WorldWideScience

Sample records for abdominal wall defects

  1. Genetics Home Reference: abdominal wall defect

    Science.gov (United States)

    ... are two main types of abdominal wall defects: omphalocele and gastroschisis . Omphalocele is an opening in the center of the ... covering the exposed organs in gastroschisis. Fetuses with omphalocele may grow slowly before birth (intrauterine growth retardation) ...

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Staged management of giant traumatic abdominal wall defect: A rare case report

    Directory of Open Access Journals (Sweden)

    Somendra Bansal

    2013-12-01

    Full Text Available Blunt traumatic abdominal wall disruptions associated with evisceration (abdominal wall injury grade type VI are very rare. We describe a case of large traumatic abdominal wall disruption with bowel evisceration and complete transection of jejunum and sigmoid colon that occurred after a 30-year-old male sustained run over injury to abdomen. Abdominal exploration and primary end to end jejuno-jejunal and colo-colic anastomosis were done. Staged management of giant abdominal wall defect was performed without any plastic reconstruction with good clinical outcome.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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

  6. Abdominal Wall Defects in Greenland 1989-2015.

    Science.gov (United States)

    Bugge, Merete; Drachmann, Gitte; Kern, Peder; Budtz-Jørgensen, Esben; Eiberg, Hans; Olsen, Britta; Tommerup, Niels; Nielsen, Inge-Merete

    2017-07-03

    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 defects has never been investigated in Greenland. The present study is based on data retrieved from three nationwide and two local registries in the Greenlandic health care system over 27 years (1989-2015). We identified 33 infants with abdominal wall defects born in the study time period. All cases were reclassified to 28 cases of gastroschisis, four cases of omphalocele, and there was 1 infant in the indeterminate group. The point prevalence at birth for gastroschisis increased significantly from 8 to 35 (average 10.7) per 10,000 liveborn and -stillborn infants. Mothers below 20 years of age represented 23% of all cases and the prevalence for this group was 17 per 10,000 liveborn and stillborn. Perinatal mortality for infants with gastroschisis was high (18%), and 1 year survival was 71%. For omphalocele, the prevalence varied from 8 to 11 per 10,000 liveborn and stillborn infants. There was no increasing rate in the period, further highlighting an etiological difference between gastroschisis and omphalocele. This study confirms the increasing prevalence of gastroschisis in Greenland in the period from 1989 to 2015. The average was 10.7 per 10,000 liveborn and -stillborn infants and, to the best of our knowledge, this is the highest prevalence ever reported. Birth Defects Research 109:836-842, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. The risk of volvulus in abdominal wall defects.

    Science.gov (United States)

    Abdelhafeez, Abdelhafeez H; Schultz, Jessica A; Ertl, Allison; Cassidy, Laura D; Wagner, Amy J

    2015-04-01

    Congenital abdominal wall defects are associated with abnormal intestinal rotation and fixation. A Ladd's procedure is not routinely performed in these patients; it is believed intestinal fixation is provided by adhesions that develop post-repair of the defects. However, patients with omphalocele may not have adequately protective postoperative adhesions because of difference in the inflammatory state of the bowel wall and in repair strategy. The aim of this study is to describe the occurrence of midgut volvulus in patients with gastroschisis or omphalocele. A retrospective chart review was performed for all patients managed in a single institution born between 1/1/2000 and 12/31/2008 with a diagnosis of gastroschisis or omphalocele. Patient charts were reviewed through 12/31/2012 for occurrence of midgut volvulus or need for second laparotomy. Of the 206 patients identified with abdominal wall defects, 142 patients (69%) had gastroschisis and 64 patients (31%) had omphalocele. Patients' follow up ranged from 4 years to 13 years. The median gestational age was 36 weeks (26-41 weeks) and the median birth weight was 2.42 kg (0.8-4.87 kg). None of the patients with gastroschisis developed midgut volvulus, however two patients (3%) with omphalocele developed midgut volvulus. No patients with gastroschisis developed midgut volvulus. Therefore, the current practice of not routinely performing a Ladd's procedure is a safe approach during surgical repair of gastroschisis. The two cases of volvulus in patients with omphalocele may be related to less bowel fixation. It is necessary to examine current practice in regards to the need for assessing the risk of volvulus during omphalocele closure and counseling of these patients. This assessment may be achieved via routine examination of the width of the small bowel mesenteric base, whenever feasible; however, the sample size is relatively small to draw any definitive conclusions. Published by Elsevier Inc.

  8. 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.

  9. Evaluation of the fetal abdomen by magnetic resonance imaging. Part 2: abdominal wall defects and tumors

    Directory of Open Access Journals (Sweden)

    Ana Paula Pinho Matos

    2018-05-01

    Full Text Available Abstract Although ultrasound is still the gold standard for the assessment of fetal malformations, magnetic resonance imaging (MRI has gained great prominence in recent years. In situations in which ultrasound has low sensitivity, such as maternal obesity, abdominal scarring, and oligohydramnios, MRI has proven to be a safe and accurate method. Regarding fetal abdominal wall defects, MRI appears to be widely used in the prognostic assessment of gastroschisis with intestinal atresia or of complications of omphalocele, allowing better perinatal management and parental counseling. In addition, MRI allows the assessment of local invasion of fetal abdominal tumors, with significant prognostic value for the postnatal period. In this article, we review the main MRI findings in the evaluation of fetal abdominal wall defects and tumors.

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

    Science.gov (United States)

    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

  11. 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.

  12. 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

    and effect on collagen and elastin production of a degradable mesh releasing basic fibroblast growth factor (bFGF). Implantation of biodegradable mesh with or without bFGF in their core has been conducted in 40 rats in an abdominal wall defect model. Samples were explanted after 4, 8, and 24 weeks...

  13. A new abdominal wall reconstruction strategy for giant omphalocele

    Directory of Open Access Journals (Sweden)

    Yoshiaki Takahashi

    2018-04-01

    Full Text Available The mortality rate of giant omphalocele has improved; however long-term follow-up has revealed umbilical defects and deformities after primary closure. We herein report the efficacy of a new abdominal wall reconstruction strategy combining a component separation technique with delayed natural and deep umbilicoplasty. Keywords: Giant omphalocele, Component separation technique, Delayed natural and deep umbilicoplasty, Abdominal wall defect

  14. 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

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

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    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.

  16. 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)

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

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    Edson Yuzur Yasojima

    2013-02-01

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

  18. The risk of midgut volvulus in patients with abdominal wall defects: A multi-institutional study.

    Science.gov (United States)

    Fawley, Jason A; Abdelhafeez, Abdelhafeez H; Schultz, Jessica A; Ertl, Allison; Cassidy, Laura D; Peter, Shawn St; Wagner, Amy J

    2017-01-01

    The management of malrotation in patients with congenital abdominal wall defects has varied among surgeons. We were interested in investigating the risk of midgut volvulus in patients with gastroschisis and omphalocele to help determine if these patients may benefit from undergoing a Ladd procedure. A retrospective chart review was performed for all patients managed at three institutions born between 1/1/2000 and 12/31/2008 with a diagnosis of gastroschisis or omphalocele. Patient charts were reviewed through 12/31/2012 for occurrence of midgut volvulus or need for second laparotomy. Of the 414 patients identified with abdominal wall defects, 299 patients (72%) had gastroschisis, and 115 patients (28%) had omphalocele. The mean gestational age at birth was 36.1±2.3weeks, and the mean birth weight was 2.57±0.7kg. There were a total of 8 (1.9%) cases of midgut volvulus: 3 (1.0%) patients with gastroschisis compared to 5 patients (4.4%) with omphalocele (p=0.04). Patients with omphalocele have a greater risk of developing midgut volvulus, and a Ladd procedure should be considered during definitive repair to mitigate these risks. III; retrospective comparative study. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. 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...

  20. 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

    BACKGROUND: 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. METHODS: 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...

  1. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

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

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair...... defect exceeding 10 cm will be randomised for intravenous administration of either 125 mg methylprednisolone or saline at the induction of anaesthesia. The primary endpoint is pain at rest on the first post-operative day. Patients will be followed until 30 days post-operatively, and secondary outcomes...

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Abdominal wall fat pad biopsy

    Science.gov (United States)

    Amyloidosis - abdominal wall fat pad biopsy; Abdominal wall biopsy; Biopsy - abdominal wall fat pad ... is the most common method of taking an abdominal wall fat pad biopsy . The health care provider cleans the ...

  4. 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

  5. Abdominal wall blocks in adults

    DEFF Research Database (Denmark)

    Børglum, Jens; Gögenür, Ismail; Bendtsen, Thomas F

    2016-01-01

    been introduced with success. Future research should also investigate the effect of specific abdominal wall blocks on neuroendocrine and inflammatory stress response after surgery.  Summary USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned......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.......  Recent findings Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated. The efficiency of USG transversus abdominis plane blocks in relation to many surgical procedures involving the abdominal wall...

  6. 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.

  7. 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.

  8. Chronic Abdominal Wall Pain.

    Science.gov (United States)

    Koop, Herbert; Koprdova, Simona; Schürmann, Christine

    2016-01-29

    Chronic abdominal wall pain is a poorly recognized clinical problem despite being an important element in the differential diagnosis of abdominal pain. This review is based on pertinent articles that were retrieved by a selective search in PubMed and EMBASE employing the terms "abdominal wall pain" and "cutaneous nerve entrapment syndrome," as well as on the authors' clinical experience. In 2% to 3% of patients with chronic abdominal pain, the pain arises from the abdominal wall; in patients with previously diagnosed chronic abdominal pain who have no demonstrable pathological abnormality, this likelihood can rise as high as 30% . There have only been a small number of clinical trials of treatment for this condition. The diagnosis is made on clinical grounds, with the aid of Carnett's test. The characteristic clinical feature is strictly localized pain in the anterior abdominal wall, which is often mischaracterized as a "functional" complaint. In one study, injection of local anesthesia combined with steroids into the painful area was found to relieve pain for 4 weeks in 95% of patients. The injection of lidocaine alone brought about improvement in 83-91% of patients. Long-term pain relief ensued after a single lidocaine injection in 20-30% of patients, after repeated injections in 40-50% , and after combined lidocaine and steroid injections in up to 80% . Pain that persists despite these treatments can be treated with surgery (neurectomy). Chronic abdominal wall pain is easily diagnosed on physical examination and can often be rapidly treated. Any physician treating patients with abdominal pain should be aware of this condition. Further comparative treatment trials will be needed before a validated treatment algorithm can be established.

  9. Challenges and outcomes of management of anterior abdominal wall defects in a Nigerian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Lukman O Abdur-Rahman

    2011-01-01

    Full Text Available Background : Abdominal wall defect presents a great challenge when it is large, ruptured, or associated with other anomalies. Objective : To review the challenges and outcome of management of anterior abdominal wall defects (AAWD. Materials and Methods : A retrospective review of omphalocele and gastroschisis managed over 8 years at our institution. Results : Omphalocele (n=49 and gastroschisis (n=7 constituted 2.4% of total admission. The median age was 23.5 hours, with male-female ratio of 1:1.1. Term infants were 91.7% and more than 75% weighed above 2.5 kg. The mean maternal age was 28.5±5.87 years and mean parity was 3.1±2.0, with P values of 0.318 and 0.768, respectively. More than 92.9% of infants were out-born, 46 pregnancies (82.1% were booked, and 51 (91.1% had at least one ultrasound scan, but only 1 (1.8% was diagnosed with gastroschisis. Ruptured omphalocele were 11 (6 major, 5 minor in number, 3 of which presented with enterocutaneous fistula, and 3 (6.1% were syndromic omphalocele. Positive blood culture confirmed septicaemia in 21 cases (37.5%. Surgical repair was done in 35 cases (62.5%, 44.6% as emergency, and 17.9% as elective. Non-operative management was done in 21 patients (37.5% and 5 (8.9% were discharged against medical advice. Median length of hospital stay was 10 days (mean, 15.98±14.38. Postoperative complication rate was 32.1% and overall mortality was 30.4%, with the highest case fatality among gastroschisis (57.1% and omphalocele major (32.1%. Conclusions: There were large numbers of out-born infants due to poor prenatal diagnosis in spite of high instances of antenatal ultrasound scan. Many patients presented with complications that resulted in poor outcome.

  10. Extragenital malignant mixed Mullerian tumor in the incisional hernia - primary carcinosarcoma in the abdominal wall: Case report

    Directory of Open Access Journals (Sweden)

    Žuvela Marinko

    2015-01-01

    Full Text Available Introduction. This report presents a primary Mullerian carcinosarcoma localized in the incisional hernia i.e. anterior abdominal wall. There is no data in the literature about this localization of extragenital Mullerian carcinosarcoma. Case Outline. The patient had previous medical history of right-sided ovarian cystadenocarcinoma managed by hysterectomy, bilateral ovariectomy and chemotherapy. An incisional hernia occurred 1 year after the operation and Mullerian carcinosarcoma at the right border of the incisional hernia 16 years later. There was no tumor spreading into the abdominal cavity and pelvis. Full thickness of the abdominal wall resection and coexisting incisional hernia resulted in a large 25x20 cm abdominal wall defect managed by the modified components separation technique and implanting meshes. Conclusion. Major abdominal wall resection and abdominal wall reconstruction using the modified components separation technique reinforced with meshes could be one of possible solutions in the surgical treatment of primary malignant mixed Mullerian tumor localized in the abdominal wall. [Projekat Ministarstva nauke Republike Srbije, br. 41030

  11. Chronic abdominal wall pain misdiagnosed as functional abdominal pain.

    Science.gov (United States)

    van Assen, Tijmen; de Jager-Kievit, Jenneke W A J; Scheltinga, Marc R; Roumen, Rudi M H

    2013-01-01

    The abdominal wall is often neglected as a cause of chronic abdominal pain. The aim of this study was to identify chronic abdominal wall pain syndromes, such as anterior cutaneous nerve entrapment syndrome (ACNES), in a patient population diagnosed with functional abdominal pain, including irritable bowel syndrome, using a validated 18-item questionnaire as an identification tool. In this cross-sectional analysis, 4 Dutch primary care practices employing physicians who were unaware of the existence of ACNES were selected. A total of 535 patients ≥18 years old who were registered with a functional abdominal pain diagnosis were approached when they were symptomatic to complete the questionnaire (maximum 18 points). Responders who scored at least the 10-point cutoff value (sensitivity, 0.94; specificity, 0.92) underwent a diagnostic evaluation to establish their final diagnosis. The main outcome was the presence and prevalence of ACNES in a group of symptomatic patients diagnosed with functional abdominal pain. Of 535 patients, 304 (57%) responded; 167 subjects (31%) recently reporting symptoms completed the questionnaire. Of 23 patients who scored above the 10-point cutoff value, 18 were available for a diagnostic evaluation. In half of these subjects (n = 9) functional abdominal pain (including IBS) was confirmed. However, the other 9 patients were suffering from abdominal wall pain syndrome, 6 of whom were diagnosed with ACNES (3.6% prevalence rate of symptomatic subjects; 95% confidence interval, 1.7-7.6), whereas the remaining 3 harbored a painful lipoma, an abdominal herniation, and a painful scar. A clinically relevant portion of patients previously diagnosed with functional abdominal pain syndrome in a primary care environment suffers from an abdominal wall pain syndrome such as ACNES.

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

    Directory of Open Access Journals (Sweden)

    Liu Z

    2014-03-01

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

  13. Left hepatic lobe herniation through an incisional anterior abdominal wall hernia and right adrenal myelolipoma: a case report and review of the literature.

    Science.gov (United States)

    Nuño-Guzmán, Carlos M; Arróniz-Jáuregui, José; Espejo, Ismael; Valle-González, Jesús; Butus, Hernán; Molina-Romo, Alejandro; Orranti-Ortega, Rodrigo I

    2012-01-10

    Herniation of the liver through an anterior abdominal wall hernia defect is rare. To the best of our knowledge, only three cases have been described in the literature. A 70-year-old Mexican woman presented with a one-week history of right upper quadrant abdominal pain, nausea, vomiting, and jaundice to our Department of General Surgery. Her medical history included an open cholecystectomy from 20 years earlier and excessive weight. She presented with jaundice, abdominal distension with a midline surgical scar, right upper quadrant tenderness, and a large midline abdominal wall defect with dullness upon percussion and protrusion of a large, tender, and firm mass. The results of laboratory tests were suggestive of cholestasis. Ultrasound revealed choledocholithiasis. A computed tomography scan showed a protrusion of the left hepatic lobe through the anterior abdominal wall defect and a well-defined, soft tissue density lesion in the right adrenal topography. An endoscopic common bile duct stone extraction was unsuccessful. During surgery, the right adrenal tumor was resected first. The hernia was approached through a median supraumbilical incision; the totality of the left lobe was protruding through the abdominal wall defect, and once the lobe was reduced to its normal position, a common bile duct surgical exploration with multiple stone extraction was performed. Finally, the abdominal wall was reconstructed. Histopathology revealed an adrenal myelolipoma. Six months after the operation, our patient remains in good health. The case of liver herniation through an incisional anterior abdominal wall hernia in this report represents, to the best of our knowledge, the fourth such case reported in the literature. The rarity of this medical entity makes it almost impossible to specifically describe predisposing risk factors for liver herniation. Obesity, the right adrenal myelolipoma mass effect, and the previous abdominal surgery are likely to have contributed to

  14. Left hepatic lobe herniation through an incisional anterior abdominal wall hernia and right adrenal myelolipoma: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Nuño-Guzmán Carlos M

    2012-01-01

    Full Text Available Abstract Introduction Herniation of the liver through an anterior abdominal wall hernia defect is rare. To the best of our knowledge, only three cases have been described in the literature. Case presentation A 70-year-old Mexican woman presented with a one-week history of right upper quadrant abdominal pain, nausea, vomiting, and jaundice to our Department of General Surgery. Her medical history included an open cholecystectomy from 20 years earlier and excessive weight. She presented with jaundice, abdominal distension with a midline surgical scar, right upper quadrant tenderness, and a large midline abdominal wall defect with dullness upon percussion and protrusion of a large, tender, and firm mass. The results of laboratory tests were suggestive of cholestasis. Ultrasound revealed choledocholithiasis. A computed tomography scan showed a protrusion of the left hepatic lobe through the anterior abdominal wall defect and a well-defined, soft tissue density lesion in the right adrenal topography. An endoscopic common bile duct stone extraction was unsuccessful. During surgery, the right adrenal tumor was resected first. The hernia was approached through a median supraumbilical incision; the totality of the left lobe was protruding through the abdominal wall defect, and once the lobe was reduced to its normal position, a common bile duct surgical exploration with multiple stone extraction was performed. Finally, the abdominal wall was reconstructed. Histopathology revealed an adrenal myelolipoma. Six months after the operation, our patient remains in good health. Conclusions The case of liver herniation through an incisional anterior abdominal wall hernia in this report represents, to the best of our knowledge, the fourth such case reported in the literature. The rarity of this medical entity makes it almost impossible to specifically describe predisposing risk factors for liver herniation. Obesity, the right adrenal myelolipoma mass effect, and

  15. Abdominal wall hernias: computed tomography findings

    International Nuclear Information System (INIS)

    D'Ippolito, Giuseppe; Rosas, George de Queiroz; Mota, Marcos Alexandre; Akisue, Sandra R. Tsukada; Galvao Filho, Mario de Melo.

    2005-01-01

    Abdominal hernias are a common clinical problem Clinical diagnosis of abdominal hernias can sometimes be challenging, particularly in obese patients or patients with previous abdominal surgery. CT scan of the abdomen allows visualization of hernias and their contents and the differentiation from other masses of the abdominal wall such as tumors, hematomas and abscesses. Moreover, CT may identify complications such as incarceration, bowel obstruction, volvulus and strangulation. This study illustrates the CT scan findings observed in different types of abdominal wall hernias. (author)

  16. 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.

  17. 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...... samples were collected every four hours and the concentrations of lactate, glycerol, glucose and pyruvate were measured. The results of MD were compared between the group of infants with gastroschisis and the group with omphalocele. The duration of parenteral nutrition and tube feeding were compared...... of infants with gastroschisis compared with the group of infants with omphalocele. The median values were 6.19mmol/l and 2.19mmol/l, respectively (P=0.006). The results from MD in the six infants in the gastroschisis group who underwent secondary closure after Silo treatment were similar to those who...

  18. Reverse Abdominoplasty Flap in Reconstruction of Post-Bilateral Mastectomies Anterior Chest Wall Defect

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    William HC Tiong

    2014-01-01

    Full Text Available Reverse abdominoplasty was originally described for epigastric lift. Since the work by Baroudi and Huger in the 1970s, it has become clear that reverse abdominoplasty application can be extended beyond just aesthetic procedure. Through the knowledge of anterior abdominal wall vascularity, its application had included reconstructive prospect in the coverage of various chest wall defects. To date, reverse abdominoplasty flap has been used to reconstruct unilateral anterior chest wall defect or for larger defect but only in combination with other reconstructive techniques. Here, we presented a case where it is used as a standalone flap to reconstruct bilateral anterior chest wall soft tissue defect post-bilateral mastectomies in oncological resection. In conclusion, reverse abdominoplasty flap provided us with a simple, faster, and satisfactory reconstructive outcome.

  19. Recovery after abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim

    2017-01-01

    Incisional hernia is a common long-term complication to abdominal surgery, occurring in more than 20% of all patients. Some of these hernias become giant and affect patients in several ways. This patient group often experiences pain, decreased perceived body image, and loss of physical function......, which results in a need for surgical repair of the giant hernia, known as abdominal wall reconstruction. In the current thesis, patients with a giant hernia were examined to achieve a better understanding of their physical and psychological function before and after abdominal wall reconstruction. Study...... was lacking. Study II was a case-control study of the effects of an enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction for a giant hernia. Sixteen consecutive patients were included prospectively after the implementation of a new enhanced recovery after surgery...

  20. 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

  1. 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.

  2. 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

  3. 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...... complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure...

  4. 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...... period. All cases were reclassified to 28 cases of gastroschisis, four cases of omphalocele, and there was 1 infant in the indeterminate group. The point prevalence at birth for gastroschisis increased significantly from 8 to 35 (average 10.7) per 10,000 liveborn and -stillborn infants. Mothers below 20...... years of age represented 23% of all cases and the prevalence for this group was 17 per 10,000 liveborn and stillborn. Perinatal mortality for infants with gastroschisis was high (18%), and 1 year survival was 71%. For omphalocele, the prevalence varied from 8 to 11 per 10,000 liveborn and stillborn...

  5. 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...

  6. 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.

  7. 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

  8. 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.

  9. Immobile defects in ferroelastic walls: Wall nucleation at defect sites

    Science.gov (United States)

    He, X.; Salje, E. K. H.; Ding, X.; Sun, J.

    2018-02-01

    Randomly distributed, static defects are enriched in ferroelastic domain walls. The relative concentration of defects in walls, Nd, follows a power law distribution as a function of the total defect concentration C: N d ˜ C α with α = 0.4 . The enrichment Nd/C ranges from ˜50 times when C = 10 ppm to ˜3 times when C = 1000 ppm. The resulting enrichment is due to nucleation at defect sites as observed in large scale MD simulations. The dynamics of domain nucleation and switching is dependent on the defect concentration. Their energy distribution follows the power law with exponents during yield between ɛ ˜ 1.82 and 2.0 when the defect concentration increases. The power law exponent is ɛ ≈ 2.7 in the plastic regime, independent of the defect concentration.

  10. Abdominal wall surgery

    Science.gov (United States)

    ... as liposuction , which is another way to remove fat. But, abdominal wall surgery is sometimes combined with liposuction. ... from the middle and lower sections of your abdomen to make it firmer ... removes excess fat and skin (love handles) from the sides of ...

  11. 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.

  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 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.

  13. 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 ...

  14. 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 ...

  15. 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.

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

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    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.

  17. Limb-body wall defect: experience of a reference service of fetal medicine from Southern Brazil.

    Science.gov (United States)

    Gazolla, Ana C; da Cunha, André C; Telles, Jorge A B; Betat, Rosilene da S; Romano, Mayara A; Marshall, Isabel; Gobatto, Amanda M; de H Bicca, Anna M; Arcolini, Camila P; Dal Pai, Thaís K V; Vieira, Luciane R; Targa, Luciano V; Betineli, Ildo; Zen, Paulo R G; Rosa, Rafael F M

    2014-10-01

    Limb-body wall defect is a rare condition characterized by a combination of large and complex defects of the ventral thorax and abdominal wall with craniofacial and limb anomalies. The aim of this study was to describe the experience of our fetal medicine service, a reference from Southern Brazil, with prenatally diagnosed patients with a limb-body wall defect in a 3 years period. Only patients who fulfilled the criteria suggested by Hunter et al. (2011) were included in the study. Clinical data and results of radiological and cytogenetic evaluation were collected from their medical records. Our sample was composed of 8 patients. Many of their mothers were younger than 25 years (50%) and in their first pregnancy (62.5%). It is noteworthy that one patient was referred due to suspected anencephaly and another due to a twin pregnancy with an embryonic sac. Craniofacial defects were verified in three patients (37.5%), thoracic/abdominal abnormalities in 6 (75%) and limb defects in eight (100%). Congenital heart defects were observed in five patients (62.5%). One of them presented a previously undescribed complex heart defect. The results disclosed that complementary exams, such as MRI and echocardiography, are important to better define the observed defects. Some of them, such as congenital heart defects, may be more common than previously reported. This definition is essential for the proper management of the pregnancy and genetic counseling of the family. The birth of these children must be planned with caution and for the prognosis a long survival possibility, despite unlikely and rare, must be considered. © 2014 Wiley Periodicals, Inc.

  18. 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

  19. 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

  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. [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.

  2. 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 ...

  3. 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.)

  4. 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.

  5. 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 ...

  6. Abdominal Wall Endometriosis: An Overlooked but Possibly Preventable Complication

    Directory of Open Access Journals (Sweden)

    Chen-Chih Teng

    2008-03-01

    Conclusion: Abdominal wall endometriosis may be caused by iatrogenic inoculation of the endometrium into the surgical wound. It is strongly recommended that, at the conclusion of the surgical procedure, the abdominal wound be cleaned thoroughly, particularly at both corner sites (especially the operator's side. If an abdominal wall endometriosis is encountered after CS but the patient plans to have future pregnancy and the symptoms are mild, excision of the endometrioma may be deferred until the next indicated CS.

  7. 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

  8. 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

  9. Long-term anisotropic mechanical response of surgical meshes used to repair abdominal wall defects.

    Science.gov (United States)

    Hernández-Gascón, B; Peña, E; Pascual, G; Rodríguez, M; Bellón, J M; Calvo, B

    2012-01-01

    Routine hernia repair surgery involves the implant of synthetic mesh. However, this type of procedure may give rise to pain and bowel incarceration and strangulation, causing considerable patient disability. The purpose of this study was to compare the long-term behaviour of three commercial meshes used to repair the partially herniated abdomen in New Zealand White rabbits: the heavyweight (HW) mesh, Surgipro(®) and lightweight (LW) mesh, Optilene(®), both made of polypropylene (PP), and a mediumweight (MW) mesh, Infinit(®), made of polytetrafluoroethylene (PTFE). The implanted meshes were mechanical and histological assessed at 14, 90 and 180 days post-implant. This behaviour was compared to the anisotropic mechanical behaviour of the unrepaired abdominal wall in control non-operated rabbits. Both uniaxial mechanical tests conducted in craneo-caudal and perpendicular directions and histological findings revealed substantial collagen growth over the repaired hernial defects causing stiffness in the repair zone, and thus a change in the original properties of the meshes. The mechanical behaviour of the healthy tissue in the craneo-caudal direction was not reproduced by any of the implanted meshes after 14 days or 90 days of implant, whereas in the perpendicular direction, SUR and OPT achieved similar behaviour. From a mechanical standpoint, the anisotropic PP-lightweight meshes may be considered a good choice in the long run, which correlates with the structure of the regenerated tissue. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. 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.)

  11. 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 ...

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

    African Journals Online (AJOL)

    hypertension after abdominal closure (8%) and only one of ... Ann Pediatr. Surg 13:69–73 c 2017 Annals of Pediatric Surgery. Annals of ... intra-abdominal hypertension ..... measurements as a guide in the closure of abdominal wall defects.

  13. 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 ...

  14. Bullhorn Hernia: A Rare Traumatic Abdominal Wall Hernia

    African Journals Online (AJOL)

    Department of Surgery, Government Medical College and Rajindra. Hospital, Patiala ‑ 147 001, Punjab, India. E‑mail: drbimal.undefined@gmail.com. INTRODUCTION. Traumatic abdominal wall hernia (TAWH) is uncommonly encountered despite the high prevalence of blunt abdominal trauma.[1] Bullhorn hernia is a rare, ...

  15. Endometrial stromal cell attachment and matrix homeostasis in abdominal wall endometriomas.

    Science.gov (United States)

    Itoh, Hiroko; Mogami, Haruta; Bou Nemer, Laurice; Word, Larry; Rogers, David; Miller, Rodney; Word, R Ann

    2018-02-01

    How does progesterone alter matrix remodeling in abdominal wall endometriomas compared with normal endometrium? Progesterone may prevent attachment of endometrial cells to the abdominal wall, but does not ameliorate abnormal stromal cell responses of abdominal wall endometriomas. Menstruation is a tightly orchestrated physiologic event in which steroid hormones and inflammatory cells cooperatively initiate shedding of the endometrium. Abdominal wall endometriomas represent a unique form of endometriosis in which endometrial cells inoculate fascia or dermis at the time of obstetrical or gynecologic surgery. Invasion of endometrium into ectopic sites requires matrix metalloproteinases (MMPs) for tissue remodeling but endometrium is not shed externally. Observational study in 14 cases and 19 controls. Tissues and stromal cells isolated from 14 abdominal wall endometriomas were compared with 19 normal cycling endometrium using immunohistochemistry, quantitative PCR, gelatin zymography and cell attachment assays. P values cell preps to provide scientific rigor to the conclusions. The results indicate that MMP2 and MMP9 are not increased by TGFβ1 in endometrioma stromal cells. Although progesterone prevents attachment of endometrioma cells to matrix components of the abdominal wall, it does not ameliorate these abnormal stromal cell responses to TGFβ1. N/A. Endometriomas were collected from women identified pre-operatively. Not all endometriomas were collected. Stromal cells from normal endometrium were from different patients, not women undergoing endometrioma resection. This work provides insight into the mechanisms by which progesterone may prevent abdominal wall endometriomas but, once established, are refractory to progesterone treatment. Tissue acquisition was supported by NIH P01HD087150. Authors have no competing interests. © The Author(s) 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All

  16. 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...... 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...

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

    International Nuclear Information System (INIS)

    Stensby, J.D.; Baker, Jonathan C.; Fox, Michael G.

    2016-01-01

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

  18. 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.)

  19. Wall stress analysis of abdominal aortic aneurysms using 3D ultrasound

    NARCIS (Netherlands)

    Kok, A. M.; Nguyen, V.L.; Speelman, L.; Schurink, G.W.H.; van de Vosse, F.N.; Lopata, R.G.P.

    2014-01-01

    Wall stress analysis of abdominal aortic aneurysms is a novel tool that has proven high potential to improve risk stratification of abdominal aortic aneurysms (AAAs). Wall stress analysis is based on computed tomography (CT) and magnetic resonance imaging, however, 3D ultrasound (US) has not been

  20. 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

  1. 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.

  2. 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 ...

  3. 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 ...

  4. Abdominal wall hernias: computed tomography findings; Hernias da parede abdomino-pelvica: aspectos tomograficos

    Energy Technology Data Exchange (ETDEWEB)

    D' Ippolito, Giuseppe; Rosas, George de Queiroz; Mota, Marcos Alexandre; Akisue, Sandra R. Tsukada; Galvao Filho, Mario de Melo[Hospital e Maternidade Sao Luiz, Sao Paulo, SP (Brazil). Setor de US/TC/RMN]. E-mail: giuseppe_dr@uol.com.br

    2005-07-15

    Abdominal hernias are a common clinical problem Clinical diagnosis of abdominal hernias can sometimes be challenging, particularly in obese patients or patients with previous abdominal surgery. CT scan of the abdomen allows visualization of hernias and their contents and the differentiation from other masses of the abdominal wall such as tumors, hematomas and abscesses. Moreover, CT may identify complications such as incarceration, bowel obstruction, volvulus and strangulation. This study illustrates the CT scan findings observed in different types of abdominal wall hernias. (author)

  5. 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 ...

  6. 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.

  7. Fetal Abdominal Wall Repair with a Collagen Biomatrix in an Experimental Sheep Model for Gastroschisis

    NARCIS (Netherlands)

    Roelofs, Luc A. J.; Eggink, Alex J.; Hulsbergen-van de Kaa, Christina A.; van den Berg, Paul P.; van Kuppevelt, Toin H.; van Moerkerk, Herman T. B.; Crevels, A. Jane; Lotgering, Fred K.; Feitz, Wout F. J.; Wijnen, Rene M. H.

    2008-01-01

    We evaluated the regeneration of the abdominal wall using a dual- layer collagen biomatrix, and the protective effect on the bowel of fetal abdominal wall repair in a fetal sheep model for gastroschisis. In 14 fetal lambs, the abdominal wall was opened at 79 days' gestation, creating a

  8. ADULT ABDOMINAL WALL HERNIA IN IBADAN.

    African Journals Online (AJOL)

    ... method for this surgical procedure.11,12 Laparoscopic mesh repair of ... 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 .... GROIN HERNIA (N=922). Side of hernia. Right. Left. Bilateral. Type of hernia. Direct.

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

    Directory of Open Access Journals (Sweden)

    Ding-Hui Dong

    2015-01-01

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

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. Improvement of mesh recolonization in abdominal wall reconstruction with adipose vs. bone marrow mesenchymal stem cells in a rodent model.

    Science.gov (United States)

    van Steenberghe, M; Schubert, T; Guiot, Y; Goebbels, R M; Gianello, P

    2017-08-01

    Reconstruction of muscle defects remains a challenge. Our work assessed the potential of an engineered construct made of a human acellular collagen matrix (HACM) seeded with porcine mesenchymal stem cells (MSCs) to reconstruct abdominal wall muscle defects in a rodent model. This study compared 2 sources of MSCs (bone-marrow, BMSCs, and adipose, ASCs) in vitro and in vivo for parietal defect reconstruction. Cellular viability and growth factor release (VEGF, FGF-Beta, HGF, IGF-1, TGF-Beta) were investigated under normoxic/hypoxic culture conditions. Processed and recellularized HACMs were mechanically assessed. The construct was tested in vivo in full thickness abdominal wall defect treated with HACM alone vs. HACM+ASCs or BMSCs (n=14). Tissue remodeling was studied at day 30 for neo-angiogenesis and muscular reconstruction. A significantly lower secretion of IGF was observed with ASCs vs. BMSCs under hypoxic conditions (-97.6%, p<0.005) whereas significantly higher VEGF/FGF secretions were found with ASCs (+92%, p<0.001 and +72%, p<0.05, respectively). Processing and recellularization did not impair the mechanical properties of the HACM. In vivo, angiogenesis and muscle healing were significantly improved by the HACM+ASCs in comparison to BMSCs (p<0.05) at day 30. A composite graft made of an HACM seeded with ASCs can improve muscle repair by specific growth factor release in hypoxic conditions and by in vivo remodeling (neo-angiogenesis/graft integration) while maintaining mechanical properties. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. 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 .

  16. Abdominal wall perforation in a patient with recurrent epithelial ovarian cancer after bevacizumab treatment

    Directory of Open Access Journals (Sweden)

    Efnan Algin

    2016-08-01

    Full Text Available Bowel perforation is a rare but well-described complication of bevacizumab, a VEGF monoclonal antibody. However, bevacizumab associated abdominal wall perforation is a more serious complication. In here, a patient with recurrent epithelial ovarian cancer developing both bowel and abdominal wall perforation after bevacizumab treatment is reported with review of the literature to point out the clinical significance of this rare complication. To our knowledge, this is the first case with bevacizumab associated abdominal wall perforation.

  17. 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 abdom...

  18. Rare Abdominal Wall Malformation: Case Report of Umbilical Cord Hernia

    Directory of Open Access Journals (Sweden)

    Andro Gliha

    2018-02-01

    Full Text Available The umbilical cord hernia is the rarest form of abdominal wall malformations, anatomically completely different from gastroschisis and omphalocele. It occurs due to the permanent physiological evisceration of abdominal organs into umbilical celom and persistence of a patent umbilical ring. The umbilical cord hernia is often mistaken for omphalocele and called “small omphalocele”. Here we present a case of a female newborn with umbilical cord hernia treated in our Hospital. After preoperative examinations surgery was done on the second day of life. The abdominal wall was closed without tension. The aim of this article is to present the importance of the proper diagnose of these three entities and to stimulate academic community for the answer, is this umbilical cord hernia or small omphalocele.

  19. Rare Abdominal Wall Malformation: Case Report of Umbilical Cord Hernia.

    Science.gov (United States)

    Gliha, Andro; Car, Andrija; Višnjić, Stjepan; Zupancic, Bozidar; Kondza, Karmen; Petracic, Ivan

    The umbilical cord hernia is the rarest form of abdominal wall malformations, anatomically completely different from gastroschisis and omphalocele. It occurs due to the permanent physiological evisceration of abdominal organs into umbilical celom and persistence of a patent umbilical ring. The umbilical cord hernia is often mistaken for omphalocele and called "small omphalocele". Here we present a case of a female newborn with umbilical cord hernia treated in our Hospital. After preoperative examinations surgery was done on the second day of life. The abdominal wall was closed without tension. The aim of this article is to present the importance of the proper diagnose of these three entities and to stimulate academic community for the answer, is this umbilical cord hernia or small omphalocele.

  20. Abdominal wall sinus due to impacting gallstone during laparoscopic cholecystectomy: an unusual complication.

    Science.gov (United States)

    Pavlidis, T E; Papaziogas, B T; Koutelidakis, I M; Papaziogas, T B

    2002-02-01

    During laparoscopic cholecystectomy, perforation of the gallbladder can occurs in extraction of the gallbladder. The fate of such lost gallstones, which can lead to the formation of an abscess, an abdominal wall mass, or a persistent sinus, has not been studied adequately. Herein we report the case of a persistent sinus of the abdominal wall after an emergent laparoscopic cholecystectomy in an 82-year-old woman with gangrenous cholecystitis and perforation of the friable wall in association with an empyema of the gallbladder. The culture of the obtained pus was positive for Escherichia coli. After a small leak of dirty fluid from the wound of the epigastric port site of 4 months' duration, surgical exploration under local anesthesia revealed that the sinus was caused by spilled gallstones impacting into the abdominal wall between the posterior sheath and left rectus abdominalis muscle. The removal of the stones resulted in complete healing. Long-term complications after laparoscopic cholecystectomy involving the abdominal wall are rare but important possible consequences that could be avoided.

  1. Case Report Meleney's Ulcer; A Rare but Fatal Abdominal Wall ...

    African Journals Online (AJOL)

    KIGZ

    Meleney's Ulcer; A Rare but Fatal Abdominal Wall Disease Complicating ... Meleney's ulcer or post operative synergistic bacterial gangrene is a rare form of ... Central venous catheterization and parenteral ... is no record of full recovery from the intra-abdominal pathology before the ... chronic undermining ulcer of Meleney.

