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Sample records for abdominal wall defects

  1. Congenital Abdominal Wall Defects

    DEFF Research Database (Denmark)

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

    2016-01-01

    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......OBJECTIVE: To evaluate the clinical utility of GORE® DUALMESH (GDM) in the staged closure of large congenital abdominal wall defects. MATERIALS AND METHODS: Data of patients with congenital abdominal wall defects managed with GDM was analyzed for outcome regarding complete fascial closure; mesh...

  2. Pulmonary complications of abdominal wall defects.

    Science.gov (United States)

    Panitch, Howard B

    2015-01-01

    The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth and development that lead to pulmonary hypoplasia, pulmonary hypertension, and alterations in thoracic cage formation. Although infants with ventral abdominal wall defects can experience life-threatening pulmonary complications, older children typically experience a more benign respiratory course. Studies of lung and chest wall function in older children and adolescents with congenital abdominal wall defects are few; such investigations could provide strategies for improved respiratory performance, avoidance of respiratory morbidity, and enhanced exercise ability for these children.

  3. Genetics Home Reference: abdominal wall defect

    Science.gov (United States)

    ... Aug;6(4):232-6. Citation on PubMed Islam S. Clinical care outcomes in abdominal wall defects. Curr ... Site Map Customer Support Selection Criteria for Links USA.gov Copyright Privacy Accessibility FOIA Viewers & Players U.S. ...

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

    African Journals Online (AJOL)

    Prof. Oluwatosin

    2011-09-13

    Sep 13, 2011 ... defect with autologous tissues – a case report ... The anterior abdominal wall is a complex fascio-muscular structure, defects of which may ... The histology of the excised specimen, surprisingly, came back as a malignant ...

  5. 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.

  6. Autologous tissue repair of large abdominal wall defects.

    NARCIS (Netherlands)

    Vries Reilingh, T.S. de; Bodegom, M.E.; Goor, H. van; Hartman, E.H.M.; Wilt, G.J. van der; Bleichrodt, R.P.

    2007-01-01

    BACKGROUND AND METHOD: Techniques for autologous repair of abdominal wall defects that could not be closed primarily are reviewed. Medline and PubMed were searched for English or German publications using the following keywords: components separation technique (CST), Ramirez, da Silva, fascia lata,

  7. Reconstruction of complex abdominal wall defects

    NARCIS (Netherlands)

    Slater, N.J.

    2014-01-01

    Incisional hernia is by far the most common complication after laparotomies, occurring in 10 – 20%. Its occurrence is secondary to insufficient healing of the postoperative scar, resulting in wound dehiscence and protrusion of abdominal contents through an opening in the musculo-fascial layer of the

  8. Teratogens inducing congenital abdominal wall defects in animal models.

    Science.gov (United States)

    Van Dorp, Dennis R; Malleis, John M; Sullivan, Brian P; Klein, Michael D

    2010-02-01

    Congenital abdominal wall defects are common anomalies which include gastroschisis, omphalocele and umbilical cord hernia. Recent reports indicate that gastroschisis is increasing in prevalence, whereas omphalocele has remained steady, suggesting that environmental factors may play a part in their pathogenesis. The aim of this study is to review animal teratogen studies resulting in abdominal wall defects to investigate their possible causes. Each report was examined not only for the teratogens causing the defects, but also to carefully identify the defect occurring and its correlation with the known clinical anomalies. We found many discrepancies between the nomenclature used by animal teratology investigators and that used by clinicians. We were able to confirm the induction of gastroschisis by 22 teratogens, omphalocele by 9 teratogens and umbilical cord hernia by 8. There is no doubt that environmental factors may be responsible, at least in part, for all three of the clinical abdominal wall defects. Future studies should take care to appreciate the differences between these anomalies and describe them in detail, so that accurate and meaningful conclusions can be obtained.

  9. Congenital Abdominal Wall Defects: Staged closure by Dual Mesh.

    Science.gov (United States)

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

    2016-01-01

    To evaluate the clinical utility of GORE® DUALMESH (GDM) in the staged closure of large congenital abdominal wall defects. Data of patients with congenital abdominal wall defects managed with GDM was analyzed for outcome regarding complete fascial closure; mesh related complications; and post-discharge gastrointestinal surgery. 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-related. Of the 30 children discharged, 28 (82%) were still alive. At follow-up, three patients (10%) were operated for a minor ventral hernia and 4 children were operated (laparotomy and adhesionolysis) for adhesive intestinal obstruction. Staged closure with GDM is a safe alternative when primary fascial closure is difficult.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Kovačević Predrag

    2014-01-01

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

  12. 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...

  13. [Diagnostics and surgical correction of postoperative myofascial defects of lateral abdominal wall and lumbar region].

    Science.gov (United States)

    Brekhov, E I; Iurasov, A V; Gribunov, Iu P; Repin, I G; Alekseev, A K; Cherniaeva, N A; Zhitnikov, G V

    2009-01-01

    Myofascial defects of lateral abdominal wall and lumbar region occur chiefly after lumbotomy--the most popular access in urosurgery. Meanwhile lumbotomy remains one of the most traumatic accesses through the lateral abdominal wall. Myofascial defects were diagnosed in 48,9% of operated patients with lumbotomy. Of them true postoperative hernias were found in 35,3%; neuropathic hernias - in 13,6%. Since 2002 the originally developed method of lateral abdominal wall reconstruction had been used for the treatment of such patients. The immediate and long-term results (maximal follow-up period 5 years) showed no hernia recurrence or complications in 26 operated patients.

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

    NARCIS (Netherlands)

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

    1991-01-01

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

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

    Science.gov (United States)

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

    2001-01-01

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

  16. 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.

  17. Reconstruction with latissimus dorsi, external abdominal oblique and cranial sartorius muscle flaps for a large defect of abdominal wall in a dog after surgical removal of infiltrative lipoma

    OpenAIRE

    2016-01-01

    This animal was presented with a large-sized infiltrative lipoma in the abdominal wall that had been noted for 4 years. This lipoma was confirmed by histological examination from a previous biopsy, and the infiltrative features were identified by a computerized tomography scan. The surgical removal created a large-sized abdominal defect that was closed by a combination of latissimus dorsi and external abdominal oblique muscle flaps in a pedicle pattern. A small dehiscence at the most distal e...

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

    Directory of Open Access Journals (Sweden)

    Zhengni Liu

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

  19. Electrospun biodegradable microfibers induce new collagen formation in a rat abdominal wall defect model

    DEFF Research Database (Denmark)

    Chen, Menglin; Glindtvad, Cecilie; Vinge Nygaard, Jens

    2017-01-01

    Half of the female population over age 50 years will experience pelvic organ prolapse. We suggest a new approach based on tissue engineering principles to functionally reconstruct the anatomical structures of the pelvic floor. The aim of this study is to investigate the mechanical performance...... 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...... after 4 weeks with bFGF but signs of elastin fibers were seen at 24 weeks. The investigation showed that a biodegradable mesh promotes tissue formation with a promising strength. The mesh with bFGF did not represent any advantage on either long or short term in comparison to the mesh without b...

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

    Directory of Open Access Journals (Sweden)

    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.

  1. QUANTITATIVE INVIVO ASSESSMENT OF THE TISSUE-RESPONSE TO DERMAL SHEEP COLLAGEN IN ABDOMINAL-WALL DEFECTS

    NARCIS (Netherlands)

    HUNT, JA; VANDERLAAN, JS; SCHAKENRAAD, J; WILLIAMS, DF

    1993-01-01

    We quantified the tissue response, tissue organization and patency of biodegradable patches for the repair of abdominal wall defects. We used dermal sheep collagen, cross-linked with hexamethylenediisocyanate in a model. The collagen patches were implanted either untreated or plasma polymerized with

  2. 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

    1993-01-01

    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 ind

  3. 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.

  4. Abdominal wall fat pad biopsy

    Science.gov (United States)

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

  5. Biomechanical and morphological study of a new elastic mesh (Ciberlastic) to repair abdominal wall defects.

    Science.gov (United States)

    Calvo, B; Pascual, G; Peña, E; Pérez-Khöler, B; Rodríguez, M; Bellón, J M

    2016-06-01

    The aim of this study was to conduct a preclinical evaluation of the behaviour of a new type of abdominal LW prosthesis (Ciberlastic), which was designed with a non-absorbable elastic polyurethane monofilament (Assuplus, Assut Europe, Italy) to allow greater adaptability to mechanical area requirements and higher bio-mimicking with the newly formed surrounding tissues. Our hypothesis was that an increase in the elasticity of the mesh filament could improve the benefits of LW prostheses. To verify our hypothesis, we compared the short- and long-term behaviour of Ciberlastic and Optilene(®) elastic commercial meshes by repairing the partially herniated abdomen in New Zealand White rabbits. The implanted meshes were mechanically and histologically assessed at 14 and 180 days post-implant. We mechanically characterized the partially herniated repaired muscle tissue and also determined mesh shrinkage at different post-implant times. This was followed by a histological study in which the tissue incorporation process was analysed over time. The new prosthesis designed by our group achieved good behaviour that was similar to that of Optilene(®), one of the most popular LW prostheses on the market, with the added advantage of its elastic property. The mechanical properties are significantly lower than those of the polypropylene Optilene(®) mesh, and the new elastic mesh meets the basic mechanical requirements for positioning in the abdominal wall, which was also demonstrated by the absence of recurrences after implantation in the experimental model. We found that the growth of a connective tissue rich in collagen over the hernial defect and the proper deposit of the collagen fibres in the regenerated tissue substantially modified the original properties of the mesh, thereby increasing its biomechanical strength and making the whole tissue/mesh stiffer.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    V. Insinga

    2014-06-01

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

  8. The omentum-polypropylene sandwich technique: an attractive method to repair large abdominal-wall defects in the presence of contamination or infection.

    NARCIS (Netherlands)

    Bleichrodt, R.P.; Malyar, A.W.; Vries Reilingh, T.S. de; Buyne, O.R.; Bonenkamp, J.J.; Goor, H. van

    2007-01-01

    BACKGROUND: Repair of abdominal wall defects in the presence of contamination or infection continues to be a significant problem for surgeons. The loss of tissue warrants reinforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive

  9. The omentum-polypropylene sandwich technique: an attractive method to repair large abdominal-wall defects in the presence of contamination or infection.

    NARCIS (Netherlands)

    Bleichrodt, R.P.; Malyar, A.W.; Vries Reilingh, T.S. de; Buyne, O.R.; Bonenkamp, J.J.; Goor, H. van

    2007-01-01

    BACKGROUND: Repair of abdominal wall defects in the presence of contamination or infection continues to be a significant problem for surgeons. The loss of tissue warrants reinforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive opera

  10. Quantitative evaluation of tissue reconfigurations after the plastic reconstruction of experimental defect of the anterior abdominal wall in rats.

    Directory of Open Access Journals (Sweden)

    Malkov I.I.

    2007-01-01

    Full Text Available The active retrieval of methods for the increase of the efficiency of ventral hernia alloplasty is performed now; however the structural-functional changes of scar and muscle tissues during their reorganization are still little studied. The analysis of relationship of connective tissue with the hemomicrocirculation elements plays the important role for the understanding of the structural-functional condition of the anterior abdominal wall and also concrete mechanisms of reorganization of microvessels taking into account the dynamics of muscle-aponeurotic structures reconfiguration. The purpose of the current study was to determine the dynamics of structural-functional reconfiguration of microcircular and muscle-aponeurotic components, as well as connective tissue in the anterior abdominal wall after alloplasty of experimental ventral defect with the polypropylene monofilament net "Prolene". The quantitative morphological analysis was carried out during 1 year. The analysis of scar tissue formation and muscles reconfiguration in the anterior abdominal wall after plastic reconstruction of experimental defect allowed to reveal that the presence of polypropylene prosthetic device increases the duration of early inflammatory processes in a moderate degree, providing, however, adequate and full structural reconfiguration of scar and muscle tissue in the future, including microcirculation components.

  11. Mesh repair of hernias of the abdominal wall

    NARCIS (Netherlands)

    W.W. Vrijland (Wietske)

    2003-01-01

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

  12. Mesh repair of hernias of the abdominal wall

    NARCIS (Netherlands)

    W.W. Vrijland (Wietske)

    2003-01-01

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

  13. Abdominal wall endometriosis.

    Science.gov (United States)

    Upadhyaya, P; Karak, A K; Sinha, A K; Kumar, B; Karki, S; Agarwal, C S

    2010-01-01

    Endometriosis of abdominal wall scar following operation on uterus and tubes is extremely rare. The late onset of symptoms after surgery is the usual cause of misdiagnosis. Scar endometriosis is a rare disease which is difficult to diagnose and should always be considered as a differential diagnosis of painful abdominal masses in women. The diagnosis is made only after excision and histopathology of the lesion. Preoperative differentials include hernia, lipoma, suture granuloma or abscess. Hence an awareness of the entity avoids delay in diagnosis, helps clinicians to a more tailored treatment and also avoids unnecessary referrals. We report a case of abdominal endometriosis. The definitive diagnosis of which was established by histopathological studies.

  14. Mesh repair of hernias of the abdominal wall

    OpenAIRE

    2003-01-01

    textabstractA hernia of the abdominal wall is a permanent or intermittent protrusion of abdominal contents outside the abdominal cavity through a defect in the abdominal wall. Approximately 75% of all hernias occur in the inguinal region. Other types of hernias of the ventral abdominal wall are incisional, umbilical, epigastric and Spigelian hernia. In chapter 1 an overview of hernias of the abdominal wall is described. The incidence, clinical implications and treatment options and their comp...

  15. 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

  16. Assessment of the abdominal wall function after pedicled TRAM flap surgery for breast reconstruction: Use of modified mesh repair for the donor defect

    Directory of Open Access Journals (Sweden)

    Cyriac Chacko

    2010-01-01

    Full Text Available Background: The pedicled TRAM flap has been a workhorse of autologous breast reconstruction for decades. However, there has been a rising concern about the abdominal wall donor site morbidity with the use of conventional TRAM flap. This has generally been cited as one of the main reasons for resorting to "abdominal wall friendly" techniques. This study has been undertaken to assess the abdominal wall function in patients with pedicled TRAM flap breast reconstruction. The entire width of the muscle and the overlying wide disk of anterior rectus sheath were harvested with the TRAM flap in all our patients and the anterior rectus sheath defect was repaired by a Proline mesh. Materials and Methods: Abdominal wall function was studied in 21 patients who underwent simultaneous primary unipedicled TRAM flap reconstruction after mastectomy for cancer. In all the patients, the abdominal wall defect was repaired using wide sheet of Proline mesh both as inlay and onlay. The assessment tools included straight and rotational curl ups and a subjective questionnaire. The abdominal wall was also examined for any asymmetry, bulge, or hernia. The minimal follow-up was 6 months postoperative. The objective results were compared with normal unoperated volunteers. Results and Conclusions: The harvesting the TRAM flap certainly results in changes to the anterior abdominal wall that can express themselves to a variable degree. A relatively high incidence of asymptomatic asymmetry of the abdomen was seen. There was total absence of hernia in our series even after a mean follow-up period of 15.5 months. A few patients were only able to partially initiate the sit up movement and suffered an important loss of strength. In most patients, synergists took over the functional movement but as the load increased, flexion and rotation performances decreased. The lack of correlation between exercise tests and the results of the questionnaire suggests that this statistically

  17. 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.

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

    Science.gov (United States)

    Vorovs'kyĭ, O O

    2012-12-01

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

  20. Abdominal wall blocks in adults

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  1. 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...

  2. REVIEW - BIOMATERIALS FOR ABDOMINAL-WALL RECONSTRUCTION

    NARCIS (Netherlands)

    SIMMERMACHER, RKJ; BLEICHRODT, RP; SCHAKENRAAD, JM

    1992-01-01

    The reconstruction of large abdominal wall defects still is a major surgical problem. Many different techniques have been developed for this purpose, most of which appeared to be unsatisfactory. The lack of sufficient tissue requires the insertion of prosthetic material. Non-absorbable prostheses

  3. 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.

  4. Application of temporary abdominal closure materials and techniques in abdominal wall defects%暂时性腹腔关闭材料及技术在腹壁缺损中的应用

    Institute of Scientific and Technical Information of China (English)

    邵建川; 韩岩

    2011-01-01

    BACKGROUND: The treatment for abdominal defects is one of the problems of surgical treatment, especially primary closure is really a challenge to surgeons. As the surgical concept of defect control develops, and many technique and materials of temporary abdominal closure appear, some effective treatments for abdominal defects are emerged to solve this problem.OBJECTIVE: To review the current status of temporary abdominal closure materials and techniques in abdominal wall defects.METHODS: A computer-based online search of PubMed database (1986/2010) and CNKI (2005/2010) was retrieved with key words of "abdomen, abdominal wall, abdominal injuries/surgery, laparotomy, temporary abdominal closure, patch,vacuum-assisted closure , wound healing" in English and in Chinese. A total of 278 literatures were collected through computer retrieval, excluding irrelevant, obsolete, repeated and similar researches, finally 31 standard literatures were included.RESULTS AND CONCLUSION: The application of temporary abdominal closure is an important treatment of abdominal wall defects, it can improve the prognosis and increase the cure rate. There are various materials and techniques of temporary abdominal closure with advantages and disadvantages, and each one has its own indications. The use of specific material and operative technique should base on the principles and specific conditions of patients.%背景:腹壁缺损是外科治疗的难题之一,设法一期关闭腹腔是外科医生的一项挑战,随着损伤控制外科理念的发展,各种暂时性腹腔关闭技术及材料的出现为该难题提供了有效的治疗方案.目的:综述暂时性腹腔关闭材料及技术在腹壁缺损中的应用现状.方法:应用计算机检索Pubmed数据库(1986/2010),以"abdomen,abdominal wall,abdominal injuries/surgery,laparotomy,temporary abdominal closure,patch,vacuum-assited closure,wound healing"为检索词;应用计算机检索中国知网数据库(2005/2010),以"腹部

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

    Directory of Open Access Journals (Sweden)

    Rooh-Allah Yegane

    2010-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Rooh-Allah Yegane

    2010-10-01

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

  7. 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...

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

    Directory of Open Access Journals (Sweden)

    Patrick dos Santos Barros dos Reis

    2012-10-01

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

  9. Prosthetics and Techniques in Repair of Animal's Abdominal Wall.

    Science.gov (United States)

    Karrouf, Gamal; Zaghloul, Adel; Abou-Alsaud, Mohamed; Barbour, Elie; Abouelnasr, Khaled

    2016-01-01

    The management of abdominal wall repair continues to present a challenging problem, especially in the repair of major defects. Many abdominal wall defects can be repaired by primary closure; however, if the defect is large and there is a tension on the closure of the wound, the use of prosthetic materials becomes indispensable. Many studies have been performed with various materials and implant techniques, without the comparison of their degrees of success, based on sound meta-analysis and/or inclusive epidemiologic studies. This review covered the effectiveness of recent advances in prosthetic materials and implant procedures used in repair of abdominal wall, based on biomechanical properties and economic aspects of reconstructed large abdominal wall defects and hernias in animals. The presented results in this review helped to reach treatment algorithms that could maximize outcomes and minimize morbidity.

  10. Abdominal wall repair with human acellular dermal autograft

    Directory of Open Access Journals (Sweden)

    Roel E. Genders

    2011-12-01

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

  11. Intra-Abdominal Hypertension and Abdominal Compartment Syndrome after Abdominal Wall Reconstruction: Quaternary Syndromes?

    Science.gov (United States)

    Kirkpatrick, A W; Nickerson, D; Roberts, D J; Rosen, M J; McBeth, P B; Petro, C C; Berrevoet, Frederik; Sugrue, M; Xiao, Jimmy; Ball, C G

    2017-06-01

    Reconstruction with reconstitution of the container function of the abdominal compartment is increasingly being performed in patients with massive ventral hernia previously deemed inoperable. This situation places patients at great risk of severe intra-abdominal hypertension and abdominal compartment syndrome if organ failure ensues. Intra-abdominal hypertension and especially abdominal compartment syndrome may be devastating systemic complications with systematic and progressive organ failure and death. We thus reviewed the pathophysiology and reported clinical experiences with abnormalities of intra-abdominal pressure in the context of abdominal wall reconstruction. Bibliographic databases (1950-2015), websites, textbooks, and the bibliographies of previously recovered articles for reports or data relating to intra-abdominal pressure, intra-abdominal hypertension, and the abdominal compartment syndrome in relation to ventral, incisional, or abdominal hernia repair or abdominal wall reconstruction. Surgeons should thus consider and carefully measure intra-abdominal pressure and its resultant effects on respiratory parameters and function during abdominal wall reconstruction. The intra-abdominal pressure post-operatively will be a result of the new intra-peritoneal volume and the abdominal wall compliance. Strategies surgeons may utilize to ameliorate intra-abdominal pressure rise after abdominal wall reconstruction including temporizing paralysis of the musculature either temporarily or semi-permanently, pre-operative progressive pneumoperitoneum, permanently removing visceral contents, or surgically releasing the musculature to increase the abdominal container volume. In patients without complicating shock and inflammation, and in whom the abdominal wall anatomy has been so functionally adapted to maximize compliance, intra-abdominal hypertension may be transient and tolerable. Intra-abdominal hypertension/abdominal compartment syndrome in the specific setting of

  12. 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 ...

  13. 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 ...

  14. Application of a Silicone Sheet in Negative-Pressure Wound Therapy to Treat an Abdominal Wall Defect after Necrotizing Fasciitis

    Science.gov (United States)

    Shin, Jin Su

    2017-01-01

    Necrotizing fasciitis (NF) is an aggressive soft-tissue infection involving the deep fascia and is characterized by extensive deterioration of the surrounding tissue. Immediate diagnosis and intensive treatment, including debridement and systemic antibiotics, represent the most important factors influencing the survival of NF patients. In this report, we present a case of NF in the abdomen due to an infection caused by a perforated small bowel after abdominal liposuction. It was successfully treated using negative-pressure wound therapy, in which a silicone sheet functioned as a barrier between the sponge and internal organs to protect the small bowel. PMID:28194352

  15. Muscle Patterning in Mouse and Human Abdominal Wall Development and Omphalocele Specimens of Humans

    OpenAIRE

    Nichol, Peter F.; Corliss, Robert F.; Yamada, Shigehito; SHIOTA, KOHEI; Saijoh, Yukio

    2012-01-01

    Human omphalocele is a congenital defect of the abdominal wall in which the secondary abdominal wall structures (muscle and connective tissue) in an area centered around the umbilicus are replaced by a translucent membranous layer of tissue. Histological examination of omphalocele development and moreover the staging of normal human abdominal wall development has never been described. We hypothesized that omphalocele is the result of an arrest in the secondary abdominal wall development and p...

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  17. 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 Ehl

  18. Recovery after abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim

    2017-01-01

    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...... pathway at the Digestive Disease Center, Bispebjerg Hospital, and compared to a control group of 16 patients included retrospectively in the period immediately prior to the implementation of the pathway. The enhanced recovery after surgery pathway included preoperative high-dose steroid, daily assessment...... of revised discharge criteria and an aggressive approach to restore bowel function (chewing gum and enema on postoperative day two). Patients who followed the enhanced recovery after surgery pathway reported low scores of pain, nausea and fatigue, and were discharged significantly faster than patients...

  19. [Abdominal wall closure by incisional hernia and herniation after laparostoma].

    Science.gov (United States)

    Mischinger, H-J; Kornprat, P; Werkgartner, G; El Shabrawi, A; Spendel, S

    2010-03-01

    As hernias and abdominal wall defects have a variety of etiologies each with its own complications and comorbidities in various constellations, efficient treatment requires patient-oriented management. There is no recommended standard treatment and the very different clinical pictures demand an individualized interdisciplinary approach. Particularly in the case of complicated hernias, the planning of the operation should focus on the problems posed by the individual patient. Treatment mainly depends on the etiology of the hernia, immediate or long-term complications and the efficiency of individual repair techniques. Abdominal wall repair for recurrent herniation requires direct closure of the fascia generally using the sublay technique with a lightweight mesh. It is still unclear whether persistent inflammation, mesh dislocation, fistula formation or other long-term complications are due to certain materials or to the surgical technique. With mesh infections it has been shown to be advantageous to remove a polytetrafluoroethylene (PTFE) mesh, while the combination of systemic and local treatment appears to suffice for a polypropylene or polyester mesh. Heavier meshes in the sublay position or plastic reconstruction with autologous tissue are indicated as substitutes for the abdominal wall for giant hernias, repeated recurrences and large abdominal wall defects. A laparostoma is increasingly more often created to treat septic intra-abdominal processes but is very often responsible for a complicated hernia. If primary repair of the abdominal wall is not an option, resorbable material or split skin is used for coverage under the auspices of a planned hernia repair.

  20. Synthetic, biological and composite scaffolds for abdominal wall reconstruction.

    Science.gov (United States)

    Meintjes, Jennifer; Yan, Sheng; Zhou, Lin; Zheng, Shusen; Zheng, Minghao

    2011-03-01

    The reconstruction of abdominal wall defects remains a huge surgical challenge. Tension-free repair is proven to be superior to suture repair in abdominal wall reconstruction. Scaffolds are essential for tension-free repair. They are used to bridge a defect or reinforce the abdominal wall. A huge variety of scaffolds are now commercially available. Most of the synthetic scaffolds are composed of polypropylene. They provide strong tissue reinforcement, but cause a foreign body reaction, which can result in serious complications. Absorbable synthetic scaffolds, such as Dexon™ (polyglycolic acid) and Vicryl™ (polyglactin 910), are not suitable for abdominal wall reconstruction as they usually require subsequent surgeries to repair recurrent hernias. Composite scaffolds combine the strength of nonabsorbable synthetic scaffolds with the antiadhesive properties of the absorbable scaffold, but require long-term follow-up. Biological scaffolds, such as Permacol™, Surgisis(®) and Alloderm(®), are derived from acellular mammalian tissues. Non-cross-linked biological scaffolds show excellent biocompatibility and degrade slowly over time. However, remnant DNA has been found in several products and the degradation leads to recurrence. Randomized controlled trials with long-term follow-up studies are lacking for all of the available scaffolds, particularly those derived from animal tissue. This article provides an overview of the different types of scaffolds available, and presents the key clinical studies of the commercially available synthetic, composite and biological scaffolds for abdominal wall reconstruction.

  1. ABDOMINAL WALL DESMOID TUMOUR OVER APPENDICECTOMY SCAR

    OpenAIRE

    Vijaya; Sarbeshwar; Gogoi

    2015-01-01

    BACKGROUND: Desmoid tumors are slow growing deep fibromatoses with aggressive infiltration of adjacent tissue but without any metastatic potential . (1,2,3) CASE PRESENTATION: We report a female patient with desmoid tumor of the abdominal wall over appendicectomy scar w ho underwent primary resection. Preoperative evaluation incl uded abdominal ultrasound, and computed tomography. The histology of this cases revealed a desmoid tumor. CONCLUSION: ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-15

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

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    Agarwal Nitin

    2009-06-01

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

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

    Science.gov (United States)

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

    1996-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Ersin Dumlu

    2014-06-01

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

  7. Abdominal Wall Desmoid during Pregnancy: Diagnostic Challenges

    Directory of Open Access Journals (Sweden)

    Johnny Awwad

    2013-01-01

    Full Text Available Background. Desmoids are benign tumors, with local invasive features and no metastatic potential, which have rarely been described to be pregnancy associated. Case. We described the rapid growth of an anterior abdominal wall mass in a 40-year-old pregnant woman. Due to its close proximity to the enlarged uterus, it was misdiagnosed to be a uterine leiomyoma by ultrasound examination. Final tissue diagnosis and radical resection were done at the time of abdominal delivery. Conclusion. Due to the diagnostic limitations of imaging techniques, desmoids should always be considered when the following manifestations are observed in combination: progressive growth of a solitary abdominal wall mass during pregnancy and well-delineated smooth tumor margins demonstrated by imaging techniques. This case emphasizes the importance of entertaining uncommon medical conditions in the differential diagnosis of seemingly common clinical manifestations.

  8. Abdominal wall hernias: imaging with spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Stabile Ianora, A.A.; Midiri, M.; Vinci, R.; Rotondo, A.; Angelelli, G. [Department of Radiology, Bari University Hospital (Italy)

    2000-06-01

    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.)

  9. Abdominal Wall Endometrioma. Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Tahiluma Santana Pedraza

    2014-08-01

    Full Text Available Abdominal wall endometrioma is a condition rarely seen by surgeons. It represents a diagnostic challenge due to its similarity with other tumors. This entity occurs in fertile women and often appears two to five years after gynecological and obstetric surgical procedures. It must be considered when dealing with a cyclically painful nodule located in a laparotomy scar. The diagnosis is established by histological examination; most imaging tests determine the characteristics of the lesion, concomitant lesions and the intra-abdominal origin or location in the abdominal wall. The cases of two patients treated at the General Surgery Department of the María Eugenia González Comprehensive Diagnostic Center in the Capital District, Venezuela, are presented. Wide excision of the tissue and histological examination were performed, confirming the diagnosis. The postoperative course was uneventful. This case is presented given the rarity of this condition.

  10. 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...

  11. Restoration of abdominal wall integrity as a salvage procedure in difficult recurrent abdominal wall hernias using a method of wide myofascial release.

    Science.gov (United States)

    Levine, J P; Karp, N S

    2001-03-01

    The management of primary and recurrent giant incisional hernias remains a complex and frustrating challenge even with multiple alloplastic and autogenous closure options. The purpose of this study was to develop a reconstructive technique of restoring abdominal wall integrity to a subcategory of patients, who have failed initial hernia therapy, by performing superior and lateral myofascial release. Over a 1.5-year period, 10 patients with previously unsuccessful treatment of abdominal wall hernias, using either primary repair or placement of synthetic material, were studied. The patients had either recurrence of the hernia or complications such as infections requiring removal of synthetic material. The hernias were not able to be treated with standard primary closure techniques or synthetic material. The average defect size was 19 x 9 cm. Each patient underwent wide lysis of bowel adhesions releasing the posterior abdominal wall fascia to the posterior axillary line, subcutaneous release of the anterior abdominal wall fascia to a similar level, and complete removal of any synthetic material (if present). The abdominal domain was reestablished by releasing the laterally retracted abdominal wall. The amount of available abdominal wall tissue was increased by wide release of the cephalic abdominal wall fascia overlying the costal margin and the external oblique fascia and muscle laterally. If needed, partial thickness of the internal oblique muscle and its anterior fascia were also released laterally to perform a tension-free primary closure of the defect. All repairs were closed with satisfactory functional and aesthetic results. All alloplastic material was removed. Fascial release was limited so as to close only the hernia defect without tension. No significant release of the rectus sheath and muscle was needed. Good, dynamic muscle function was noted postoperatively. All repairs have remained intact, and no further abdominal wall hernias have been noted on follow-up.

  12. 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 .

  13. [Laparoscopic treatment of abdominal wall hernias: prosthesis material comparison].

    Science.gov (United States)

    Biondi, A; Tropea, A; Monaco, N; Musmeci, G; Basile, G; Basile, F

    2011-12-01

    Hernia is due to abdominal wall weakening. This allows the contents of the abdomen to protrude from normal boundaries. Hernias are repaired by implanting a sterile surgical mesh to strengthen the weakened abdominal wall. Aim of this study is to compare the results obtained by bard Composix® L/P mesh or Dualmesh Plus Gore® implanting. The mesh has various beneficial characteristics. It is a reinforcing material for the abdominal wall, even when in the direct contact with the intestinal tract does not cause adhsion problems. The use of biocompatible materials is necessary in laparoscopic hernia repair. e-PTFE prosthesis and Dual Mesh® were the first to be used for laparoscopic treatment of the abdominal wall defects. These prosthesis are the result of many improvements, actually they are 1-mm thick and the two surfaces have different characteristics. Compound meshes are composed by e-PTFE and polypropylene with different percentage of the two materials and methods of interactions. The incidence of early complications were poor in relation to both types of implants, only seroma cases e-PTFE treated showed a prevalence of complication, in agreement with literature. About relapses in our experience we found that e-PTFE cases were predominantly. Dual Mesh® has better adaptability than Bard Composix®, which allows easier placement of the prosthesis as well as a better adaptation to the wall surface. The Bard Composix®, thanks to rigidity due to the polypropylene component has better handling than the Dual Mesh®, as it promotes a rapid and easy deployment of the prosthesis inside the abdominal cavity, favoring its positioning. The use of both prosthesis depends also on the experience specific to each operator, moreover, a rigorous surgical technique remains fundamental for the application of the mesh used.

  14. Abdominal wall paresis as a complication of laparoscopic surgery

    NARCIS (Netherlands)

    G.H. van Ramshorst (Gabrielle); G.J. Kleinrensink (Gert Jan); J.J. Hermans (John); T. Terkivatan (Türkan); J.F. Lange (Johan)

    2009-01-01

    textabstractPurpose: Abdominal wall nerve injury as a result of trocar placement for laparoscopic surgery is rare. We intend to discuss causes of abdominal wall paresis as well as relevant anatomy. Methods: A review of the nerve supply of the abdominal wall is illustrated with a rare case of a patie

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

    Science.gov (United States)

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

    2004-09-01

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

  16. Muscle patterning in mouse and human abdominal wall development and omphalocele specimens of humans.

    Science.gov (United States)

    Nichol, Peter F; Corliss, Robert F; Yamada, Shigehito; Shiota, Kohei; Saijoh, Yukio

    2012-12-01

    Human omphalocele is a congenital defect of the abdominal wall in which the secondary abdominal wall structures (muscle and connective tissue) in an area centered around the umbilicus are replaced by a translucent membranous layer of tissue. Histological examination of omphalocele development and moreover the staging of normal human abdominal wall development has never been described. We hypothesized that omphalocele is the result of an arrest in the secondary abdominal wall development and predicted that we would observe delays in myoblast maturation and an arrest in secondary abdominal wall development. To look for evidence in support of our hypothesis, we performed a histological analysis of normal human abdominal wall development and compared this to mouse. We also conducted the first histological analysis of two human specimens with omphalocele. In these two omphalocele specimens, secondary abdominal wall development appears to have undergone an arrest around Carnegie Stage 19. In both specimens disruptions in the unidirectional orientation of myofibers were observed in the external and internal obliques, and rectus abdominis but not in the transversus abdominis. These latter findings support a model of normal abdominal wall development in which positional information instructs the orientation of myoblasts as they organize into individual muscle groups.

  17. O uso de telas Parietex® e Surgisis® na correção de defeitos produzidos na parede abdominal de coelhos The repair of abdominal defects in rabbits with Parietex® and Surgisis® meshes abdominal wall

    Directory of Open Access Journals (Sweden)

    João Batista Baroncello

    2008-12-01

    MMP8 e MMP13 em relação à Surgisis®.BACKGROUND: In general surgery, the repair of abdominal wall hernias has a prominent place, and the indications and uses of meshes have increased due to better results. AIM: To compare the repair of induced abdominal wall defects with Parietex® and Surgisis® meshes, in direct contact with abdominal viscera (intraperitoneal mesh. METHOD: For the experiments, were used 16 female young adult rabbits. Two full thickness triangular defects of 2 cm base by 2.5 cm high were created, lateral to the linea alba, one at each side. They were repaired with rectangular meshes of 3 cm base by 3.5 cm high, on the right side with Parietex® mesh (polyester/collagen-polyethylenglycol-glycerol, and on the left side with Surgisis® mesh (lyophilized porcine small bowel submucosa. The evaluation included clinical-surgical findings as well as histological and immunohistochemical parameters. Eight rabbits were subjected to euthanasia after 30 days, and the eight after 60 days. RESULTS: Both meshes induced skin erosions, despite the varying levels of mesh undermining evaluated, no incisional hernia occurred. There were peritoneal adhesions to the surface of both types of meshes after 30 days and in a lower extent and intensity after 60 days. Meshes' shrinking correspond to 1/3 of the original size and Parietex® caused less inflammatory process at the histologic evaluation. Deposition of collagen type I presented no significant difference between the meshes, but deposition of collagen type III was more intense after 60 days, in both groups. Regarding collagen's rearrangement, the production of MMP8 was higher on Parietex® after 30 days, and MMP13 enzyme was increased after 60 days, in both meshes (significant only for Parietex®. CONCLUSION: Both meshes were efficient in the correction of abdominal wall defects, and with similar results, but Parietex® presented less inflammatory process and greater amount of matrix-metalloproteinases MMP8 and MMP13

  18. Tissue Expander Capsule for Abdominal Wall in Autologous Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Ronaldo Scholze Webster, MD, PhD

    2014-11-01

    Full Text Available Summary: Adjuvant treatment planning can change after breast cancer resection and definitive pathological examination. Radiation therapy is often chosen as a supplementary treatment. Rectus abdominis–based muscle flaps are one of the main choices when breast reconstruction plans must be changed from implant-based to autologous methods. We herein report a case in which the patient’s own tissue expander capsule was used to repair an abdominal wall defect after muscle-sparing transverse rectus abdominis myocutaneous flap reconstruction.

