspicious visceral damage. Laparotomy was performed in 4 cases, and revealed obvious lesion in 3 cases, including segmental necrosis of small intestine, partial necrosis of diaphragm, left liver and gastric wall, and greater omentum. Five patients underwent abdominal wall reconstruction using island retrograde latissimus dorsi myocutaneous flap or free/island composite anterolateral thigh myocutaneous flap. All flaps survived, abdominal bulging occurred in 3 cases after follow-up of 12 to 36 months. Conclusions: The clinical manifestations and wound features of abdomen collectively suggest a possible requirement of laparotomy for severe abdominal electrical burns. Retrograde latissimus dorsi myocutaneous flap or composite anterolateral thigh myocutaneous flap is an effective option for reconstruction of abdominal wall loss, the long-term complication of abdominal bulging, however, remains a significant clinical challenge. PMID:28723751

  1. Trapping of defect point to improve response time via controlled azimuthal anchoring in a vertically aligned liquid crystal cell with polymer wall

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Gyun; Kim, Sung Min; Kim, Youn Sik; Lee, Hee Kyu; Lee, Seung Hee [Polymer BIN Fusion Research Center, School of Advanced Materials Engineering, Chonbuk National University, Chonju, Chonbuk 561-756 (Korea, Republic of); Lyu, Jae-Jin; Kim, Kyeong Hyeon [AMLCD Division, Samsung Electronics, Kiheung, Kyunggi-Do 449-711 (Korea, Republic of); Lu, Ruibo; Wu, Shin-Tson [College of Optics and Photonics, University of Central Florida, Orlando FL 32816 (United States)], E-mail: lsh1@chonbuk.ac.kr

    2008-03-07

    Conventional multi-domain vertically aligned liquid crystal (LC) cells have defect points due to the collision of LC directors during the formation of multiple domains. In addition, the location of defects changes with time resulting in a slow response time. This paper proposes a robust vertically aligned LC cell, where the LCs are locked by polymer walls, and the azimuthal anchoring on the surface of the alignment layer is controlled by the polymerization of a UV curable reactive mesogen monomer. As a result, the defect points are trapped at a single position, resulting in a greatly improved response time.

  2. Hernia Following Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    N Aghaie

    2009-10-01

    Full Text Available Traumatic abdominal wall hernia is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occurs with the overlying skin remaining intact. Diagnosis of this problem is very difficult and delayed. Traumatic hernia is often diagnosed during laparatomy or laparascopy, but CT scan also has a role in distinguishing this pathology. Delay in diagnosis is very dangerous and can result in gangrene and necrosis of the organs in the hernia. The case report of a 35 years old man with liftruck blunt trauma is reported. His vital signs were stable. On physical examination, tenderness of RUQ was seen. He underwent Dpl for suspected hemoprotein. Dpl was followed up by laparatomy. Laparatomy revealed that the transverse and ascending colon partially herniated in the abdominal wall defect. The colon was reduced in the abdomen and repair of abdominal hernia was done. The patient was discharged after 5 day. The etiology, pathogenesis and management are discussed.

  3. Brief clinical report: prune belly syndrome: observations supporting the hypothesis of abdominal overdistention.

    Science.gov (United States)

    Burton, B K; Dillard, R G

    1984-03-01

    We report on an infant with the prune belly syndrome who was unusual in that the typical manifestations of the disorder were accompanied by an anterior abdominal wall defect. We speculate that this defect may have occurred as a result of splitting of the abdominal wall secondary to massive bladder dilatation and stretching of the abdominal muscles. An alternative explanation is that the defect may have been the result of secondary pressure necrosis from stretching forces or from contact with another structure, such as the cervix. This case lends further support to the hypothesis that bladder distention with overdistention of the abdomen may be the primary event leading to the findings observed in the prune belly syndrome.

  4. Plasma induced material defects and threshold values for thermal loads in high temperature resistant alloys and in refractory metals for first wall application in fusion reactors

    International Nuclear Information System (INIS)

    Bolt, H.; Hoven, H.; Kny, E.; Koizlik, K.; Linke, J.; Nickel, H.; Wallura, E.

    1986-10-01

    Materials for the application in the first wall of fusion reactors of the tokamak type are subjected to pulsed heat fluxes which range from some 0.5 MW m -2 to 10 MW m -2 during normal plasma operation, and which can exceed 1000 MW m -2 during total plasma disruptions. The structural defects and material fatigue caused by this types of plasma wall interaction are investigated and the results are plotted in threshold loading curves. Additionally, the results are, as far as possible, compared with quantitative, theoretical calculations. These procedures allow a semiquantitative evaluation of the applicability of the mentioned metals in the first wall of fusion reactors. (orig.) [de

  5. The pedicled omentoplasty and split skin graft (POSSG) for reconstruction of large chest wall defects. A validity study of 34 patients

    NARCIS (Netherlands)

    C.M.E. Contant; A.N. van Geel (Albert); B. van der Holt (Bronno); T. Wiggers (Theo)

    1996-01-01

    textabstractThe aim of this study was to evaluate retrospectively the results of pedicled omentoplasty and split skin graft (POSSG) in reconstructing (full thickness) chest wall defects, and to define its role as a palliative procedure for local symptom control. Thirty-four patients with recurrent

  6. Abdominal wall integrity after open abdomen: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM).

    Science.gov (United States)

    Willms, A; Schaaf, S; Schwab, R; Richardsen, I; Bieler, D; Wagner, B; Güsgen, C

    2016-12-01

    The open abdomen has become a standard technique in the management of critically ill patients undergoing surgery for severe intra-abdominal conditions. Negative pressure and mesh-mediated fascial traction are commonly used and achieve low fistula rates and high fascial closure rates. In this study, long-term results of a standardised treatment approach are presented. Fifty-five patients who underwent OA management for different indications at our institution from 2006 to 2013 were enrolled. All patients were treated under a standardised algorithm that uses a combination of vacuum-assisted wound closure and mesh-mediated fascial traction. Structured follow-up assessments were offered to patients and included a medical history, a clinical examination and abdominal ultrasonography. The data obtained were statistically analysed. The fascial closure rate was 74 % in an intention-to-treat analysis and 89 % in a per-protocol analysis. The fistula rate was 1.8 %. Thirty-four patients attended follow-up. The median follow-up was 46 months (range 12-88 months). Incisional hernias developed in 35 %. Patients with hernias needed more operative procedures (10.3 vs 3.4, p = 0.03) than patients without hernia formation. A Patient Observer Scar Assessment Scale (POSAS) of 31.1 was calculated. Patients with symptomatic hernias (NAS of 2-10) had a significantly lower mean POSAS score (p = 0.04). Vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) seem to result in low complication rates and high fascial closure rates. Abdominal wall reconstruction, which is a challenging and complex procedure and causes considerable patient discomfort, can thus be avoided in the majority of cases. Available results are based on studies involving only a small number of cases. Multi-centre studies and registry-based data are therefore needed to validate these findings.

  7. Periodontal regenerative effect of a bovine hydroxyapatite/collagen block in one-wall intrabony defects in dogs: a histometric analysis.

    Science.gov (United States)

    Jung, Ui-Won; Lee, Jung-Seok; Park, Weon-Yeong; Cha, Jae-Kook; Hwang, Ji-Wan; Park, Jung-Chul; Kim, Chang-Sung; Cho, Kyoo-Sung; Chai, Jung-Kiu; Choi, Seong-Ho

    2011-12-01

    The aim of this study was to elucidate the effect of a bovine hydroxyapatite/collagen (BHC) block in one-wall intrabony periodontal defects in dogs. A one-wall intrabony periodontal defect (4 mm wide and 5 mm deep) was prepared bilaterally at the mesial side of the mandibular fourth premolar in five beagle dogs. After thorough root planing, block-type BHC (4×5×5 mm) was placed on one side. The contralateral defect area did not receive any material as a sham-surgery control. Histological analysis of the sites was performed after an 8-week healing period. Two of five samples in the experimental group healed well without dissipation of the graft materials, and histological analysis revealed excellent regeneration of the periodontal tissues. However, most of the grafted materials had been displaced in the other three samples, leaving only a small portion of the graft. The measured parameters exhibited large standard deviations, and the mean values did not differ significantly between the experimental and sham-surgery control sides. The application of BHC alone-without a barrier membrane-to wide, one-wall intrabony periodontal defects yielded inconsistent results regarding both periodontal regeneration and substantivity of the graft materials. Thus, the use of a barrier membrane for noncontained-type defects is recommended to improve the stability of the grafted material, and to condense it.

  8. How should an infected perinephric haematoma be drained in a tetraplegic patient with baclofen pump implanted in the abdominal wall? – A case report

    Directory of Open Access Journals (Sweden)

    Watt John WH

    2002-09-01

    Full Text Available Abstract Background We present a case to illustrate controversies in percutaneous drainage of infected, perinephric haematoma in a tetraplegic patient, who had implantation of baclofen pump in anterior abdominal wall on the same side as perinephric haematoma. Case presentation A 56-year-old male with C-4 tetraplegia had undergone implantation of programmable pump in the anterior abdominal wall for intrathecal infusion of baclofen to control spasticity. He developed perinephric haematoma while he was taking warfarin as prophylactic for deep vein thrombosis. Perinephric haematoma became infected with a resistant strain of Pseudomonas aeruginosa, and required percutaneous drainage. Positioning this patient on his abdomen without anaesthesia, for insertion of a catheter from behind, was not a realistic option. Administration of general anaesthesia in this patient in the radiology department would have been hazardous. Results and Conclusion Percutaneous drainage was carried out by anterior approach under propofol sedation. The site of entry of percutaneous catheter was close to cephalic end of baclofen pump. By carrying out drainage from anterior approach, and by keeping this catheter for ten weeks, we took a risk of causing infection of the baclofen pump site, and baclofen pump with a resistant strain of Pseudomonas aeruginosa. The alternative method would have been to anaesthetise the patient and position him prone for percutaneous drainage of perinephric collection from behind. This would have ensured that the drainage track was far away from the baclofen pump with minimal risk of infection of baclofen pump, but at the cost of incurring respiratory complications in a tetraplegic subject.