  2. 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

  3. 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

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

    Directory of Open Access Journals (Sweden)

    V. Lambropoulos

    2016-01-01

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

  6. Mechanical behaviour of synthetic surgical meshes: finite element simulation of the herniated abdominal wall.

    Science.gov (United States)

    Hernández-Gascón, B; Peña, E; Melero, H; Pascual, G; Doblaré, M; Ginebra, M P; Bellón, J M; Calvo, B

    2011-11-01

    The material properties of meshes used in hernia surgery contribute to the overall mechanical behaviour of the repaired abdominal wall. The mechanical response of a surgical mesh has to be defined since the haphazard orientation of an anisotropic mesh can lead to inconsistent surgical outcomes. This study was designed to characterize the mechanical behaviour of three surgical meshes (Surgipro®, Optilene® and Infinit®) and to describe a mechanical constitutive law that accurately reproduces the experimental results. Finally, through finite element simulation, the behaviour of the abdominal wall was modelled before and after surgical mesh implant. Uniaxial loading of mesh samples in two perpendicular directions revealed the isotropic response of Surgipro® and the anisotropic behaviour of Optilene® and Infinit®. A phenomenological constitutive law was used to reproduce the measured experimental curves. To analyze the mechanical effect of the meshes once implanted in the abdomen, finite element simulation of the healthy and partially herniated repaired rabbit abdominal wall served to reproduce wall behaviour before and after mesh implant. In all cases, maximal displacements were lower and maximal principal stresses higher in the implanted abdomen than the intact wall model. Despite the fact that no mesh showed a behaviour that perfectly matched that of abdominal muscle, the Infinit® mesh was able to best comply with the biomechanics of the abdominal wall. Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  7. 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.

  8. Anterior abdominal wall leiomyoma arising de novo in a fertile women: A case report

    International Nuclear Information System (INIS)

    Cho, Je Young; Woo, Ji Young; Hong, Hye Suk; Yang, Ik; Lee, Yul; Hwang, Ji Young; Kim, Han Myun; Shin, Mi Kyung

    2016-01-01

    Abdominal wall leiomyoma arising de novo is very rare, hence the reported imaging findings of this disease are also rare. We reported the case of a 33-year-old woman who presented with an abdominal wall mass without antecedent gynecological surgeries. The initial abdominal computed tomography (CT) showed thickening of the left rectus abdominis and the loss of intervening fat between the rectus abdominis and the lateral abdominal muscles. After 8 months, the follow-up contrast-enhanced CT and ultrasonography (US) showed a lentiform-shaped mass with isodensity to the adjacent muscles. The US-guided biopsy was consistent with leiomyoma

  9. Anterior abdominal wall leiomyoma arising de novo in a fertile women: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Je Young; Woo, Ji Young; Hong, Hye Suk; Yang, Ik; Lee, Yul; Hwang, Ji Young; Kim, Han Myun; Shin, Mi Kyung [Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of)

    2016-01-15

    Abdominal wall leiomyoma arising de novo is very rare, hence the reported imaging findings of this disease are also rare. We reported the case of a 33-year-old woman who presented with an abdominal wall mass without antecedent gynecological surgeries. The initial abdominal computed tomography (CT) showed thickening of the left rectus abdominis and the loss of intervening fat between the rectus abdominis and the lateral abdominal muscles. After 8 months, the follow-up contrast-enhanced CT and ultrasonography (US) showed a lentiform-shaped mass with isodensity to the adjacent muscles. The US-guided biopsy was consistent with leiomyoma.

  10. 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 ...

  11. Characterization of the anisotropic mechanical behavior of human abdominal wall connective tissues.

    Science.gov (United States)

    Astruc, Laure; De Meulaere, Maurice; Witz, Jean-François; Nováček, Vit; Turquier, Frédéric; Hoc, Thierry; Brieu, Mathias

    2018-06-01

    Abdominal wall sheathing tissues are commonly involved in hernia formation. However, there is very limited work studying mechanics of all tissues from the same donor which prevents a complete understanding of the abdominal wall behavior and the differences in these tissues. The aim of this study was to investigate the differences between the mechanical properties of the linea alba and the anterior and posterior rectus sheaths from a macroscopic point of view. Eight full-thickness human anterior abdominal walls of both genders were collected and longitudinal and transverse samples were harvested from the three sheathing connective tissues. The total of 398 uniaxial tensile tests was conducted and the mechanical characteristics of the behavior (tangent rigidities for small and large deformations) were determined. Statistical comparisons highlighted heterogeneity and non-linearity in behavior of the three tissues under both small and large deformations. High anisotropy was observed under small and large deformations with higher stress in the transverse direction. Variabilities in the mechanical properties of the linea alba according to the gender and location were also identified. Finally, data dispersion correlated with microstructure revealed that macroscopic characterization is not sufficient to fully describe behavior. Microstructure consideration is needed. These results provide a better understanding of the mechanical behavior of the abdominal wall sheathing tissues as well as the directions for microstructure-based constitutive model. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Clinical evaluation of extraperitoneal colostomy without damaging the muscle layer of the abdominal wall.

    Science.gov (United States)

    Dong, L-R; Zhu, Y-M; Xu, Q; Cao, C-X; Zhang, B-Z

    2012-01-01

    This study investigated whether extraperitoneal colostomy without damaging the muscle layer of the abdominal wall is an improved surgical procedure compared with conventional sigmoid colostomy in patients undergoing abdominoperineal resection. Patients with rectal cancer undergoing abdominoperineal resection were selected and randomly divided into two groups: the study group received extraperitoneal colostomy without damaging the muscle layer of the abdominal wall and the control group received conventional colostomy. Clinical data from both groups were analysed. A total of 128 patients were included: 66 received extraperitoneal colostomy without damaging the muscle layer of the abdominal wall and 62 received conventional colostomy. Significant differences between the two groups were found in relation to colostomy operating time, defaecation sensation, bowel control and overall stoma-related complications. Duration of postoperative hospital stay was also significantly different between the study groups. Extraperitoneal colostomy without damaging the muscle layer of the abdominal wall was found to be an improved procedure compared with conventional sigmoid colostomy in abdominoperineal resection, and may reduce colostomy-related complications, shorten operating time and postoperative hospital stay, and potentially improve patients' quality of life.

  13. Towards the mechanical characterization of abdominal wall by inverse analysis.

    Science.gov (United States)

    Simón-Allué, R; Calvo, B; Oberai, A A; Barbone, P E

    2017-02-01

    The aim of this study is to characterize the passive mechanical behaviour of abdominal wall in vivo in an animal model using only external cameras and numerical analysis. The main objective lies in defining a methodology that provides in vivo information of a specific patient without altering mechanical properties. It is demonstrated in the mechanical study of abdomen for hernia purposes. Mechanical tests consisted on pneumoperitoneum tests performed on New Zealand rabbits, where inner pressure was varied from 0mmHg to 12mmHg. Changes in the external abdominal surface were recorded and several points were tracked. Based on their coordinates we reconstructed a 3D finite element model of the abdominal wall, considering an incompressible hyperelastic material model defined by two parameters. The spatial distributions of these parameters (shear modulus and non linear parameter) were calculated by inverse analysis, using two different types of regularization: Total Variation Diminishing (TVD) and Tikhonov (H 1 ). After solving the inverse problem, the distribution of the material parameters were obtained along the abdominal surface. Accuracy of the results was evaluated for the last level of pressure. Results revealed a higher value of the shear modulus in a wide stripe along the craneo-caudal direction, associated with the presence of linea alba in conjunction with fascias and rectus abdominis. Non linear parameter distribution was smoother and the location of higher values varied with the regularization type. Both regularizations proved to yield in an accurate predicted displacement field, but H 1 obtained a smoother material parameter distribution while TVD included some discontinuities. The methodology here presented was able to characterize in vivo the passive non linear mechanical response of the abdominal wall. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. 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.

  15. 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

  16. Heterotopic mesenteric and abdominal wall ossification – Two case reports in one institution

    OpenAIRE

    Cátia Ferreira; Carina Gomes; Ana Melo; Nádia Tenreiro; Bruno Pinto; Herculano Moreira; Artur Ribeiro; Paulo Avelar

    2017-01-01

    Introduction: Heterotopic ossification occurs when bone develops in tissues which usually don’t undergo ossification. Heterotopic mesenteric ossification, also known as intra-abdominal myositis ossificans, is a rare and benign form of ossification, usually related with previous abdominal surgery or trauma. Presentation of cases: We report two cases of heterotopic ossification both after multiple abdominal surgeries, with intraoperative findings of mesenteric and abdominal wall ossification...

  17. 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.

  18. Challenges and outcomes of management of anterior abdominal ...

    African Journals Online (AJOL)

    Challenges and outcomes of management of anterior abdominal wall defects in a Nigerian tertiary hospital. ... African Journal of Paediatric Surgery ... Postoperative complication rate was 32.1% and overall mortality was 30.4%, with the ...

  19. Complicated acute appendicitis presenting as a rapidly progressive soft tissue infection of the abdominal wall: a case report.

    Science.gov (United States)

    Beerle, Corinne; Gelpke, Hans; Breitenstein, Stefan; Staerkle, Ralph F

    2016-12-01

    We report a case of a rare complication of acute appendicitis with perforation through the abdominal wall. The case points out that an intraabdominal origin should be considered in patients presenting with rapidly spreading soft tissue infections of the trunk. A 58-year-old European woman presented to our hospital with a 1-week history of severe abdominal pain accompanied by rapidly spreading erythema and emphysema of the lower abdomen. On admission, the patient was in septic shock with leukocytosis and elevation of C-reactive protein. Among other diagnoses, necrotizing fasciitis was suspected. Computed tomography showed a large soft tissue infection with air-fluid levels spreading through the lower abdominal wall. During the operation, we found a perforated appendicitis breaking through the fascia and causing a rapidly progressive soft tissue infection of the abdominal wall. Appendicitis was the origin of the soft tissue infection. The abdominal wall was only secondarily involved. Even though perforated appendicitis as an etiology of a rapidly progressive soft tissue infection of the abdominal wall is very rare, it should be considered in the differential diagnosis of abdominal wall cellulitis. The distinction between rapidly spreading subcutaneous infection with abscess formation and early onset of necrotizing fasciitis is often difficult and can be confirmed only by surgical intervention.

  20. 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.

  1. [Vesico-cutaneous fistula revealing abdominal wall malakoplakia accompanied by Boeck's sarcoidosis].

    Science.gov (United States)

    Knausz, József; Lipták, József; Andrásovszky, Zsolt; Baranyay, Ferenc

    2010-02-07

    Malakoplakia is an acquired granulomatous disorder first described by Michaelis and Gutmann in 1902. The pathogenesis of malakoplakia is hardly known, but it thought to be secondary to an acquired bactericidal defect in macrophages occurring mostly in immunosuppressed patients. 63-year-old female patient had been treated with methylprednisolone for ten years, because of pulmonary sarcoidosis. For six month, recurrent abdominal abscess and vesico-cutaneous fistula developed. Histological examination proved malakoplakia, and Escherichia coli was detected in the abscess cavity. Hematoxyline eosin staining, periodic acid-Schiff, Berlin-blue and Kossa reactions were performed. Microscopically malakoplakia consists of mainly macrophages, known as von Hansemann cells with scattered targetoid intracytoplasmic inclusions known as Michaelis-Gutmann bodies. In our presented case, after urological-surgical intervention and antibiotic therapy, the patient became free from complaints and symptoms. Malakoplakia has been described in numerous anatomic locations, mainly in the urogenital tract. Malakoplakia may be complicated with fistulas in different locations: vesico-coccygeal, rectoprostatic, anorectal fistulas have been were reported in the literature, while 6 cases of malakoplakia with Boeck's sarcoidosis are published. In the presented case sarcoidosis and the 10-year immunosuppressive treatment with methylprednisolone might have been in the background of abdominal wall malakoplakia, complicated by vesico-cutaneous fistula. The patient was successfully treated with surgery and the followed antibiotic therapy.

  2. Current concepts and systematic review of vascularized composite allotransplantation of the abdominal wall.

    Science.gov (United States)

    Berli, Jens U; Broyles, Justin M; Lough, Denver; Shridharani, Sachin M; Rochlin, Danielle; Cooney, Damon S; Lee, W P Andrew; Brandacher, Gerald; Sacks, Justin M

    2013-01-01

    Abdominal wall vascularized composite allotransplantation (AW-VCA) is a rarely utilized technique for large composite abdominal wall defects. The goal of this article is to systematically review the literature and current concepts of AW-VCA, outline the challenges ahead, and provide an outlook for the future. Systematic review of the literature was performed using MEDLINE, EMBASE, and PubMed to identify relevant articles discussing results of AW-VCA. Cadaver and animal studies were excluded from the systematic review, but selectively included in the discussion. The resultant five papers report their results on AW-VCA(Transplantation, 85, 2008, 1607; Am J Transplant, 7, 2007, 1304; Transplant Proc, 41, 2009, 521; Transplant Proc, 36, 2004, 1561; Lancet, 361, 2003, 2173). These papers represent the result of two study groups in which a total of 18 AW-VCA were performed in 17 patients. Two different operative approaches were used. Overall flap/graft survival was 88%. No mortality related to the transplant was reported. One cadaver study and two animal models were identified and separately presented (Transplant Proc, 43, 2011, 1701; Transplantation, 90, 2010, 1590; Journal of Surgical Research, 162, 2010, 314). Literature review reports AW-VCA is technically feasible with low morbidity and mortality. Functional outcomes are not reported and minimally considered. With advancements in vascularized composite allotransplantation research and decreasing toxicity of immunosuppression therapies and immunomodulatory regimens, AW-VCA can be applied in circumstances beyond conjunction with visceral transplantation. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    International Nuclear Information System (INIS)

    Cairo, J.L.B.; Marins, J.L.C.; Prando, A.; Pereira, R.M.

    1988-01-01

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

  4. 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 ...

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

    Directory of Open Access Journals (Sweden)

    Osama S. Al Beteddini

    2016-01-01

    Conclusion: 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.

  6. 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.

  7. 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.

  8. 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 ...

  9. 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.

  10. Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia.

    Science.gov (United States)

    Rodriguez-Acevedo, Omar; Elstner, Kristen E; Jacombs, Anita S W; Read, John W; Martins, Rodrigo Tomazini; Arduini, Fernando; Wehrhahm, Michael; Craft, Colette; Cosman, Peter H; Dardano, Anthony N; Ibrahim, Nabeel

    2018-02-01

    Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair. This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017. Serial non-contrast abdominal CT imaging was performed to evaluate changes in lateral oblique muscle length and thickness. All hernias were repaired laparoscopically, or laparoscopic-open-laparoscopic (LOL) using intraperitoneal onlay mesh. 56 patients received BTA injections at predetermined sites to the lateral oblique muscles, which were well tolerated. Mean patient age was 59.7 years, and mean BMI was 30.9 kg/m 2 (range 21.8-54.0). Maximum defect size was 24 × 27 cm. A subset of 18 patients underwent preoperative pneumoperitoneum as an adjunct procedure. A comparison of pre-BTA to post-BTA imaging demonstrated an increase in mean lateral abdominal wall length from 16.1 cm to 20.1 cm per side, a mean gain of 4.0 cm/side (range 1.0-11.7 cm/side) (p LOL primary closure was achieved in all cases, with no clinical evidence of raised intra-abdominal pressures. One patient presented with a new fascial defect 26 months post-operative. Preoperative BTA to the lateral abdominal wall muscles is a safe and effective technique for the preparation of patients prior to operative management of complex ventral hernias. BTA temporary flaccid paralysis relaxes, elongates and thins the chronically contracted abdominal musculature. This in turn reduces lateral traction forces facilitating laparoscopic repair and fascial closure of large

  11. 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.

  12. Proteomic identification of differentially expressed proteins in aortic wall of patients with ruptured and nonruptured abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Urbonavicius, Sigitas; Lindholt, Jes S.; Vorum, Henrik

    2009-01-01

    To compare the basic proteomic composition of abdominal aortic aneurysm (AAA) wall tissue in patients with nonruptured and ruptured aneurysms.......To compare the basic proteomic composition of abdominal aortic aneurysm (AAA) wall tissue in patients with nonruptured and ruptured aneurysms....

  13. 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 ...

  14. 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)

  15. Fat deposition in the urinary bladder wall: Incidental finding on abdominal computed tomography: A case report

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-15

    In a computed tomography (CT) scan, fat deposition in the urinary bladder wall is seen as a linear hypoattenuating band surrounded by soft tissue density. It is uncommon, but is often seen in normal cases. However, there is no report of fat deposition in the urinary bladder wall in Korea. The authors encountered a 62-year-old male patient who showed an incidental hypoattenuating band in the urinary bladder wall on abdominal CT. The patient showed no clinical signs related to fat deposition in the urinary bladder wall. When the patient's previous abdominal CT was retrospectively reviewed, the same CT finding was seen. This linear hypoattenuating band within the urinary bladder wall should be considered as a normal CT finding, although it is uncommon.

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

    Science.gov (United States)

    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

    2013-02-01

    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 collateral veins of the abdominal wall contra-laterally to the renal transplant. Cultures from abdominal wall micro-abscesses yielded Prevotella bivia as the causative agent. This complication has not been described before in the context of renal transplantation. The pathogenesis and management of this serious complication are discussed in this paper.

  17. 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

  18. Detection of cardiac wall motion defects with combined amplitude/phase analysis

    International Nuclear Information System (INIS)

    Bacharach, S.L.; Green, M.V.; Bonow, R.O.; Pace, L.; Brunetti, A.; Larson, S.M.

    1985-01-01

    Fourier phase images have been used with some success to detect and quantify left ventricular (LV) wall motion defects. In abnormal regions of the LV, wall motion asynchronies often cause the time activity curve (TAC) to be shifted in phase. Such regional shifts are detected by analysis of the distribution function of phase values over the LV. However, not all wall motion defects result in detectable regional phase abnormalities. Such abnormalities may cause a reduction in the magnitude of contraction (and hence TAC amplitude) without any appreciable change in TAC shape(and hence phase). In an attempt to improve the sensitivity of the Fourier phase method for the detection of wall motion defects the authors analyzed the distribution function of Fourier amplitude as well as phase. 26 individuals with normal cardiac function and no history of cardiac disease served as controls. The goal was to detect and quantify wall motion as compared to the consensus of 3 independent observers viewing the scintigraphic cines. 26 subjects with coronary artery disease and mild wall motion defects (22 with normal EF) were studied ate rest. They found that analysis of the skew of thew amplitude distribution function improved the sensitivity for the detection of wall motion abnormalities at rest in the group from 65% to 85% (17/26 detected by phase alone, 22/26 by combined phase and amplitude analysis) while retaining a 0 false positive rate in the normal group. The authors conclude that analysis of Fourier amplitude distribution functions can significantly increase the sensitivity of phase imaging for detection of wall motion abnormalities

  19. Omphalocele

    Science.gov (United States)

    Birth defect - omphalocele; Abdominal wall defect - infant; Abdominal wall defect - neonate; Abdominal wall defect - newborn ... Omphalocele is considered an abdominal wall defect (a hole in the abdominal wall). The child's intestines usually ...

  20. Fungal abdominal wall abscess in a renal transplant recipient

    International Nuclear Information System (INIS)

    Sanavi, R. Suzan; Gashti, Hossein Nejad; Afshar, R.

    2006-01-01

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

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    M. F. Ulum

    2014-12-01

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

  3. 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

  4. 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.

  5. 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.

  6. Desmoid Fibromatosis of the Lower Abdominal Wall in Irrua Nigeria

    African Journals Online (AJOL)

    In: Townsend C, Beauchamp RD,. Evers BM, Mattox K, editors. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia, USA: Elsevier Saunders; 2015. p. 768‑82. 3. Jain D, Lubane P, Pancholi M. Large desmoid tumour of the anterior abdominal wall: A case report of a 4.6kg ...

  7. 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.

  8. 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.

  9. Defect detection of wall thinning defect in pipes using lock-in photo-infrared thermography technique

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Su Ok; Park, Jong Hyun; Choi, Tae Ho; Jung, Hyun Chul; Kim, Kyoung Suk [Chosun Univ., Gwangju (Korea, Republic of)

    2008-07-01

    Piping in the Nuclear Power plants (NPP) are mostly consisted of carbon steel pipe. The wall thinning defect is mainly occurred by the affect of the Flow Accelerated Corrosion (FAC) of fluid which flows in carbon steel pipes. This type of defect becomes the cause of damage or destruction of piping. Therefore, it is very important to measure defect which is existed not only on the welding partbut also on the whole field of pipe. Over the years, Infrared Thermography (IRT) has been used as a non destructive testing methods of the various kinds of materials. This technique has many merits and applied to the industrial field but has limitation to the materials. Therefore, this method was combined with lock-in technique. So IRT detection resolution has been progressively improved using lock-in technique. In this paper, the quantitative analysis results of the location and the size of wall thinning defect that is artificially processed inside the carbon steel pipe by using IRT are obtained.

  10. 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.

  11. 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.

  12. Tissue-engineering with muscle fiber fragments improves the strength of a weak abdominal wall in rats

    DEFF Research Database (Denmark)

    Jangö, Hanna; Gräs, Søren; Christensen, Lise

    2017-01-01

    INTRODUCTION AND HYPOTHESIS: Alternative approaches to reinforce the native tissue in patients with pelvic organ prolapse (POP) are needed to improve surgical outcome. Our aims were to develop a weakened abdominal wall in a rat model to mimic the weakened vaginal wall in women with POP and then e...... showed a significantly higher strength than the group with MPEG-PLGA alone (p = 0.034). CONCLUSION: Tissue-engineering with MFFs seeded on a scaffold of biodegradable MPEG-PLGA might be an interesting adjunct to future POP repair.......INTRODUCTION AND HYPOTHESIS: Alternative approaches to reinforce the native tissue in patients with pelvic organ prolapse (POP) are needed to improve surgical outcome. Our aims were to develop a weakened abdominal wall in a rat model to mimic the weakened vaginal wall in women with POP...

  13. 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

  14. 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.

  15. Primary solitary peritoneal tumor of the abdominal wall-report of a rare case and review of the literature.

    Science.gov (United States)

    Efthimiadis, Christoforos; Ioannidis, Aristeidis; Kofina, Konstantinia; Grigoriou, Marios

    2017-06-01

    Abdominal wall tumors are sometimes diagnosed as metastases of ovarian cancer, however, primary peritoneal tumors should be taken into consideration in the final diagnosis. A 49-year-old female patient was admitted in our Department for the excision of a pulpable abdominal wall lump, with no other abnormalities shown on imaging investigation. On histology examination, the excised specimen revealed characteristics of metastatic high-grade serous ovarian carcinoma. Total hysterectomy, bilateral oophorectomy, omentectomy and appendectomy were performed. No signs of malignancy were proved on histology, leading to the final diagnosis of a primary serous peritoneal tumor. This is the third described case of solitary primary serous peritoneal tumor located in the abdominal wall. This condition should be included in the differential diagnosis of a probable metastatic ovarian carcinoma, as both present similar histologic characteristics.

  16. 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

  17. Primary solitary peritoneal tumor of the abdominal wall?report of a rare case and review of the literature

    OpenAIRE

    Efthimiadis, Christoforos; Ioannidis, Aristeidis; Kofina, Konstantinia; Grigoriou, Marios

    2017-01-01

    Abstract Abdominal wall tumors are sometimes diagnosed as metastases of ovarian cancer, however, primary peritoneal tumors should be taken into consideration in the final diagnosis. A 49-year-old female patient was admitted in our Department for the excision of a pulpable abdominal wall lump, with no other abnormalities shown on imaging investigation. On histology examination, the excised specimen revealed characteristics of metastatic high-grade serous ovarian carcinoma. Total hysterectomy, ...

  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. "EFFECTIVENESS OF ABDOMINAL WALL ELEVATOR IN REDUCING INTRA-ABDOMINAL PRESSURE AND CO2 VOLUME DURING LAPAROSCOPIC CHOLECYSTECTOMY"

    Directory of Open Access Journals (Sweden)

    A. Yaghoobi Notash

    2004-06-01

    Full Text Available Since CO2 pneumoperitoneum is the dominant method of laparoscopic exposure due to facility and good view, its physiologic effects are most relevant to the surgeons. CO2 pneumoperitoneum may affects hemodynamics by increased intra-abdominal pressure (IAP and the physiologic effects of absorbed CO2. The adverse effects of both mechanisms relate directly to the duration of the pneumoperitoneum and the elevation of IAP. Gasless laparoscopy involves obtaining exposure for laparoscopy by placing an internal retracting device through a small incision and lifting the anterior abdominal wall. We designed and made a mechanical wall elevator and used it in 24 patients, compared with a control group (52 cases using a conventional laparoscopic cholecystectomy. A prospective trial was undertaken in Sina Hospital, Tehran University of Medical Sciences from 1998 to 2000. The patients were assigned randomly to two groups. There was a significant decrease in IAP and CO2 consumption in the group using mechanical wall elevator as compared to conventional laparoscopic cholecystectomy, (mean IAP of 3.5 mmHg compared to 11.4 mmHg in the control group, mean CO2 volume 17 liters compared to 73 liters in the control group. We recommend this semigasless method in laparoscopy due to safety in performance and significant reduction in IAP through the surgery. This method provides a satisfactory view and easy performance without any increase in time or complications. The hospital stay and costs did not increase.

  20. 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.

  1. 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.

  2. Muscular sarcoidosis involving the chest and abdominal walls: case report with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seunghyun; Lee, In Sook; Song, You Seon [Pusan National University Hospital, Biomedical Research Institute, Department of Radiology, Busan (Korea, Republic of); Pusan National University School of Medicine, Busan (Korea, Republic of); Mok, Jeongha [Pusan National University Hospital, Biomedical Research Institute, Department of Internal Medicine, Busan (Korea, Republic of); Choi, Kyung-Un [Pusan National University Hospital, Biomedical Research Institute, Department of Pathology, Busan (Korea, Republic of)

    2018-03-15

    Sarcoidosis is an inflammatory disorder that is characterized by the presence of noncaseating granulomas in tissues, involving many organs and tissues. Extra-pulmonary, especially muscular sarcoidosis is a rare condition. The most common location of the muscular sarcoidosis is known to be the proximal muscles of the extremities; however, there have been no cases of diffuse involvement of the chest and abdominal wall muscles. Here, we report a rare muscular sarcoidosis with infiltrative pattern in the chest and abdominal wall muscles and describe the MR imaging findings that were mistaken as lymphoma at initial diagnosis. Although our case did not show characteristic MR findings of muscular sarcoidosis, clinicians or radiologists who are aware of these imaging features can perform early systemic survey for sarcoidosis. Also muscle biopsy is very important to confirm the sarcoidosis and distinguish it from other tumors. (orig.)

  3. Muscular sarcoidosis involving the chest and abdominal walls: case report with MR imaging

    International Nuclear Information System (INIS)

    Lee, Seunghyun; Lee, In Sook; Song, You Seon; Mok, Jeongha; Choi, Kyung-Un

    2018-01-01

    Sarcoidosis is an inflammatory disorder that is characterized by the presence of noncaseating granulomas in tissues, involving many organs and tissues. Extra-pulmonary, especially muscular sarcoidosis is a rare condition. The most common location of the muscular sarcoidosis is known to be the proximal muscles of the extremities; however, there have been no cases of diffuse involvement of the chest and abdominal wall muscles. Here, we report a rare muscular sarcoidosis with infiltrative pattern in the chest and abdominal wall muscles and describe the MR imaging findings that were mistaken as lymphoma at initial diagnosis. Although our case did not show characteristic MR findings of muscular sarcoidosis, clinicians or radiologists who are aware of these imaging features can perform early systemic survey for sarcoidosis. Also muscle biopsy is very important to confirm the sarcoidosis and distinguish it from other tumors. (orig.)

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

    International Nuclear Information System (INIS)

    Nakamura, Katsumasa; Shioyama, Yoshiyuki; Nomoto, Satoru; Ohga, Saiji; Toba, Takashi; Yoshitake, Tadamasa; Anai, Shigeo; Terashima, Hiromi; Honda, Hiroshi

    2007-01-01

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

  5. Evaluation of Cases of Abdominal Wall Endometriosis at Universidade Estadual de Campinas in a period of 10 Years

    OpenAIRE

    Yela, Daniela Angerame; Trigo, Lucas; Benetti-Pinto, Cristina Laguna

    2017-01-01

    Abstract Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical ...

  6. Minilaparotomy with a gasless laparoscopic-assisted procedure by abdominal wall lifting for ileorectal anastomosis in patients with slow transit constipation.

    Science.gov (United States)

    Tomita, Ryouichi; Fujisak, Shigeru

    2009-01-01

    Total colectomy with ileorectal anastomosis (IRA) is the most widely adopted procedure. The aim of this study was to introduce a minimally invasive procedure, i.e., minilaparotomy with laparoscopic-assisted procedure, by abdominal wall lifting for IRA in patients with slow transit constipation (STC). Six STC patients (6 women, aged 40-69 years, mean age 56.3 years) underwent minilaparotomy with gasless laparoscopic-assisted approach by abdominal wall lifting for IRA. The present procedure involved a 7-cm lower abdominal median incision made at the beginning of the operation. 12 mm ports were also placed in the right and left upper abdominal quadrant positions. The upper abdominal wall was lifted by a subcutaneous Kirshner wire. The small wound was pulled upward and/or laterally by retractors (abdominal lifting) and conventional surgical instruments were used through the wound. Occasionally laparoscopic assistance was employed. The terminal ileum with total colon was brought out through the small wound and transected, approximately 5 cm from the ileocecal valve. The colon was also resected at the level of promontrium. Then, IRA was performed in the instruments. The total surgical time was 197.7 +/- 33.9 min and the mean estimated blood loss was 176.8 +/- 42.2 ml. There was no surgical mortality. Post-operative hospitalization was 8.1 +/- 2.1 days. Six months after surgery, they defecated 1.8 +/- 2.1 times daily, have no abdominal distension, pain, and incontinence. The patients also take no laxatives. All subjects were satisfied with this procedure. Minilaparotomy with gasless laparoscopic-assisted IRA by abdominal wall lifting could be a safe and efficient technique in the treatment of STC.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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....

  13. 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

    BACKGROUND: Repair of large incisional hernias remains a surgical and costly challenge. Temporary paralysis of the lateral abdominal wall muscles with topical administration of botulinum toxin A (BTA) is a new therapeutic concept, which may obviate the need for component separation technique (CST...

  14. 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.)

  15. 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.

  16. The Relationship Between Surface Curvature and Abdominal Aortic Aneurysm Wall Stress.

    Science.gov (United States)

    de Galarreta, Sergio Ruiz; Cazón, Aitor; Antón, Raúl; Finol, Ender A

    2017-08-01

    The maximum diameter (MD) criterion is the most important factor when predicting risk of rupture of abdominal aortic aneurysms (AAAs). An elevated wall stress has also been linked to a high risk of aneurysm rupture, yet is an uncommon clinical practice to compute AAA wall stress. The purpose of this study is to assess whether other characteristics of the AAA geometry are statistically correlated with wall stress. Using in-house segmentation and meshing algorithms, 30 patient-specific AAA models were generated for finite element analysis (FEA). These models were subsequently used to estimate wall stress and maximum diameter and to evaluate the spatial distributions of wall thickness, cross-sectional diameter, mean curvature, and Gaussian curvature. Data analysis consisted of statistical correlations of the aforementioned geometry metrics with wall stress for the 30 AAA inner and outer wall surfaces. In addition, a linear regression analysis was performed with all the AAA wall surfaces to quantify the relationship of the geometric indices with wall stress. These analyses indicated that while all the geometry metrics have statistically significant correlations with wall stress, the local mean curvature (LMC) exhibits the highest average Pearson's correlation coefficient for both inner and outer wall surfaces. The linear regression analysis revealed coefficients of determination for the outer and inner wall surfaces of 0.712 and 0.516, respectively, with LMC having the largest effect on the linear regression equation with wall stress. This work underscores the importance of evaluating AAA mean wall curvature as a potential surrogate for wall stress.

  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. 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

  19. A Novel Diagnostic Aid for Detection of Intra-Abdominal Adhesions to the Anterior Abdominal Wall Using Dynamic Magnetic Resonance Imaging.

    Science.gov (United States)

    Randall, David; Fenner, John; Gillott, Richard; Ten Broek, Richard; Strik, Chema; Spencer, Paul; Bardhan, Karna Dev

    2016-01-01

    Introduction. Abdominal adhesions can cause serious morbidity and complicate subsequent operations. Their diagnosis is often one of exclusion due to a lack of a reliable, non-invasive diagnostic technique. Development and testing of a candidate technique are described below. Method. During respiration, smooth visceral sliding motion occurs between the abdominal contents and the walls of the abdominal cavity. We describe a technique involving image segmentation and registration to calculate shear as an analogue for visceral slide based on the tracking of structures throughout the respiratory cycle. The presence of an adhesion is attributed to a resistance to visceral slide resulting in a discernible reduction in shear. The abdominal movement due to respiration is captured in sagittal dynamic MR images. Results. Clinical images were selected for analysis, including a patient with a surgically confirmed adhesion. Discernible reduction in shear was observed at the location of the adhesion while a consistent, gradually changing shear was observed in the healthy volunteers. Conclusion. The technique and its validation show encouraging results for adhesion detection but a larger study is now required to confirm its potential.

  20. A Novel Diagnostic Aid for Detection of Intra-Abdominal Adhesions to the Anterior Abdominal Wall Using Dynamic Magnetic Resonance Imaging

    Science.gov (United States)

    Randall, David; Fenner, John; Gillott, Richard; ten Broek, Richard; Strik, Chema; Spencer, Paul; Bardhan, Karna Dev

    2016-01-01

    Introduction. Abdominal adhesions can cause serious morbidity and complicate subsequent operations. Their diagnosis is often one of exclusion due to a lack of a reliable, non-invasive diagnostic technique. Development and testing of a candidate technique are described below. Method. During respiration, smooth visceral sliding motion occurs between the abdominal contents and the walls of the abdominal cavity. We describe a technique involving image segmentation and registration to calculate shear as an analogue for visceral slide based on the tracking of structures throughout the respiratory cycle. The presence of an adhesion is attributed to a resistance to visceral slide resulting in a discernible reduction in shear. The abdominal movement due to respiration is captured in sagittal dynamic MR images. Results. Clinical images were selected for analysis, including a patient with a surgically confirmed adhesion. Discernible reduction in shear was observed at the location of the adhesion while a consistent, gradually changing shear was observed in the healthy volunteers. Conclusion. The technique and its validation show encouraging results for adhesion detection but a larger study is now required to confirm its potential. PMID:26880884

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. Evolution of defect signatures at ferroelectric domain walls in Mg-doped LiNbO3

    International Nuclear Information System (INIS)

    Nataf, Guillaume F.; Guennou, Mael; Haussmann, Alexander; Barrett, Nick; Kreisel, Jens

    2016-01-01

    The domain structure of uniaxial ferroelectric lithium niobate single crystals is investigated using Raman spectroscopy mapping. The influence of doping with magnesium and poling at room temperature is studied by analysing frequency shifts at domain walls and their variations with dopant concentration and annealing conditions. It is shown that defects are stabilized at domain walls and that changes in the defect structures with Mg concentration can be probed by the shift of Raman modes. We show that the signatures of polar defects in the bulk and at the domain walls differ. (copyright 2016 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  6. Double-lock technique: a simple method to secure abdominal wall closure

    International Nuclear Information System (INIS)

    Jategaonkar, P.A.; Yadav, S.P.

    2013-01-01

    Secure closure of a laparotomy incision remains an important aspect of any abdominal operation with the aim to avoid the postoperative morbidity and hasten the patient's recovery. Depending on the operator's preference and experience, it may be done by the continuous or the interrupted methods either using a non-absorbable or delayed-absorbable suture. We describe a simple, secure and quick technique of abdominal wall closure which involves continuous suture inter-locked doubly after every third bite. This simple and easy to use mass closure technique can be easily mastered by any member of the surgical team and does not need any assistant. It amalgamates the advantages of both, the continuous and the interrupted methods of closures. To our knowledge, such a technique has not been reported in the literature. (author)

  7. 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.

  8. [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.

  9. 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.

  10. Desmoid Fibromatosis of the Abdominal Wall: Surgical Resection and Reconstruction with Biological Matrix Egis®

    Directory of Open Access Journals (Sweden)

    Saveria Tropea

    2017-02-01

    Full Text Available Desmoid tumor is a rare monoclonal fibroblast proliferation that is regarded as benign. The clinical management of desmoid tumors is very complex and requires a multidisciplinary approach because of the unpredictable disease course. For those cases localized in the anterior abdominal wall, symptomatic and unresponsive to medical treatment, radical resection and reconstruction with a prosthetic device are indicated. We present here a case of desmoid fibromatosis of the left anterolateral abdominal wall with a marked increase of the mass that required a large excision followed by reconstruction with biological matrix. The fact that it can be incorporated in patient tissue without a fibrotic response and that it can resist future infections, together with a very competetive price, made the new collagen matrix Egis® our first choice.

  11. Desmoid Fibromatosis of the Abdominal Wall: Surgical Resection and Reconstruction with Biological Matrix Egis®

    Science.gov (United States)

    Tropea, Saveria; Mocellin, Simone; Stramare, Roberto; Bonavina, Maria Giuseppina; Rossi, Carlo Riccardo; Rastrelli, Marco

    2017-01-01

    Desmoid tumor is a rare monoclonal fibroblast proliferation that is regarded as benign. The clinical management of desmoid tumors is very complex and requires a multidisciplinary approach because of the unpredictable disease course. For those cases localized in the anterior abdominal wall, symptomatic and unresponsive to medical treatment, radical resection and reconstruction with a prosthetic device are indicated. We present here a case of desmoid fibromatosis of the left anterolateral abdominal wall with a marked increase of the mass that required a large excision followed by reconstruction with biological matrix. The fact that it can be incorporated in patient tissue without a fibrotic response and that it can resist future infections, together with a very competetive price, made the new collagen matrix Egis® our first choice. PMID:28413398

  12. 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

  13. 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.

  14. 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.

  15. A Novel Diagnostic Aid for Detection of Intra-Abdominal Adhesions to the Anterior Abdominal Wall Using Dynamic Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    David Randall

    2016-01-01

    Full Text Available Introduction. Abdominal adhesions can cause serious morbidity and complicate subsequent operations. Their diagnosis is often one of exclusion due to a lack of a reliable, non-invasive diagnostic technique. Development and testing of a candidate technique are described below. Method. During respiration, smooth visceral sliding motion occurs between the abdominal contents and the walls of the abdominal cavity. We describe a technique involving image segmentation and registration to calculate shear as an analogue for visceral slide based on the tracking of structures throughout the respiratory cycle. The presence of an adhesion is attributed to a resistance to visceral slide resulting in a discernible reduction in shear. The abdominal movement due to respiration is captured in sagittal dynamic MR images. Results. Clinical images were selected for analysis, including a patient with a surgically confirmed adhesion. Discernible reduction in shear was observed at the location of the adhesion while a consistent, gradually changing shear was observed in the healthy volunteers. Conclusion. The technique and its validation show encouraging results for adhesion detection but a larger study is now required to confirm its potential.

  16. Giant gallstone in abdominal wall: a rare complication of laparoscopic cholecystectomy

    OpenAIRE

    YİĞİTLER, Cengizhan; DUMAN, Kazım; ÖZCAN, Ali

    2013-01-01

    We aim to report a case of abdominal wall mass formation secondary to gallbladder perforation and stone spillage occurring during laparoscopic cholecystectomy (LC). A 73-year-old women presented with purulent discharge from one of her previous port sites one year after she underwent LC. The latter revealed a round opaque mass in an abscess like cavity, and subsequently an ultrasonography showed a round echogenity with acoustic shadow posteriorly. Axial CT images verified the presence of a wel...

  17. 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.