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

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    Oskay Kaya

    2012-01-01

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

  20. Comparação entre pericárdio bovino preservado em glicerina e malha de poliéster no reparo de falhas da parede abdominal em ratos Comparison of glycerin preserved bovine pericardium and a polyester mesh for the repair of abdominal wall defects in rats

    Directory of Open Access Journals (Sweden)

    Juliany Gomes Quitzan

    2003-08-01

    Full Text Available OBJETIVO: Comparar uma malha comercial de poliéster com o pericárdio bovino preservado em glicerina na reconstituição de defeitos da parede abdominal. MÉTODOS: Foram utilizados 30 ratos, divididos em dois grupos eqüitativos. Efetuou-se uma excisão retangular de 2,5 x 2 cm, incluindo toda a musculatura abdominal e peritônio. No grupo I a parede abdominal foi reparada com malha de poliéster e no grupo II com pericárdio bovino conservado em glicerina. Os animais foram sacrificados aos 15, 60 e 90 dias de pós-operatório, sendo o local cirúrgico avaliado macroscópica e histologicamente. RESULTADOS: Os animais do grupo I apresentaram aderências mais severas e em maior número quando comparados aos do grupo II; porém, sem comprometimento funcional. A análise histológica revelou incorporação dos tecidos aos implantes, com maior resposta fibroblástica nos animais do grupo I. CONCLUSÃO: A malha de poliéster oferece maior resistência estrutural e resposta fibroblástica mais intensa; contudo, promove grande quantidade de aderências às vísceras abdominais, quando comparada ao pericárdio bovino.PURPOSE: The aim of the study was to compare polyester mesh and glycerin preserved bovine pericardium for the repair of abdominal wall defects. METHODS: Thirty rats divided into two equal experimental groups were used. A 2.5 x 2 cm rectangular defect including all abdominal muscles and peritoneum was performed. The defect was reconstructed using polyester mesh in group I and glycerin preserved bovine pericardium in group II. The animals were submitted to euthanasia at 15, 60 and 90 days postoperatively, and the surgical area was evaluated by macroscopic and microscopic examination. RESULTS: The animals of the Group I had more abdominal adhesions and those were more severe than the animals of the Group II. The microscopic examination showed incorporation of the tissues in the implants with accentuated fibroblastic reaction in the animals of

  1. Ectodermal Wnt signaling regulates abdominal myogenesis during ventral body wall development.

    Science.gov (United States)

    Zhang, Lingling; Li, Hanjun; Yu, Jian; Cao, Jingjing; Chen, Huihui; Zhao, Haixia; Zhao, Jianzhi; Yao, Yiyun; Cheng, Huihui; Wang, Lifang; Zhou, Rujiang; Yao, Zhengju; Guo, Xizhi

    2014-03-01

    Defects of the ventral body wall are prevalent birth anomalies marked by deficiencies in body wall closure, hypoplasia of the abdominal musculature and multiple malformations across a gamut of organs. However, the mechanisms underlying ventral body wall defects remain elusive. Here, we investigated the role of Wnt signaling in ventral body wall development by inactivating Wls or β-catenin in murine abdominal ectoderm. The loss of Wls in the ventral epithelium, which blocks the secretion of Wnt proteins, resulted in dysgenesis of ventral musculature and genito-urinary tract during embryonic development. Molecular analyses revealed that the dermis and myogenic differentiation in the underlying mesenchymal progenitor cells was perturbed by the loss of ectodermal Wls. The activity of the Wnt-Pitx2 axis was impaired in the ventral mesenchyme of the mutant body wall, which partially accounted for the defects in ventral musculature formation. In contrast, epithelial depletion of β-catenin or Wnt5a did not resemble the body wall defects in the ectodermal Wls mutant. These findings indicate that ectodermal Wnt signaling instructs the underlying mesodermal specification and abdominal musculature formation during ventral body wall development, adding evidence to the theory that ectoderm-mesenchyme signaling is a potential unifying mechanism for the origin of ventral body wall defects.

  2. Mini-abdominoplasty combined with mesh used for abdominal wall endometriosis

    Institute of Scientific and Technical Information of China (English)

    ZHAO Ru; WANG Xiao-jun; SONG Ke-xin; ZHU Lan; LI Bin

    2012-01-01

    Background Wide excision is considered the treatment of endometriosis.It is difficult to surgeon for reconstruction of a large full-thickness defect through the abdominal-wall.We introduce a method of mini-abdominoplasty combined with mesh that can be used for reconstruction of a large full-thickness defect through the abdominal-wall after wide excision of abdominal wall endometriosis.Methods This retrospective study includes a series of patients who underwent wide excision of abdominal wall endometriosis and reconstruction of a large full-thickness defect through the abdominal-wall over a 5-year period.Information obtained from chart reviews includes age,size of lesion and defect,complications and revisions.Results The method was used for 8 patients including 2 patients with recurrence.The mean size of the masses was (3.5±2.0) cm.The mean size of the fascia defects was 7.1 cm x 8.6 cm.The mean length of follow-up was (24±12)months.There was no recurrence,no hernia,and no other complications.The technique generated only a horizontal scar.The scar and contour of the lower abdomen provided a more pleasant appearance than the traditional procedure.Conclusions Mini-abdominoplasty combined with mesh is a useful and acceptable reconstruction method for large full-thickness defects through the abdominal wall after endometriosis resection.It is feasible for wide excision with 1 cm normal tissues around the margin.It provides an aesthetically pleasing result.

  3. Spontaneous abdominal wall endometriosis: a case report.

    Science.gov (United States)

    Papavramidis, Th S; Sapalidis, K; Michalopoulos, N; Karayanopoulou, G; Raptou, G; Tzioufa, V; Kesisoglou, I; Papavramidis, S T

    2009-01-01

    Endometriosis is the presence of endometrial glands and stroma outside the uterus. Spontaneous abdominal wall endometriosis (AWE) is any ectopic endometrium found superficial to the peritoneum without the presence of any previous scar. Rarely, endometriosis represents a disease of specific interest to the general surgeon, on account of its extrapelvic localisations. We describe a case with spontaneous AWE presenting as a painful mass with cyclic symptoms. A 28-year-old woman presented to the day-surgery division of our department, suffering from a painful mass in the left lower abdominal quadrant. A mobile mass of 5 x 4 cm was identified. The initial diagnosis was lipoma and excision was planned. During the operation two masses were spotted, very close to one another, and were excised within healthy limits. Pathology revealed endometrial glands surrounded by a disintegrating mantle of endometrial stroma and fibrous scar tissue in which there was a scattering of leucocytes. The woman had no scars. She was discharged from hospital after 2 hours. Two years after the excision she is free of disease and no recurrence has been observed. Spontaneous AWE is rare, accounting for 20% of all AWEs. The triad ; mass, pain and cyclic symptomatology helps in the diagnosis, but unfortunately it is not present in all cases. Spontaneous endometriomas are usually diagnosed by pathology and the treatment of choice is surgical excision.

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  5. Lateral abdominal wall hernia following blunt trauma - a rare case

    OpenAIRE

    Michael Walsh; Antony Pittathankal; Nnamdi Nwaejike

    2009-01-01

    The presence of superficial bruising, no abnormal signs on abdominal examination and a negative FAST scan of the abdomen may not be enough to rule out intra-abdominal pathology. We report on the usefulness of CT in diagnosing a post-traumatic abdominal wall hernia.

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

    Science.gov (United States)

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

    2007-04-01

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

  7. 猪脱细胞真皮基质修复兔腹壁缺损的实验研究%PORCINE ACELLULAR DERMAL MATRIX FOR REPAIR OF ABDOMINAL WALL DEFECTS IN RABBIT MODEL

    Institute of Scientific and Technical Information of China (English)

    马绍英; 王旭昇; 董丽; 李幼忱; 周沫; 赵亚平; 李宝兴

    2011-01-01

    matrix in the reconstruction of abdominal wall defects in rabbits, and to investigate the application feasibility of xeno-transplantation of acellular dermal matrix. Methods The porcine acellular dermal matrix was prepared from a health white pig. Twenty-six Japanese white rabbits (weighing 2.2-2.3 kg, female or male) were randomly assigned to 2 groups: the control group (n=6) and the experimental group (?=20). In the control group, the full-thickness abdominal wall defect of 5.0 cm × 0.5 cm was made, and the defect was sutured directly, in the experimental group, the full-thickness abdominal wall defect of 5.0 cm × 2.5 cm was made, and the defect was repaired with porcine acellular dermal matrix patch at the same size as the defect. At 5 weeks after surgery, the incidence of hernia and the intra-abdominal adhesions were observed and the wound breaking strength was compared between the patch-fascia interface and the fascia-fascia interface. The graft vascularization was evaluated through histological analysis at 6 months after surgery in the experimental group. Results No hernia occurred in all rabbits of 2 groups. At 5 weeks after surgery, healing was observed between patch and the muscularfascia; the vascularization was seen in the porcine acellular dermal matrix patch. There was no significant difference in the adhesion grade (Z= -0.798, P=0.425) between the experimental group (grade 2 in 1 rabbit, grade 1 in 5, and grade 0 in 12) and the control group (grade 1 in 1 and grade 0 in 5). No significant difference was found (t= -0.410, P=0.683) in the breaking strength between the patch-fascia interface in the experimental group [(13.0 ± 5.5) N] and the fascia-fascia interface in control group [(13.6 ± 4.0) N]. In the experimental group, the small vessels and the infiltration of inflammatory cells were observed in the porcine acellular dermal matrix patch after 5 weeks through histological observations. The junctions of the patch-fascia interface healed with fibrous

  8. Abdominal Wall Hernia: new perspectives for clinical research

    NARCIS (Netherlands)

    H.H. Eker (Hasan)

    2014-01-01

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

  9. 彩色多普勒超声产前诊断胎儿前腹壁畸形%Prenatal diagnosis of fetal anterior abdominal wall defects with color Doppler ultrasonography

    Institute of Scientific and Technical Information of China (English)

    赵新美; 吴春燕; 陈雷

    2011-01-01

    目的 探讨彩色多普勒超声(CDU)在产前诊断胎儿前腹壁畸形(AAWDs)中的价值.方法 回顾性分析21胎经引产或随访证实的胎儿AAWDs声像图特征.结果 21胎AAWDs中,8胎为腹裂,10胎为脐膨出,3胎为体蒂异常.CDU确诊19胎,误诊2胎,诊断准确率90.48%.结论 CDU通过辨认胎儿脐带与AAWDs的关系,能较准确地显示AAWDs的病理特征,在胎儿AAWDs的诊断与鉴别诊断中起重要作用.%Objective To investigate the value of color Doppler ultrasonography (CDU) in diagnosis of prenatal fetal anterior abdominal wall defects (AAWDs).Methods The sonographic features of 21 fetuses with AAWDs confirmed with induced labor or follow-up were analyzed retrospectively.Results There were 21 AAWDs fetuses, included 8 gastroschisis, 10 omphalocele and 3 body stalk anomaly.Nineteen in 21 fetuses were diagnosed with CDU, while 2 were misdiagnosed.The ultrasonographic diagnostic accuracy was 90.48%.Conclusion CDU can identify the relationship between the defects and the umbilical cord, and thus accurately demonstrate the pathologic features of AAWDs, playing an important role in diagnosis and differential diagnosis of AAWDs.

  10. 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

  11. 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.

  12. Reconstruction of the abdominal wall by using a combination of the human acellular dermal matrix implant and an interpositional omentum flap after extensive tumor resection in patients with abdominal wall neoplasm:A preliminary result

    Institute of Scientific and Technical Information of China (English)

    Yan Gu; Rui Tang; Ding-Quan Gong; Yun-Liang Qian

    2008-01-01

    AIM:To present our trial using a combination of the human acellular dermal matrix (HADM) implant and an interpositional omentum flap to repair giant abdominal wall defects after extensive tumor resection.METHODS:Between February and October of 2007,three patients with giant defects of the abdominal wall after extensive tumor resection underwent reconstruction with a combination of HADM and omentum flap.Postoperative morbidities and signs of herniation were monitored.RESULTS:The abdominal wall reconstruction was successful in these three patients,there was no severe morbidity and no signs of herniation in the follow-up period.CONCLUSION:The combination of HADM and omentum flap offers a new,safe and effective alternative to traditional forms in the repair of giant abdominal wall defects.Further analysis of the long-term outcome and more cases are needed to assess the reliability of this technique.

  13. Z-plasty for uterus-to-abdominal-wall fistula

    Institute of Scientific and Technical Information of China (English)

    Lou Xiaoli; Zhang Mingli; Cui Ying; Song Jianxing

    2009-01-01

    Objective: Uterus-to-abdominal-wall fistula is a very rare complication after uterine-incision delivery over the last decades. It can even lead to death. Mainly, the fistula occurs when big tension and critical infection exist within the incision of uterus and abdominal wall. Methods: The authors described the clinical presentation, pathology of uterus-to-abdominal-wall fistula, and reported their experience in 6 cases who underwent Z-plasty operation for this rare complication from January 1998 to January 2008. Results: All flaps survived completely and all the wounds in abdominal walls healed very well. The six cases were followed up for 1 to 5 years, and no fistula recurrence occurred. Conclusion: Z-plasty technique is a very simple and efficient approach to repair uterus to abdominal fistula after uterine-incision delivery.

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

    Directory of Open Access Journals (Sweden)

    Suyiene Cordeiro Falcão

    2008-02-01

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

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

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    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.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    -old man who developed AAC after abdominal wall repair with mesh (Rives-Stoppa procedure) 1 day after discharge from the hospital. To the best of our knowledge, this is the first paper to report AAC after abdominal incisional hernia repair. Although it is known to be more common in critically ill patients...

  17. Enterotomy risk in abdominal wall repair: a prospective study.

    NARCIS (Netherlands)

    Broek, R.P. Ten; Schreinemacher, M.H.; Jilesen, A.P.; Bouvy, N.; Bleichrodt, R.P.; Goor, H. van

    2012-01-01

    OBJECTIVES: To establish the incidence and predictive factors of enterotomy made during adhesiolysis in abdominal wall repair and to assess the impact of enterotomies and long-lasting adhesiolysis on postoperative morbidity such as sepsis, wound infection, abdominal complications and pneumonia, and

  18. Abdominal Wall Endometrioma after Laparoscopic Operation of Uterine Endometriosis

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    Tihomir Vukšić

    2016-01-01

    Full Text Available Endometriosis is presence of functional endometrium outside of uterine cavum. As a pluripotent tissue, endometrium has the possibility of implanting itself almost everywhere; even implantation in abdominal wall was described, but it is not common site. This case report presents implantation of functional endometrium in abdominal wall, inside scar tissue, and after insertion of a laparoscopic trocar port. Final diagnosis was confirmed by pathohistological examination.

  19. Membrana de látex da seringueira (Hevea brasiliensis, com e sem polilisina a 0,1% e tela de marlex na reconstrução de defeitos iatrogênicos da parede abdominal de ratos Seringueira's latex membrane (Hevea brasiliensis with and without polylysine 0,1% and marlex mesh for the reconstruction of iatrogenics abdominal wall defects in rats

    Directory of Open Access Journals (Sweden)

    Neusa Margarida Paulo

    2005-08-01

    Full Text Available OBJETIVO: Comparar o implante de membrana de látex da seringueira sem e com polilisina 0,1% e tela de marlex na reparação de defeitos abdominais iatrogênicos em ratos. MÉTODOS: Ressectou-se em bloco um segmento circular de aproximadamente três centímetros de diâmetro da parede muscular abdominal ventral de 31 ratos Wistar, preservando-se a pele. Os animais foram divididos em 3 grupos: grupo látex sem polilisina, grupo látex com polilisina 0,1% e grupo marlex. Os animais foram sacrificados aos cinco e aos 120 dias após o procedimento cirúrgico. Fragmentos da parede abdominal foram coletados e submetidos à avaliação histopatológica. RESULTADOS: As principais alterações observadas nos grupos tratados com as membranas de látex sem e com polilisina 0,1% foram deiscência (21 animais e evisceração (dois animais. A eliminação dos implantes nos grupos tratados com látex ocorreu, em média, aos 13,8 dias. Nestes animais ocorreu a formação de tecido conjuntivo fibroso, similar ao observado no grupo que recebeu o marlex. Outras alterações notadas foram aderências viscero-parietais em todos os grupos avaliados. CONCLUSÃO: A membrana de látex da seringueira com e sem polilisina a 0,1%, quando utilizada para reconstrução de defeitos abdominais em ratos é eliminada, em média, aos 13,8 dias após a sua implantação, deixando uma base fibrosa de reparação, similar à observada após a implantação da tela de marlex.PURPOSE: To compare seringueira latex membrane implant, with and without polilysine at 0.1% and marlex mesh on the repair of iatrogenic abdominal defects in rats. METHODS: A circular segment block of approximate three centimeters of diameter was sectioned out of the ventral adominal muscle wall of 31 Wistar rats. The skin was preserved. The animals were divided into three experimental groups: only latex, latex and polilysine at 0.1%, and marlex mesh. Some rats underwent eutranasia at five and some at 120 days

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

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    Parag J Karkera

    2013-01-01

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

  1. Bullhorn hernia: A rare traumatic abdominal wall hernia

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    Bimaljot Singh

    2015-01-01

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

  2. Early metastasis to anterior abdominal wall following radical cystectomy: A rare presentation.

    Science.gov (United States)

    Sawant, Ajit; Bansal, Sumit; Pawar, Prakash; Kasat, Gaurav

    2016-01-01

    Abdominal wall metastasis from urothelial cancer is extremely rare and very few such cases have been reported in the literature. As such the treatment protocols are not so well defined. We present an interesting case of a 65-year-old male patient, known case of chronic kidney disease, who presented with a large, fungating infraumbilical mass 8 months postradical cystectomy. The mass involved full thickness anterior abdominal wall and small bowel including the ileal conduit. Wide excision of the mass along with adhered bowel loops and partial excision of the ileal conduit with right ureteric reimplant was performed. The large defect in the anterior abdominal wall was closed using a mesh (permanent with a bioresorbable coating inside) and myocutaneous thigh flap. The histopathological examination of the excised mass was consistent with secondary from the urothelial tumor.

  3. Early metastasis to anterior abdominal wall following radical cystectomy: A rare presentation

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    Ajit Sawant

    2016-01-01

    Full Text Available Abdominal wall metastasis from urothelial cancer is extremely rare and very few such cases have been reported in the literature. As such the treatment protocols are not so well defined. We present an interesting case of a 65-year-old male patient, known case of chronic kidney disease, who presented with a large, fungating infraumbilical mass 8 months postradical cystectomy. The mass involved full thickness anterior abdominal wall and small bowel including the ileal conduit. Wide excision of the mass along with adhered bowel loops and partial excision of the ileal conduit with right ureteric reimplant was performed. The large defect in the anterior abdominal wall was closed using a mesh (permanent with a bioresorbable coating inside and myocutaneous thigh flap. The histopathological examination of the excised mass was consistent with secondary from the urothelial tumor.

  4. Biomechanical evaluation of microbial cellulose (Zoogloea sp. and expanded polytetrafluoroethylene membranes as implants in repair of produced abdominal wall defects in rats Avaliação biomecânica de membranas de celulose microbiana (Zoogloea sp. e de politetrafluoretileno expandido como implantes no reparo de defeitos produzidos na parede abdominal em ratos

    Directory of Open Access Journals (Sweden)

    Suyiene Cordeiro Falcão

    2008-04-01

    Full Text Available PURPOSE: To evaluate the Load of Rupture of implants of membranes of microbial cellulose (Zoogloea sp. and extended polytetrafuoroethylene in sharp defects of abdominal wall of rats. METHODS: Sixty Wistar male rats, with a mean weight of 437,7g ± 40,9, anesthetized by a mixture of ketamine (5mg/100g and xylazine (2mg/100g, were submitted to a rectangular (2x3cm excision of the abdominal wall, including fascia, muscle and peritoneum, and treated with membranes of microbial cellulose (MC (MC Group- 30 animals or extended polytetrafluoroethylene (ePTFE (ePTFE Group- 30 animals. Each group was subdivided in 14th POD, 28th POD and 60th POD Subgroups. Under anesthesia, animals were submitted to euthanasia at 14th POD, 28th POD and 60th POD for evaluation of Load of Rupture. RESULTS: Load of Rupture levels were significantly elevated (pOBJETIVO: Avaliar a Carga de Ruptura de implantes de membranas de celulose microbiana (Zoogloea sp. e de politetrafluoretileno expandido em defeitos agudos produzidos na parede abdominal de ratos. MÉTODOS: Sessenta ratos machos Wistar, com média de peso de 437,7g ± 40,9, anestesiados com uma mistura de cetamina (5mg/100g e xilazina (2mg/100g, foram submetidos à excisão retangular (2x3cm na parede ventral do abdômen, incluindo fáscia, músculo e peritônio. Subseqüentemente, foram tratados com implante de membranas de celulose microbiana (CM (Grupo CM - 30 animais ou de politetrafluoretileno expandido (PTFEe (Grupo PTFEe - 30 animais. Cada grupo foi ainda subdividido nos Subgrupos 14º DPO, 28º DPO e 60º DPO. Os animais foram submetidos à eutanásia com doses letais de tiopental no 14º DPO, 28º DPO e 60º DPO, para avaliação da Carga de Ruptura na área do implante. RESULTADOS: Os níveis da Carga de Ruptura foram significativamente elevados (p<0,05 entre os Subgrupos 14º DPO, 28º DPO e 60º DPO de cada grupo estudado. Quando comparados entre Grupos, os valores da Carga de Ruptura foram

  5. 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

  6. Improving the efficiency of abdominal aortic aneurysm wall stress computations.

    Science.gov (United States)

    Zelaya, Jaime E; Goenezen, Sevan; Dargon, Phong T; Azarbal, Amir-Farzin; Rugonyi, Sandra

    2014-01-01

    An abdominal aortic aneurysm is a pathological dilation of the abdominal aorta, which carries a high mortality rate if ruptured. The most commonly used surrogate marker of rupture risk is the maximal transverse diameter of the aneurysm. More recent studies suggest that wall stress from models of patient-specific aneurysm geometries extracted, for instance, from computed tomography images may be a more accurate predictor of rupture risk and an important factor in AAA size progression. However, quantification of wall stress is typically computationally intensive and time-consuming, mainly due to the nonlinear mechanical behavior of the abdominal aortic aneurysm walls. These difficulties have limited the potential of computational models in clinical practice. To facilitate computation of wall stresses, we propose to use a linear approach that ensures equilibrium of wall stresses in the aneurysms. This proposed linear model approach is easy to implement and eliminates the burden of nonlinear computations. To assess the accuracy of our proposed approach to compute wall stresses, results from idealized and patient-specific model simulations were compared to those obtained using conventional approaches and to those of a hypothetical, reference abdominal aortic aneurysm model. For the reference model, wall mechanical properties and the initial unloaded and unstressed configuration were assumed to be known, and the resulting wall stresses were used as reference for comparison. Our proposed linear approach accurately approximates wall stresses for varying model geometries and wall material properties. Our findings suggest that the proposed linear approach could be used as an effective, efficient, easy-to-use clinical tool to estimate patient-specific wall stresses.

  7. Abdominal wall closure after a stomal reversal procedure.

    Science.gov (United States)

    López-Cano, Manuel; Pereira, José Antonio; Villanueva, Borja; Vallribera, Francesc; Espin, Eloy; Armengol Carrasco, Manuel; Arbós Vía, María Antonia; Feliu, Xavier; Morales-Conde, Salvador

    2014-01-01

    The closure of a temporary stoma involves 2 different surgical procedures: the stoma reversal procedure and the abdominal wall reconstruction of the stoma site. The management of the abdominal wall has different areas that should be analyzed such us how to avoid surgical site infection (SSI), the technique to be used in case of a concomitant hernia at the stoma site or to prevent an incisional hernia in the future, how to deal with the incision when the stoma reversal procedure is performed by laparoscopy and how to close the skin at the stoma site. The aim of this paper is to analyze these aspects in relation to abdominal wall reconstruction during a stoma reversal procedure.

  8. Colonic diverticulosis is associated with abdominal wall hernia

    DEFF Research Database (Denmark)

    Oma, Erling; Jorgensen, L N; Meisner, S

    2017-01-01

    PURPOSE: Colonic diverticulosis and abdominal wall hernia are common pathologies. Studies have suggested that connective tissue alterations play a role in the formation of both diverticulosis and abdominal wall hernia. The aim of this cohort study was to evaluate the association between...... diverticulosis and abdominal wall hernia in a large cohort of patients undergoing colonoscopy. METHODS: All consecutive patients who underwent colonoscopy between 2001 and 2013 at Bispebjerg Hospital were eligible for inclusion. The endoscopists prospectively registered the findings of diverticulosis...... in a database. Data were merged with the Danish Hernia Database identifying patients who underwent groin and ventral hernia repair. Calculated odds ratios (ORs) were used to describe the extent of association and multivariable logistic regression models were utilized to adjust for age and gender. RESULTS...

  9. Desmoid tumors of the abdominal wall: A case report

    Directory of Open Access Journals (Sweden)

    Textor Hans Jochen

    2003-07-01

    Full Text Available Abstract Background Desmoid tumors are slow growing deep fibromatoses with aggressive infiltration of adjacent tissue but without any metastatic potential. Case Presentation We report on two female patients with desmoid tumor of the abdominal wall who underwent primary resection. Both patients had a history of an earlier abdominal surgery. Preoperative evaluation included abdominal ultrasound, magnetic resonance imaging and computed tomography. The histology in both cases revealed a desmoid tumor. Conclusion Complete surgical resection is the first line management of this tumor entity.

  10. 应用猪小肠黏膜下层与肌腱细胞构建组织工程支架修复大鼠腹壁缺损的实验研究%Repair of abdominal wall defect with engineered scaffold using tenocytes seeded porcine small intestinal submucosa in rats

    Institute of Scientific and Technical Information of China (English)

    宋致成; 顾岩

    2012-01-01

    目的:应用猪小肠黏膜下层(small intestinal submucosa,SIS)与肌腱细胞构建组织工程支架,研究其在修复腹壁缺损时的生物力学特性.方法:制作SD大鼠腹壁缺损模型,应用所构建的组织工程支架修补缺损,术后4周取样进行大体观察,检测组织学及力学性能.结果:组织工程支架修补术后的SD大鼠无腹部裂开及疝发生,支架与腹腔内脏器有轻微粘连;HE及Masson染色发现支架与肌肉组织交界区有显著新生血管出现及肌肉组织长入.力学性能检测显示组织工程支架的力学强度显著大于SD大鼠腹壁肌肉强度.结论:构建组织工程支架可有效修补大鼠的腹壁缺损.%Objective To investigate the biomechanicai properties of the engineered scaffold using tenocytes seeded small intestinal submucosa (SIS) in abdominal wall defect. Methods Abdominal wall defect was repaired using engineered scaffold in rat modes. The rats were sacrificed after 4 weeks and the sample tissues were analyzed by gross observation, histological method and mechanical testing. Results All rats had no abdominal dehiscence or hernia. The engineered scaffold caused slight adhesion with organs. HE and Masson staining proved the junction between SIS and surrounding tissue had more new vessels. The muscle grew into the engineered scaffold. The mechanical strength of the engineered scaffold was much more than the abdominal wall muscles, which could provide sufficient mechanical strength. Conclusions Engineered scaffold repairing abdominal wall defect is a feasible and effective method.

  11. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    Directory of Open Access Journals (Sweden)

    Al Soub Hussam

    2008-01-01

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

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

    Science.gov (United States)

    Varela, N; Golvano, M; Monedero, P

    2016-10-01

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

  13. Criteria for definition of a complex abdominal wall hernia

    NARCIS (Netherlands)

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

    2014-01-01

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

  14. Classification of primary and incisional abdominal wall hernias

    NARCIS (Netherlands)

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

    2009-01-01

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

  15. A New Rat Model for Orthotopic Abdominal Wall Allotransplantation

    Directory of Open Access Journals (Sweden)

    William W. Lao, MD

    2014-04-01

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

  16. Classification of primary and incisional abdominal wall hernias

    NARCIS (Netherlands)

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

    2009-01-01

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

  17. Which mesh or graft? Prosthetic devices for abdominal wall reconstruction.

    Science.gov (United States)

    Abid, Shazia; El-Hayek, Kevin

    2016-03-01

    This article reviews the ever-increasing number of prosthetic devices--both synthetic mesh and biologic grafts--now in use for abdominal wall reconstruction. It also introduces a novel hybrid synthetic/biologic graft (Zenapro) and suture passer device (Novapass).

  18. Abdominal wall lipoma--CT and MRI appearance.

    Science.gov (United States)

    Bloom, R A; Gomori, J M; Fields, S I; Katz, E

    1991-01-01

    Although soft tissue lipomata are common tumours, a large lipoma arising from the deep layers of the abdominal wall would appear to be excessively rare and the site of origin may be difficult to determine. The CT and MRI appearances of such a tumour are described.

  19. Criteria for definition of a complex abdominal wall hernia

    NARCIS (Netherlands)

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

    2014-01-01

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

  20. An unusual abdominal wall mass in a child.

    Science.gov (United States)

    Souza, Amalia Maria do Espirito Santo; Barbuto, Tomas Marzagão; Freitas, Flávia Alessandra; Vianna, Nathalia Fernandes; Zanchetta, Carla Maria Costa; Forsait, Silvana; Borba, Claudio; Azambuja, Alessandra Milani Prandini de; Cristofani, Lilian Maria; Odone, Vicente

    2017-04-13

    Abdominal tumors are one of the most common types of pediatric cancer. Therefore, they should always be included in the differential diagnosis of abdominal masses. Here, we present the case of a child whose initial hypothesis of diagnosis contemplated this possibility. Later, it was demonstrated that the abdominal mass found was secondary to a common parasitosis. A 2-year old, moderately malnourished and pale white boy was referred with a history of a rapidly growing, well-limited, middle abdominal mass. The mass was 10 by 3 cm, hard and poorly movable, apparently involving both abdominal rectus muscles. A complete resection was performed, revealing an abdominal wall abscess, with intense eosinophilic proliferation, secondary to a local and intense reaction to innumerous Ascaris lumbricoides eggs. Extra luminal infestations with Ascaris, that usually form peritoneal granulomas have been previously described. However, neither external trauma nor fistula, that could explain the superficial presence of the eggs, was found. This description reinforces the relevance of infectious diseases within the differential diagnosis of abdominal masses, particularly in areas with high prevalence of parasitic infestations.

  1. An unusual abdominal wall mass in a child

    Directory of Open Access Journals (Sweden)

    Amalia Maria do Espirito Santo Souza

    Full Text Available ABSTRACT Abdominal tumors are one of the most common types of pediatric cancer. Therefore, they should always be included in the differential diagnosis of abdominal masses. Here, we present the case of a child whose initial hypothesis of diagnosis contemplated this possibility. Later, it was demonstrated that the abdominal mass found was secondary to a common parasitosis. A 2-year old, moderately malnourished and pale white boy was referred with a history of a rapidly growing, well-limited, middle abdominal mass. The mass was 10 by 3 cm, hard and poorly movable, apparently involving both abdominal rectus muscles. A complete resection was performed, revealing an abdominal wall abscess, with intense eosinophilic proliferation, secondary to a local and intense reaction to innumerous Ascaris lumbricoides eggs. Extra luminal infestations with Ascaris, that usually form peritoneal granulomas have been previously described. However, neither external trauma nor fistula, that could explain the superficial presence of the eggs, was found. This description reinforces the relevance of infectious diseases within the differential diagnosis of abdominal masses, particularly in areas with high prevalence of parasitic infestations.

  2. REPAIR OF ABDOMINAL WALL ASSOCIATED WITH BARIATRIC SURGERY FOR MORBID OBESITY. GASTRIC PLICATION AT THE GREATER CURVATURE – CASE PRESENT

    OpenAIRE

    R.C. Tiutiuca; C. Ivașcu; Iuliana Tiutiuca; Carmen Vaida; C. Bîrleanu; C. Botez

    2011-01-01

    White line hernias are about 2% of all hernias and among them epigastric hernia are relatively rare (a rate of 8%). Surgery of anterolateral abdominal wall defects has been for long a therapeutic challenge because of the need to use effective methods aimed to reduce the risk of relapse. Its incidence depends on several factors including primarily obesity, than age, sex, type of surgery, type of suture, postoperative abdominal complications, wound healing power and metabolic diseases and cardi...

  3. 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 gastroschisis

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. 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.

  7. Abdominal wall endometrioma: Our experience in Vladimir, Russia

    Directory of Open Access Journals (Sweden)

    Mahir Gachabayov

    2016-01-01

    Full Text Available Background: Endometriosis is defined as an estrogen-dependent, benign inflammatory disease characterized by the presence of ectopic endometrial implants. Abdominal wall endometrioma (AWE being a rare entity is a benign tumor defined as ectopic functional, endometrial tissue located in the abdominal wall. Subjects and Methods: A retrospective study of 23 female patients treated with AWE in four departments of three centers in Vladimir city, Russia, from January 2010 to December 2014 was performed. Results: In twenty patients (87%, AWE was symptomatic, and in three patients (13%, AWE was asymptomatic. Esquivel triad presented in 17 patients (74%, and modified Esquivel triad existed in 20 patients (87%. All 23 patients were operated, and AWE excision was performed. Recurrence occurred in 4 cases (17.4% and was associated with postoperative pain and seroma. Conclusion: Postoperative pain for more than 7 days and seroma (on ultrasonography seem to be associated with recurrence of AWE.

  8. Abdominal wall actinomycosis associated with an IUD. A case report.

    Science.gov (United States)

    Adachi, A; Kleiner, G J; Bezahler, G H; Greston, W M; Friedland, G H

    1985-02-01

    Abdominal wall actinomycosis without pelvic organ involvement in users of intrauterine contraceptive devices (IUDs) has not been reported on previously. We encountered one such patient, whose uterine cervix was colonized superficially with Actinomyces. We suggest that systemic actinomycosis be included in the differential diagnosis of pain in IUD users when Actinomyces is found on Papanicolaou smears or in endocervical curettings. Such patients should be treated with appropriate antibiotic therapy, especially prior to any surgical intervention.

  9. 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.

  10. Effects of the flexibility of the arterial wall on the wall shear stresses and wall tension in Abdominal Aortic Aneurysms.

    Science.gov (United States)

    Salsac, Anne-Virginie; Fernandez, Miguel; Chomaz, Jean-Marc

    2005-11-01

    As an abdominal aortic aneurysm develops, large changes occur in the composition and structure of the arterial wall, which result in its stiffening. So far, most studies, whether experimental or numerical, have been conducted assuming the walls to be rigid. A numerical simulation of the fluid structure interactions is performed in different models of aneurysms in order to analyze the effects that the wall compliance might have on the flow topology. Both symmetric and non-symmetric models of aneurysms are considered, all idealistic in shape. The wall mechanical properties are varied in order to simulate the progressive stiffening of the walls. The spatial and temporal distributions of wall tension are calculated for the different values of the wall elasticity and compared to the results for the rigid walls. In the case of rigid walls, the calculation of the wall shear stresses and pressure compare very well with experimental results.

  11. 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)

  12. Extended mesh repair with external oblique muscle reinforcement for abdominal wall contour abnormalities following TRAM flap.