  9. Obesity-Associated Abdominal Elephantiasis

    Directory of Open Access Journals (Sweden)

    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.

  10. A nicotina atua como fator deletério na reparação da parede abdominal The nicotine has a deleterious effect on the healing of abdominal wall

    Directory of Open Access Journals (Sweden)

    Aldo da Cunha Medeiros

    2003-01-01

    Full Text Available OBJETIVO: Avaliar o efeito da nicotina na cicatrização da camada musculoaponeurótica da parede abdominal. MÉTODOS: Estudo experimental em que foram usados 16 ratos da raça Wistar pesando em média 210± 8g, separados aleatoriamente em 2 grupos de 8. Nos animais do grupo A foi implantado disco de nicotina (Nicotinel Ò na dose de 5mg/Kg de peso/dia no subcutâneo da região dorsal, trocado a cada dois dias, a partir do 5º dia antes da operação em que foi feita laparotomia mediana de 5 cm, até o 10º dia de observação. No grupo B (controle foram usados discos de celulose com o mesmo diâmetro. Tubo de silicone multiperfurado foi implantado no subcutâneo a 1cm da lesão da parede abdominal. A camada musculoaponeurótica e a pele foram suturadas com fio de nylon 5-0. No 10º dia pós-operatório foi colhido 1ml de líquido seroso do tubo de silicone por punção percutânea para dosagem de pO2 e os animais receberam dose letal de anestésico. Foi ressecado um segmento da camada musculoaponeurótica com 2cm de largura para tensiometria, em seguida processado e corado em HE e tricrômico de Masson para análise quantitativa dos dados histopatológicos em sistema digitalizado. A análise estatística foi feita pelo ANOVA e teste Newman-Keuls, com significância 0,05. RESULTADOS: No grupo A a pO2 do líquido tecidual atingiu o valor 17,75± 3,4 mmHg e no grupo B (controle a pO2 = 40,75± 6,4 mmHg (pOBJETIVE: An experimental study was done to evaluate the effect of nicotine on the healing of abdominal wall. METHODS: Sexteen Wistar rats weighing 210± 8g were randomly separated into two groups of eight rats each. In the group A Nicotine (Nicotinel Ò was implanted in the back subcutaneous 5mg/Kg each two days, begining at the fifth preoperative day. A 5cm median laparotomy was done, sutured with nylon 5-0 and the rats were observed in individual cages. The group B (control didn’t use nicotine. A multiperfurated silicone tube was implanted

  11. Effects of concomitant use of fibroblast growth factor (FGF)-2 with beta-tricalcium phosphate (β-TCP) on the beagle dog 1-wall periodontal defect model

    International Nuclear Information System (INIS)

    Anzai, Jun; Kitamura, Masahiro; Nozaki, Takenori; Nagayasu, Toshie; Terashima, Akio; Asano, Taiji; Murakami, Shinya

    2010-01-01

    Research highlights: → Concomitant use of FGF-2 and β-TCP (an osteo-conductive scaffold) significantly promotes periodontal regeneration in the severe periodontitis model (1-wall defect model) of beagle dog. → FGF-2 enhanced new bone formation via β-TCP at the defects. → In particular, FGF-2 dramatically regenerated new periodontal ligament and cementum formations at the defects, that is one of the most important healing outcomes during the process of periodontal regeneration. → Epithelial downgrowth (undesirable wound healing) was decreased by administration of FGF-2. → This manuscript indicates for the first time that concomitant use of FGF-2 and β-TCP is efficacious in regenerating periodontal tissue following severe destruction of the tissue by progression of periodontitis. -- Abstract: The effects of concomitant use of fibroblast growth factor-2 (FGF-2) and beta-tricalcium phosphate (β-TCP) on periodontal regeneration were investigated in the beagle dog 1-wall periodontal defect model. One-wall periodontal defects were created in the mesial portion of both sides of the mandibular first molars, and 0.3% FGF-2 plus β-TCP or β-TCP alone was administered. Radiographic evaluation was performed at 0, 3, and 6 weeks. At 6 weeks, the periodontium with the defect site was removed and histologically analyzed. Radiographic findings showed that co-administration of FGF-2 significantly increased bone mineral contents of the defect sites compared with β-TCP alone. Histologic analysis revealed that the length of the regenerated periodontal ligament, the cementum, distance to the junctional epithelium, new bone height, and area of newly formed bone were significantly increased in the FGF-2 group. No abnormal inflammatory response or ankylosis was observed in either group. These findings indicate the efficacy of concomitant use of FGF-2 and β-TCP as an osteoconductive material for periodontal regeneration following severe destruction by progressive

  12. Effects of concomitant use of fibroblast growth factor (FGF)-2 with beta-tricalcium phosphate ({beta}-TCP) on the beagle dog 1-wall periodontal defect model

    Energy Technology Data Exchange (ETDEWEB)

    Anzai, Jun, E-mail: anzai_jun@kaken.co.jp [Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co., Ltd., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto 607-8042 (Japan); Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan); Kitamura, Masahiro, E-mail: kitamura@dent.osaka-u.ac.jp [Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan); Nozaki, Takenori, E-mail: tnozaki@dent.osaka-u.ac.jp [Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan); Nagayasu, Toshie, E-mail: nagayasu_toshie@kaken.co.jp [Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co., Ltd., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto 607-8042 (Japan); Terashima, Akio, E-mail: terashima_akio@kaken.co.jp [Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co., Ltd., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto 607-8042 (Japan); Asano, Taiji, E-mail: asano_taiji@kaken.co.jp [Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co., Ltd., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto 607-8042 (Japan); Murakami, Shinya, E-mail: ipshinya@dent.osaka-u.ac.jp [Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)

    2010-12-17

    Research highlights: {yields} Concomitant use of FGF-2 and {beta}-TCP (an osteo-conductive scaffold) significantly promotes periodontal regeneration in the severe periodontitis model (1-wall defect model) of beagle dog. {yields} FGF-2 enhanced new bone formation via {beta}-TCP at the defects. {yields} In particular, FGF-2 dramatically regenerated new periodontal ligament and cementum formations at the defects, that is one of the most important healing outcomes during the process of periodontal regeneration. {yields} Epithelial downgrowth (undesirable wound healing) was decreased by administration of FGF-2. {yields} This manuscript indicates for the first time that concomitant use of FGF-2 and {beta}-TCP is efficacious in regenerating periodontal tissue following severe destruction of the tissue by progression of periodontitis. -- Abstract: The effects of concomitant use of fibroblast growth factor-2 (FGF-2) and beta-tricalcium phosphate ({beta}-TCP) on periodontal regeneration were investigated in the beagle dog 1-wall periodontal defect model. One-wall periodontal defects were created in the mesial portion of both sides of the mandibular first molars, and 0.3% FGF-2 plus {beta}-TCP or {beta}-TCP alone was administered. Radiographic evaluation was performed at 0, 3, and 6 weeks. At 6 weeks, the periodontium with the defect site was removed and histologically analyzed. Radiographic findings showed that co-administration of FGF-2 significantly increased bone mineral contents of the defect sites compared with {beta}-TCP alone. Histologic analysis revealed that the length of the regenerated periodontal ligament, the cementum, distance to the junctional epithelium, new bone height, and area of newly formed bone were significantly increased in the FGF-2 group. No abnormal inflammatory response or ankylosis was observed in either group. These findings indicate the efficacy of concomitant use of FGF-2 and {beta}-TCP as an osteoconductive material for periodontal

  13. Effectiveness of triclosan-coated PDS Plus versus uncoated PDS II sutures for prevention of surgical site infection after abdominal wall closure: the randomised controlled PROUD trial.

    Science.gov (United States)

    Diener, Markus K; Knebel, Phillip; Kieser, Meinhard; Schüler, Philipp; Schiergens, Tobias S; Atanassov, Vladimir; Neudecker, Jens; Stein, Erwin; Thielemann, Henryk; Kunz, Reiner; von Frankenberg, Moritz; Schernikau, Utz; Bunse, Jörg; Jansen-Winkeln, Boris; Partecke, Lars I; Prechtl, Gerald; Pochhammer, Julius; Bouchard, Ralf; Hodina, René; Beckurts, K Tobias E; Leißner, Lothar; Lemmens, Hans-Peter; Kallinowski, Friedrich; Thomusch, Oliver; Seehofer, Daniel; Simon, Thomas; Hyhlik-Dürr, Alexander; Seiler, Christoph M; Hackert, Thilo; Reissfelder, Christoph; Hennig, René; Doerr-Harim, Colette; Klose, Christina; Ulrich, Alexis; Büchler, Markus W

    2014-07-12

    Postoperative surgical site infections are one of the most frequent complications after open abdominal surgery, and triclosan-coated sutures were developed to reduce their occurrence. The aim of the PROUD trial was to obtain reliable data for the effectiveness of triclosan-coated PDS Plus sutures for abdominal wall closure, compared with non-coated PDS II sutures, in the prevention of surgical site infections. This multicentre, randomised controlled group-sequential superiority trial was done in 24 German hospitals. Adult patients (aged ≥18 years) who underwent elective midline abdominal laparotomy for any reason were eligible for inclusion. Exclusion criteria were impaired mental state, language problems, and participation in another intervention trial that interfered with the intervention or outcome of this trial. A central web-based randomisation tool was used to randomly assign eligible participants by permuted block randomisation with a 1:1 allocation ratio and block size 4 before mass closure to either triclosan-coated sutures (PDS Plus) or uncoated sutures (PDS II) for abdominal fascia closure. The primary endpoint was the occurrence of superficial or deep surgical site infection according to the Centers for Disease Control and Prevention criteria within 30 days after the operation. Patients, surgeons, and the outcome assessors were masked to group assignment. Interim and final analyses were by modified intention to treat. This trial is registered with the German Clinical Trials Register, number DRKS00000390. Between April 7, 2010, and Oct 19, 2012, 1224 patients were randomly assigned to intervention groups (607 to PDS Plus, and 617 to PDS II), of whom 1185 (587 PDS Plus and 598 PDS II) were analysed by intention to treat. The study groups were well balanced in terms of patient and procedure characteristics. The occurrence of surgical site infections did not differ between the PDS Plus group (87 [14·8%] of 587) and the PDS II group (96 [16·1%] of 598