  18. Evolution of defect signatures at ferroelectric domain walls in Mg-doped LiNbO{sub 3}

    Energy Technology Data Exchange (ETDEWEB)

    Nataf, Guillaume F. [Materials, Research and Technology Department, Luxembourg Institute of Science and Technology, 41 Rue du Brill, 4422, Belvaux (Luxembourg); Service de Physique de l' Etat Condense, DSM/IRAMIS/SPEC, CNRS UMR 3680, CEA Saclay, 91191, Gif sur Yvette cedex (France); Guennou, Mael [Materials, Research and Technology Department, Luxembourg Institute of Science and Technology, 41 Rue du Brill, 4422, Belvaux (Luxembourg); Haussmann, Alexander [Institut fuer Angewandte Photophysik, Technische Universitaet Dresden, George-Baehr-Str. 1, 01069, Dresden (Germany); Barrett, Nick [Service de Physique de l' Etat Condense, DSM/IRAMIS/SPEC, CNRS UMR 3680, CEA Saclay, 91191, Gif sur Yvette cedex (France); Kreisel, Jens [Materials, Research and Technology Department, Luxembourg Institute of Science and Technology, 41 Rue du Brill, 4422, Belvaux (Luxembourg); Physics and Materials Science Research Unit, University of Luxembourg, 41 Rue du Brill, 4422, Belvaux (Luxembourg)

    2016-03-15

    The domain structure of uniaxial ferroelectric lithium niobate single crystals is investigated using Raman spectroscopy mapping. The influence of doping with magnesium and poling at room temperature is studied by analysing frequency shifts at domain walls and their variations with dopant concentration and annealing conditions. It is shown that defects are stabilized at domain walls and that changes in the defect structures with Mg concentration can be probed by the shift of Raman modes. We show that the signatures of polar defects in the bulk and at the domain walls differ. (copyright 2016 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  19. 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.

  20. 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.

  1. Laparoscopic cholecystectomy using abdominal wall retraction. Hemodynamics and gas exchange, a comparison with conventional pneumoperitoneum

    NARCIS (Netherlands)

    Meijer, D. W.; Rademaker, B. P.; Schlooz, S.; Bemelman, W. A.; de Wit, L. T.; Bannenberg, J. J.; Stijnen, T.; Gouma, D. F.

    1997-01-01

    BACKGROUND: Disadvantages related to CO2 pneumoperitoneum have led to development of the abdominal wall retractor (AWR), a device designed to facilitate laparoscopic surgery without conventional pneumoperitoneum (15 mmHg CO2). We investigated the effects of the AWR on hemodynamics and gas exchange

  2. 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)

  3. Reconstruction of the full thickness chest wall defect. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Moriguchi, T; Sano, S; Ogawa, Y; Fujimori, Y [Kyoto Univ. (Japan). Faculty of Medicine; Abe, R

    1977-03-01

    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.

  4. 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.)

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. Importance of initial stress for abdominal aortic aneurysm wall motion: Dynamic MRI validated finite element analysis

    NARCIS (Netherlands)

    Merkx, M.A.G.; Veer, van 't M.; Speelman, L.; Breeuwer, M.; Buth, J.; Vosse, van de F.N.

    2009-01-01

    Currently the transverse diameter is the primary decision criterion to assess rupture risk in patients with an abdominal aortic aneurysm (AAA). To obtain a measure for more patient-specific risk assessment, aneurysm wall stress, calculated using finite element analysis (FEA), has been evaluated in

  11. Minimally Invasive, Organ-preserving Surgery for Large Submucosal Tumors in the Abdominal Esophagus.

    Science.gov (United States)

    Kanehira, Eiji; Tanida, Takashi; Kamei, Aya; Takahashi, Kodai

    2017-06-01

    Surgical resection of submucosal tumors (SMTs) in the abdominal esophagus is not standardized. Enucleation may be a minimally invasive option, whereas its oncological validity is not very clear. Moreover, how to treat the esophageal wall defect after enucleation and necessity of additional antireflux procedure are also undetermined. In 13 patients with a SMT originating the abdominal esophagus laparoscopic enucleation was performed with preserving the integrity of submucosa. When the muscular layer defect was esophagus was dissected posteriorly or the myotomy was not closed. Tumors were resected en-bloc without rupture in all cases. In 5 patients myotomy was closed, whereas in the remaining 8 it was left open. In 11 patients fundoplication was added (Toupet in 5 and Dor in 6). The patients developed neither regurgitation nor stenosis postoperatively. The histopathologic findings revealed leiomyoma in 9 patients, whereas the other 4 were miscellaneous. The average tumor size was 5.5 cm (range, 2.8 to 8.8). Microscopically surgical margin was negative in all cases. Laparoscopic enucleation of SMTs in the abdominal esophagus seems to be safe, reproducible operation enabling preservation of function of the lower esophagus and esophagogastric junction. Even when the muscular defect is not approximated additional fundoplication can minimize the risk of postoperative reflux disease.

  12. 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.

  13. 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.

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

    Science.gov (United States)

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

    2016-03-01

    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. Project supported by the National Natural Science Foundation of China (Grant Nos. 11374087, 11274088, and 11304074), the Natural Science Foundation of Hebei Province, China (Grant Nos. A2014202123 and A2016202282), the Research Project of Hebei Education Department, China (Grant Nos. QN2014130 and QN2015260), and the Key Subject Construction Project of Hebei Province University, China.

  15. Repair of chest wall defects after irradiation for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, L E

    1976-03-01

    A simple technique using a contralateral deltopectoral flap is described for the immediate repair of defects of the chest wall resulting from excision of radionecrosis or persistent tumour after radiotherapy. Successful use in 3 consecutive cases has shown that the deltopectoral flap may be rotated through a full 180/sup 0/ without compromise of blood supply and that primary healing may be obtained.

  16. Lateral abdominal muscle size at rest and during abdominal drawing-in manoeuvre in healthy adolescents.

    Science.gov (United States)

    Linek, Pawel; Saulicz, Edward; Wolny, Tomasz; Myśliwiec, Andrzej; Kokosz, Mirosław

    2015-02-01

    Lateral abdominal wall muscles in children and adolescents have not been characterised to date. In the present report, we examined the reliability of the ultrasound measurement and thickness of the oblique external muscle (OE), oblique internal muscle (OI) and transverse abdominal muscle (TrA) at rest and during abdominal drawing-in manoeuvre (ADIM) on both sides of the body in healthy adolescents. We also determined possible differences between boys and girls and defined any factors-such as body mass, height and BMI-that may affect the thickness of the abdominal muscles. B-mode ultrasound was used to assess OE, OI and TrA on both sides of the body in the supine position. Ultrasound measurements at rest and during ADIM were reliable in this age group (ICC3,3 > 0.92). OI was always the thickest and TrA the thinnest muscle on both sides of the body. In this group, an identical pattern of the contribution of the individual muscles to the structure of the lateral abdominal wall (OI > OE > TrA) was observed. At rest and during ADIM, no statistically significant side-to-side differences were demonstrated in either gender. The body mass constitutes between 30% and <50% of the thickness differences in all muscles under examination at rest and during ADIM. The structure of lateral abdominal wall in adolescents is similar to that of adults. During ADIM, the abdominal muscles in adolescents react similarly to those in adults. This study provided extensive information regarding the structure of the lateral abdominal wall in healthy adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. 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.

  18. 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 ...

  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)

    Zhao, Huamin; He, Cunfu; Yan, Lyu; Zhang, Haijun

    2018-03-02

    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.

  20. Ruptured tuberculous false aneurysm of the abdominal aorta: a case report.

    Science.gov (United States)

    Mechchat, Alae; Lekehal, Brahim; Mesnaoui, Abbes; Ammar, Fannid; Bensaid, Younes

    2011-01-01

    Tuberculous false aneurysm of the aorta is rare and has an unpredictable complication of aneurysm rupture. We report a case of a 32-year old woman who was referred to the Department of Vascular Surgery, Avicenne Hospital for severe abdominal pain. Chest x-ray revealed miliary tuberculosis. Contrast enhanced computed tomography (CT) scan showed a false aortic aneurysm involving the juxtarenal aorta. Antituberculous treatment was started because of high presumption of tuberculosis. Five days later, the patient presented with symptoms of aneurysm rupture. She underwent an emergency a surgical resection of the aneurysm with repair of the aortic wall defect by a Dacron Silver patch. The histopathologic examination of the aortic wall showed features of tuberculosis.

  1. Necrotizing fasciitis involving the chest and abdominal wall caused by Raoultella planticola

    Directory of Open Access Journals (Sweden)

    Kim Si-Hyun

    2012-03-01

    Full Text Available Abstract Background Raoultella planticola was originally considered to be a member of environmental Klebsiella. The clinical significance of R. planticola is still not well known. Case presentation We describe the first case of necrotizing fasciitis involving the chest and abdominal wall caused by R. planticola. The identity of the organism was confirmed using 16S rRNA sequencing. The patient was successfully treated with the appropriate antibiotics combined with operative drainage and debridement. Conclusions R. planticola had been described as environmental species, but should be suspected in extensive necrotizing fasciitis after minor trauma in mild to moderate immunocompromised patients.

  2. 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.

  3. Automatic determination of the dynamic geometry of abdominal aortic aneurysm from MR with application to wall stress simulations

    NARCIS (Netherlands)

    Putter, de S.; Breeuwer, M.; Kose, U.; Vosse, van de F.N.; Gerritsen, F.A.; Lemke, H.U.

    2005-01-01

    The current surgical intervention criterion for abdominal aortic aneurysm is based on the maximum transverse diameter of the aorta. Recent research advances indicate that a better rupture predictor may be derived from the wall stress, which can be computed with the finite element method. An

  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

    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...... not predict abdominal wall outcome after emergency surgery for colonic anastomotic leakage....

  5. 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

  6. Prone versus supine thallium myocardial SPECT: A method to decrease artifactual inferior wall defects

    International Nuclear Information System (INIS)

    Segall, G.M.; Davis, M.J.

    1989-01-01

    Artifactual inferior wall defects as a result of diaphragmatic attenuation of activity are a frequent source of error in thallium myocardial single photon emission computed tomography (SPECT) studies. Thirty-four patients and 11 clinically normal volunteers were studied prospectively to see if specificity of inferior wall defects for right coronary artery disease could be improved by scanning patients prone versus supine. All individuals were scanned both prone and supine, in random order, following symptom limited treadmill exercise. Images were acquired at 3 degrees steps, 25 sec per frame, in a 180 degrees elliptical orbit always beginning in the 45 degrees right anterior oblique position relative to the patient. Polar maps generated from the short axis slices were used to calculate the average regional activity. The prone studies showed consistently higher inferior wall activity compared to the supine studies on both the exercise (182 +/- 22 vs. 160 +/- 23, p less than or equal to 0.001) and 4-hr delay studies (183 +/- 20 vs. 175 +/- 21, p less than or equal to 0.001). Prone imaging resulted in a significantly higher specificity for RCA disease compared to supine imaging (90% vs. 66%, p less than 0.05) with an improvement in accuracy from 71% to 82%. Sensitivity, specificity, and accuracy for left anterior descending and left circumflex artery disease were not significantly affected by patient position during imaging. All patients having SPECT thallium myocardial perfusion studies should be imaged prone to minimize artifactual inferior wall defects and improve accuracy

  7. 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

  8. 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.

  9. Feasibility of wall stress analysis of abdominal aortic aneurysms using three-dimensional ultrasound.

    Science.gov (United States)

    Kok, Annette M; Nguyen, V Lai; Speelman, Lambert; Brands, Peter J; Schurink, Geert-Willem H; van de Vosse, Frans N; Lopata, Richard G P

    2015-05-01

    Abdominal aortic aneurysms (AAAs) are local dilations that can lead to a fatal hemorrhage when ruptured. Wall stress analysis of AAAs is a novel tool that has proven high potential to improve risk stratification. Currently, wall stress analysis of AAAs is based on computed tomography (CT) and magnetic resonance imaging; however, three-dimensional (3D) ultrasound (US) has great advantages over CT and magnetic resonance imaging in terms of costs, speed, and lack of radiation. In this study, the feasibility of 3D US as input for wall stress analysis is investigated. Second, 3D US-based wall stress analysis was compared with CT-based results. The 3D US and CT data were acquired in 12 patients (diameter, 35-90 mm). US data were segmented manually and compared with automatically acquired CT geometries by calculating the similarity index and Hausdorff distance. Wall stresses were simulated at P = 140 mm Hg and compared between both modalities. The similarity index of US vs CT was 0.75 to 0.91 (n = 12), with a median Hausdorff distance ranging from 4.8 to 13.9 mm, with the higher values found at the proximal and distal sides of the AAA. Wall stresses were in accordance with literature, and a good agreement was found between US- and CT-based median stresses and interquartile stresses, which was confirmed by Bland-Altman and regression analysis (n = 8). Wall stresses based on US were typically higher (+23%), caused by geometric irregularities due to the registration of several 3D volumes and manual segmentation. In future work, an automated US registration and segmentation approach is the essential point of improvement before pursuing large-scale patient studies. This study is a first step toward US-based wall stress analysis, which would be the modality of choice to monitor wall stress development over time because no ionizing radiation and contrast material are involved. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  10. Heavy Metal Bioaccumulation in an Atypical Primitive Neuroectodermal Tumor of the Abdominal Wall.

    Science.gov (United States)

    Roncati, Luca; Gatti, Antonietta Morena; Capitani, Federico; Barbolini, Giuseppe; Maiorana, Antonio; Palmieri, Beniamino

    2015-01-01

    Heavy metals are able to interfere with the function of vital cellular components. Besides in trace heavy metals, which are essential at low concentration for humans, there are heavy metals with a well-known toxic and oncogenic potential. In this study, for the first time in literature, we report the unique adulthood case of an atypical primitive neuroectodermal tumor of the abdominal wall, diagnosed by histology and immunohistochemistry, with the molecular hybridization support. The neoplasia occurred in a patient chronically exposed to a transdermal delivery of heavy metal salts (aluminum and bismuth), whose intracellular bioaccumulation has been revealed by elemental microanalysis.

  11. 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 S.; 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....

  12. 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

  13. The role of prophylactic cefazolin in the prevention of infection after various types of abdominal wall hernia repair with mesh

    Directory of Open Access Journals (Sweden)

    Mostafa Mehrabi Bahar

    2015-07-01

    Conclusion: Preoperative administration of single-dose cefazolin for prosthetic hernia repairs did not markedly decrease the risk of wound infection. Our results do not support the use of cefazolin as a prophylactic antibiotic for various kinds of abdominal wall hernia repair with mesh.

  14. Dirichlet topological defects

    International Nuclear Information System (INIS)

    Carroll, S.M.; Trodden, M.

    1998-01-01

    We propose a class of field theories featuring solitonic solutions in which topological defects can end when they intersect other defects of equal or higher dimensionality. Such configurations may be termed open-quotes Dirichlet topological defects,close quotes in analogy with the D-branes of string theory. Our discussion focuses on defects in scalar field theories with either gauge or global symmetries, in 3+1 dimensions; the types of defects considered include walls ending on walls, strings on walls, and strings on strings. copyright 1998 The American Physical Society

  15. 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.

  16. Biomechanical and histologic evaluation of two application forms of surgical glue for mesh fixation to the abdominal wall.

    Science.gov (United States)

    Ortillés, Á; Pascual, G; Peña, E; Rodríguez, M; Pérez-Köhler, B; Mesa-Ciller, C; Calvo, B; Bellón, J M

    2017-11-01

    The use of an adhesive for mesh fixation in hernia repair reduces chronic pain and minimizes tissue damage in the patient. This study was designed to assess the adhesive properties of a medium-chain (n-butyl) cyanoacrylate glue applied as drops or as a spray in a biomechanical and histologic study. Both forms of glue application were compared to the use of simple-loose or continuous-running polypropylene sutures for mesh fixation. Eighteen adult New Zealand White rabbits were used. For mechanical tests in an ex vivo and in vivo study, patches of polypropylene mesh were fixed to an excised fragment of healthy abdominal tissue or used to repair a partial abdominal wall defect in the rabbit respectively. Depending on the fixation method used, four groups of 12 implants each or 10 implants each respectively for the ex vivo and in vivo studies were established: Glue-Drops, Glue-Spray, Suture-Simple and Suture-Continuous. Biomechanical resistance in the ex vivo implants was tested five minutes after mesh fixation. In vivo implants for biomechanical and histologic assessment were collected at 14 days postimplant. In the ex vivo study, the continuous suture implants showed the highest failure sample tension, while the implants fixed with glue showed lower failure sample tension values. However, the simple and continuous suture implants returned the highest stretch values. In the in vivo implants, failure sample tension values were similar among groups while the implants fixed with a continuous running suture had the higher stretch values, and the glue-fixed implants the lower stretch values. All meshes showed good tissue integration within the host tissue regardless of the fixation method used. Our histologic study revealed the generation of a denser, more mature repair tissue when the cyanoacrylate glue was applied as a spray rather than as drops. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. CT diagnosis of concealed rupture of intestine following abdominal trauma

    International Nuclear Information System (INIS)

    Ji Jiansong; Wei Tiemin; Wang Zufei; Zhao Zhongwei; Tu Jianfei; Fan Xiaoxi; Xu Min

    2009-01-01

    Objective: To investigate CT findings of concealed rupture of intestine following abdominal trauma. Methods: CT findings of 11 cases with concealed rupture of intestine following abdominal trauma proved by surgery were identified retrospectively. Results: The main special signs included: (1) Free air in 4 cases, mainly around injured small bowel or under the diaphragm, or in the retroperitoneal space or and in the lump. (2) High density hematoma between the intestines or in the bowel wall (4 cases). (3) Bowel wall injury sign, demonstrated as low density of the injured intestinal wall, attenuated locally but relatively enhanced in neighbor wall on enhanced CT. (4) Lump around the injured bowel wall with obvious ring-shaped enhancement (4 cases). Other signs included: (1) Free fluid in the abdominal cavity or between the intestines with blurred borders. (2) Bowel obstruction. Conclusion: CT is valuable in diagnosing concealed rupture of intestine following abdominal trauma. (authors)

  18. Appearance of abdominal wall endometriosis on MR imaging

    International Nuclear Information System (INIS)

    Busard, Milou P.H.; Kuijk, Cees van; Waesberghe, Jan Hein T.M. van; Mijatovic, Velja; Hompes, Peter G.A.

    2010-01-01

    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 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 -3 /mm 2 /s. MR imaging seems to be useful in determining the location and depth of infiltration in surrounding tissue preoperatively. (orig.)

  19. Histopathological analysis of cellular localization of cathepsins in abdominal aortic aneurysm wall.

    Science.gov (United States)

    Lohoefer, Fabian; Reeps, Christian; Lipp, Christina; Rudelius, Martina; Zimmermann, Alexander; Ockert, Stefan; Eckstein, Hans-Henning; Pelisek, Jaroslav

    2012-08-01

    An important feature of abdominal aortic aneurysm (AAA) is the destruction of vessel wall, especially elastin and collagen. Besides matrix metalloproteinases, cathepsins are the most potent elastolytic enzymes. The expression of cathepsins with known elastolytic and collagenolytic activities in the individual cells within AAA has not yet been determined. The vessel wall of 32 AAA patients and 10 organ donors was analysed by immunohistochemistry for expression of cathepsins B, D, K, L and S, and cystatin C in all cells localized within AAA. Luminal endothelial cells (ECs) of AAA were positive for cathepsin D and partially for cathepsins B, K and S. Endothelial cells of the neovessels and smooth muscle cells in the media were positive for all cathepsins tested, especially for cathepsin B. In the inflammatory infiltrate all cathepsins were expressed in the following pattern: B > D = S > K = L. Macrophages showed the highest staining intensity for all cathepsins. Furthermore, weak overall expression of cystatin C was observed in all the cells localized in the AAA with the exception of the ECs. There is markedly increased expression of the various cathepsins within the AAA wall compared to healthy aorta. Our data are broadly consistent with a role for cathepsins in AAA; and demonstrate expression of cathepsins D, B and S in phagocytic cells in the inflammatory infiltrate; and also may reveal a role for cathepsin B in lymphocytes. © 2012 The Authors. International Journal of Experimental Pathology © 2012 International Journal of Experimental Pathology.

  20. Challenges in the repair of large abdominal wall hernias in Nigeria: review of available options in resource limited environments.

    Science.gov (United States)

    Ezeome, E R; Nwajiobi, C E

    2010-06-01

    To evaluate the challenges and outcome of management of large abdominal wall hernias in a resource limited environment and highlight the options available to surgeons in similar conditions. A review of prospectively collected data on large abdominal wall hernias managed between 2003 and 2009. University of Nigeria Teaching Hospital, Enugu, Nigeria and surrounding hospitals. Patients with hernias more than 4 cm in their largest diameter, patients with closely sited multiple hernias or failed previous repairs and in whom the surgeon considers direct repair inappropriate. Demographics of patients with large hernias, methods of hernia repair, recurrences, early and late complications following the repair. There were 41 patients, comprising 28 females and 13 males with ages 14 - 73 years. Most (53.7%) were incisional hernias. Gynecological surgeries (66.7%) were the most common initiating surgeries. Fifteen of the patients (36.6%) have had failed previous repairs, 41.5% were obese, five patients presented with intestinal obstruction. Thirty nine of the hernias were repaired with prolene mesh, one with composite mesh and one by danning technique. Most of the patients had extra peritoneal mesh placement. Three patients needed ventilator support. After a mean follow up of 18.6 months, there was a single failed repair. Two post op deaths were related to respiratory distress. There were 12 wound infection and 8 superficial wound dehiscence, all of which except one resolved with dressing. One reoperation was done following mesh infection and extrusion. Large abdominal wall hernia repair in resource limited environments present several challenges with wound infection and respiratory distress being the most notable. Surgeons who embark on it in these environments must be prepared t o secure the proper tissue replacement materials and have adequate ventilation support.

  1. 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

  2. Perforated peptic ulcer associated with abdominal compartment syndrome.

    Science.gov (United States)

    Lynn, Jiun-Jen; Weng, Yi-Ming; Weng, Chia-Sui

    2008-11-01

    Abdominal compartment syndrome (ACS) is defined as an increased intra-abdominal pressure with adverse physiologic consequences. Abdominal compartment syndrome caused by perforated peptic ulcer is rare owing to early diagnosis and management. Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS. We report a case of perforated peptic ulcer associated with ACS. A 74-year-old man with old stroke and dementia history was found to have distended abdomen, edema of bilateral legs, and cyanosis. Laboratory tests revealed deterioration of liver and kidney function. Abdominal compartment syndrome was suspected, and image study was arranged to find the cause. The study showed pneumoperitoneum, contrast stasis in heart with decreased caliber of vessels below the abdominal aortic level, and diffuse lymphedema at the abdominal walls. Emergent laparotomy was performed. Perforated peptic ulcer was noted and the gastrorrhaphy was done. The symptoms, and liver and kidney function improved right after emergent operation.

  3. Component separation of abdominal wall with intraoperative botulinum A presents satisfactory outcomes in large incisional hernias: a case report.

    Science.gov (United States)

    Oliveira, Lucas Torres; Essu, Felipe Futema; de Mesquita, Gustavo Heluani Antunes; Jardim, Yuri Justi; Iuamoto, Leandro Ryuchi; Suguita, Fábio Yuji; Martines, Diego Ramos; Nii, Fernanda; Waisberg, Daniel Reis; Meyer, Alberto; Andraus, Wellington; D'Albuquerque, Luiz Augusto Carneiro

    2017-01-01

    Transplantation patients have a series of associated risk factors that make appearance of incisional hernia (IH) more likely. A number of aspects of the closure of large defects remain controversial. In this manuscript, we present the repair of a large IH following liver transplantation through the technique of posterior components separation combined with the anterior, together with the intraoperative use of botulinum toxin A and the placement of mesh. As a secondary objective, we analyze the incidence of IH following liver transplantation in our service. Between the years 2013 and 2016, 247 patients underwent liver transplantation in the Liver Transplantation Service at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. We analyzed the incidence of IH in these patients. One of these cases operated in March 2017 presented a defect in the abdominal wall of 22×16.6×6.4cm in the median and paramedian regions. We present the details of this innovative surgical technique. The total operating time was 470min. During the postoperative phase the patient presented ileus paralysis, without systemic repercussions. Resumption of an oral diet on the fifth postoperative day, without incident. Hospital discharge occurred on the 12th postoperative day, with outpatient follow up. In our service, the incidence of incisional hernias following liver transplantation is 14.5%. We described a successful approach for selected patient group for whom there is no established standard treatment. Given the complexity of such cases, however, more studies are necessary. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Combined laparoscopic and open technique for repair of congenital abdominal hernia

    Science.gov (United States)

    Ye, Qinghuang; Chen, Yan; Zhu, Jinhui; Wang, Yuedong

    2017-01-01

    Abstract Background: Prune belly syndrome (PBS) is a rare congenital disorder among adults, and the way for repairing abdominal wall musculature has no unified standard. Materials and methods: We described combining laparoscopic and open technique in an adult male who presented with PBS. Physical examination and radiological imaging verified the case of PBS. The deficiency of abdominal wall musculature was repaired by combining laparoscopic and open technique using a double-deck complex patch. Results: The patient successfully underwent abdominal wall repair by combining laparoscopic and open technique. Postoperative recovery was uneventful, and improvement in symptom was significant in follow-up after 3, 6, 12, and 24 months. Conclusions: Combining laparoscopic and open technique for repair of deficiency of abdominal wall musculature in PBS was an exploratory way to improve life quality. PMID:29049186

  5. Possible Genetic Origin of Limb-Body Wall Complex.

    Science.gov (United States)

    Gajzer, David C; Hirzel, Alicia Cristina; Saigal, Gaurav; Rojas, Claudia Patricia; Rodriguez, Maria Matilde

    2015-01-01

    Limb body wall complex (LBWC) is characterized by multiple severe congenital malformations including an abdominal and/or thoracic wall defect covered by amnion, a short or absent umbilical cord with the placenta almost attached to the anterior fetal wall, intestinal malrotation, scoliosis, and lower extremity anomalies. There is no consensus about the etiology of LBWC and many cases with abnormal facial cleft do not meet the requirements for the true complex. We describe a series of four patients with LBWC and other malformations in an attempt to explain their etiology. There are several reports of fetuses with LBWC and absent gallbladder and one of our patients also had polysplenia. Absent gallbladder and polysplenia are associated with laterality genes including HOX, bFGF, transforming growth factor beta/activins/BMP4, WNT 1-8, and SHH. We postulate that this severe malformation may be due to abnormal genes involved in laterality and caudal development.

  6. 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

  7. 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.)

  8. DIEP breast reconstruction following multiple abdominal liposuction procedures

    OpenAIRE

    Farid, Mohammed; Nicholson, Simon; Kotwal, Ashutosh; Akali, Augustine

    2014-01-01

    Objective: 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. Methods: Review of case notes and radiological investigations of two patients, and a PubMed search using the ter...

  9. A rare case of severe third degree friction burns and large Morel-Lavallee lesion of the abdominal wall.

    Science.gov (United States)

    Brown, Darnell J; Lu, Kuo Jung G; Chang, Kristina; Levin, Jennifer; Schulz, John T; Goverman, Jeremy

    2018-01-01

    Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients. We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL. The internal degloving caused significant devascularization of the overlying soft tissue and skin which required surgical drainage of hematoma, abdominal wall reconstruction with tangential excision, allografting, negative pressure wound therapy, and ultimately autografting. MLL is a rare, often overlooked, internal degloving injury. Surgeons must maintain a high index of suspicion when dealing with third degree friction burns as they may mask underlying injuries such as MLL, and a delay in diagnosis can lead to increased morbidity.

  10. Abdominal endometriosis: Ultrasonographic findings (report of two cases)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Beum; Kim, Yong Goo; Lee, Yong Chul; Kim, Kun Sang [Chung Ang University Hospital, Seoul (Korea, Republic of)

    1993-12-15

    Endometriosis in the abdominal wall is a rare condition that most commonly occurs in the physiological scar of the umbilicus and in surgical scars of pelvic operation. The ultrasonographic findings are often non-specific, but with scrutinized physical examination and history, correct diagnosis can be made. We report ultrasonographic findings of abdominal wall endometriosis in two cases, both of which were related to previous cesarian section scar

  11. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    Frei, Pascal

    2015-09-02

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.

  12. Pseudotumors after primary abdominal lipectomy as a new sequela in patients with abdominal apron.

    Science.gov (United States)

    Dragu, Adrian; Bach, Alexander D; Polykandriotis, Elias; Kneser, Ulrich; Horch, Raymund E

    2009-11-01

    Malnutrition and overweight is a common problem in modern societies. Primary abdominal lipectomy is a standard surgical tool in patients with these problems. However, unknown secondary problems result from recent advances in obesity surgery. Plication of the anterior musculoaponeurotic wall is a widely and commonly used operative technique during abdominoplasty. Many different plication techniques have been published. So far no common standard and long-term effectiveness is proven. In addition, there is no sufficient literature dealing with the postoperative risks of plication of the musculoaponeurotic wall. Four patients with development of pseudotumors were reviewed. All four patients received 12 months in advance a primary abdominal lipectomy including a vertical plication of the musculoaponeurotic wall. All four patients were females with mean age of 61 years and mean body mass index (BMI) of 37 kg/m(2). All four patients had developed a pseudotumor of the abdomen as a long-term complication more than 12 months after primary abdominal lipectomy including a vertical plication of the anterior rectus sheath. One should be aware of the potential long-term risk of secondary postoperative hematoma formation, with or without partial necrosis of the anterior rectus sheath after vertical plication of the anterior musculoaponeurotic wall. Viewed clinically and radiologically, such sequelas may appear as pseudotumor like masses and require immediate revision.

  13. Radiological evaluation of abdominal trauma

    International Nuclear Information System (INIS)

    Ahn, K. S.; Cho, Y. H.; Kim, O.

    1982-01-01

    Simple abdomen film has played an important role in decision of emergency operations in patients with the abdominal trauma. Nowadays, it still acts as a primary and inevitable processes in emergency condition. At the Department of Radiology, Hanil Hospital, 70 patients, who were laparotomied due to penetrating or nonpernetraing abdominal trauma, were observed and analyzed with simple abdomen film after comparison with the operative findings. The results are as follows: 1. Most frequent age distribution was 10 to 39 years and marked 70%. Male was in 90% incidence. 2. Penetrating injury largely involved the small bowel and abdominal wall. Non-penetrating injury usually involved the spleen, small bowel, liver, kidney, pancreas, duodenum. 3. Single organ injury occurred in higher incidence at the small bowel and abdominal wall. Multiple organ injury occurred in higher incidence at the spleen, liver, kidney and pancreas. 4. Organ distribution was 26% in spleen, 22% in small bowel, 14% in liver, 11% in abdominal wall. 7% in pancreas, 7% in kidney. 5% in duodenum, 4% in GB and CBD, 2% in diaphragm, 2% in colon, and 1% in stomach. 5. The specific roentgen findings and their frequency which useful in differential diagnosis at abdominal trauma, were as follows: a) flank fluid; Detectable possibility was 71% in liver laceration, 69% in spleen laceration and 57% in pancreas laceration. b) ipsilateral psoas shadow obliteration; Detectable possibility was 57% in liver laceration, 57% in kidney laceration and 46% in spleen laceration. c) free air; Detactable possibility was 60% in duodenal perforation, and 36% in peroration of upper part of small bowel. d) Reflex ileus; Detectable possibility was 64% in small bowel, 50% in liver laceration and 35% in spleen laceration. e) rib fracture; Detactable possibility was 36% in liver laceration and 23% in spleen laceration. f) pleural effusion; Detectable possibility was 29% in liver laceration and 27% in spleen laceration

  14. Dependence of the electrical properties of defective single-walled carbon nanotubes on the vacancy density

    International Nuclear Information System (INIS)

    Luo Yu-Pin; Tien Li-Gan; Tsai Chuen-Horng; Lee Ming-Hsien; Li Feng-Yin

    2011-01-01

    The relationship between the electric properties and the vacancy density in single-walled carbon nanotubes has been investigated from first principles as well as the dependence of the influencing range of a vacancy in the nanotube on the nanotube chirality. Compared with the long-range interaction of the vacancies in a single-walled carbon nanotube with non-zero chiral angle, a much shorter interaction was found between vacancies in a zigzag single-walled carbon nanotube. In this study, we investigated the bandstructure fluctuations caused by the nanotube strain, which depends on both the vacancy density and the tube chirality. These theoretical results provide new insight to understand the relationship between the local deformation of a defective single-walled carbon nanotube and its measurable electronic properties. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

  15. Passive mechanical properties of rat abdominal wall muscles suggest an important role of the extracellular connective tissue matrix.

    Science.gov (United States)

    Brown, Stephen H M; Carr, John Austin; Ward, Samuel R; Lieber, Richard L

    2012-08-01

    Abdominal wall muscles have a unique morphology suggesting a complex role in generating and transferring force to the spinal column. Studying passive mechanical properties of these muscles may provide insights into their ability to transfer force among structures. Biopsies from rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were harvested from male Sprague-Dawley rats, and single muscle fibers and fiber bundles (4-8 fibers ensheathed in their connective tissue matrix) were isolated and mechanically stretched in a passive state. Slack sarcomere lengths were measured and elastic moduli were calculated from stress-strain data. Titin molecular mass was also measured from single muscle fibers. No significant differences were found among the four abdominal wall muscles in terms of slack sarcomere length or elastic modulus. Interestingly, across all four muscles, slack sarcomere lengths were quite long in individual muscle fibers (>2.4 µm), and demonstrated a significantly longer slack length in comparison to fiber bundles (p resistance to lengthening at long muscle lengths. Titin molecular mass was significantly less in TrA compared to each of the other three muscles (p < 0.0009), but this difference did not correspond to hypothesized differences in stiffness. Copyright © 2012 Orthopaedic Research Society.

  16. Women in the Military; Pregnancy, Command Climate, Organizational Behavior, and Outcome. Part 1

    Science.gov (United States)

    1996-05-01

    temperature 17) abdominal wall defect 18) ruptured x cord 19) deceleration 20) nonreassuring tracing 21) omphalocele 22) terminal bradychardig 23...44-45 03) RO sepsis 04) IUFD 05) infant death 06) apnea (primary) 07) twins 08) NICU 09) temperature 10) abdominal wall defect 11) omphalocele 12

  17. 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.

  18. Modified sandwich vacuum pack technique for temporary closure of abdominal wounds: an African perspective.

    Science.gov (United States)

    van As, A B; Navsaria, P; Numanoglu, A; McCulloch, M

    2007-01-01

    South Africa has very high levels of accidental trauma as well as interpersonal violence. There are more admissions for trauma in South Africa than for any other disease; therefore it can be regarded as the Number 1 disease in the country. Complex abdominal injuries are common, requiring specific management techniques. The aim is to document our experience with the Modified Sandwich Vacuum Pack technique for temporary closure of abdominal wounds. After providing a short historical overview, we will demonstrate the technique which we carefully adapted over the last decade to the present Modified Sandwich Vacuum Pack technique. In the Last 5 years we utilized our Modified Sandwich Vacuum Pack technique 153 times in 69 patients. Five (5) patients were under the age of 12 years. In the patient group over 12 years the most common indication for using our technique were penetrating injuries (40), abdominal sepsis (28), visceral edema (10), abdominal compartment syndrome (9), abdominal packs (6),Abdominal wall defects (2). In the group under 12-years the 2 children had liver ruptures (posttraumatic) and 3 liver transplantations. The average cost for the materials used with our technique was ZAR 96. (10 Euro and 41 cents). In our experience the Modified Sandwich Vacuum Pack technique is an effective, cheap methodology to deal with open abdomens in the African setting.A drawback may be the technical expertise required, particular in centers dealing with low numbers of complex abdominal trauma.

  19. Abdominal imaging findings in gastrointestinal basidiobolomycosis.

    Science.gov (United States)

    Flicek, Kristina T; Vikram, Holenarasipur R; De Petris, Giovanni D; Johnson, C Daniel

    2015-02-01

    To describe the abdominal imaging findings of patients with gastrointestinal Basidiobolus ranarum infection. A literature search was performed to compile the abdominal imaging findings of all reported worldwide cases of gastrointestinal basidiobolomycosis (GIB). In addition, a retrospective review at our institution was performed to identify GIB cases that had imaging findings. A radiologist aware of the diagnosis reviewed the imaging findings in detail. Additional information was obtained from the medical records. A total of 73 GIB cases have been published in the medical literature. The most common abdominal imaging findings were masses in the colon, the liver, or multiple sites and bowel wall thickening. Initially, many patients were considered to have either a neoplasm or Crohn disease. We identified 7 proven cases of GIB at our institution, of which 4 had imaging studies (4 computed tomography [CT] examinations, 4 abdominal radiographs, and an upper gastrointestinal study). Imaging studies showed abnormalities in all 4 cases. Three-fourths of our study patients had an abdominal mass at CT. Two of 3 masses involved the kidneys and included urinary obstruction. All masses showed an inflammatory component with adjacent soft tissue stranding, with or without abscess formation. Radiologists should consider GIB when a patient from an arid climate presents with abdominal pain, weight loss, and an inflammatory abdominal mass on CT. Abdominal masses of the colon or liver, bowel wall thickening, and abscesses are the most common imaging findings.

  20. Abdominal ultrasonographic manifestation of Henoch-schonlein purpura

    International Nuclear Information System (INIS)

    Eun, Hyo Won; Kim, Mi Sung; Kang, Beoung Chul; Lee, Sun Wha

    1998-01-01

    The purpose of this study was to describe the ultrasonographic features and assess the diagnostic value of sonography in the evaluation of children with Henoch-Schonlein purpura. Between October 1993, and Febuary 1998, 67 children with Henoch-Schonlein purpura underwent abdominal ultrasonography, which in 13 was used for follow up. Bowel wall thickness and location, pattern of color Doppler signal in the thickened bowel wall, the size and location of enlarged mesenteric lymph node and the presence of ascites were evaluated. In 42 cases(63%), sonographic findings were positive, and indicated mesenteric lymphadenopathy(n=3D21), small bowel wall thickening(n=3D20), and ascites(n=3D17). Thickened bowels were demonstrated at the ileum in 11 cases, the jejunum in five, the duodenum in one, and combined wall thickening at the duodenum and jejunum in two;thickening of the duodenum and ileum was seen in one case. Thickness varied from 3 to 10 mm(mean:6.5 mm). On follow-up sonography, regression of bowel wall thickening was observed earlier than that of mesenteric lymphadenopathy or ascites, and correlated well with improved abdominal symptoms. Abdominal ultrasonographic manifestations of Henoch-Schonlein purpura were bowel wall thickening, mesentric lymphadenopathy and ascites. Sonography was a simple and useful method for the evaluation of gastrointestinal manifestation of Henoch-Schonlein purpura.=20

  1. Unusual variant of Cantrell′s pentalogy?

    Directory of Open Access Journals (Sweden)

    Kumar Basant

    2008-01-01

    Full Text Available A 12-hour-old male infant presented with prolapsed abdominal content through a defect on left side of chest wall with respiratory distress. A thorough clinical examination suggested absence of ectopia cordis, abdominal wall defect, and any bony anomaly. The child expired after 6 hours of admission because of respiratory distress and electrolyte imbalance. Is congenital defect of chest wall associated with diaphragmatic hernia without ectopia cordis and omphalocele, an unusual variant of Cantrell′s pentalogy?

  2. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.

    LENUS (Irish Health Repository)

    Carney, John

    2008-12-01

    Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.

  3. 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

  4. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot

    Directory of Open Access Journals (Sweden)

    Christos Stefanou

    2016-01-01

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

  5. Efficacy of transversus abdominis plane block with liposomal bupivacaine during open abdominal wall reconstruction.

    Science.gov (United States)

    Fayezizadeh, Mojtaba; Majumder, Arnab; Neupane, Ruel; Elliott, Heidi L; Novitsky, Yuri W

    2016-09-01

    Transversus abdominis plane block (TAPb) is an analgesic adjunct used for abdominal surgical procedures. Liposomal bupivacaine (LB) demonstrates prolonged analgesic effects, up to 72 hours. We evaluated the analgesic efficacy of TAPb using LB for patients undergoing open abdominal wall reconstruction (AWR). Fifty patients undergoing AWR with TAPb using LB (TAP-group) were compared with a matched historical cohort undergoing AWR without TAPb (control group). Outcome measures included postoperative utilization of morphine equivalents, numerical rating scale pain scores, time to oral narcotics, and length of stay (LOS). Cohorts were matched demographically. No complications were associated with TAPb or LB. TAP-group evidenced significantly reduced narcotic requirements on operative day (9.5 mg vs 16.5 mg, P = .004), postoperative day (POD) 1 (26.7 mg vs 39.5 mg, P = .01) and POD2 (29.6 mg vs 40.7 mg, P = .047) and pain scores on operative day (5.1 vs 7.0, P consumption and improved pain control. TAPb allowed for earlier discontinuation of intravenous narcotics and shorter LOS. Intraoperative TAPb with LB appears to be an effective adjunct for perioperative analgesia in patients undergoing open AWR. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Trauma abdominal penetrante consecutivo à corrente elétrica industrial

    Directory of Open Access Journals (Sweden)

    Átila Varela Velho

    Full Text Available The authors present a case report of a victim of high power electric shock. The main electric lesion was a penetrating abdominal wound with loss of substance of the abdominal wall and an electric lesion of the hepatic segment and of the gallbladder. The surgical treatment included hepatic segmentectomy, cholecystectomy, repair of the abdominal wall with Marlex prosthesis and skin graft, besides the debridment of the lesions of extremities. The postoperative evolution was satisfactory and the follow-up for 6 months didn't show any sequelae.