    Science.gov (United States)

    Israeli, Ron; Hazani, Ron; Feingold, Randall S; DeNoto, George; Scheiner, Marc S

    2009-12-01

    Many patients undergoing reconstructive surgery after mastectomy opt for reconstruction with the transverse rectus abdominis myocutaneous (TRAM) flap. Among the morbidities related to TRAM flap reconstruction is the development of abdominal wall contour abnormalities, including bulges or hernias. Several repair techniques at the flap abdominal wall donor site have been described for use at the time of flap harvest in an attempt to reduce the risk of such abdominal wall complications. For patients that develop abdominal wall contour abnormalities, numerous reconstructive options have been reported, with mixed results. Ten patients were identified as having abdominal wall contour abnormalities after a TRAM flap and underwent an extended mesh repair with external oblique muscle reinforcement. The mesh was secured to the bony landmarks of the lower abdomen and the abdominal wall fascia. All patients achieved complete resolution of abdominal wall bulging. In the follow-up period, no recurrences, infections, or seromas were noted. One patient, who failed an earlier repair at the inferior abdominal wall, reported symptoms consistent with a scar neuroma. Symptoms were treated successfully with gabapentin and a nonsteroidal anti-inflammatory drug. We propose a novel and reliable method of lower abdominal wall reconstruction for patients with post-TRAM flap abdominal wall contour abnormalities. This technique incorporates the use of a large Marlex mesh reinforced with bilateral external oblique muscle flaps. We report a series of 10 patients who have achieved resolution of their symptoms and have regained a natural, flat-appearing abdominal wall contour.

  13. Abdominal wall abscess containing gallstones as a late complication to laparoscopic cholecystectomy performed 17 years earlier

    DEFF Research Database (Denmark)

    Christensen, Anders Mark; Christensen, Mads Mark

    2013-01-01

    of a 53-year-old woman who developed two abscesses--one intra-abdominally and one in the abdominal wall-17 years after an LC. Three gallstones were found during surgical excision of the abdominal wall abscess. Surgeons should strive to avoid perforation of the gall bladder during LC. If spillage...

  14. Electrical muscle stimulation for deep stabilizing muscles in abdominal wall.

    Science.gov (United States)

    Coghlan, Simon; Crowe, Louis; McCarthyPersson, Ulrik; Minogue, Conor; Caulfield, Brian

    2008-01-01

    Low back pain is associated with dysfunction in recruitment of muscles in the lumbopelvic region. Effective rehabilitation requires preferential activation of deep stabilizing muscle groups. This study was carried out in order to quantify the response of deep stabilizing muscles (transverses abdominis) and superficial muscle in the abdominal wall (external oblique) to electrical muscle stimulation (EMS). Results demonstrate that EMS can preferentially stimulate contractions in the deep stabilizers and may have significant potential as a therapeutic intervention in this area, pending further refinements to the technology.

  15. Congenital Anaplastic Rhabdomyosarcoma Presenting As Abdominal Wall Mass.

    Science.gov (United States)

    Mondal, Krishnendu; Mandal, Rupali

    2016-01-01

    Rhabdomyosarcoma encompasses a group of malignant myogenic neoplasms expressing a multitude of clinical and pathological diversities. It is the commonest soft tissue sarcoma of childhood but neonates are rarely affected. Embryonal subtype is the most frequent. Head-neck and genitourinary tracts are predominant sites, while trunk is considered among the unusual sites of rhabdomyosarcoma. Herein we report a case of anaplastic rhabdomyosarcoma in a newborn girl presenting, at the Pediatric Surgery Outpatient Department of North Bengal Medical College and Hospital, India in 2013 with a large tumor mass in the left flank region, arising from abdominal wall muscles.

  16. Post-operative Abdominal Wall Mucormycosis-a Case Series.

    Science.gov (United States)

    Nain, Prabhdeep Singh; Matta, Harish; Singh, Kuldip; Chhina, Deepinder; Trehan, Munish; Batta, Nishant

    2015-12-01

    Mucormycosis is caused by saprophtytic fungi which cause acute invasive zygomycosis. It clinically presents with necrosis, and on histopathology, acute and chronic infiltrates are seen. It rarely infects a healthy host, but is devastating in an immunocompromised host. We studied five cases with post-operative abdominal wall mucormycosis, three females and two males. Three patients were post-operative while the other two had mucormycosis following trauma and infection was found in sutured wound. All were initially diagnosed as cases of necrotizing fasciitis. Two patients eventually survived after intensive medical therapy and extensive debridements.

  17. 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.

  18. 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.

  19. Cadaver as an experimental model to study abdominal wall tension

    Directory of Open Access Journals (Sweden)

    Nahas Fábio Xerfan

    2003-01-01

    Full Text Available The use of cadaver as an experimental model to evaluate tension of the abdominal wall after aponeurotic incisions and muscular undermining is described on this article. The tension required to pull the anterior and the posterior rectus sheaths towards the midline was studied in fresh cadavers at two levels: 3 cm above and 2 cm below the umbilicus. Traction measurement was assessed with a dynamometer attached to suture loops on the anterior and posterior recti sheaths, close to the midline, above and below the umbilicus. The quotient of the force used to mobilize the aponeurotic site to the midline and its resulting displacement was called the traction index. These indices were compared in three situations: 1 prior to any aponeurotic undermining; 2 after the incision of the anterior rectus sheath and the undermining of the rectus muscle from its posterior sheath; and 3 after additionally releasing and undermining of the external oblique muscle. The experimental model described showed to be feasible to demonstrate the effects on tension of the abdominal wall after incisions and undermining of its muscles and aponeurosis.

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

    Directory of Open Access Journals (Sweden)

    Mirian Natalia Herrera Toro

    2010-08-01

    Full Text Available

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

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

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

  1. Arterial embolization for traumatic lethal lateral abdomi-nal wall hemorrhage in a liver cirrhosis patient

    Institute of Scientific and Technical Information of China (English)

    Seiji Morita; Tomoatsu Tsuji; Takeshi Yamagiwa; Hiroyuki Otsuka; Sadaki Inokuchi

    2009-01-01

    @@ B lood loss due to abdominal wall hemorrhage is generally managed conservatively. Further, abdominal wall hemorrhage rarely develops into a life-threatening condition. However, it is difficult to sur-gically achieve hemostasis. We report the case of a liver cirrhosis patient with life-threatening abdominal wall hemorrhage that developed as a result of a minor trauma and was successfully treated with arterial embolization (AE).

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

    Science.gov (United States)

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

    2016-02-01

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

  3. 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.)

  4. 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.

  5. Abdominal compliance, parasternal activation, and chest wall motion.

    Science.gov (United States)

    Cala, S J; Edyvean, J; Engel, L A

    1993-03-01

    We measured abdominal compliance (Cab) and rib cage displacement (delta Vrc) relative to abdominal displacement (delta Vab) during relaxation and tidal breathing in upright (U) and supine (S) postures in five normal subjects. In S, an abdominal binder was used to decrease Cab in two to five increments. We also measured the electrical activity of the parasternal muscle (EMGps) with the use of fine-wire intramuscular electrodes during CO2 rebreathing in U and in supine unbound (SU) and supine bound (SB) postures. During maximum binding (SB2), Cab decreased to 39 +/- 7% of the SU value (P = 0.01), matching Cab in U (P = 0.16). In the SB condition, the ratio of tidal delta Vrc/delta Vab to relaxation delta Vrc/delta Vab increased as Cab decreased, matching the data in U. For the group, this ratio decreased during SU to 47 +/- 10% (P = 0.02) but increased during SB2 to 86 +/- 7% (P = 0.18) of the value in U. During CO2 rebreathing, EMGps increased linearly with tidal volume (r > 0.727, P < 0.01). However, at any given tidal volume, the SU and SB2 EMGps were not significantly different (P = 0.12), and both were less than that in U (P < 0.02). The results suggest that the differences in chest wall motion between U and S may be due to the difference in Cab and not to different patterns of respiratory muscle recruitment. The mechanism may relate to changes in mechanical coupling between the diaphragm and the rib cage.

  6. New composite patches and biologic patches for repair of contaminated abdominal wall defect in dogs: A comparative study%污染环境下新型复合补片和生物补片修补犬腹壁缺损的比较研究

    Institute of Scientific and Technical Information of China (English)

    郑亚杰; 田文; 丁国飞; 姚京; 马冰

    2012-01-01

    Objective To compare the characteristics of two compound patches made of collagen and polypropylene(PP) and the feasibility of their application in repair of contaminated wounds. Methods Twenty-four adult male dogs, weighing 16-20kg, were included in this study. A dog model with 3 contaminated defects at the upper, left and right abdominal wall was established. The 3 abdominal wall defects were repaired by implanting 3 kinds of patches into them. The patches were divided into PP and collagen compound patch group(group A), porcine cross-linked biologic patch group(group B), and cattle cross-linked biologic patch group(group C). A dog abdominal hernia model was established. A segment of small intestine was removed, into which 10ml 0.9% sodium chloride solution was injected and then aspirated to contaminate the abdominal cavity, abdominal wall and patches. The abdominal wall defects were closed with 5cm × 5cm patches. The dogs were killed on day 90 after operation to observe the adhesion of organs in abdominal cavity. The patches and their adjacent tissue were cut into sections for histological study. Results No death occurred while patch and omentum adhesion was observed in different groups 90 days after operation. Histological study showed that the scores of proliferating fibroblasts, inflammatory reaction and formation of new blood vessels were higher in group A than in groups B and C. Conclusion The effect of PP and collagen compound patch and biological patch is similar in preventing adhesion under contaminated environment. However, it leads to severer proliferation of fibroblasts, inflammatory reaction and formation of new blood vessels than biologic patch.%目的 比较胶原蛋白与聚丙烯(polypropylene,PP) 制作的复合补片和两种生物补片的特点及其应用于污染伤口一期修补的可行性.方法 成年雄性普通犬24 只,体质量16-20kg,在同一只动物上、左、右腹部建立三个污染缺损模型,将3 种补

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    F.J. Gabilondo Zubizarreta

    2006-09-01

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

  9. Seatbelt triad: severe abdominal wall disruption, hollow viscus injury, and major vascular injury.

    Science.gov (United States)

    Kulvatunyou, Narong; Albrecht, Roxie M; Bender, Jeffrey S; Friese, Randy S; Joseph, Bellal; Latifi, Rifat; O'Keefe, Terrance; Wynn, Julie L; Rhee, Peter M

    2011-05-01

    The triad of seatbelt-related severe abdominal wall disruption, hollow viscus injury, and distal abdominal aortic injury after a motor vehicle collision is uncommon. We present a small case series involving those three clinical features with the goal of preventing a future missed diagnosis of the distal abdominal aortic injury in particular.

  10. Clinical analysis of abdominal wall endometriosis in 101 cases

    Institute of Scientific and Technical Information of China (English)

    Cheng Ning-hai; Zhu Lan; Lang Jing-he; Liu Zhu-feng; Sun Da-wei; Leng Jin-hua

    2006-01-01

    Objective: To review the clinical characteristics, treatment and prognoses of abdominal wall endometriosis(AWE).Methods: A retrospective study of 101 cases of AWE from 1992 to 2005 at Obstetric and Gynecologic Department of Peking Union Medical College Hospital was performed. Ninety-eight patients had a history of caesarean section. The mean age of the patients was (33.3±4.8) years and the average size of the mass was 1.5 cm. Abdominal wall mass associated pain during the menstrual cycle was noticed in 89.8% of the patients. The occurrence of AWE after caesarean section was 0.05% at our hospital. In patients without pelvic endometriosis or adenomyosis, 20.5% were presented with high CA125 >35 U/ml and the highest one was 93.4 U/ml. 92.1% of patients were diagnosed before surgery. 4 patients were administrated first in General Surgical Department with painless abdominal mass. Medication was adopted in 16 cases pre-operatively and 14 cases post-operatively.Results: The mean size of the resected mass was 4.2 cm, significantly larger than the estimation with palpation or ultrasonography, which was 0.8-1.2 cm (P=0.006, P<0.001). Pelvic endometriosis or adenomyosis was detected during the operation in 13 patients. One patient was diagnosed as atypical endometriosis by pathological examination in the beginning but transformed to be sarcoma finally. Ten patients recurred after surgery. 2 of them received medication and 5 of them received second operation.Conclusions: Ultrasonography can be used to evaluate the size of the mass and the infiltrative scope pre-operation. The serum CA125 is not specific for diagnosis of AWE. Complete eradication of the lesion with at least 1 cm beyond the edge of the mass is recommended as the primary treatment. Eradication should be considered also in recurrent cases. It may transform to malignant lesions after multiple recurrence.

  11. 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.

  12. Uso del Fingerprinting de ADN para asignar paternidad en un rebaño con casos de malformación congénita de la pared abdominal Application of DNA Fingerprinting to determine paternity in cattle with large congenital abdominal wall defect progeny

    Directory of Open Access Journals (Sweden)

    N. GORLA

    1998-01-01

    Full Text Available Se evaluó la efectividad del fingerprinting de ADN para determinarla paternidad en un rebaño bovino con casos de malformacióncongénita de la pared abdominal. La técnica elegida fue elfingerprinting multilocus con la sonda (CAC5. Las muestrasde ADN fueron obtenidas de sangre periférica por los métodoshabituales, digeridas con la enzima de restricción Hae III, transferidasa membranas de nylon e hibridadas. Se analizaron en forma visual los patronesde banda obtenidos y los datos fueron procesados por el programa "PATER".A pesar de la alta consanguinidad de las razas estudiadas, la probabilidadde paternidad (W obtenida fue en un caso W = 0.80 y en el otro W = 0.93,lo que demostró la efectividad de la sonda (CAC5 paradeterminar la paternidad de un mismo toro sobre los dos terneros afectadosThe efficiency of DNA fingerprinting to solve a paternity dispute wasevaluated in four Hereford bulls of a Cebú/Hereford cattle herdwith two calves affected by a congenital abdominal wall malformation. Thetest was carried out using multi-locus probe (CAC5. 8 DNA samples ?twofrom the affected calves, two from their corresponding mothers and 4 frombulls (supposed sires? were processed. These samples were digested withrestriction enzyme Hae III, blotted onto nylon membranes and hybridisedwith (CAC5. The bands obtained were visually analysed and data was processedby the computer program "PATER" (with the "PATER" computer program. Theprobability of paternity (W was W = 0.80 in one case and W = 0.93 in theother. Despite the known inbreeding of the bovine breed tested, it waspossible to ascertain the paternity with multilocus DNA fingerprinting(CAC5

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... wall reconstruction showed a significantly greater improvement of percent predicted peak expiratory flow compared with patients undergoing colorectal resection. CONCLUSION: Abdominal wall reconstruction for large incisional hernia improved long-term expiratory lung function. Respiratory quality of life...

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Danielle Duck Schulz

    2009-12-01

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

  16. 三种复合补片在污染环境下修补大鼠腹壁缺损的比较研究%COMPARISON OF THREE COMPOSITE PATCHES FOR REPAIR OF ABDOMINAL WALL DEFECT IN RATS UNDER CONTAMINATED ENVIRONMENT

    Institute of Scientific and Technical Information of China (English)

    姚京; 田文; 李佳

    2011-01-01

    目的 观察聚丙交己内酯(polylactide-co-caprolactone,PLC)、透明质酸(hyaluronic acid,HA)、胶原蛋白与聚丙烯(polypropylene,PP)网片复合,在污染环境下修补大鼠腹壁缺损后粘连情况和修补效果,比较3种复合补片特点及一期修补可行性.方法 成年雄性Wistar大鼠93只,体重150~250 g,随机分为3组(n=31):PP/PLC复合补片组(A组),PP/HA/PLC复合补片组(B组),PP/胶原蛋白/PLC复合补片组(C组).各组取1只大鼠小肠制备污染源匀浆.其余大鼠制备直径约1 cm的腹壁疝模型后,根据分组将直径1.5 cm的复合补片缝合于腹壁缺损处.术后观察大鼠一般情况;于术后30、60、90 d处死大鼠,大体观察腹腔脏器粘连情况;切取补片及其周围组织进行组织学观察.结果 术后10~70 d共6只大鼠死亡,其中A组2只,B组3只,C组1只;死亡原因均与补片修补无关.术后各时间点各组均见腹腔脏器与补片粘连,主要为肠管、网膜、肝.按照修正的Katada粘连评分方法,术后30、60 d各组间粘连评分比较,差异均无统计学意义(P>0.05);90 d时C组粘连评分显著低于A、B组(P<0.05).组织学观察,术后30 d各组补片周围可见炎性细胞浸润,成纤维细胞出现且胶原分泌增加,可吸收材料残留:60 d时补片周围炎性细胞较前减少,成纤维细胞数量及胶原分泌较前增加,各组仅见PLC残留;90d时成纤维细胞日趋成熟,可见胶原充填,腹腔面可见间皮层逐渐形成,各组残留PLC较前减少.结论 在污染环境下,PP/胶原蛋白/PLC复合补片在腹腔粘连及局部组织反应方面均优于PP/PLC及PP/HA/PLC复合补片,更适于一期修补大鼠腹壁缺损,但其远期效果及安全性仍待进一步确定.%Objective To observe the anti-adhesion and repair effect of 3 composite patches which composed of polylactide-co-caprolactone (PLC), hyaluronic acid (HA), collagen, and polypropylene (PP) mesh repairing abdominal wall defect in rats under

  17. Effects of aging on abdominal wall healing in rats

    Directory of Open Access Journals (Sweden)

    Biondo-Simões Maria de Lourdes Pessole

    2005-01-01

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

  18. Case report of traumatic abdominal wall hernia following blunt motorcycle handlebar injury and review of the literature.

    Science.gov (United States)

    Ogundiran, T O; Obamuyide, H A; Adesina, M A; Ademola, A F

    2012-01-01

    A 25-year-old man, riding a motorcycle, rammed into a moving car at a T junction and sustained a blunt lower-right abdominal injury with the handlebar of his motorbike. He developed a swelling at the point of impact for which he presented in hospital 10 days later. Clinical assessment revealed a healthy young man with a soft, nontender reducible swelling over the lateral half of the right inguinal area. A diagnosis of acute traumatic hernia was made. Abdominal ultrasonography revealed a wide-necked defect in the anterior abdominal wall over the right inguinal area with protruding bowel loops beneath an intact skin. He was planned for herniorrhaphy but has defaulted since then.

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

    Directory of Open Access Journals (Sweden)

    Maarten Philip Cornelissen

    2016-04-01

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

  20. 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.)

  1. [Results of a national survey on abdominal wall closure].

    Science.gov (United States)

    Pereira, José Antonio; López-Cano, Manuel; Marsal, Francesc; Feliu, Xavier

    2013-12-01

    To assess knowledge on the abdominal wall closure through a surgeon cohort survey. A twenty question individual questionnaire on laparotomy in elective surgery. A total of 131 surgeons from seven hospitals responded (72% specialists and 28% in training). 71% of respondents estimated the frequency of incisional hernia to be higher than 15% and 54% considered the technique to be the most significant risk factor. 85% considered midline laparotomy closed with slow absorbable suture (57%) in a single layer (66%) to be the most appropriate technique. 67% believed retention sutures to be the appropriate prevention technique. 50% did not know or could not apply the 4:1 technique. 87% considered that an incisional hernia can be prevented and that the technique is the most important factor on which to act. 84% believed that a prosthesis can prevent the occurrence of incisional hernia, whereas 40% of respondents never use it and only 38% use it in patients at risk. On comparing surveys between specialists and residents, significant differences appeared in terms of a better understanding of the theoretical technical aspects in trainee surgeons. Although the results show an adequate understanding of the epidemiology and risk factors for development of incisional hernia, training and consensus measures are likely to be introduced in some basic technical aspects in order to improve results in laparotomy closure. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  2. The biomechanical behavior and host response to porcine-derived small intestine submucosa, pericardium and dermal matrix acellular grafts in a rat abdominal defect model.

    Science.gov (United States)

    Zhang, Jian; Wang, Guan Yu; Xiao, Yi Pin; Fan, Lie Ying; Wang, Qiang

    2011-10-01

    Several porcine-derived acellular biologic grafts are increasingly used in abdominal wall reconstruction due to the limitations of synthetic meshes in many clinical situations. However, relatively little is known so far about their comparative mechanical characteristics and performance after defect repair. We therefore investigated three most commonly used porcine-derived acellular biomaterials, small intestine submucosa (P-SIS), pericardium (P-PC) and acellular dermal matrix (P-ADM) immediately after prepared, and their effectiveness, biomechanical and histological characteristics in repairing full-thickness abdominal defect in a rat model. P-PC had the best native performance in the burst strength, tensile strength and ball burst among the three porcine-derived scaffolds. P-SIS showed a significantly higher water vapor transmission in comparison with P-PC or P-ADM. Abdominal wall defects in rats were all satisfied repaired with P-SIS, P-PC or P-ADM. No laxity or fistula was observed in the repaired abdominal wall in the P-SIS group up to 8 weeks after surgery. However, there was a tendency for high postoperative abdominal eventration in the P-ADM and P-PC groups as compared with the P-SIS group. With regard to overall aspects of the postoperative laxity, intra-abdominal adhesion formation, tensile stress, stretchability, and degree of tissue ingrowth in terms of collagen deposition and neovascularization, P-SIS exhibits clear advantages over P-PC as well as P-ADM after large abdominal wall defect reconstruction.

  3. 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.

  4. Deletion of mesenchymal glucocorticoid receptor attenuates embryonic lung development and abdominal wall closure.

    Directory of Open Access Journals (Sweden)

    Aiqing Li

    Full Text Available As a member of the nuclear hormone receptor superfamily of ligand-activated transcription factors, the glucocorticoid receptor (GR is essential for normal embryonic development. To date, the role of mesenchymal glucocorticoid signaling during development has not been fully elucidated. In the present study, we investigated the role of the GR during embryogenesis specifically in mesenchymal tissues. To this aim, we crossed GRflox mice with Dermo1-Cre mice to generate GR(Dermo1 mice, where the GR gene was deleted within mesenchymal cells. Compared to their wild type littermates, GR(Dermo1 mice displayed severe pulmonary atelectasis, defects in abdominal wall formation resulting in intestinal herniation, abnormal extracellular matrix synthesis in connective tissues and high postnatal lethality. Lungs of GR(Dermo1 mice failed to progress from the canalicular to saccular stage, as evidenced by the presence of immature air sacs, thickened interstitial mesenchyme and an underdeveloped vascular network between E17.5 and E18.5. Furthermore, myofibroblasts and vascular smooth muscle cells, although present in normal numbers in GR(Dermo1 animals, were characterized by significantly reduced elastin synthesis, whilst epithelial lining cells of the immature saccules were poorly differentiated. A marked reduction in normal elastin and collagen deposits were also observed in connective tissues adjacent to the umbilical hernia. This study demonstrates that eliminating the GR in cells of the mesenchymal lineage results in marked effects on interstitial fibroblast function, including a significant decrease in elastin synthesis. This results in lung atelectasis and postnatal lethality, as well as additional and hitherto unrecognized developmental defects in abdominal wall formation. In addition, altered glucocorticoid signaling in the mesenchyme attenuates normal lung epithelial differentiation.

  5. Detection of Wall-Thinned Defects Using IR Thermography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ju Hyun; No, Young Gyu; Park, Soon Ho; Na, Man Gyun; Kim, Jin Weon; Jung, Hyun Chul; Kim, Kyeong Suk [Chosun University, Gwangju (Korea, Republic of)

    2011-10-15

    Recently, the number of the life-extended nuclear power plants (NPPs) is increasing. Thus, the degradation can occur in the various structures of the NPP secondary systems caused by the fatigue or corrosion, etc. Among these problems, the wall-thinned defect by the fluids of the inner wall can break the pipe due to the local stress concentrations. This cases have already emerged as an important issue in terms of ensuring the soundness and safety in NPPs. There are many NDT techniques to detect the wall-thinned defect from the inner wall. The infrared thermography which is one of these techniques provides real-time images by scanning the temperature of the target surface and then, converting it to the temperature. This technique can solve the existing problems by identifying the presence or absence of the defect through observation of the temperature difference

  6. Sonography of Abdominal Wall Masses and Masslike Lesions: Correlation With Computed Tomography and Magnetic Resonance Imaging.

    Science.gov (United States)

    Ahn, Sung Eun; Park, Seong Jin; Moon, Sung Kyoung; Lee, Dong Ho; Lim, Joo Won

    2016-01-01

    Sonography is usually regarded as a first-line imaging modality for masses and masslike lesions in the abdominal wall. A dynamic study focusing on a painful area or palpable mass and the possibility of ultrasound-guided aspiration or biopsy are the major advantages of sonography. On the other hand, cross-sectional imaging clearly shows anatomy of the abdominal wall; thereby, it is valuable for diagnosing and evaluating the extent of diseases. Cross-sectional imaging can help differentiate neoplastic lesions from non-neoplastic lesions. This pictorial essay focuses on sonographic findings of abdominal wall lesions compared with computed tomographic and magnetic resonance imaging findings.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

  8. Ureteral reconstruction with abdominal wall muscle flap: experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    Nelson Alfred Smith

    2014-12-01

    Full Text Available The authors detail the experimental development of a technique for the reconstruction of the ureter using a tubular shape, muscle flap of the abdominal wall. the preliminary results indicate the feasibility of this surgical technique.

  9. Ureteral reconstruction with abdominal wall muscle flap: experimental study in rabbits

    OpenAIRE

    Nelson Alfred Smith; Paulo Cesar Silva; Manoel Luiz Ferreira; Alberto Schanaider

    2014-01-01

    The authors detail the experimental development of a technique for the reconstruction of the ureter using a tubular shape, muscle flap of the abdominal wall. the preliminary results indicate the feasibility of this surgical technique.

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

    Directory of Open Access Journals (Sweden)

    Abdulwahid M. Salih

    2017-01-01

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

  11. [MORPHOLOGICAL PECULIARITIES OF MUSCULO-APONEUROTIC TISSUES OF ANTERIOR ABDOMINAL WALL IN PATIENTS, SUFFERING MORBID OBESITY].

    Science.gov (United States)

    Usenko, O Yu; Gomolyako, I V; Kondratenko, B M; Moskalenko, V V

    2015-11-01

    Results of morphological investigation of musculo-aponeurotic structures of anterior abdominal wall were presented in the morbid obesity patients. The role of obesity as a primary cause for morphofunctional insufficience of musculo-aponeurotic structures was established.

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

    Directory of Open Access Journals (Sweden)

    Kosuke Kobayashi

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  14. Architectural and morphological assessment of rat abdominal wall muscles: comparison for use as a human model.

    Science.gov (United States)

    Brown, Stephen H M; Banuelos, Karina; Ward, Samuel R; Lieber, Richard L

    2010-09-01

    The abdominal wall is a composite of muscles that are important for the mechanical stability of the spine and pelvis. Tremendous clinical attention is given to these muscles, yet little is known about how they function in isolation or how they interact with one another. Given the morphological, vascular, and innervation complexities associated with these muscles and their proximity to the internal organs, an appropriate animal model is important for understanding their physiological and mechanical significance during function. To determine the extent to which the rat abdominal wall resembles that of human, 10 adult male Sprague-Dawley rats were killed and formalin-fixed for architectural and morphological analyses of the four abdominal wall muscles (rectus abdominis, external oblique, internal oblique, and transversus abdominis). Physiological cross-sectional areas and optimal fascicle lengths demonstrated a pattern that was similar to human abdominal wall muscles. In addition, sarcomere lengths measured in the neutral spine posture were similar to human in their relation to optimal sarcomere length. These data indicate that the force-generating and length change capabilities of these muscles, relative to one another, are similar in rat and human. Finally, the fiber lines of action of each abdominal muscle were similar to human over most of the abdominal wall. The main exception was in the lower abdominal region (inferior to the pelvic crest), where the external oblique becomes aponeurotic in human but continues as muscle fibers into its pelvic insertion in the rat. We conclude that, based on the morphology and architecture of the abdominal wall muscles, the adult male Sprague-Dawley rat is a good candidate for a model representation of human, particularly in the middle and upper abdominal wall regions.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    OpenAIRE

    2009-01-01

    Proteus syndrome is an extremely rare congenital disorder that produces multifocal overgrowth of tissue. This report presents a surgical case of a large lipoma in the abdominal wall of a patient with Proteus syndrome. She was diagnosed with Proteus syndrome based on certain diagnostic criteria. The neoplasm increased in size gradually, producing hemihypertrophy of her left lower extremity and trunk, and spread to her retroperitoneum and her left abdominal wall. She experienced gradually progr...

  17. 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

  18. Kinetics of implant-induced inflammatory angiogenesis in abdominal muscle wall in mice.

    Science.gov (United States)

    Castro, Pollyana R; Marques, Suzane M; Campos, Paula P; Cardoso, Cibele C; Sampaio, Fernanda P; Ferreira, Monica A N D; Andrade, Silvia P

    2012-07-01

    Injury of skeletal abdominal muscle wall is a common medical condition and implantation of synthetic or biological material is a procedure to repair musculofascial defects. We proposed to characterize the dynamics of inflammatory cell recruitment, newly formed blood vessels, cytokine production and fibrogenesis in the abdominal skeletal muscle in response to polyether-polyurethane sponge implants in mice. At 2, 4, 7 and 10days after implantation the muscle tissue underneath the sponge matrix was removed for the assessment of the angiogenic response (hemoglobin content, vascular endothelial growth factor and morphometric analysis of the number of vessels) and inflammation (myeloperoxidase and n-acethyl-B-d-glucosaminidase activities, cytokines). In addition, muscle fibrogenesis was determined by the levels of TGF-β1 and collagen deposition. Hemoglobin content, wash out rate of sodium fluorescein (indicative of blood flow) and the number of vessels increased in the abdominal muscle bearing the synthetic matrix in comparison with the intact muscle. Neutrophil recruitment peaked in the muscle at day 2, followed by macrophage accumulation at day 4 post-injury. The levels of the cytokines, VEGF, TNF-α, CCL-2/MCP-1 were higher in the injured muscle compared with the intact muscle and peaked soon after muscle injury (days 2 to 4). Collagen levels were higher in sponge-bearing muscle compared with the non-bearing tissue soon after injury (day 2). The implantation technique together with the inflammatory and vascular parameters used in this study revealed inflammatory, angiogenic and fibrogenic events and mechanisms associated with skeletal muscle responses to synthetic implanted materials.

  19. Abdominal wall reconstruction by a regionally distinct biocomposite of extracellular matrix digest and a biodegradable elastomer.

    Science.gov (United States)

    Takanari, Keisuke; Hong, Yi; Hashizume, Ryotaro; Huber, Alexander; Amoroso, Nicholas J; D'Amore, Antonio; Badylak, Stephen F; Wagner, William R

    2016-09-01

    Current extracellular matrix (ECM) derived scaffolds offer promising regenerative responses in many settings, however in some applications there may be a desire for more robust and long lasting mechanical properties. A biohybrid composite material that offers both strength and bioactivity for optimal healing towards native tissue behavior may offer a solution to this problem. A regionally distinct biocomposite scaffold composed of a biodegradable elastomer (poly(ester urethane)urea) and porcine dermal ECM gel was generated to meet this need by a concurrent polymer electrospinning/ECM gel electrospraying technique where the electrosprayed component was varied temporally during the processing. A sandwich structure was achieved with polymer fiber rich upper and lower layers for structural support and an ECM-rich inner layer to encourage cell ingrowth. Increasing the upper and lower layer fiber content predictably increased tensile strength. In a rat full thickness abdominal wall defect model, the sandwich scaffold design maintained its thickness whereas control biohybrid scaffolds lacking the upper and lower fiber-rich regions failed at 8 weeks. Sandwich scaffold implants also showed higher collagen content 4 and 8 weeks after implantation, exhibited an increased M2 macrophage phenotype response at later times and developed biaxial mechanical properties better approximating native tissue. By employing a processing approach that creates a sheet-form scaffold with regionally distinct zones, it was possible to improve biological outcomes in body wall repair and provide the means for further tuning scaffold mechanical parameters when targeting other applications. Copyright © 2013 John Wiley & Sons, Ltd.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: The material and the surgical technique used to close an abdominal wall incision are important determinants of the risk of developing an incisional hernia. Optimising closure of abdominal wall incisions holds a potential to prevent patients suffering from incisional hernias...... and for important costs savings in health care. METHODS: The European Hernia Society formed a Guidelines Development Group to provide guidelines for all surgical specialists who perform abdominal incisions in adult patients on the materials and methods used to close the abdominal wall. The guidelines were developed...... using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and methodological guidance was taken from Scottish Intercollegiate Guidelines Network (SIGN). The literature search included publications up to April 2014. The guidelines were written using the AGREE II...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-06-01

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

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

    Science.gov (United States)

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

    2009-07-14

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

  3. Resection and repair of large abdominal wall lesions in gynecologic patients

    Institute of Scientific and Technical Information of China (English)

    LIU Zhu-feng; WANG Jin-hui; CUI Bing-qian; FAN Qing-bo; WANG Xiao-jun; ZHAO Ru; SONG Ke-xin

    2013-01-01

    Background The techniques of resection and repair of large lesions in the abdominal wall are very challenging in the area of gynecology.We explored the techniques of resection and plastic surgical repair of large abdominal wall lesions in gynecologic patients.Methods Twenty-six patients with large lesions in the abdominal wall underwent resection by the gynecologists and repair through abdominal plasty and V-Y plasty with or without fascia patch grafting by the gynecologists or plastic surgeons from March 2003 to October 2010.Results All patients had a history of cesarean section.One patient had an infected sinus tract after cesarean section,one patient had an inflammatory nodule,and the others had lesions of endometriosis,including one cancer.The average largest lesion diameter was (4.79 ± 4.18) cm according to the ultrasonography results.The lesions of all patients were completely resected with pretty abdominal contour.A polypropylene biological mesh was added to the fascia in 20 patients.One patient underwent groin flap repair,and one underwent V-Y advanced skin flap repair on the left of the incision to relieve the suture tension.Conclusions Multi-department cooperation involving the gynecology and plastic surgery departments,and even the general surgery department,is essential for patients with large lesions in the abdominal wall.This cooperative effort enabled surgeons to completely resect large lesions.Abdominal wall plastic surgical repair can ameliorate large wounds of the abdominal wall.

  4. Abdominal and scrotal wall emphysema in a patient with severe ulcerative colitis.

    Science.gov (United States)

    Sharma, Manik; Thandassery, Ragesh Babu; Hilli, Shatha Al; Kaabi, Saad Al

    2014-07-01

    Severe ulcerative colitis can be associated with bowel perforation. Bowel perforation rarely leads on to abdominal wall and scrotal wall emphysema. Bowel perforation in such cases can be spontaneous or iatrogenic (colonoscopy-related). We report a rare scenario where a patient presented with abdominal wall and scrotal emphysema after topical corticosteroid enema-induced traumatic rectal perforation. Topical corticosteroids were stopped immediately after identification of rectal perforation. The patient was managed conservatively with intravenous antibiotics. With this report we intend to sensitise clinicians and topical enema manufacturers regarding this rare complication.

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

    Institute of Scientific and Technical Information of China (English)

    Ding-Hui Dong; Wen-Yan Liu; Hai-Bo Feng; Yi-Li Fu; Shi Huang; Jun-Xi Xiang; Yi Lyu

    2015-01-01

    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 × x2 + P2 x 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.

  6. 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.

  7. [Resection of malignant fibrous histiocytoma through a combined thoracic and abdominal wall approach].

    Science.gov (United States)

    Otsuka, T; Harada, A; Wakida, K; Aoki, M; Nagata, T; Kariatsumari, K; Sakasegawa, K; Nakamura, Y; Sato, M; Nakayama, H; Kitajima, S

    2012-05-01

    We report a case of resection of malignant fibrous histiocytoma (MFH) via combined thoracic and abdominal wall incision reconstructed using GORE DUALMESH. A 60-year-old woman underwent resection of a left lower chest wall tumor. Since the tumor infiltrated into the diaphragm, a part of the left diaphragm and left upper abdominal wall were resected together. The left chest was closed by suturing the diaphragm to the ribs. The resected area of the thoracic and abdominal wall was 12×12 cm and was reconstructed with GORE DUALMESH. She received adjuvant radiotherapy as the tumor cells were detected in the surgical margin of the diaphragm. The patient has remained well without signs of recurrence for 10 months after the operation.

  8. 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.