  14. A preclinical evaluation of polypropylene/polylacticacid hybrid meshes for fascial defect repair using a rat abdominal hernia model

    Science.gov (United States)

    Le Teuff, Isabelle; Huberlant, Stephanie; Carteron, Patrick; Letouzey, Vincent; de Tayrac, Renaud

    2017-01-01

    Objectives Synthetic mesh surgery for both abdominal and urogenital hernia repair is often unsatisfactory in the long-term due to postoperative complications. We hypothesized that a semi-degradable mesh hybrid may provide more appropriate biocompatibility with comparable mechanical properties. The aim was to compare its in vivo biocompatibility with a commercial polypropylene (PP) mesh. Methods 72 rats were randomly allocated to either our new composite mesh (monofilament PP mesh knitted with polylactic-acid-fibers (PLA)) or to a commercially available PP mesh that was used as a control. 15, 90, and 180 days after implantation into the rat abdomen mesh tissue complexes were analysed for erosion, contraction, foreign body reaction, tissue integration and biomechanical properties. Results No differences were seen in regard to clinical parameters including erosion, contraction or infection rates between the two groups. Biomechanical properties including breaking load, stiffness and deformation did not show any significant differences between the different materials at any timepoint. Macrophage staining did not reveal any significant differences between the two groups or between timepoints either. In regard to collagen I there was significantly less collagen I in the PP group compared to the PP/ PLA group at day 180. Collagen III did not show any significant differences at any timepoint between the two groups. Conclusion A PP/PLA hybrid mesh, leaving a low amount of PP after PLA degradation seems to have comparable biomechanical properties like PP at 180 days due to enhanced collagen production without significant differences in erosion, contraction, herniation or infection rates. PMID:28598983

  15. A preclinical evaluation of polypropylene/polylacticacid hybrid meshes for fascial defect repair using a rat abdominal hernia model.

    Directory of Open Access Journals (Sweden)

    Daniela Ulrich

    Full Text Available Synthetic mesh surgery for both abdominal and urogenital hernia repair is often unsatisfactory in the long-term due to postoperative complications. We hypothesized that a semi-degradable mesh hybrid may provide more appropriate biocompatibility with comparable mechanical properties. The aim was to compare its in vivo biocompatibility with a commercial polypropylene (PP mesh.72 rats were randomly allocated to either our new composite mesh (monofilament PP mesh knitted with polylactic-acid-fibers (PLA or to a commercially available PP mesh that was used as a control. 15, 90, and 180 days after implantation into the rat abdomen mesh tissue complexes were analysed for erosion, contraction, foreign body reaction, tissue integration and biomechanical properties.No differences were seen in regard to clinical parameters including erosion, contraction or infection rates between the two groups. Biomechanical properties including breaking load, stiffness and deformation did not show any significant differences between the different materials at any timepoint. Macrophage staining did not reveal any significant differences between the two groups or between timepoints either. In regard to collagen I there was significantly less collagen I in the PP group compared to the PP/ PLA group at day 180. Collagen III did not show any significant differences at any timepoint between the two groups.A PP/PLA hybrid mesh, leaving a low amount of PP after PLA degradation seems to have comparable biomechanical properties like PP at 180 days due to enhanced collagen production without significant differences in erosion, contraction, herniation or infection rates.

  16. Experimental study of ASCs combined with POC-PLA patch for the reconstruction of full-thickness chest wall defects.

    Directory of Open Access Journals (Sweden)

    Yuanzheng Zhang

    Full Text Available To explore the repairing effect of combination of adipose stem cells (ASCs and composite scaffolds on CWR, the electrospun Poly 1, 8-octanediol-co-citric acid (POC-poly-L-lactide acid (PLA composite scaffolds were prepared, followed by in vitro and in vivo biocompatibility evaluation of the scaffolds. Afterwards, ASCs were seeded on POC-PLA to construct the POC-PLA-ASCs scaffolds, and the POC-PLA, POC-PLA-ASCs, and traditional materials expanded polytetrafluoroethylene (ePTFE were adopt for CWR in New Zealand white (NZW rabbit models. As results, the POC-PLA-ASCs patches possessed good biocompatibility as the high proliferation ability of cells surrounding the patches. Rabbits in POC-PLA-ASCs groups showed better pulmonary function, less pleural adhesion, higher degradation rate and more neovascularization when compared with that in other two groups. The results of western blot indicated that POC-PLA-ASCs patches accelerated the expression of VEGF and Collagen I in rabbit models. From the above, our present study demonstrated that POC-PLA material was applied for CWR successfully, and ASCs seeded on the sheets could improve the pleural adhesions and promote the reparation of chest wall defects.

  17. Experimental study of ASCs combined with POC-PLA patch for the reconstruction of full-thickness chest wall defects.

    Science.gov (United States)

    Zhang, Yuanzheng; Fang, Shuo; Dai, Jiezhi; Zhu, Lei; Fan, Hao; Tang, Weiya; Fan, Yongjie; Dai, Haiying; Zhang, Peipei; Wang, Ying; Xing, Xin; Yang, Chao

    2017-01-01

    To explore the repairing effect of combination of adipose stem cells (ASCs) and composite scaffolds on CWR, the electrospun Poly 1, 8-octanediol-co-citric acid (POC)-poly-L-lactide acid (PLA) composite scaffolds were prepared, followed by in vitro and in vivo biocompatibility evaluation of the scaffolds. Afterwards, ASCs were seeded on POC-PLA to construct the POC-PLA-ASCs scaffolds, and the POC-PLA, POC-PLA-ASCs, and traditional materials expanded polytetrafluoroethylene (ePTFE) were adopt for CWR in New Zealand white (NZW) rabbit models. As results, the POC-PLA-ASCs patches possessed good biocompatibility as the high proliferation ability of cells surrounding the patches. Rabbits in POC-PLA-ASCs groups showed better pulmonary function, less pleural adhesion, higher degradation rate and more neovascularization when compared with that in other two groups. The results of western blot indicated that POC-PLA-ASCs patches accelerated the expression of VEGF and Collagen I in rabbit models. From the above, our present study demonstrated that POC-PLA material was applied for CWR successfully, and ASCs seeded on the sheets could improve the pleural adhesions and promote the reparation of chest wall defects.

  18. Evaluation of a platelet lysate bilayered system for periodontal regeneration in a rat intrabony three-wall periodontal defect.

    Science.gov (United States)

    Babo, Pedro S; Cai, Xinjie; Plachokova, Adelina S; Reis, Rui L; Jansen, John; Gomes, Manuela E; Walboomers, X Frank

    2018-02-01

    With currently available therapies, full regeneration of lost periodontal tissues after periodontitis cannot be achieved. In this study, a combined compartmentalized system was tested, composed of (a) a platelet lysate (PL)-based construct, which was placed along the root aiming to regenerate the root cementum and periodontal ligament, and (b) a calcium phosphate cement composite incorporated with hyaluronic acid microspheres loaded with PL, aiming to promote the regeneration of alveolar bone. This bilayered system was assessed in a 3-wall periodontal defect in Wistar rats. The periodontal healing and the inflammatory response of the materials were scored for a period up to 6 weeks after implantation. Furthermore, histomorphometrical measurements were performed to assess the epithelial downgrowth, the formation of alveolar bone, and the formation of new connective tissue attachment. Our data showed that the stabilization of platelet-origin proteins on the root surface increased the overall periodontal healing score and restricted the formation of long epithelial junctions. Nevertheless, the faster degradation of the cement component with incorporated hyaluronic acid microspheres compromised the stability of the system, which hampered the periodontal regeneration. Overall, in this work, we proved the positive therapeutic effect of the immobilization of a PL-based construct over the root surface in a combined compartmentalized system to assist predictable healing of functional periodontium. Therefore, after optimization of the hard tissue analogue, the system should be further elaborated in (pre)clinical validation studies. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Bone regeneration in 3D printing bioactive ceramic scaffolds with improved tissue/material interface pore architecture in thin-wall bone defect.

    Science.gov (United States)

    Shao, Huifeng; Ke, Xiurong; Liu, An; Sun, Miao; He, Yong; Yang, Xianyan; Fu, Jianzhong; Liu, Yanming; Zhang, Lei; Yang, Guojing; Xu, Sanzhong; Gou, Zhongru

    2017-04-12

    Three-dimensional (3D) printing bioactive ceramics have demonstrated alternative approaches to bone tissue repair, but an optimized materials system for improving the recruitment of host osteogenic cells into the bone defect and enhancing targeted repair of the thin-wall craniomaxillofacial defects remains elusive. Herein we systematically evaluated the role of side-wall pore architecture in the direct-ink-writing bioceramic scaffolds on mechanical properties and osteogenic capacity in rabbit calvarial defects. The pure calcium silicate (CSi) and dilute Mg-doped CSi (CSi-Mg6) scaffolds with different layer thickness and macropore sizes were prepared by varying the layer deposition mode from single-layer printing (SLP) to double-layer printing (DLP) and then by undergoing one-, or two-step sintering. It was found that the dilute Mg doping and/or two-step sintering schedule was especially beneficial for improving the compressive strength (∼25-104 MPa) and flexural strength (∼6-18 MPa) of the Ca-silicate scaffolds. The histological analysis for the calvarial bone specimens in vivo revealed that the SLP scaffolds had a high osteoconduction at the early stage (4 weeks) but the DLP scaffolds displayed a higher osteogenic capacity for a long time stage (8-12 weeks). Although the DLP CSi scaffolds displayed somewhat higher osteogenic capacity at 8 and 12 weeks, the DLP CSi-Mg6 scaffolds with excellent fracture resistance also showed appreciable new bone tissue ingrowth. These findings demonstrate that the side-wall pore architecture in 3D printed bioceramic scaffolds is required to optimize for bone repair in calvarial bone defects, and especially the Mg doping wollastontie is promising for 3D printing thin-wall porous scaffolds for craniomaxillofacial bone defect treatment.