  7. 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.

  8. Periodontal tissue reaction to customized nano-hydroxyapatite block scaffold in one-wall intrabony defect: a histologic study in dogs.

    Science.gov (United States)

    Lee, Jung-Seok; Park, Weon-Yeong; Cha, Jae-Kook; Jung, Ui-Won; Kim, Chang-Sung; Lee, Yong-Keun; Choi, Seong-Ho

    2012-04-01

    This study evaluated histologically the tissue responses to and the effects of a customized nano-hydroxyapatite (n-HA) block bone graft on periodontal regeneration in a one-wall periodontal-defect model. A customized block bone for filling in the standardized periodontal defect was fabricated from prefabricated n-HA powders and a polymeric sponge. Bilateral 4×4×5 mm (buccolingual width×mesiodistal width×depth), one-wall, critical-size intrabony periodontal defects were surgically created at the mandibular second and fourth premolars of five Beagle dogs. In each dog, one defect was filled with block-type HA and the other served as a sham-surgery control. The animals were sacrificed following an 8-week healing interval for clinical and histological evaluations. Although the sites that received an n-HA block showed minimal bone formation, the n-HA block was maintained within the defect with its original hexahedral shape. In addition, only a limited inflammatory reaction was observed at sites that received an n-HA block, which might have been due to the high stability of the customized block bone. In the limitation of this study, customized n-HA block could provide a space for periodontal tissue engineering, with minimal inflammation.

  9. Development of engineering program for integrity evaluation of pipes with local wall thinned defects

    International Nuclear Information System (INIS)

    Park, Chi Yong; Lee, Sung Ho; Kim, Tae Ryong; Park, Sang Kyu

    2008-01-01

    Integrity evaluation of pipes with local wall thinning by erosion and corrosion is increasingly important in maintenance of wall thinned carbon steel pipes in nuclear power plants. Though a few program for integrity assessment of wall thinned pipes have been developed in domestic nuclear field, however those are limited to straight pipes and methodology proposed in ASME Sec.XI Code Case N-597. Recently, the engineering program for integrity evaluation of pipes with all kinds of local wall defects such as straight, elbow, reducer and branch pipes was developed successfully. The program was designated as PiTEP (Pipe Thinning Evaluation Program), which name was registered as a trademark in the Korea Intellectual Property Office. A developed program is carried out by sequential step of four integrity evaluation methodologies, which are composed of construction code, code case N-597, its engineering method and two developed owner evaluation method. As PiTEP program will be performed through GUI (Graphic User Interface) with user's familiarity, it would be conveniently used by plant engineers with only measured thickness data, basic operation conditions and pipe data

  10. 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.

  11. A comparative study of lyophilized bovine pericardium and tunica ...

    African Journals Online (AJOL)

    The aim of this study is to investigate the effectiveness of lyophilized bovine pericardium and tunica vaginalis in repairing large abdominal wall defect in a rabbit model. Full thickness (all the layers of muscles except the skin) abdominal wall defects (3 x 4 cm) were created in 18 anaesthetized male clinically healthy New ...

  12. In vitro fertilization surrogate pregnancy in a patient who underwent radical hysterectomy followed by ovarian transposition, lower abdominal wall radiotherapy, and chemotherapy.

    Science.gov (United States)

    Steigrad, Stephen; Hacker, Neville F; Kolb, Bradford

    2005-05-01

    To describe an IVF surrogate pregnancy from a patient who had a radical hysterectomy followed by excision of a laparoscopic port site implantation with ovarian transposition followed by abdominal wall irradiation and chemotherapy, which resulted in premature ovarian failure from which there was partial recovery. Case report. Tertiary referral university women's hospital in Sydney, Australia and private reproductive medicine clinic in California. A 34-year-old woman who underwent laparoscopy for pelvic pain, shortly afterward followed by radical hysterectomy and pelvic lymph node dissection, who subsequently developed a laparoscopic port site recurrence, which was excised in association with ovarian transposition before abdominal wall irradiation and chemotherapy. Modified IVF treatment, transabdominal oocyte retrieval, embryo cryopreservation in Australia, and transfer to a surrogate mother in the United States. Pregnancy. Miscarriage in the second cycle and a twin pregnancy in the fourth cycle. This is the first case report of ovarian stimulation and oocyte retrieval performed on transposed ovaries after a patient developed premature ovarian failure after radiotherapy and chemotherapy with subsequent partial ovarian recovery.

  13. 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

  14. On the effect of computed tomography resolution to distinguish between abdominal aortic aneurysm wall tissue and calcification: A proof of concept.

    Science.gov (United States)

    Barrett, H E; Cunnane, E M; O Brien, J M; Moloney, M A; Kavanagh, E G; Walsh, M T

    2017-10-01

    The purpose of this study is to determine the optimal target CT spatial resolution for accurately imaging abdominal aortic aneurysm (AAA) wall characteristics, distinguishing between tissue and calcification components, for an accurate assessment of rupture risk. Ruptured and non-ruptured AAA-wall samples were acquired from eight patients undergoing open surgical aneurysm repair upon institutional review board approval and informed consent was obtained from all patients. Physical measurements of AAA-wall cross-section were made using scanning electron microscopy. Samples were scanned using high resolution micro-CT scanning. A resolution range of 15.5-155μm was used to quantify the influence of decreasing resolution on wall area measurements, in terms of tissue and calcification. A statistical comparison between the reference resolution (15.5μm) and multi-detector CT resolution (744μm) was also made. Electron microscopy examination of ruptured AAAs revealed extremely thin outer tissue structure leverage an improved assessment of AAA rupture risk. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. 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

  16. 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 < 0.001). In the AWR group, there were significantly fewer ventral hernia recurrences when the repair was reinforced compared with bridged (5.3% vs 38.5%; p < 0.001). There was no statistically significant difference in ventral hernia recurrence between the AWR and AWR+O groups. Bridging was associated

  17. Predicting hollow viscus injury in blunt abdominal trauma with computed tomography.

    Science.gov (United States)

    Bhagvan, Savitha; Turai, Matthew; Holden, Andrew; Ng, Alexander; Civil, Ian

    2013-01-01

    Evaluation of blunt abdominal trauma is controversial. Computed tomography (CT) of the abdomen is commonly used but has limitations, especially in excluding hollow viscus injury in the presence of solid organ injury. To determine whether CT reports alone could be used to direct operative treatment in abdominal trauma, this study was undertaken. The trauma database at Auckland City Hospital was accessed for patients who had abdominal CT and subsequent laparotomy during a five-year period. The CT scans were reevaluated by a consultant radiologist who was blinded to operative findings. The CT findings were correlated with the operative findings. Between January 2002 and December 2007, 1,250 patients were evaluated for blunt abdominal injury with CT. A subset of 78 patients underwent laparotomy, and this formed the study group. The sensitivity and specificity of CT scan in predicting hollow viscus injury was 55.33 and 92.06 % respectively. The positive and negative predictive values were 61.53 and 89.23 % respectively. Presence of free fluid in CT scan was sensitive in diagnosing hollow viscus injury (90 %). Specific findings for hollow viscus injuries on CT scan were free intraperitoneal air (93 %), retroperitoneal air (100 %), oral contrast extravasation (100 %), bowel wall defect (98 %), patchy bowel enhancement (97 %), and mesenteric abnormality (94 %). CT alone cannot be used as a screening tool for hollow viscus injury. The decision to operate in hollow viscus injury has to be based on mechanism of injury and clinical findings together with radiological evidence.

  18. 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.

  19. Abdominal elephantiasis: a case report.

    Science.gov (United States)

    Hanna, Dominique; Cloutier, Richard; Lapointe, Roch; Desgagné, Antoine

    2004-01-01

    Elephantiasis is a well-known condition in dermatology usually affecting the legs and external genitalia. It is characterized by chronic inflammation and obstruction of the lymphatic channels and by hypertrophy of the skin and subcutaneous tissues. The etiology is either idiopathic or caused by a variety of conditions such as chronic filarial disease, leprosy, leishmaniasis, and chronic recurrent cellulites. Elephantiasis of the abdominal wall is very rare. A complete review of the English and French literature showed only two cases reported in 1966 and 1973, respectively. We report a third case of abdominal elephantiasis and we briefly review this entity. We present the case of a 51-year-old woman who had progressively developed an enormous pediculated abdominal mass hanging down her knees. The skin was thickened, hyperpigmented, and fissured. She had a history of multiple abdominal cellulites. She underwent an abdominal lipectomy. Histopathology of the specimen confirmed the diagnosis of abdominal elephantiasis. Abdominal elephantiasis is a rare disease that represents end-stage failure of lymph drainage. Lipectomy should be considered in the management of this condition.

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

    African Journals Online (AJOL)

    Dhar AM, Bhargava S, Bankata S. Isolated abdominal parietal cold abscess diagnosed on ultrasound. Indian J Radiol Imaging. 1999;9:157-8. 8. Dixit R, Dixit K, Shah H, Shah K. Tuberculous abscess of rectus abdominis muscle. Indian J Tuberc 2004;51:231-3. 9. Sharma N, Sharma S. Tuberculosis abscess of the abdominal ...

  1. 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

  2. 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.

  3. Ultrasonographic abdominal anatomy of healthy captive caracals (Caracal caracal).

    Science.gov (United States)

    Makungu, Modesta; du Plessis, Wencke M; Barrows, Michelle; Koeppel, Katja N; Groenewald, Hermanus B

    2012-09-01

    Abdominal ultrasonography was performed in six adult captive caracals (Caracal caracal) to describe the normal abdominal ultrasonographic anatomy. Consistently, the splenic parenchyma was hyperechoic to the liver and kidneys. The relative echogenicity of the right kidney's cortex was inconsistent to the liver. The gall bladder was prominent in five animals and surrounded by a clearly visualized thin, smooth, regular echogenic wall. The wall thickness of the duodenum measured significantly greater compared with that of the jejunum and colon. The duodenum had a significantly thicker mucosal layer compared with that of the stomach. Such knowledge of the normal abdominal ultrasonographic anatomy of individual species is important for accurate diagnosis and interpretation of routine health examinations.

  4. 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)

  5. 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

  6. 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.

  7. Gastroschisis and associated defects: an international study.

    LENUS (Irish Health Repository)

    Mastroiacovo, Pierpaolo

    2007-04-01

    Our objective was to evaluate the frequency and type of malformations associated with gastroschisis in a large pool of international data, to identify malformation patterns, and to evaluate the role of maternal age in non-isolated cases. Case-by-case information from 24 registries, all members of the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR), were evaluated. After the exclusion of other abdominal wall defects cases were classified as: (a) isolated; (b) recognizable syndrome, chromosomal or not; (c) multiple congenital anomalies (MCA). Our results showed that out of 3,322 total cases 469 non-isolated cases were registered (14.1%): 41 chromosomal syndromes, 24 other syndromes, and 404 MCA. Among MCA four groups of anomalies were most frequent: CNS (4.5%), cardio-vascular (2.5%), limb (2.2%), and kidney anomalies (1.9%). No similar patterns emerged except two patterns resembling limb-body wall complex and OEIS. In both of them the gastroschisis could be however misclassified. Chromosomal trisomies and possibly non-syndromic MCA are associated with an older maternal age more than isolated cases. On consideration of our data and the most valid studies published in the literature, the best estimate of the proportion of gastroschisis associated with major unrelated defects is about 10%, with a few cases associated to recognizable syndromes. Recognized syndromes with gastroschisis seem to be so exceptional that the well documented and validated cases are worth being published as interesting case report. An appropriate case definition in etiological studies should include only isolated gastroschisis after an appropriate definition of isolated and non-isolated cases and a thorough case-by-case review.

  8. MR imaging in congenital complicated anterior body wall defects; MRT von komplizierten angeborenen Bauchwanddefekten

    Energy Technology Data Exchange (ETDEWEB)

    Hoermann, M.; Scharitzer, M. [Universitaetsklinik fuer Radiodiagnostik, AKH-Wien (Austria); Pumberger, W. [Universitaetsklinik fuer Kinderchirurgie, AKH-Wien (Austria); Patzak, B. [Pathologisch-anatomisches Museum im Narrenturm, AKH-Wien (Austria)

    2003-04-01

    Introduction: Aim of this study was to estimate the value of postmortem MR imaging in evaluation of specimen with congenital anterior body wall defects of the museum of pathologic-anatomy. Material and Methods: We examined 19 specimen with a 1.5 Tesla unit by using T{sub 1}- and T{sub 2}-weighted sagittal and coronal sequences. In some specimen additional axial T{sub 2}-weighted images were obtained. We evaluated the site of the bowel, the liver, the heart and presence of associated disorders. Results: The bowels were completely intraabdominal, in two specimen, completely extraabdominal in 12 specimen and in 5 specimen intra- and extraabdominal. The liver was in two specimen completely extraabdominal/in 12 completely intracorporal, and in 5 specimen intra- and extraabdominal. In 5 cases the heart was located extraanatomically. In 12 specimen we found disorders of the spine and the extremities. Congenital disorders of the kidneys were found in 6 specimen. Conclusion: MR imaging is of great value in the assessment of congenital anterior body wall defects. In the light of ultrafast sequences the role of fetal MR imaging in the evaluation of congenital body wall defects may be mandatory in the future. (orig.) [German] Einleitung: Wir nutzten die Sammlung des pathologisch-anatomischen Museums in Wien, um die Wertigkeit der MRT zur Beschreibung von angeborenen vorderen Bauchwanddefekten und deren assoziierten Erkrankungen zu bestimmen. Material und Methode: Wir untersuchten 19 Exponate mit einem 1,5-Tesla-Geraet unter Verwendung von sagittalen und koronalen T{sub 1}- und T{sub 2}-gewichteten Sequenzen. Ausgewertet wurden die Lage des Darmes, der Leber, des Herzens und assoziierte Missbildungen. Ergebnisse: Der Darm lag in zwei Faellen intraabdominal, zur Gaenze extraabdominal in 12 Faellen, intra- und extraabdominal in 5 Faellen. Die Leber war in zwei Exponaten zur Gaenze extraabdominal, in 5 intra- und extraabdominal und in 12 Exponaten intraabdominal. Assoziiert waren

  9. The value of right lateral decubitus position to decrease artificial defect of cardiac anterior wall in 99Tcm-MIBI SPECT myocardial perfusion imaging for women

    International Nuclear Information System (INIS)

    Huang Kemin; Feng Yanlin; Wen Guanghua; Liang Weitang; Yu Fengwen; Liu Dejun

    2013-01-01

    Objective: To explore the value of right lateral decubitus position MPI for differentiating myocardial perfusion defect from cardiac anterior wall attenuation artificial defect, caused by breast of woman. Methods: Forty-nine patients(average age (61.5±8.4) years) who had low likelihood of coronary artery disease and had perfusion defect in the anterior wall after exercise stress 99 Tc m -MIBI MPI were included. All underwent supine and right lateral decubitus position during resting SPECT images. The myocardial perfusion SPECT images at left ventricle were reconstructed and were measured by Bull's-eye, based on the counts. Results from both supine position imaging and right lateral decubitus position imaging were compared. Paired t test was used to statistically analyse the data by SPSS 13.0. Results: Compared with supine position, the counts of the anterior, inferior, apex and lateral wall in right lateral decubitus position were significantly higher: (71.30±3.53)% vs (66.50±3.85)%, (70.06±4.45)% vs (65.44±4.16)%, (77.90±3.00)% vs (75.81±4.08)%,(79.30±2.26)% vs (72.60±3.87)% (t=6.731, 5.286, 3.555, 10.885, all P<0.01). The counts of septal wall were significantly lower ((66.60±3.98)% vs (70.06±4.51)%, t=-4.625, P<0.01) in right lateral decubitus position than that in supine position. Among the different regions of anterior wall, the counts of the anterior-middle ((76.40 ± 3.80)% vs (68.60 ± 4.76)%) and anterior-apex region ((77.10±3.24)% vs (69.00±3.54)%) were significantly higher (t=9.916, 8.870, both P<0.01) in right lateral decubitus position than those in supine position, but there was insignificance ((56.94±6.06)% vs (58.50±4.98)%, t=-1.493, P>0.05) at anterior-basal region. The artificial defect of different degrees in anterior wall was observed in all patients in supine position, 23 cases (46.9%, 23/49) showed artificial defect in the anterior-middle region and 16 cases (32.7%, 16/49) in the anterior-apex region. All artificial defect

  10. Thoracoschisis: case report and review of the literature | Eck ...

    African Journals Online (AJOL)

    Introduction: Thoracoschisis is a rare congenital malformation characterized by herniation of intraabdominal contents through a thoracic wall defect. There have been six previously reported cases. We describe our novel approach incorporating closure of the chest wall defect with temporary abdominal wall expansion ...

  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. Combined laparoscopic and open technique for repair of congenital abdominal hernia: A case report of prune belly syndrome.

    Science.gov (United States)

    Ye, Qinghuang; Chen, Yan; Zhu, Jinhui; Wang, Yuedong

    2017-10-01

    Prune belly syndrome (PBS) is a rare congenital disorder among adults, and the way for repairing abdominal wall musculature has no unified standard. We described combining laparoscopic and open technique in an adult male who presented with PBS. Physical examination and radiological imaging verified the case of PBS. The deficiency of abdominal wall musculature was repaired by combining laparoscopic and open technique using a double-deck complex patch. The patient successfully underwent abdominal wall repair by combining laparoscopic and open technique. Postoperative recovery was uneventful, and improvement in symptom was significant in follow-up after 3, 6, 12, and 24 months. Combining laparoscopic and open technique for repair of deficiency of abdominal wall musculature in PBS was an exploratory way to improve life quality.

  13. Defect Depth Measurement of Straight Pipe Specimen Using Shearography

    International Nuclear Information System (INIS)

    Chang, Ho Seob; Kim, Kyung Suk

    2012-01-01

    In the nuclear industry, wall thinning defect of straight pipe occur the enormous loss in life evaluation and safety evaluation. To use non-destructive technique, we measure deformation, vibration, defect evaluation. But, this techniques are a weak that is the measurement of the wide area is difficult and the time is caught long. In the secondary side of nuclear power plants mostly used steel pipe, artificiality wall thinning defect make in the side and different thickness make to the each other, wall thinning defect part of deformation measure by using shearography. In addition, optical measurement through deformation, vibration, defect evaluation evaluate pipe and thickness defects of pressure vessel is to evaluate quantitatively. By shearography interferometry to measure the pipe's internal wall thinning defect and the variation of pressure use the proposed technique, the quantitative defect is to evaluate the thickness of the surplus. The amount of deformation use thickness of surplus prediction of the actual thickness defect and approximately 7 percent error by ensure reliability. According to pressure the amount of deformation and the thickness of the surplus through DB construction, nuclear power plant pipe use wall thinning part soundness evaluation. In this study, pressure vessel of thickness defect measure proposed nuclear pipe of wall thinning defect prediction and integrity assessment technology development. As a basic research defected theory and experiment, pressure vessel of advanced stability and soundness and maintainability is expected to contribute foundation establishment

  14. Prune-belly syndrome in two children and review of the literature.

    Science.gov (United States)

    Bogart, Megan M; Arnold, Holly E; Greer, Kenneth E

    2006-01-01

    Prune-belly syndrome is a congenital disorder characterized by abdominal wall musculature deficiency, urinary tract anomalies, and bilateral cryptorchidism. Because of the defect in the musculature, the abdominal skin has a peculiar wrinkled appearance. The syndrome is commonly associated with pulmonary, skeletal, cardiac, and gastrointestinal defects. Developmental delays and growth retardation have also been reported. The incidence of prune belly syndrome is approximately 1:40,000 live births. Over 95% of patients are men. Urinary tract disease is the major prognostic factor, with the complications of pulmonary hypoplasia and end stage renal disease resulting in a mortality rate of 60%. Treatment involves surgical correction of the abdominal wall defect and urinary tract abnormalities, early orchiopexy, and supportive management of associated defects.

  15. Are there sex differences in Fetal Abdominal Subcutaneous Tissue (FAST) measurements?

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: To determine if Fetal Abdominal Subcutaneous Tissue (FAST) measurements using antenatal ultrasound differ between male and female fetuses. STUDY DESIGN: Women who had an ultrasound examination for fetal growth between 20 and 40 weeks gestation were studied. Women with diabetes mellitus were excluded. The fetal anterior abdominal subcutaneous tissue was measured on the anterior abdominal wall in millimetres anterior to the margins of the ribs, using magnification at the level of the abdominal circumference. The fetal sex was recorded after delivery. RESULTS: A total of 557 fetuses were measured, 290 male and 267 female. The FAST measurements increased with gestational age. The FAST increased at the same rate for both male and female fetuses and at any given week there was no sex difference. CONCLUSIONS: The increased fat composition in females reported after birth was not found in abdominal wall subcutaneous fat measurements using ultrasound during pregnancy. Antenatal centile charts for FAST do not need to be based on sex.

  16. 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

  17. 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)

  18. Hypotrophy of conduit artery walls of the offspring of nitric oxide-defective rats

    Directory of Open Access Journals (Sweden)

    Kristek F.

    2004-01-01

    Full Text Available The objective of the present study was to investigate the structure of the arterial walls of the offspring stemming from nitric oxide (NO-defective hypertensive parents. The parents were treated with N G-nitro-L-arginine methyl ester (40 mg kg-1 day-1 for 5 weeks. Blood pressure was measured noninvasively in six 30-day-old rats and nine age-matched controls. The cardiovascular system was perfused with glutaraldehyde at 120 mmHg. The thoracic aorta and carotid artery were processed for electron microscopy, and geometry was determined by light microscopy. Endothelial cells, smooth muscle cells (SMC and extracellular matrix (ECM were determined by the point counting method in electron micrographs of the carotid artery. The blood pressure of experimental offspring was 150.0 ± 2.3 vs 104.6 ± 2.1 mmHg (P < 0.01 for the controls and their heart/body weight ratio of 3.9 ± 0.1 vs 4.4 ± 0.2 (P < 0.05 for the controls indicated cardiac hypotrophy. The wall thickness (tunica intima and media of the thoracic aorta and carotid artery of experimental offspring was decreased to 78.9% (P < 0.01 and 83.8% (P < 0.01, respectively, compared to controls, as confirmed by a respective cross-sectional area of 85.3% (P < 0.01 and 84.1% (P < 0.01. The wall thickness/inner diameter ratio was reduced to 75% (P < 0.01 in the thoracic artery and to 81.5% (P < 0.01 in the carotid artery. No change in endothelial cell volume density or ECM was observed in the tunica intima of the carotid artery, and SMC volume density was lower in the tunica media (37.6 ± 0.9 vs 44.7 ± 1.1% for controls, P < 0.01, indicating compromised SMC development. Interference with arginine metabolism, a decrease in NO, and other factors are possible mechanisms underlying the structural alterations of the cardiovascular system of offspring from NO-defective hypertensive rats.

  19. [Feasibility of using connective tissue prosthesis for autoplastic repair of urinary bladder wall defects (an experimental study)].

    Science.gov (United States)

    Tyumentseva, N V; Yushkov, B G; Medvedeva, S Y; Kovalenko, R Y; Uzbekov, O K; Zhuravlev, V N

    2016-12-01

    Experiments on laboratory rats have shown the feasibility of autoplastic repair of urinary bladder wall defects using a connective-tissue capsule formed as the result of an inflammatory response to the presence of a foreign body. The formation of connective tissue prosthesis is characterized by developing fibrous connective tissue, ordering of collagen fibers, reducing the number of cells per unit area with a predominance of more mature cells - fibroblasts. With increasing time of observation, connective tissue prostheses were found to acquire a morphological structure similar to that of the urinary bladder wall. By month 12, the mucosa, the longitudinal and circular muscle layers were formed. The proposed method of partial autoplastic repair of urinary bladder wall is promising, has good long-term results, but requires further experimental studies.

  20. 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

  1. Heterotopic bone formation as a result of abdominal polytrauma

    International Nuclear Information System (INIS)

    Petkov, G.; Penev, B.; Kirova, G.; Ruskova, E.; Karagiozov, P.

    2015-01-01

    Full text: Heterotopic bone formation within the abdominal cavity is a rare complication of the posttraumatic abdominal surgery. There are only few cases reported in the medical literature and most of them involve the mesentery or the abdominal wall. A case of 49y-old men is presented who developed intraabdominal heterotopic ossifications as a consequence of numeral exploratory laparotomies performed after a blunt abdominal trauma. The condition was detected during the follow-up MDCT 11 months later. The case is of interest because of the rarity of the condition and the diffuse character of the calcifications in the abdominal structures, which could pose some differential diagnostic difficulties

  2. 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.

  3. 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.

  4. Abdominal imaging in AIDS patients

    International Nuclear Information System (INIS)

    Zhao Dawei; Wang Wei; Yuan Chunwang; Jia Cuiyu; Zhao Xuan; Zhang Tong; Ma Daqing

    2007-01-01

    Objective: To evaluate abdominal imaging in AIDS. Methods: The imaging examinations (including US, CT and MR) of 6 patients with AIDS associated abdominal foci were analysed retrospectively. All the cases were performed US, and CT scan, of which 4 performed enhanced CT scan and 1 with MR. Results: Abdominal tuberculosis were found in 4 patients, including abdominal lymph nodes tuberculosis (3 cases) and pancreatic tuberculosis (1 case). The imaging of lymph nodes tuberculosis typically showed enlarged peripheral tim enhancement with central low-attenuation on contrast-enhanced CT. Pancreatic tuberculosis demonstrated low-attenuation area in pancreatic head and slightly peripheral enhancement. Disseminated Kaposi's sarcoma was seen in 1 case: CT and MRI scan demonstrated tumour infiltrated along hepatic portal vein and bronchovascular bundles. Pelvic tumor was observed in 1 case: CT scan showed large mass with thick and irregular wall and central low attenuation liquefacient necrotic area in the pelvic cavity. Conclusion: The imaging findings of AIDS with abdominal foci is extraordinarily helpful to the diagnosis of such disease. Tissue biopsy is needed to confirm the diagnosis. (authors)

  5. DYNAMICS OF HOSPITALIZATION OF PATIENTS WITH ACUTE SURGICAL PATHOLOGY OF ABDOMINAL AND ABDOMINAL ORGANS IN KUZBASS

    Directory of Open Access Journals (Sweden)

    Валерий Иванович Подолужный

    2018-03-01

    Full Text Available Publications of recent years do not reflect the regional dynamics of hospitalization of patients with acute surgical pathology of the abdominal cavity and anterior abdominal wall. Goal – to determine the volume of hospitalizations and treatment of patients with acute surgical pathology of the abdominal and anterior abdominal wall in the Kuzbass in the dynamics from 1993 to 2016. Materials and methods. A comparative analysis of the volume of treatment of patients with acute appendicitis, acute cholecystitis, acute pancreatitis, intestinal obstruction, perforated ulcer of the stomach and duodenum and strangulated hernia in surgical departments of Kuzbass from 1993 to 2016 to understand the changes occurring in abdominal surgery. Estimated in the comparative aspect for two decades (1993-2002 and 2007-2016 the average annual number of treated. The estimation of indicators in calculation on 100000 population is executed. The statistical processing was carried out using IBM SPSS Statistica computer version 24 and the nonparametric Mann-Whitney test. Result. Statistically significantly decreased the number of patients with acute appendicitis and perforated ulcers of the stomach and duodenum. The average annual hospitalization of patients with acute pancreatitis and strangulated abdominal hernias has significantly increased in the last decade. There are no significant differences in the increase in the total number of patients with acute cholecystitis and acute intestinal obstruction. Conclusions: 1. Over the past decade compared with 1993-2002, the incidence of acute appendicitis per 100000 thousand of the population decreased in the region by 39.9 %, the incidence of perforated gastric ulcer and duodenal ulcer by 30.2 %. 2. At this time, the number of people treated with 100000 people with acute pancreatitis increased by 94.7 %; with acute cholecystitis by 12.4 %; with an acute intestinal obstruction by 9.8 % and with a strangulated

  6. 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.

  7. 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.

  8. Congenital heart defects in newborns with apparently isolated single gastrointestinal malformation: A retrospective study.

    Science.gov (United States)

    Schierz, Ingrid Anne Mandy; Pinello, Giuseppa; Giuffrè, Mario; La Placa, Simona; Piro, Ettore; Corsello, Giovanni

    2016-12-01

    Congenital gastrointestinal system malformations/abdominal wall defects (GISM) may appear as isolated defects (single or complex), or in association with multiple malformations. The high incidence of association of GISM and congenital heart defects (CHD) in patients with syndromes and malformative sequences is known, but less expected is the association of apparently isolated single GISM and CHD. The aim of this study was to investigate the frequency of CHD in newborns with isolated GISM, and the possibility to modify the diagnostic-therapeutic approach just before the onset of cardiac symptoms or complications. Anamnestic, clinical, and imaging data of newborns requiring abdominal surgery for GISM, between 2009 and 2014, were compared with a control group of healthy newborns. Distribution of GISM and cardiovascular abnormalities were analyzed, and risk factors for adverse outcomes were identified. Seventy-one newborns with isolated GISM were included in this study. More frequent GISM were intestinal rotation and fixation disorders. CHD were observed in 15.5% of patients, augmenting their risk for morbidity. Risk factors for morbidity related to sepsis were identified in central venous catheter, intestinal stoma, and H2-inhibitor-drugs. Moreover, 28.2% of newborns presented only functional cardiac disorders but an unexpectedly higher mortality. The high incidence of congenital heart disease in infants with apparently isolated GISM confirms the need to perform an echocardiographic study before surgery to improve perioperative management and prevent complications such as sepsis and endocarditis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. CT diagnosis of intraperitoneal bladder rupture with blunt abdominal trauma

    International Nuclear Information System (INIS)

    Kong Fanbin

    2000-01-01

    Objective: To evaluate CT examination in the diagnosis of intraperitoneal bladder rupture (IPBR) caused by blunt abdominal trauma. Methods: All CT and clinical data of 9 patients with IPBR were reviewed retrospectively. Results: IPBR was detected on CT scans in all 9 patients. CT findings of IPBR included low -attenuation free intraperitoneal fluid collections in the lateral paravesical fossae, the pericolic space, the culde-sac of the pelvis, Morison's pouch, the peri-hepatic space, the perisplenic space and interspace of bowel loops in 9 cases with a lower CT density compared with pure blood. The disruption of the bladder wall was located by CT scan in 5 cases: high-attenuation bladder wall with focal defect in 3 cases and a tear drop-like deformity of the bladder in 2 cases. Other CT findings supporting the diagnosis of IPBR included an underfilled bladder in 8 cases, bladder contusion in 4 cases, and blood clots within the bladder in 6 cases. Conclusion: The presence of intraperitoneal fluid with a CT density less than that of pure blood strongly suggests extravasated urine in the trauma. Intraperitoneal and extraperitoneal rupture can be distinguished based on location of extravasated urine seen on CT scans. The precise localization of the ruptured bladder wall may be demonstrated by CT scan, which is valuable for surgical treatment

  10. Port site endometrioma: a rare cause of abdominal wall pain following laparoscopic surgery.

    Science.gov (United States)

    Siddiqui, Zohaib A; Husain, Fahd; Siddiqui, Zain; Siddiqui, Midhat

    2017-06-18

    Endometriomas are a rare cause of abdominal wall pain. We report a case of a port site endometrioma presenting with an umbilical swelling. The patient underwent a laparoscopy for pelvic endometriosis 6 months previously and presented with a swelling around her umbilical port site scar associated with cyclical pain during menses. Ultrasound scan reported a well-defined lesion in the umbilicus and MRI scanning excluded other pathology. As she was symptomatic, she underwent an exploration of the scar and excision of the endometrioma with resolution of her symptoms. Precautions should be taken to reduce the risk of endometrial seeding during laparoscopic surgery. All tissues should be removed in an appropriate retrieval bag and the pneumoperitoneum should be deflated completely before removing ports to reduce the chimney effect of tissue being forced through the port site. The diagnosis should be considered in all women of reproductive age presenting with a painful port site scar. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Evaluation of the levels of metalloproteinsase-2 in patients with abdominal aneurysm and abdominal hernias.

    Science.gov (United States)

    Antoszewska, Magdalena

    2013-05-01

    Abdominal aortic aneurysms and abdominal hernias become an important health problems of our times. Abdominal aortic aneurysm and its rupture is one of the most dangerous fact in vascular surgery. There are some theories pointing to a multifactoral genesis of these kinds of diseases, all of them assume the attenuation of abdominal fascia and abdominal aortic wall. The density and continuity of these structures depend on collagen and elastic fibers structure. Reducing the strength of the fibers may be due to changes in the extracellular matrix (ECM) by the proteolytic enzymes-matrix metalloproteinases (MMPs) that degrade extracellular matrix proteins. These enzymes play an important role in the development of many disease: malignant tumors (colon, breast, lung, pancreas), cardiovascular disease (myocardial infarction, ischemia-reperfusion injury), connective tissue diseases (Ehler-Danlos Syndrome, Marfan's Syndrome), complications of diabetes (retinopathy, nephropathy). One of the most important is matrix metalloproteinase-2 (MMP-2). The aim of the study was an estimation of the MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia, and in patients with only abdominal aortic aneurysm. The study involved 88 patients aged 42 to 89 years, including 75 men and 13 women. Patients were divided into two groups: patients with abdominal aortic aneurysm and primary abdominal hernia (45 persons, representing 51.1% of all group) and patients with only abdominal aortic aneurysm (43 persons, representing 48,9% of all group). It was a statistically significant increase in MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia compared to patients with only abdominal aortic aneurysm. It was a statistically significant increase in the prevalence of POCHP in patients with only abdominal aortic aneurysm compared to patients with abdominal aortic aneurysm and primary abdominal hernia. Statistically significant

  12. Suprascarpal fat pad thickness may predict venous drainage patterns in abdominal wall flaps.

    Science.gov (United States)

    Bast, John; Pitcher, Austin A; Small, Kevin; Otterburn, David M

    2016-02-01

    Abdominal wall flaps are routinely used in reconstructive procedures. In some patients inadequate venous drainage from the deep vein may cause fat necrosis or flap failure. Occasionally the superficial inferior epigastric vessels (SIEV) are of sufficient size to allow for microvascular revascularization. This study looked at the ratio of the sub- and suprascarpal fat layers, the number of deep system perforators, and SIEV diameter to determine any correlation of the fat topography and SIEV. 50 abdominal/pelvic CT angiograms (100 hemiabdomens) were examined in women aged 34-70 years for number of perforators, SIEV diameter, and fat pad thickness above and below Scarpa's fascia. Data was analyzed using multivariate model. The average suprascarpal and subscarpal layers were 18.6 ± 11.5 mm and 6.2 ± 7.2 mm thick, respectively. The average SIEV diameter was 2.06 ± 0.81 mm and the average number of perforators was 2.09 ± 1.03 per hemiabdomen. Hemiabdomens with suprascarpal thickness>23 mm had greater SIEV diameter [2.69 mm vs. 1.8 mm (P fat layer thickness did not correlate with the number of perforators. Neither subscarpal fat thickness nor suprascarpal-to-subscarpal fat layer thickness correlated significantly with SIEV caliber or number of perforators in multivariate model. Suprascarpal fat pad thicker than 23 mm had larger SIEVs irrespective of the number of deep system perforators. This may indicate a cohort of patients at risk of venous congestion from poor venous drainage if only the deep system is revascularized. We recommend harvesting the SIEV in patients with suprascarpal fat pad >23 mm to aid in superficial drainage. © 2015 Wiley Periodicals, Inc.

  13. An Autologous Muscle Tissue Expansion Approach for the Treatment of Volumetric Muscle Loss

    Science.gov (United States)

    2015-07-01

    Gamba PG, Conconi MT, Lo Piccolo R, et al. Experimental abdominal wall defect repaired with acellular matrix. Pediatr Surg Int. 2002;18:327–331. 41...tissue was removed (*75mg). Sus- tained release buprenorphine (72 h) was delivered (1.2mg/kg SC) before surgery for pain . Construct preparation...regeneration with a dermis/small intestinal submucosa scaffold in a rat full-thickness abdominal wall defect model. J Biomed Mater Res B Appl Biomater

  14. A novel approach for the closure of challenging giant omphalocele

    Directory of Open Access Journals (Sweden)

    Barkat Ali

    2015-11-01

    Full Text Available Omphalocele is a congenital condition characterized by midline defect of the anterolateral abdominal wall whereby intra-abdominal contents covered by peritoneal sac are found herniated. It can be defined by size of defect or visceral contents. There are various ways of surgical management of omphalocele. Giant omphalocele presents particular challenge in reconstructing the abdominal wall. In this regard the use of tissues expansion as an adjunct in an attempt to recreate functional abdominal wall domain has been emerging. We are presenting a case of giant omphalocele that was closed with the help of extra peritoneal inter muscular tissue expanders.The patient was born at 37 weeks to a 33 year old healthy gravida 3, para 0 G3P0 mother via planned cesarean section. There were no prenatal, natal or postnatal complications. The giant omphalocele was diagnosed prenatally on screening Ultrasound. The patient remained in the neonatal intensive care unit for 6 weeks. The sac was large with abdominal contents including the entire liver. The sac was allowed to epithelialize completely over the course of two years. Due to the small size of the abdominal wall defect contents of the sac, loss of abdominal domain and inability of the abdominal cavity to accommodate the liver, we chose for rectangular tissue expander placement at age 30 months. 3 months later the patient was planned for tissue expander removal and abdominal wall closure. The tissue expanders were removed and omphalocele closure was performed. The patient has been followed up at 6 months and without recurrence of hernia.The management of giant omphalocele is technically challenging. Use of tissue expansion helps in recreating functional abdominal wall domain. There is growing evidence in the literature supporting the use of intra-abdominal tissue expansion in the management of giant omphalocele however because of hemodynamic consequences we think that the use of rectangular shaped, extra

  15. Morphologic study of three collagen materials for body wall repair.

    Science.gov (United States)

    Soiderer, Emily E; Lantz, Gary C; Kazacos, Evelyn A; Hodde, Jason P; Wiegand, Ryan E

    2004-05-15

    The search for ideal prostheses for body wall repair continues. Synthetic materials such as polypropylene mesh (PPM) are associated with healing complications. A porcine-derived collagen-based material (CBM), small intestinal submucosa (SIS), has been studied for body wall repair. Renal capsule matrix (RCM) and urinary bladder submucosa (UBS) are CBMs not previously evaluated in this application. This is the first implant study using RCM. Full-thickness muscle/fascia ventral abdominal wall defects were repaired with SIS, RCM, UBS, and PPM in rats with omentum and omentectomy. A random complete block design was used to allot implant type to each of 96 rats. Healing was evaluated at 4 and 8 weeks. Adhesion tenacity and surface area were scored. Implant site dimensions were measured at implantation and necropsy. Inflammation, vascularization, and fibrosis were histopathologically scored. Data were compared by analysis of variance (P response in contrast to the organized healing of CBM implants. CBM mean scores were lower than PPM scores for adhesion tenacity, surface area, and inflammation at each follow-up time for rats with omentums (P fibrotic response to PPM was unique and more intense compared to CBMs. These CBM implants appear morphologically acceptable and warrant continued investigation.

  16. 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 ... It develops following intra abdominal surgery in the immediate vicinity of the surgical ... appreciated in making the diagnosis and the difficulties of management.