  9. Defect-Defect Interaction in Single-Walled Carbon Nanotubes Under Torsional Loading

    Science.gov (United States)

    Huq, Abul M. A.; Bhuiyan, Abuhanif K.; Liao, Kin; Goh, Kheng Lim

    This paper presents an analysis of interactions between a pair of Stone-Wales (SW) defects in a single-walled carbon nanotube (SWCNT) that has been subjected to an external torque. Defect pairs, representing the different combinations of SW defect of A (SW-A) and B (SW-B) modes, were incorporated in SWCNT models of different chirality and diameter and solved using molecular mechanics. Defect-defect interaction was investigated by evaluating the C-C steric interactions in the defect that possesses the highest potential energy, E, as a function of inter-defect distance, D. This study reveals that the deformation of the C-C bond is attributed to bond stretching and bending. In the SW-B defects, there is an additional contributor arising from the dihedral angular deformation. The magnitude of E depends on the type of defect but the profile of the E versus D curve depends on the orientation of the defects. The largest indifference length, D0, beyond which two defects cease to interact, is approximately 30 Å. When the angular displacement of the tube increases two-fold, E increases, but the profile of the E versus D curve is not affected. The sense of rotation affects the magnitude of E but not the profile of the E versus D curve.

  10. 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 Emergenc

  11. 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 Emergenc

  12. Diagnosis and Management of Abdominal Wall Endometriosis: A Systematic Review and Clinical Recommendations.

    Science.gov (United States)

    Rindos, Noah B; Mansuria, Suketu

    2017-02-01

    Abdominal wall endometriosis (AWE) is a rare but easily treated cause of pain in women, especially those who have undergone cesarean deliveries. This article reviews the diagnosis and management of AWE, a condition that generally develops after surgery but may arise spontaneously. We present a systematic review of the existing literature on AWE, as well as our clinical recommendations for medical and surgical management. We searched PubMed and other databases using the search criteria "abdominal wall endometriosis," "abdominal wall endometriomas," and "abdominal wall mass." The references of those articles were then reviewed, and additional publications were evaluated. Many case reports and case series have been published describing AWE. The overall quality of evidence is poor due to the lack of prospective studies and heterogeneous descriptions of AWE lesions and treatment options. Based on the available literature, it appears that AWE may arise spontaneously but is generally associated with prior pelvic surgery. Abdominal wall endometriosis can be diagnosed with a careful history and physical examination. Imaging including ultrasound and magnetic resonance imaging can assist with localization of the lesions, and aid in surgical excision and management. Lesions that have been removed in their entirety are unlikely to reoccur. Although limited, the body of literature describing management of AWE suggests that it can be successfully treated in most patients with careful surgical planning.

  13. 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.

  14. Defect in the uterine wall with prolapse of amniotic sac into it at 32 weeks' gestation in a primigravida woman without any previous uterine surgery.

    Science.gov (United States)

    Mishina, Miyuki; Hasegawa, Junichi; Ichizuka, Kiyotake; Oba, Tomohiro; Sekizawa, Akihiko; Okai, Takashi

    2014-03-01

    We experienced a case of uterine wall defect with amniocele in a primigravida woman without any history of uterine surgery. On admission due to acute abdominal pain at 32 weeks' gestation, an ultrasound examination showed a 9 × 7-cm sized echogenic cystic area in the Morrison pouch. Color Doppler revealed a flow from the uterus into the cystic area through a myometrial defect. During the operation, a 1-cm defect in the uterine myometrium was found on the right fundus. An intact amniotic sac was prolapsed into the abdominal cavity through the myometrial defect. This was an extremely rare case of unexplained uterine wall defect. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

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

    Directory of Open Access Journals (Sweden)

    Maciej Nowacki

    2015-01-01

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

  16. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Zhoubing [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 (United States); Allen, Wade M. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37235 (United States); Baucom, Rebeccah B.; Poulose, Benjamin K. [General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37235 (United States); Landman, Bennett A. [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 and Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37235 (United States)

    2013-12-15

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

  18. 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.

  19. [Use of nickel-titanium alloys in plasty of the anterior abdominal wall].

    Science.gov (United States)

    Veronskiĭ, G I; Zotov, V A

    2000-01-01

    The work presents results of the surgical treatment of postoperative hernias of the abdominal wall using explants of titanium nickelide in 48 patients. Data of biopsy of the anterior abdominal wall muscles in these patients are given. The anatomo-morphological and functional incompetence is shown. A method of preparing the patients with giant hernias to operation with the help of dynamic pneumocompression is described. The indications to using the explants in hernioplasty are determined by the methods of somatometry and intraoperative dynamometry. The data of three methods of combined hernioplasty are presented: with the use of a superelastic network from a nickelide-titanium alloy; explant with tractional properties, effect of the "shape memory"; method of extracorporeal extension of the abdominal wall at the postoperative period. The nearest and long-term results followed-up during 3 years are shown.

  20. 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...... 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. Results Truncal flexion...

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

    Directory of Open Access Journals (Sweden)

    Jayme Fortunato Athias

    1997-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Yoshifumi Nakayama; Shinichi Kusuda; Naoki Nagata; Koji Yamaguchi

    2009-01-01

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

  3. Invasive group A Streptococcus resulting in sepsis and abdominal wall abscess after adenotonsillectomy.

    Science.gov (United States)

    Wilson, Paul F; Wannemuehler, Todd J; Matt, Bruce H

    2015-05-01

    Systemic infectious complications following adenotonsillectomy are exceedingly rare. We describe an otherwise healthy 2-year-old patient who developed group A beta-hemolytic Streptococcus sepsis and presumptive scarlet fever 3 days after an uncomplicated adenotonsillectomy. After resolution of fever, rash, and discharge home on antibiotics, the patient returned on postoperative day 10 with an abdominal wall abscess. This is the first reported case of an abdominal wall abscess as a complication of adenotonsillectomy. This case demonstrates that an awareness of unexpected infectious complications of adenotonsillectomy should be a part of postsurgical management. Laryngoscope, 125:1230-1232, 2015.

  4. Polymicrobial abdominal wall necrotizing fasciitis after cesarean section.

    Science.gov (United States)

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

    2012-09-01

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

  5. "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.

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

    Science.gov (United States)

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

    2016-07-01

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

  7. 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....

  8. 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.

  9. Experimental modeling hernia of anterior abdominal wall with abdomino-visceral obesity

    OpenAIRE

    KHAYITOV ILKHOM

    2016-01-01

    Improve the results of treatment of patients with postoperative ventral hernias, and based on the study of changes in the anterior abdominal wall of the experimental method of modeling To achieve this goal the first objective of the study was to develop an adequate experimental model of postoperative ventral hernias.

  10. Abdominal Wall Sinus: A Late Complication of Gallstone Spillage During Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Michael D. Graham

    1997-01-01

    Full Text Available Long term complications of laparoscopic cholecystectomy are uncommon. However, as experience with this procedure accumulates, sporadic reports of non-biliary complication have been published. We report a case of abdominal wall sinus formation secondary to gallbladder perforation and stone spillage occurring during laparoscopic cholecystectomy.

  11. Clinical Application of a Silk Fibroin Protein Biologic Scaffold for Abdominal Wall Fascial Reinforcement

    Directory of Open Access Journals (Sweden)

    Mark W. Clemens, MD

    2014-11-01

    Conclusions: Postoperative complication rates after 18 months were low, and most surgical complications were managed nonoperatively on an outpatient basis without mesh removal. To our knowledge, this is the only series to report on a long-lasting, transitory SBS for abdominal wall repair and reinforcement. Procedure-specific outcome studies are warranted to delineate optimal patient selection and define potential device characteristic advantages.

  12. [Primary actinomycosis of the abdominal wall. Description of 2 cases and review of the literature].

    Science.gov (United States)

    García García, J C; Núñez Fernández, M J; Cerqueiro González, J M; García Martín, C; Rodríguez García, J C; Anibarro García, L; de Lis Muñoz, J M; Piñeiro Gómez-Durán, L

    2001-02-01

    We report two cases of isolated abdominal wall actinomycosis and review 18 previously reported cases to further characterize the clinical findings and the therapeutic management of this syndrome. This diagnosis would be advocated in patients with a palpable abdominal mass of subacute appearance with a previous history of digestive medical illness, diabetes, abdominal surgery, or prolonged IUD use. In contrast with other actinomycosis locations, remarkable data were a more elevated mean age of patients; a female predominance; a prevalent location of mass in abdominal lower left quadrant; and a shorter duration of symptomatology before to diagnosis. The CT is the first choice for imaging study and percutaneous needle aspiration would be recommended for definite diagnosis. The long-term antibiotic therapy, with or without percutaneous drainage, is the first treatment choice because is very effective and made unnecessary a more invasive surgical management. The prognosis is excellent with adequated treatment.

  13. Indications and Outcomes of the Components Separation Technique in the Repair of Complex Abdominal Wall Hernias: Experience From the Cambridge Plastic Surgery Department

    Science.gov (United States)

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

    2013-01-01

    Objectives: The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Methods: Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. Results: There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). Conclusions: The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects. PMID:24058718

  14. Comparative Study of Acellular Small Intestinal Submucosa and Acellular Pericardium for Repairing Abdominal Wall Defects in Rats%脱细胞小肠黏膜下层与脱细胞心包修复大鼠腹壁缺损的对比研究

    Institute of Scientific and Technical Information of China (English)

    肖毅频; 王冠宇; 王强; 张剑

    2011-01-01

    Objective: To investigate the effects of small intestinal submucosa (SIS)and acellular pericardium (PC)on repairing wall defeats in rats, to compare compatibility of the two biological materials. Methods: A full-thickness 3cm × 2cm abdominal wall defeat was created in 40 rats weight from 200 to 250g, then they were repaired with an interpositional implant( SIS,n=20; PC,n=20). And the rats were harvested at week 1, week 2, week 4,and week 8 after operation. Animal general state of health, intra-abdominal adhesions and tensile strength were investigated. Results:All rats survived and the defeats were completely repaired by the materials without fistula or hernia. There were leas adhesion in SIS group than that in PC group 4、8 weeks after operation, the tensile strength of abdominal wall in SIS group is stronger than that in PC group (p <0.05). No obvious immunoreaction was observed in two groups by histology.Remodeling and regeneration and vascularization of the abdominal wall were better in SIS group compared with PC group. There was not difference of inflammatory reaction of the two groups. Conlusion:Both SIS and PC were feasible to repair full-thickness abdominal wall defeat and SIS is superior to PC in regards to tissue compatibility.%目的:观察小肠黏膜下层(small intestinal submucosa,SIS)和脱细胞心包(pericardium,PC)修复大鼠腹壁缺损的效果,比较两种生物材料相容性.方法:SD大鼠40只,体重200~250g,手术造成3cmx2cm全层腹壁缺损,随机分为二组(n=20),分别采用相同面积的小肠黏膜下层(small intestinal submucosa,SIS)和脱细胞真皮基质(acellular dermal matr,ADM)补片进行修补.术后1、2、4和8周分批取出腹壁修复材料,行动物一般情况观察、腹腔内粘连情况评价、力学强度测定及组织学观察.结果:术后动物都成活,两种材料术后8周均无疝瘘发生,缺损得到完整修复.术后各期SIS组的腹腔粘连评分明显低于PC组.术后4、8周,SIS组

  15. Closure of the abdominal wall at the umbilicus and the development of umbilical hernias in a group of foals from birth to 11 months of age.

    Science.gov (United States)

    Enzerink, E; van Weeren, P R; van der Velden, M A

    2000-07-08

    The closure of the body wall defect at the umbilicus was studied in relation to the development of umbilical hernias in a group of 44 normal foals, 25 of which were followed from birth until five months of age, and 19 from birth until 11 months of age. At birth, 19 of the foals had a defect in the body wall at the umbilicus that was termed a 'palpable umbilical ring'. In 18 of them this defect disappeared within four days, but in the other the ring did not close and a hernial sac with abdominal contents was palpable. This foal was considered to be the only foal to have a truly congenital umbilical hernia. Twelve foals developed an umbilical hernia between five and eight weeks of age. The prevalence of umbilical hernias was much higher than in other studies, possibly owing to the prospective nature of the study.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Chowbey Pradeep

    2006-01-01

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

  18. Charging and defects in single-walled carbon nanotubes

    Science.gov (United States)

    Nguyen, Khoi Thi

    2011-12-01

    Single-Walled Carbon Nanotubes (SWCNTs) have been one of the most intensively studied materials. Because of their single-atomic-layer structure, SWCNTs are extremely sensitive to environmental interactions, in which charge transfer and defect formation are the most notable effects. Among a number of microscopic and spectroscopic methods, Raman spectroscopy is a widely used technique to characterize physics and chemistry of CNTs. By utilizing simultaneous Raman and electron transport measurements along with polymer electrolyte gating, this dissertation focuses on studying charging and defects in SWCNTs at single nanotube level and in single layer graphene, the building block of SWCNTs. By controllably charging metallic SWCNTs (m-CNTs), the intrinsic nature of the broad and asymmetric Fano lineshape in Raman G band of m-CNTs was first time evidenced. The observation that Fano component is most broadened and downshifted when Fermi level is close to the Dirac point (DP) reveals its origin as the consequence of coupling of phonon to vertical electronic transitions. Furthermore, we have systematically introduced covalent defects to m-CNTs to study how phonon softening and electrical characteristics are affected by disorders. In addition to decreasing electrical conductance with increasing on/off current ratio eventually leading to semiconducting behavior, adding covalent defects reduces the degree of softening and broadening of longitudinal optical (LO) phonon mode but enhances the softening of transverse optical (TO) mode of the G-band near the DP. Charging and defect effects in semiconducting SWCNTs and single layer graphene, a closely related material to SWCNTs, have also been discussed.

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

    Directory of Open Access Journals (Sweden)

    Boutros Cherif

    2010-08-01

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

  20. [Laparoscopic treatment of a large trichobezoar in the stomach with gastric perforation and abdominal wall abscess].

    Science.gov (United States)

    Zaharie, F; Iancu, C; Tanţău, M; Mocan, L; Bartoş, A; Mihăileanu, F; Iancu, D; Tomuş, C; Zaharie, R; Vlad, L

    2010-01-01

    Trichobezoar represents a mass of swallowed hair inside the stomach. Here we report a 17-year-old girl who presented in our department with symptoms of gastric ulcer. Ultrasound examination followed by upper endoscopy revealed a large trichobezoar in the stomach with simultaneous gastric perforation. Laparoscopy also revealed a penetration into the anterior abdominal wall accompanied by abscess at this level. We performed a laparoscopic gastrotomy with trichobezoar extraction and laparoscopic treatment of perforation and abdominal wall abscess. The postoperative evolution was normal and the patient was discharged on the fifth postoperative day. We show that laparoscopic approach may be safely used in the treatment of the large gastric complicated trichobezoar. Several laparoscopic approaches were described for the treatment of tricobezoar and its complications but as far as we know this is the first report of laparoscopic treatment of large tricobezoar and associate gastric perforation.

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

    Directory of Open Access Journals (Sweden)

    H. Krentel

    2012-01-01

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

  2. 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.

  3. Recidivant desmoide fibromatosis of anterior abdominal wall et desmoide fibromatosis of retroperitoneum: Case report

    Directory of Open Access Journals (Sweden)

    Marijanović G.

    2015-01-01

    Full Text Available Desmoide or aggressive fibromatosis belong to the group of benign tumor characterized by a locally infiltrative growth and tendency to recur and which do not metastasize. Here is shown 46 years old woman who is coming for examination because of recurrent tumors of the anterior abdominal wall, PH earlier verified as desmoide fibromatosis. With a tumor of the anterior abdominal wall measuring 14.7 x 7.0 x 12.5 cm, CT diagnostics discovered a tumor size of 5.8 x 8.8 cm 6,2x in the lodge earlier removed right kidney, which is in close communication with v. cava inferior (VCI and A. Illiaca comunis dex. (AIC dex.. Compression of VCI and AIC has resulted in swelling of the right leg as a whole who retired after excision of the tumor. The postoperative course was uneventful.

  4. The use of an anterior abdominal wall peritoneal flap in the laparoscopic repair of vesicouterine fistula.

    Science.gov (United States)

    Tasdemir, Nicel; Abali, Remzi; Celik, Cem; Yazici, Cenk Murat; Akkus, Didem

    2014-01-01

    Vesicouterine fistula (VUF) is a rare type of genitourinary fistula. Lower-segment cesarean section is the leading cause of VUF. Patients mostly present with the classical triad of menouria, amenorrhea, and urinary incontinence, with the history of a previous cesarean section. Conservative management with catheterization and open, laparoscopic, and robotic surgeries are the prescribed treatment options. We present the case of a 35-year-old woman who presented with cyclical menouria and urinary incontinence. After diagnosis of VUF by cystoscopy, the laparoscopic approach was chosen. During the procedure, we used anterior abdominal wall peritoneum and adjacent adipose tissue interposition for the first time, instead of omental interposition, because of the unavailability of omentum. The postoperative period was uneventful, and the procedure was successful. In conclusion, the laparoscopic approach is feasible and the anterior abdominal wall peritoneal flap can be used instead of omentum for tissue interposition when the omentum is not available.

  5. Primary mucormycosis of abdominal wall: A rare fungal infection in a immunocompetent patient.

    Science.gov (United States)

    Tapish, Sahu; Taha, Mustafa; Naresh, Garg; Neeraj, Dhamija; Malik Vinod, K

    2010-07-01

    Mucormycosis of the anterior abdominal wall is an uncommon disease and it is very rare to find this disease in immunocompetent, non-diabetic patients which usually affects patients with trauma, with contaminated wounds, patients with underlying malignancies or patients with immunocompromised state, e.g., diabetics. We herein report a case of primary cutaneous mucormycosis in an immunocompetent and non-diabetic patient. Our patient was a 48-year-old female, executive by profession. She was diagnosed to have cutaneous mucormycosis of the anterior abdominal wall, and was managed with multiple debridements of the wound and intravenous amphotericin B therapy. She was administered a total of 1500 mg of liposomal amphotericin B and when fully healed, split skin grafting was done. We would like to emphasize the importance of high index of suspicion and early start of therapy in a condition with high rate of mortality.

  6. The relationship between wall shear stress distributions and intimal thickening in the human abdominal aorta

    Directory of Open Access Journals (Sweden)

    Butany Jagdish

    2003-11-01

    Full Text Available Abstract Purpose The goal of this work was to determine wall shear stress (WSS patterns in the human abdominal aorta and to compare these patterns to measurements of intimal thickness (IT from autopsy samples. Methods The WSS was experimentally measured using the laser photochromic dye tracer technique in an anatomically faithful in vitro model based on CT scans of the abdominal aorta in a healthy 35-year-old subject. IT was quantified as a function of circumferential and axial position using light microscopy in ten human autopsy specimens. Results The histomorphometric analysis suggests that IT increases with age and that the distribution of intimal thickening changes with age. The lowest WSS in the flow model was found on the posterior wall inferior to the inferior mesenteric artery, and coincided with the region of most prominent IT in the autopsy samples. Local geometrical features in the flow model, such as the expansion at the inferior mesenteric artery (common in younger individuals, strongly influenced WSS patterns. The WSS was found to correlate negatively with IT (r2 = 0.3099; P = 0.0047. Conclusion Low WSS in the abdominal aorta is co-localized with IT and may be related to atherogenesis. Also, rates of IT in the abdominal aorta are possibly influenced by age-related geometrical changes.

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2010-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Yuhki Koike

    2015-06-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Imtiaz Wani

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-06-15

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

  13. Ultrasound-guided microwave ablation for abdominal wall metastatic tumors: A preliminary study

    Institute of Scientific and Technical Information of China (English)

    Cai Qi; Xiao-Ling Yu; Ping Liang; Zhi-Gang Cheng; Fang-Yi Liu; Zhi-Yu Han; Jie Yu

    2012-01-01

    AIM:To evaluate the feasibility,safety and efficacy of ultrasound-guided microwave (MW) ablation for abdominal wall metastatic tumors.METHODS:From August 2007 to December 2010,a total of 11 patients with 23 abdominal wall nodules (diameter 2.59 cm ±1.11 cm,range 1.3 cm to 5.0cm) were treated with MW ablation.One antenna was inserted into the center of tumors less than 1.7 cm,and multiple antennae were inserted simultaneously into tumors 1.7 cm or larger.A 21 gauge thermocouple was inserted near important organs which required protection (such as bowel or gallbladder) for real-timetemperature monitoring during MW ablation.Treatment outcome was observed by contrast-enhanced ultrasound and magnetic resonance imaging (MRI) [or computed tomography (CT)] during follow-up.RESULTS:MW ablation was well tolerated by all patients.Six patients with 11 nodules had 1 thermocouple inserted near important organs for real-time temperature monitoring and the maximum temperature was 56 ℃.Major complications included mild pain (54.5%),post-ablation fever (100%) and abdominal wall edema (25%).All 23 tumors (100%) in this group were completely ablated,and no residual tumor or local recurrence was observed at a median follow-up of 13 mo (range 1 to 32 mo).The ablation zone was well defined on contrast-enhanced imaging (contrast-enhanced CT,MRI and/or contrast-enhanced ultrasound)and gradually shrank with time.CONCLUSION:Ultrasound-guided MW ablation may be a feasible,safe and effective treatment for abdominal wall metastatic tumors in selected patients.

  14. A Case of an Abdominal Wall Abscess Associated with Spilled Gallstones: Imaging Findings and Clinical Significance

    Energy Technology Data Exchange (ETDEWEB)

    Son, Youn Mi; Kim, Hyuk Jung; Bak, Cheol Hee [Seoul Medical Center, Seoul (Korea, Republic of)

    2011-06-15

    Laparoscopic cholecystectomy (LC) has been the gold standard for symptomatic gall stones for the last 20 years. The spillage of stones is reported in up to one-third of all LCs but clinical squeals caused by dropped gallstones are uncommon. We recently observed a patient with late abdominal wall abscess formation as a result of dropped gall stones after LC, who in the end, underwent open surgery because the medical therapy including antibiotics and percutaneous catheter drainage was not fully effective

  15. 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.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Polzer Stanislav

    2012-08-01

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

  18. Current practice of abdominal wall closure in elective surgery – Is there any consensus?

    Directory of Open Access Journals (Sweden)

    Ridwelski Karsten

    2009-05-01

    Full Text Available Abstract Background Development of incisional hernia after open abdominal surgery remains a major cause of post-operative morbidity. The aim of this study was to determine the current practice of surgeons in terms of access to and closure of the abdominal cavity in elective open surgery. Methods Twelve surgical departments of the INSECT-Trial group documented the following variables for 50 consecutive patients undergoing abdominal surgery: fascial closure techniques, applied suture materials, application of subcutaneous sutures, subcutaneous drains, methods for skin closure. Descriptive analysis was performed and consensus of treatment variables was categorized into four levels: Strong consensus >95%, consensus 75–95%, overall agreement 50–75%, no consensus Results 157 out of 599 patients were eligible for analysis (85 (54% midline, 54 (35% transverse incisions. After midline incisions the fascia was closed continuously in 55 patients (65%, using slowly absorbable (n = 47, 55%, braided (n = 32, 38% sutures with a strength of 1 (n = 48, 57%. In the transverse setting the fascia was closed continuously in 39 patients (72% with slowly absorbable (n = 22, 41% braided sutures (n = 27, 50% with a strength of 1 (n = 30, 56%. Conclusion In the present evaluation midline incision was the most frequently applied access in elective open abdominal surgery. None of the treatments for abdominal wall closure (except skin closure in the midline group is performed on a consensus level.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-01

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

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

    Science.gov (United States)

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

    2009-02-01

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

  1. Value-based Clinical Quality Improvement (CQI) for Patients Undergoing Abdominal Wall Reconstruction.

    Science.gov (United States)

    Stephan, Bradley; Ramshaw, Bruce; Forman, Brandie

    2015-05-01

    Patients with complex ventral/incisional hernias often undergo an abdominal wall reconstruction (AWR). These operations have a high cost of care and often result in a long hospital stay and high complication rates. Using the principles of clinical quality improvement (CQI), several attempts at process improvement were implemented in one hernia program over a 3-year period. For consecutive cases of patients undergoing abdominal wall reconstruction, process improvement attempts included the use of a long-term resorbable synthetic mesh (TIGR® Resorbable Matrix, Novus Scientific, Uppsala, Sweden) in place of a biologic mesh, the use of the transversus abdominis release approach in place of an open or endoscopic component separation (external oblique release) technique, and the use of a preoperative transversus abdominis plane (TAP) block using a long-acting local anesthetic (Exparel®, Pacira Pharmaceutical, Parsippany, NJ) as a part of perioperative multi-modal pain management and an enhanced recovery program. After over 60 cases, improvement in materials costs and postoperative outcomes were documented. No mesh-related complications occurred and no mesh removal was required. In this real-world, value-based application of CQI, several attempts at process improvement led to decreased costs and improved outcomes for patients who underwent abdominal wall reconstruction for complex ventral/incisional hernias. Value-based CQI could be a tool for improved health care value globally.

  2. Effect of Lock-in Frequency on Wall-Thinned Defects Detection Using IR Thermography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kwae Hwan; Kim, Ju Hyun; Na, Man Gyun; Kim, Jin Weon; Jung, Hyun Cheol; Kim, Kyeong Suk [Chosun University, Gwangju (Korea, Republic of)

    2014-08-15

    Recently, various inspection techniques for improving the safety of nuclear power plants (NPPs) are being studied. Wall-thinned defect of the pipe are a major cause of reducing the NPP integrity. The purpose of this study was to detect the wall-thinned defects of Nuclear Power Plant (NPP) pipes using the lock-in infrared (IR) thermography method. When using the technique of lock-in IR thermography to detect wall-thinned defects of the pipe, it is very important to select the appropriate lock-in frequency. In this study, we applied a cooling and heating method for detecting wall-thinned defects of the pipe of NPPs.

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

    Science.gov (United States)

    2014-05-09

    acinetobacter Resistant E coli (ESBL) Acinetobacter Klebsiella Coliform ITU LOS 14 days 12 days 4 days 13 days 13 days Hospital LOS 25 days 18 days 20...dressing to his abdomen. On second look in theatre, these small wounds on the abdomen were found to be still grossly contaminated and infected and...implanting foreign materials because of the risk of infection and the need to repair a ventral hernia, however, where this was not possible (ie, cases 2 and

  4. Importance of defect detectability in Positron Emission Tomography imaging of abdominal lesions

    Directory of Open Access Journals (Sweden)

    Shozo Yamashita

    2015-07-01

    Full Text Available Objective(s: This study was designed to assess defect detectability in positron emission tomography (PET imaging of abdominal lesions. Methods: 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. Results: 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. Conclusion: 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.

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

    Science.gov (United States)

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

    2015-01-01

    Objective(s): This study was designed to assess defect detectability in positron emission tomography (PET) imaging of abdominal lesions. Methods: 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). Results: 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. Conclusion: 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. PMID:27408887

  6. A triceps musculocutaneous flap for chest-wall defects

    Energy Technology Data Exchange (ETDEWEB)

    Hartrampf, C.R. Jr.; Elliott, L.F.; Feldman, S. (Emory Univ. School of Medicine, Atlanta, GA (USA))

    1990-09-01

    A posterior upper arm flap based on the profunda brachii vessels has been described to cover soft-tissue defects in the upper anterolateral chest. In our series, the posterior upper arm skin is elevated with the long head of the triceps muscle to cover seven chest-wall defects resulting from indolent postradiation open wounds following partial TRAM flap failure (n = 2), soft-tissue deficiencies following partial TRAM flap loss (n = 3), and primarily as an ancillary flap in TRAM flap breast reconstruction (n = 2). This flap also may be used to supply well-vascularized tissue in the regions of the shoulder, axilla, and posterolateral back. A prerequisite for this operation is redundant tissue of the upper arm often present in middle-aged women and in patients with lymphedema following mastectomy. In our series of seven patients, all donor sites were closed primarily, and there was no subjective functional deficit following transfer of the long head of the triceps muscle.

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

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

    Institute of Scientific and Technical Information of China (English)

    李国庆; 单根法; 张辅贤; 钟竑

    2003-01-01

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

  9. Rejection of Permacol(R) mesh used in abdominal wall repair: A case report

    Institute of Scientific and Technical Information of China (English)

    Franchesca T Wotton; Jacob A Akoh

    2009-01-01

    Permacol(R) mesh has shown promise when used in abdominal wall repair, especially in the presence of a contaminated surgical field. This biomaterial, derived from porcine dermis collagen, has proposed advantages over synthetic materials due to increased biocompatibility and reduced foreign body reaction within human tissues. However, we present a case report describing a patient who displayed rejection to a Permacol(R) mesh when used in the repair of abdominal wound dehiscence following an emergency laparotomy. Review of the English language literature using PubMed and Medline, showed only two previously published cases of explantation of Permacol(R) due to sepsis or wound breakdown. The authors believe this is the first case of severe foreign body reaction leading to rejection of Permacol(R). Both animal and human studies show conflicting evidence of biocompatibility. There are several reports of successful use of Permacol(R) to repair complex incisional herniae or abdominal walls in the presence of significant contamination. It appears from the literature that Permacol(R) is a promising material, but as we have demonstrated, it has the potential to evoke a foreign body reaction and rejection in certain subjects.

  10. Rejection of Permacol mesh used in abdominal wall repair: a case report.

    Science.gov (United States)

    Wotton, Franchesca T; Akoh, Jacob A

    2009-09-14

    Permacol mesh has shown promise when used in abdominal wall repair, especially in the presence of a contaminated surgical field. This biomaterial, derived from porcine dermis collagen, has proposed advantages over synthetic materials due to increased biocompatibility and reduced foreign body reaction within human tissues. However, we present a case report describing a patient who displayed rejection to a Permacol mesh when used in the repair of abdominal wound dehiscence following an emergency laparotomy. Review of the English language literature using PubMed and Medline, showed only two previously published cases of explantation of Permacol due to sepsis or wound breakdown. The authors believe this is the first case of severe foreign body reaction leading to rejection of Permacol. Both animal and human studies show conflicting evidence of biocompatibility. There are several reports of successful use of Permacol to repair complex incisional herniae or abdominal walls in the presence of significant contamination. It appears from the literature that Permacol is a promising material, but as we have demonstrated, it has the potential to evoke a foreign body reaction and rejection in certain subjects.

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

    Directory of Open Access Journals (Sweden)

    McGloughlin Timothy M

    2007-10-01

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

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

    Science.gov (United States)

    Suleiman, Nergis Nina

    2016-01-01

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

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

    Science.gov (United States)

    Kassem, M I; El-Haddad, H M

    2016-10-01

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

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

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    Rafailidis Vasileios

    2013-01-01

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

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

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    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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    HyunSuk Jang

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

  18. 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.

  19. A simple, effective and clinically applicable method to compute abdominal aortic aneurysm wall stress.

    Science.gov (United States)

    Joldes, Grand Roman; Miller, Karol; Wittek, Adam; Doyle, Barry

    2016-05-01

    Abdominal aortic aneurysm (AAA) is a permanent and irreversible dilation of the lower region of the aorta. It is a symptomless condition that if left untreated can expand to the point of rupture. Mechanically-speaking, rupture of an artery occurs when the local wall stress exceeds the local wall strength. It is therefore desirable to be able to non-invasively estimate the AAA wall stress for a given patient, quickly and reliably. In this paper we present an entirely new approach to computing the wall tension (i.e. the stress resultant equal to the integral of the stresses tangent to the wall over the wall thickness) within an AAA that relies on trivial linear elastic finite element computations, which can be performed instantaneously in the clinical environment on the simplest computing hardware. As an input to our calculations we only use information readily available in the clinic: the shape of the aneurysm in-vivo, as seen on a computed tomography (CT) scan, and blood pressure. We demonstrate that tension fields computed with the proposed approach agree well with those obtained using very sophisticated, state-of-the-art non-linear inverse procedures. Using magnetic resonance (MR) images of the same patient, we can approximately measure the local wall thickness and calculate the local wall stress. What is truly exciting about this simple approach is that one does not need any information on material parameters; this supports the development and use of patient-specific modelling (PSM), where uncertainty in material data is recognised as a key limitation. The methods demonstrated in this paper are applicable to other areas of biomechanics where the loads and loaded geometry of the system are known. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. 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...

  1. 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.

  2. 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.

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

    Science.gov (United States)

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

    2014-08-01

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

  4. 螺旋CT对腹壁膨出的临床诊断价值%Clinical Application of Abdominal Wall Bulge with CT Scan

    Institute of Scientific and Technical Information of China (English)

    刘飞德; 邢新博; 李基业; 王世斌; 朱瑛梅; 姚胜

    2012-01-01

    目的 探讨螺旋CT对腹壁膨出的临床诊断价值.方法 收集本科就诊并行螺旋CT检查的腹壁膨出32例,观察腹壁膨出的部位及大小,行手术治疗者术后行螺旋CT复查手术效果.结果 32例腹壁膨出患者中,14例接受外科手术治疗,18例未行手术治疗.腹壁膨出在螺旋CT中表现为膨出区域的腹壁三层肌肉菲薄或消失,无明显疝囊或腹腔内容物疝出.术后螺旋CT复查可见膨出区域的侧腹壁三层肌肉及肌肉间隙出现,部分可见补片影.结论 螺旋CT对腹壁膨出的诊断和鉴别诊断具有确定性作用,同时可以为综合评估患者病情、选择手术方法及判断术后效果提供重要依据.%Objective To evaluate the clinical application of CT examination in abdominal wall bulge. Methods Retrospective study were carried out to 32 cases of abdominal wall bulge of which patients were accepted CT examination. The site and size of the bulge were evaluated, and postoperative CT examination was performed to evaluate the effect of the operation. Results Out of the 32 cases, 14 accepted surgical repair using synthetic mesh while the rest didn' t. CT scan demonstrated no facial defect or herniation of any intra-abdominal content in the bulge area, but the lateral abdominal wall musculature (external oblique, internal oblique, and transversus abdominal muscles) and/or rectus muscle on the bulge side appeared attenuated compared with the corresponding structures on the opposite side. The following CT scan check-up showed that the three layers of abdominal muscles on the bulge side appeared to be thicker compared with preoperative structures and the spaces between the three muscular layers emerged. And the mesh could be seen in some cases in CT scan. Conclusion CT scan is perfect in the diagnosis of the abdominal wall bulge and plays an important role in the evaluation of the patient situation, surgical technique and effectiveness of surgical repair.

  5. Intramedullary spinal cord ganglioglioma presenting with abnormal abdominal wall movement. Case report.

    Science.gov (United States)

    Aslanabadi, Saeid; Azhough, Ramin; Motlagh, Parviz Samad; Hadidchi, Shahram; Tabrizi, Ali Dastranj; Zonouzy, Keivan Kashy

    2004-10-15

    The authors present a case of intramedullary ganglioglioma in a 6-year-old girl. Since the age of 4 months the patient had experienced a spontaneous wavy undulating movement of her anterior abdominal wall resembling a severe peristalsis. The movement was continuous even during sleep, and this symptom was named "belly dance." Magnetic resonance images revealed an intramedullary tumor with ill-defined borders, and the lesion was partially resected. The patient made a good recovery, although 4 years postsurgery her scoliosis had progressed.

  6. Abdominal wall hernias-A local manifestation of systemically impaired quality of the extracellular matrix

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Throughout life, inguinal hernia develops in approximately every fourth man, some of whom develop multiple hernias. If patients at risk of developing multiple hernias could be identified by a serologic biomarker, treatment might be able to be tailored and improved. Evidence suggests...... that abdominal wall hernia formation is associated with altered collagen metabolism. The aim of this study was to evaluate biomarkers for type IV and V collagen turnover in patients with multiple hernias and control subjects without hernia. METHODS: Venous blood was collected from 88 men (mean age, 62 years...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-15

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

  8. 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.

  9. Metastasis of Dermatofibrosarcoma from the Abdominal Wall to the Thyroid Gland: Case Report

    Directory of Open Access Journals (Sweden)

    Alexander Kreze

    2012-01-01

    Full Text Available Metastases in the thyroid gland are very rare. Even the rarer are sarcoma metastases. A 52-year-old woman was referred to our department for evaluation of a nodule in the right lobe of the thyroid gland. She had a history dermatosarcoma of the abdominal wall with known metastasis in the lung. Clinically she had neck pain and worsened swallowing. Objective assessment (ultrasound, computed tomography, and magnetic resonance indicated a voluminous right lobe nodule with mechanical syndrome, and a fine-needle aspiration biopsy revealed a very suspicious malignant finding. After surgery, the diagnosis was metastasis of dermatofibrosarcoma protuberans. Subsequent treatment was radio- and chemotherapy.