  20. Weighted abdominal traction for assistance in abdominal closure

    Directory of Open Access Journals (Sweden)

    Wendy Jo Svetanoff

    2018-02-01

    Discussion: One of the concerns with temporary abdominal closure is retraction of the fascia. We report three cases where the fascia and abdominal wall were placed on weighted traction, which allowed for retention of abdominal domain and delayed primary closure without grafts or mesh. This approach adds to the options available to aid in closure of the complex abdomen.

  1. Spontaneous Ag-Nanoparticle Growth at Single-Walled Carbon Nanotube Defect Sites: A Tool for In Situ Generation of SERS Substrate

    Directory of Open Access Journals (Sweden)

    Jason Maley

    2011-01-01

    Full Text Available Silver nanoparticles were spontaneously formed on pristine and oxidized single-wall nanotubes. Nanoparticles were observed on carbon nanotubes with AFM, and the presence of Ag nanoparticles were confirmed by ESR experiments. Raman spectroscopy of the Ag-treated carbon nanotubes had a 4–10X enhancement of intensity compared to untreated carbon nanotubes. Ag nanoparticles formed at defect sites on the CNT surface, where free electrons located at the defect sites reduced Ag+ to Ag. A mechanism for the propagation of the nanoparticles is through a continual negative charge generation on the nanoparticle by electron transfer from doublet oxygen (O2−.

  2. Computational modeling of abdominal hernia laparoscopic repair with a surgical mesh.

    Science.gov (United States)

    Todros, Silvia; Pachera, Paola; Baldan, Nicola; Pavan, Piero G; Pianigiani, Silvia; Merigliano, Stefano; Natali, Arturo N

    2018-01-01

    Although new techniques and prostheses have been introduced in ventral hernia surgery, abdominal hernia repair still presents complications, such as recurrence, pain, and discomfort. Thus, this work implements a computational method aimed at evaluating biomechanical aspects of the abdominal hernia laparoscopic repair, which can support clinical research tailored to hernia surgery. A virtual solid model of the abdominal wall is obtained from MRI scans of a healthy subject. The mechanical behavior of muscular and fascial tissues is described by constitutive formulations with specific parameters. A defect is introduced to reproduce an incisional hernia. Laparoscopic repair is mimicked via intraperitoneal positioning of a surgical mesh. Numerical analyses are performed to evaluate the mechanical response of the abdominal wall in healthy, herniated and post-surgery configurations, considering physiological intra-abdominal pressures. During the deformation of the abdominal wall at increasing pressures, a percentage displacement increment up to 6% is found in the herniated condition, while the mechanical behavior of the repaired abdomen is similar to the healthy one. In the pressure range between 8 mmHg and 55 mmHg, the herniated abdomen shows an incremental stiffness differing of 7% with respect to the healthy condition, while the post-surgery condition shows an increase of the incremental stiffness up to 58%. This computational approach may be exploited to investigate different aspects of abdominal wall surgical repair, including mesh mechanical characteristics and positioning. Numerical modeling offers a helpful support for selecting the best-fitting prosthesis for customize pre-surgery planning.

  3. A comparative study on treatment of two and three walled periodontal bony defects utilizing open flap debridement with and without enamel matrix derivatives

    Directory of Open Access Journals (Sweden)

    Soleimani Shayesteh Y.

    2006-08-01

    Full Text Available Background and Aim: Intrabony periodontal defects are important problems in periodontology and up to now several ways have been suggested for their treatment .Treatment with enamel matrix derivatives (EMD has been shown to enhance periodontal regeneration. There is limited information available from clinical trials regarding the performance of EMD in the treatment of periodontal intrabony defects. This study was designed to compare the clinical and radiographic effects of EMD treatment to that of open flap debridment (OFD for two and three walled intrabony defects. Materials and Methods: 18 patients were included in this clinical trial which have 24 two and/ or three intrabony defects. Defects were randomly divided into two groups (test and control. Defects in test group were treated with flap surgery plus EMD and in control group with open flap debridment. At baseline and at 3 and 6 months follow up, clinical and radiographic measurements were performed. Data were analyzed using Greenhouse-Geisser test with p<0.05 as the limit of significance. Results: At 3 and 6 months, mean probing pocket depth reduction was greater in the test group (EMD (4.33 mm and 4.70 mm compared to the OFD group (2.54 mm and 3.09 mm. Mean values for clinical attachment gain in the EMD group after 3 and 6 months were 4.29 mm and 4.98 mm, and in OFD group were 2.83 and 2.82 mm respectively. Radiographic bone gain measured by radiovisiography technique was greater in the EMD group compared to the OFD group (4.66 mm in EMD and 1.11 mm in OFD group after 3 months and 5.78 mm in EMD and 1.39 mm in OFD group after 6 months. Conclusion: Based on the results of this study, treatment with flap surgery and EMD compared to open flap debridment, produced more favorable clinical improvements in two and three walled intrabony defects.

  4. Omphalocele, exstrophy of cloaca, imperforate anus and spinal defect (OEIS Complex) with overlapping features of body stalk anomaly (limb body wall complex).

    Science.gov (United States)

    Mandrekar, Suresh R S; Amoncar, Sangeeta; Banaulikar, Siddhartha; Sawant, Vishal; Pinto, R G W

    2014-04-01

    OEIS is an extremely rare constellation of malformations, which includes omphalocele, exstrophy of cloaca, imperforate anus, and spinal defect. We report here autopsy findings in a case of OEIS complex, which apart from the major anomalies of the complex had bilateral club foot that is, congenital talipes equinovarus, right hydroureter, and body stalk anomaly. The umbilical cord was absent, and the umbilical vessels were embedded in an amniotic sheet, which connected the skin margin of the anterior body wall defect to the placenta, this feature being the hallmark of limb body wall complex (LBWC). This case further supports the view that OEIS and LBWC represent a continuous spectrum of abnormalities rather than separate conditions and may share a common etiology and pathogenetic mechanism as proposed by some authors.

  5. Prenatal MRI evaluation of limb-body wall complex

    Energy Technology Data Exchange (ETDEWEB)

    Aguirre-Pascual, Elisa [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Hospital Universitario Doce de Octubre, Department of Radiology, Madrid (Spain); Epelman, Monica [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Nemours Children' s Hospital, Department of Medical Imaging, Orlando, FL (United States); Johnson, Ann M.; Chauvin, Nancy A.; Coleman, Beverly G.; Victoria, Teresa [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States)

    2014-11-15

    The sonographic (US) features of limb-body wall complex have been well documented; however the literature regarding the findings on MRI in limb-body wall complex is scant. To characterize the prenatal MRI features of limb-body wall complex. We performed a retrospective review of all MRI scans of fetuses diagnosed with limb-body wall complex at our institution from 2001 to 2011. Fetuses without correlating US scans or follow-up information were excluded. Three pediatric radiologists blinded to the specific US findings reviewed the prenatal MRIs. Images were evaluated for the organ location and attachment, the body part affected, characterization of the body wall defect, and spinal, limb and umbilical cord abnormalities. Ten subjects met inclusion criteria. MRI was able to detect and characterize the body part affected and associated abnormalities. All fetuses had ventral wall defects, a small thorax and herniated liver and bowel. The kidneys were extracorporeal in three cases. The extruded organs were attached to the placenta or the uterine wall in all cases. Abnormal spinal curvatures of various degrees of severity were present in all cases. Eight cases had a short, uncoiled cord. Limb anomalies were present in 6 of the 10 cases. We illustrate the common fetal MRI findings of limb-body wall complex. The prenatal diagnosis of limb-body wall complex and the differentiation of this defect from treatable abdominal wall defects are crucial to providing appropriate guidance for patient counseling and management. (orig.)

  6. It is highly unlikely that the development of an abdominal wall hernia can be attributable to a single strenuous event.

    Science.gov (United States)

    Pathak, Samir; Poston, Graeme J

    2006-03-01

    There is a commonly held belief that the development of a hernia can be attributed to a single strenuous or traumatic event. Hence, many litigants are successful in compensation claims, causing mounting financial burdens on employers, the courts, insurance companies and the tax-payer. However, there is very little scientific evidence to support this assertion. The aim of this study was to ascertain whether there was any causal link in this process. A total of 133 new patients with 135 abdominal herniae of all varieties (115 inguinal, 3 femoral, 9 umbilical, 4 incisional, and 4 ventral or epigastric), of which 25 were recurrent received structured questionnaires on arrival in the surgical clinic. These questionnaires covered all possible aetiological factors for hernia development (type of work, COAD, smoking, pregnancy, obesity, chronic bladder outflow obstruction, previous surgery including appendicectomy), in addition to any possible attribution to a single strenuous or traumatic event. We then reviewed the GP records in the surgery of all patients who answered positively to the latter possible cause. In the study group, 119 (89%) reported a gradual onset of symptoms. Of the 15 (12 male, 3 female; 11%) who believed that their hernia might be related to a single strenuous or traumatic event, 5 had no other aetiological factors. However, not one of the 15 was found to have contemporaneous forensic medical evidence to support their possible claim. We conclude that we are unable to find any clinical evidence to support the hypothesis that a hernia might develop as the result of one single strenuous or traumatic event. While we accept that this mechanism might still possibly occur, we believe that, at best, it is extremely uncommon. If a medical expert is preparing a report on such a case in a claim for personal injury, then they have a duty to the court to examine carefully all the contemporaneous medical records. If no clinical evidence exists to support the claim

  7. Ventral hernia repair in patients with abdominal loss of domain: an observational study of one institution's experience.