  17. Anterior Cutaneous Nerve Entrapment Syndrome in a Pediatric Patient Previously Diagnosed With Functional Abdominal Pain: A Case Report.

    Science.gov (United States)

    DiGiusto, Matthew; Suleman, M-Irfan

    2018-03-23

    Chronic abdominal pain is common in children and adolescents but challenging to diagnose, because practitioners may be concerned about missing serious occult disease. Abdominal wall pain is an often ignored etiology for chronic abdominal pain. Anterior cutaneous nerve entrapment syndrome causes abdominal wall pain but is frequently overlooked. Correctly diagnosing patients with anterior cutaneous nerve entrapment syndrome is important because nerve block interventions are highly successful in the remittance of pain. Here, we present the case of a pediatric patient who received a diagnosis of functional abdominal pain but experienced pain remittance after receiving a trigger-point injection and transverse abdominis plane block.

  18. A novel nonoperative approach to abdominal compartment syndrome after abdominal wall reconstruction.

    Science.gov (United States)

    Hasan, Zeenat R; Sorensen, G Brent

    2013-01-01

    Intraabdominal hypertension and abdominal compartment syndrome have been increasingly recognized as significant causes of morbidity and mortality in both medical and surgical patients. The gold standard remains surgical intervention; however, nonoperative approaches have been investigated less. Here, we describe the successful treatment of a severe acute case by intubation, nasogastric decompression, and paralysis--a novel approach not previously described in the literature. After the patient underwent laparoscopic bilateral component separation and repair of a large recurrent ventral hernia with a 20 30-cm Strattice mesh (LifeCell Corp, Branchburg, NJ), acute renal failure developed within 12 hours postoperatively, and was associated with oliguria, hyperkalemia, and elevated peak airway and bladder pressures. The patient was treated nonoperatively with intubation, nasogastric tube decompression, and paralysis with a vecuronium drip. Rapid reversal was seen, avoiding further surgery. Within 2 hours after intubation and paralysis, our patient's urine output improved dramatically with an initial diuresis of approximately 1 L, his bladder pressures decreased, and within 12 hours his creatinine level had normalized. Although surgical intervention has traditionally been thought of as the most effective--and thus the gold standard--for abdominal compartment syndrome, this preliminary experience demonstrates nonoperative management as highly efficacious, with the added benefit of decreased morbidity. Therefore, nonoperative management could be considered first-line therapy, with laparotomy reserved for refractory cases only. This suggests a more complex pathology than the traditional teaching of congestion and edema alone.

  19. Experimental and numerical study of steel pipe with part-wall defect reinforced with fibre glass sleeve

    International Nuclear Information System (INIS)

    Mazurkiewicz, Lukasz; Tomaszewski, Michal; Malachowski, Jerzy; Sybilski, Kamil; Chebakov, Mikhail; Witek, Maciej; Yukhymets, Peter; Dmitrienko, Roman

    2017-01-01

    The paper presents numerical and experimental burst pressure evaluation of the gas seamless hot-rolled steel pipe. The main goal was to estimate mechanical toughness of pipe wrapped with composite sleeve and verify selected sleeve thickness. The authors used a nonlinear explicit FE code with constitutive models which allows for steel and composite structure failure modelling. Thanks to the achieved numerical and analytical results it was possible to perform the comparison with data received from a capacity test and good correlation between the results were obtained. Additionally, the conducted analyses revealed that local reduction of pipe wall thickness from 6 mm to 2.4 mm due to corrosion defect can reduce high pressure resistance by about 40%. Finally, pipe repaired by a fibre glass sleeve with epoxy resin with 6 mm thickness turned out more resistant than an original steel pipe considering burst pressure. - Highlights: • Numerical and experimental burst pressure evaluation of steel pipe was performed. • Seamless hot-rolled steel pipe with and without corrosion defect were considered. • Local reduction of pipe wall thickness from 6 to 2.4 mm reduces resistance by 40%. • Pipe repaired by a 6 mm fibre glass sleeve was more resistant than an original pipe.

  20. Adult abdominal hernias.

    LENUS (Irish Health Repository)

    Murphy, Kevin P

    2014-06-01

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

  1. Biliary peritonitis caused by a leaking T-tube fistula disconnected at the point of contact with the anterior abdominal wall: a case report

    Directory of Open Access Journals (Sweden)

    Nikolić Marko

    2008-09-01

    Full Text Available Abstract Introduction Operations on the common bile duct may lead to potentially serious complications such as biliary peritonitis. T-tube insertion is performed to reduce the risk of this occurring postoperatively. Biliary leakage at the point of insertion into the common bile duct, or along the fistula, can sometimes occur after T-tube removal and this has been reported extensively in the literature. We report a case where the site at which the T-tube fistula leaked proved to be the point of contact between the fistula and the anterior abdominal wall, a previously unreported complication. Case presentation A 36-year-old sub-Saharan African woman presented with gallstone-induced pancreatitis and, once her symptoms settled, laparoscopic cholecystectomy was performed, common bile duct stones were removed and a T-tube was inserted. Three weeks later, T-tube removal led to biliary peritonitis due to the disconnection of the T-tube fistula which was recannulated laparoscopically using a Latex drain. Conclusion This case highlights a previously unreported mechanism for bile leak following T-tube removal caused by detachment of a fistula tract at its contact point with the anterior abdominal wall. Hepatobiliary surgeons should be aware of this mechanism of biliary leakage and the use of laparoscopy to recannulate the fistula.

  2. 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

  3. 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

  4. 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

  5. Body stalk anomaly in Denmark during 20 years (1970-1989)

    DEFF Research Database (Denmark)

    Bugge, Merete

    2012-01-01

    Body stalk anomaly is a severe defect of the abdominal wall with uncovered thoracic and/or abdominal organs. The umbilical cord is absent or very short. Here I present epidemiological and clinical data on 16 infants with body stalk anomaly. The 16 infants represent 3.4% of the 469 infants...... ascertained in an almost complete nationwide data set of live- and stillborn infants born with abdominal wall defects during the two decades 1970-1989 in Denmark. The prevalence was 0.12 per 10,000 live- and stillborn. Nine of the infants were stillbirths, seven were live births, and they all died shortly...

  6. Abdominal- versus thigh-based reconstruction of perineal defects in patients with cancer.

    Science.gov (United States)

    Pang, John; Broyles, Justin M; Berli, Jens; Buretta, Kate; Shridharani, Sachin M; Rochlin, Danielle H; Efron, Jonathan E; Sacks, Justin M

    2014-06-01

    An abdominoperineal resection is an invasive procedure that leaves the patient with vast pelvic dead space. Traditionally, the vertical rectus abdominus myocutaneous flap is used to reconstruct these defects. Oftentimes, this flap cannot be used because of multiple ostomy placements or previous abdominal surgery. The anterolateral thigh flap can be used; however, the efficacy of this flap has been questioned. We report a single surgeon's experience with perineal reconstruction in patients with cancer with the use of either the vertical rectus abdominus myocutaneous flap or the anterolateral thigh flap to demonstrate acceptable outcomes with either repair modality. From 2010 to 2012, 19 consecutive patients with perineal defects secondary to cancer underwent flap reconstruction. A retrospective chart review of prospectively entered data was conducted to determine the frequency of short-term and long-term complications. This study was conducted at an academic, tertiary-care cancer center. Patients in the study were patients with cancer who were receiving perineal reconstruction. Interventions were surgical and included either abdomen- or thigh-based reconstruction. The main outcome measures included infection, flap failure, length of stay, and time to radiotherapy. Of the 19 patients included in our study, 10 underwent anterolateral thigh flaps and 9 underwent vertical rectus abdominus myocutaneous flaps for reconstruction. There were no significant differences in demographics between groups (p > 0.05). Surgical outcomes and complications demonstrated no significant differences in the rate of infection, hematoma, bleeding, or necrosis. The mean length of stay after reconstruction was 9.7 ± 3.4 days (± SD) in the anterolateral thigh flap group and 13.4 ± 7.7 days in the vertical rectus abdominus myocutaneous flap group (p > 0.05). The limitations of this study include a relatively small sample size and retrospective evaluation. This study suggests that the

  7. 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

  8. [Intraabdominal hypertension and abdominal compartment syndrome

    DEFF Research Database (Denmark)

    Sonne, M.; Hilligsø, Jens Georg

    2008-01-01

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various...... medical and surgical conditions increase the intraabdominal volume. When the content exceeds the compliance of the abdominal wall, the IAP rises. Increased IAP affects the functioning of the brain, lungs, circulation, kidneys, and bowel. The treatment of ACS is a reduction of IAP Udgivelsesdato: 2008/2/11...

  9. An unusual complication of stenosis of a colostomy.

    Science.gov (United States)

    Haiart, D. C.

    1985-01-01

    A patient is reported in whom stenosis of the colostomy was responsible for perforation of the colostomy by a bone. Necrotizing gangrene of the abdominal wall developed. The management of the resulting full thickness defect of the abdominal wall is described. Images Figure 1 Figure 2 PMID:4011545

  10. Computed Tomography (CT) Imaging of Injuries from Blunt Abdominal Trauma: A Pictorial Essay

    OpenAIRE

    Hassan, Radhiana; Abd. Aziz, Azian

    2010-01-01

    Blunt abdominal trauma can cause multiple internal injuries. However, these injuries are often difficult to accurately evaluate, particularly in the presence of more obvious external injuries. Computed tomography (CT) imaging is currently used to assess clinically stable patients with blunt abdominal trauma. CT can provide a rapid and accurate appraisal of the abdominal viscera, retroperitoneum and abdominal wall, as well as a limited assessment of the lower thoracic region and bony pelvis. T...

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

    International Nuclear Information System (INIS)

    Wang Yang; Wang Wei; Wang Longxia; Wang Junyan; Tang Jie

    2011-01-01

    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.

  12. 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.

  13. The Utility of Diagnostic Laparoscopy in Post-Bariatric Surgery Patients with Chronic Abdominal Pain of Unknown Etiology.

    Science.gov (United States)

    Alsulaimy, Mohammad; Punchai, Suriya; Ali, Fouzeyah A; Kroh, Matthew; Schauer, Philip R; Brethauer, Stacy A; Aminian, Ali

    2017-08-01

    Chronic abdominal pain after bariatric surgery is associated with diagnostic and therapeutic challenges. The aim of this study was to evaluate the yield of laparoscopy as a diagnostic and therapeutic tool in post-bariatric surgery patients with chronic abdominal pain who had negative imaging and endoscopic studies. A retrospective analysis was performed on post-bariatric surgery patients who underwent laparoscopy for diagnosis and treatment of chronic abdominal pain at a single academic center. Only patients with both negative preoperative CT scan and upper endoscopy were included. Total of 35 post-bariatric surgery patients met the inclusion criteria, and all had history of Roux-en-Y gastric bypass. Twenty out of 35 patients (57%) had positive findings on diagnostic laparoscopy including presence of adhesions (n = 12), chronic cholecystitis (n = 4), mesenteric defect (n = 2), internal hernia (n = 1), and necrotic omentum (n = 1). Two patients developed post-operative complications including a pelvic abscess and an abdominal wall abscess. Overall, 15 patients (43%) had symptomatic improvement after laparoscopy; 14 of these patients had positive laparoscopic findings requiring intervention (70% of the patients with positive laparoscopy). Conversely, 20 (57%) patients required long-term medical treatment for management of chronic abdominal pain. Diagnostic laparoscopy, which is a safe procedure, can detect pathological findings in more than half of post-bariatric surgery patients with chronic abdominal pain of unknown etiology. About 40% of patients who undergo diagnostic laparoscopy and 70% of patients with positive findings on laparoscopy experience significant symptom improvement. Patients should be informed that diagnostic laparoscopy is associated with no symptom improvement in about half of cases.

  14. Arabidopsis thaliana plants lacking the ARP2/3 complex show defects in cell wall assembly and auxin distribution.

    Science.gov (United States)

    Pratap Sahi, Vaidurya; Cifrová, Petra; García-González, Judith; Kotannal Baby, Innu; Mouillé, Gregory; Gineau, Emilie; Müller, Karel; Baluška, František; Soukup, Aleš; Petrášek, Jan; Schwarzerová, Katerina

    2017-12-25

    The cytoskeleton plays an important role in the synthesis of plant cell walls. Both microtubules and actin cytoskeleton are known to be involved in the morphogenesis of plant cells through their role in cell wall building. The role of ARP2/3-nucleated actin cytoskeleton in the morphogenesis of cotyledon pavement cells has been described before. Seedlings of Arabidopsis mutants lacking a functional ARP2/3 complex display specific cell wall-associated defects. In three independent Arabidopsis mutant lines lacking subunits of the ARP2/3 complex, phenotypes associated with the loss of the complex were analysed throughout plant development. Organ size and anatomy, cell wall composition, and auxin distribution were investigated. ARP2/3-related phenotype is associated with changes in cell wall composition, and the phenotype is manifested especially in mature tissues. Cell walls of mature plants contain less cellulose and a higher amount of homogalacturonan, and display changes in cell wall lignification. Vascular bundles of mutant inflorescence stems show a changed pattern of AUX1-YFP expression. Plants lacking a functional ARP2/3 complex have decreased basipetal auxin transport. The results suggest that the ARP2/3 complex has a morphogenetic function related to cell wall synthesis and auxin transport. © The Author(s) 2017. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. 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

  16. Abdominal actinomycosis: a report of three cases of this uncommon infection; Actinomicos abdominal: una infeccion poco frecuente. A proposito de tres casos

    Energy Technology Data Exchange (ETDEWEB)

    Ostiz, S.; Sanchez, C.; Jimenez, G.; Caballero, P.; Cordero, J. L.; Montes, M. [Hospital Virgen del Camino. Pamplona (Spain)

    1999-07-01

    Abdominal actinomycosis is a rare infection caused by Actinomyces, a grampositive bacterium that generally exists as a saprophyte in the oral cavity and colon. The diagnosis is usually difficult due to its low incidence and nonspecific clinical and radiological findings. We present three new cases of abdominal actinomycosis. The first involved several pelvic structures and abdominal wall. The second was detected in left hepatic lobe. In the third case, the infection was located in descending colon. We stress the wide range of presenting signs, describing the findings that, when taken together, suggest the correct diagnosis. (Author) 13 refs.

  17. Flow rates through earthen, geomembrane ampersand composite cut-off walls

    International Nuclear Information System (INIS)

    Tachavises, C.; Benson, C.H.

    1997-01-01

    Flow rates through soil-bentonite (SIB), geomembrane (GM), and composite geomembrane-soil (CGS) cut-off walls were determined using a numerical model of ground water flow. Various geological and wall conditions were simulated. Results of the simulations show that flow rates past all wall types are affected by hydraulic conductivities of the aquifer and underlying confining layer. Flow rates past GM walls with perfect joints are very low, provided the confining layer has low hydraulic conductivity. However, if a small fraction of the joints are defective, GM walls can be ineffective in blocking flow. CGS walls with a low hydraulic conductivity shell are less sensitive to joint defects. CGS walls with good shells typically have lower flow rates than SB and GM walls, even if the CGS wall contains defective joints

  18. 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

  19. 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.

  20. 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

  1. Abdominal stab wound protocol: prospective study documents applicability for widespread use.

    Science.gov (United States)

    Rosemurgy, A S; Albrink, M H; Olson, S M; Sherman, H; Albertini, J; Kramer, R; Camps, M; Reiss, A

    1995-02-01

    Traditionally, stab wounds violating the abdominal wall fascia led to exploratory celiotomy that was often nontherapeutic. In an attempt to limit the number of nontherapeutic celiotomies (NTC), we devised a protocol to prospectively study stab wounds violating the anterior abdominal wall fascia. Through protocol, abdominal stab wounds were explored in stable adults. If the anterior fascia was violated, paracentesis and, if necessary, peritoneal lavage was undertaken in the absence of previous abdominal surgery. If evisceration was noted, it was reduced and the patient lavaged. Fascial penetration was noted in 72 patients. 46 patients underwent celiotomy: because of shock/peritonitis in 8 (2 NTC), fascial penetration with a history of previous celiotomy in 7 (5 NTC), positive paracentesis in 20 (5 NTC), or positive lavage in 10 (4 NTC). One patient underwent late celiotomy without ill-effect after a negative lavage because she subsequently developed fever and localized peritonitis (ice pick injury to cecum). Eleven patients had evisceration; nine underwent celiotomy. Patients with abdominal stab wounds can be selectively managed safely. More than one-third with fascial penetration, some with evisceration, avoided exploration. Only one patient underwent delayed celiotomy and did so without detriment. Nontherapeutic celiotomy rates were highest in patients with previous abdominal surgery who, thereby, could not undergo paracentesis/lavage; excluding these patients, the nontherapeutic celiotomy rate was 17% (11/65) for those with fascial penetration.

  2. Changes in the frequencies of abdominal wall hernias and the preferences for their repair: a multicenter national study from Turkey.

    Science.gov (United States)

    Seker, Gaye; Kulacoglu, Hakan; Öztuna, Derya; Topgül, Koray; Akyol, Cihangir; Çakmak, Atıl; Karateke, Faruk; Özdoğan, Mehmet; Ersoy, Eren; Gürer, Ahmet; Zerbaliyev, Elbrus; Seker, Duray; Yorgancı, Kaya; Pergel, Ahmet; Aydın, Ibrahim; Ensari, Cemal; Bilecik, Tuna; Kahraman, İzzettin; Reis, Erhan; Kalaycı, Murat; Canda, Aras Emre; Demirağ, Alp; Kesicioğlu, Tuğrul; Malazgirt, Zafer; Gündoğdu, Haldun; Terzi, Cem

    2014-01-01

    Abdominal wall hernias are a common problem in the general population. A Western estimate reveals that the lifetime risk of developing a hernia is about 2%. As a result, hernia repairs likely comprise the most frequent general surgery operations. More than 20 million hernias are estimated to be repaired every year around the world. Numerous repair techniques have been described to date however tension-free mesh repairs are widely used today because of their low hernia recurrence rates. Nevertheless, there are some ongoing debates regarding the ideal approach (open or laparoscopic), the ideal anesthesia (general, local, or regional), and the ideal mesh (standard polypropylene or newer meshes).

  3. Ramos colaterais parietais e terminais da aorta abdominal em Myocastor coypus (nutria Terminal and parietal colateral branches of the abdominal aorta in Myocastor coypus (nutria

    Directory of Open Access Journals (Sweden)

    Paulete de Oliveira Vargas Culau

    2008-08-01

    , in order to irrigate part of the diaphragm and the cranial lateral abdominal walls. The abdominal aorta emitted, dorsally, the median sacral artery, cranially to its bifurcation into the common iliac arteries. These common iliac arteries, terminal branches of the aorta, originate the internal and external iliac arteries. The internal iliac artery was distributed along the pelvic cavity viscera. The external iliac artery emitted an umbilical artery and, before reaching the inguinal ring, emitted the deep circunflex iliac artery to 2/3 of the caudal lateral abdominal wall. The external iliac artery emitted the pudendoepigastric trunk, wich has originated the caudal epigastric artery, to the ventral abdominal wall, and the external pudendal artery, wich passed through the inguinal ring to irrigate the external genital. The direct parietal branches of the abdominal aorta were the lumbar arteries and the median sacral artery, while the phrenicoabdominal arteries, deep circunflex iliac and the caudal epigastric artery were indirect colateral parietal branches. The terminal branches of the abdominal aorta were the common iliac arteries with its branches, the internal and external iliac arteries.

  4. Obstructed abdominal hernia at the Wesley Guild Hospital, Nigeria ...

    African Journals Online (AJOL)

    Obstructed abdominal hernia at the Wesley Guild Hospital, Nigeria. ... wall hernia who had operative intervention and other postoperative management. ... elective in 23 patients (21%) who had spontaneous reduction while awaiting surgery.

  5. Chronic inflammation, immune response, and infection in abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Shi, G-P

    2006-01-01

    Abdominal aortic aneurysms (AAA) are associated with atherosclerosis, transmural degenerative processes, neovascularization, decrease in content of vascular smooth muscle cells, and a chronic infiltration, mainly located in the outer aortic wall. The chronic infiltration consists mainly of macrop......Abdominal aortic aneurysms (AAA) are associated with atherosclerosis, transmural degenerative processes, neovascularization, decrease in content of vascular smooth muscle cells, and a chronic infiltration, mainly located in the outer aortic wall. The chronic infiltration consists mainly...... matrix metalloproteases and cysteine proteases for aortic matrix remodeling. The lymphocyte activation may be mediated by microorganisms as well as autoantigens generated from vascular structural proteins, perhaps through molecular mimicry. As in autoimmune diseases, the risk of AAA is increased...

  6. 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.

  7. The influence of wall stress on AAA growth and biomarkers

    NARCIS (Netherlands)

    Speelman, L.; Hellenthal, F.A.M.V.I.; Pulinx, B.; Bosboom, E.M.H.; Breeuwer, M.; Sambeek, M.R.; Vosse, van de F.N.; Jacobs, M.J.H.M.; Wodzig, W.K.W.H.; Schurink, G.W.H.

    2010-01-01

    Objectives This study investigated the relation between abdominal aortic aneurysm (AAA) wall stress, AAA growth rate and biomarker concentrations. With increasing wall stress, more damage may be caused to the AAA wall, possibly leading to progression of the aneurysm and reflection in up- or

  8. A Case of Pediatric Abdominal Wall Reconstruction: Components Separation within the Austere War Environment

    Directory of Open Access Journals (Sweden)

    Ian Valerio, MD, MS, MBA, FACS

    2014-07-01

    Full Text Available Summary: Reconstructive surgeons supporting military operations are required to definitively treat severe pediatric abdominal injuries in austere environments. The safety and efficacy of using a components separation technique to treat large ventral hernias in pediatric patients in this setting remains understudied. Components separation technique was required to achieve definitive closure in a 12-month-old pediatric patient in Kandahar, Afghanistan. Her course was complicated by an anastomotic leak after small bowel resection. Her abdominal was successfully reopened, the leak repaired, and closed primarily without incident on postinjury day 9. Abdominal trauma with a large ventral hernia requiring components separation is extremely rare. A pediatric patient treated with components separation demonstrated minimal complications, avoidance of abdominal compartment syndrome, and no mortality.

  9. 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

  10. Childhood abdominal cystic lymphangioma

    International Nuclear Information System (INIS)

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra; Dlugy, Elena; Freud, Enrique; Kessler, Ada; Horev, Gadi

    2002-01-01

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two. Conclusions: US

  11. Childhood abdominal cystic lymphangioma

    Energy Technology Data Exchange (ETDEWEB)

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)

    2002-02-01

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two

  12. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Directory of Open Access Journals (Sweden)

    Ghodratollah Maddah

    2014-05-01

    Full Text Available The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag. The study population comprised of 11 (57.9% male and 8 (42.1% female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9% patients, subjective judgment that the fascia closure is too tight in 6 (31.6% patient's damage control surgery in one patient (5.3% and development of abdominal compartment surgery in one patient (5.3%. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4% patients, post operative intestinal fistula in 4 (21.1% patients, post traumatic intra abdominal bleeding in 3 (15.8% patients and intestinal obstructions in 3 (15.8% patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0% patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1 early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3% late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54 months. Currently 10 patients (52.6% are alive at a follow up of 45 (range 1

  13. 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

  14. Eddy current inspection of weld defects in tubing

    Science.gov (United States)

    Katragadda, G.; Lord, W.

    1992-01-01

    An approach using differential probes for the inspection of weld defects in tubing is studied. Finite element analysis is used to model the weld regions and defects. Impedance plane signals are predicted for different weld defect types and compared wherever possible with signals from actual welds in tubing. Results show that detection and sizing of defects in tubing is possible using differential eddy current techniques. The phase angle of the impedance plane trajectory gives a good indication of the sizing of the crack. Data on the type of defect can be obtained from the shape of the impedance plane trajectory and the phase. Depending on the skin depth, detection of outer wall, inner wall, and subsurface defects is possible.

  15. Prune belly syndrome with pouch colon and absent dermatome.

    Science.gov (United States)

    Baba, Aejaz A; Hussain, Syed A; Shera, Altaf H; Patnaik, Rekha

    2010-01-01

    Prune belly syndrome (PBS) is a rare congenital constellation of defects in pediatric surgical practice. Although anorectal anomalies have been reported in association with PBS, only few case of pouch colon with PBS has been reported. [1] In addition, our patient had deficient abdominal wall with absent dermatome in left upper quadrant, which has never been reported in the English literature. This association with abdominal wall deficiency and absent dermatome not only strengthens the theory of mesodermal arrest in the etiology of PBS but also points towards a defect in the ectodermal development.

  16. Partial Avulsion of Common Bile Duct and Duodenal Perforation in a Blunt Abdominal Trauma

    OpenAIRE

    Mirza, Bilal; Ijaz, Lubna; Iqbal, Shahid; Sheikh, Afzal

    2010-01-01

    Complete or partial avulsion of common bile duct is a very rare injury following blunt abdominal trauma in children. A 7-year old boy presented to ER following blunt abdominal trauma by a moving motorcycle. X ray abdomen revealed free air under diaphragm and CT scan showed pancreatic contusion injury. At operation anterior wall of common bile duct (CBD) along with a 2mm rim of duodenal tissue on either side of anterior wall of CBD were found avulsed from the duodenum. The avulsed portion of C...

  17. 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−.

  18. [Prevalence of birth defects according to the level of care in two hospitals, Cali, Colombia, 2012-2013].

    Science.gov (United States)

    Pachajoa, Harry; Villota, Vania A; Cruz, Luz Marina; Ariza, Yoseth

    2015-01-01

    Birth defects are morphologic alterations diagnosed prenatal or postnatally. Surveillance systems have been used to estimate the prevalence in high complexity care centers; however, the variation of the prevalence among different complexity care centers remains unknown. To compare the prevalence of birth defects among two different complexity care centers in Cali, Colombia. A descriptive hospital-based study following the methodology of the Latin American Collaborative Study of Congenital Malformations was conducted during 20 months in a medium complexity hospital and a high complexity hospital. During the study period, 7,140 births were attended of which 225 had at least one birth defect. The prevalence of these was of 1.7% (IC95% 1.3-2.0) and 7.4% (IC95% 6.2-8.7) for the medium complexity hospital and the high complexity hospital, respectively. The highest frequencies for the high complexity care center were: ventricular septal defect, 10%; congenital hydronephrosis, 7%; abdominal wall defects, 6%, and hydrocephalus, 5%, while for the medium complexity were: polydactyly, 15%; preauricular skin tags, 8%; congenital talipes equino varus, 7%, and hemangioma, 6%. The prevalence of birth defects among different complexity care centers varies in quantity, type and severity of the anomaly diagnosed. The surveillance of birth defects is a useful tool for any level of care. It allows estimating more accurately the prevalence of the city, as well being a base for the planning and targeting of resources according to the prevalence of different congenital defects.

  19. 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.

  20. Intra­‑abdominal adhesions in ultrasound. Part I: The visceroperitoneal bordeline, anatomy and the method of examination

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński

    2012-12-01

    Full Text Available It needs to be emphasized that ultrasonography is a primary test performed in order to evaluate the abdominal wall and structures located in their vicinity. It allows for the determination of the anatomy and lesions in this localization. Thorough knowledge con‑ cerning the ultrasound anatomy of the tested structures constitutes a basis of all diagnos‑ tic successes. Therefore, this part of the article is devoted to this subject matter. The pos‑ sibility to diagnose intra-abdominal adhesions with ultrasound is underestimated and rarely used. The aim of this paper is to discuss and document the ultrasound anatomy of the posterior surface of the abdominal wall as well as to present techniques directed at the detection of adhesions, in particular the visceroperitoneal ones. The posterior surface of the abdominal wall constitutes an extensive tissue area of complex structure, with folds and ligaments surrounded by various amounts of the epiperitoneal fat. In some places, this tissue separates the components of the fascia and peritoneum complex. The ultra‑ sound manifestation of this complex is two hyperechogenic lines placed parallelly to each other in the places where they are not separated by the accumulated adipose tissue. Another factor which separates the peritoneum from the viscera is of dynamic character. It is a so-called visceral slide induced by easy or deep breathing. Its size should not be lower than 1 cm and the deflections gradually and symmetrically diminish from the epi‑ gastric to hypogastric region. Last but not least, the evaluation of the reciprocal relation of the abdominal wall with viscera may be aided by rhythmical manual compressions on the abdominal wall (ballottement sign performed below the applied ultrasound trans‑ ducer. During this test, the size of the visceral slide in relation to the abdominal wall is observed. The maneuver is usually performed in uncooperative patients or those with shallow breath. The

  1. 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.

  2. Tissue factor levels and the fibrinolytic system in thin and thick intraluminal thrombus and underlying walls of abdominal aortic aneurysms.

    Science.gov (United States)

    Siennicka, Aldona; Zuchowski, Marta; Kaczmarczyk, Mariusz; Cnotliwy, Miłosław; Clark, Jeremy Simon; Jastrzębska, Maria

    2018-03-20

    The hemostatic system cooperates with proteolytic degradation in processes allowing abdominal aortic aneurysm (AAA) formation. In previous studies, it has been suggested that aneurysm rupture depends on intraluminal thrombus (ILT) thickness, which varies across each individual aneurysm. We hypothesized that hemostatic components differentially accumulate in AAA tissue in relation to ILT thickness. Thick (A1) and thin (B1) segments of ILTs and aneurysm wall sections A (adjacent to A1) and B (adjacent to B1) from one aneurysm sac were taken from 35 patients undergoing elective repair. Factor levels were measured using enzyme-linked immunosorbent assay of protein extract. Tissue factor (TF) activities were significantly higher in thinner segments of AAA (B1 vs A1, P = .003; B vs A, P thick thrombus-covered wall segments (A) than in B, A1, and B1 (P = .015, P thick ILT (P = .021) and thick ILT (A1; P thick ILT (A1). However, no correlations were found at B sites, except for a correlation between plasmin and TF activities (r = 0.55; P = .004). These results suggest that higher TF activities are present in thinner AAA regions. These parameters and local fibrinolysis may be part of the processes leading to destruction of the aneurysm wall. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  3. Computed Tomography (CT) Imaging of Injuries from Blunt Abdominal Trauma: A Pictorial Essay.

    Science.gov (United States)

    Hassan, Radhiana; Abd Aziz, Azian

    2010-04-01

    Blunt abdominal trauma can cause multiple internal injuries. However, these injuries are often difficult to accurately evaluate, particularly in the presence of more obvious external injuries. Computed tomography (CT) imaging is currently used to assess clinically stable patients with blunt abdominal trauma. CT can provide a rapid and accurate appraisal of the abdominal viscera, retroperitoneum and abdominal wall, as well as a limited assessment of the lower thoracic region and bony pelvis. This paper presents examples of various injuries in trauma patients depicted in abdominal CT images. We hope these images provide a resource for radiologists, surgeons and medical officers, as well as a learning tool for medical students.

  4. Lectures on cosmic topological defects

    Energy Technology Data Exchange (ETDEWEB)

    Vachaspati, T [Department of Astronomy and Astrophysics, Colaba, Mumbai (India) and Physics Department, Case Western Reserve University, Cleveland (United States)

    2001-11-15

    These lectures review certain topological defects and aspects of their cosmology. Unconventional material includes brief descriptions of electroweak defects, the structure of domain walls in non-Abelian theories, and the spectrum of magnetic monopoles in SU(5) Grand Unified theory. (author)

  5. 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

  6. [Gallbladder contractility in children with functional abdominal pain or irritable bowel syndrome].

    Science.gov (United States)

    Iwańczak, Franciszek; Siedlecka-Dawidko, Jolanta; Iwanczak, Barbara

    2013-07-01

    III Rome Criteria of functional gastrointestinal disorders in children, distinguished the disturbances with abdominal pain, to which irritable bowel syndrome, functional abdominal pains, functional dyspepsia and abdominal migraine were included. THE AIM OF THE STUDY was sonographic assessment of the gallbladder and its contractility in functional abdominal pain and irritable bowel syndrome in children. The study comprised 96 children aged 6 to 18 years, 59 girls and 37 boys. Depending on diagnosis, the children were divided into three groups. 38 children with functional abdominal pain constituted the first group, 26 children with irritable bowel syndrome were included to the second group, the third group consisted of 32 healthy children (control group). Diagnosis of functional abdominal pain and irritable bowel syndrome was made based on the III Rome Criteria. In irritable bowel syndrome both forms with diarrhea (13) and with constipation (13) were observed. Anatomy and contractility of the gallbladder were assessed by ultrasound examination. The presence of septum, wall thickness, thick bile, vesicle volume in fasting state and 30th and 60th minute after test meal were taken into consideration. Test meal comprised about 15% of caloric requirement of moderate metabolism. Children with bile stones and organic diseases were excluded from the study. Thickened vesicle wall and thick bile were present more frequently in children with irritable bowel syndrome and functional abdominal pain than in control group (p functional abdominal pain than in irritable bowel syndrome and control group (p = 0.003, p = 0.05). Vesicle contractility after test meal was greatest in children with functional abdominal pain. Evaluation of diminished (smaller than 30%) and enlarged (greater then 80%) gallbladder contractility at 30th and 60th minute after test meal demonstrated disturbances of contractility in children with irritable bowel syndrome and functional abdominal pain. In children

  7. Case report

    African Journals Online (AJOL)

    Raoul

    2009-06-10

    Jun 10, 2009 ... Gokhan Yildirim et al [5] reported that EC is frequently associated with other congenital defects involving multiple organ systems. Ventricular septal defects and tetralogy of Fallot are the most common associated intracardiac defects, while omphalocele is the most common associated abdominal wall defect.

  8. [Abdomen specific bioelectrical impedance analysis (BIA) methods for evaluation of abdominal fat distribution].

    Science.gov (United States)

    Ida, Midori; Hirata, Masakazu; Hosoda, Kiminori; Nakao, Kazuwa

    2013-02-01

    Two novel bioelectrical impedance analysis (BIA) methods have been developed recently for evaluation of intra-abdominal fat accumulation. Both methods use electrodes that are placed on abdominal wall and allow evaluation of intra-abdominal fat area (IAFA) easily without radiation exposure. Of these, "abdominal BIA" method measures impedance distribution along abdominal anterior-posterior axis, and IAFA by BIA method(BIA-IAFA) is calculated from waist circumference and the voltage occurring at the flank. Dual BIA method measures impedance of trunk and body surface at the abdominal level and calculates BIA-IAFA from transverse and antero-posterior diameters of the abdomen and the impedance of trunk and abdominal surface. BIA-IAFA by these two BIA methods correlated well with IAFA measured by abdominal CT (CT-IAFA) with correlatipn coefficient of 0.88 (n = 91, p abdominal adiposity in clinical study and routine clinical practice of metabolic syndrome and obesity.

  9. Advanced sclerosis of the chest wall skin secondary to chronic graft-versus-host disease: a case with severe restrictive lung defect.

    Science.gov (United States)

    Ödek, Çağlar; Kendirli, Tanil; İleri, Talia; Yaman, Ayhan; Fatih Çakmakli, Hasan; Ince, Elif; İnce, Erdal; Ertem, Mehmet

    2014-10-01

    Pulmonary chronic graft-versus-host disease (cGvHD) is one of the most common causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (aHSCT). Herein, we describe a patient with severe restrictive lung defect secondary to cGvHD. A 21-year-old male patient was admitted to our pediatric intensive care unit (PICU) with pneumonia and respiratory distress. He had a history of aHSCT for chronic myelogeneous leukemia at the age of 17 years. Six months after undergoing aHSCT, he had developed cGvHD involving skin, mouth, eye, lung, liver, and gastrointestinal tract. At the time of PICU admission he had respiratory distress and required ventilation support. Thorax high-resolution computed tomography was consistent with bronchiolitis obliterans. Although bronchiolitis obliterans is an obstructive lung defect, a restrictive pattern became prominent in the clinical course because of the sclerotic chest wall skin. The activity of cGvHD kept increasing despite the therapy and we lost the patient because of severe respiratory distress and massive hemoptysis secondary to bronchiectasis. In conclusion, pulmonary cGvHD can present with restrictive changes related with the advanced sclerosis of the chest wall skin. Performing a fasciotomy or a scar revision for the rigid chest wall in selected patients may improve the patients ventilation.

  10. Patient-specific AAA wall stress analysis: 99-percentile versus peak stress

    NARCIS (Netherlands)

    Speelman, L.; Bosboom, E.M.H.; Schurink, G.W.H.; Hellenthal, F.A.M.V.I.; Buth, J.; Breeuwer, M.; Jacobs, M.J.; Vosse, van de F.N.

    2008-01-01

    Objective Biomechanically, rupture of an Abdominal Aortic Aneurysm (AAA) occurs when the stress acting on the wall due to the blood pressure, exceeds the strength of the wall. Peak wall stress estimations, based on CT reconstruction, may be prone to observer variation. This study focuses on the

  11. Percutaneous debridement and washout of walled-off abdominal abscess and necrosis using flexible endoscopy: a large single-center experience.

    Science.gov (United States)

    Mathers, Bradley; Moyer, Matthew; Mathew, Abraham; Dye, Charles; Levenick, John; Gusani, Niraj; Dougherty-Hamod, Brandy; McGarrity, Thomas

    2016-01-01

    Direct percutaneous endoscopic necrosectomy has been described as a minimally invasive intervention for the debridement of walled-off pancreatic necrosis (WOPN). In this retrospective cohort study, we aimed to confirm these findings in a US referral center and evaluate the clinical value of this modality in the treatment of pancreatic necrosis as well as other types of intra-abdominal fluid collections and necrosis. Twelve consecutive patients with WOPN or other abdominal abscess requiring debridement and washout underwent computed tomography (CT)-guided drainage catheter placement. Each patient then underwent direct percutaneous endoscopic necrosectomy and washout with repeat debridement performed until complete. Drains were then removed once output fell below 30 mL/day and imaging confirmed resolution. The primary endpoints were time to clinical resolution and sustained resolution at 1-year follow up.  Ten patients were treated for WOPN, one for necrotic hepatic abscesses, and one for omental necrosis. The median time to intervention was 85 days with an average of 2.3 necrosectomies performed. Complete removal of drains was accomplished in 11 patients (92 %). The median time to resolution was 57 days. No serious adverse events occurred; however, one patient developed pancreaticocutaneous fistulas. Ten patients completed 1-year surveillance of which none required drain replacement. No patients required surgery or repeat endoscopy. This series supports the premise that direct percutaneous endoscopic necrosectomy is a safe and effective intervention for intra-abdominal fluid collections and necrosis in appropriately selected patients. Our study demonstrates a high clinical success rate with minimal adverse events. This modality offers several potential advantages over surgical and transgastric approaches including use of improved accessibility, an excellent safety profile, and requirement for only deep or moderate sedation.

  12. Surgical tactic of high bilateral abdominal testicular retention in patient with a prune belly syndrome

    Directory of Open Access Journals (Sweden)

    I. A. Panchenko

    2014-11-01

    Full Text Available Bilateral abdominal cryptorchism in combination with other defects of urogenital system and a prune belly syndrome keep within a syndrome of connective tissue dysplasia. In our medical center developed the method of surgical correction of a high bilateral abdominal testicular retention with preservation of vessels.

  13. Surgical tactic of high bilateral abdominal testicular retention in patient with a prune belly syndrome

    Directory of Open Access Journals (Sweden)

    I. A. Panchenko

    2013-01-01

    Full Text Available Bilateral abdominal cryptorchism in combination with other defects of urogenital system and a prune belly syndrome keep within a syndrome of connective tissue dysplasia. In our medical center developed the method of surgical correction of a high bilateral abdominal testicular retention with preservation of vessels.