  10. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  12. Sepramesh vs. Dualmesh for abdominal wall hernia repairs in a rabbit model.

    Science.gov (United States)

    Young, Ricardo M; Gustafson, Robert; Dinsmore, Robert C

    2004-01-01

    To compare the relative strength of incorporation and adhesion formation for mesh hernia repairs performed with Sepramesh (Genzyme Corp., Cambridge, Massachusetts) and Dualmesh (WL Gore and Assoc., Flagstaff, Arizona). A prospective randomized study was conducted using 30 New Zealand white rabbits, with 15 animals randomized to each limb. A standardized abdominal defect was created in each animal. The defect was then repaired using either Sepramesh or Dualmesh. Animals were sacrificed at 4 weeks. The area of adhesions was determined using digital analysis of inked specimens. Strength of incorporation was determined using an Instron Tensiometer. (Department of Clinical Research, D. D. Eisenhower Army Medical Center, Fort Gordon, GA 30905.) Sepramesh had a 30.6% stronger strength of incorporation compared with Dualmesh. (p = 0.011) The difference in area of adhesions was not statistically significant between the 2 products. The use of Sepramesh for abdominal hernia repairs provides a significantly stronger strength of incorporation without increasing the amount of adhesions as compared with Dualmesh.

  13. Whole abdominal wall segmentation using augmented active shape models (AASM) with multi-atlas label fusion and level set

    Science.gov (United States)

    Xu, Zhoubing; Baucom, Rebeccah B.; Abramson, Richard G.; Poulose, Benjamin K.; Landman, Bennett A.

    2016-03-01

    The abdominal wall is an important structure differentiating subcutaneous and visceral compartments and intimately involved with maintaining abdominal structure. Segmentation of the whole abdominal wall on routinely acquired computed tomography (CT) scans remains challenging due to variations and complexities of the wall and surrounding tissues. In this study, we propose a slice-wise augmented active shape model (AASM) approach to robustly segment both the outer and inner surfaces of the abdominal wall. Multi-atlas label fusion (MALF) and level set (LS) techniques are integrated into the traditional ASM framework. The AASM approach globally optimizes the landmark updates in the presence of complicated underlying local anatomical contexts. The proposed approach was validated on 184 axial slices of 20 CT scans. The Hausdorff distance against the manual segmentation was significantly reduced using proposed approach compared to that using ASM, MALF, and LS individually. Our segmentation of the whole abdominal wall enables the subcutaneous and visceral fat measurement, with high correlation to the measurement derived from manual segmentation. This study presents the first generic algorithm that combines ASM, MALF, and LS, and demonstrates practical application for automatically capturing visceral and subcutaneous fat volumes.

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

    Science.gov (United States)

    Fechner, R; Schwarz-Wings, D

    2013-06-01

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

  15. Mechanically relevant consequences of the composite laminate-like design of the abdominal wall muscles and connective tissues.

    Science.gov (United States)

    Brown, Stephen H M

    2012-05-01

    Together, three abdominal wall muscles (external oblique, internal oblique and transversus abdominis) form a tightly bound muscular sheet that has been likened to a composite-laminate structure. Previous work has demonstrated the ability of force generated by these three muscles to be passed between one another through connective tissue linkages. Muscle fibres in each muscle are obliquely oriented with respect to its neighbouring muscles. It is proposed here is that this unique morphology of the abdominal wall muscles functions, through the application of constraining forces amongst the muscles, to increase force- and stiffness-generating capabilities. This paper presents a mathematical formulation of the stress-strain relationship for a transversely isotropic fibrous composite, and establishes a strengthening and stiffening effect when stress can be transferred between the fibrous layers. Application of empirical mechanical properties to this formulation demonstrates this effect for the abdominal wall muscles and, in greater proportion, for the anterior aponeurosis of the abdominal wall. This has implications for increasing the stiffness and passive load bearing ability of the abdominal wall muscles, and has the potential to modulate the whole muscle force-length and force-velocity relationships during contraction.

  16. Synthetic surgical meshes used in abdominal wall surgery: Part I-materials and structural conformation.

    Science.gov (United States)

    Todros, S; Pavan, P G; Natali, A N

    2017-04-01

    Surgical implants are commonly used in abdominal wall surgery for hernia repair. Many different prostheses are currently offered to surgeons, comprising permanent synthetic polymer meshes and biologic scaffolds. There is a wide range of synthetic meshes currently available on the market with differing chemical compositions, fiber conformations, and mesh textures. These chemical and structural characteristics determine a specific biochemical and mechanical behavior and play a crucial role in guaranteeing a successful post-operative outcome. Although an increasing number of studies report on the structural and mechanical properties of synthetic surgical meshes, nowadays there are no consistent guidelines for the evaluation of mechanical biocompatibility or common criteria for the selection of prostheses. The aim of this work is to review synthetic meshes by considering the extensive bibliography documentation of their use in abdominal wall surgery, taking into account their material and structural properties, in Part I, and their mechanical behavior, in Part II. The main materials available for the manufacture of polymeric meshes are described, including references to their chemical composition, fiber conformation, and textile structural properties. These characteristics are decisive for the evaluation of mesh-tissue interaction process, including foreign body response, mesh encapsulation, infection, and adhesion formation. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 689-699, 2017. © 2015 Wiley Periodicals, Inc.

  17. Neuromuscular independence of abdominal wall muscles as demonstrated by middle-eastern style dancers.

    Science.gov (United States)

    Moreside, Janice M; Vera-Garcia, Francisco J; McGill, Stuart M

    2008-08-01

    Previous studies analyzing neuromuscular independence of the abdominal wall have involved a participant population with no specific training in separating individual muscle segments. We chose to study nine women trained in the art of middle-eastern dance, anticipating they may have unique skills in motor control. Specifically, we were searching for evidence of separation of upper rectus abdominis (URA) from lower rectus abdominis (LRA), as well as understanding what role the oblique muscles play in abdominal wall synergies. EMG analysis was done on eight trunk muscles bilaterally as the dancers participated in 30 dance, planar, and curl-up activities. The filtered data were then cross-correlated to determine the time lag between pairs of signals. Only three dance movements demonstrated consistent evidence of an ability to separate URA/LRA activation timing. The external and internal oblique muscles tend to align themselves temporally with the LRA. However, these findings were only evident in these three specific "belly-roll" conditions, all with low levels of muscle activation, and no external torque. Evidence of significantly different activation levels (% MVC) between URA/LRA was demonstrated in eight conditions, all of which required various pelvis movements with minimal thorax motion.

  18. POSTOPERATIVE RECOVERY OF MUSCLE FORCE THROUGH MUSCLE TONING IN ABDOMINAL PARIETAL DEFECTS

    Directory of Open Access Journals (Sweden)

    Gabriela Monica Moacă

    2015-10-01

    Full Text Available The present paper’s aim is to elaborate a program of postoperative recovery for patients suffering from abdominal parietal defects, and to indicate the beneficial implications, both of the preoperative preparations and of the postoperative physiotherapist actions. The programs of functional postoperative recovery have been elaborated individually for the 254 patients under study – of which 139 belong to lot A (operated under a scheduled regime, after the preoperative preparation and 115 belong to lot B (operated in an emergency regime, in the General Surgery Clinic III of the University Emergency Hospital of Bucharest, between 1998 and 2009. The postoperative recovery program has been individualized for each patient, depending on his / her pathology and co-morbidities, and the physiotherapist has trained and took care that the patients should execute exercises of respiratory re-education, active mobilization of their limbs, coordinated with the breath, isometric exercises for the toning of their arms and legs and of the abdomen muscles. They started the muscle toning exercises slowly and increased them progressively in duration and intensity. The recovery started with isometric-type exercises and continued with the isotonic-type ones. Though mainly the abdominal muscles are aimed at, respectively the flexor muscles of the torso, the physiotherapy program shall comprise the toning of the other muscle groups of the torso, as well. It has been noticed - for the patients in lot A, compared to those of lot B - an obvious net favorable postoperative evolution, characterized through: a reduction of the respiratory, cardiac and thromboembolic complications, a quick postoperative recovery and the immediate social reintegration. An overview of the two lots proves the importance of the cardio-respiratory and locomotive preparation of the patients suffering from big abdominal parietal defects. The simple gestures of respiratory re-education, of

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

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    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.

  20. [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.

  1. 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.

  2. 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

  3. Effect of Topological Defects on Buckling Behavior of Single-walled Carbon Nanotube

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    Wang Guoxiu

    2011-01-01

    Full Text Available Abstract Molecular dynamic simulation method has been employed to consider the critical buckling force, pressure, and strain of pristine and defected single-walled carbon nanotube (SWCNT under axial compression. Effects of length, radius, chirality, Stone–Wales (SW defect, and single vacancy (SV defect on buckling behavior of SWCNTs have been studied. Obtained results indicate that axial stability of SWCNT reduces significantly due to topological defects. Critical buckling strain is more susceptible to defects than critical buckling force. Both SW and SV defects decrease the buckling mode of SWCNT. Comparative approach of this study leads to more reliable design of nanostructures.

  4. Morphological characteristics of tissues of anterior abdominal wall of rats after implantation of alloplastic material, processed with collagen, in the initially infected wounds

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    Svisenko O. V.

    2010-01-01

    Full Text Available A research purpose was to investigate the tissue reactions on implantation of polypropylene mesh, processed with collagen, after the plastic of experimental defect at rats at underaponevrotic localization of prosthesis in the initially infected wounds. Research was performed in two experimental groups. Group 1 – at 27 rats in the conditions of the infected wound the monofilamentous polypropylene mesh of size 1×1,5 sm was fixed under aponevrosis. Group 2 – at 27 rats at analogous conditions with the previously infected wound the underaponevrotic fixation of polypropylene mesh, processed with collagen, was performed. From the data of morphological analysis, use of polypropylene mesh, processed with collagen, after the plastic of experimental defect at rats at underaponevrotic localization of prosthesis in the initially infected wounds accompanied with the acceleration of reparative processes and improvement of restructuring of connective tissue, muscular and vascular components of anterior abdominal wall during 4 weeks after intervention.

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

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    Souvagya Panigrahi

    2012-01-01

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

  6. Tension-free repair during extensive radical surgery for cecal cancer with abdominal wall invasion and inguinal lymph node metastasis

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    Xu K

    2014-05-01

    Full Text Available Kaiwu Xu, Zhihui Chen, Xinming SongGastrointestinal and Pancreatic Surgery Department, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, People's Republic of ChinaAbstract: We report a case of cecal cancer with invasion of the abdominal wall and right inguinal lymph node metastasis. This patient had undergone an appendectomy 2 years previously. He underwent extensive radical right hemicolectomy with anastomosis and tension-free repair of the damaged right lower abdominal wall. The surgery progressed successfully, and the vital signs of the patient were stable (approximately 200 mL blood loss. Postoperative diagnosis revealed moderately to poorly differentiated adenocarcinoma of the cecum with invasion of the abdominal wall and metastasis of the inguinal lymph nodes (pT4bN2bM1, IV4a. The patient has remained well post-surgery.Keywords: right hemicolectomy, GORE® DUALMESH®, adjuvant chemotherapy, appendicitis

  7. Tension-free repair during extensive radical surgery for cecal cancer with abdominal wall invasion and inguinal lymph node metastasis.

    Science.gov (United States)

    Xu, Kaiwu; Chen, Zhihui; Song, Xinming

    2014-01-01

    We report a case of cecal cancer with invasion of the abdominal wall and right inguinal lymph node metastasis. This patient had undergone an appendectomy 2 years previously. He underwent extensive radical right hemicolectomy with anastomosis and tension-free repair of the damaged right lower abdominal wall. The surgery progressed successfully, and the vital signs of the patient were stable (approximately 200 mL blood loss). Postoperative diagnosis revealed moderately to poorly differentiated adenocarcinoma of the cecum with invasion of the abdominal wall and metastasis of the inguinal lymph nodes (pT4bN2bM1, IV4a). The patient has remained well post-surgery.

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

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    Sinan Carkman

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2017-03-01

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

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

    Science.gov (United States)

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

    2017-01-01

    [Purpose] Continuous electrical stimulation of abdominal wall muscles is known to induce mild muscle fatigue. However, it is not clear whether this is also true for functional electrical stimulation delivered only during the expiratory phase of breathing. This study aimed to examine whether or not intermittent electrical stimulation delivered to abdominal wall muscles induces muscle fatigue. [Subjects and Methods] The subjects were nine healthy adults. Abdominal electrical stimulation was applied for 1.5 seconds from the start of expiration and then turned off during inspiration. The electrodes were attached to both sides of the abdomen at the lower margin of the 12th rib. Abdominal electrical stimulation was delivered for 15 minutes with the subject in a seated position. Expiratory flow was measured during stimulus. Trunk flexor torque and electromyography activity were measured to evaluate abdominal muscle fatigue. [Results] The mean stimulation on/off ratio was 1:2.3. The declining rate of abdominal muscle torque was 61.1 ± 19.1% before stimulus and 56.5 ± 20.9% after stimulus, not significantly different. The declining rate of mean power frequency was 47.8 ± 11.7% before stimulus and 47.9 ± 10.2% after stimulus, not significantly different. [Conclusion] It was found that intermittent electrical stimulation to abdominal muscles synchronized with the expiratory would not induce muscle fatigue. PMID:28356636

  12. 腹壁脓肿16例误诊分析%Misdiagnosis of abdominal 16 cases wall abscess

    Institute of Scientific and Technical Information of China (English)

    李泉洪

    2011-01-01

    Objective To analyze the causes of misdiagnosis of abdominal wall abscess and countermeasures.Methods A retrospective analysis of our hospital 3 years ( 2008-2010 ) treatment of 16 cases of abdominal wall abscess misdiagnosed cases.Results Of this study 16 patients were diagnosed as abdominal wall abscess last.Conclusion Careful physical examination,abdominal wall abscess could be way to avoid misdiagnosis.Puncture could improve the early diagnosis of abdominal abscess,reduce misdiagnosis rate.%目的 分析腹壁脓肿的误诊原因及对策.方法 回顾性分析诊治的16例腹壁脓肿误诊病例.结果 误诊腹部肿块8例,胆囊炎2例,肝脓肿1例,阑尾周围脓肿2例,腹壁纤维瘤3例.结论 仔细的体检,警惕腹壁脓肿的可能,从而避免误诊.穿刺术能提高腹壁脓肿的早期诊断水平,降低误诊率.

  13. Application of biologic mesh in hernia and abdominal wall surgery%生物补片在疝和腹壁外科的应用

    Institute of Scientific and Technical Information of China (English)

    李基业

    2012-01-01

    Biologic meshes have been used to repair abdominal wall hernia and defect for more than 10 years, and a number of clinical experience of the use of biologic mesh has been accumulated. The majority of surgeons have the opinion that biologic mesh provides an important and new tool for repair of hernia and defect of the abdominal wall, especially for the contaminated and infected fields. Most of the clinical results showed the short-term outcome of the repair of hernia and defect using biologic mesh is satisfactory, and long-term outcome need to be further investigated. A multicenter, prospective, randomized control trial should be conducted to make sure the relationship of both the types of biologic mesh and the mesh placement to the results of treatment, and the different effect of biologic mesh for repairing hernia and defect with and without contaminated and infected fields.%生物补片用于修补腹壁疝及缺损已10余年,积累了一定的临床经验.多数术者认为生物补片为外科医生修复腹壁疝和腹壁缺损、特别是有污染和感染的病人提供了重要的工具.大部分临床结果表明生物补片修补疝和腹壁缺损近期效果良好,远期效果有待进一步观察研究.对于生物补片种类与治疗效果关系,补片放置方法与治疗效果的关系,污染、感染情况下与清洁状况下使用生物补片效果差别,需要多中心、前瞻性随机对照研究.

  14. Subscapularis muscle flap for reconstruction of posterior chest wall skeletal defect

    Directory of Open Access Journals (Sweden)

    Mitsuaki Sakai

    2015-01-01

    Conclusion: The use of a subscapularis muscle flap to repair chest wall defect is a simple and safe technique that can be conducted in the same surgical field as the initial reconstruction surgery and does not require plastic surgery support.

  15. Torsion of an Abdominal-Wall Pedunculated Lipoma: A Rare Differential Diagnosis for Right Iliac Fossa Pain

    Directory of Open Access Journals (Sweden)

    Daniel Lee John Bunker

    2013-01-01

    Full Text Available Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a rare differential of acute abdominal pain.

  16. Torsion of an abdominal-wall pedunculated lipoma: a rare differential diagnosis for right iliac fossa pain.

    Science.gov (United States)

    Bunker, Daniel Lee John; Ilie, Victor George; Halder, Tushar K

    2013-01-01

    Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a rare differential of acute abdominal pain.

  17. Sunken Eye Induced by Superior Orbital Wall Defect After Craniofacial Surgery

    Science.gov (United States)

    Joo, Sung-Pil; Kim, Sung-Hyun; Park, Hong-Ju; Jung, Seunggon; Han, Jeong Joon; Kim, Tae-Sun

    2016-01-01

    Abstract Enophthalmos after a ventriculo-peritoneal (V-P) shunt placement is very rare. Previous defects of the orbital wall with intracranial hypotension can cause enophthalmos after V-P shunting. The authors present 2 patients of enophthalmos with orbital wall defects resulting from anterior clinoidectomy that was performed during previous aneurysmal surgery. Both patients received a V-P shunt for hydrocephalus after subarachnoid hemorrhage. Although the hydrocephalus was improved by V-P shunts in both patients, sunken eyes were observed. The patients received reconstructive surgery of the superior orbital wall using titanium mesh and recovered after surgery without any neurological deficits. Here, the authors present 2 patients of enophthalmos with orbital wall defects treated by orbital wall reconstruction. PMID:27483101

  18. Examinations of a new long-term degradable electrospun polycaprolactone scaffold in three rat abdominal wall models.

    Science.gov (United States)

    Jangö, Hanna; Gräs, Søren; Christensen, Lise; Lose, Gunnar

    2017-02-01

    Alternative approaches to reinforce native tissue in reconstructive surgery for pelvic organ prolapse are warranted. Tissue engineering combines the use of a scaffold with the regenerative potential of stem cells and is a promising new concept in urogynecology. Our objective was to evaluate whether a newly developed long-term degradable polycaprolactone scaffold could provide biomechanical reinforcement and function as a scaffold for autologous muscle fiber fragments. We performed a study with three different rat abdominal wall models where the scaffold with or without muscle fiber fragments was placed (1) subcutaneously (minimal load), (2) in a partial defect (partial load), and (3) in a full-thickness defect (heavy load). After 8 weeks, no animals had developed hernia, and the scaffold provided biomechanical reinforcement, even in the models where it was subjected to heavy load. The scaffold was not yet degraded but showed increased thickness in all groups. Histologically, we found a massive foreign body response with numerous large giant cells intermingled with the fibers of the scaffold. Cells from added muscle fiber fragments could not be traced by PKH26 fluorescence or desmin staining. Taken together, the long-term degradable polycaprolactone scaffold provided biomechanical reinforcement by inducing a marked foreign-body response and attracting numerous inflammatory cells to form a strong neo-tissue construct. However, cells from the muscle fiber fragments did not survive in this milieu. Properties of the new neo-tissue construct must be evaluated at the time of full degradation of the scaffold before its possible clinical value in pelvic organ prolapse surgery can be evaluated.

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

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    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.

  20. Trocar-related abdominal wall bleeding in 200 patients after laparoscopic cholecistectomy: Personal experience

    Institute of Scientific and Technical Information of China (English)

    Girolamo Geraci; Carmelo Sciumè; Franco Pisello; Francesco Li Volsi; Tiziana Facella; Giuseppe Modica

    2006-01-01

    AIM: To determine the complications and incidence of the first and second access-related vascular injuries induced by videolaparoscopic cholecistectomy.METHODS: We retrospectively reviewed vascular injuries in 200 consecutive patients who underwent videolaparoscopic cholecistectomy from 2003 to 2005.One hundred and one patients with placement of radial expanding trocars were assigned into group A and 99patients with placement of pyramidal tipped trocars into group B. All the patients were submitted to open access according to Hasson for the first trocar.RESULTS: Bleeding did not occur at the intraoperative cannula-site in group A. However, it occurred at the intraoperative cannula-site of 7 patients (7.1%) in group B, with a statistically significant difference (P < 0.01).No mortality was registered. More vascular lesions were found in group B.CONCLLSION: The advantage of Hasson technique is that peritoneal cavity access is gained under direct vision, preventing most severe injuries. The open technique with radial expanding trocars is recommended for secure access to the abdominal cavity in videolaparoscopy. Great care should be taken to avoid major complications and understanding the abdominal wall anatomy is important for reducing bleeding during or after s placement of trocars.

  1. Anterior abdominal wall abscess with epididymo-orchitis: An unusual presentation of acute pancreatitis

    Directory of Open Access Journals (Sweden)

    P M Kamble

    2011-01-01

    Full Text Available Pancreatitis indicates inflammation of the pancreas. Clinically acute pancreatitis typically presents as upper abdominal pain mostly in epigastric region, nausea, vomiting and elevated levels of amylase and lipase. Depending upon severity of acute pancreatitis patient may presents with minimal symptoms to more severe signs of acute abdomen like generalized guarding and rigidity. Inspite of absence of disease-specific signs and symptoms for acute pancreatitis, diagnosis is usually not difficult using a combination of clinical, laboratory and radiological findings. Sometimes pancreatitis may presents atypically, which may be misleading in the management especially when typical presentation of pancreatitis as described above is absent. We have described a case of pancreatitis where patient presented with anterior abdominal wall abscess with epididymo-orchitis because of tracking of pancreatic fluid into the retroperitoneum till scrotum. Patients presentation may be different depending upon complication occurred during the course of pancreatitis. After reviewing the literature we found very few cases in which you may not get a clue to diagnose pancreatitis because of atypical presentation. In the described case, patient managed conservatively with percutaneous drainage of the abscess by pigtail catheter placement and scrotal support for epididymoorchitis. This avoided unnecessary exploration in above patient.

  2. 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.

  3. Torsion of an Abdominal-Wall Pedunculated Lipoma: A Rare Differential Diagnosis for Right Iliac Fossa Pain

    OpenAIRE

    2013-01-01

    Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a r...

  4. On-power detection of wall-thinned defects using lock-in infrared thermography

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Kwae Hwan; Kim, Ju Hyun [Department of Nuclear Engineering, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 501-759 (Korea, Republic of); Na, Man Gyun, E-mail: magyna@chosun.ac.kr [Department of Nuclear Engineering, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 501-759 (Korea, Republic of); Kim, Jin Weon [Department of Nuclear Engineering, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 501-759 (Korea, Republic of); Kim, Kyeong Suk [Department of Mechanical Design Engineering, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 501-759 (Korea, Republic of)

    2014-12-15

    Highlights: • Lock-in IR thermography was proposed to detect wall-thinned defects during normal NPP operation. • A mock-up loop was constructed that contained artificially generated defects. • The fluid inside the loop was maintained at a temperature similar to NPP operating conditions. • The boundary of the wall-thinned defective part was clear from acquired images. - Abstract: Recently, nuclear power plants (NPPs) have been using ultrasonic testing (UT) to inspect the pipes of secondary piping systems. However, UT is not suitable for measuring wall-thinned defects in small-diameter pipes and requires a long period of time to acquire analysis results. In addition, it is less reliable when inspecting small-diameter piping, and it is almost impossible to inspect defects during NPP normal operation. Therefore, UT is not reliable for detecting wall-thinned defects in the small-diameter pipes of NPPs during normal operation. In this study, we developed a lock-in infrared (IR) thermography technique to detect wall-thinned defects in the small diameter pipes of a NPP's secondary systems during normal operation. For experiments, a mock-up loop was constructed that contained artificially generated defects. The fluid inside the loop was maintained at a temperature similar to the operating conditions of a NPP. Based on the results of experiments where lock-in IR thermography was applied, it is expected to be possible to detect wall-thinned defects in piping during normal operation, shorten the maintenance time of NPPs, and improve the work efficiency of the inspector.

  5. Effects of arterial blood flow on walls of the abdominal aorta: distributions of wall shear stress and oscillatory shear index determined by phase-contrast magnetic resonance imaging.

    Science.gov (United States)

    Sughimoto, Koichi; Shimamura, Yoshiaki; Tezuka, Chie; Tsubota, Ken'ichi; Liu, Hao; Okumura, Kenichiro; Masuda, Yoshitada; Haneishi, Hideaki

    2016-07-01

    Although abdominal aortic aneurysms (AAAs) occur mostly inferior to the renal artery, the mechanism of the development of AAA in relation to its specific location is not yet clearly understood. The objective of this study was to evaluate the hypothesis that even healthy volunteers may manifest specific flow characteristics of blood flow and alter wall shear or oscillatory shear stress in the areas where AAAs commonly develop. Eight healthy male volunteers were enrolled in this prospective study, aged from 24 to 27. Phase-contrast magnetic resonance imaging (MRI) was performed with electrocardiographic triggering. Flow-sensitive four-dimensional MR imaging of the abdominal aorta, with three-directional velocity encoding, including simple morphological image acquisition, was performed. Information on specific locations on the aortic wall was applied to the flow encodes to calculate wall shear stress (WSS) and oscillatory shear index (OSI). While time-framed WSS showed the highest peak of 1.14 ± 0.25 Pa in the juxtaposition of the renal artery, the WSS plateaued to 0.61 Pa at the anterior wall of the abdominal aorta. The OSI peaked distal to the renal arteries at the posterior wall of the abdominal aorta of 0.249 ± 0.148, and was constantly elevated in the whole abdominal aorta at more than 0.14. All subjects were found to have elevated OSI in regions where AAAs commonly occur. These findings indicate that areas of constant peaked oscillatory shear stress in the infra-renal aorta may be one of the factors that lead to morphological changes over time, even in healthy individuals.

  6. 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

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

    Science.gov (United States)

    Roje, Zdravko; Roje, Zeljka; Matić, Dario; Librenjak, Davor; Dokuzović, Stjepan; Varvodić, Josip

    2011-12-23

    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 four times. Other

  8. [Case of abdominal wall malignant peripheral nerve sheath tumor which is difficult to distinguish from a urachal disease].

    Science.gov (United States)

    Tatenuma, Tomoyuki; Sakata, Ryoko; Sugiura, Shinpei; Tajiri, Takehiro; Gondo, Toshikazu; Kitami, Kazuo

    2013-09-01

    Malignant peripheral nerve sheath tumors (MPNST) are highly malignant soft tissue sarcomas. It is very rare for MPNST to arise in the abdominal wall. We report a case of abdominal wall MPNST that was difficult to distinguish from a urachal disease. A 72-year-old woman found a mass of the umbilicus in October 2011. She visited a digestive surgery department in November because it gradually enlarged. Diagnostic imaging suggested a urachal tumor. She was then referred to our clinic. Contrast enhanced CT showed that the 5-cm cystic tumor extended from the umbilicus to abdominal wall. The tumor showed low uptake value in PET-CT. We diagnosed her with a urachal cyst, but could not deny urachal carcinoma. Therefore, we performed surgical resection in January 2012. The pathological diagnosis was MPNST. She has not experienced recurrence for 9 months. MPNST mostly occur in the retroperitoneum close to the spine, extremities, head, and neck. It is very rare for them to occur in the abdominal wall. This is the sixth case including overseas reports. In addition, this is the first case in which it was difficult to distinguish from a urachal disease.

  9. 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....

  10. Mechanical Properties of Single-Walled (5,5) Carbon Nanotubes with Vacancy Defects

    Institute of Scientific and Technical Information of China (English)

    YUAN Shi-Jun; KONG Yong; LI Fa-Shen

    2007-01-01

    First-principles simulation is used to investigate the structural and mechanical properties of vacancy defective single-walled (5,5) carbon nanotubes. The relations of the defect concentration, distribution and characteristic of defects to Young's modulus of nanotubes are quantitatively studied. It is found that each dangling-bond structure (per supercell) decreases Young's modulus of nanotube by 6.1% for symmetrical distribution cases. However the concentrative vacancy structure with saturated atoms has less influence on carbon nanotubes. It is suggested that the mechanical properties of carbon nanotubes depend strongly upon the structure and relative position of vacancies in a certain defect concentration.

  11. Measurement of defect thickness of the wall thinning defect pipes by lock-in infrared thermography technique

    Science.gov (United States)

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

    2010-03-01

    Mostly piping which is using for the nuclear power plants are made up of carbon steel pipes. The wall thinning defects occurs by the effect of the flow accelerated corrosion of fluid that flows in carbon steel pipes. The defects could be found on the welding part and anywhere in the pipes. The infrared thermography technique which is one of the non-destructive testing method has used for detecting the defects of various kinds of materials over the years. There is a limitation for measuring the defect of metals that have a big coefficient of thermal diffusion. However, a technique using lock-in method gets over the difficulty. Consequently, the lock-in infrared thermography technique has been applied to the various industry fields. In this paper, the defect thickness of the straight pipe which has an artificial defect the inside of the pipes was measured by using the lock-in infrared thermography technique and the result could be utilized in detecting defects of carbon steel pipes.

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

    Directory of Open Access Journals (Sweden)

    Tanasković Irena

    2010-01-01

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

  13. 3-D segmentation and quantitative analysis of inner and outer walls of thrombotic abdominal aortic aneurysms

    Science.gov (United States)

    Lee, Kyungmoo; Yin, Yin; Wahle, Andreas; Olszewski, Mark E.; Sonka, Milan

    2008-03-01

    An abdominal aortic aneurysm (AAA) is an area of a localized widening of the abdominal aorta, with a frequent presence of thrombus. A ruptured aneurysm can cause death due to severe internal bleeding. AAA thrombus segmentation and quantitative analysis are of paramount importance for diagnosis, risk assessment, and determination of treatment options. Until now, only a small number of methods for thrombus segmentation and analysis have been presented in the literature, either requiring substantial user interaction or exhibiting insufficient performance. We report a novel method offering minimal user interaction and high accuracy. Our thrombus segmentation method is composed of an initial automated luminal surface segmentation, followed by a cost function-based optimal segmentation of the inner and outer surfaces of the aortic wall. The approach utilizes the power and flexibility of the optimal triangle mesh-based 3-D graph search method, in which cost functions for thrombus inner and outer surfaces are based on gradient magnitudes. Sometimes local failures caused by image ambiguity occur, in which case several control points are used to guide the computer segmentation without the need to trace borders manually. Our method was tested in 9 MDCT image datasets (951 image slices). With the exception of a case in which the thrombus was highly eccentric, visually acceptable aortic lumen and thrombus segmentation results were achieved. No user interaction was used in 3 out of 8 datasets, and 7.80 +/- 2.71 mouse clicks per case / 0.083 +/- 0.035 mouse clicks per image slice were required in the remaining 5 datasets.

  14. Defective anterior wall of inguinal canal and its role in the pathophysiology of direct inguinal hernias

    Directory of Open Access Journals (Sweden)

    Abdolvahabi SA

    2002-06-01

    Full Text Available Regrding pathophysiology of direct inguinal hernias the following are pointed our:1-Absence of contribution of fascia of transverses abdominis muscle along with fascia transversalis in making posterior wall of the inguinal canal causing defect point in Hesselbachs triangle.2- Defects in protectin mechanisms of the inguinal canal such as: I shutter like effect of the arch of internal oblique and transverses abdominis muscles. ii Sphincter like effect of fascia of oblique muscle (anterior wall of canl.During several years of observation and practice in the field of surgical repair of hernias, a new phenomenon was observed regarding the etiology of direct hernias.Evaluation of superficial ring and Ant. Wall of inguinal canal in 25 patients showed that the ant. Wall was not perfect and the defect was seen as a spectrum of moderate defect to complete absence of the wall. This phenomenon may be a newly observed mechanism in pathology of direct inguinal hernia that might help the operative repair. Taking this into account, i.e. repair of this defect, might help the classic herniorrhaphy techniques

  15. Giant desmoid tumor of the abdominal wall in a patient with Gardner Syndrome

    Directory of Open Access Journals (Sweden)

    Daniel Paulino Santana

    2012-09-01

    Full Text Available Gardner syndrome (GS is a rare entity characterized by a triad of familial colonic polyposis, multiple osteomas and soft tissue tumors, including desmoid tumor (DT. This is a case report of a 30 year-old patient with GS who developed giant DT in the abdominal wall after undergoing several laparotomies. The patient has taken a long time to search for medical care, and at first he saw another team that refused to operate him by judging the lesion unresectable. The surgery in our department was performed in three steps. Initially, we resected the lesion with macroscopic margins, and as there were small bowel adhesions in the tumor, we performed enterectomy and closed using the "Bogotá" technique, with skin closure on the bag. On the fourth postoperative day (POD, we reoperated the abdomen without identifying any signs of fistula. On the seventh POD there was another surgical intervention, this time to insert a double-sided mesh. The patient recovered well, and had no debilitating motor deficit, despite the extensive resection of the abdominal muscles. Curative treatment of DT is based on surgical resection and only sequential surveillance allows us an early diagnosis, when the lesion is still resectable.Tumor desmoide gigante de parede abdominal em paciente portador da Síndrome de Gardner. A Síndrome de Gardner (SG é uma entidade rara caracterizada pela tríade polipose colônica familial, múltiplos osteomas e tumores de tecidos moles, dentre eles o tumor desmoide (TD. Tratou-se de um relato de caso de um paciente de 30 anos, com SG que evoluiu com TD gigante em parede abdominal, após ser submetido a diversas laparotomias prévias. O paciente levou longo tempo para procurar o serviço de cirurgia, passando por outra equipe que se negou a abordá-lo por julgar a lesão irressecável. A cirurgia no nosso serviço se deu em três tempos. Inicialmente, foi feita a ressecção da lesão com margens macroscópicas e, por haver aderências de al

  16. On-Power Detection of Wall-Thinned Defects Using IR Thermography in NPPs

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ju Hyun; Kim, Jae Hwan; Lee, Sim Won; Na, Man Gyun; Kim, Jin Weon; Jung, Hyun Chul; Kim, Kyeong Suk [Chosun University, Gwangju (Korea, Republic of)

    2012-05-15

    Recently, the number of nuclear power plants (NPPs) that are aging by long-term operations has increased. Accordingly, the number of operational interruptions has increased due to malfunctions of the NPPs secondary systems. These cases occur in the NPPs secondary systems with various structures by the fatigue, wall-thinned defects, corrosions and so on. Of these problems, the wall thinned defects occur in the pipes by the diffusion of the corrosion with the flow of the fluids, and the defects frequently take place in the carbon steel pipes of the lower Cr contents. Periodic inspections are required for systematic management of the wall-thinned defects. In particular, they are also needed during the normal operations of the NPPs. There are many NDT techniques to detect the wall-thinned defects such as the UT, PT, ECT, MT, etc. These NDT techniques include the infrared thermography. This technique may solve the existing constraints of NDT by detecting the defects through observations of the temperature differentials on the object surface

  17. Developing a new methodology to characterize in vivo the passive mechanical behavior of abdominal wall on an animal model.

    Science.gov (United States)

    Simón-Allué, R; Montiel, J M M; Bellón, J M; Calvo, B

    2015-11-01

    The most common surgical repair of abdominal wall hernia goes through implanting a mesh that substitutes the abdominal muscle/fascia while it is healing. To reduce the risk of relapse or possible complications, this mesh needs to mimic the mechanical behavior of the muscle/fascia, which nowadays is not fully determined. The aim of this work is to develop a methodology to characterize in vivo the passive mechanical behavior of the abdominal wall. For that, New Zealand rabbits were subjected to pneumoperitoneum tests, taking the inner pressure from 0 mmHg to 12 mmHg, values similar to those used in human laparoscopies. Animals treated were divided into two groups: healthy and herniated animals with a surgical mesh (polypropylene Surgipro(TM) Covidien) previously implanted. All experiments were recorded by a stereo rig composed of two synchronized cameras. During the postprocessing of the images, several points over the abdominal surface were tracked and their coordinates extracted for different levels of internal pressure. Starting from that, a three dimensional model of the abdominal wall was reconstructed. Pressure-displacement curves, radii of curvature and strain fields were also analysed. During the experiments, animals tissue mostly deformed during the first levels of pressure, showing the noticeable hyperelastic passive behavior of abdominal muscles. Comparison between healthy and herniated specimen displayed a strong stiffening for herniated animals in the zone where the high density mesh was situated. Cameras were able to discern this change, so this method can be used to measure the possible effect of other meshes.