    Science.gov (United States)

    Azar, F K; Crawford, T C; Poruk, K E; Farrow, N; Cornell, P; Nadra, O; Azoury, S C; Soares, K C; Cooney, C M; Eckhauser, F E

    2017-04-01

    Abdominal wall hernias are a common problem. The success of abdominal wall reconstruction decreases with increasing hernia size. This study summarizes the outcomes of one surgeon's experience using a "sandwich" technique for hernia repair in patients with loss of abdominal domain. We reviewed our ventral hernia repair (VHR) experience from 2008 to 2015 among patients with loss of domain, as defined by a hernia defect greater than 300 cm 2 . The percent of herniation through the defect, defined by a hernia sac-to-abdominal cavity volume ratio, was measured on preoperative CT scans by four independent reviewers and averaged. Outcomes were compared among those with giant ventral hernias (hernia sac-to-abdominal cavity volume >30%) and those with smaller defect ratios. Over the study period, 21 patients underwent VHR. In 17 patients (81%), a "sandwich" technique was utilized. Ten patients had hernia sac-to-abdominal cavity defects less than 30%, and 11 had defects greater than 30%. Preoperative characteristics were similar in both groups with the exception of a higher ASA score in those with giant ventral hernias and more Ventral Hernia Working Group Grade 3 hernias in those without giant ventral hernias. Postoperative outcomes were similar in both groups. There were no mortalities. There were two recurrences (18%) in the giant VHR group and none in the smaller defect group (p = 0.16). Surgical site occurrences were noted in 48% of patients and did not differ between giant and non-giant VHR groups (50 vs 45%, p = 0.84). Average postoperative length of stay was significantly longer in the giant VHR group (31 vs. 17 days, p = 0.03). Our results suggest that the "sandwich" technique for VHR is a safe and durable method to restore abdominal wall integrity in those with LOD, even in patients with giant ventral hernias.

  8. Defect-induced Catalysis toward the Oxygen Reduction Reaction in Single-walled Carbon Nanotube: Nitrogen doped and Non-nitrogen doped

    International Nuclear Information System (INIS)

    Lu, Di; Wu, Dan; Jin, Jian; Chen, Liwei

    2016-01-01

    Single-walled carbon nanotubes (SWNTs) are post-treated by argon (Ar) or ammonia (NH 3 ) plasma irradiation to introduce defects that are potentially related to catalysis towards the oxygen reduction reaction (ORR). Electrochemical characterization in alkali medium suggests that the plasma irradiated SWNTs demonstrate enhanced catalytic activity toward the ORR with a positively shifted threshold potential. Moreover the enhanced desired four-electron pathway catalytic activity, which exhibited as the positive shifted threshold potential, is independent of the nitrogen dopant. The nature of the defects is probed with Raman and X-ray photoelectron spectroscopy. The results indicate that the non-nitrogen doped defects of SWNTs contribute to the actual active site for the ORR.

  9. DIEP breast reconstruction following multiple abdominal liposuction procedures.

    Science.gov (United States)

    Farid, Mohammed; Nicholson, Simon; Kotwal, Ashutosh; Akali, Augustine

    2014-01-01

    Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. Review of case notes and radiological investigations of two patients, and a PubMed search using the terms "DIEP", "deep inferior epigastric", "TRAM", "transverse rectus abdominis", "perforator" and "laparotomy", "abdominal wall", "liposuction", "liposculpture", "fat graft", "pfannenstiel", with subsequent appraisal of relevant papers by the first and second authors. Patient 1 had 3 episodes of liposuction from the abdomen for fat grafting to a reconstructed breast. Subsequent revision reconstruction of the same breast with DIEP flap was preceded by CT angiography, which demonstrated normal perforator anatomy. The reconstruction healed well with no ischaemic complications. Patient 2 had 5 liposuction procedures from the abdomen to graft fat to a wide local excision defect. Recurrence of cancer led to mastectomy and immediate reconstruction with free DIEP flap. Preoperative MR angiography demonstrated a large perforator right of the umbilicus, with which the intraoperative findings were consistent. The patient had an uneventful recovery and good healing with no fat necrosis or wound dehiscence. We demonstrate that DIEP flaps can safely be raised without perfusion-related complications following multiple liposuction procedures to the abdomen. The safe interval between procedures is difficult to quantify, but we demonstrate successful free flap after 16 months.

  10. Ultrasonic Thickness of Lateral Abdominal Wall Muscles in Response to Pelvic Floor Muscle Contraction in women with stress incontinency with and without Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    Farideh Dehghan-Manshadi

    2014-01-01

    Full Text Available Objective: Urinary Incontinence (UI as a common lower urinary tract dysfunction , results from Pelvic Floor Muscle's (PFM underactivity.Because of co-activation of PFM and the Lateral Abdominal Wall Muscles (LAWM, this study was aimed to investigate the changes in the ultrasonic thickness of the LAWM in response to PFM contraction in stress urinary incontinent (SUIwomen with and without Chronic Low Back Pain (CLBP. Materials & Methods: A total of 28 women, 10 healthy, 18 SUI with and without CLBP (9 in each group participated in this quasi-experimental study. After collecting demographic information and assessment of PFM function, changes in ultrasonic thickness of right LAWM were measured in response to PFM contraction. One way ANOVA, Kruskal-Wallis and Pearson’s correlation tests were performed to analyze the data. Values of P0.05. There was a significant increase in thickness of the Traversus Abdominis Muscle (TrA during PFM contraction in control group comparing experimental groups (P=0.03. Women in control group showed significantly higher PFM strength and more intravaginal pressure (P=0.001. Conclusion: Changes in ultrasonic thickness of the TrA during PFM contraction revealed disturbance of co-activation of the LAWM and the PFM in women with and without SUI CLBP.

  11. Defective Pollen Wall 2 ( DPW2 ) Encodes an Acyl Transferase Required for Rice Pollen Development

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Dawei [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences; Shi, Jianxin [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences; Rautengarten, Carsten [Univ. of Melbourne (Australia). ARC Centre of Excellence in Plant Cell Walls; Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Joint BioEnergy Inst. and Biological Systems and Engineering Division; Yang, Li [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences; Qian, Xiaoling [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences; Uzair, Muhammad [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences; Zhu, Lu [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences; Luo, Qian [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences; An, Gynheung [Kyung Hee Univ., Yongin (Korea). Crop Biotech Inst.; Waßmann, Fritz [Univ. of Bonn (Germany). Inst. of Cellular and Molecular Botany; Schreiber, Lukas [Univ. of Bonn (Germany). Inst. of Cellular and Molecular Botany; Heazlewood, Joshua L. [Univ. of Melbourne (Australia). ARC Centre of Excellence in Plant Cell Walls; Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Joint BioEnergy Inst. and Biological Systems and Engineering Division; Scheller, Henrik Vibe [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Joint BioEnergy Inst. and Biological Systems and Engineering Division; Univ. of California, Berkeley, CA (United States). Dept. of Plant and Microbial Biology; Hu, Jianping [Michigan State Univ., East Lansing, MI (United States). Dept. of Energy Plant Research Lab.; Zhang, Dabing [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences; Univ. of Adelaide, SA (Australia). School of Agriculture, Food and Wine; Liang, Wanqi [Shanghai Jiao Tong Univ. (China). Joint International Research Lab. of Metabolic and Developmental Sciences

    2016-05-31

    Aliphatic and aromatic lipids are both essential structural components of the plant cuticle, an important interface between the plant and environment. Although cross links between aromatic and aliphatic or other moieties are known to be associated with the formation of leaf cutin and root and seed suberin, the contribution of aromatic lipids to the biosynthesis of anther cuticles and pollen walls remains elusive. In this study, we characterized the rice (Oryza sativa) male sterile mutant, defective pollen wall 2 (dpw2), which showed an abnormal anther cuticle, a defective pollen wall, and complete male sterility. Compared with the wild type, dpw2 anthers have increased amounts of cutin and waxes and decreased levels of lipidic and phenolic compounds. DPW2 encodes a cytoplasmically localized BAHD acyltransferase. In vitro assays demonstrated that recombinant DPW2 specifically transfers hydroxycinnamic acid moieties, using v-hydroxy fatty acids as acyl acceptors and hydroxycinnamoyl-CoAs as acyl donors. Thus, The cytoplasmic hydroxycinnamoyl-CoA:v-hydroxy fatty acid transferase DPW2 plays a fundamental role in male reproduction via the biosynthesis of key components of the anther cuticle and pollen wall.

  12. Tuberculosis abdominal Abdominal tuberculosis

    OpenAIRE

    T. Rubio; M. T. Gaztelu; A. Calvo; M. Repiso; H. Sarasíbar; F. Jiménez Bermejo; A. Martínez Echeverría

    2005-01-01

    La tuberculosis abdominal cursa con un cuadro inespecífico, con difícil diagnóstico diferencial respecto a otras entidades de similar semiología. Presentamos el caso de un varón que ingresa por presentar dolor abdominal, pérdida progresiva y notoria de peso corporal y fiebre de dos meses de evolución. El cultivo de la biopsia de colon mostró presencia de bacilo de Koch.Abdominal tuberculosis develops according to a non-specific clinical picture, with a difficult differential diagnosis with re...