  14. Suprarenal Abdominal Aortic Coarctation Diagnosed During Pregnancy

    Directory of Open Access Journals (Sweden)

    Sh Hajsadeghi

    2010-12-01

    Full Text Available Coarctation of the abdominal aorta is an extremely rare vascular defect inwhich congenital or acquired etiologies have been described. This case concernsa 30-year-old pregnant woman with 15-years history of uncontrolled hypertensionand lower limb claudication presented with worsened hypertension during herfirst pregnancy. Magnetic resonance angiography study of aorta revealed astenosis in abdominal aorta about 12mm from the origin of celiac axisaccompanied by left sided aortic arch and right aberrant subclavian artery. Thiscase highlights the importance of a throughout physical examination in patientspresented with hypertension and it emphasizes considering the coarctation of theabdominal aorta during the diagnostic workup of hypertension, especially inyoung patients. In such cases magnetic resonance angiography of the aorta is auseful tool to reach a definitive diagnosis especially in pregnant women.Also to our knowledge, this patient is the first one found to have aortic archmalformation combined with an abdominal coarctation.

  15. Abdominal manifestations of autoimmune disorders

    International Nuclear Information System (INIS)

    Triantopoulou, C.

    2015-01-01

    Full text: Immunoglobulin G4-related disease was recognized as a systemic disease since various extrapancreatic lesions were observed in patients with autoimmune pancreatitis (AIP). The real etiology and pathogenesis of IgG4-RD is still not clearly understood. Moreover the exact role of IgG4 or IgG4-positive plasma cells in this disease has not yet been elucidated. only some inconsistent biological features such as hypergammaglobulinemia or hypocomplementemia support the autoimmune nature of the disease process. various names have been ascribed to this clinicopathological entity including IgG4-related sclerosing disease, IgG4-related systemic sclerosing disease, IgG4-related disease, IgG4-related autoimmune disease, hyper-IgG4 disease and IgG4-related systemic disease. The extrapancreatic lesions of IgG4-RD also exhibit the same characteristic histologic features including dense lymphoplasmacytic infiltrate, massive storiform fibrosis, and obliterative phlebitis as seen in IgG4-related pancreatitis. Abdominal manifestations include the following organs/systems: Bile ducts: Sclerosing cholangitis; Gallbladder and liver: Acalculous sclerosis cholecytitis with diffuse wall thickening; hepatic inflammatory pseudotumorts; Kidneys: round or wedge-shaped renal cortical nodules, peripheral cortical; lesions, mass like lesions or renal pelvic involvement; Prostate, urethra, seminal vesicle, vas deferens, uterine cervix; Autoimmune prostatitis; Retroperitoneum: Retroperitoneal fibrosis. thin or mildly thick homogeneous soft tissue lesion surrounding the abdominal aorta and its branches but also bulky masses causing hydronephroureterosis; Mesentery: Sclerosing mesenteritis usually involving the root of the mesentery; Bowel: Inflammatory bowel diseases mimicking Crohn’s disease or ulcerative colitis. various types of sclerosing nodular lesions of the bowel wall; Stomach: Gastritis, gastric ulcers and focal masses mimicking submucosal tumor; omentum: Infiltration mimicking

  16. Plasma levels of plasmin-antiplasmin-complexes are predictive for small abdominal aortic aneurysms expanding to operation-recommendable sizes

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Jørgensen, B; Fasting, H

    2001-01-01

    Three proteolytic systems seem involved in the aneurysmal degradation of the aortic wall. Plasmin is a common activator of the systems and could thus be predictive for the progression of abdominal aortic aneurysms (AAAs).......Three proteolytic systems seem involved in the aneurysmal degradation of the aortic wall. Plasmin is a common activator of the systems and could thus be predictive for the progression of abdominal aortic aneurysms (AAAs)....

  17. Solitary fibrous tumor of the abdominal wall re-surfacing as unilateral pleural effusion and mass: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Xia Bi

    Full Text Available Background: Solitary fibrous tumors (SFTs are rare fibroblastic mesenchymal neoplasms that were initially described in the pleura, but have been increasingly recognized to occur in other parts of the body. They have been traditionally regarded as indolent tumors that are rare to metastasize after surgical resection. Here, we describe a case of a Filipino female who initially presented with unilateral pleural effusion and mass, and was ultimately diagnosed with recurrent solitary fibrous tumor that originated from the abdominal wall. Then, we reviewed existing literature on intra- and extrathoracic SFTs with focus on pathological characteristics, recommendations for treatment as well as post-treatment surveillance. Case presentation: A 79-year-old Filipino female with a history of solitary fibrous tumor of the abdominal wall status post complete surgical resection 3 years ago presented with unilateral pleural effusion and mass, and was diagnosed with recurrent solitary fibrous tumor that metastasized to the lung. She was not a candidate for systemic chemotherapy and ultimately died 1 year later from progressive respiratory failure. Conclusions: Solitary fibrous tumor are rare mesenchymal tumors that were initially described in the pleura, but have now been reported in many other sites. Complete surgical resection is the mainstay therapy for all cases; however, long-term monitoring and surveillance several years after initial presentation is crucial to prevent disease recurrence, and adjuvant treatment may be necessary for patients with high-risk features. Additional studies are needed to demonstrate the clinical utility of risk stratification models and to develop post-treatment surveillance guidelines for extrathoracic SFTs.

  18. Limb-body wall complex: Prenatal sonographic findings versus autopsy findings

    International Nuclear Information System (INIS)

    Song, Mi Jin; Cho, Jeong Yeon; Lee, Young Ho

    2001-01-01

    To evaluate prenatal ultrasonographic findings of limb-body wall complex and to correlate them with autopsy findings. From October 1995 to June 2000, a retrospectively review of prenatal ultrasonography (US) of 11 patients with pathologically proven limb-body wall complex was done. US findings were then compared with autopsy findings. Prenatal ultrasonography revealed thoraco-abdominoschists (n=7.64%), kyphoscoliosis (n=7.64%), cranial defect (n=5.45%), limb defect (n=4.36%), facial defect (n=1.10%), amniotic band (n=5.45%), and umbilical cord anomaly (n=3.27%). Meanwhile, autopsy findings showed thoraco-abdominoschisis (n=8.72%), limb defect (n=7.64%), facial defect (n=7.64%), kyphoscoliosis (n=5.45%), cranial defect (n=5.45%), amniotic band (n=5.45%) and umbilical cord anomaly (n=4.36%). The most common ultrasonography features of limb-body wall complex were thoraco-abdominoschisis and kyphoscoliosis while the thoraco-abdominoschisis and limb defects were the most frequent findings at autopsy.

  19. The long-term behavior of lightweight and heavyweight meshes used to repair abdominal wall defects is determined by the host tissue repair process provoked by the mesh.

    Science.gov (United States)

    Pascual, Gemma; Hernández-Gascón, Belén; Rodríguez, Marta; Sotomayor, Sandra; Peña, Estefania; Calvo, Begoña; Bellón, Juan M

    2012-11-01

    Although heavyweight (HW) or lightweight (LW) polypropylene (PP) meshes are widely used for hernia repair, other alternatives have recently appeared. They have the same large-pore structure yet are composed of polytetrafluoroethylene (PTFE). This study compares the long-term (3 and 6 months) behavior of meshes of different pore size (HW compared with LW) and composition (PP compared with PTFE). Partial defects were created in the lateral wall of the abdomen in New Zealand White rabbits and then repaired by the use of a HW or LW PP mesh or a new monofilament, large-pore PTFE mesh (Infinit). At 90 and 180 days after implantation, tissue incorporation, gene and protein expression of neocollagens (reverse transcription-polymerase chain reaction/immunofluorescence), macrophage response (immunohistochemistry), and biomechanical strength were determined. Shrinkage was measured at 90 days. All three meshes induced good host tissue ingrowth, yet the macrophage response was significantly greater in the PTFE implants (P .05). Host collagen deposition is mesh pore size dependent whereas the macrophage response induced is composition dependent with a greater response shown by PTFE. In the long term, macroporous meshes show comparable biomechanical behavior regardless of their pore size or composition. Copyright © 2012 Mosby, Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Wurl Peter

    2006-11-01

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

  1. 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

  2. Prune belly syndrome with pouch colon and absent dermatome

    Directory of Open Access Journals (Sweden)

    Baba Aejaz

    2010-01-01

    Full Text Available Prune belly syndrome (PBS is a rare congenital constellation of defects in pediatric surgical practice. Although anorectal anomalies have been reported in association with PBS, only few case of pouch colon with PBS has been reported. [1] In addition, our patient had deficient abdominal wall with absent dermatome in left upper quadrant, which has never been reported in the English literature. This association with abdominal wall deficiency and absent dermatome not only strengthens the theory of mesodermal arrest in the etiology of PBS but also points towards a defect in the ectodermal development.

  3. Abdominal ultrasound in AIDS patients

    International Nuclear Information System (INIS)

    Escribano, J.; Gonzalez, J.; Alvarez, M.; Rivero, S.; Raya, J.L.; Ruza, M.

    1998-01-01

    To analyze the ultrasonography findings in abdomen in the AIDS patients in our hospital, as well as the indications for this exploration, assessing the role of abdominal ultrasound (AU). The ultrasonographic and clinical findings in 527 patients who underwent a total of 715 explorations between 1992 and 1996 were studied. Hepatomegaly and/or splenomegaly, usually homogeneous, were observed in nearly half of the studies (45%); one third of the patients with marked splenomegaly presented visceral leishmaniasis. Focal lesions in liver and/or spleen, corresponding to angiomas, abscesses, lymphomatous lesions and metastasis, were detected in 5.7% of the explorations. Thirty-five percent of the AU revealed the presence of lymphadenopathy; nodes measuring over 2.5 cm were usually related to potential treatable infection or neoplasm. Thickening of the gallbladder wall did not usually indicate the presence of acute cholecystitis unless Murphy''s sign was also detected. Bile duct dilation and wall thickening was related to opportunistic cholangitis, and the increase in the echogenicity of the renal parenchyma was linked to AIDS-related nephropathy. Despite the fact that many of findings with AU are nonspecific, we consider that this approach should be the principal diagnostic technique in AIDS patients with suspected abdominal pathology or fever of unknown origin. (Author) 43 refs,

  4. Primary solitary peritoneal tumor of the abdominal wall—report of a rare case and review of the literature

    Science.gov (United States)

    Efthimiadis, Christoforos; Ioannidis, Aristeidis; Grigoriou, Marios

    2017-01-01

    Abstract Abdominal wall tumors are sometimes diagnosed as metastases of ovarian cancer, however, primary peritoneal tumors should be taken into consideration in the final diagnosis. A 49-year-old female patient was admitted in our Department for the excision of a pulpable abdominal wall lump, with no other abnormalities shown on imaging investigation. On histology examination, the excised specimen revealed characteristics of metastatic high-grade serous ovarian carcinoma. Total hysterectomy, bilateral oophorectomy, omentectomy and appendectomy were performed. No signs of malignancy were proved on histology, leading to the final diagnosis of a primary serous peritoneal tumor. This is the third described case of solitary primary serous peritoneal tumor located in the abdominal wall. This condition should be included in the differential diagnosis of a probable metastatic ovarian carcinoma, as both present similar histologic characteristics. PMID:28616156

  5. 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.

  6. Abdominal Fascial Closure in Obstetrics: Comparison of Outcome ...

    African Journals Online (AJOL)

    Background: Midline laparotomies are in common use in obstetrics for caesarean section and other obstetric laparotomies. Current challenges in this surgical approach include the best approach to the repair of the abdominal wall incision, the optimal suture material for its fascial repair and poor cosmetic outcome of the scar ...

  7. Abdominal aspergillosis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Suk Keu, E-mail: pagoda20@hanmail.net [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: kimhyejin@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: jhbyun@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: aykim@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: mglee@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: hkha@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)

    2011-03-15

    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  8. 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.

  9. Prevention of intra-abdominal adhesion by bi-layer electrospun membrane.

    Science.gov (United States)

    Jiang, Shichao; Wang, Wei; Yan, Hede; Fan, Cunyi

    2013-06-04

    The aim of this study was to compare the anti-adhesion efficacy of a bi-layer electrospun fibrous membrane consisting of hyaluronic acid-loaded poly(ε-caprolactone) (PCL) fibrous membrane as the inner layer and PCL fibrous membrane as the outer layer with a single-layer PCL electrospun fibrous membrane in a rat cecum abrasion model. The rat model utilized a cecal abrasion and abdominal wall insult surgical protocol. The bi-layer and PCL membranes were applied between the cecum and the abdominal wall, respectively. Control animals did not receive any treatment. After postoperative day 14, a visual semiquantitative grading scale was used to grade the extent of adhesion. Histological analysis was performed to reveal the features of adhesion tissues. Bi-layer membrane treated animals showed significantly lower adhesion scores than control animals (p compared with the PCL membrane. Histological analysis of the bi-layer membrane treated rat rarely demonstrated tissue adhesion while that of the PCL membrane treated rat and control rat showed loose and dense adhesion tissues, respectively. Bi-layer membrane can efficiently prevent adhesion formation in abdominal cavity and showed a significantly decreased adhesion tissue formation compared with the control.

  10. Failure Behavior of Elbows with Local Wall Thinning

    Science.gov (United States)

    Lee, Sung-Ho; Lee, Jeong-Keun; Park, Jai-Hak

    Wall thinning defect due to corrosion is one of major aging phenomena in carbon steel pipes in most plant industries, and it results in reducing load carrying capacity of the piping components. A failure test system was set up for real scale elbows containing various simulated wall thinning defects, and monotonic in-plane bending tests were performed under internal pressure to find out the failure behavior of them. The failure behavior of wall-thinned elbows was characterized by the circumferential angle of thinned region and the loading conditions to the piping system.

  11. Activation amplitude and temporal synchrony among back extensor and abdominal muscles during a controlled transfer task: comparison of men and women.

    Science.gov (United States)

    Hubley-Kozey, Cheryl L; Butler, Heather L; Kozey, John W

    2012-08-01

    Muscle synergies are important for spinal stability, but few studies examine temporal responses of spinal muscles to dynamic perturbations. This study examined activation amplitudes and temporal synergies among compartments of the back extensor and among abdominal wall muscles in response to dynamic bidirectional moments of force. We further examined whether responses were different between men and women. 19 women and 18 men performed a controlled transfer task. Surface electromyograms from bilateral sites over 6 back extensor compartments and 6 abdominal wall muscle sites were analyzed using principal component analysis. Key features were extracted from the measured electromyographic waveforms capturing amplitude and temporal variations among muscle sites. Three features explained 97% of the variance. Scores for each feature were computed for each measured waveform and analysis of variance found significant (pWomen had more differences among muscle sites than men for the lateral flexion moment feature. For the abdominal wall muscles the oblique muscles responded with synergies related to fiber orientation, with women having higher amplitudes and more responsiveness to the lateral flexion moment than men. Synergies between the abdominal and back extensor sites as the moment demands change are discussed. These findings illustrate differential activation among erector spinae compartments and abdominal wall muscle sites supporting a highly organized pattern of response to bidirectional external moments with asynchronies more apparent in women. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. 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.

  13. Traumatisk ventralhernie

    DEFF Research Database (Denmark)

    El-Charnoubi, Waseem A Ghulam; Berg, Jais Oliver; Rosenstock, Steffen Jais

    2010-01-01

    Traumatic abdominal wall hernias are rare. We describe a case of a handlebar hernia which was initially misinterpreted as a rectus haematoma, and consequently the patient was discharged without any treatment. The patient was admitted two days after with severe pain and computed tomography showed ...... a defect in the abdominal wall. The patient underwent laparoscopic hernial repair with a Goretex mesh after some weeks when the primary tissue damage had subsided....

  14. Geospatial clustering of gastroschisis in Poland: Data from the Polish Registry of Congenital Malformations (PRCM

    Directory of Open Access Journals (Sweden)

    Anna Materna-Kiryluk

    2016-06-01

    Full Text Available Objectives: The aims of this study were: to evaluate the prevalence of abdominal wall defects in the Polish population, to analyze temporal trends in the prevalence, to identify areas (clusters of high risk of abdominal wall defects, and to characterize, with respect to epidemiology, children with abdominal wall defects and their mothers in the area defined as a cluster. Material and Methods: We used isolated congenital malformations (gastroschisis Q79.3 and omphalocele Q79.2 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10, the extended version data reported to the Polish Registry of Congenital Malformations (PRCM over the years 1998– 2008 based on the population of 2 362 502 live births. We analyzed 11 administrative regions of Poland with complete epidemiologic data. Results: Of 11 regions, 2 had a significantly higher standardized prevalence of isolated gastroschisis: Dolnośląskie (1.7/10 000 live births, p = 0.0052 and Śląskie (1.9/10 000 live births, p < 0.0001. Furthermore, within the region of Dolnośląskie, we defined a clear prevalence of the isolated gastroschisis cluster (p = 0.023. We comprehensively examined demographic and socio-economic risk factors for abdominal wall defects in this area, and we found that these factors failed to account for the cluster. Conclusions: We identified a distinct prevalence cluster for isolated gastroschisis, although a precise reason for the disease clustering in this region remains unknown. Cluster identification enables more focused research aimed at identification of specific factors with teratogenic effects.

  15. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial.

    LENUS (Irish Health Repository)

    McDonnell, John G

    2007-01-01

    The transversus abdominis plane (TAP) block is a novel approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. We evaluated its analgesic efficacy in patients during the first 24 postoperative hours after abdominal surgery, in a randomized, controlled, double-blind clinical trial.

  16. Fetal Sirenomelia Associated with an Abdominal Cyst Originating from a Saccular Cloaca.

    Science.gov (United States)

    Kinjo, Yui; Masamoto, Hitoshi; Nitta, Hayase; Kinjo, Tadatsugu; Tamaki, Tomoko; Yoshimi, Naoki; Aoki, Yoichi

    2018-01-01

    A 40-year-old pregnant woman presented with a fetal abdominal cyst and oligohydramnios. Color Doppler scan revealed a single blood vessel from the fetal aorta into a single umbilical artery. Severe oligohydramnios limited ultrasonographic evaluation of the fetal lower limbs, kidneys, or bladder. The pregnancy was terminated; the fetus showed fused lower limbs, bulging abdomen, and absent external genitalia and was diagnosed with type III sirenomelia. On autopsy, no normal bladder was observed, but duodenal atresia, anorectal atresia, and right renal agenesis were found. An intra-abdominal cyst, diagnosed histologically as a saccular cloaca, occupied the abdominal cavity. Ultrasonographic diagnosis of fetal sirenomelia is difficult due to poor depiction of the lower limbs. A vitelline artery leading to a single umbilical artery and a fetal abdominal cyst occupying most of the abdominal cavity are considered fetal sirenomelia associated with large defects of the gastrointestinal and genitourinary tracts.

  17. Fetal Sirenomelia Associated with an Abdominal Cyst Originating from a Saccular Cloaca

    Directory of Open Access Journals (Sweden)

    Yui Kinjo

    2018-01-01

    Full Text Available A 40-year-old pregnant woman presented with a fetal abdominal cyst and oligohydramnios. Color Doppler scan revealed a single blood vessel from the fetal aorta into a single umbilical artery. Severe oligohydramnios limited ultrasonographic evaluation of the fetal lower limbs, kidneys, or bladder. The pregnancy was terminated; the fetus showed fused lower limbs, bulging abdomen, and absent external genitalia and was diagnosed with type III sirenomelia. On autopsy, no normal bladder was observed, but duodenal atresia, anorectal atresia, and right renal agenesis were found. An intra-abdominal cyst, diagnosed histologically as a saccular cloaca, occupied the abdominal cavity. Ultrasonographic diagnosis of fetal sirenomelia is difficult due to poor depiction of the lower limbs. A vitelline artery leading to a single umbilical artery and a fetal abdominal cyst occupying most of the abdominal cavity are considered fetal sirenomelia associated with large defects of the gastrointestinal and genitourinary tracts.

  18. Imaging active topological defects in carbon nanotubes

    Science.gov (United States)

    Suenaga, Kazu; Wakabayashi, Hideaki; Koshino, Masanori; Sato, Yuta; Urita, Koki; Iijima, Sumio

    2007-06-01

    A single-walled carbon nanotube (SWNT) is a wrapped single graphene layer, and its plastic deformation should require active topological defects-non-hexagonal carbon rings that can migrate along the nanotube wall. Although in situ transmission electron microscopy (TEM) has been used to examine the deformation of SWNTs, these studies deal only with diameter changes and no atomistic mechanism has been elucidated experimentally. Theory predicts that some topological defects can form through the Stone-Wales transformation in SWNTs under tension at 2,000 K, and could act as a dislocation core. We demonstrate here, by means of high-resolution (HR)-TEM with atomic sensitivity, the first direct imaging of pentagon-heptagon pair defects found in an SWNT that was heated at 2,273 K. Moreover, our in situ HR-TEM observation reveals an accumulation of topological defects near the kink of a deformed nanotube. This result suggests that dislocation motions or active topological defects are indeed responsible for the plastic deformation of SWNTs.

  19. Geometrical size effect in high cycle fatigue strength of heavy-walled Ductile Cast Iron GJS400: Weakest link vs. defect-based approach

    Directory of Open Access Journals (Sweden)

    Cova Matteo

    2014-06-01

    Full Text Available Fatigue strength is known to decrease with increasing dimension of the component. This is due to a technological size effect, related to the production process, and to a geometrical size effect, due to a higher probability of finding a large defect. To investigate the latter, an heavy-walled component made of Ductile Cast Iron (DCI has been trepanned and a fatigue test plan has been carried out using 4 different specimen geometries. An attempt has been made to relate the resulting fatigue strength using a weakest-link approach based on the effective volumes and surfaces. This approach seems to work well only in cases of different specimen's lengths. Some of the fracture surfaces were analyzed by means of SEM and the initiating defects were identified and measured. An approach in which the defects population can be randomly distributed in the specimen has been tried. Virtual fatigue tests have been carried out by considering pure propagation of the worst defect. The resulting fatigue curves showed that this approach is promising but needs further description of the initiation phase.

  20. Vaginal Cuff Dehiscence with Small Bowel Evisceration 14 Months after Total Abdominal Hysterectomy

    Directory of Open Access Journals (Sweden)

    Nida Jareemit, M.D.

    2017-11-01

    Full Text Available Introduction: Vaginal cuff dehiscence is a rare complication following hysterectomy. The condition coexisting with intraabdominal organ evisceration occurs even rarer. Nevertheless this should not be neglected owing to high morbidity and mortality. Case presentation: The reported case is a 48-year-old widow presenting with vaginal cuff dehiscence and small bowel evisceration after undergoing a total abdominal hysterectomy (TAH in the past 14 months due to myoma uteri. She denied having a history of sexual intercourse after the operation. The exposed bowel, 60 cm in length, appeared viable and no peritoneal sign was observed. There was a vaginal cuff defect approximately 3 cm in length. An exploratory laparotomy was then carried out. Eviscerated bowel was reduced back in the abdominal cavity and the vaginal cuff defect was repaired. No complications such as recurrent dehiscence were observed during one year follow-up. Conclusion: To minimize the incidence of vaginal cuff dehiscence after hysterectomy, surgical techniques should be of concern. Patient instructions, including delaying sexual intercourse and avoiding all possible causes of increased intra-abdominal pressure should be provided postoperatively.

  1. The Effect of Ethanol Extract of Rose (Rosa damascena) on Intra-abdominal Adhesions After Laparotomy in Rats.

    Science.gov (United States)

    Karimi, Mehrdad; Yazdan Asadi, Sayyed; Parsaei, Pouya; Rafieian-Kopaei, Mahmoud; Ghaheri, Hafez; Ezzati, Sareh

    2016-05-01

    Abdominal adhesions are pathological connections in peritoneal surfaces that are created after abdominal surgery. The aim of this study was to evaluate the inhibitory effect of Rosa damascena extract on adhesions, considering the antioxidant properties of rose. Thirty healthy rats were divided into 3 groups: rats treated by 1% (A) and 5% (B) of R. damascena extract and the con- trol group (C). After administering anesthesia, the abdominal wall was opened and 3 shallow incisions (2 cm) were made on the right wall, and a 2 × 2 piece of peritoneal surface was removed on the left side of the abdominal wall. Then 3 mL of 1% (A) and 5% (B) R. damascena extract was administered into the abdominal cavity. The control group (C) received 3 mL of distilled water. The abdominal cavity was sutured, and a second laparotomy was carried out 14 days later to the created adhesions according to the Canbaz scale, and a histopathologic examination was also performed. All data was analyzed by SPSS volume 16 (Chicago, IL); P less than 0.05 was considered statistically significant. The amount of adhesion in group A was significantly lower than that of group C, 1.4 ± 1.265 versus 3 ± 0.816, (P = 0.007). The histological investigation also showed significant differences in the se- verity of fibrosis (P = 0.029) and inflammation (P = 0.009) between groups A and C; all rats in group B (5%) were found dead. This study indicated the use of R. damascena at a 1% level resulted in a remarkable decrease of intra-abdominal adhesions after laparotomy in rats. Further studies are necessary on this extract and its derivatives for treatment of such diseases in the human model.

  2. The effect of variable size posterior wall acetabular fractures on contact characteristics of the hip joint.

    Science.gov (United States)

    Olson, S A; Bay, B K; Pollak, A N; Sharkey, N A; Lee, T

    1996-01-01

    The indications for open reduction and internal fixation of posterior wall acetabular fractures associated with a clinically stable hip joint are unclear. In previous work a large posterior wall defect (27% articular surface area) resulted in significant alteration of load transmission across the hip; specifically, there was a transition from evenly distributed loading along the acetabular articular surface to loading concentrated mainly in the superior portion of the articular surface during simulated single leg stance. However, the majority of posterior wall fractures involve a smaller amount of the articular surface. Posterior wall acetabular fractures not associated with instability of the hip are commonly treated nonoperatively. This practice does not account for the size of the posterior wall fracture. To study the biomechanical consequences of variably sized articular defects, a laboratory experiment was conducted evaluating three progressively larger posterior wall defects of the acetabulum during simulated single leg stance using superlow Fuji prescale film (Itochu International, New York): (a) 1/3 articular surface width through a 50 degrees arc along the posterior wall of the acetabulum, (b) 2/3, and (c) 3/3 articular width defects through the same 50 degrees arc along the posterior wall of the acetabulum. In the intact acetabulum, 48% of the total articular contact was located in the superior acetabulum. Twenty-eight percent of articular contact was in the anterior wall region of the acetabulum and 24% in the posterior wall region. After the 1/3 width posterior wall defect, 64% of the articular contact was located in the superior acetabulum (p = 0.0011). The 2/3 width posterior wall defect resulted in 71% of articular contact area being located in the superior acetabulum (p = 0.0006). After the 3/3 width posterior wall defect, 77% of articular contact was located in the superior acetabulum, significantly greater than the intact condition (p < 0

  3. Defect generation during solidification of aluminium foams

    International Nuclear Information System (INIS)

    Mukherjee, M.; Garcia-Moreno, F.; Banhart, J.

    2010-01-01

    The reason for the frequent occurrence of cell wall defects in metal foams was investigated. Aluminium foams often expand during solidification, a process which is referred as solidification expansion (SE). The effect of SE on the structure of aluminium foams was studied in situ by X-ray radioscopy and ex situ by X-ray tomography. A direct correlation between the magnitude of SE and the number of cell wall ruptures during SE and finally the number of defects in the solidified foams was found.

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

    Directory of Open Access Journals (Sweden)

    Danilo N. S. Paulo

    1997-12-01

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

  6. Cesarean section after abdominal mesh repair for pregnancy-related desmoid tumor: a case report

    Directory of Open Access Journals (Sweden)

    Ooi S

    2017-07-01

    Full Text Available Sara Ooi, Harry Ngo Obstetrics and Gynaecology Department, Liverpool Hospital, Liverpool, NSW, Australia Abstract: We report the case of a 32-year-old gravida 2 para 1 woman with a background of partially resected desmoid tumor (DT arising from the previous cesarean section (CS scar. This case details the management of her DT by surgical resection and mesh repair and second pregnancy following this. Pregnancy-related DTs are a relatively rare entity, and there is a paucity of literature regarding their management during pregnancy. There are only five reported cases of DTs arising from CS scars. To our knowledge, this is the only report to illustrate that subsequent CS is possible after desmoid resection and abdominal mesh repair. It provides evidence that CS can be safely accomplished following abdominal wall reconstructions and further arguments against elective lower segment CS. Keywords: abdominal wall, cesarean section, complications, desmoid tumor, surgical mesh

  7. Perioperative Challenges in Repeat Bladder Exstrophy Repair - Case Report

    Directory of Open Access Journals (Sweden)

    Otu Enenyi Etta

    2015-07-01

    Full Text Available Bladder exstrophy is a rare congenital malformation. It presents as leakage of urine in the anterior abdominal wall following defects in midline anterior abdominal wall skin and bladder. We report the use of combined general anaesthesia and caudal epidural analgesia in a 4yr old boy for repeat bladder exstrophy repair. Problems of prolonged surgery and the challenges of pain and sedation management in the post operative period are discussed.

  8. 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 ...

  9. Prenatal ultrasound diagnosis of omphalocele

    International Nuclear Information System (INIS)

    Rio Romero, Luskenia del; Blanco Figueredo, Nadia; Rodriguez Dominguez, Zulay

    2014-01-01

    Omphalocele is an abdominal wall defect at the midline characterized by herniation of abdominal contents and covered by peritoneum and amnion. The aim of this paper is to present a case of omphalocele with gestational age of 23 weeks and prenatal diagnosis by ultrasonography. Using ultrasound diagnosis in a patient inquest made 40 years of age in the second trimester (gestational age 23 weeks) showed a level of the anterior fetal echogenic image that sticks through the abdominal wall and then locate the cord umbilical. Stomach is seen displaced and loss of normal anatomy of the abdominal circumference. Genetic counseling was conducted at the Municipal Center for Genetics of Manzanillo. Pathologically the fetus presented short and wide neck, low-set ears, defect omphalomesenteric of ductal closure, hernia sac occupied by the caudate lobe of the liver and gallbladder bed, wide base heart dissection showing cava-cava absence of interventricular septum was observed pulmonary valve stenosis most dilation of supravalvular pulmonary artery, large defect and aorta intraventricular septum ride, which speaks in favor of a heart rate troncoconal fallop trilogy over the omphalocele. Prenatal diagnosis by ultrasonography is an efficient and reliable method for prenatal diagnosis of omphalocele

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

    Directory of Open Access Journals (Sweden)

    João Vieira Lopes

    2008-10-01

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

  11. Agricultural Compounds in Water and Birth Defects.

    Science.gov (United States)

    Brender, Jean D; Weyer, Peter J

    2016-06-01

    Agricultural compounds have been detected in drinking water, some of which are teratogens in animal models. The most commonly detected agricultural compounds in drinking water include nitrate, atrazine, and desethylatrazine. Arsenic can also be an agricultural contaminant, although arsenic often originates from geologic sources. Nitrate has been the most studied agricultural compound in relation to prenatal exposure and birth defects. In several case-control studies published since 2000, women giving birth to babies with neural tube defects, oral clefts, and limb deficiencies were more likely than control mothers to be exposed to higher concentrations of drinking water nitrate during pregnancy. Higher concentrations of atrazine in drinking water have been associated with abdominal defects, gastroschisis, and other defects. Elevated arsenic in drinking water has also been associated with birth defects. Since these compounds often occur as mixtures, it is suggested that future research focus on the impact of mixtures, such as nitrate and atrazine, on birth defects.

  12. Strain measurement of abdominal aortic aneurysm with real-time 3D ultrasound speckle tracking.

    Science.gov (United States)

    Bihari, P; Shelke, A; Nwe, T H; Mularczyk, M; Nelson, K; Schmandra, T; Knez, P; Schmitz-Rixen, T

    2013-04-01

    Abdominal aortic aneurysm rupture is caused by mechanical vascular tissue failure. Although mechanical properties within the aneurysm vary, currently available ultrasound methods assess only one cross-sectional segment of the aorta. This study aims to establish real-time 3-dimensional (3D) speckle tracking ultrasound to explore local displacement and strain parameters of the whole abdominal aortic aneurysm. Validation was performed on a silicone aneurysm model, perfused in a pulsatile artificial circulatory system. Wall motion of the silicone model was measured simultaneously with a commercial real-time 3D speckle tracking ultrasound system and either with laser-scan micrometry or with video photogrammetry. After validation, 3D ultrasound data were collected from abdominal aortic aneurysms of five patients and displacement and strain parameters were analysed. Displacement parameters measured in vitro by 3D ultrasound and laser scan micrometer or video analysis were significantly correlated at pulse pressures between 40 and 80 mmHg. Strong local differences in displacement and strain were identified within the aortic aneurysms of patients. Local wall strain of the whole abdominal aortic aneurysm can be analysed in vivo with real-time 3D ultrasound speckle tracking imaging, offering the prospect of individual non-invasive rupture risk analysis of abdominal aortic aneurysms. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  13. 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.

  14. Preoperative evaluation of the abdominal aortic aneurysm using spiral CT

    International Nuclear Information System (INIS)

    Chisuwa, Hisanao; Nishimaki, Keiji; Arai, Masayuki; Honda, Haruyasu; Urata, Koichi; Miyagawa, Yusuke; Makuuchi, Masatoshi; Shimizu, Mikio; Okamoto, Kohei.

    1995-01-01

    Six patients with abdominal aortic aneurysm (AAA) were studied with three-dimensionally reconstructed CT angiography (3D-CTA) in order to evaluate its usefulness as a diagnostic tool for vascular surgery patients. Images of the intravenously contrasted abdominal aorta were obtained with spiral scan during a single breath hold. The images of the abdominal aorta and its major branches were three-dimensionally reconstructed with a shaded surface display mode. The three-dimensional image reconstruction was successful in all the six cases and performed without difficulties. Shaded surface display presented a deficit to depict the aortic wall with mural thrombus. However, multidirectional display of the abdominal aorta and its branches facilitated interpretation of the anatomical details of the lesions and planning of surgical repair. 3D-CTA is an alternative to conventional aortography for preoperative diagnosis of AAA. Moreover it was shown to be noninvasive, easy to proceed. It presented good angiographical resolution that can be used as a precise diagnostic tool in vascular surgery. (author)

  15. Patient med gigant umbilikalhernie præoperativt behandlet med botulintoksin A

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Hensler, Margaret; Arnesen, Regnar Bøge

    2017-01-01

    Surgical closure of giant abdominal wall hernia defects remains challenging. We report our initial experience with administration of botulinum toxin type A (BTA) for this approach in a 51-year-old female with a giant primary umbilical hernia and abdominal loss of domain. Four weeks prior to surge...

  16. Imaging findings of abdominal extraosseous plasma cell neoplasm

    International Nuclear Information System (INIS)

    Park, Yang Sin; Byun, Jae Ho; Won, Hyung Jin; Kim, Ah Young; Shin, Yong Moon; Kim, Pyo Nyun; Ha, Hyun Kwon; Lee, Moon Gyu; Bae, Kyung Soo

    2006-01-01

    To evaluate the imaging findings of abdominal extraosseous plasma cell neoplasm. From April 2000 to January 2005, eight patients (four men, four women; mean age, 50.6 years) with pathologically proved, extraosseous plasma cell neoplasm involving the abdominal organs were included in this study. The diagnoses were based on consensus agreement between two radiologists who retrospectively reviewed CT, ultrasonography, and enteroclysis findings. We evaluated the findings by focusing on the location, size, margin, and enhancement pattern of the lesion, and lymphadenopathy on each image. There were multiple myeloma in four patients and extramedullary plasmacytoma in the remaining four. Involved abdominal organs were the liver (n = 4), spleen (n 4), lymph node (n = 3), stomach (n = 1), small bowel (n = 1), and colon (n 1). The hepatic involvement of plasma cell neoplasm presented as a homogeneous, well-defined, solitary mass (n = 1), multiple nodules (n = 1), and hepatomegaly (n = 2). Its involvement of the spleen and lymph node appeared as splenomegaly and lymphadenopathy, respectively. Its involvement of the gastrointestinal tract including the stomach, small bowel, and colon, presented as a homogeneous, diffuse wall thickening or mass in the gastrointestinal tract. Abdominal extraosseous plasma cell neoplasm involves occasionally the liver, spleen, and lymph node, and rarely the gastrointestinal tract. When we encounter a well-defined, homogeneous lesion of the abdominal organs in patients diagnosed or suspected as having plasma cell neoplasm, we should consider its involvement of the abdominal organs

  17. Infected abdominal sacrocolpopexies: diagnosis and treatment.

    Science.gov (United States)

    Mattox, T Fleming; Stanford, Edward J; Varner, E

    2004-01-01

    The abdominal sacrocolpopexy is an excellent procedure to surgically treat vaginal vault prolapse. A synthetic graft is often used to support the vaginal apex, but has the potential to become infected or erode, requiring its removal or revision. The purpose of this paper is to report our experience in the management of patients with infected synthetic grafts after abdominal sacrocolpopexy. A review of the patient databases from three specialty gynecology centers was performed from March 1996 to June 2002. Only patients with an infected graft after an abdominal sacrocolpopexy were included in the study; patients with either suture or graft erosion responding to conservative treatment were excluded. Twenty-two women, ages 37-73 years, developed infection of the synthetic graft after an abdominal sacrocolpopexy (1-60 months after their initial surgery, mean 8.8 months). The infected materials included polytetrafluoroethylene (PTFE, Goretex, n =15) and polypropylene (n=7). Nine of the 15 PTFE meshes and four of the seven polypropylene meshes were placed at the time of a contaminated case (abdominal hysterectomy [n=12], colon resection [n=1]). Eighteen (82%) of the infected grafts involved braided permanent suture to attach the graft to the vaginal wall, monofilament/non-braided permanent suture was used in three patients, and suture type could not be determined in one. All graft removals were attempted vaginally, and this was successful in 16 cases (73%). Two patients experienced significant bleeding: the first patient required an emergency laparotomy and the second patient's bleeding was controlled with packing. A rectovaginal fistula occurred 3 weeks postoperatively in one patient. Synthetic graft infection should be considered as the differential diagnosis in a patient who has undergone an abdominal sacrocolpopexy. Transvaginal removal is preferred, but is fraught with potentially serious complications. The use of braided permanent sutures to affix the graft to the

  18. Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

    Directory of Open Access Journals (Sweden)

    Edivaldo Massazo Utiyama

    Full Text Available OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years; 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

  19. 18F-FDG uptake assessed by PET/CT in abdominal aortic aneurysms is associated with cellular and molecular alterations prefacing wall deterioration and rupture.

    Science.gov (United States)

    Courtois, Audrey; Nusgens, Betty V; Hustinx, Roland; Namur, Gauthier; Gomez, Pierre; Somja, Joan; Defraigne, Jean-Olivier; Delvenne, Philippe; Michel, Jean-Baptiste; Colige, Alain C; Sakalihasan, Natzi

    2013-10-01

    Rupture of abdominal aortic aneurysms (AAAs) leads to a significant morbidity and mortality in aging populations, and its prediction would be most beneficial to public health. Spots positive for uptake of (18)F-FDG detected by PET are found in 12% of AAA patients (PET+), who are most often symptomatic and at high rupture risk. Comparing the (18)F-FDG-positive site with a negative site from the same aneurysm and with samples collected from AAA patients with no (18)F-FDG uptake should allow the discrimination of biologic alterations that would help in identifying markers predictive of rupture. Biopsies of the AAA wall were obtained from patients with no (18)F-FDG uptake (PET0, n = 10) and from PET+ patients (n = 8), both at the site positive for uptake and at a distant negative site of the aneurysmal wall. Samples were analyzed by immunohistochemistry, quantitative real-time polymerase chain reaction, and zymography. The sites of the aneurysmal wall with a positive (18)F-FDG uptake were characterized by a strikingly increased number of adventitial inflammatory cells, highly proliferative, and by a drastic reduction of smooth muscle cells (SMCs) in the media as compared with their negative counterpart and with the PET0 wall. The expression of a series of genes involved in the maintenance and remodeling of the wall was significantly modified in the negative sites of PET+, compared with the PET0 wall, suggesting a systemic alteration of the aneurysmal wall. Furthermore, a striking increase of several matrix metalloproteinases (MMPs), notably the MMP1 and MMP13 collagenases, was observed in the positive sites, mainly in the adventitia. Moreover, PET+ patients were characterized by a higher circulating C-reactive protein. Positive (18)F-FDG uptake in the aneurysmal wall is associated with an active inflammatory process characterized by a dense infiltrate of proliferating leukocytes in the adventitia and an increased circulating C-reactive protein. Moreover, a loss of SMC

  20. Significance of bacterial flora in abdominal irradiation-induced inhibition of lung metastases

    International Nuclear Information System (INIS)

    Matsumoto, T.; Ando, K.; Koike, S.