  18. Tumor desmóide da parede abdominal durante a gravidez: relato de caso Desmoid tumor of the abdominal wall during pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Denise Gonçalves Priolli

    2005-05-01

    Full Text Available Tumores desmóides são neoplasias do tecido conjuntivo, caracterizadas por apresentarem crescimento exclusivamente loco-regional, recorrência freqüente e mínimo potencial metastático. Acometem principalmente portadores de polipose adenomatosa familial dos cólons, sendo sua ocorrência isolada extremamente rara. São mais freqüentes nas mulheres em idade reprodutiva e durante a gravidez. Descreve-se um caso de tumor desmóide de grandes proporções, localizado na parede abdominal, que surgiu a partir da 17ª semana em gestante sem antecedentes de polipose adenomatosa familial. A neoplasia foi totalmente extirpada utilizando-se prótese de polipropileno para reconstituição da parede abdominal. Atualmente a doente encontra-se bem, um ano após a cirurgia, em uso de antiinflamatório não hormonal para prevenção de recidivas.Desmoid tumors are neoplasms of the conjunctive tissue that are characterized by exclusive locoregional growth, frequent recurrence and minimal metastatic potential. They mainly affect individuals with familial adenomatous polyposis of the colon, and rarely occur isolated. The single form of this neoplasm most frequently appears in women of reproductive age, and during pregnancy. A case of a desmoid tumor of large proportions located in the abdominal wall is described. It appeared at the 17th week of pregnancy in a woman without any history of familial adenomatous polyposis. The neoplasm was totally extirpated, with the use of a polypropylene prosthesis for reconstitution of the abdominal wall. One year after the surgery, the patient continues to be well, while using non-steroidal anti-inflammatory drugs for the prevention of relapses.

  19. Experimental evaluation of the wall thinned defects using IR thermography

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Young Jin; Kwon, Min Ki; Kim, Ju Hyun; Na, Man Gyun; Kim, Jin Weon; Won, Yun Kyung; Kim, Kyeong Suk [Chosun Univ., Gwangju (Korea, Republic of)

    2012-10-15

    Local wall thinning is the main degradation mechanism of carbon steel piping components in nuclear power plants (NPPs), resulting from flow accelerated corrosion (FAC). Local wall thinning reduces the failure pressure, load carrying capacity, deformation ability, and fatigue resistance of piping components. Therefore, the appropriate integrity assessment procedure is required. From past several decades, there have been lots of nondestructive inspection technologies widely. On the other hand, thermography method in these nondestructive testing (NDT) has recently expanded its application range gradually with the development of vision technology. The infrared thermo r graph y which is one of these techniques provides real time images by scanning the temperature of the target surface and then, converting it to the temperature. Though observation of the temperature difference this technique can assess the appropriated integrity of carbon steel piping.

  20. Hérnia traumática da parede abdominal Traumatic abdominal hernia

    Directory of Open Access Journals (Sweden)

    Alexandre Cruz Henriques

    1999-10-01

    Full Text Available A rare case of blunt traumatic abdominal hernia is presented in which jejunal loops herniated through the abdominal wall. The patient had a serious motor vehicle accident seven years ago, while wearing the seat belt. He developed a traumatic hernia in the anterior lateral abdominal wall, which was operated, and relapsed after some months. The patient was reoperated and we observed the unattachment of the anterior lateral abdominal musculature from the ilium crest. After the hernial sac treatment, the defect was solved with the use of a polypropylene mesh. The postoperative evolution was good and four months later there were no signs of recurrence. Traumatic abdominal hernia remains a rare clinical entity, despite the increase in blunt abdominal trauma. Traumatic abdominal wall hernia falls into two general categories: small lower quadrant abdominal defects, typically the result of blunt trauma with bicycle handlebars, and larger abdominal wall defects related to motor vehicle accidents. The diagnosis may be often established by the physical examination alone. Conventional radiology and computerized tomography usefulness have been proved. In the vast majority of cases, early repair is recommended. The appropriate treatment is the reduction of the herniated bowel into the abdomen, the debridment of nonviable tissues, and a primary tension free closure of the detect.

  1. Numerical analysis of contact line dynamics passing over a single wettable defect on a wall

    Science.gov (United States)

    Yamamoto, Yasufumi; Higashida, Shohei; Tanaka, Hiroyuki; Wakimoto, Tatsuro; Ito, Takahiro; Katoh, Kenji

    2016-08-01

    In this study, the dynamics of a contact line passing a single defect, which was represented by a locally wettable part (whose static contact angle is less than the other part, namely, chemically heterogeneous and physically flat part), was analyzed using numerical simulations employing the front-tracking method and the generalized Navier boundary condition. We observed that the contact line was distorted with a logarithmic shape far from the defect; however, the distortion was dependent on the wall velocity. The apparent (averaged) dynamic contact angle of the wall with a defect was evaluated using a macroscopic energy balance. The apparent dynamic contact angles estimated from the energy balance agree well with the arithmetic averaged angles obtained from the present simulations. The macroscopic energy balance is useful to consider the effect of heterogeneity or roughness of the wall on the relation between the dynamic contact angle and contact line speed.

  2. Metastatic breast carcinoma of the abdominal wall muscle: a case report.

    Science.gov (United States)

    Ogiya, Akiko; Takahashi, Kaoru; Sato, Mutsumi; Kubo, Yoshiko; Nishikawa, Noriko; Kikutani, Mariko; Tadokoro, Yukiko; Tanaka, Kumiko; Uematsu, Takayoshi; Watanabe, Junichiro; Kasami, Masako; Yamasaki, Seiji

    2015-03-01

    Metastasis from breast carcinoma is an uncommon occurrence in skeletal muscle, compared to local invasion into muscle from direct tumor spread. A 49-year-old woman was referred to our hospital with an 8.5-cm mass in the right breast. Core needle biopsy revealed metaplastic carcinoma with squamous metaplasia. The mass was rapidly growing and metaplastic, so mastectomy with dissection of axillary lymph nodes was performed. Pathological examination showed metaplastic carcinoma, histological grade 3, triple negative, and a MIB-1 labeling index of 80%. Six months postoperatively, during adjuvant chemotherapy treatment, she reported numbness and pain in the right lateral thigh and a mass in the right lower abdomen. Computed tomography revealed multiple lined masses in the abdominal wall and iliac muscle. Core needle biopsy showed metastatic breast carcinoma. Radio- and chemotherapy were administered, but the mass in the muscle became enlarged. To control her pain, a combined treatment with morphine, fentanyl, ketamine, antiepilepsy drug, and NSAIDs was administered. Liver metastasis appeared 9 months (15 months postoperatively) after recognition of muscle metastasis, and the patient died 16 months postoperatively. Skeletal muscle metastasis is uncommon, and therapeutic intervention is mainly palliative. The most common symptom of skeletal muscle metastasis is pain; thus, pain control is a pivotal goal of treatment.

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

    Science.gov (United States)

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

    2015-06-01

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

  4. Abdominal wall hernias-A local manifestation of systemically impaired quality of the extracellular matrix.

    Science.gov (United States)

    Henriksen, Nadia A; Mortensen, Joachim H; Lorentzen, Lea; Ågren, Magnus S; Bay-Jensen, Anne C; Jorgensen, Lars N; Karsdal, Morten A

    2016-07-01

    Throughout life, inguinal hernia develops in approximately every fourth man, some of whom develop multiple hernias. If patients at risk of developing multiple hernias could be identified by a serologic biomarker, treatment might be able to be tailored and improved. Evidence suggests that abdominal wall hernia formation is associated with altered collagen metabolism. The aim of this study was to evaluate biomarkers for type IV and V collagen turnover in patients with multiple hernias and control subjects without hernia. Venous blood was collected from 88 men (mean age, 62 years) with a history of more than 3 hernia repairs and 86, age-matched men without hernias. Biomarkers for synthesis of collagen type IV (P4NP) and type V (P5CP) as well as breakdown (C4M and C5M) were measured in serum by validated, solid-phase, competitive assays. Collagen turnover was indicated by the ratio between the biomarker for synthesis and breakdown. Type IV collagen turnover was 1.4-fold increased in patients with multiple hernias compared to control subjects (P hernias exhibit increased turnover of type IV collagen and a decreased turnover of type V collagen, demonstrating systemically altered collagen turnover. Biomarkers for type V collagen turnover may be used to identify patients at risk for or with multiple hernias. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Nutritional risk index is predictor of postoperative complications in operations of digestive system or abdominal wall?

    Science.gov (United States)

    Thieme, Rubia Daniela; Cutchma, Gislaine; Chieferdecker, Maria Eliana Madalozzo; Campos, Antônio Carlos Ligocki

    2013-01-01

    Malnutrition can be considered the most common disease in hospitals due to its high prevalence. To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries. This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated. A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (p<0,05). Nutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.

  6. Prosthetic abdominal wall hernia repair in emergency surgery: from polypropylene to biological meshes

    Directory of Open Access Journals (Sweden)

    Campanelli G

    2008-12-01

    Full Text Available Abstract The use of nonabsorbable prosthetic materials such as polypropylene, polyester, and ePTFE, have expanded and are now widely used in reparative surgery for abdominal wall hernias. There are still difficulties to find correct indication for prosthetic implant in emergency hernia surgery: as a matter of fact there is still a great debate if to use non-absorbable prostheses in potentially or truly infected operating fields [e.g. after intestinal resections]. All these problems can be avoided with the use of absorbable prosthetic materials such as those composed of lactic acid polymers or lactic and glycolic acid copolymers: however, the use of these absorbable prosthesis exposes the patient to a rapid and inevitable hernia recurrence. It is important to remember that prosthetic repair has been proven to have a significant less risk of recurrence than repair with direct sutures. Recently, new "biologic" prosthetic materials have been developed and proposed for the clinical use in infected fields. These materials can be called "remodeling" for the way by which they are replaced after their placement within the patient. The "remodeling" process is made possible through a process of incorporation, where a reproduction of a site-specific tissue similar to the original host tissue is created.

  7. Pipe wall damage detection by electromagnetic acoustic transducer generated guided waves in absence of defect signals.

    Science.gov (United States)

    Vasiljevic, Milos; Kundu, Tribikram; Grill, Wolfgang; Twerdowski, Evgeny

    2008-05-01

    Most investigators emphasize the importance of detecting the reflected signal from the defect to determine if the pipe wall has any damage and to predict the damage location. However, often the small signal from the defect is hidden behind the other arriving wave modes and signal noise. To overcome the difficulties associated with the identification of the small defect signal in the time history plots, in this paper the time history is analyzed well after the arrival of the first defect signal, and after different wave modes have propagated multiple times through the pipe. It is shown that the defective pipe can be clearly identified by analyzing these late arriving diffuse ultrasonic signals. Multiple reflections and scattering of the propagating wave modes by the defect and pipe ends do not hamper the defect detection capability; on the contrary, it apparently stabilizes the signal and makes it easier to distinguish the defective pipe from the defect-free pipe. This paper also highlights difficulties associated with the interpretation of the recorded time histories due to mode conversion by the defect. The design of electro-magnetic acoustic transducers used to generate and receive the guided waves in the pipe is briefly described in the paper.

  8. 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.

  9. A XANES characterization of structural defects in single-walled carbon nanotubes

    Energy Technology Data Exchange (ETDEWEB)

    Zhong Jun [Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049 (China); Song Li [Institute of Physics, Chinese Academy of Sciences, Beijing 100080 (China); Yan Dongwei [Institute of Chemistry, Chinese Academy of Sciences, Beijing 100080 (China); Wu Ziyu [Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049 (China) and National Center for NanoScience and Technology, Beijing 100080 (China)]. E-mail: wuzy@mail.ihep.ac.cn; Wang Chunru [Institute of Chemistry, Chinese Academy of Sciences, Beijing 100080 (China); Xie Sishen [Institute of Physics, Chinese Academy of Sciences, Beijing 100080 (China); Qian Haijie [Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049 (China)

    2006-11-15

    Structural defects play an important role in the physics of carbon nanototube. However, very few investigations of the structural changes induced by purifying process and other treatments have been performed by means of X-ray absorption near-edge structure (XANES) spectroscopy. We used XANES spectroscopy to detect the presence of defects induced in single-walled carbon nanotubes (SWNTs) by nitric acid treated processes and by an Ar{sup +} ion bombardment. The relationship between the features in XANES spectrum and the structural defects has been discussed systematically. Data also addresses evidence of oxygen effect induced by aging on nanotubes.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, D. I.; Suh, J. S.; Kim, G. E.; Park, C. Y. [Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    1981-09-15

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

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

    Directory of Open Access Journals (Sweden)

    Fortunato Jayme Athias

    1998-04-01

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

  12. 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

  13. Utilization of Lamp Lock-in for Wall-Thinned Defects Detection Using IR Thermography

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Kwaehwan; Kim, Juhyun; Na, Mangyun; Kim, Jinweon; Jung, Hyunchul; Kim, Kyeongsuk [Chosun Univ., Gwangju (Korea, Republic of)

    2013-05-15

    In this study, lock-in techniques and output adjustment were applied to the heating device using the IR thermography in order to detect the wall-thinned defects in the pipe specimen. As a result of experiment, the location and size of the wall-thinned defects are detected well in case of using the lock-in technique than heating the pipe specimen continuously. By using the lock-in technique with Lab View, an inspector can control the heating device through the computer. Recently, the number of long-term aged nuclear power plants (NPPs) has increased. As a result, the problem of the NPP secondary system equipment also increased. For these reasons, the interest about NDT for checking the integrity of the major equipment is growing. The infrared (IR) thermography can detect the defects by analyzing the surface radiant energy from the object through real-time temperature-changing images. To detect the wall-thinned defects of the pipe inside precisely and quickly, it is most important to control the heating device. The IR thermography is expected to show a variety of applications in the field of NDT because it is much safer and faster than other techniques. Through this study, we have developed the inspection technique that can detect the defects by using the lock-in technique in the IR thermography for inspection of pipes in the NPPs during the overhaul.

  14. 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.

  15. On power detection of pipe wall-thinned defects using IR thermography in NPPs

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ju Hyun; Yoo, Kwae Hwan; Na, Man Gyun; Kim, Jin Weon; Kim, Kyeong Suk [Chosun University, Gwangju (Korea, Republic of)

    2014-04-15

    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.

  16. 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.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  18. Finite Element Modeling of Wall Thinning Defects: Applications to Lamb Wave Generation and Interaction

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hyun Jo; Kim, Tae Ho [Wonkwang University, Iksan (Korea, Republic of); Lee, Seung Seok; Kim, Young Kil [KRISS, Daejeon (Korea, Republic of)

    2008-04-15

    The generation of axisymmetric Lamb waves and interaction with wall thinning (corrosion) defects in hollow cylinders are simulated using the finite element method. Guided wave interaction with defects in cylinders is challenged by the multi-mode dispersion and the mode conversion. In this paper, two longitudinal, axisymmetric modes are generated using the concept of a time-delay periodic ring arrays (TDPRA), which makes use of the constructive/destructive interference concept to achieve the unidirectional emission and reception of guided waves. The axisymmetric scattering by the wall thinning extending in full circumference of a cylinder is studied with a two-dimensional FE simulation. The effect of wall thinning depth, axial extension, and the edge shape on the reflections of guided waves is discussed.

  19. 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)

  20. A case report of necrotizing fasciitis of the abdominal wall: A rare, life-threatening complication of a common disease process

    Directory of Open Access Journals (Sweden)

    Anya Romanoff, MD

    2016-01-01

    Conclusion: It is imperative to maintain a high index of suspicion for intra-abdominal pathology in patients who present with necrotizing infections of the abdominal wall, flank, back, or groin. The importance of recognizing this complication early and proceeding immediately to the operating room cannot be overstated.

  1. Haematogenous abdominal wall metastasis of differentiated, alpha-fetoprotein-negative hepatocellular carcinoma after previous antiandrogen therapy within a site of lipoma manifestation since childhood

    OpenAIRE

    2012-01-01

    Abstract Background Cases with subcutaneous metastasis of differentiated hepatocellular carcinoma to the abdominal wall without prior seeding as a consequence of local interventions with a negative or normal alpha-fetoprotein level in the serum are extremely rare. Case report This is the first report of a case with AFP-negative, differentiated hepatocellular carcinoma metastasis to the abdominal wall within a pre-existing subcutaneous lipoma since childhood after antiandrogen therapy with leu...

  2. O uso do pneumoperitônio progressivo no pré-operatório das hérnias volumosas da parede abdominal Preoperative progressive pneumoperitoneum in voluminous abdominal wall hernias

    Directory of Open Access Journals (Sweden)

    José Guilherme Minossi

    2009-06-01

    .CONTEXT: Correction of voluminous hernias and large abdominal wall defects is a big challenge in surgical practice due to technical difficulties and the high incidence of respiratory and cardiovascular complications. OBJECTIVES: To present the authors experience with inducing progressive pneumoperitoneum preoperative to surgical treatment of voluminous hernias of the abdominal wall. METHODS: Retrospective study of six patients who presented voluminous hernias of the abdominal wall and were operated after installation of a pneumoperitoneum. The procedure was performed by placing a catheter in the abdominal cavity at the level of the left hypochondrium with ambient air insufflation for 10 to 15 days. RESULTS: Four of the six patients were female and two male. Ages ranged from 42 to 62 years. Hernia duration varied from 5 to 40 years. Four patients had incisional, one umbilical, and one inguinal hernias. Mean pneumoperitoneum time was 11.6 days. There were no complications related to pneumoperitoneum installation and maintenance. All hernias were corrected without technical difficulties. The Lichtenstein technique was used to correct the inguinal hernia, peritoneal aponeurotic transposition for one of the incisional hernias, with the rest corrected using polypropylene mesh. One death and one wall infection were observed post operatively. No recurrences were reported until now, in 4 to 36 months of follow-up. CONCLUSION: Preoperative progressive pneumoperitoneum is a safe and easy executed procedure, which simplifies surgery and reduces post-operative respiratory and cardiovascular complications. It is indicated for patients with hernias that have lost the right of domain in the abdominal cavity.

  3. Reconstruction of chest wall defects after resection of large neoplasms: ten-year experience.

    Science.gov (United States)

    Novoa, Nuria; Benito, Pablo; Jiménez, Marcelo F; de Juan, Ana; Luis Aranda, José; Varela, Gonzalo

    2005-06-01

    We review our experience in the treatment of complex large chest-wall defects needing a multidisciplinary approach due to primary or secondary neoplasms. Non-small cell lung cancer with chest-wall invasion cases are excluded. Fifteen patients underwent whole thickness resection of the chest wall due to lesions affecting at least three ribs, sternum, clavicle or thoracic spine and the surrounding soft tissue. Previously operated breast cancer and sarcoma were the most frequent diagnoses. Partial or total sternectomy plus rib resection was performed in 8 patients. Immediate closure of the defects was performed in all cases: 12 with single prosthesis placement and 3 with a rigid one of methylmethacrylate. Coverage was achieved using myocutaneous flaps in most cases and, in one case, using the greater omentum that supported a free split-thickness skin graft. No 30-days mortality was recorded. Three patients had a post-operative complication. Mean hospital stay was 11.7+/-9 days. All cases of primary tumours were alive at the time of review (range: 6-126 months). In conclusion, resection and immediate reconstruction of large chest wall defects can be accomplished without operative mortality and low morbidity whenever close cooperation between plastic and thoracic teams exists.

  4. Reconstrução da parede torácica nos defeitos adquiridos Chest wall reconstruction in acquired defects

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius H. de Carvalho

    2010-02-01

    Full Text Available Acquired chest wall defects present a challenging problem for thoracic surgeons. Many of such defects can be repaired with the use of local and regional musculocutaneous flaps, but larger defects compromising skeletal structure require increasingly sophisticated reconstructive techniques. The following discussion will review the options for repair acquired chest wall defects based in literature. The authors searched the Pubmed (www.pubmed.com and found citations from January 1996 to February 2008. By reading the titles and the abstracts most of the citations were discharged because they focused in congenital chest wall defects or were cases report. However, many papers were found describing the outcome of large series of patients with acquired chest wall deformities. A review of recent literature shows that the repair of chest wall defects with soft tissues, if possible, remains the treatment of choice. Large chest wall defects require skeletal reconstruction to prevent paradoxical respiration. The selection of the most appropriate flap is primary dictated by the location and the size of the defect. It is important to transfer tissue with good vitality, so understanding the vascular supply is imperative. Autogenous grafts have been used in the past for skeletal reconstruction but a combination of synthetic materials with musculocutaneous flaps has been used lately. Based in the literature, the use of prosthetic material in chest wall reconstruction does not significantly increases the risk of wound infection.

  5. Domain-wall conduction in ferroelectric BiFeO3 controlled by accumulation of charged defects

    Science.gov (United States)

    Rojac, Tadej; Bencan, Andreja; Drazic, Goran; Sakamoto, Naonori; Ursic, Hana; Jancar, Bostjan; Tavcar, Gasper; Makarovic, Maja; Walker, Julian; Malic, Barbara; Damjanovic, Dragan

    2016-11-01

    Mobile charged defects, accumulated in the domain-wall region to screen polarization charges, have been proposed as the origin of the electrical conductivity at domain walls in ferroelectric materials. Despite theoretical and experimental efforts, this scenario has not been directly confirmed, leaving a gap in the understanding of the intriguing electrical properties of domain walls. Here, we provide atomic-scale chemical and structural analyses showing the accumulation of charged defects at domain walls in BiFeO3. The defects were identified as Fe4+ cations and bismuth vacancies, revealing p-type hopping conduction at domain walls caused by the presence of electron holes associated with Fe4+. In agreement with the p-type behaviour, we further show that the local domain-wall conductivity can be tailored by controlling the atmosphere during high-temperature annealing. This work has possible implications for engineering local conductivity in ferroelectrics and for devices based on domain walls.

  6. 腹腔镜与开放式腹壁切口疝补片修补术的对比研究%Comparison study of open and laparoscope patch herniorrhaphy on abdominal wall incisional hernia

    Institute of Scientific and Technical Information of China (English)

    白东; 张健; 周忠笑

    2011-01-01

    目的 比较开放手术及腹腔镜补片修补腹壁切口疝的手术效果,探讨腹腔镜腹壁切口疝修补术的价值.方法 回顾分析56例腹壁切口疝患者的临床资料.根据手术方式分为腹腔镜组(24例)和开放组(32例),对2组切口疝类型、腹壁缺损大小、手术时间、术后并发症、术后疼痛评分、术后住院时间、复发率等进行对比分析.结果 2组手术时间、术后并发症发生率、术后复发率比较均无显著性差异.腹腔镜组术后疼痛评分、术后住院时间和手术出血量均明显少于开放组.结论 腹腔镜腹壁切口疝修补术是安全可行的.它可以从腹腔内在原切口薄弱区添加一个MESH,修复缺损,加强腹壁,避免切开原切口,避免分离腹壁组织,具有创伤小、住院时间短、恢复快等优点,符合力学原理,是修补腹壁切口疝的理想术式,特别对于巨大腹壁切口疝优于开放式腹壁切口疝补片修补术.%Objective It is to compare the operation effect of open surgery and laparoscope patch herniorrhaphy on abdominal wall incisional hernia and approach the value of laparoscope abdominal wall incisional hernia herniorrhaphy. Methods The clinical data of 56 patients with abdominal wall incisional hernia who were in our hospital from January 2004 to January 2010 were analyzed retrospectively. The patients were divided into laparoscope group ( 24 cases ) and open group ( 32 cases ) according operation manner. The type of incisional hernia, abdominal wall defect size , operation time , postoperative complications, postoperative pain score, postoperative hospitalization time and recurrence rate of the two groups were compared and analyaed. Results There were all no significant differences on operation time, postoperative complications incidence rate and postoperative recurrence rate hetween the two groups. The postoperative pain score, postoperative hospitalization time and operation hemorrhage quantity in

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

    Directory of Open Access Journals (Sweden)

    Nikhil Gupta

    2011-12-01

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

  8. 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

  9. Evaluation of the abdominal wall cicatrization of rabbits exposed to nicotine and undergone abdominoplasty using nylon thread or cyanoacrylate

    OpenAIRE

    Luciano Assis Costa; Paulo dos Reis Jardim; Pedro Henrique Alvares Paiva Macedo; Vânia da Fonseca Amaral; Alcino Lázaro da Silva; Cirênio de Almeida Barbosa

    2012-01-01

    PURPOSE: To compare the wound healing of the abdominal wall of rabbits exposed to nicotine and submitted to abdominoplasty using 2-octyl cyanoacrylate or nylon thread for the surgery suture. METHODS: Thirty two rabbits were used. They were divided in subgroups: A1, A2, B1 e B2. Group A received saline 0.9%; group B received nicotine, both groups for 14 days before surgery. We performed an abdominoplasty with a nylon suture into the A1 and B1 subgroups; as for A2 and B2 groups the suture was p...

  10. Defects in Protein Folding Machinery Affect Cell Wall Integrity and Reduce Ethanol Tolerance in S. cerevisiae.

    Science.gov (United States)

    Narayanan, Aswathy; Pullepu, Dileep; Reddy, Praveen Kumar; Uddin, Wasim; Kabir, M Anaul

    2016-07-01

    The chaperonin complex CCT/TRiC (chaperonin containing TCP-1/TCP-1 ring complex) participates in the folding of many crucial proteins including actin and tubulin in eukaryotes. Mutations in genes encoding its subunits can affect protein folding and in turn, the physiology of the organism. Stress response in Saccharomyces cerevisiae is important in fermentation reactions and operates through overexpression and underexpression of genes, thus altering the protein profile. Defective protein folding machinery can disturb this process. In this study, the response of cct mutants to stress conditions in general and ethanol in specific was investigated. CCT1 mutants showed decreased resistance to different conditions tested including osmotic stress, metal ions, surfactants, reducing and oxidising agents. Cct1-3 mutant with the mutation in the conserved ATP-binding region showed irreversible defects than other mutants. These mutants were found to have inherent cell wall defects and showed decreased ethanol tolerance. This study reveals that cell wall defects and ethanol sensitivity are linked. Genetic and proteomic analyses showed that the yeast genes RPS6A (ribosomal protein), SCL1 (proteasomal subunit) and TDH3 (glyceraldehyde-3-phosphate dehydrogenase) on overexpression, improved the growth of cct1-3 mutant on ethanol. We propose the breakdown of common stress response pathways caused by mutations in CCT complex and the resulting scarcity of functional stress-responsive proteins, affecting the cell's defence against different stress agents in cct mutants. Defective cytoskeleton and perturbed cell wall integrity reduce the ethanol tolerance in the mutants which are rescued by the extragenic suppressors.

  11. 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)

  12. 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.

  13. Optical signature of structural defects in single walled and multiwalled carbon nanotubes.

    Science.gov (United States)

    Singh, Dilip K; Iyer, P K; Giri, P K

    2009-09-01

    Though defects are invariably present in as-grown and purified carbon nanotubes (NTs), spectroscopic properties of defects in NTs have not been established yet. In this work, single walled (SW) and multiwalled (MW) carbon nanotubes (NTs) grown by chemical vapor deposition have been studied by high resolution transmission electron microscopy (HRTEM), Raman scattering and photoluminescence (PL), electron spin resonance (ESR) and thermo gravometric (TGA) analysis. Raman spectra of both SWNT and MWNT show additional features in the frequency range intermediate between 600-1300 cm(-1) and 1700-2600 cm(-1), in addition to well-known radial breathing modes, D- and G-bands. Room temperature PL studies show two broad but distinct peaks centered at approximately 2.05 eV and approximately 2.33 eV, for both SWNT and MWNT samples. TGA analysis shows very low impurity content in MWNT sample as compared to the SWNT sample. HRTEM analysis reveals various kinds of structural defects in nanotube wall. With the help of HRTEM and ESR studies, we argue that the intermediate frequency Raman modes and the visible PL from the pristine NTs are definite signatures of structural defects in the nanotubes.

  14. Giant Cutaneous Leiomyosarcoma Originating From the Abdominal Wall: A Case Report

    Science.gov (United States)

    Eken, Huseyin; Karagul, Servet; Topgül, Koray; Yoruker, Savaş; Ozen, Necati; Gun, Seda; Balci, Mecdi Gurhan; Somuncu, Erkan; Cimen, Orhan; Soyturk, Mehmet; Karavas, Erdal

    2016-01-01

    Patient: Male, 44 Final Diagnosis: Cutaneous Leiomyosarcoma Symptoms: Abdominal mass Medication: — Clinical Procedure: Surgery Specialty: Surgery Objective: Rare disease Background: Leiomyosarcoma, a rare type of tumor, accounts for 5–10% of all soft tissue tumors. Case Report: A 44-year-old male patient was admitted to the emergency service of our medical faculty with the complaints of fatigue and abdominal mass. Conclusions: The pathology result was leiomyosarcoma. Leiomyosarcoma of the skin is rare and our case is the largest such lesion reported in the literature. PMID:26787636

  15. A role of 18F-fluorodeoxyglucose positron emission/computed tomography in a strategy for abdominal wall metastasis of colorectal mucinous adenocarcinoma developed after laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Kaneko Hironori

    2011-02-01

    Full Text Available Abstract Metastasis to the abdominal wall including port sites after laparoscopic surgery for colorectal cancer is rare. Resection of metastatic lesions may lead to greater survival benefit if the abdominal wall metastasis is the only manifestation of recurrent disease. A 57-year-old man, who underwent laparoscopic surgery for advanced mucinous adenocarcinoma of the cecum 6 years prior, developed a nodule in the surgical wound at the lower right abdomen. Although tumor markers were within normal limits, the metastasis to the abdominal wall and abdominal cavity from the previous cecal cancer was suspected. An abdominal computed tomography scan did not provide detective evidence of metastasis. 18F-fluorodeoxyglucose positron emission/computed tomography (18F-FDG PET/CT was therefore performed, which demonstrated increased 18F-fluorodeoxyglucose uptake (maximum standardized uptake value: 3.1 in the small abdominal wall nodule alone. Histopathological examination of the resected nodule confirmed the diagnosis of metastatic mucinous adenocarcinoma. Prognosis of intestinal mucinous adenocarcinoma is reported to be poorer than that of non-mucinous adenocarcinoma. In conclusion, this case suggests an important role of 18F-FDG PET/CT in early diagnosis and decision-making regarding therapy for recurrent disease in cases where a firm diagnosis of recurrent colorectal cancer is difficult to make.

  16. 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 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.

  17. 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.

  18. Tacrolimus does not affect early wound healing in a rodent model of bowel anastomoses and abdominal wall closure.

    Directory of Open Access Journals (Sweden)

    Martine C M Willems

    Full Text Available BACKGROUND: Use of immunosuppressant drugs has been associated with complications in wound healing. The calcineurin inhibitor tacrolimus is thought to have a relatively low complication rate, but preclinical research has yielded contradictory data, prompting the current comprehensive study. METHODS: Three groups of 33 male Wistar rats received a daily subcutaneous dose of 0,5, 2 or 5 mg/kg tacrolimus. A control group received saline. On day 0 a resection of 1 cm ileum and 1 cm colon was performed, and end-to-end anastomoses were constructed. Ten rats of each group were killed on day 3 and day 5 and the remaining animals on day 7. Both anastomoses and the wound in the abdominal wall were analyzed. Wound strength was the primary outcome parameter. RESULTS: Mean strength of the abdominal wall increased significantly over time in all groups (p<0.0001. Both the breaking strength and the bursting pressure of the ileum and colon anastomoses followed the same pattern. No differences were observed between control and experimental groups. In addition, no consistent differences were found between groups regarding wound hydroxyproline content and the activities of matrix metalloproteinase-2 and -9. CONCLUSION: Tacrolimus does not affect early wound healing.

  19. Effects of Defects and Strain on Thermoelectric Properties of Single-walled Carbon Nanotubes

    Science.gov (United States)

    Ohnishi, Masato; Shiga, Takuma; Shiomi, Junichiro

    Carbon nanotubes (CNTs) have attracted much attention as a thermoelectric material. Although CNTs have large lattice thermal conductivity, CNT-based composites are promising candidates for thermoelectric material because the phonon transport is suppressed by scattering at contacts between CNTs. Therefore, previous studies have mainly focused on thermoelectric properties at contacts between CNTs. However, understanding the effects of defects and strain on the thermoelectric properties of CNTs themselves are important because they exist inevitably in real systems. In this study, we study the effects of defects, vacancy and Stone-Wales defect, and uniaxial compressive strain on single-walled CNTs (SWNTs) employing nonequilibrium molecular dynamics simulation and Green's function method. We find that the defects and buckling deformation significantly decrease electron conductance, and the effect is much stronger than that on thermal conductivity and Seebeck coefficient, resulting in severe reduction of the figure of merit. In addition, the estimation of thermoelectric performance including a inter-SWNT contact indicates that the effect of defects and strain can deteriorate the figure of merit of the SWNT networks. This work is partially supported by Thermal Management Materials and Technology Research Association (TherMAT).

  20. Evaluation of the Components Separation Method for treatment of patients with large abdominal wall defects

    NARCIS (Netherlands)

    Geffen, H.J.A.A. van

    2007-01-01

    An incisional hernia occurs in 11 % to 18.7 % of patients, within 10 years after laparotomy. Morbidity of reconstruction is high and long term results are poor with recurrence rates varying from 32 - 63 % after 10 years of follow-up. Oscar Ramirez described good results by using the Components Separ

  1. 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

    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...

  2. 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

    2017-01-01

    Half of the female population over age 50 years will experience pelvic organ prolapse. We suggest a new approach based on tissue engineering principles to functionally reconstruct the anatomical structures of the pelvic floor. The aim of this study is to investigate the mechanical performance...

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

    Science.gov (United States)

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

    2016-04-29

    Le ernie giganti sono rare nei Paesi sviluppati ed ancora più raramente sono associate ad altre ernie della parete addominale, come un’ernia inguinale controlaterale o un’ernia ombelicale. La presenza di più difetti di parete facilità il riposizionamento in addome del contenuto di una voluminosa ernia inguinale senza compromettere la funzionalità cardiorespiratoria, ma il rischio di intasamento o strozzamento intestinale negli altri orifizi erniari aumenta. In letteratura non esistono opinioni convergenti se riparare simultaneamente o in maniera sequenziale, cioè in maniera distanziata nel tempo, le diverse ernie di parete, quando sono associate ad un’ernia gigante. Riportiamo in questo lavoro il caso clinico di un uomo di 60 anni, italiano, che si recò nel nostro ambulatorio di chirurgia lamentando da molti anni la presenza di un’ernia inguinale gigante associata ad un’ernia inguinale controlaterale ed un’ernia ombelicale. Il paziente alla visita presentava difficoltà di deambulazione, ma non riferiva disturbi di canalizzazione. Aveva diverse comorbidità e tra queste quella più importante era una insufficienza respiratoria severa. Dopo un accurato studio cardiologico, respiratorio e metabolico il paziente fu sottoposto a riparazione delle ernie a partire da quella gigante, in maniera sequenziale ed in anestesia spinale secondo la tecnica di Lichtenstein. L’ernia ombelicale fu riparata per ultima con tecnica diretta, senza protesi, ed anch’essa in anestesia spinale. Il decorso operatorio fu regolare dopo i tre interventi e non si ebbe alcuna complicanza respiratoria, cardiologica né di canalizzazione. In conclusione riteniamo che nei pazienti con importanti comorbidità la riparazione di un’ernia gigante associata ad altre ernie di parete debba avvenire in maniera sequenziale, monitorando con attenzione la canalizzazione e soprattutto il progressivo adattamento dei visceri in addome attraverso la palpazione degli orifizi erniari. I dati della letteratura sono pochi ed ulteriori esperienze sono richieste.