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Evaluation of inflammatory cells in abdominal aortic aneurysmal wall by tomography emission positron; Anevrisme de l aorte abdominale et inflammation vasculaire: place de la tomographie par emission de positons

    Energy Technology Data Exchange (ETDEWEB)

    Sakalihasan, N. [Service de chirurgie cardiovasculaire et thoracique, CHU de liege, domaine universitaire du Sart Tilman, batimant B-35, 4000 liege 1, (Belgium); Hustinx, R. [Service de medecine nucleaire, CHU de Liege, (Belgium); Gomez, P.; Defraigne, J.O. [Departement de medecine nucleaire, CHU de Liege, (Belgium)

    2009-05-15

    The objective was to identify the methods of functional imaging and the molecular markers that could help to predict the imminence of a rupture in abdominal aortic aneurysm. The potential of the PET was studied to detect a hyper-metabolic state in the aneurysm wall and this information was connected with the evolution of the disease. An uptake of F.D.G. in the aneurysm wall reflects the presence of a great density of inflammatory cells (macrophages, lymphocytes, polymorphonuclear cells). It has been observed an accumulation of polymorphonuclear cells accompanying a dense infiltration of macrophages and lymphocytes only in the site of break. Our preliminary study and our most recent observations (not yet published) suggest a possible relationship between the F.G.D. captation by the aneurysm wall and the start of the activity of the matrix metallo-proteinases leading to the break. The PET scan could be useful for high risk patients because a positive PET imaging stigmatizes a greater risk of break. consequently, the positive PET imaging represents a diagnosis argument to proceed to a surgical operation, despite the age of the patient, the size of the abdominal aorta aneurysm and the higher operative risk. however, more data to better define the criteria of using the PET/T.D.M. in the evaluation of abdominal aorta aneurysm and to determine its exact contribution in the treatment determination. (N.C.)

  15. Response of the muscles in the pelvic floor and the lower lateral abdominal wall during the Active Straight Leg Raise in women with and without pelvic girdle pain: An experimental study.

    Science.gov (United States)

    Sjödahl, Jenny; Gutke, Annelie; Ghaffari, Ghazaleh; Strömberg, Tomas; Öberg, Birgitta

    2016-06-01

    The relationship between activation of the stabilizing muscles of the lumbopelvic region during the Active Straight Leg Raise test and pelvic girdle pain remains unknown. Therefore, the aim was to examine automatic contractions in relation to pre-activation in the muscles of the pelvic floor and the lower lateral abdominal wall during leg lifts, performed as the Active Straight Leg Raise test, in women with and without persistent postpartum pelvic girdle pain. Sixteen women with pelvic girdle pain and eleven pain-free women performed contralateral and ipsilateral leg lifts, while surface electromyographic activity was recorded from the pelvic floor and unilaterally from the lower lateral abdominal wall. As participants performed leg lifts onset time was calculated as the time from increased muscle activity to leg lift initiation. No significant differences were observed between the groups during the contralateral leg lift. During the subsequent ipsilateral leg lift, pre-activation in the pelvic floor muscles was observed in 36% of women with pelvic girdle pain and in 91% of pain-free women (P=0.01). Compared to pain-free women, women with pelvic girdle pain also showed significantly later onset time in both the pelvic floor muscles (P=0.01) and the muscles of the lower lateral abdominal wall (Pactivation patterns influence women's ability to stabilize the pelvis during leg lifts. This could be linked to provocation of pain during repeated movements. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Usefulness of pulse-wave doppler tissue sampling and dobutamine stress echocardiography for identification of false positive inferior wall defects in SPECT

    International Nuclear Information System (INIS)

    Altinmakas, S.; Dagdeviren, B.; Turkmen, M.; Gursurer, M.; Say, B.; Tezel, T.; Ersek, B.

    2000-01-01

    False positive inferior wall perfusion defects restrict the accuracy of SPECT in diagnosis of coronary artery disease (CAD). Pulse-Wave Tissue Doppler (PWTD) has been recently proposed to assess regional wall motion velocities. The objectives of this study were to evaluate the presence of CAD by using PWTD during dobutamine stress echocardiography (DSE) in patients with an inferior perfusion defect detected by SPECT and compare PWTD parameters of normal cases with patients who had inferior perfusion defect and CAD. Sixty-five patients (mean age 58±8 years, 30 men) with a normal LV systolic function at rest according to echocardiographic evaluation with an inferior ischemia determined by SPECT and a control group (CG) of 34 normal cases (mean age 56±7 years, 16 men) were included in this study. All patients underwent a standard DSE (up to 40 μg/kg/min with additional atropine during sub-maximum heart rate responses). Pulse-wave Doppler tissue sampling of inferior wall was performed in the apical 2-chamber view at rest and stress. The coronary angiography was performed within 24 hours. The results were evaluated for the prediction of significant right coronary artery (RCA) and/or left circumflex coronary artery (CX) with narrowing (≥50% diameter stenosis, assessed by quantitative coronary angiography). It was observed that the peak stress mean E/A ratio was lower in patients with CAD when compared to patients without CAD (0.78±0.2 versus 1.29±0.11 p<0.0001). Also the peak stress E/A ratio of normal cases was significantly higher than patients who had CAD (1.19±0.3 versus 0.78±0.2 p<0.0001). When the cut off point for the E/A ratio was determined as 1, the sensitivity and specificity of dobutamine stress PWTD E/A were 89% and 86%, respectively. The peak stress E/A ratio was higher than 1 in all patients with a false positive perfusion defect. Systolic S velocity increase during DSE was significantly lower in patients with CAD (54%±17 versus 99%±24 p=0

  17. Abdominal tap

    Science.gov (United States)

    Peritoneal tap; Paracentesis; Ascites - abdominal tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap ... You then receive a local numbing medicine. The tap needle is inserted 1 to 2 inches (2. ...

  18. Buckling analysis of defective cross-linked functionalized single- and double-walled carbon nanotubes with polyethylene chains using molecular dynamics simulations.

    Science.gov (United States)

    Ajori, S; Ansari, R; Parsapour, H

    2016-12-01

    Functionalized carbon nanotubes (CNTs) can be used for improving the mechanical properties and load transfer in nanocomposites. In this research, the buckling behavior of perfect and defective cross-linked functionalized CNTs with polyethylene (PE) chains is studied employing molecular dynamics (MD) simulations. Two different configurations with the consideration of vacancy defects, namely mapped and wrapped, are selected. According to the results, critical buckling force of cross-linked functionalized CNTs with PE chains increases as compared to pure CNTs, especially in the case of double-walled carbon nanotubes (DWCNTs). By contrast, it is demonstrated that critical strain of cross-linked functionalized CNTs decreases as compared to that of pristine CNTs. Also, it is observed that increasing the weight percentage leads to the higher increase and the decrease in critical buckling force and strain of cross-linked functionalized CNTs, respectively. Moreover, the presence of defect considerably reduces both critical buckling force and strain of cross-linked functionalized CNTs. Finally, it is shown that the critical buckling strain is more sensitive to the presence of defects as compared to critical buckling force.

  19. Preoperative abdominal muscle elongation with botulinum toxin A for complex incisional ventral hernia repair.

    Science.gov (United States)

    Farooque, Faisal; Jacombs, Anita S W; Roussos, Emmanouel; Read, John W; Dardano, Anthony N; Edye, Michael; Ibrahim, Nabeel

    2016-01-01

    Surgical repair of recurrent abdominal incisional hernia(s) can be challenging due to complex operative conditions, intense post-operative pain, potential respiratory compromise and lateral muscle traction predisposing to early recurrence. We report our preliminary results with botulinum toxin A (BTA) injection causing flaccid paralysis (relaxation) of the lateral abdominal wall muscles prior to surgery. A prospective pilot study measured the effect of preoperative BTA prior to elective repair of recurrent abdominal hernias. Under ultrasound control, 2 weeks prior to surgery, 50 units of BTA was injected into the external oblique, internal oblique and transversus abdominis muscles at three sites on each side of the lateral abdominal wall (total dose 300 units). Pre- and post-BTA abdominal computed tomography measured changes in abdominal wall muscle thickness and length. All hernias were repaired with laparoscopic or laparoscopic-assisted mesh techniques in a single or two-staged procedure. Eight patients received BTA injections which were tolerated with no complications. Post-BTA preoperative computed tomography showed a significant increase in mean length of lateral abdominal wall from 18.5 cm pre-BTA to 21.3 cm post-BTA (P = 0.017) with a mean unstretched length gain of 2.8 cm per side (range 0.8-6.0 cm). All hernias were surgically reduced with mesh with no early recurrence. Preoperative BTA injection prior to complex abdominal hernia repair is a safe procedure that causes flaccid relaxation, elongation and thinning of the lateral abdominal muscles and decrease in hernia defect. Although further evaluation is required, BTA injections may be a useful adjunct to surgical repair of complex incisional hernias. © 2015 Royal Australasian College of Surgeons.

  20. Abdominal wall fat pad biopsy

    Science.gov (United States)

    ... more difficult procedure. Normal Results The fat pad tissues are normal. What Abnormal Results Mean In the case of amyloidosis, abnormal results mean there is amyloid. This is a protein that collects in tissues and impairs organ and tissue function. Risks There ...

  1. Abdominal Compartment Syndrome Secondary to Chronic Constipation

    Directory of Open Access Journals (Sweden)

    Helene Flageole

    2011-01-01

    Full Text Available Abdominal compartment syndrome (ACS is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not.

  2. A Case of “en bloc” Excision of a Chest Wall Leiomyosarcoma and Closure of the Defect with Non-Cross-Linked Collagen Matrix (Egis®

    Directory of Open Access Journals (Sweden)

    Marco Rastrelli

    2016-10-01

    Full Text Available Sarcomas arising from the chest wall account for less than 20% of all soft tissue sarcomas, and at this site, primitive tumors are the most frequent to occur. Leiomyosarcoma is a malignant smooth muscle tumor and the best outcomes are achieved with wide surgical excision. Although advancements have been made in treatment protocols, leiomyosarcoma remains one of the more difficult soft tissue sarcoma to treat. Currently, general local control is obtained with surgical treatment with wide negative margins. We describe the case of a 50-year-old man who underwent a chest wall resection involving a wide portion of the pectoralis major and minor muscle, the serratus and part of the second, third and fourth ribs of the left side. The full-thickness chest wall defect of 10 × 8 cm was closed using a non-cross-linked acellular dermal matrix (Egis® placed in two layers, beneath the rib plane and over it. A successful repair was achieved with no incisional herniation and with complete tissue regeneration, allowing natural respiratory movements. No complications were observed in the postoperative course. Biological non-cross-linked matrix, derived from porcine dermis, behaves like a scaffold supporting tissue regeneration; it can be successfully used as an alternative to synthetic mesh for chest wall reconstruction.