    1988-01-01

    We have previously reported that abdominal irradiation prior to i.v. injection of syngeneic tumor cells reduced metastases in lung. Our report described an investigation of the significance of intestinal organisms in the radiation effect. We found that eliminating intestinal organisms with antibiotics totally abolished the radiation effect. Monoassociation of germ-free mice revealed that the radiation effect was observable only for Enterobacter cloacae, never for Streptococcus faecium, Bifidobacterium adlesentis, or Escherichia coli. After abdominal irradiation of regular mice, E. cloacae multiplied in cecal contents, adhered to mucous membranes, invaded the cecal wall, and translocated to mesenteric lymph nodes. Intravenous administration of E. cloacae in place of abdominal irradiation inhibited metastases. E. cloacae-monoassociated mice developed fewer metastases than germ-free mice, and the reduction was further enhanced by abdominal irradiation. We concluded that abdominal irradiation caused the invasion of E. cloacae from the mucous membrane of the intestine and inhibited formation of lung metastases

  1. Virtual modeling of robot-assisted manipulations in abdominal surgery.

    Science.gov (United States)

    Berelavichus, Stanislav V; Karmazanovsky, Grigory G; Shirokov, Vadim S; Kubyshkin, Valeriy A; Kriger, Andrey G; Kondratyev, Evgeny V; Zakharova, Olga P

    2012-06-27

    To determine the effectiveness of using multidetector computed tomography (MDCT) data in preoperative planning of robot-assisted surgery. Fourteen patients indicated for surgery underwent MDCT using 64 and 256-slice MDCT. Before the examination, a specially constructed navigation net was placed on the patient's anterior abdominal wall. Processing of MDCT data was performed on a Brilliance Workspace 4 (Philips). Virtual vectors that imitate robotic and assistant ports were placed on the anterior abdominal wall of the 3D model of the patient, considering the individual anatomy of the patient and the technical capabilities of robotic arms. Sites for location of the ports were directed by projection on the roentgen-positive tags of the navigation net. There were no complications observed during surgery or in the post-operative period. We were able to reduce robotic arm interference during surgery. The surgical area was optimal for robotic and assistant manipulators without any need for reinstallation of the trocars. This method allows modeling of the main steps in robot-assisted intervention, optimizing operation of the manipulator and lowering the risk of injuries to internal organs.

  2. Effects of abdominal pressure on venous return: abdominal vascular zone conditions.

    Science.gov (United States)

    Takata, M; Wise, R A; Robotham, J L

    1990-12-01

    The effects of changes in abdominal pressure (Pab) on inferior vena cava (IVC) venous return were analyzed using a model of the IVC circulation based on a concept of abdominal vascular zone conditions analogous to pulmonary vascular zone conditions. We hypothesized that an increase in Pab would increase IVC venous return when the IVC pressure at the level of the diaphragm (Pivc) exceeds the sum of Pab and the critical closing transmural pressure (Pc), i.e., zone 3 conditions, but reduce IVC venous return when Pivc is below the sum of Pab and Pc, i.e., zone 2 conditions. The validity of the model was tested in 12 canine experiments with an open-chest IVC bypass. An increase in Pab produced by phrenic stimulation increased the IVC venous return when Pivc-Pab was positive but decreased the IVC venous return when Pivc - Pab was negative. The value of Pivc - Pab that separated net increases from decreases in venous return was 1.00 +/- 0.72 (SE) mmHg (n = 6). An increase in Pivc did not influence the femoral venous pressure when Pivc was lower than the sum of Pab and a constant, 0.96 +/- 0.70 mmHg (n = 6), consistent with presence of a waterfall. These results agreed closely with the predictions of the model and its computer simulation. The abdominal venous compartment appears to function with changes in Pab either as a capacitor in zone 3 conditions or as a collapsible Starling resistor with little wall tone in zone 2 conditions.

  3. Perinatal management of gastroschisis

    Directory of Open Access Journals (Sweden)

    Vincenzo Insinga

    2014-01-01

    Full Text Available Gastroschisis is an abdominal wall defect, typically located to the right of the umbilical cord, requiring an early surgical treatment shortly after birth. Affected patients can be identified during intrauterine life with US and should be delivered in referral hospitals where a multisciplinary approach can be provided, involving neonatologists, clinical geneticists, surgeons and other specialists. These patients require a complex management in Neonatal Intensive Care Unit (NICU and a long term follow-up after discharge. Exceed the acute neonatal condition, gastroschisis has a good prognosis, if there are no overlapping complications, and it should be differentiated from omphalocele, burdened with worse prognosis, and other conditions in the wide spectrum of abdominal wall defects.

  4. Computed tomographic findings of abdominal complications of Crohn's disease - pictorial essay

    International Nuclear Information System (INIS)

    Zissin, R.; Hertz, M.; Osadchy, A.; Novis, B.; Gayer, G.

    2005-01-01

    Crohn's disease (CD) is a chronic, transmural, inflammatory disease of the gastrointestinal tract (CIT) most often affecting the terminal ileum and colon. Diarrhea, abdominal pain, anorexia, nausea, and weight loss are the most common clinical symptoms. Abdominal complications of CD, both intestinal and extraintestinal, are frequent and variable. The most common intestinal complications include ileocolitis with external or internal fistulas and abscess formation, strictures, and bowel obstruction. Less common are free perforation, intussusception, and malignancy. The extraintestinal complications include nephrolithiasis, cholelithiasis, fatty liver, portal vein gas, and thromboembolic events. Nowadays, computed tomography (CT) provides superb anatomic detail and diagnostic accuracy of various intra-abdominal pathological processes, and it thus has become an essential diagnostic tool in the evaluation and management of patients wit known CD for the assessment of bowel wall involvement, the mesenteric extent of the disease, and inn-abdominal complications. In addition, as CT is frequently performed to evaluate patients with acute abdomen, it may encounter clinically unsuspected complications in patients with CD. This article reviews the CT features of various intra-abdominal complications of CD. (author)

  5. Trichobezoar – A Rare Cause of Abdominal Mass and Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Ana Couceiro

    2016-01-01

    Full Text Available The authors present the clinical case of a 14-year old girl with weight loss, anorexia, epigastric abdominal pain and postprandial vomiting with 5 months duration. There was a background of trichophagia for 2 years without evidence of alopecia or psychiatric history. The physical examination revealed an epigastric mass motionless, stony, with poorly defined limits, painful on palpation and about 7 cm diameter. Abdominal ultrasonography showed thickening of the gastric wall and antrum with gastric distension. The abdominal tomography scan and endoscopic examination revealed the presence of a bulky trichobezoar occupying almost the entire gastric lumen. It was decided to undergo gastrotomy and extraction of the bezoar. The postoperative period was uneventful.

  6. Atomic structure of defects in GaN:Mg grown with Ga polarity

    International Nuclear Information System (INIS)

    Liliental-Weber, Z.; Tomaszewicz, T.; Zakharov, D.; Jasinski, J.; O'Keefe, M.A.; Hautakangas, S.; Laakso, A.; Saarinen, K.

    2003-01-01

    Electron microscope phase images, produced by direct reconstruction of the scattered electron wave from a focal series of high-resolution images, were used to determine the nature of defects formed in GaN:Mg crystals. We studied bulk crystals grown from dilute solutions of atomic nitrogen in liquid gallium at high pressure and thin films grown by the MOCVD method. All the crystals were grown with Ga-polarity. In both types of samples the majority of defects were three dimensional Mg-rich hexagonal pyramids with bases on the (0001) plane and six walls on {11(und 2)3} planes seen in cross-section as triangulars. Some other defects appear in cross-section as trapezoidal (rectangular) defects as a result of presence of truncated pyramids. Both type of defects have hollow centers. They are decorated by Mg on all six side walls and a base. The GaN which grows inside on the defect walls shows polarity inversion. It is shown that change of polarity starts from the defect tip and propagates to the base, and that the stacking sequence changes from ab in the matrix to bc inside the defect. Exchange of the Ga sublattice with the N sublattice within the defect leads to 0.6 ± 0.2(angstrom) displacement between Ga sublattices outside and inside the defects. It is proposed that lateral overgrowth of the cavities formed within the defect takes place to restore matrix polarity on the defect base

  7. The incidence and functional consequences of RT-associated cardiac perfusion defects

    International Nuclear Information System (INIS)

    Marks, Lawrence B.; Yu Xiaoli; Prosnitz, Robert G.; Zhou Sumin; Hardenbergh, Patricia H.; Blazing, Michael; Hollis, Donna; Lind, Pehr; Tisch, Andrea; Wong, Terence Z.; Borges-Neto, Salvador

    2005-01-01

    Purpose: Radiation therapy (RT) for left-sided breast cancer has been associated with cardiac dysfunction. We herein assess the temporal nature and volume dependence of RT-induced left ventricular perfusion defects and whether these perfusion defects are related to changes in cardiac wall motion or alterations in ejection fraction. Methods: From 1998 to 2001, 114 patients were enrolled onto an IRB-approved prospective clinical study to assess changes in regional and global cardiac function after RT for left-sided breast cancer. Patients were imaged 30 to 60 minutes after injection of technetium 99m sestamibi or tetrofosmin. Post-RT perfusion scans were compared with the pre-RT studies to assess for RT-induced perfusion defects as well as functional changes in wall motion and ejection fraction. Two-tailed Fisher's exact test and the Cochran-Armitage test for linear trends were used for statistical analysis. Results: The incidence of new perfusion defects 6, 12, 18, and 24 months after RT was 27%, 29%, 38%, and 42%, respectively. New defects occurred in approximately 10% to 20% and 50% to 60% of patients with less than 5%, and greater than 5%, of their left ventricle included within the RT fields, respectively (p = 0.33 to 0.00008). The rates of wall motion abnormalities in patients with and without perfusion defects were 12% to 40% versus 0% to 9%, respectively; p values were 0.007 to 0.16, depending on the post-RT interval. Conclusions: Radiation therapy causes volume-dependent perfusion defects in approximately 40% of patients within 2 years of RT. These perfusion defects are associated with corresponding wall-motion abnormalities. Additional study is necessary to better define the long-term functional consequences of RT-induced perfusion defects

  8. A Novel Diagnostic Aid for Detection of Intra-Abdominal Adhesions to the Anterior Abdominal Wall Using Dynamic Magnetic Resonance Imaging

    NARCIS (Netherlands)

    Randall, D.; Fenner, J.; Gillott, R.; Broek, R.P.G ten; Strik, C.; Spencer, P.; Bardhan, K.D.

    2016-01-01

    Introduction. Abdominal adhesions can cause serious morbidity and complicate subsequent operations. Their diagnosis is often one of exclusion due to a lack of a reliable, non-invasive diagnostic technique. Development and testing of a candidate technique are described below. Method. During

  9. Reproducibility of ECG-gated Ultrasound Diameter Assessment of Small Abdominal Aortic Aneurysms

    DEFF Research Database (Denmark)

    Bredahl, K; Eldrup, N; Meyer, C

    2013-01-01

    No standardised ultrasound procedure to obtain reliable growth estimates for abdominal aortic aneurysms (AAA) is currently available. We investigated the feasibility and reproducibility of a novel approach controlling for a combination of vessel wall delineation and cardiac cycle variation....

  10. MULTISCAN--a Scandinavian multicenter second trimester obstetric ultrasound and serum screening study

    DEFF Research Database (Denmark)

    Jørgensen, F S; Valentin, L; Salvesen, K A

    1999-01-01

    AIM: To study the detection rates of second trimester ultrasound screening for neural tube defects (NTD), abdominal wall defects (AWD) and Down's syndrome (DS) in low risk populations at tertiary centers, and to compare the ultrasound screening detection rates with those that were obtainable by b...

  11. 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

  12. 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

  13. Mechanics, Mechanobiology, and Modeling of Human Abdominal Aorta and Aneurysms

    Science.gov (United States)

    Humphrey, J.D.; Holzapfel, G.A.

    2011-01-01

    Biomechanical factors play fundamental roles in the natural history of abdominal aortic aneurysms (AAAs) and their responses to treatment. Advances during the past two decades have increased our understanding of the mechanics and biology of the human abdominal aorta and AAAs, yet there remains a pressing need for considerable new data and resulting patient-specific computational models that can better describe the current status of a lesion and better predict the evolution of lesion geometry, composition, and material properties and thereby improve interventional planning. In this paper, we briefly review data on the structure and function of the human abdominal aorta and aneurysmal wall, past models of the mechanics, and recent growth and remodeling models. We conclude by identifying open problems that we hope will motivate studies to improve our computational modeling and thus general understanding of AAAs. PMID:22189249

  14. The Houdini effect--an unusual case of blunt abdominal trauma resulting in perforative appendicitis.

    LENUS (Irish Health Repository)

    O'Kelly, F

    2012-03-01

    We present a unique case of perforative appendicitis that occurred in an adult following blunt abdominal trauma. This case represents the first such reported case from Ireland. It also represents a modern practical example of Laplace\\'s theory of the effect of increased pressure on colonic wall tension leading to localized perforation, and serves to highlight not only the importance in preoperative imaging for blunt abdominal trauma, but also the importance of considering appendiceal perforation.

  15. 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

  16. Comparison of lateral abdominal muscle thickness between weightlifters and matched controls.

    Science.gov (United States)

    Sitilertpisan, Patraporn; Pirunsan, Ubon; Puangmali, Aatit; Ratanapinunchai, Jonjin; Kiatwattanacharoen, Suchart; Neamin, Hudsaleark; Laskin, James J

    2011-11-01

    To compare lateral abdominal muscle thickness between weightlifters and matched controls. A case control study design. University laboratory. 16 female Thai national weightlifters and 16 matched controls participated in this study. Ultrasound imaging with a 12-MHz linear array was used to measure the resting thickness of transversus abdominis (TrA), internal oblique (IO) and total thickness (Total) of lateral abdominal muscle (LAM) on the right side of abdominal wall. The absolute muscle thickness and the relative contribution of each muscle to the total thickness were determined. Weightlifters had significantly thicker absolute TrA and IO muscles than matched controls (p routine Olympic style weight training among female weightlifters appears to result in preferential hypertrophy or adaptation of the IO muscle. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Patent abdominal subcutaneous veins caused by congenital absence of the inferior vena cava: a case report

    Directory of Open Access Journals (Sweden)

    Lipp Rainer W

    2010-07-01

    Full Text Available Abstract Introduction Patent paraumbilical and abdominal subcutaneous veins are found frequently as collaterals in patients due to portal hypertension mainly in liver cirrhosis. Case presentation For evaluation of portal hypertension in a 72-year-old Caucasian man without liver cirrhosis, magnetic resonance imaging with gadolinium contrast-enhancement was performed and demonstrated a missing inferior vena cava. A blood return from the lower extremities was shown through enlarged collateral veins of the abdominal wall, vena azygos and hemiazygos continuation, and multiple liver veins emptying into the right cardiac atrium. We describe a rare case of abdominal subcutaneous wall veins as collaterals caused by a congenitally absent infrarenal inferior vena cava with preservation of a hypoplastic suprarenal segment. Conclusion Knowledge of these congenital variations can be of clinical importance and it is imperative for the reporting radiologist to identify these anomalies as they can have a significant impact on the clinical management of the patient.

  18. Ultrasound in the diagnosis of palpable abdominal masses in children.

    Science.gov (United States)

    Annuar, Z; Sakijan, A S; Annuar, N; Kooi, G H

    1990-12-01

    Ultrasound examinations were done to evaluate clinically palpable abdominal masses in 125 children. The examinations were normal in 21 patients. In 15 patients, the clinically palpable masses were actually anterior abdominal wall abscesses or hematomas. Final diagnosis was available in 87 of 89 patients with intraabdominal masses detected on ultrasound. The majority (71%) were retroperitoneal masses where two-thirds were of renal origin. Ultrasound diagnosis was correct in 68 patients (78%). All cases of hydronephrosis were correctly diagnosed based on characteristic ultrasound appearances. Correct diagnoses of all cases of adrenal hematoma, psoas abscess, liver hematoma, liver abscess and one case of liver metastases were achieved with correlation of relevant clinical information.

  19. Ion-irradiation-induced defects in bundles of carbon nanotubes

    International Nuclear Information System (INIS)

    Salonen, E.; Krasheninnikov, A.V.; Nordlund, K.

    2002-01-01

    We study the structure and formation yields of atomic-scale defects produced by low-dose Ar ion irradiation in bundles of single-wall carbon nanotubes. For this, we employ empirical potential molecular dynamics and simulate ion impact events over an energy range of 100-1000 eV. We show that the most common defects produced at all energies are vacancies on nanotube walls, which at low temperatures are metastable but long-lived defects. We further calculate the spatial distribution of the defects, which proved to be highly non-uniform. We also show that ion irradiation gives rise to the formations of inter-tube covalent bonds mediated by carbon recoils and nanotube lattice distortions due to dangling bond saturation. The number of inter-tube links, as well as the overall damage, linearly grows with the energy of incident ions

  20. 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...

  1. [The etiological aspects of acute abdominal pain in children].

    Science.gov (United States)

    Dinu, C A; Moraru, D

    2011-01-01

    The study of the etiological aspects of acute abdominal pain in children, in order to perceive the clinical-etiological correlations and the disorders distribution related to age, gender and the origin of the patients. The criteria for including patients were age (between 0 and 18 years) and the presence of acute abdominal pain before or during the consultation with the physician. The research on acute abdominal pain in children was performed on the level of the Surgery and Pediatrics II clinical departments of the "Sf. Ioan" Children's Emergency Clinical Hospital in Galati, between 01.01.2009 - 01.01.2011. The clinical study performed on the patients registered in the studied groups focused on the identification, the evaluation of the symptoms of acute abdominal pain in children, diagnosing and treating it. The criteria for excluding patients were an age older than 18 years or the absence of acute abdominal pain as a symptom before or during the examination. The statistical analysis used the descriptive and analytical methods. The data was centralized and statistically processed in M.S.EXCEL and S.P.S.S. databases. The patients with acute abdominal pain represent a percentage of 92.9% (2358 cases) of the total number of patients who suffer from abdominal pain (N=2537). The highest frequency of cases is represented by acute appendicitis (1056 cases - 44.8%). In the 5-18 years age group, acute appendicitis, mesenteric lymphadenitis, ovarian follicular cysts, acute pyelenophritis and salpingitis are predominant. In the 0-4 years age group gastroenteritis, acute pharyngitis, reactive hepatitis and lower digestive bleeding are predominant. In females, acute appendicitis, gastroenteritis, gastroduodenitis and cystitis are predominant, whereas in males, peritonitis, sepsis through E. coli, the contusion of the abdominal wall and acute pharyngitis are predominant.

  2. Ultrasonographic characteristics of the abdominal esophagus and cardia in dogs.

    Science.gov (United States)

    Gory, Guillaume; Rault, Delphine N; Gatel, Laure; Dally, Claire; Belli, Patrick; Couturier, Laurent; Cauvin, Eddy

    2014-01-01

    Differential diagnoses for regurgitation and vomiting in dogs include diseases of the gastroesophageal junction. The purpose of this cross-sectional study was to describe ultrasonographic characteristics of the abdominal esophagus and gastric cardia in normal dogs and dogs with clinical disease involving this region. A total of 126 dogs with no clinical signs of gastrointestinal disease and six dogs with clinical diseases involving the gastroesophageal junction were included. For seven euthanized dogs, ultrasonographic features were also compared with gross pathology and histopathology. Cardial and abdominal esophageal wall thicknesses were measured ultrasonographically for all normal dogs and effects of weight, sex, age, and stomach filling were tested. Five layers could be identified in normal esophageal and cardial walls. The inner esophageal layer was echogenic, corresponding to the cornified mucosa and glandular portion of the submucosa. The cardia was characterized by a thick muscularis, and a transitional zone between echogenic esophageal and hypoechoic gastric mucosal layers. Mean (±SD) cardial wall thicknesses for normal dogs were 7.6 mm (±1.6), 9.7 mm (±1.8), 10.8 mm (±1.6), 13.3 mm (±2.5) for dogs in the dog weight group. Ultrasonography assisted diagnosis in all six clinically affected dogs. Findings supported the use of transabdominal ultrasonography as a diagnostic test for dogs with suspected gastroesophageal disease. © 2014 American College of Veterinary Radiology.

  3. Staged abdominal re-operation for abdominal trauma.

    Science.gov (United States)

    Taviloglu, Korhan

    2003-07-01

    To review the current developments in staged abdominal re-operation for abdominal trauma. To overview the steps of damage control laparotomy. The ever increasing importance of the resuscitation phase with current intensive care unit (ICU) support techniques should be emphasized. General surgeons should be familiar to staged abdominal re-operation for abdominal trauma and collaborate with ICU teams, interventional radiologists and several other specialties to overcome this entity.

  4. Reconstruction with a patient-specific titanium implant after a wide anterior chest wall resection

    Science.gov (United States)

    Turna, Akif; Kavakli, Kuthan; Sapmaz, Ersin; Arslan, Hakan; Caylak, Hasan; Gokce, Hasan Suat; Demirkaya, Ahmet

    2014-01-01

    The reconstruction of full-thickness chest wall defects is a challenging problem for thoracic surgeons, particularly after a wide resection of the chest wall that includes the sternum. The location and the size of the defect play a major role when selecting the method of reconstruction, while acceptable cosmetic and functional results remain the primary goal. Improvements in preoperative imaging techniques and reconstruction materials have an important role when planning and performing a wide chest wall resection with a low morbidity rate. In this report, we describe the reconstruction of a wide anterior chest wall defect with a patient-specific custom-made titanium implant. An infected mammary tumour recurrence in a 62-year old female, located at the anterior chest wall including the sternum, was resected, followed by a large custom-made titanium implant. Latissimus dorsi flap and split-thickness graft were also used for covering the implant successfully. A titanium custom-made chest wall implant could be a viable alternative for patients who had large chest wall tumours. PMID:24227881

  5. Abdominal Tuberculosis Mimicking Intra-abdominal Malignancy: A ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    BACKGROUND. Abdominal TB usually presents with nonspecific findings and may thus m.,mw a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.

  6. Abdominal tuberculosis mimicking intra-abdominal malignancy: A ...

    African Journals Online (AJOL)

    Background: Abdominal TB usually presents with nonspecific findings and may thus mimic a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.

  7. Chylous ascites associated with abdominal trauma and intestinal resection-anastomosis in a pet ferret (Mustela putorius furo).

    Science.gov (United States)

    Chassang, Lucile; Langlois, Isabelle; Loos, Pauline; Freire, Mila; O'Toole, Elizabeth

    2018-05-15

    CASE DESCRIPTION A 10-week-old 0.73-kg (1.6-lb) castrated male domestic ferret (Mustela putorius furo) was referred for exploratory laparotomy because of pneumoperitoneum and possible septic peritonitis after being bitten by the owner's dog. CLINICAL FINDINGS Abdominal exploration revealed a large laceration of the duodenum, tears of the jejunal mesentery, and 2 small tears in the abdominal wall. Chylous abdominal effusion developed 48 hours after surgery. TREATMENT AND OUTCOME Postoperative care included supportive treatment, analgesia, and antimicrobials. An abdominal drain was placed during the laparotomy and enabled monitoring of abdominal fluid production. Enteral feeding was provided through an esophagostomy tube. The chylous fluid production rapidly decreased after treatment with octreotide was initiated, and the ferret improved. Chyloabdomen resolved after 8 days of hospitalization and medical treatment. CLINICAL RELEVANCE Findings suggested that chylous ascites can potentially develop secondary to blunt abdominal trauma in ferrets. In this ferret, chyloabdomen was successfully treated with octreotide administration and abdominal drainage.

  8. Handlebar Hernia With Jejunal and Duodenal Injuries: A Case Report

    Directory of Open Access Journals (Sweden)

    Ching-Wen Huang

    2004-09-01

    Full Text Available Traumatic abdominal wall hernia is an uncommon complication of abdominal blunt trauma. Handlebar hernia is even more infrequent. To the best of our knowledge, there are fewer than 30 cases of handlebar hernia reported in the English literature. Associated intra-abdominal injuries are infrequent. We present a case of handlebar hernia with jejunal and duodenal injuries. Emergency surgical intervention included primary repair of the disrupted musculofascial defect and injuries of the duodenum and jejunum. Bile- stained discharge from the drain tube was noted, so a second operation was performed about 7 days after the first. Leakage from the sutured jejunal perforation and another irregular perforation in the posterior wall of the fourth portion of the duodenum were noted. The two perforations were debrided and repaired. The muscular and fascial defects were debrided and closed with interrupted sutures. The patient recovered smoothly and was discharged 30 days after the blunt injury. No other major complication was noted 11 months after surgery.

  9. The impact of a massive transfusion protocol (1:1:1) on major hepatic injuries: does it increase abdominal wall closure rates?

    Science.gov (United States)

    Ball, Chad G; Dente, Christopher J; Shaz, Beth; Wyrzykowski, Amy D; Nicholas, Jeffrey M; Kirkpatrick, Andrew W; Feliciano, David V

    2013-10-01

    Massive transfusion protocols (MTPs) using high plasma and platelet ratios for exsanguinating trauma patients are increasingly popular. Major liver injuries often require massive resuscitations and immediate hemorrhage control. Current published literature describes outcomes among patients with mixed patterns of injury. We sought to identify the effects of an MTP on patients with major liver trauma. Patients with grade 3, 4 or 5 liver injuries who required a massive blood component transfusion were analyzed. We compared patients with high plasma:red blood cell:platelet ratio (1:1:1) transfusions (2007-2009) with patients injured before the creation of an institutional MTP (2005-2007). Among 60 patients with major hepatic injuries, 35 (58%) underwent resuscitation after the implementation of an MTP. Patient and injury characteristics were similar between cohorts. Implementation of the MTP significantly improved plasma: red blood cell:platelet ratios and decreased crystalloid fluid resuscitation (p = 0.026). Rapid improvement in early acidosis and coagulopathy was superior with an MTP (p = 0.009). More patients in the MTP group also underwent primary abdominal fascial closure during their hospital stay (p = 0.021). This was most evident with grade 4 injuries (89% vs. 14%). The mean time to fascial closure was 4.2 days. The overall survival rate for all major liver injuries was not affected by an MTP (p = 0.61). The implementation of a formal MTP using high plasma and platelet ratios resulted in a substantial increase in abdominal wall approximation. This occurred concurrently to a decrease in the delivered volume of crystalloid fluid.

  10. Defect structure in proton-irradiated copper and nickel

    International Nuclear Information System (INIS)

    Tsukuda, Noboru; Ehrhart, P.; Jaeger, W.; Schilling, W.; Dworschak, F.; Gadalla, A.A.

    1987-01-01

    This single crystals of copper or nickel with a thickness of about 10 μm are irradiated with 3 MeV protons at room temperature and the structures of resultant defects are investigated based on measurements of the effects of irradiation on the electrical resistivity, length, lattice constants, x-ray diffraction line profile and electron microscopic observations. The measurements show that the electrical resistivity increases with irradiation dose, while leveling off at high dose due to overlapping of irradiation cascades. The lattice constants decreases, indicating that many vacancies still remain while most of the interstitial stoms are eliminated, absorbed or consumed for dislocation loop formation. The x-ray line profile undergoes broadening, which is the result of dislocation loops, dislocation networks and SFT's introduced by the proton irradiation. Various defects have different effects though they cannot be identified separately from the profile alone. A satellite peak appears at a low angle, which seems to arise from periodic defect structures that are found in electron microscopic observations. In both copper and nickel, such periodic defect structures are seen over a wide range from high to low dose. Defect-free and defect-rich domains (defect walls), 0.5 to several μm in size, are alingned parallel to the {001} plane at intervals of 60 nm. The defect walls, which consist of dislocations, dislocation loops and SFT's, is 20 - 40 nm thick. (Nogami, K.)

  11. Defect dynamics and coarsening dynamics in smectic-C films

    Science.gov (United States)

    Pargellis, A. N.; Finn, P.; Goodby, J. W.; Panizza, P.; Yurke, B.; Cladis, P. E.

    1992-12-01

    We study the dynamics of defects generated in free-standing films of liquid crystals following a thermal quench from the smectic-A phase to the smectic-C phase. The defects are type-1 disclinations, and the strain field between defect pairs is confined to 2π walls. We compare our observations with a phenomenological model that includes dipole coupling of the director field to an external ordering field. This model is able to account for both the observed coalescence dynamics and the observed ordering dynamics. In the absence of an ordering field, our model predicts the defect density ρ to scale with time t as ρ lnρ~t-1. When the dipole coupling of the director field to an external ordering field is included, both the model and experiments show the defect coarsening proceeds as ρ~e-αt with the strain field confined to 2π walls. The external ordering field most likely arises from the director's tendency to align with edge dislocations within the liquid-crystal film.

  12. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    International Nuclear Information System (INIS)

    Marincek, B.

    2002-01-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  13. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Energy Technology Data Exchange (ETDEWEB)

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-09-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  14. Prenatal ultrasonographic findings of cloacal anomaly

    Energy Technology Data Exchange (ETDEWEB)

    Song, Mi Jin [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-09-15

    To evaluate the ultrasonographic characteristic of a rare malformation comples, Cloacal anomaly on prenatal ultrasonography. From March 1991 to July 2001, eight cases with the persistent cloaca (4 cases in female and 1 case in male) and cloacal exstrophy (3 cases) diagnosed by prenatal ultrasound examination were included, and all of them were pathologically confirmed by autopsy. One radiologist retrospectively analyzed the prenatal sonographic images, including the urinary bladder, kidney, pelvic cyst, abdominal wall defect and amount of amniotic fluid. The ultrasonographic diagnosis was established at 21.8 {+-} 7.8 weeks of gestation. The prenatal ultrasonographic findings of the persistent cloaca were absent bladder (n=2), distended bladder (n=2) and small thick bladder (n=1). Sonography of the kidney showed normal (n=2), hydronephrosis (n=1), dysplasia (n=1) and unilateral hydronephrosis with absent contralateral kidney (n=1). Four fetuses showed septated pelvic cyst; three fetuses, oligohydramnios. The prenatal ultrasonographic findings of cloacal exstrophy included absent bladder (n=3), normal kidney (n=1), hydronephrosis (n=1) and absent kidney (n=1). All fetuses with cloacal exstrophy had abdominal wall defect while two of them had oligohydramnios. A prenatal diagnosis of persistent cloaca can be confidently made when there is septated pelvic cyst combined oligohydramnios, sediments within the cyst and intraluminal calcifications. Cloacal exstrophy should be included in diagnosis if there is a low abdominal wall defect with absent urinary bladder.

  15. Computed tomographic findings of abdominal complications of Crohn's disease - pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel)]. E-mail: zisinrivka@clalit.org.il; Hertz, M. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv (Israel); Osadchy, A. [Tel-Aviv Univ., Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Novis, B. [Tel-Aviv Univ., Dept. of Gastroenterology, Sapir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv (Israel); Gayer, G. [Tel-Aviv Univ., Department of Diagnostic Imaging, Assaf Harode Medical Center, Zrifin, Sackler Faculty of Medicine, Tel Aviv (Israel)

    2005-02-15

    Crohn's disease (CD) is a chronic, transmural, inflammatory disease of the gastrointestinal tract (CIT) most often affecting the terminal ileum and colon. Diarrhea, abdominal pain, anorexia, nausea, and weight loss are the most common clinical symptoms. Abdominal complications of CD, both intestinal and extraintestinal, are frequent and variable. The most common intestinal complications include ileocolitis with external or internal fistulas and abscess formation, strictures, and bowel obstruction. Less common are free perforation, intussusception, and malignancy. The extraintestinal complications include nephrolithiasis, cholelithiasis, fatty liver, portal vein gas, and thromboembolic events. Nowadays, computed tomography (CT) provides superb anatomic detail and diagnostic accuracy of various intra-abdominal pathological processes, and it thus has become an essential diagnostic tool in the evaluation and management of patients wit known CD for the assessment of bowel wall involvement, the mesenteric extent of the disease, and inn-abdominal complications. In addition, as CT is frequently performed to evaluate patients with acute abdomen, it may encounter clinically unsuspected complications in patients with CD. This article reviews the CT features of various intra-abdominal complications of CD. (author)

  16. Plasma levels of cathepsins L, K, and V and risks of abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lv, Bing-Jie; Lindholt, Jes S; Wang, Jing

    2013-01-01

    Cathepsin L (CatL), cathepsin K (CatK), and cathepsin V (CatV) are potent elastases implicated in human arterial wall remodeling. Whether plasma levels of these cathepsins are altered in patients with abdominal aortic aneurysms (AAAs) remains unknown....

  17. The thermal conductivity of defect-free single-walled carbon nanotubes

    International Nuclear Information System (INIS)

    Pronevskij, A.G.; Tivanov, M.S.

    2015-01-01

    The heat conduction model of defect-free SWCNTs was proposed. This model is based on the known Debye's model for heat capacity and on the kinetic model for the phonon heat transfer that takes into account the length of SWCNTs due to redetermining of Debye's model for the case of nanoscale structures and also of the contribution made by phonon-phonon scattering on the basis of Clemens's formula. The length is considered in the context of parameterization of the lower integration frequency in the Debye formula. Based on this model, the dependences of the two-dimensional thermal conductivity of defect-free SWCNTs on their length and temperature were defined. It was found that the obtained temperature dependences of the two-dimensional thermal conductivity of defect-free SWCNTs have an obvious maximum slightly shifted on the temperature axis to higher temperatures with an increase in the length of SWCNTs. Particularly this aspect determines the effective temperature interval for the use of CNTs as heat-sink elements in nanoelectronic devices. The absolute value of a maximum at the curve for the two-dimensional thermal conductivity as a function of temperature is increased with the SWCNT length, gradually reaching saturation. Thermal conductivities for defect-free SWCNTs show insignificant differences as a function of their chirality ('zigzag' or 'armchair'). (authors)

  18. Mode B ultrasonography and abdominal Doppler in crab-eating-foxes ( Cerdocyon thous

    Directory of Open Access Journals (Sweden)

    Alanna S.L. Silva

    2014-12-01

    Full Text Available Abstract: Annually hundreds of crab-eating foxes (Cerdocyon thous are referred to rehabilitation centers and zoos in Brazil. The ultrasonographic study of wildlife species is an important tool for a non-invasive and accurate anatomical description and provides important information for wildlife veterinary care. The aim of the present study was to determine the characteristics of the main abdominal organs as well as the vascular indexes of the abdominal aorta and renal arteries of crab-eating foxes (Cerdocyon thous using mode B ultrasonography and Doppler ultrasonography, respectively. Ultrasonographic features of the main abdominal organs were described and slight differences were noticed between ultrasound imaging of abdominal organs of crab-eating foxes and other species. The bladder presented wall thickness of 12±0.01mm, with three defined layers. Both, the right and left kidneys presented corticomedullary ratio of 1:1 and similarly to the adrenals and the liver, they were homogeneous and hypoechoic compared to the spleen. The spleen was homogeneous and hyperechoic compared to the kidneys. The stomach presented 3 to 5 peristaltic movements per minute, wall thickness of 39±0.05mm and lumen and mucosa with hyperechoic and hypoechoic features, respectively. Small and large intestines presented 2 to 3 peristaltic movements per minute, wall thickness of 34±0.03mm and three defined layers with hyperechogenic (submucosa and serosa and hypoechogenic (muscular features. Ovaries of the female crab-eating fox were hypoechoic compared to the spleen and with heterogeneous parenchyma due to the presence of 2x2mm ovarian follicles. Prostates of the six males were regular and with a well defined boundary, with a homogeneous and hyperechoic parenchyma compared to the spleen. Vascular indexes of the abdominal aorta (PSV: 25.60±0.32cm/s; EDV: 6.96±1.68cm/s; PI: 1.15±0.07 e RI: 0.73±0.07 and right (PSV: 23.08±3.34cm/s; EDV: 9.33±2.36cm/s; PI: 1.01±0

  19. Magnitude of Birth Defects in Central and Northwest Ethiopia from 2010-2014: A Descriptive Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Molla Taye

    Full Text Available Birth defects are defined as structural and functional defects that develop during the organogenesis period and present at birth or detected later in life. They are one of the leading causes of infant and child mortality, morbidity, and long term disability. The magnitude of birth defects varies from country to country and from race/ethnicity to race/ethnicity, and about 40-60% of their causes are unknown. The known causes of birth defects are genetic and environmental factors which may be prevented. For various reasons, there is lack of data and research on birth defects in Ethiopia.The major objective of this study is to estimate the magnitude of birth defects in Ethiopia.A hospital based, retrospective, cross sectional, descriptive study was conducted. The subjects were babies/children aged 0-17years who visited selected hospitals between 2010 and 2014. Fourteen hospitals (8 in Addis Ababa, 6 in Amhara Region were selected purposively based on case load. A data retrieving form was developed to extract relevant information from record books.In the hospitals mentioned, 319,776 various medical records of children aged 0-17years were found. Of these, 6,076 (1.9% with 95% CI: 1.85%-1.95% children were diagnosed as having birth defects. The majority (58.5% of the children were male and 41.5% female. A slightly more than half (51.1% of the children were urban dwellers, while 48.9% were from rural areas. Among the participants of the study the proportion of birth defects ranged as follows: orofacial (34.2%, neural tube (30.8%, upper and lower limb (12.8%, cardiovascular system (10.3%, digestive system and abdominal wall (4.8%, unspecified congenital malformations (2.5%, Down syndrome (2%, genitourinary system (2%, head, face, and neck defects (0.4%, and others (0.3%. The trend of birth defects increased linearly over time [Extended Mantel-Haenszel chi square for linear trend = 356.7 (P<0.0001]. About 275 (4.5% of the cases had multiple (associated

  20. Optimizing the hydrogen storage in boron nitride nanotubes by defect engineering

    Energy Technology Data Exchange (ETDEWEB)

    Oezdogan, Kemal; Berber, Savas [Physics Department, Gebze Institute of Technology, Cayirova Kampusu, Gebze, 41400 Kocaeli (Turkey)

    2009-06-15

    We use ab initio density functional theory calculations to study the interaction of hydrogen with vacancies in boron nitride nanotubes to optimize the hydrogen storage capacity through defect engineering. The vacancies reconstruct by forming B-B and N-N bonds across the defect site, which are not as favorable as heteronuclear B-N bonds. Our total energy and structure optimization results indicate that the hydrogen cleaves these reconstructing bonds to form more stable atomic structures. The hydrogenated defects offer smaller charge densities that allow hydrogen molecule to pass through the nanotube wall for storing hydrogen inside the nanotubes. Our optimum reaction pathway search revealed that hydrogen molecules could indeed go through a hydrogenated defect site with relatively small energy barriers compared to the pristine nanotube wall. The calculated activation energies for different diameters suggest a preferential diameter range for optimum hydrogen storage in defective boron nitride nanotubes. (author)

  1. Eight-point Compass Rose Underlay Technique in 72 Consecutive Elderly Patients with Large Incisional Hernia

    Directory of Open Access Journals (Sweden)

    Attilio Ignazio Lo Monte

    2011-09-01

    Conclusion: This surgical procedure, like laparoscopic treatment, allows the surgeon to avoid dissection of the abdominal layer and improves prosthesis adhesion with reinforcement of the incisional area near the abdominal defect. The reduction in operation time is remarkable. Despite good results in terms of safety and minimal recurrence for laparoscopy in the management of IH, the use of minimally invasive techniques for large incisional wall defects, especially in elderly patients, is still controversial and practiced by few surgeons. This open technique avoids cardiopulmonary complications arising from pneumoperitoneum in the elderly.

  2. Limb body wall complex: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Panduranga Chikkannaiah

    2013-01-01

    Full Text Available We present autopsy findings of a case of limb body wall complex (LBWC. The fetus had encephalocele, genitourinary agenesis, skeletal anomalies and body wall defects. The rare finding in our case is the occurrence of both cranial and urogenital anomalies. The presence of complex anomalies in this fetus, supports embryonal dysplasia theory of pathogenesis for LBWC.