  4. 胃肠外科与疝和腹壁外科相互影响并发展%Mutual influence and development between Gastrointestinal surgery and hernia and abdominal wall surgery

    Institute of Scientific and Technical Information of China (English)

    陈双

    2015-01-01

    The aim of this article is to expound on the crossing and influence each other of gastrointestinal surgery and abdominal wall hernia surgery.Although these two departments are independent respectively, but due to the existence of association among anatomy, physiology and pathology, so they are also overlapping.First of all, the abdominal wall and digestive tract are interdependent, and the abdominal wall provides "protection" for gut.In case of large abdominal wall defect, intra-abdominal viscera, breathing,circulation system and spine will change accordingly.In addition,when intra-abdominal pressure increases due to various reasons,laparotomy is an effective way.But laparotomy is not an easy case, but a crisis.One of the most difficult problems is "enteroatmospheric fistulae".Therefore, to avoid serious complications after laparotomy, the concept of planned ventral hernia is proposed.When life safety is threatened by inter-abdominal hypertension, planned abdominal wall hernia is the style to save life.This is a kind of concept of innovation, and is the concrete practice of the theory of damage control surgery.For a planned abdominal wall hernia patient, it is better to wait and watch, and after making a comprehensive assessment, multidisciplinary collaboration mode should be applied to ensure the safety of surgery.%本文阐述了胃肠外科与疝和腹壁外科间的相互交叉与影响.这两个专科虽已分别独立,但由于解剖、生理和病理存在着相关性,两个科之间又相互交叉.首先,与消化道相互依存,腹壁的完整性为消化道提供"保护".若腹壁发生较大缺损,腹腔内脏器和呼吸、循环系统及脊柱都会发生相应的变化.另外,临床上由于种种原因出现腹内压升高或腹腔内高压(ACS)时,开放腹腔是行之有效的办法.但开放腹腔并不是一劳永逸,而是危机重重,其中最棘手的是"肠管空气瘘".因此,要避免开放腹腔后严重的并发症,有人又提出"计划

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

    Science.gov (United States)

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

    2016-02-01

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

  6. Recommendations for reporting outcome results in abdominal wall repair: results of a Consensus meeting in Palermo, Italy, 28-30 June 2012.

    Science.gov (United States)

    Muysoms, F E; Deerenberg, E B; Peeters, E; Agresta, F; Berrevoet, F; Campanelli, G; Ceelen, W; Champault, G G; Corcione, F; Cuccurullo, D; DeBeaux, A C; Dietz, U A; Fitzgibbons, R J; Gillion, J F; Hilgers, R-D; Jeekel, J; Kyle-Leinhase, I; Köckerling, F; Mandala, V; Montgomery, A; Morales-Conde, S; Simmermacher, R K J; Schumpelick, V; Smietański, M; Walgenbach, M; Miserez, M

    2013-08-01

    The literature dealing with abdominal wall surgery is often flawed due to lack of adherence to accepted reporting standards and statistical methodology. The EuraHS Working Group (European Registry of Abdominal Wall Hernias) organised a consensus meeting of surgical experts and researchers with an interest in abdominal wall surgery, including a statistician, the editors of the journal Hernia and scientists experienced in meta-analysis. Detailed discussions took place to identify the basic ground rules necessary to improve the quality of research reports related to abdominal wall reconstruction. A list of recommendations was formulated including more general issues on the scientific methodology and statistical approach. Standards and statements are available, each depending on the type of study that is being reported: the CONSORT statement for the Randomised Controlled Trials, the TREND statement for non randomised interventional studies, the STROBE statement for observational studies, the STARLITE statement for literature searches, the MOOSE statement for metaanalyses of observational studies and the PRISMA statement for systematic reviews and meta-analyses. A number of recommendations were made, including the use of previously published standard definitions and classifications relating to hernia variables and treatment; the use of the validated Clavien-Dindo classification to report complications in hernia surgery; the use of "time-to-event analysis" to report data on "freedom-of-recurrence" rather than the use of recurrence rates, because it is more sensitive and accounts for the patients that are lost to follow-up compared with other reporting methods. A set of recommendations for reporting outcome results of abdominal wall surgery was formulated as guidance for researchers. It is anticipated that the use of these recommendations will increase the quality and meaning of abdominal wall surgery research.

  7. Successful three stage repair of a large congenital abdominal region defect

    Directory of Open Access Journals (Sweden)

    Vaidehi Agrawal

    2015-06-01

    Full Text Available We present two infants born with large, right upper quadrant defects which cannot be categorized as either a gastroschisis or omphalocele. We successfully managed one infant with a three stage repair using polytetrafluoroethylene (PTFE patch, porcine urinary bladder matrix (UBM and delayed surgical closure. The second infant passed away due to parental consent care withdrawal.

  8. A reasonable criterion of reactivities at the defective region of single-walled carbon nanotubes

    Science.gov (United States)

    Jia, Gui-Xiao; Li, Jun-Qian; Chen, Lin-Gang; Li, Yi; Ding, Kai-Ning; Zhang, Yong-Fan

    Defect directional curvature KD-def was proposed as a reasonable criterion for the reactivities and adduct structures at the defective region of single-walled carbon nanotubes (SWCNTs). B3LYP/6-31G* calculations for the [2 + 1] and [1 + 1] additions of a series of 11-layer (n, n) (n = 4-8) and six-layer (10,0) SWCNTs with Stone-Wales defects showed that the KD-def or its mean KM-def was a good index to judge the adduct structures and the reactivities. Adducts of the [2 + 1] additions were divided into two types: one was the adduct with the C-X-C configuration and corresponding to the large KD-def and the large binding energy, and another was the adduct with the closed -3MR structure and corresponding to the small KD-def and the small binding energy. It must be pointed out that, besides mainly relying on the KD-def, the adduct structures and the reactivities of the [2 + 1] additions had been weakly affected by topologic structures. The calculated results for the [1 + 1] additions of the 11-layer (5,5) SWCNT with defect A revealed that the binding energies monotonously increased with the KM-def.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-04

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

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

    OpenAIRE

    Kristek F.; Gerová M.

    2004-01-01

    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 elect...

  11. Thoracoabdominal wall defect with complete ectopia cordis and gastroschisis: a case report and review of the literature.

    Science.gov (United States)

    Pepper, Michael A; Fishbein, Gregory A; Teitell, Michael A

    2013-01-01

    Ventral wall defects are extremely rare anomalies that are likely caused by the failure of the ventral wall to close during week 4 of development. We report a case of severe thoracoabdominal wall defect including complete thoracic ectopia cordis and gastroschisis. This combination represents a novel constellation of findings in a single patient. This unique case further demonstrates an anatomically normal heart with age-appropriate development and an intact diaphragm. We review the literature of other reports and discussions of entities that share overlapping features with this case.

  12. Abdominal Wall Mycetoma Presented as Obstructed Incisional Hernia of Cesarean Section in Eastern Sudan

    Science.gov (United States)

    Elhardello, Osama A.; Adam, Elsadig S.; Adam, Ishag

    2007-01-01

    Mycetoma a worldwide disease frequently occurs in the tropics with the highest prevalence being in Africa. Madurella mycetomatis is the main causative organism of human eumycetoma in Sudan. The legs and feet were commonly the sites of the infection. A 22-year-old lady was presented with painful abdominal swelling around a previous caesarian section scar. A provisional diagnosis of obstructed incisional hernia was put. Histopathological examination revealed macroscopically four masses of soft tissue. Microscopic sections showed grains of Madurella mycetomatis. PMID:17485822

  13. Abdominal Wall Mycetoma Presented as Obstructed Incisional Hernia of Cesarean Section in Eastern Sudan

    Directory of Open Access Journals (Sweden)

    Osama A. Elhardello

    2007-01-01

    Full Text Available Mycetoma a worldwide disease frequently occurs in the tropics with the highest prevalence being in Africa. Madurella mycetomatis is the main causative organism of human eumycetoma in Sudan. The legs and feet were commonly the sites of the infection. A 22-year-old lady was presented with painful abdominal swelling around a previous caesarian section scar. A provisional diagnosis of obstructed incisional hernia was put. Histopathological examination revealed macroscopically four masses of soft tissue. Microscopic sections showed grains of Madurella mycetomatis.

  14. THORACO - ABDOMINAL FLAP FOR RESURFACING LARGE POST MASTECTOMY DEFECTS IN LOCALLY ADVANCED CA. BREAST

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-02-01

    Full Text Available Covering of large wounds after mastectomy in locally advanced Ca breast with skin that can withstand radiotherapy is a challenge to the surgeon. Here this study we used a local advancement flap from the adjacent area called Thoraco - A bdominal F la p (TA flap for such giant defects. This is based on superficial and lumbar arteries and is thick to with stand consequent RT . MATERIALS AND METHODS: Of the total 107 cases of LABC 32 had post mastectomy defects of larger than 12 cm and could not be closed by simple approximation. Among the 32 cases 17 cases are covered by split thickness skin grafting. 15 cases are covered by TA flap. These cases are assessed for mean operating time, mean blood loss, post - operative stay, flap necrosis and viability of the f lap after radiotherapy. RESULTS: There is minimal extra time or blood loss in these cases . All the flaps healed well except for small edge necrosis in 4 cases. In all the patients we could start radiotherapy in the fourth week of surgery and all the flaps withstood RT well. After further evaluation probably this can be recommended as procedure for giant post mastectomy defects particularly for those who require RT early

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Sofos SS

    2015-01-01

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

  17. Changes in the Frequencies of Abdominal Wall Hernias and the Preferences for Their Repair: A Multicenter National Study From Turkey

    Science.gov (United States)

    Şeker, 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, İbrahim; 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%.1–3 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.4 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),5,6 the ideal anesthesia (general, local, or regional),7,8 and the ideal mesh (standard polypropylene or newer meshes).9,10 PMID:25216417

  18. [Results of partial splenic resection and transposition to the lateral abdominal wall in portal hypertension in childhood].

    Science.gov (United States)

    Bennek, J; Tröbs, R B; Mühlig, K; Richter, T

    1996-01-01

    Between 1977 and 1995, 19 children with portal hypertension (nine extrahepatic, ten intrahepatic) were treated by transpositioning the spleen into the left abdominal wall. Among the patients with intrahepatic portal hypertension three died. Two patients underwent secondary diminuition of the transposed spleen due to relapsed hypersplenism. In one of our first patients the transposed spleen atrophied after tangential resection. All surviving patients except one preserved hepatic function. The serum colloid osmotic pressure was stable. Plasma ammonia levels were normal. Serum immunoglobulins (IgG, IgM, IgA and IgG subclasses) and complement components (C3c, C4) were analyzed. After transposition patients had normal or slightly elevated values of these proteins compared with controls.

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

    Science.gov (United States)

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

    2017-08-01

    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 characteristics of these women were calculated, as well as the recurrence rate of AWE. To determine the risk factors for disease recurrence, Fisher's exact test was used. Results The mean age of the patients was 30.71 ± 5.91 years. The main clinical manifestations were pain (98%) and sensation of a mass (36.5%). We observed that 94% of these women had undergone at least 1 cesarean section, and 73% had used medication for the postoperative control of endometriosis. The lesion was most commonly located in the cesarean section scar (65%). The recurrence rate of the disease was of 26.9%. All 14 women who had relapsed had surgical margins compromised in the previous surgery. There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51). Conclusion Women with previous cesarean sections with local pain or lumps should be investigated for AWE. The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

  20. In-Service Inspection of Wall-thinned Defects Using a Lock-in Technique of IR Thermography

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Kwae Hwan; Kim, Ju Hyun; Na, Man Gyun; Kim, Jin Weon [Chosun Univ., Gwangju (Korea, Republic of)

    2013-10-15

    In this study, a lock-in technique and power adjustment were applied to the cooling device for the IR thermography in order to detect the wall-thinned defects of the pipe specimen in a normal operation NPPs. According as the number of the cooling devices is increased and air volume transferred by the cooling device increases, wall-thinned defects inside pipes are more visible. By cooling the pipe using a lock-in technique in IR thermography, the boundary of the wall-thinned defective part is clear and the defect detection is easy. It is expected to detect the wall-thinned defects of piping during normal operation, to shorten the maintenance time of the NPPs, and to improve the work efficiency of the inspector. Recently, the safety problem of nuclear power plants (NPPs) has emerged as a global concern. As a result, the secondary system equipment in long-term aged NPPs has been growing interest. For these reasons, NDT for checking the integrity of the secondary system equipment is performed. The infrared (IR) thermography is one of the NDT. It is possible for us to solve the problems of the existing NDT. IR thermography can detect without contact the wall-thinned defects in pipes. Also, IR thermography using a lock-in technique for inspection is much safer and faster than other techniques. It is expected to be able to accurately detect the boundary of the non-defect parts and the defect parts, and shows a high utilization in the industrial field. Through this study, we have developed the inspection technique that can detect the defects by using the lock-in technique in IR thermography for inspection of pipes in the NPPs during the normal operation.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

    Science.gov (United States)

    Kristek, F; Gerová, M

    2004-04-01

    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 NG-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 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.

  3. Comparação entre o uso de fio inabsorvível (polipropileno e fio absorvível (poliglactina 910 na fixação de prótese de polipropileno em correção de defeitos músculo-aponeurótico da parede abdominal: estudo experimental em ratos Comparison between fixation of polypropylene mesh with polypropylene suture and polyglactin 910 suture for treatment of muscle-aponeurotic defects of abdominal wall: experimental study in rats

    Directory of Open Access Journals (Sweden)

    Álvaro Gianlupi

    2004-04-01

    (polypropylene one. METHODS: Eighty-one male rats of the Wistar breed, weighing from 180g to 220g, were submitted to a longitudinally resection of a musculoaponeurotic and peritoneal segment (3x2 cm of the abdominal wall. Reconstruction was performed by reinforcement with polypropylene mesh, overlaid on the aponeurosis. They were distributed in two groups according to the thread used for mesh fixation as follows: (1 polyglactin 910 group, fixed with 8 stitches 4.0 Polyglactin 910 suture; and (2 Polipropylene group, fixed with 4.0 polypropylene suture. The skin suture was performed with 4.0 nylon continuous stitches. After 90 days, animals were sacrificed and submitted to macroscopic evaluation for the presence of hernias. Histologic samples were stained for Hematoxylin-Eosine and Sirius-Red and were assessed for signs of cicatrization such as chronic inflammatory reaction, fibrosis, suture absortion and percentage of fibrosis by computer-assisted video morfometric technic. RESULTS: There was no significant difference between the groups studied in relation to hernia formation (p=0,194. The histologic study showed significant increase of fibrotic reaction in the polipropylene group (p=0,0005, but this finding was not confirmed in the video-morfometric evaluation. Considering chronic inflammatory reaction, there was no difference between groups in relation to giant cells, lymphocytes and neutrophils. However, in the polipropylene group, macrophages were significantly increased (p=0,02. Polyglactin 910 has not been absorved 90 days after the procedure. CONCLUSIONS: The results of this study suggest that the fixation of polipropilene mesh is effective using absorbable sutures in the repair of ventral (incisional hernias.

  4. EuraHS: The Development of an international online platform for registration and outcome measurement of ventral abdominal wall Hernia repair

    NARCIS (Netherlands)

    F.E. Muysoms (Filip); G. Campanelli (Giampiero); G.G. Champault; A.C. DeBeaux; U.A. Dietz; J. Jeekel (Hans); U. Klinge; F. Köckerling; V. Mandala; A. Montgomery; S. Morales Conde (S.); W. Puppe; R.K.J. Simmermacher; M. Śmietański; M. Miserez

    2012-01-01

    textabstractBackground Although the repair of ventral abdominal wall hernias is one of the most commonly performed operations, many aspects of their treatment are still under debate or poorly studied. In addition, there is a lack of good definitions and classifications that make the evaluation of st

  5. EuraHS: The Development of an international online platform for registration and outcome measurement of ventral abdominal wall Hernia repair

    NARCIS (Netherlands)

    F.E. Muysoms (Filip); G. Campanelli (Giampiero); G.G. Champault; A.C. DeBeaux; U.A. Dietz; J. Jeekel (Hans); U. Klinge; F. Köckerling; V. Mandala; A. Montgomery; S. Morales Conde (S.); W. Puppe; R.K.J. Simmermacher; M. Śmietański; M. Miserez

    2012-01-01

    textabstractBackground Although the repair of ventral abdominal wall hernias is one of the most commonly performed operations, many aspects of their treatment are still under debate or poorly studied. In addition, there is a lack of good definitions and classifications that make the evaluation of st

  6. Haematogenous abdominal wall metastasis of differentiated, alpha-fetoprotein-negative hepatocellular carcinoma after previous antiandrogen therapy within a site of lipoma manifestation since childhood

    Directory of Open Access Journals (Sweden)

    Zachau L

    2012-05-01

    Full Text Available Abstract Background Cases with subcutaneous metastasis of differentiated hepatocellular carcinoma to the abdominal wall without prior seeding as a consequence of local interventions with a negative or normal alpha-fetoprotein level in the serum are extremely rare. Case report This is the first report of a case with AFP-negative, differentiated hepatocellular carcinoma metastasis to the abdominal wall within a pre-existing subcutaneous lipoma since childhood after antiandrogen therapy with leuprorelin and buserelin acetate for prostate cancer without seeding. Methods Clinical features including histology, immunohistochemistry, clinical course and surgical approach are presented. Results Histological examination revealed a hepatocellular carcinoma with a trabecular and pseudoglandular growth pattern with moderately atypical hepatocytes with multifocal bile formation within a lipoma. The postoperative course of abdominal wall reconstruction with a monocryl-prolene mesh and a local flap after potentially curative resection was uncomplicated. Discussion and conclusion It may be that previous antiandrogen treatment for prostate carcinoma contributed to the fact that our patient developed alpha-fetoprotein-negative and androgen receptor-negative subcutaneous abdominal wall metastasis within a pre-existing lipoma since childhood.

  7. A selective way to create defects by the thermal treatment of fluorinated double walled carbon nanotubes

    Institute of Scientific and Technical Information of China (English)

    Hiroyuki Muramatsu; Kazunori Fujisawa; Yong-Il Ko; Kap-Seung Yang; Takuya Hayashi; Morinobu Endo; Cheol-Min Yang; Yong Chae Jung; Yoong Ahm Kim

    2014-01-01

    Nanoscale defects in the outer tube to preserve the electrical and optical features of the inner tube can be engineered to exploit the intrinsic properties of double walled carbon nanotubes (DWCNTs) for various promising applications. We demonstrated a selective way to make defects in the outer tube by the fluorination of DWCNTs followed by the thermal detachment of the F atoms at 1000 °C in argon. Fluorinated DWCNTs with different amounts of F atoms were prepared by reacting with fluorine gas at 25, 200, and 400 °C that gave the stoichiometry of CF0.20, CF0.30, and CF0.43, respective-ly. At the three different temperatures used, we observed preservation of the coaxial morphology in the fluorinated DWCNTs. For the DWCNTs fluorinated at 25 and 200 °C, the strong radial breathing modes (RBMs) of the inner tube and weakened RBMs of the outer tube indicated selective fluorine attachment onto the outer tube. However, the disappearance of the RBMs in the Raman spectrum of the DWCNTs fluorinated at 400 °C showed the introduction of F atoms onto both inner and outer tubes. There was no significant change in the morphology and optical properties when the DWCNTs fluorinated at 25 and 200 °C were thermally treated at 1000 °C in argon. However, in the case of the DWCNTs fluorinated at 400 °C, the recovery of strong RBMs from the inner tube and weakened RBMs from the outer tube indicated the selective introduction of substantial defects on the outer tube while preserving the original tubular shape. The thermal detachment of F atoms from fluori-nated DWCNTs is an efficient way to make highly defective outer tubes for preserving the electrical conduction and optical activity of the inner tubes.

  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. Computed tomography scan measurement of abdominal wall thickness for application of near-infrared spectroscopy probes to monitor regional oxygen saturation index of gastrointestinal and renal circulations in children.

    Science.gov (United States)

    Balaguru, Duraisamy; Bhalala, Utpal; Haghighi, Mohammad; Norton, Karen

    2011-05-01

    To measure abdominal wall thickness to determine the depth at which the renal vascular bed and mesenteric vascular bed are located, and to determine the appropriate site for placement of near-infrared spectroscopy probes for accurate monitoring regional oxygen saturation index in children. Abdominal computerized tomography scans in children were used to measure the abdominal wall thickness and to ascertain the location of kidneys. Tertiary care children's hospital. Children 0-18 yrs of age; n = 38. None. The main mass of the kidneys is located between vertebral levels T12 and L2 on both sides. The left kidney is located about a half-vertebral length higher than the right kidney. Posterior abdominal wall thickness ranged from 6.6 to 115.8 mm (median, 22.1 mm). Posterolateral abdominal wall thickness ranged from 6.7 to 114.5 mm (median, 19.6 mm). Anterior abdominal wall thickness in the supraumbilical level ranged from 3.5 to 62.9 mm (median, 16.0 mm). All abdominal wall thicknesses correlated better with weight of the subjects than their age. Abdominal wall thickness potentially exceeds the sampling depth of currently used near-infrared spectroscopy probes above a certain body size. Application of current near-infrared spectroscopy probes and design of future probes should consider patient size variations in the pediatric population.

  10. Micromagnetic modeling of domain wall motion in sub-100-nm-wide wires with individual and periodic edge defects

    Directory of Open Access Journals (Sweden)

    S. Dutta

    2015-12-01

    Full Text Available Reducing the switching energy of devices that rely on magnetic domain wall motion requires scaling the devices to widths well below 100 nm, where the nanowire line edge roughness (LER is an inherent source of domain wall pinning. We investigate the effects of periodic and isolated rectangular notches, triangular notches, changes in anisotropy, and roughness measured from images of fabricated wires, in sub-100-nm-wide nanowires with in-plane and perpendicular magnetic anisotropy using micromagnetic modeling. Pinning fields calculated for a model based on discretized images of physical wires are compared to experimental measurements. When the width of the domain wall is smaller than the notch period, the domain wall velocity is modulated as the domain wall propagates along the wire. We find that in sub-30-nm-wide wires, edge defects determine the operating threshold and domain wall dynamics.

  11. Primary prevascular and retropsoas hernias: incidence of rare abdominal wall hernias.

    Science.gov (United States)

    Powell, B S; Lytle, N; Stoikes, N; Webb, D; Voeller, G

    2015-06-01

    To describe the incidence and treatment of prevascular and retropsoas hernias in a large-volume general surgery practice. Femoral hernias are considered uncommon with an incidence between 2 and 8 % of groin hernias. There are no large studies describing the subtypes of femoral hernias or retropsoas hernias, and therefore no reported incidence or standardized treatment recommendations for these hernias exist. This study is a retrospective review of all patients undergoing total extraperitoneal (TEP) laparoscopic herniorrhaphy between August 1993 and December 2011. A single surgeon performed all the repairs. Demographics and patient outcomes were reported. 2,436 patients underwent 3,242 TEP repairs. The subtypes were: indirect 1,523 (46.9 %), direct 1,473 (45.4 %), femoral 156 (4.8 %), obturator 35 (1.1 %), prevascular 25 (0.77 %), Spigelian 20 (0.61 %), retropsoas 3 (0.09 %). Prevascular hernias accounted for 16 % of femoral hernias. Patients with prevascular hernias had a mean age of 70.3 years and were all male. 13 of the 25 patients (52 %) with prevascular hernias had other associated defects and four (16 %) of the patients had prevascular hernias as a recurrence from a prior hernia operation. There were three patients with retropsoas hernias that only would not have been seen from an anterior open approach. There are no intraoperative complications or known recurrences from this study group. Prevascular and retropsoas hernias are uncommon, but have a higher incidence than previously believed. Prevascular hernias tend to be associated with older age and other defects. The diagnosis and management of these hernias are readily achieved using the laparoscopic TEP approach.

  12. [Morphology of tissue reactions around implants after combined surgical repair of the abdominal wall].

    Science.gov (United States)

    Vostrikov, O V; Zotov, V A; Nikitenko, E V

    2004-01-01

    Tissue reactions to titanium-nickelide and polypropylen and caprone implants used in surgical treatment of anterior aldomen wall hernias were studied in experiment. Digital density of leukocytes, fibroblasts, vessels, thickness of the capsule were studied. Pronounced inflammatory reaction was observed on day 3 which attenuated on day 14 in case of titanium nickelide and on day 30-60 in case of polypropylene and caprone. Fibroplastic processes start in the first group after 7 days while in the second group only after 30 days of the experiment. Thickness of the capsule around titanium-nickelide was 2-3 times less than around polypropylene and caprone. Thus, titanium-nickelide material is biologically more inert than caprone and polypropylen which are widely used in surgery of hernias.

  13. Intraperitoneal tension-free repair of a small midline ventral abdominal wall hernia: randomized study with a mean follow-up of 3 years.

    Science.gov (United States)

    Bensaadi, Hocine; Paolino, Luca; Valenti, Antonio; Polliand, Claude; Barrat, Christophe; Champault, Gérard

    2014-01-01

    Funding received from Cousin Biotech, Wervicq Sud, France, and CR Bard Inc., Cranston, RI. The aim of this prospective randomized study was to determine the long-term recurrence and complication rates after small abdominal wall hernia repair with two different bilayer prostheses. Hernia repair using prosthetic mesh material has become the preferred method of repair, because the recurrence rates are much lower than with conventional repair techniques. The use of a hernia bilayer patch, composite expanded polytetrafluoroethylene (ePTFE)-polypropylene, with intraperitoneal placement behind the hernia defect, through a small incision, may be efficient, safe, and cost-effective. This study is a randomized, single-institution trial, including 83 selected consecutive patients with primary (umbilical, epigastric) or incisional anterior abdominal wall defects from 2 to 5 cm. Hernia repair was performed by direct local access in ambulatory surgery; the prosthesis used was a circular bilayer with an inner face in ePTFE to avoid bowel adhesion. One group was treated with a Ventralex® Hernia Patch (Bard USA). The second group was treated with a Cabs'Air® Composite (Cousin Biotech France), which was delivered with two to four fixation sutures and a balloon to properly deploy the mesh intraperitoneally. Patients' characteristics and operative and postoperative data were prospectively collected. The primary outcome was late recurrence. Secondary outcomes included, pain, discomfort and quality of life before and after (3 months) surgery using the SF-12 questionnaire, patient-surgeon satisfaction, and early and late complications. Among 98 patients, 83 were included in the study protocol between January 2007 and August 2011. The two groups were comparable according to pre- and intraoperative data. According to surgeon experience, placement of the Cabs'Air® device was significantly faster (P = 0.01) and easier. At 3 months, there was significantly less pain and less discomfort for

  14. 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

  15. Changes in hemodynamics and autonomic nervous activity in patients undergoing laparoscopic cholecystectomy: differences between the pneumoperitoneum and abdominal wall-lifting method.

    Science.gov (United States)

    Uemura, N; Nomura, M; Inoue, S; Endo, J; Kishi, S; Saito, K; Ito, S; Nakaya, Y

    2002-08-01

    Intraoperative changes in circulatory hemodynamics and autonomic nervous activity were evaluated in 33 patients with cholelithiasis who underwent laparoscopic cholecystectomy. Of these patients, 18 were treated using a pneumoperitoneum (group G) and 15 using the abdominal wall-lifting method (group WL). Their ECG, blood pressure, arterial oxygen saturation, and expiratory carbon dioxide partial pressure were monitored. Autonomic nervous function was evaluated by spectral analysis of the heart rate. Mean blood pressure increased significantly in group G during surgery, but did not vary in group WL during any stage of surgery. The high-frequency (HF) power, an index of parasympathetic activity, decreased significantly in group G after pneumoperitoneum. However, the HF power did not decrease significantly in group WL. The LF/HF ratio, an index of sympathetic activity, increased significantly in group G after pneumoperitoneum, but did not vary in group WL. In addition, the incidence of ventricular or supraventricular arrhythmias and the severity of the arrhythmias as determined by Lown's classification were higher in group G than in group WL. These findings suggest that intraoperative changes in autonomic nervous activity, due to increased intra-abdominal pressure, were smaller in patients undergoing laparoscopic cholecystectomy using the abdominal wall-lifting method than in those undergoing laparoscopic cholecystectomy using pneumoperitoneum. The results also demonstrated that hemodynamic changes were smaller in patients undergoing the abdominal wall-lifting method than in those undergoing pneumoperitoneum. It was concluded that hemodynamics should be carefully monitored during pneumoperitoneum, and that the abdominal wall-lifting approach in laparoscopic cholecystectomy is a method worthy of consideration for elderly patients or those with cardiopulmonary complications.

  16. A Point Mutation in Myh10 Causes Major Defects in Heart Development and Body Wall Closure

    Science.gov (United States)

    Ma, Xuefei; Adelstein, Robert S.

    2014-01-01

    Background The three isoforms of nonmuscle myosin II (NMII-A, NMII-B and NMII-C) play various roles during mouse embryonic development. Previous work, using knockout and hypomorphic mice, showed that MYH10 encoding myosin heavy chain II-B is critical for cardiac and brain development. Ablating or decreasing NMII-B by 80% results in cardiac (ventricular septal defect, double outlet of the right ventricle) and brain defects but not midline fusion defects. Neither NMII-A nor II-C appear to play roles in early myocardial development. Methods and Results We had previously generated point mutant knock-in mice and now report novel findings due to expressing motor deficient NMII-B at wild-type levels. Homozygous mice die at E14.5 in cardiac failure exhibiting abnormalities not seen in NMII-B null and hypomorphic mice: a failure in midline fusion resulting in a cleft palate, ectopia cordis, and a large omphalocele. Fusion of the sternum and endocardial cushions is impaired in the mutant mice associated with a failure in apoptosis of the mesenchyme cells. Failure to disassemble myocyte cell-cell adhesions during cardiac outflow tract development contributes to impaired outflow tract myocardialization and displacement of the aorta to the right ventricle. Conclusions Expression of motor impaired NMII-B disrupts normal ventral body wall closure, due to a dominant negative effect. This is not due to the loss of NMII-B function but rather to a gain-of-function resulting from prolonged crosslinking of NMII-B to actin-filaments thereby interfering with the dynamics of actomyosin cytoskeletal structure. Moreover impaired NMII-B motor activity inhibits outflow tract myocardialization leading to mis-localization of the aorta. PMID:24825879

  17. Characteristic Features of Stone-Wales Defects in Single-Walled Carbon Nanotube; Adsorption, Dispersion, and Field Emission

    Directory of Open Access Journals (Sweden)

    Seungkwang Roh

    2010-01-01

    Full Text Available Adsorption behaviors of dodecanethiol (C12H25SH molecules are investigated on the surface of single-walled carbon nanotubes (SWCNTs with vibrational and X-ray photoelectron spectrometers. The active adsorption sites are proved as Stone-Wales (SW defects (5–7 ring defects. The SW defect-removed SWCNTs formed by reacting nanotubes with allyl acrylate molecules are compared with pristine SWCNTs in dispersion and field emission. The former shows higher dispersion and field emission than the latter.

  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. 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.

  20. 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; Chao, Tzu-Cheng; Zhu, Chengcheng; Chang, Hing-Chiu; Mendes, Jason; Chung, Hsiao-Wen; Gillard, Jonathan; Graves, Martin

    2017-03-22

    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.

  1. Evaluation of the abdominal wall cicatrization of rabbits exposed to nicotine and undergone abdominoplasty using nylon thread or cyanoacrylate.

    Science.gov (United States)

    Costa, Luciano Assis; Jardim, Paulo dos Reis; Macedo, Pedro Henrique Alvares Paiva; Amaral, Vânia da Fonseca; Silva, Alcino Lázaro da; Barbosa, Cirênio de Almeida

    2012-12-01

    To compare the wound healing of the abdominal wall of rabbits exposed to nicotine and submitted to abdominoplasty using 2-octyl cyanoacrylate or nylon thread for the surgery suture. Thirty two rabbits were used. They were divided in subgroups: A1, A2, B1 e B2. Group A received saline 0.9%; group B received nicotine, both groups for 14 days before surgery. We performed an abdominoplasty with a nylon suture into the A1 and B1 subgroups; as for A2 and B2 groups the suture was performed with cyanoacrylate. The euthanasia happened in the 14th post-operative day. After, we evaluated: swollen process, fibroblast proliferation, collagen, neovascularization, and macroscope and microscope epithelization of the scars. We observed the presence of eosinophils in all scars exposed to the cyanoacrylate, and a significant increase of neovascularization in the subgroup B2 comparing to the A2 one (p=0.037). The other variables haven't showed any statistical difference. Nicotine hasn't influenced the swollen process, the fibroblast proliferation, the presence of collagen, neither the epithelialization. The neovascularization showed cicatricial immaturity when comparing group A2 to group B2. The eosinophils in the scars repaired with glue showed that the substance has acted as an allergen.

  2. Evaluation of nano ceramic coating on radiographic defects of thin-walled AL4-4 aluminum alloy sand casting

    Directory of Open Access Journals (Sweden)

    Mansour Borouni

    2016-10-01

    Full Text Available Internal defects are among the problems in gravity casting of aluminum parts. The main internal volumetric defects are gas and shrinkage defects which form during solidification of the melt and drastically reduce the quality of the produced parts. These defects adversely affect the mechanical properties of thin walled castings parts. In this study, ceramic nanoparticles coatings were applied on the sand mold and the effect of mold coatings on the reduction of defects were investigated. X-ray radiography was used to detect defects in sand molds with ceramic nanoparticles coatings. For comparison, this test was performed on molds with micro-ceramic and graffiti coatings and uncoated sand mold. The results showed that the maximum amount of gas and shrinkage defects was observed in casting parts from AL4-1 alloy in uncoated molds. On the other hand, the minimum defects were found in molds coated with ceramic nanoparticles. It seems that the reduced defects in casting parts in molds coated with ceramic nanoparticles may be due to high thermal and chemical stability and higher heat transfer rate of the coating. These results can facilitate the production of high quality aluminum alloys parts using nanotechnology.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-08-15

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

  4. Tamoxifen up-regulates catalase production, inhibits vessel wall neutrophil infiltration, and attenuates development of experimental abdominal aortic aneurysms.

    Science.gov (United States)

    Grigoryants, Vladimir; Hannawa, Kevin K; Pearce, Charles G; Sinha, Indranil; Roelofs, Karen J; Ailawadi, Gorav; Deatrick, Kristopher B; Woodrum, Derek T; Cho, Brenda S; Henke, Peter K; Stanley, James C; Eagleton, Matthew J; Upchurch, Gilbert R

    2005-01-01

    Selective estrogen receptor modulators (SERMs), similar to estrogens, possess vasoprotective effects by reducing release of reactive oxygen species. Little is known about the potential effects of SERMs on the pathogenesis of abdominal aortic aneurysms (AAAs). This study's objective was to investigate the growth of experimental AAAs in the setting of the SERM tamoxifen. In the first set of experiments, adult male rats underwent subcutaneous tamoxifen pellet (delivering 10 mg/kg/day) implantation (n = 14) or sham operation (n = 16). Seven days later, all animals underwent pancreatic elastase perfusion of the abdominal aorta. Aortic diameters were determined at that time, and aortas were harvested 7 and 14 days after elastase perfusion for immunohistochemistry, real-time polymerase chain reaction, Western blot analysis, and zymography. In the second set of experiments, a direct irreversible catalase inhibitor, 3-amino-1,2,4-triazole (AT), was administered intraperitoneally (1 mg/kg) daily to tamoxifen-treated (n = 6) and control rats (n = 6), starting on day 7 after elastase perfusion. Aortic diameters were measured on day 14. In a third set of experiments, rats were perfused with catalase (150 mg/kg) after the elastase (n = 5), followed by daily intravenous injections of catalase (150 mg/kg/day) administered for 10 days. A control group of rats (n = 7) received 0.9% NaCl instead of catalase. Mean AAA diameters were approximately 50% smaller in tamoxifen-treated rats compared with sham rats 14 days after elastase perfusion (P = .002). The tamoxifen-treated group's aortas had a five-fold increase in catalase mRNA expression (P = .02) on day 7 and an eight-fold increase in catalase protein on day 14 (P = .04). Matrix metalloprotroteinase-9 activity was 2.4-fold higher (P = .01) on day 7 in the aortas of the controls compared to the tamoxifen-treated group's aortas. Tamoxifen-treated rats had approximately 40% fewer aortic polymorphonuclear neutrophils compared to

  5. Laparoscopic morgagni hernia repair using single-site umbilical and full-thickness abdominal wall repair: Technical report of two cases

    Directory of Open Access Journals (Sweden)

    Martin L van Niekerk

    2013-01-01

    Full Text Available Single incision laparoscopic surgery is used in many centres for routine cases such as appendisectomy, splenectomy and cholecystectomy. Morgagni hernias are uncommon and account for 1-2% of all congenital diaphragmatic hernia. We report our first laparoscopic repair of two Morgagni hernias, using a single umbilical incision and full-thickness abdominal wall repair with standard straight laparoscopic instruments. Operative time was short and compared favourably with the laparoscopic repair.