  3. Effect of vacancy defect on electrical properties of chiral single-walled carbon nanotube under external electrical field

    International Nuclear Information System (INIS)

    Luo Yu-Pin; Tien Li-Gan; Tsai Chuen-Horng; Lee Ming-Hsien; Li Feng-Yin

    2011-01-01

    Ab initio calculations demonstrated that the energy gap modulation of a chiral carbon nanotube with mono-vacancy defect can be achieved by applying a transverse electric field. The bandstructure of this defective carbon nanotube varying due to the external electric field is distinctly different from those of the perfect nanotube and defective zigzag nanotube. This variation in bandstructure strongly depends on not only the chirality of the nanotube and also the applied direction of the transverse electric field. A mechanism is proposed to explain the response of the local energy gap between the valence band maximum state and the local gap state under external electric field. Several potential applications of these phenomena are discussed. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

  4. 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

    OpenAIRE

    Maria Elaine Trevisan; Juliana Corrêa Soares; Tatiana Zacarias Rondinel

    2010-01-01

    A cirurgia abdominal alta está associada a um risco elevado de complicações pulmonares que podem ser reduzidas pelo uso criterioso de manobras terapêuticas visando a expansão pulmonar. O objetivo foi comparar duas técnicas de incentivo respiratório na recuperação da dinâmica toracoabdominal em pacientes submetidos à cirurgia abdominal alta. O grupo de estudo experimental foi constituído por 16 pacientes internados na Clínica Cirúrgica do Hospital Universitário de Santa Maria distribuídos alea...

  5. Histological Analysis of the Effect of Accelerated Portland Cement as a Bone Graft Substitute on Experimentally-Created Three-Walled Intrabony Defects in Dogs

    Directory of Open Access Journals (Sweden)

    Mohamad Javad Ashraf

    2007-12-01

    Full Text Available

    Background and aims. Recent literature shows that accelerated Portland cement (APC is a non-toxic material that may have potential to promote bone healing. The objective of this study was to histologically evaluate periodontal healing focusing on new bone regeneration following implantation of APC into intra-bony defects in dogs.

    Materials and methods. Three-wall intra-bony periodontal defects were surgically created at the mesial aspect of the first molar in both sides of mandible in six dogs. One side was randomly filled with the material and other received a flap operation only. The animals were euthanized eight weeks post-surgery when block sections of the defect sites were collected and prepared for qualitative histological analysis.

    Results. Compared to control group, stimulation of growth of new bone tissue in the cavity containing APC was significantly prominent in three of six cases, showing osteoid formation with osteoblastic rimming and new bone trabeculla. New bone formation was observed just close to cavity containing APC. Connective tissue proliferation and downgrowth of epithelium were significantly less than those of control group.

    Conclusion. Our results are encouraging for the use of APC as a bone substitute, but more comprehensive study are necessary before warranting clinical use.

  6. Effect of triclosan-coated sutures on the incidence of surgical site infection after abdominal wall closure in gastroenterological surgery: a double-blind, randomized controlled trial in a single center.

    Science.gov (United States)

    Ichida, Kosuke; Noda, Hiroshi; Kikugawa, Rina; Hasegawa, Fumi; Obitsu, Tamotsu; Ishioka, Daisuke; Fukuda, Rintaro; Yoshizawa, Ayuha; Tsujinaka, Shingo; Rikiyama, Toshiki

    2018-02-02

    Surgical site infection is one of the most common postoperative complications after gastroenterologic surgery. This study investigated the effect of triclosan-coated sutures in decreasing the incidence of surgical site infections after abdominal wall closure in gastroenterologic surgery. A prospective, double-blind, randomized, controlled parallel adaptive group-sequential superiority trial was conducted from March 2014 to March 2017 in a single center. Eligible patients were those who underwent gastroenterologic surgery. Patients were allocated randomly to receive either abdominal wall closure with triclosan-coated sutures (the study group) or sutures without triclosan (the control group). The primary end point was the incidence of superficial or deep surgical site infections within 30 days after operation. This study was registered with the University Hospital Medical Information Network-Clinical Trials Registry (http://www.umin.ac.jp/ctr/), identification number UMIN000013054. A total of 1,013 patients (study group, 508 patients; control group, 505 patients) were analyzed by a modified intention-to-treat approach. The wounds in 990 (97.7%) of the 1,013 patients were classified as clean-contaminated. The primary end point (incidence of superficial or deep surgical site infections) was 35 (6.9%) of 508 patients in the study group and 30 (5.9%) of 505 in the control group. The incidence of surgical site infections did not differ markedly between the 2 groups (95% confidence interval: 0.686-2.010, P = .609). Of the 65 infections, 42 (64.6%) were superficial surgical site infections, with similar frequencies in the 2 groups, and 23 (35.4%) were deep surgical site infections, again with similar frequencies in the 2 groups. Triclosan-coated sutures did not decrease the incidence of surgical site infections after abdominal wall closure in gastroenterologic surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. UV Photofunctionalization Effect on Bone Graft in Critical One-Wall Defect around Implant: A Pilot Study in Beagle Dogs

    Science.gov (United States)

    Kim, Min-Young; Lee, Jae-Hoon; Kim, Jee-Hwan; Jung, Han-Sung; Park, Young-Bum

    2016-01-01

    The purpose of this study was to compare and evaluate, through histomorphometric and radiological analysis, the effects of UV photofunctionalization on an implant placed over a critical defect area with and without a bone graft. Four female beagle dogs were first divided into control and bone graft groups. Each group was then subdivided into UV-treated and UV-untreated groups. The mandibular premolars in each dog were extracted. 12 weeks after extraction, implants were placed according to the condition of each group. Four and 12 weeks after implantation on left and right mandible, the dogs were sacrificed. The specimens were prepared for histomorphometric and micro-computed tomographic analysis. In both 4-week and 12-week groups, UV-treated implant surfaces showed better osseointegration than SA implant surfaces. Also, with implant surfaces placed over the critical defect with bone graft, UV photofunctionalization increased bone-to-implant contact (BIC) and new bone formation at the initial stage (4 weeks). Based on the results of this study, it can be suggested that UV photofunctionalization on the surface of implants placed over large critical defects with bone graft aids initial osseointegration and osteogenesis. PMID:28116296

  8. UV Photofunctionalization Effect on Bone Graft in Critical One-Wall Defect around Implant: A Pilot Study in Beagle Dogs

    Directory of Open Access Journals (Sweden)

    Min-Young Kim

    2016-01-01

    Full Text Available The purpose of this study was to compare and evaluate, through histomorphometric and radiological analysis, the effects of UV photofunctionalization on an implant placed over a critical defect area with and without a bone graft. Four female beagle dogs were first divided into control and bone graft groups. Each group was then subdivided into UV-treated and UV-untreated groups. The mandibular premolars in each dog were extracted. 12 weeks after extraction, implants were placed according to the condition of each group. Four and 12 weeks after implantation on left and right mandible, the dogs were sacrificed. The specimens were prepared for histomorphometric and micro-computed tomographic analysis. In both 4-week and 12-week groups, UV-treated implant surfaces showed better osseointegration than SA implant surfaces. Also, with implant surfaces placed over the critical defect with bone graft, UV photofunctionalization increased bone-to-implant contact (BIC and new bone formation at the initial stage (4 weeks. Based on the results of this study, it can be suggested that UV photofunctionalization on the surface of implants placed over large critical defects with bone graft aids initial osseointegration and osteogenesis.

  9. Association of the use of bacterial cell wall synthesis Inhibitor drugs in early childhood with the Developmental Defects of Enamel

    Science.gov (United States)

    Tariq, Amna; Alam Ansari, Munawar; Owais Ismail, Muhammad; Memon, Zahida

    2014-01-01

    Objective: Our objective of the study was to determine the association between frequent use of Penicillins and Cephalosporins with developmental defects of enamel in pediatric age group. Methods: This is a cross sectional study, conducted at Ziauddin University. A total of 367 children, having the history of either Penicillin or Cephalosporin exposure were included. The parents of children were asked to complete a questionnaire related to disease and drug history. Dental examination was carried out to assess the hypomineralization in tooth enamel based on modified Developmental Defects of Enamel (DDE) index. Results: Out of 367 children, 124 (34%) were males and females were 243(66%). In the study group 22.6% (n= 83) of children were found to be hypomineralized. The maximum type of teeth defects were diffused opacities that was 12.0% (n=44). The statistically significant association (p-value antibiotic use and hypomineralization for most teeth. Children who were exposed to either Penicillins or Cephalosporin in early childhood showed significant (p-value hypomineralized enamel. Conclusion: This study concludes that frequent use of antibiotics such as penicillins and cephalosporins has positive association with enamel hypomineralization in developing tooth structure. PMID:24772150

  10. [What do general, abdominal and vascular surgeons need to know on plastic surgery - aspects of plastic surgery in the field of general, abdominal and vascular surgery].