  3. Síntese de colágeno após a implantação de telas de polipropileno em parede abdominal de ratos jovens e velhos Collagen synthesis after the implantation of polypropylene nets in the abdominal wall of young and old rats

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Pessole Biondo-Simões

    2005-08-01

    collagen I and III synthesis, and still others have reported normal synthesis. The objective of the present study was to determine the collagen deposition occurring through the pores of a propylene net implanted in the abdominal wall of young adult rats compared to old rats. METHODS: Ten male rats aged 100 to 120 days and 10 rats aged 850 to 900 days were used. Under inhalatory anesthesia, a median incision was made in the ventral abdominal wall and a 4 cm² gap was formed. The muscle-aponeurosis plane was removed and the peritoneal plane was maintained. The gap was corrected with a polypropylene mesh fixed with separate 5.0 polypropylene sutures and the skin margins were joined. The animals were sacrificed 30 days later and the ventral abdominal wall with the prosthesis was removed. The flap with the graft was divided into 2 parts, one for the traction assay and the other for histopathological study. The sections obtained were stained with hematoxylin-eosin and Sirius-red and examined under a polarized light microscope using the Image Plus software. RESULTS: The traction assay did not demonstrate a significant difference in resistance between groups. An acute-chronic inflammatory reaction with large quantities of giant foreign body cells was present at similar intensity in both groups, the same being observed for total collagen concentration (p=0.1440 and type I collagen concentration (p=0.3981. In contrast, type III collagen concentration was higher in the sections from old animals (p=0.0364. CONCLUSIONS: These results permit us to conclude that aging does not impair the resistance gain or collagen deposition, although a delayed tissue maturation occurs.

  4. Fluid, solid and fluid-structure interaction simulations on patient-based abdominal aortic aneurysm models.

    Science.gov (United States)

    Kelly, Sinead; O'Rourke, Malachy

    2012-04-01

    This article describes the use of fluid, solid and fluid-structure interaction simulations on three patient-based abdominal aortic aneurysm geometries. All simulations were carried out using OpenFOAM, which uses the finite volume method to solve both fluid and solid equations. Initially a fluid-only simulation was carried out on a single patient-based geometry and results from this simulation were compared with experimental results. There was good qualitative and quantitative agreement between the experimental and numerical results, suggesting that OpenFOAM is capable of predicting the main features of unsteady flow through a complex patient-based abdominal aortic aneurysm geometry. The intraluminal thrombus and arterial wall were then included, and solid stress and fluid-structure interaction simulations were performed on this, and two other patient-based abdominal aortic aneurysm geometries. It was found that the solid stress simulations resulted in an under-estimation of the maximum stress by up to 5.9% when compared with the fluid-structure interaction simulations. In the fluid-structure interaction simulations, flow induced pressure within the aneurysm was found to be up to 4.8% higher than the value of peak systolic pressure imposed in the solid stress simulations, which is likely to be the cause of the variation in the stress results. In comparing the results from the initial fluid-only simulation with results from the fluid-structure interaction simulation on the same patient, it was found that wall shear stress values varied by up to 35% between the two simulation methods. It was concluded that solid stress simulations are adequate to predict the maximum stress in an aneurysm wall, while fluid-structure interaction simulations should be performed if accurate prediction of the fluid wall shear stress is necessary. Therefore, the decision to perform fluid-structure interaction simulations should be based on the particular variables of interest in a given

  5. Splanchnic and renal deterioration during and after laparoscopic cholecystectomy: a comparison of the carbon dioxide pneumoperitoneum and the abdominal wall lift method.

    Science.gov (United States)

    Koivusalo, A M; Kellokumpu, I; Ristkari, S; Lindgren, L

    1997-10-01

    Carbon dioxide (CO2) pneumoperitoneum together with an increased intraabdominal pressure (IAP) induces a hemodynamic stress response, diminishes urine output, and may compromise splanchnic perfusion. A new retractor method may be less traumatic. Accordingly, 30 ASA physical status I or II patients undergoing laparoscopic cholecystectomy were randomly allocated to a CO2 pneumoperitoneum (IAP 12-13 mm Hg) (control) or to a gasless abdominal wall lift method (retractor) group. Anesthesia and intravascular fluids were standardized. Direct mean arterial pressure (MAP), urine output, urine-N-acetyl-beta-D-glucosaminidase (U-NAG), arterial blood gases, gastric mucosal PCO2, and intramucosal pH (pHi) were measured. Normoventilation was instituted in all patients. MAP increased (P mechanical retractor method (gasless) was compared with conventional CO2 pneumoperitoneum for laparoscopic cholestectomy. The gasless method ensured stable hemodynamics, prevented respiratory acidosis, and provided protection against the renal and splanchnic ischemia seen with CO2 pneumoperitoneum.

  6. Research Status of the Skeletalre Construction of Chest Wall

    Directory of Open Access Journals (Sweden)

    Daixing ZHONG

    2018-04-01

    Full Text Available Chest wall defect may be caused by many factors such as the resection of tumor and trauma, and the reconstruction of bone-defection is still the key point of thoracic surgery. With the development of material science, more and more new materials have been used in medical practice, which makes huge progress in the surgery of chest wall. However, none of these materials satisfy all the practical needs of the reconstruction. Recently, with the development of the capacity of computer, 3D-printing technology has been gradually used in clinical work, and the idea of individual treatment has been accepted by more and more people. The weakness of these materials may be solved by the new material and the application of individual treatment, which could also make great advance in chest wall surgery. This article will make a summary of the research on the reconstruction of chest wall.

  7. Omphalocele repair - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100033.htm Omphalocele repair - series—Normal anatomy To use the sharing ... Go to slide 4 out of 4 Overview Omphalocele is an abdominal wall defect at the base ...

  8. A novel diagnostic aid for intra-abdominal adhesion detection in cine-MR imaging: Pilot study and initial diagnostic impressions.

    Science.gov (United States)

    Randall, David; Joosten, Frank; ten Broek, Richard; Gillott, Richard; Bardhan, Karna Dev; Strik, Chema; Prins, Wiesje; van Goor, Harry; Fenner, John

    2017-07-14

    A non-invasive diagnostic technique for abdominal adhesions is not currently available. Capture of abdominal motion due to respiration in cine-MRI has shown promise, but is difficult to interpret. This article explores the value of a complimentary diagnostic aid to facilitate the non-invasive detection of abdominal adhesions using cine-MRI. An image processing technique was developed to quantify the amount of sliding that occurs between the organs of the abdomen and the abdominal wall in sagittal cine-MRI slices. The technique produces a 'sheargram' which depicts the amount of sliding which has occurred over 1-3 respiratory cycles. A retrospective cohort of 52 patients, scanned for suspected adhesions, made 281 cine-MRI sagittal slices available for processing. The resulting sheargrams were reported by two operators and compared to expert clinical judgement of the cine-MRI scans. The sheargram matched clinical judgement in 84% of all sagittal slices and 93-96% of positive adhesions were identified on the sheargram. The sheargram displayed a slight skew towards sensitivity over specificity, with a high positive adhesion detection rate but at the expense of false positives. Good correlation between sheargram and absence/presence of inferred adhesions indicates quantification of sliding motion has potential to aid adhesion detection in cine-MRI. Advances in Knowledge: This is the first attempt to clinically evaluate a novel image processing technique quantifying the sliding motion of the abdominal contents against the abdominal wall. The results of this pilot study reveal its potential as a diagnostic aid for detection of abdominal adhesions.

  9. Multidetector CT findings of bowel Transection in blunt abdominal trauma

    International Nuclear Information System (INIS)

    Cho, Hyun Suk; Woo, Ji Young; Hong, Hye Suk; Park, Mee Hyun; Yang, Ik; Lee, Yul; Jung, Ah Young; Hwang, Ji Young; Ha, Hong Il

    2013-01-01

    Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.

  10. Tensile strength study of the abdominal wall following laparotomy synthesis using three types of surgical wires in Wistar rats Estudo da resistência tênsil da parede abdominal após síntese de laparotomia usando três tipos de fios cirúrgicos em ratos Wistar

    Directory of Open Access Journals (Sweden)

    Lucas Félix Rossi

    2008-02-01

    Full Text Available PURPOSE: To study the tensile strength of the abdominal wall following laparotomy synthesis utilizing three types of surgical wires. METHODS: Thirty Wistar rats were randomized into three groups of ten rats each. Each group underwent a 3cm-laparotomy which was closed with 3-0 polyglactin 910, polyglecrapone and catgut wires. After 63 days, euthanasia was performed and part of the abdominal wall was removed with which a strip was produced measuring 2.0 cm in length by 6.0 cm in width comprising the abdominal muscles with the implanted mesh. The sample was fixed in a mechanical test machine in which constant force was applied contrary to the tissue strips. Maximum force was considered, expressed in Newton, until full rupture of the tissue occurred. The non-parametrical Kruskal - Wallis test was used for the statistical analysis, admitting pOBJETIVO: Estudar a resistência tênsil da parede abdominal após síntese de laparotomia utilizando três tipos de fios cirúrgicos. MÉTODOS: Trinta ratos da linhagem Wistar randomizados em três grupos de dez exemplares cada um. Em cada grupo fez-se uma laparotomia de dois centímetros que foi fechada com fios 3-0 de poliglactina 910, poliglecaprone e categute. Após 63 dias, foi feita a eutanásia e retirou-se uma área da parede abdominal com a qual fez-se uma tira medindo 2,0 cm de comprimento por 6,0 cm de largura englobando os músculos abdominais com a tela implantada. A amostra foi fixada em máquina de ensaios mecânicos na qual se aplicou força constante contrária às tiras de tecido. Foi considerada a força máxima expressa em Newton até ocorrer a ruptura total da amostra. Para a análise estatística, utilizou-se teste não paramétrico de Kruskal - Wallis admitindo-se p<0,05. RESULTADOS: A média de resistência do grupo categute foi ligeiramente menor (33.50 N ao da poliglactina (34.23 N, sendo essa diferença não estatisticamente significativa (p=0,733. O grupo poliglecaprone foi o que

  11. Leak before break behaviour of austenitic and ferritic pipes containing circumferential defects

    Energy Technology Data Exchange (ETDEWEB)

    Stadtmueller, W.; Sturm, D.

    1997-04-01

    Several research projects carried out at MPA Stuttgart to investigate the Leak-before-Break (LBB) behavior of safety relevant pressure bearing components are summarized. Results presented relate to pipes containing circumferential defects subjected to internal pressure and external bending loading. An overview of the experimentally determined results for ferritic components is presented. For components containing postulated or actual defects, the dependence of the critical loading limit on the defect size is shown in the form of LBB curves. These are determined experimentally and/or by calculation for through-wall slits, and represent the boundary curve between leakage and massive fracture. For surface defects and a given bending moment and internal pressure, no fracture will occur if the length at leakage remains smaller than the critical defect length given by the LBB curve for through-wall defects. The predictive capability of engineering calculational methods are presented by way of example. The investigation programs currently underway, testing techniques, and initial results are outlined.

  12. CFD Modelling of Abdominal Aortic Aneurysm on Hemodynamic Loads Using a Realistic Geometry with CT

    Directory of Open Access Journals (Sweden)

    Eduardo Soudah

    2013-01-01

    Full Text Available The objective of this study is to find a correlation between the abdominal aortic aneurysm (AAA geometric parameters, wall stress shear (WSS, abdominal flow patterns, intraluminal thrombus (ILT, and AAA arterial wall rupture using computational fluid dynamics (CFD. Real AAA 3D models were created by three-dimensional (3D reconstruction of in vivo acquired computed tomography (CT images from 5 patients. Based on 3D AAA models, high quality volume meshes were created using an optimal tetrahedral aspect ratio for the whole domain. In order to quantify the WSS and the recirculation inside the AAA, a 3D CFD using finite elements analysis was used. The CFD computation was performed assuming that the arterial wall is rigid and the blood is considered a homogeneous Newtonian fluid with a density of 1050 kg/m3 and a kinematic viscosity of 4×10-3 Pa·s. Parallelization procedures were used in order to increase the performance of the CFD calculations. A relation between AAA geometric parameters (asymmetry index (β, saccular index (γ, deformation diameter ratio (χ, and tortuosity index (ε and hemodynamic loads was observed, and it could be used as a potential predictor of AAA arterial wall rupture and potential ILT formation.

  13. CT diagnosis of abdominal abscess in children

    International Nuclear Information System (INIS)

    Li Xin; Yang Zhiyong

    1998-01-01

    Purpose: To evaluate CT in the diagnosis of abdominal abscess in children. Methods: Analysis of CT manifestations in 23 cases proved by operation and needle aspiration. Causes: acute appendicitis 13 cases, ascending colon perforation 1 case, Meckel diverticulitis 2 cases, cause obscured 7 cases. Bolus injection of contrast medium was given in 19 cases. Results: The CT value had no relationship to the course of disease and type of bacteria, amount of abscess had positive relevance relative with course of illness. Air-fluid level or scattered gas bubbles was seen in abscesses in 52%; little calcified plague was present in 22%. All cases presented nonhomogeneous thick wall enhancement after one week of illness. Conclusion: The characteristic CT features of intra-abdominal abscess were the presence of air and little calcified plague shadow; a large air-fluid level was indicative of fistula, while the absence of air in the abscess can not exclude fistula

  14. Expert consensus document

    DEFF Research Database (Denmark)

    Brioude, Frédéric; Kalish, Jennifer M; Mussa, Alessandro

    2018-01-01

    Beckwith-Wiedemann syndrome (BWS), a human genomic imprinting disorder, is characterized by phenotypic variability that might include overgrowth, macroglossia, abdominal wall defects, neonatal hypoglycaemia, lateralized overgrowth and predisposition to embryonal tumours. Delineation of the molecu...

  15. Transversus abdominal plane (TAP) block for postoperative pain management: a review.

    Science.gov (United States)

    Jakobsson, Jan; Wickerts, Liselott; Forsberg, Sune; Ledin, Gustaf

    2015-01-01

    Transversus abdominal plane (TAP) block has a long history and there is currently extensive clinical experience around TAP blocks. The aim of this review is to provide a summary of the present evidence on the effects of TAP block and to provide suggestions for further studies. There are several approaches to performing abdominal wall blocks, with the rapid implementation of ultrasound-guided technique facilitating a major difference in TAP block performance. During surgery, an abdominal wall block may also be applied by the surgeon from inside the abdominal cavity. Today, there are more than 11 meta-analyses providing a compiled evidence base around the effects of TAP block. These analyses include different procedures, different techniques of TAP block administration and, importantly, they compare the TAP block with a variety of alternative analgesic regimes. The effects of TAP block during laparoscopic cholecystectomy seem to be equivalent to local infiltration analgesia and also seem to be beneficial during laparoscopic colon resection. The effects of TAP are more pronounced when it is provided prior to surgery and these effects are local anaesthesia dose-dependent. TAP block seems an interesting alternative in patients with, for example, severe obesity where epidural or spinal anaesthesia/analgesia is technically difficult and/or poses a risk. There is an obvious need for further high-quality studies comparing TAP block prior to surgery with local infiltration analgesia, single-shot spinal analgesia, and epidural analgesia. These studies should be procedure-specific and the effects should be evaluated, both regarding short-term pain and analgesic requirement and also including the effects on postoperative nausea and vomiting, recovery of bowel function, ambulation, discharge, and protracted recovery outcomes (assessed by e.g., postoperative quality of recovery scale).

  16. Inflaton fluctuations in the presence of cosmological defects

    Science.gov (United States)

    Cho, Hing-Tong; Ng, Kin-Wang; Wang, I.-Chin

    2014-11-01

    We study quantum fluctuations of a free massless scalar field during inflation in the presence of a point, line, or plane defect such as a black hole, cosmic string, or domain wall, using a perturbative expansion in powers of small defect parameters. We provide results for the scalar two-point correlation functions that show explicitly a small violation of translational invariance during inflation.

  17. Comparative study of abdominal cavity temporary closure techniques for damage control

    Directory of Open Access Journals (Sweden)

    MARCELO A. F. RIBEIRO JR

    Full Text Available ABSTRACT The damage control surgery, with emphasis on laparostomy, usually results in shrinkage of the aponeurosis and loss of the ability to close the abdominal wall, leading to the formation of ventral incisional hernias. Currently, various techniques offer greater chances of closing the abdominal cavity with less tension. Thus, this study aims to evaluate three temporary closure techniques of the abdominal cavity: the Vacuum-Assisted Closure Therapy - VAC, the Bogotá Bag and the Vacuum-pack. We conducted a systematic review of the literature, selecting 28 articles published in the last 20 years. The techniques of the bag Bogotá and Vacuum-pack had the advantage of easy access to the material in most centers and low cost, contrary to VAC, which, besides presenting high cost, is not available in most hospitals. On the other hand, the VAC technique was more effective in reducing stress at the edges of lesions, removing stagnant fluids and waste, in addition to acting at the cellular level by increasing proliferation and cell division rates, and showed the highest rates of primary closure of the abdominal cavity.

  18. The aspects regarding plugging the defective tubes of the steam generator using plastic deformation of the plug wall by conventional or unconventional techniques

    International Nuclear Information System (INIS)

    Gyongyosi, Tiberiu

    2006-01-01

    After a brief introduction the advantages and disadvantages of two plugging methods of the defective tubes from steam generator by plastic deformation of the wall of the plug, deformation performed by mechanical rolling (conventional technique) and by electrohydraulic shock (unconventional technique), respectively, are showed. The paper gives the results of the experimental tests to install the plugs at the end of the tube having the same geometry with those of the steam generator, the performance reached in this stage and some conclusions in the end

  19. Structural domain walls in polar hexagonal manganites

    Science.gov (United States)

    Kumagai, Yu

    2014-03-01

    The domain structure in the multiferroic hexagonal manganites is currently intensely investigated, motivated by the observation of intriguing sixfold topological defects at their meeting points [Choi, T. et al,. Nature Mater. 9, 253 (2010).] and nanoscale electrical conductivity at the domain walls [Wu, W. et al., Phys. Rev. Lett. 108, 077203 (2012).; Meier, D. et al., Nature Mater. 11, 284 (2012).], as well as reports of coupling between ferroelectricity, magnetism and structural antiphase domains [Geng, Y. et al., Nano Lett. 12, 6055 (2012).]. The detailed structure of the domain walls, as well as the origin of such couplings, however, was previously not fully understood. In the present study, we have used first-principles density functional theory to calculate the structure and properties of the low-energy structural domain walls in the hexagonal manganites [Kumagai, Y. and Spaldin, N. A., Nature Commun. 4, 1540 (2013).]. We find that the lowest energy domain walls are atomically sharp, with {210}orientation, explaining the orientation of recently observed stripe domains and suggesting their topological protection [Chae, S. C. et al., Phys. Rev. Lett. 108, 167603 (2012).]. We also explain why ferroelectric domain walls are always simultaneously antiphase walls, propose a mechanism for ferroelectric switching through domain-wall motion, and suggest an atomistic structure for the cores of the sixfold topological defects. This work was supported by ETH Zurich, the European Research Council FP7 Advanced Grants program me (grant number 291151), the JSPS Postdoctoral Fellowships for Research Abroad, and the MEXT Elements Strategy Initiative to Form Core Research Center TIES.

  20. Platelet rich fibrin in jaw defects

    Science.gov (United States)

    Nica, Diana; Ianes, Emilia; Pricop, Marius

    2016-03-01

    Platelet rich fibrin (PRF) is a tissue product of autologous origin abundant in growth factors, widely used in regenerative procedures. Aim of the study: Evaluation of the regenerative effect of PRF added in the bony defects (after tooth removal or after cystectomy) Material and methods: The comparative nonrandomized study included 22 patients divided into 2 groups. The first group (the test group) included 10 patients where the bony defects were treated without any harvesting material. The second group included 12 patients where the bony defects were filled with PRF. The bony defect design was not critical, with one to two walls missing. After the surgeries, a close clinically monitoring was carried out. The selected cases were investigated using both cone beam computer tomography (CBCT) and radiographic techniques after 10 weeks postoperatively. Results: Faster bone regeneration was observed in the bony defects filled with PRF comparing with the not grafted bony defects. Conclusions: PRF added in the bony defects accelerates the bone regeneration. This simplifies the surgical procedures and decreases the economic costs.

  1. VACUUM THERAPY VERSUS ABDOMINAL EXERCISES ON ABDOMINAL OBESITY

    Directory of Open Access Journals (Sweden)

    Nevein Mohammed Mohammed Gharib

    2016-06-01

    Full Text Available Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week. All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05. Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.

  2. Evaluation of peritoneal adhesions formation and tissue response to polypropylene - poli (2-hydroxyethyl methacrylate-(polyHEMA implant on rats' abdominal wall Avaliação da formação de aderências peritoneais e da resposta tecidual ao implante de poli (2-hidroxietil dimetacrilato-(poliHEMA na parede abdominal de ratos

    Directory of Open Access Journals (Sweden)

    Neusa Margarida Paulo

    2010-08-01

    Full Text Available PURPOSE: To verify if the composit poli (2-hydroxyethyl methacrylate-PolyHEMA/polypropylene mesh implanted in the female rat's abdominal wall could be suitable for the prevention of peritoneal adhesions, and for the evaluation of the tecidual response produced by this biomaterial. METHODS: Polypropylene meshes (Group PP, n=20 and polypropylene meshes coated with a layer of poli (2-hydroxyethyl methacrylate-PolyHEMA (Group PH, n=20 were implanted on the abdominal wall of Wistar female rats. Ten animals from each group were submitted to euthanasia at 15 and 30 days of the postoperative period. RESULTS: The animals from the group PP presented visceral adhesions on the mesh surface, which was not observed in the ones from group PH. At the histopathological examination foreign body response was observed in both groups, whilst there was a greater intensity of inflammatory response in group PH on both moments. CONCLUSION: The poli (2-hydroxyethyl methacrylate polyHEMA hydrogel associated to polypropylene mesh reduces visceral adhesion formation in rats, although it may be associated to greater inflammatory reaction.OBJETIVO: Verificar se compósito poli 2-hidroxietil dimetacrilato (PoliHEMA / tela de polipropileno implantado na parede abdominal de ratas seria adequado para prevenção de aderências peritoneais e avaliar a resposta tecidual desencadeada por este biomaterial. MÉTODOS: Foram implantadas telas de polipropileno - Grupo PP (n=20 e telas de polipropileno revestidas por uma camada de poli 2 (hidroxietil dimetacrilato-PolyHEMA - Grupo PH (n=20 na parede abdominal de ratas da linhagem Wistar. Dez animais de cada grupo foram submetidos à eutanásia aos 15 e 30 dias de pós-operatório. RESULTADOS: Os animais do grupo PP apresentaram aderências viscerais na superfície da tela, o que não foi observado nos do grupo PH. Observou-se no exame histopatológico resposta tipo corpo estranho nos dois grupos sendo que no grupo PH houve maior

  3. A micromagnetic study of the oscillations of pinned domain walls in magnetic ribbons

    Energy Technology Data Exchange (ETDEWEB)

    Alejos, Oscar [Dpto. Electricidad y Electronica, Universidad de Valladolid, 47071 Valladolid (Spain)]. E-mail: oscaral@ee.uva.es; Torres, Carlos [Dpto. Electricidad y Electronica, Universidad de Valladolid, 47071 Valladolid (Spain); Hernandez-Gomez, Pablo [Dpto. Electricidad y Electronica, Universidad de Valladolid, 47071 Valladolid (Spain); Lopez-Diaz, Luis [Dpto. Fisica Aplicada, Universidad de Salamanca, 37071 Salamanca (Spain); Torres, Luis [Dpto. Fisica Aplicada, Universidad de Salamanca, 37071 Salamanca (Spain); Martinez, Eduardo [Dpto. Ingenieria Electromecanica, Universidad de Burgos, 09001 Burgos (Spain)

    2007-09-15

    The work studies the dynamics of domain walls in magnetic ribbons with thicknesses of the order of magnitude of the permalloy exchange length (5.7 nm) by means of micromagnetic simulations. Two small defects are symmetrically placed on both edges of the ribbon, one on each edge, occupying the whole ribbon thickness. One transverse domain wall is pinned by the defects, in a head-to-head configuration. A free wall oscillation is forced by applying a static external magnetic field in the direction of the large axis until the wall reaches a new equilibrium position (elongation), and then removed. Three dynamic regimes are observed depending on the size of the cross ribbon section.

  4. A micromagnetic study of the oscillations of pinned domain walls in magnetic ribbons

    International Nuclear Information System (INIS)

    Alejos, Oscar; Torres, Carlos; Hernandez-Gomez, Pablo; Lopez-Diaz, Luis; Torres, Luis; Martinez, Eduardo

    2007-01-01

    The work studies the dynamics of domain walls in magnetic ribbons with thicknesses of the order of magnitude of the permalloy exchange length (5.7 nm) by means of micromagnetic simulations. Two small defects are symmetrically placed on both edges of the ribbon, one on each edge, occupying the whole ribbon thickness. One transverse domain wall is pinned by the defects, in a head-to-head configuration. A free wall oscillation is forced by applying a static external magnetic field in the direction of the large axis until the wall reaches a new equilibrium position (elongation), and then removed. Three dynamic regimes are observed depending on the size of the cross ribbon section

  5. Data fusion of ultrasound and GPR signals for analysis of historic walls

    International Nuclear Information System (INIS)

    Salazar, A; Gosalbez, J; Safont, G; Vergara, L

    2012-01-01

    This paper presents an application of ultrasounds and ground-penetrating radar (GPR) for analysis of historic walls. The objectives are to characterize the deformation of a historic wall under different levels of load weights and to obtain an enhanced image of the wall. A new method that fuses data from ultrasound and GPR traces is proposed which is based on order statistics digital filters. Application results are presented for non destructive testing (NDT) of two replicates of historic ashlars' masonry walls: the first one homogeneous and the second one containing controlled defects such as cracks and nooks. The walls are measured separately using ultrasounds and GPR at different load steps. Time and frequency parameters extracted from the signals and different B-Scans for each of the NDT techniques are obtained. After this, a new fused representation is obtained, which results demonstrate the improvement of characterization and defect detection in historic walls using data fusion.

  6. Reduced Wall Acetylation Proteins Play Vital and Distinct Roles in Cell Wall O-Acetylation in Arabidopsis

    DEFF Research Database (Denmark)

    Manabe, Yuzuki; Verhertbruggen, Yves; Gille, Sascha

    2013-01-01

    The Reduced Wall Acetylation (RWA) proteins are involved in cell wall acetylation in plants. Previously, we described a single mutant, rwa2, which has about 20% lower level of O-acetylation in leaf cell walls and no obvious growth or developmental phenotype. In this study, we generated double....... The quadruple rwa mutant can be completely complemented with the RWA2 protein expressed under 35S promoter, indicating the functional redundancy of the RWA proteins. Nevertheless, the degree of acetylation of xylan, (gluco) mannan, and xyloglucan as well as overall cell wall acetylation is affected differently...... in different combinations of triple mutants, suggesting their diversity in substrate preference. The overall degree of wall acetylation in the rwa quadruple mutant was reduced by 63% compared with the wild type, and histochemical analysis of the rwa quadruple mutant stem indicates defects in cell...

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

    Directory of Open Access Journals (Sweden)

    Tanasković Irena

    2013-01-01

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

  8. Superior vesical fissure concealed by giant omphalocele: A case report

    OpenAIRE

    Hayek, Danial; Massanyi, Eric; Mancuso, Melissa; Krepkovich, Katherine; Garrison, Aaron

    2016-01-01

    Omphalocele is an abdominal wall defect characterized by exteriorization of abdominal viscera that is covered by a membrane. Omphalocele has a well-known association with chromosome abnormalities. Here we present a case of a superior vesical fissure (SVF) initially disguised as a giant omphalocele in a newborn with trisomy 18. We also show unique prenatal imaging and discuss the importance and limitations of prenatal genetic testing.

  9. The radiology of abdominal calcification including demonstration of a readily useful and comprehensive classification scheme

    Energy Technology Data Exchange (ETDEWEB)

    Baker, S R [University Hospital, Newark, New Jersey (United States)

    1996-12-31

    The analysis of abdominal calcifications and other radiopacities on plain radiographs is often a diagnostic challenge. Occasionally, historical information will be a value; at times, physical examination will contribute important clues. Laboratory date such as the presence of microscopic hematuria will sometimes be helpful. Yet, very frequently, the appearance of the opacity is unexpected. The contents are morphology; concretions; conduit wall, cyst wall, solid mass calcification; mobility; effect of respiration; effect of peristalsis, growth of masses.

  10. The radiology of abdominal calcification including demonstration of a readily useful and comprehensive classification scheme

    International Nuclear Information System (INIS)

    Baker, S.R.

    1995-01-01

    The analysis of abdominal calcifications and other radiopacities on plain radiographs is often a diagnostic challenge. Occasionally, historical information will be a value; at times, physical examination will contribute important clues. Laboratory date such as the presence of microscopic hematuria will sometimes be helpful. Yet, very frequently, the appearance of the opacity is unexpected. The contents are morphology; concretions; conduit wall, cyst wall, solid mass calcification; mobility; effect of respiration; effect of peristalsis, growth of masses

  11. [Use and versatility of titanium for the reconstruction of the thoracic wall].

    Science.gov (United States)

    Córcoles Padilla, Juan Manuel; Bolufer Nadal, Sergio; Kurowski, Krzysztof; Gálvez Muñoz, Carlos; Rodriguez Paniagua, José Manuel

    2014-02-01

    Chest wall deformities/defects and chest wall resections, as well as complex rib fractures require reconstruction with various prosthetic materials to ensure the basic functions of the chest wall. Titanium provides many features that make it an ideal material for this surgery. The aim is to present our initial results with this material in several diseases. From 2008 to 2012, 14 patients were operated on and titanium was used for reconstruction of the chest wall. A total of 7 patients had chest wall tumors, 2 with sternal resection, 4 patients with chest wall deformities/defects and 3 patients with severe rib injury due to traffic accident. The reconstruction was successful in all cases, with early extubation without detecting problems in the functionality of the chest wall at a respiratory level. Patients with chest wall tumors including sternal resections were extubated in the operating room as well as the chest wall deformities. Chest trauma cases were extubated within 24h from internal rib fixation. There were no complications related to the material used and the method of implementation. Titanium is an ideal material for reconstruction of the chest wall in several clinical situations allowing for great versatility and adaptability in different chest wall reconstructions. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  12. Apparatus for treating the walls and floor of the pelvic cavity with radiation

    International Nuclear Information System (INIS)

    Clayton, R.S.

    1975-01-01

    An apparatus for reaing carcinoma of the walls and floor of the pelvic cavity is described. An elongated tube has an inner end adapted to be placed in the pelvic cavity and an outer end adapted to extend through to the outside of the body. Radioactive material is placed at the inner end. An inner balloon above the radioactive material is inflated to hold a body of liquid shielding material such as mercury. A lower balloon portion beneath the inner balloon spaces areas to be treated such as the walls and floor of the pelvic cavity from the radioactive material. An upper balloon portion above the inner balloon keeps the intestines out of the pelvic cavity and away from the radioactive material. The apparatus is inserted into the pelvic cavity through an abdominal incision. When treating a woman for carcinoma in the walls and floor of the pelvic cavity the tube is moved through the vaginal passage from the inside outwardly. When treating a woman with a closed vaginal passage, as may result from surgery, or when treating a man, such as for carcinoma of the bladder, the tube will pass out of the body through a lower abdominal incision. Following treatment, all balloons are deflated so that the apparatus can be withdrawn through the vaginal passage or the lower abdominal incision, as the case may be. (auth)

  13. Prenatal ultrasonographic findings of cloacal anomaly

    International Nuclear Information System (INIS)

    Song, Mi Jin

    2002-01-01

    To evaluate the ultrasonographic characteristic of a rare malformation comples, Cloacal anomaly on prenatal ultrasonography. From March 1991 to July 2001, eight cases with the persistent cloaca (4 cases in female and 1 case in male) and cloacal exstrophy (3 cases) diagnosed by prenatal ultrasound examination were included, and all of them were pathologically confirmed by autopsy. One radiologist retrospectively analyzed the prenatal sonographic images, including the urinary bladder, kidney, pelvic cyst, abdominal wall defect and amount of amniotic fluid. The ultrasonographic diagnosis was established at 21.8 ± 7.8 weeks of gestation. The prenatal ultrasonographic findings of the persistent cloaca were absent bladder (n=2), distended bladder (n=2) and small thick bladder (n=1). Sonography of the kidney showed normal (n=2), hydronephrosis (n=1), dysplasia (n=1) and unilateral hydronephrosis with absent contralateral kidney (n=1). Four fetuses showed septated pelvic cyst; three fetuses, oligohydramnios. The prenatal ultrasonographic findings of cloacal exstrophy included absent bladder (n=3), normal kidney (n=1), hydronephrosis (n=1) and absent kidney (n=1). All fetuses with cloacal exstrophy had abdominal wall defect while two of them had oligohydramnios. A prenatal diagnosis of persistent cloaca can be confidently made when there is septated pelvic cyst combined oligohydramnios, sediments within the cyst and intraluminal calcifications. Cloacal exstrophy should be included in diagnosis if there is a low abdominal wall defect with absent urinary bladder.

  14. An Intra-Abdominal Desmoid Tumor, Embedded in the Pancreas, Preoperatively Diagnosed as an Extragastric Growing Gastrointestinal Stromal Tumor

    Directory of Open Access Journals (Sweden)

    Mari Mizuno

    2017-04-01

    Full Text Available A 45-year-old woman was found to have a pancreatic tumor by abdominal ultrasound performed for a medical check-up. Abdominal contrast-enhanced computed tomography showed a hypovascular tumor measuring 30 mm in diameter in the pancreatic tail. Endoscopic ultrasound-guided fine needle aspiration was performed. An extragastric growing gastrointestinal stromal tumor was thereby diagnosed preoperatively, and surgical resection was planned. Laparoscopic surgery was attempted but conversion to open surgery was necessitated by extensive adhesions, and distal pancreatectomy, splenectomy, and partial gastrectomy were performed. The histological diagnosis was an intra-abdominal desmoid tumor. A desmoid tumor is a fibrous soft tissue tumor arising in the fascia and musculoaponeurotic tissues. It usually occurs in the extremities and abdominal wall, and only rarely in the abdominal cavity. We experienced a case with an intra-abdominal desmoid tumor that was histologically diagnosed after laparotomy, which had been preoperatively diagnosed as an extragastric growing gastrointestinal stromal tumor. Although rare, desmoid tumors should be considered in the differential diagnosis of intra-abdominal tumors. Herein, we report this case with a literature review.

  15. γ-Aminobutyric acid transaminase deficiency impairs central carbon metabolism and leads to cell wall defects during salt stress in Arabidopsis roots.

    Science.gov (United States)

    Renault, Hugues; El Amrani, Abdelhak; Berger, Adeline; Mouille, Grégory; Soubigou-Taconnat, Ludivine; Bouchereau, Alain; Deleu, Carole

    2013-05-01

    Environmental constraints challenge cell homeostasis and thus require a tight regulation of metabolic activity. We have previously reported that the γ-aminobutyric acid (GABA) metabolism is crucial for Arabidopsis salt tolerance as revealed by the NaCl hypersensitivity of the GABA transaminase (GABA-T, At3g22200) gaba-t/pop2-1 mutant. In this study, we demonstrate that GABA-T deficiency during salt stress causes root and hypocotyl developmental defects and alterations of cell wall composition. A comparative genome-wide transcriptional analysis revealed that expression levels of genes involved in carbon metabolism, particularly sucrose and starch catabolism, were found to increase upon the loss of GABA-T function under salt stress conditions. Consistent with the altered mutant cell wall composition, a number of cell wall-related genes were also found differentially expressed. A targeted quantitative analysis of primary metabolites revealed that glutamate (GABA precursor) accumulated while succinate (the final product of GABA metabolism) significantly decreased in mutant roots after 1 d of NaCl treatment. Furthermore, sugar concentration was twofold reduced in gaba-t/pop2-1 mutant roots compared with wild type. Together, our results provide strong evidence that GABA metabolism is a major route for succinate production in roots and identify GABA as a major player of central carbon adjustment during salt stress. © 2012 Blackwell Publishing Ltd.

  16. 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

  17. 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.

  18. Topological defects from the multiverse

    Science.gov (United States)

    Zhang, Jun; Blanco-Pillado, Jose J.; Garriga, Jaume; Vilenkin, Alexander

    2015-05-01

    Many theories of the early universe predict the existence of a multiverse where bubbles continuously nucleate giving rise to observers in their interior. In this paper, we point out that topological defects of several dimensionalities will also be produced in de Sitter like regions of the multiverse. In particular, defects could be spontaneously nucleated in our parent vacuum. We study the evolution of these defects as they collide with and propagate inside of our bubble. We estimate the present distribution of defects in the observable part of the universe. The expected number of such nearby defects turns out to be quite small, even for the highest nucleation rate. We also study collisions of strings and domain walls with our bubble in our past light cone. We obtain simulated full-sky maps of the loci of such collisions, and find their angular size distribution. Similarly to what happens in the case of bubble collisions, the prospect of detecting any collisions of our bubble with ambient defects is greatly enhanced in the case where the cosmological constant of our parent vacuum is much higher than the vacuum energy density during inflation in our bubble.

  19. Topological defects from the multiverse

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jun [Institute of Cosmology, Department of Physics and Astronomy, Tufts University, Medford, MA 02155 (United States); Blanco-Pillado, Jose J. [Department of Theoretical Physics, University of the Basque Country UPV/EHU, 48080 Bilbao (Spain); IKERBASQUE, Basque Foundation for Science, 48013, Bilbao (Spain); Garriga, Jaume [Departament de Fisica Fonamental i Institut de Ciencies del Cosmos, Universitat de Barcelona, Marti i Franques, 1, 08028, Barcelona (Spain); Vilenkin, Alexander [Institute of Cosmology, Department of Physics and Astronomy, Tufts University, Medford, MA 02155 (United States)

    2015-05-28

    Many theories of the early universe predict the existence of a multiverse where bubbles continuously nucleate giving rise to observers in their interior. In this paper, we point out that topological defects of several dimensionalities will also be produced in de Sitter like regions of the multiverse. In particular, defects could be spontaneously nucleated in our parent vacuum. We study the evolution of these defects as they collide with and propagate inside of our bubble. We estimate the present distribution of defects in the observable part of the universe. The expected number of such nearby defects turns out to be quite small, even for the highest nucleation rate. We also study collisions of strings and domain walls with our bubble in our past light cone. We obtain simulated full-sky maps of the loci of such collisions, and find their angular size distribution. Similarly to what happens in the case of bubble collisions, the prospect of detecting any collisions of our bubble with ambient defects is greatly enhanced in the case where the cosmological constant of our parent vacuum is much higher than the vacuum energy density during inflation in our bubble.

  20. Topological defects from the multiverse

    International Nuclear Information System (INIS)

    Zhang, Jun; Vilenkin, Alexander; Blanco-Pillado, Jose J.; Garriga, Jaume

    2015-01-01

    Many theories of the early universe predict the existence of a multiverse where bubbles continuously nucleate giving rise to observers in their interior. In this paper, we point out that topological defects of several dimensionalities will also be produced in de Sitter like regions of the multiverse. In particular, defects could be spontaneously nucleated in our parent vacuum. We study the evolution of these defects as they collide with and propagate inside of our bubble. We estimate the present distribution of defects in the observable part of the universe. The expected number of such nearby defects turns out to be quite small, even for the highest nucleation rate. We also study collisions of strings and domain walls with our bubble in our past light cone. We obtain simulated full-sky maps of the loci of such collisions, and find their angular size distribution. Similarly to what happens in the case of bubble collisions, the prospect of detecting any collisions of our bubble with ambient defects is greatly enhanced in the case where the cosmological constant of our parent vacuum is much higher than the vacuum energy density during inflation in our bubble