    Science.gov (United States)

    Damert, H G; Altmann, S; Stübs, P; Infanger, M; Meyer, F

    2015-02-01

    There is overlap between general, abdominal and vascular surgery on one hand and plastic surgery on the other hand, e.g., in hernia surgery, in particular, recurrent hernia, reconstruction of the abdominal wall or defect closure after abdominal or vascular surgery. Bariatric operations involve both special fields too. Plastic surgeons sometimes use skin and muscle compartments of the abdominal wall for reconstruction at other regions of the body. This article aims to i) give an overview about functional, anatomic and clinical aspects as well as the potential of surgical interventions in plastic surgery. General/abdominal/vascular surgeons can benefit from this in their surgical planning and competent execution of their own surgical interventions with limited morbidity/lethality and an optimal, in particular, functional as well as aesthetic outcome, ii) support the interdisciplinary work of general/abdominal/vascular and plastic surgery, and iii) provide a better understanding of plastic surgery and its profile of surgical interventions and options. Georg Thieme Verlag KG Stuttgart · New York.

  11. Identification of defect distribution at ferroelectric domain walls from evolution of nonlinear dielectric response during the aging process

    Czech Academy of Sciences Publication Activity Database

    Mokrý, Pavel; Sluka, T.

    2016-01-01

    Roč. 93, č. 6 (2016), č. článku 064114. ISSN 2469-9950 R&D Projects: GA ČR(CZ) GA14-32228S Institutional support: RVO:61389021 Keywords : Nonlinear dielectric response * ferroelectric domain walls * aging process * phase field simulations Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 3.836, year: 2016 http://journals.aps.org/prb/abstract/10.1103/PhysRevB.93.064114

  12. Inhibition of fucosylation of cell wall components by 2-fluoro 2-deoxy- l -fucose induces defects in root cell elongation

    Energy Technology Data Exchange (ETDEWEB)

    Dumont, Marie [Laboratoire Glycobiologie et Matrice Extracellulaire Végétale, EA 4358, IRIB, VASI, Normandie Université, 76821 Mont-Saint-Aignan France; Lehner, Arnaud [Laboratoire Glycobiologie et Matrice Extracellulaire Végétale, EA 4358, IRIB, VASI, Normandie Université, 76821 Mont-Saint-Aignan France; Bardor, Muriel [Laboratoire Glycobiologie et Matrice Extracellulaire Végétale, EA 4358, IRIB, VASI, Normandie Université, 76821 Mont-Saint-Aignan France; Burel, Carole [Laboratoire Glycobiologie et Matrice Extracellulaire Végétale, EA 4358, IRIB, VASI, Normandie Université, 76821 Mont-Saint-Aignan France; Vauzeilles, Boris [Institut de Chimie Moléculaire et des Matériaux d' Orsay (ICMMO) UMR CNRS 8182, Université de Paris Sud, 91405 Orsay France; Institut de Chimie des Substances Naturelles (ICSN) UPR CNRS 2301, 91198 Gif-sur-Yvette France; Click4Tag, Zone Luminy Biotech, Case 922, 163 Avenue de Luminy 13009 Marseille France; Lerouxel, Olivier [Centre de Recherches sur les Macromolécules Végétales (CERMAV) - CNRS BP 53, 38041 Grenoble Cedex 9 France; Anderson, Charles T. [Department of Biology and Center for Lignocellulose Structure and Formation, Pennsylvania State University, University Park Pennsylvania USA; Mollet, Jean-Claude [Laboratoire Glycobiologie et Matrice Extracellulaire Végétale, EA 4358, IRIB, VASI, Normandie Université, 76821 Mont-Saint-Aignan France; Lerouge, Patrice [Laboratoire Glycobiologie et Matrice Extracellulaire Végétale, EA 4358, IRIB, VASI, Normandie Université, 76821 Mont-Saint-Aignan France

    2015-12-01

    Screening of commercially available fluoro monosaccharides as putative growth inhibitors in Arabidopsis thaliana revealed that 2-fluoro 2-l-fucose (2F-Fuc) reduces root growth at micromolar concentrations. The inability of 2F-Fuc to affect an Atfkgp mutant that is defective in the fucose salvage pathway indicates that 2F-Fuc must be converted to its cognate GDP nucleotide sugar in order to inhibit root growth. Chemical analysis of cell wall polysaccharides and glycoproteins demonstrated that fucosylation of xyloglucans and of N-linked glycans is fully inhibited by 10 μm 2F-Fuc in Arabidopsis seedling roots, but genetic evidence indicates that these alterations are not responsible for the inhibition of root development by 2F-Fuc. Inhibition of fucosylation of cell wall polysaccharides also affected pectic rhamnogalacturonan-II (RG-II). At low concentrations, 2F-Fuc induced a decrease in RG-II dimerization. Both RG-II dimerization and root growth were partially restored in 2F-Fuc-treated seedlings by addition of boric acid, suggesting that the growth phenotype caused by 2F-Fuc was due to a deficiency of RG-II dimerization. Closer investigation of the 2F-Fuc-induced growth phenotype demonstrated that cell division is not affected by 2F-Fuc treatments. In contrast, the inhibitor suppressed elongation of root cells and promoted the emergence of adventitious roots. This study further emphasizes the importance of RG-II in cell elongation and the utility of glycosyltransferase inhibitors as new tools for studying the functions of cell wall polysaccharides in plant development. Moreover, supplementation experiments with borate suggest that the function of boron in plants might not be restricted to RG-II cross-linking, but that it might also be a signal molecule in the cell wall integrity-sensing mechanism.

  13. Effects of bromopride on abdominal wall healing with induced peritoneal sepsis after segmental colectomy and colonic anastomosis in rats Efeitos da bromoprida na cicatrização da parede abdominal com sepse peritoneal induzida e submetidos à ressecção segmentar e anastomose do cólon esquerdo em ratos

    Directory of Open Access Journals (Sweden)

    Marcos Vinícius Melo de Oliveira

    2011-12-01

    Full Text Available PURPOSE: Evaluate the effects of bromopride on abdominal wall healing of rats with induced peritoneal sepsis after segmental colectomy and colonic anastomosis. METHODS: Forty rats underwent sectioning of the left colon and end-to-end anastomosis and were divided into two groups of 20 animals for the administration of bromopride (bromopride group - B or saline solution (control group - C. Each group was divided into subgroups of 10 animals each to be killed on the third (GB3 and GC3 or seventh postoperative day (GB7 and GC7. It was analyzed the following characteristics: breaking strength of the abdominal wall's wound; surgical and histopathological features of the abdominal wall; and clinical features of the rats. RESULTS: There was no difference between the groups in relation to the weight of the rats and the breaking strength of the abdominal wall's wound. The GB7 group presented less edema and less quantity of fibrin during histopathological evaluation compared to the GC7 group. CONCLUSION: Bromopride did not have harmful effects on the healing of abdominal wall in rats.OBJETIVO: Avaliar o efeito da bromoprida, na cicatrização da ferida operatória da parede abdominal de ratos com sepse peritoneal experimentalmente induzida e submetidos a ressecção segmentar e anastomose de cólon esquerdo. MÉTODOS: 40 ratos distribuídos em dois grupos contendo 20 animais, para administração de bromoprida (grupo bromoprida- B ou solução de NaCl 0,9% (grupo controle - C. Cada grupo foi dividido em subgrupos contendo 10 animais, para eutanásia no terceiro (GB3 e GC3 ou sétimo dia (GB7 e GE7 de pós-operatório. Os ratos foram submetidos à secção do cólon esquerdo e anastomose término-terminal. No dia da eutanásia foram avaliadas as características cirúrgicas da cavidade abdominal e clínicas dos ratos. Foram coletados segmentos da parede para a avaliação histopatológica e de resistência tênsil da ferida operatória. RESULTADOS: N

  14. Asymptomatic Incisional Endometrioma Presenting as Abdominal ...

    African Journals Online (AJOL)

    Asymptomatic incisional endometrioma of the anterior abdominal wall is rare. Clinical diagnosis may be difficult. We present a 26 year old woman with incisional abdominal wall endometrioma discovered 5 years after caeserian section. It was painless and there was no change in size with menstruation. The patient's body ...

  15. Effect of alpha lipoic acid co-administration on structural and immunohistochemical changes in subcutaneous tissue of anterior abdominal wall of adult male albino rat in response to polypropylene mesh implantation.

    Science.gov (United States)

    Mazroa, Shireen A; Asker, Samar A; Asker, Waleed; Abd Ellatif, Mohamed

    2015-06-01

    Polypropylene mesh is commonly used in the treatment of abdominal hernia. Different approaches were addressed to improve their tissue integration and consequently reduce long-term complications. This study aimed to investigate the effect of alpha-lipoic acid (ALA) co-administration on structural and immunohistochemical (IHC) changes in the subcutaneous tissues of the anterior abdominal wall of the adult rat in response to polypropylene mesh implantation. Forty adult male albino rats were divided into: group I (control), group II (receiving ALA), group III (polypropylene mesh implantation) and group IV (mesh implantation + ALA co-administration). After 4 weeks, subcutaneous tissue samples were prepared for light microscopy and IHC study of CD34 as a marker for angiogenesis. In groups I and II rats, positive CD34 expression was demonstrated by IHC reaction, localized to endothelial cells lining small blood vessels. Group III showed an excess inflammatory reaction, deposition of both regular and irregularly arranged collagen fibres around mesh pores and few elastic fibres. CD34-positive was detected not only in cells lining small blood vessels but also in other cells scattered in the connective tissue indicating angiogenesis. In group IV, ALA co-administration resulted in less inflammatory reaction, regular collagen deposition, enhanced elastic fibres synthesis and a significant increase in CD34-positive cells and small blood vessels reflecting improved angiogenesis. ALA co-administration with polypropylene mesh implantation controlled the inflammatory reaction, helped regular collagen deposition, enhanced elastic fibres synthesis and improved angiogenesis in the subcutaneous tissue of anterior abdominal wall of adult albino rats, suggesting a possible role of ALA in optimizing mesh integration in subcutaneous tissue. © 2015 The Authors. International Journal of Experimental Pathology © 2015 International Journal of Experimental Pathology.

  16. Videolaparoscopic cholecystecto