  6. Laparoscopic Morgagni hernia repair using single-site umbilical and full-thickness abdominal wall repair: technical report of two cases.

    Science.gov (United States)

    van Niekerk, Martin L

    2013-01-01

    Single incision laparoscopic surgery is used in many centres for routine cases such as appendectomy, splenectomy and cholecystectomy. Morgagni hernias are uncommon and account for 1-2% of all congenital diaphragmatic hernia. We report our first laparoscopic repair of two Morgagni hernias, using a single umbilical incision and full-thickness abdominal wall repair with standard straight laparoscopic instruments. Operative time was short and compared favourably with the laparoscopic repair.

  7. Indications and Outcomes of the Components Separation Technique in the Repair of Complex Abdominal Wall Hernias: Experience From the Cambridge Plastic Surgery Department

    OpenAIRE

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

    2013-01-01

    Objectives: The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Methods: Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. Results: There were 7 women and 6 men in the series with a mean age of 53 years (ra...

  8. [Influence of mydocalm on the degree of intra-abdominal hypertension and local blood circulation in the intestinal wall in experiment].

    Science.gov (United States)

    Sapegin, V I; Sapegin, I D; Il'chenko, F N

    2014-01-01

    The effect of mydocalm (tolperison, 5 mg/kg single dose) on the dynamics of intra-abdominal hypertension (IAH), blood circulation regulation, and oxygen balance in the tissues of intestinal wall were studied in acute experiments on rabbits. Using a special stand of original design, the initial IAH level was modeled at 200 mm H2O with the subsequent stopping of further receipt of liquid during 3 hours in an elastic container in the abdominal cavity. During 3-h observation without drug administration, no changes in IAH due to the tone of muscles of the frontal abdominal wall takes place, but there is progressive deceleration of local blood flow (-35.33 + 0.99%, p < 0.01), suppressed dilation (-20.02 + 0.54%, p < 0.01) and constriction (-60.45 + 1.17%, p < 0.01) reactivity of vessels, and decreased oxygen tension (-47.18 + 0.75%, p < 0.01) in the intestinal wall at the end of experiment. The introduction of mydocalm reduces the tone of muscles of the frontal abdominal wall, which leads to a decrease in IAH (maximum effect after 1.5 hours, -20.81 + 0.84%, p < 0.01) and prevents decrease in the local blood flow (-26.77 + 0.41%, p < 0.01), suppression of dilation (-16.51 + 0.34%, p < 0.01) and constriction (-37.85 + 0.61%, p < 0.01) reactivity of vessels, and reduction in oxygen tension (-36.60 + 1.18%, p < 0.01) at the end of experiment. The administration of mydocalm can extend the limits of application of a conservative therapy for patients with IAH and to improve the results.

  9. Application of FOX-TEK sensors to measure strains in steel pipe with wall thinning defects under internal pressure

    Energy Technology Data Exchange (ETDEWEB)

    Tennyson, R.C.; Lin, W.; Doiron, A. [Natural Resources Canada, Ottawa, ON (Canada)

    2002-06-30

    A project was undertaken as part of the ISPIR program to investigate the application of fiber optic sensing to monitor pipelines. This report discussed the application of FOX-TEK (FT) sensors to measure strains in steel pipe with wall thinning defects under internal pressure. Sensor installation and pipe test results were both discussed. Several illustrations were offered, including the geometry of pipes with internal defects and location of FT sensors; smoothing of the pipe surface prior to bonding sensors; close-up views of 2 FT sensors bonded over defect areas of the steel pipe; an overview of steel pipe with 3 FT sensors; and an internal pressure test of steel pipe with 4 FT sensors connected to an FTI 3300 instrument. FT sensor strain results were plotted for 2 different sized cutouts and a finite element analysis was conducted to calculate the circumferential strain distribution for 24 inch and 4 inch cutouts, with and without the weld seams present. It was concluded that the FT sensors can accurately detect the hoop strains for uniform wall sections, circumferential defect areas and large regions of wall thinning for a pipe under internal pressure. 1 tab., 8 figs.

  10. Determination of an Test Condition for IR Thermography to Inspect a Wall-Thinning Defect in Nuclear Piping Components

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Weon; Yun, Won Kyung; Jung, Hyun Chul; Kim, Kyeong Suk [Chosun University, Gwnagju (Korea, Republic of)

    2012-02-15

    This study conducted infrared (IR) thermography tests using pipe and plate specimens with artificial wall-thinning defects to find an optimal condition for IR thermography test on the wall-thinned nuclear piping components. In the experiment halogen lamp was used to heat the specimens. The distance between the specimen and the lamp and the intensity of halogen lamp were regarded as experimental parameter. When the distance was set to 1{approx}2 m and the lamp intensity was above 60 % of full power, a single scanning of IR thermography detected all artificial wall-thinning defects, whose minimum dimension was 2{theta} = 90 .deg., d/t=0.5, and L/D{sub o}, within the pipe of 500 mm in length. Regardless of the distance between the specimen and the lamp, the image of wall-thinning defect in IR thermography became distinctive as the intensity of halogen lamp increased. The detectability of IR thermography was similar for both plate and pipe specimens, but the optimal test condition for IR thermography depended on the type of specimen.

  11. Late complications from abdominal wall surgery: report of three cases of mesh migration into hollow viscus; Complications tardives de la chirurgie parietale abdominale: a propos de trois cas de migration de prothese dans un organe creux

    Energy Technology Data Exchange (ETDEWEB)

    Szitkar, B.; Yzet, T.; Robert, B.; Lafaye-Boucher, N.; Verhaeghe, P. [CHU Nord Amiens, Service de Radiologie, 80 - Amiens (France); Auquier, M.A.; Remond, A. [CHU Sud Amiens, Service de Radiologie, 80 - Amiens (France)

    2010-01-15

    Laparoscopic mesh repair of ventral abdominal wall hernias is routinely performed. Mesh detachment and migration within the abdominal cavity is a late complication of this procedure. Symptoms are non-specific and imaging diagnosis is difficult to achieve because this complication is rare and overlooked. (authors)

  12. A prospective study comparing the functional impact of SIEA, DIEP, and muscle-sparing free TRAM flaps on the abdominal wall: Part II. Bilateral reconstruction.

    Science.gov (United States)

    Selber, Jesse C; Fosnot, Joshua; Nelson, Jonas; Goldstein, Jesse; Bergey, Meredith; Sonnad, Seema; Serletti, Joseph M

    2010-11-01

    The purpose of this study was to demonstrate the impact of bilateral free flap breast reconstruction on the abdominal wall. This is the second installation of a two-part series. Presented here are bilateral combinations of three techniques: the muscle-sparing free transverse rectus abdominis musculocutaneous (TRAM) flap, deep inferior epigastric perforator (DIEP) flap, and superficial inferior epigastric artery (SIEA) flap. A blinded prospective cohort study was performed involving 234 patients. Patients were evaluated preoperatively and for 1 year postoperatively. At each encounter, patients underwent objective abdominal strength testing using the Manual Muscle Function Test and Functional Independence Measure and psychometric testing using the Short Form 36 questionnaire. At postoperative visits, patients also completed a questionnaire specific to breast reconstruction. Statistical analysis included the Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon signed rank tests. A total of 234 patients were enrolled. Of these, 157 underwent reconstruction, 82 of which were bilateral. There was a significant decline in upper (p=0.02) and lower (p=0.05) abdominal strength from bilateral free TRAM flaps compared with bilateral DIEP flaps. Likewise, there was a significant decline in upper (p=0.055) and lower (p=0.04) abdominal strength from bilateral free TRAM flaps compared with bilateral SIEA flaps. For combinations, the most muscle impairment to least was as follows: free TRAM/free TRAM, free TRAM/DIEP, DIEP/DIEP, DIEP/SIEA, and SIEA/SIEA. The free TRAM/SIEA data were not significant. Although psychometric testing showed trends, there was no significant difference among treatment groups. Abdominal wall strength following various combinations of bilateral free flap breast reconstruction techniques closely adheres to theoretical predictions based on the degree of surgical muscle sacrifice.

  13. Biomechanical and histological evaluation of abdominal wall compliance with intraperitoneal onlay mesh implants in rabbits: a comparison of six different state-of-the-art meshes.

    Science.gov (United States)

    Konerding, M A; Chantereau, P; Delventhal, V; Holste, J-L; Ackermann, M

    2012-09-01

    An ideal prosthetic mesh for incisional hernia repair should mimic the anisotropic compliance of the abdominal wall, and at lower loads should exhibit higher distensibility without impairment of safety at higher loads. This study evaluated the biomechanical properties of six meshes in a rabbit model. New Zealand white rabbits were used for this study. Two meshes of the same brand (Ethicon Physiomesh™, Bard Composix(®) L/P, Gore Dualmesh(®), Bard Sepramesh(®), Ethicon Proceed(®) or Parietex™ Composite) were implanted into each animal for assessment of intra-abdominal hernia repair, with a total of ten meshes per group. Twelve weeks after implantation, the abdominal walls with ingrown meshes were harvested and examined biomechanically with a plunger test. The mesh-tissue compliance was evaluated by the forces exerted at given displacements and also described through a simple mathematical approximation. Abdominal wall samples were collected for histopathology, cell turnover and morphometry. No mesh-related complications were seen. The adhesion score was significantly higher in Bard Composix(®) L/P and Ethicon Proceed(®) meshes. Significant shrinkage was seen in Gore Dualmesh(®) and Parietex™ Composite meshes. Physiomesh™ exhibited the highest compliance during plunger testing, characterized by lower, more physiological reaction forces against tissue displacement than the competitor meshes. In contrast, the safety modulus was comparable in all groups. Histology showed less collagen and less foreign body reaction in the Physiomesh™ samples contributing to patient's comfort. In terms of safety, this study showed no superiority of any single mesh. The comfort modulus however differed, being lowest in the newly developed Physiomesh™. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  14. Thoraco-abdominal ectopia cordis in southwest Cameroon.

    Science.gov (United States)

    Chishugi, John B; Franke, Trixy J

    2014-01-01

    Ectopia cordis is a rare congenital defect where the heart is completely displaced outside the chest wall. Cantrell's pentalogy is an embryologic anomaly with five classic midline deficiencies often associated with ectopia cordis. Here we present a case of thoraco-abdominal ectopia cordis, brief literature review, and possible implications for changes in antenatal care.

  15. Thoraco-abdominal Ectopia Cordis in Southwest Cameroon

    OpenAIRE

    Chishugi, John B; Franke, Trixy J

    2014-01-01

    Ectopia cordis is a rare congenital defect where the heart is completely displaced outside the chest wall. Cantrell's pentalogy is an embryologic anomaly with five classic midline deficiencies often associated with ectopia cordis. Here we present a case of thoraco-abdominal ectopia cordis, brief literature review, and possible implications for changes in antenatal care.

  16. Abdominal wall surgery

    Science.gov (United States)

    ... pregnancy. Skin and muscle cannot regain its normal tone. This can be a problem for very overweight people who lost a lot of weight. Tummy tuck is major surgery. It is important to read about the procedure before having it. ...

  17. Laparoscopic repair of an abdominal hernia using an expanded polytetrafluoroethylene patch secured by a four-corner tacking technique.

    Science.gov (United States)

    Tagaya, N; Mikami, H; Kogure, H; Ohyama, O

    1995-01-01

    An improved technique for performing laparoscopic repair of an abdominal hernia is described herein. To ensure a successful repair, it is most important that adequate tension of the expanded-polytetrafluoroethylene (e-PTFE) patch be achieved, and that the defect be completely covered and securely stapled. Our technique involves tacking the four corners of the patch to the abdominal wall with a 2-0 nylon suture using a straight needle, then stapling it to the anterior abdominal wall over the defect with a laparoscopic stapler. We believe that this technique is a safe and reliable method which will prove useful for laparoscopic surgery.

  18. [What do general, abdominal and vascular surgeons need to know on plastic surgery - aspects of plastic surgery in the field of general, abdominal and vascular surgery].

    Science.gov (United States)

    Damert, H G; Altmann, S; Stübs, P; Infanger, M; Meyer, F

    2015-02-01

    There is overlap between general, abdominal and vascular surgery on one hand and plastic surgery on the other hand, e.g., in hernia surgery, in particular, recurrent hernia, reconstruction of the abdominal wall or defect closure after abdominal or vascular surgery. Bariatric operations involve both special fields too. Plastic surgeons sometimes use skin and muscle compartments of the abdominal wall for reconstruction at other regions of the body. This article aims to i) give an overview about functional, anatomic and clinical aspects as well as the potential of surgical interventions in plastic surgery. General/abdominal/vascular surgeons can benefit from this in their surgical planning and competent execution of their own surgical interventions with limited morbidity/lethality and an optimal, in particular, functional as well as aesthetic outcome, ii) support the interdisciplinary work of general/abdominal/vascular and plastic surgery, and iii) provide a better understanding of plastic surgery and its profile of surgical interventions and options.

  19. Mini-laparotomy with abdominal wall lifting for partial gastrectomy in patients with early gastric mucosal cancer at lesser curvature of the middle stomach.

    Science.gov (United States)

    Tomita, Ryouichi; Fujisak, Shigeru; Park, Yeong Ji

    2009-01-01

    Partial gastrectomy (PG) is the most frequently adopted minimally invasive procedure for early gastric cancer (EGC), especially mucosal cancer (MC). The aim of this study was to introduce a minimally invasive procedure, i.e., minilaparotomy with abdominal wall lifting for PG in patients with early mucosal gastric cancer at the lesser curvature of the middle stomach. Well differentiated adenocarcionoma in MC at the lesser curvature of the middle stomach was selected, where no lymph node metastasis (NO) was confirmed using ultrasonic endoscopy, CT, and MRI during the preoperative examinations. PG was also chosen for patients with a tumor size of 2cm or less and non-depressive type in whom endoscopic mucosal resection (EMR) or endoscopic submucosal resection (ESD) was not possible. Five MC patients (3 men and 2 women, aged 44-62 years, mean age 53.3 years) underwent mini-laparotomy with abdominal wall lifting for PG. Our procedure involved a 6 cm upper abdominal median incision made at the beginning of the operation. The upper abdominal wall was lifted by a subcutaneous Kirshner wire. The small wound was also pulled upward and/or laterally by Kent retractors and conventional surgical instruments were used through the wound. The middle stomach could be detected through the small wound and partially resected, approximately 1 cm from the tumor edge under the guide of the endoscope. The resected stomach margin was stitched layer-to-layer. In this way, PG was easily completed. The total surgical time was 71.8 +/- 12.9 min and the mean estimated blood loss was 30.8 +/- 20.5 ml. Day of starting diet was 3 +/- 0.7 days after operation. Post-operative hospitalization was 8.2 +/- 1.3 days. There was no surgical mortality. All subjects were satisfied with this procedure. Mini-laparotomy with abdominal wall lifting is a safe and efficient technique in the treatment of PG for MC with NO at the lesser curvature of the middle stomach when EMR or ESD is impossible.

  20. 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.

  1. Abdominopelvic actinomycosis in three different locations with invasion of the abdominal wall and ureteric obstruction: An uncommon presentation

    Directory of Open Access Journals (Sweden)

    Christian L. Galata

    2015-01-01

    Conclusion: A rare actinomyceal infection should be considered in patients with a non-specific pelvic mass and atypical abdominal presentations, especially if a previous history of IUD usage is known.

  2. 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.

  3. Fatores de risco associados à deiscência aponeurótica no fechamento da parede abdominal Risk factors associated to aponeurotic dehiscence in abdominal wall closure

    OpenAIRE

    Olival Cirilo Lucena da Fonseca-Neto; Rômulo Vasconcelos; Antônio Lopes de Mirian

    2008-01-01

    RACIONAL: A deiscência aponeurótica do abdômen após intervenções cirúrgicas responde por índices de morbi-mortalidade em torno de 9% a 49% e apresenta incidência aproximada de 0,5% a 3%. OBJETIVO: Identificar os fatores de risco mais prevalentes e elaborar aspecto epidemiológico do perfil dos pacientes susceptíveis à esta complicação. MÉTODOS: Foram estudados no período de março a agosto de 2005 15 pacientes que estiveram internados e que apresentaram deiscência aponeurótica abdominal, proven...

  4. Fine structural study of the innervation of muscle spindles in the internal oblique muscle of the abdominal wall in the adult mouse.

    Science.gov (United States)

    Desaki, Junzo; Ezaki, Taichi; Nishida, Naoya

    2010-01-01

    We examined by electron microscopy the innervation of muscle spindles in the internal oblique muscle of the mouse abdominal wall. In the equatorial region, in addition to the sensory innervation on individual intrafusal muscle fibers, sensory cross terminals were often observed between nuclear chain fibers. In the area from the juxtaequatorial region to the polar region, nuclear bag fibers were supplied by trail and plate-type motor endings, while nuclear chain fibers were innervated by sensory endings, being probably secondary sensory endings. From these findings, it is clear that the innervation patterns differ between two types of intrafusal muscle fibers.

  5. Recombinant human bone morphogenetic protein 2-induced heterotopic ossification of the retroperitoneum, psoas muscle, pelvis and abdominal wall following lumbar spinal fusion

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Raj K. [The George Washington University School of Medicine, Washington, DC (United States); Moncayo, Valeria M.; Pierre-Jerome, Claude; Terk, Michael R. [Emory University School of Medicine, Radiology Department, Musculoskeletal Division, Atlanta, GA (United States); Smitson, Robert D. [Emory University School of Medicine, Atlanta, GA (United States)

    2010-05-15

    A 45-year-old man presented with vertebral collapse at L5 as an initial manifestation of multiple myeloma and underwent spinal fusion surgery using recombinant human bone morphogenetic protein-2 (rhBMP-2). Subsequent computed tomography (CT) scans and X-rays revealed heterotopic ossification of the left psoas muscle, pelvis, and anterior abdominal wall. While the occurrence of heterotopic ossification has previously been reported when rhBMP-2 has been used for spinal fusion surgery, this case demonstrates that it can occur to a much greater degree than previously seen. (orig.)

  6. Theoretical Investigation on Single-Wall Carbon Nanotubes Doped with Nitrogen, Pyridine-Like Nitrogen Defects, and Transition Metal Atoms

    Directory of Open Access Journals (Sweden)

    Michael Mananghaya

    2012-01-01

    Full Text Available This study addresses the inherent difficulty in synthesizing single-walled carbon nanotubes (SWCNTs with uniform chirality and well-defined electronic properties through the introduction of dopants, topological defects, and intercalation of metals. Depending on the desired application, one can modify the electronic and magnetic properties of SWCNTs through an appropriate introduction of imperfections. This scheme broadens the application areas of SWCNTs. Under this motivation, we present our ongoing investigations of the following models: (i (10, 0 and (5, 5 SWCNT doped with nitrogen (CNxNT, (ii (10, 0 and (5, 5 SWCNT with pyridine-like defects (3NV-CNxNT, (iii (10, 0 SWCNT with porphyrine-like defects (4ND-CNxNT. Models (ii and (iii were chemically functionalized with 14 transition metals (TMs: Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Pd, Ag, Pt and Au. Using the spin-unrestricted density functional theory (DFT, stable configurations, deformations, formation and binding energies, the effects of the doping concentration of nitrogen, pyridine-like and porphyrine-like defects on the electronic properties were all examined. Results reveal that the electronic properties of SWCNTs show strong dependence on the concentration and configuration of nitrogen impurities, its defects, and the TMs adsorbed.

  7. 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.

  8. Effects of a tetracycline blended polylactic and polyglycolic acid membrane on the healing of one-wall intrabony defects in beagle dogs

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Il-Young [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Jung, Ui-Won [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Kim, Chang-Sung [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Lee, Yong-Keun [Department and Research Institute of Dental Biomaterials and Bioengineering, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-750 (Korea, Republic of); Cho, Kyoo-Sung [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Chai, Jung-Kiu [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Kim, Chong-Kwan [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of); Choi, Seong-Ho [Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752l (Korea, Republic of)

    2007-09-15

    The purpose of this study was to evaluate the regenerative effects of a tetracycline blended polylactic and polyglycolic acid (TC-PLGA) and non-blended polylactic and polyglycolic acid (PLGA) barrier membrane on one-wall intrabony defects in beagle dogs. It can be concluded that when used for guided tissue regeneration TC-PLGA membranes show a beneficial effect on one-wall intrabony defects in beagle dogs.

  9. Image-guided intensity-modulated radiotherapy for refractory bilateral breast cancer in a patient with extensive cutaneous metastasis in the chest and abdominal walls

    Directory of Open Access Journals (Sweden)

    Lu YF

    2016-05-01

    Full Text Available Yueh-Feng Lu,1 Yu-Chin Lin,2 Kuo-Hsin Chen,3,4 Pei-Wei Shueng,1 Hsin-Pei Yeh,1 Chen-Hsi Hsieh1,5,6 1Division of Radiation Oncology, Department of Radiology, 2Division of Oncology and Hematology, Department of Medicine, 3Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, 4Department of Electrical Engineering, Yuan-Ze University, Taoyuan, 5Department of Medicine, 6Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Abstract: Treatment for bilateral breast cancer with chest wall and abdominal skin invasion normally involves conventional radiotherapy (RT; however, conventional RT provides inadequate target volume coverage and excessive treatment of large volumes of normal tissue. Helical tomotherapy (HT has the ability to deliver continuous craniocaudal irradiation that suppresses junction problems and provides good conformity of dose distribution. A 47-year-old female with stage IV bilateral breast cancer with chest wall and pectoralis major muscle invasion, lymphadenopathy, bilateral pleural effusion, and multiple bone metastases received chemotherapy and target therapy beginning in January 2014; 4 months after the initiation of chemotherapy, computed tomography revealed progression of chest and abdominal wall invasion. A total dose of 70.2 Gy was delivered to both breasts, the chest wall, the abdominal wall, and the bilateral supraclavicular nodal areas in 39 fractions via HT. The total planning target volume was 4,533.29 cm3. The percent of lung volume receiving at least 20 Gy (V20 was 28%, 22%, and 25% for the right lung, left lung, and whole lung, respectively. The mean dose to the heart was 8.6 Gy. Follow-up computed tomography revealed complete response after the RT course. Grade 1 dysphagia, weight loss, grade 2 neutropenia, and grade 3 dermatitis were noted during the RT course. Pain score decreased from 6 to 1. No cardiac, pulmonary, liver, or intestinal toxicity

  10. Diagnosis and surgical treatment of defects in the wall of the orbit of children and adults using demineralized bone allografts.

    Science.gov (United States)

    Ryabov, Alexey; Lekishvili, Mikhail

    2016-09-01

    Accuracy of diagnosis defines the quality of treatment in patients with traumatic damage to eyelet walls. In this area, complex functional and anatomical breaches are typical and require full characterization of pathological changes in bone and soft tissue structures. A new plastic material with a high degree level of demineralization called "Perfoost" can be used to treat defects in the bones of the face of children and adults. In the present study, 79 patients with fractured eyelet walls were treated between 1999 and 2006 by grafting the defect wall with demineralized bone allografts. Grafts were applied from 2 days to 18 months after trauma. Magnetic resonance computer CT was used to check the realignment of allografts every 6 months after the reconstructive operation. The post-operative period of the observation was from 6 months to 7 years after the operation. Good or satisfactory results were obtained for 97.47 % of patients.

  11. Finite Element Implementation of a Structurally-Motivated Constitutive Relation for the Human Abdominal Aortic Wall with and without Aneurysms

    DEFF Research Database (Denmark)

    Enevoldsen, Marie Sand; Henneberg, Kaj-Åge; Lönn, L

    2011-01-01

    The structural integrity of the abdominal aorta is maintained by elastin, collagen, and vascular smooth muscle cells. Changes with age in the structure can lead to develop-ment of aneurysms. This paper presents initial work to capture these changes in a finite element model (FEM) of a structural......-ly-motivated anisotropic constitutive relation for the “four fiber family” arterial model. First a 2D implementation is used for benchmarking the FEM implementation to fitted biaxial stress-strain data obtained experimentally from four different groups of persons; 19-29 years, 30-60 years, 61-79 years and abdominal aortic...

  12. 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.

  13. 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.

  14. The hypertrophy of the lateral abdominal wall and quadratus lumborum is sport-specific: an MRI segmental study in professional tennis and soccer players.

    Science.gov (United States)

    Sanchis-Moysi, Joaquin; Idoate, Fernando; Izquierdo, Mikel; Calbet, Jose A; Dorado, Cecilia

    2013-03-01

    The aim was to determine the volume and degree of asymmetry of quadratus lumborum (QL), obliques, and transversus abdominis; the last two considered conjointly (OT), in tennis and soccer players. The volume of QL and OT was determined using magnetic resonance imaging in professional tennis and soccer players, and in non-active controls (n = 8, 14, and 6, respectively). In tennis players the hypertrophy of OT was limited to proximal segments (cephalic segments), while in soccer players it was similar along longitudinal axis. In tennis players the hypertrophy was asymmetric (18% greater volume in the non-dominant than in the dominant OT, p = 0.001), while in soccer players and controls both sides had similar volumes (p > 0.05). In controls, the non-dominant QL was 15% greater than that of the dominant (p = 0.049). Tennis and soccer players had similar volumes in both sides of QL. Tennis alters the dominant-to-non-dominant balance in the muscle volume of the lateral abdominal wall. In tennis the hypertrophy is limited to proximal segments and is greater in the non-dominant side. Soccer, however, is associated to a symmetric hypertrophy of the lateral abdominal wall. Tennis and soccer elicit an asymmetric hypertrophy of QL.

  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. Long-term Observation of Regenerated Periodontium Induced by FGF-2 in the Beagle Dog 2-Wall Periodontal Defect Model.

    Science.gov (United States)

    Anzai, Jun; Nagayasu-Tanaka, Toshie; Terashima, Akio; Asano, Taiji; Yamada, Satoru; Nozaki, Takenori; Kitamura, Masahiro; Murakami, Shinya

    2016-01-01

    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 healing process.

  17. A prospective study comparing the functional impact of SIEA, DIEP, and muscle-sparing free TRAM flaps on the abdominal wall: part I. unilateral reconstruction.

    Science.gov (United States)

    Selber, Jesse C; Nelson, Jonas; Fosnot, Joshua; Goldstein, Jesse; Bergey, Meredith; Sonnad, Seema S; Serletti, Joseph M

    2010-10-01

    The purpose of this two-part study was to demonstrate the impact of free flap breast reconstruction on the abdominal wall. In Part I, the authors present the results for unilateral techniques. A blinded, prospective, cohort study was performed involving 234 free flap breast reconstruction patients. Patients were evaluated preoperatively, and followed for 1 year. At each encounter, patients underwent abdominal strength testing using the Upper and Lower Rectus Abdominis Manual Muscle Function Test, the Functional Independence Measure, and psychometric testing using the 36-Item Short-Form Health Survey. Patients also completed a satisfaction questionnaire specific to breast reconstruction. Statistical analysis included the Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon signed rank tests. Two-hundred thirty-four patients were enrolled. Of these, 157 underwent reconstruction (75 of which were unilateral), completed follow-up, and were included in the analysis. There was a significantly greater decline in upper abdominal strength in patients undergoing muscle-sparing free transverse rectus abdominis musculocutaneous (TRAM) flap surgery compared with deep inferior epigastric perforator (DIEP) flap surgery at early (p = 0.01) and late follow-up (p = 0.02). Unilateral superficial inferior epigastric artery flap procedures (n = 3) were too few for a meaningful conclusion to be reached. Lower abdominal and Functional Independence Measure scores showed no significant differences. Psychometric testing showed that there was a significant decline in physical health within the free TRAM flap group. No significant difference among groups was appreciable. In unilateral cases, the impact of the muscle-sparing free TRAM flap versus the DIEP flap follows theoretical predictions based on the degree of muscle sacrifice: the muscle-sparing free TRAM flap demonstrated a greater decline than the DIEP flap in certain measurable parameters.

  18. A Study on Multi-defect Constrained Bendability of Thin-walled Tube NC Bending Under Different Clearance

    Institute of Scientific and Technical Information of China (English)

    LI Heng; YANG He

    2011-01-01

    Thin-walled tube numerical control (NC) bending is a tri-nonlinear physical process with multi-defect and multi-die constraints. The clearance on each contact interface is the major factor to indicate the contact conditions. A three-dimensional-finite element (3D-FE) model is established to consider the realistic dynamic boundary conditions of multiple dies under ABAQUS/Explicit platform. Combined with experiment, numerical study on bending behavior and bendability under different clearance between tube and various dies is conducted in terms of wrinkling, wall thinning and cross section deformation. The results show that (1)with smaller clearance of tube-wiper die and tube-mandrel, the wrinkling can be restrained while the wall thinning It and cross-section deformation Id increase; while excessive small clearance blocks tube materials to flow past tangent point and causes piles up, the onset of wrinkling enhances It and Id. (2)Both It and Id decrease with smaller clearance of tube-pressure die; the wrinkling possibility rises with larger clearance on this interface if the mandrel's freedom along Y-axis is opened; smaller clearance of tube-bend die prevents wrinkling while increases It, and the clearance on this interface has little effect on Id. (3)A modified Yoshida buckling test (YBT) is used to address the wrinkling mechanisms under normal constraints in tube bending: the smaller clearance may restrain wrinkling efficiently; the smaller wall thickness, the less critical clearance needed; the critical clearance for tube bending 38 mm× 1 mm×57 mm (tube outer diameter×wall thickness×centerline bending radius) equals about 20% of initial wall thickness.

  19. 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.

  20. Computation of turbulent boundary layers employing the defect wall-function method. M.S. Thesis

    Science.gov (United States)

    Brown, Douglas L.

    1994-01-01

    In order to decrease overall computational time requirements of spatially-marching parabolized Navier-Stokes finite-difference computer code when applied to turbulent fluid flow, a wall-function methodology, originally proposed by R. Barnwell, was implemented. This numerical effort increases computational speed and calculates reasonably accurate wall shear stress spatial distributions and boundary-layer profiles. Since the wall shear stress is analytically determined from the wall-function model, the computational grid near the wall is not required to spatially resolve the laminar-viscous sublayer. Consequently, a substantially increased computational integration step size is achieved resulting in a considerable decrease in net computational time. This wall-function technique is demonstrated for adiabatic flat plate test cases from Mach 2 to Mach 8. These test cases are analytically verified employing: (1) Eckert reference method solutions, (2) experimental turbulent boundary-layer data of Mabey, and (3) finite-difference computational code solutions with fully resolved laminar-viscous sublayers. Additionally, results have been obtained for two pressure-gradient cases: (1) an adiabatic expansion corner and (2) an adiabatic compression corner.

  1. Abdominopelvic actinomycosis in three different locations with invasion of the abdominal wall and ureteric obstruction: An uncommon presentation

    OpenAIRE

    2015-01-01

    Introduction: Actinomycosis is a rare chronic infectious disease caused by Gram-positive anaerobic bacteria that normally colonize the bronchial system and gastrointestinal tract in humans. The most common diseases associated with actinomycosis are orocervicofacial, thoracic and abdominal infections involving Actinomyces israelii. Due to its rarity, its various clinical presentations and often-infiltrative characteristics in radiological imaging, it can easily be mistaken for other clinical c...

  2. The defects influence on domain wall propagation in bistable glass-coated microwires

    Energy Technology Data Exchange (ETDEWEB)

    Rodionova, V. [Magnetism Division, Faculty of Physics, M.V. Lomonosov Moscow State University, Moscow 119991 (Russian Federation); Immanuel Kant Baltic Federal University, Kaliningrad 236041 (Russian Federation); Dpto. Fisica de Materiales, Fac. Quimicas, UPV/EHU, San Sebastian 20018 (Spain); Zhukova, V., E-mail: valentina.zhukova@ehu.es [Dpto. Fisica de Materiales, Fac. Quimicas, UPV/EHU, San Sebastian 20018 (Spain); Ilyn, M.; Ipatov, M. [Dpto. Fisica de Materiales, Fac. Quimicas, UPV/EHU, San Sebastian 20018 (Spain); Perov, N. [Magnetism Division, Faculty of Physics, M.V. Lomonosov Moscow State University, Moscow 119991 (Russian Federation); Zhukov, A. [Dpto. Fisica de Materiales, Fac. Quimicas, UPV/EHU, San Sebastian 20018 (Spain); IKERBASQUE, Basque Foundation for Science, Bilbao 48011 (Spain)

    2012-05-01

    We studied the domain wall (DW) dynamics of magnetically bistable amorphous glass-coated Fe{sub 74}B{sub 13}Si{sub 11}C{sub 2} microwires. In according to our experimental results magnetic field dependences of DW velocity of studied microwires can be divided into two groups: with uniform or uniformly accelerated DW propagation along the microwire. Strong correlation between the type of the magnetic field dependence of domain wall velocity, v(H), and the distribution of the local nucleation fields has been observed. Moreover, we observed abrupt increasing of DW velocity (jump) on the magnetic field dependences of the domain wall velocity, v(H), for the both types of the v(H) dependences. At the same time usual linear increasing of the domain wall velocity with magnetic field persists below these jumps. It was found that the jump height correlates with the location of nucleation place of the new domain wall. We have measured local nucleation field distribution in all the microwires. From local nucleation field distribution we have obtained the DW nucleation locations and estimated the jump height.

  3. Reação histopatológica da parede da aorta abdominal ao stent não recoberto Histopathological reaction of the abdominal aorta wall to non-covered stents

    Directory of Open Access Journals (Sweden)

    Rubio Bombonato

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a reação histopatológica da parede aorta abdominal, em suínos, no nível das artérias renais, na presença de stent metálico não recoberto. MÉTODO: Foi estudada histopatologicamente a aorta abdominal de 10 suínos, com peso médio de 86,6 quilos e idade média de 6 meses, submetidos a implante de stent metálico posicionado na aorta, no nível das artérias renais, após 100 dias do implante. Os stents foram liberados por auto-expansão com laparotomia. Os cortes histológicos foram realizados nos seguintes locais: 1 transição entre a aorta normal e aorta contendo stent; 2 aorta contendo o stent; 3 porção contendo os óstios das artérias renais, 4 linfonodos periaórticos e, 5 parênquima renal. As lâminas foram coradas pela técnica da hematoxilina e eosina. RESULTADOS: Os achados macroscópicos revelaram: linfonodomegalia periaórtica; espessamento da parede aórtica; artérias lombares e renais pérvias; estrutura anatômica renal normal. Análises microscópicas, próximas aos stents, evidenciaram espessamento da parede vascular, secundário à fibrose intimal e camada média comprometida com fibrose intersticial. Medidas micrométricas da parede aórtica com o stent, comparada à aorta sem o stent, apresentaram aumento da espessura da parede (75,9% por hiperplasia da camada íntima secundária à proliferação de fibroblastos; depósitos de colágeno com infiltrado inflamatório e granulomas do tipo corpo estranho. CONCLUSÃO: O stent de aço inoxidável descoberto, implantado na aorta de suínos, produziu importante reação inflamatória, com fibrose nas camadas média e íntima, evidenciada pelas análises histopatológicas e a sua presença não comprometeu o estado pérvio da aorta e dos ramos lombares e renais.OBJECTIVE: To evaluate the histopathological reaction of the abdominal aorta wall in pigs' renal arteries to the presence of non-covered stainless steel stents. METHODS: The abdominal aorta of

  4. Abdominal hernias: Radiological features

    Science.gov (United States)

    Lassandro, Francesco; Iasiello, Francesca; Pizza, Nunzia Luisa; Valente, Tullio; Stefano, Maria Luisa Mangoni di Santo; Grassi, Roberto; Muto, Roberto

    2011-01-01

    Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external, diaphragmatic and internal hernias on the basis of their localisation. Groin hernias are the most common with a prevalence of 75%, followed by femoral (15%) and umbilical (8%). There is a higher prevalence in males (M:F, 8:1). Diagnosis is usually made on physical examination. However, clinical diagnosis may be difficult, especially in patients with obesity, pain or abdominal wall scarring. In these cases, abdominal imaging may be the first clue to the correct diagnosis and to confirm suspected complications. Different imaging modalities are used: conventional radiographs or barium studies, ultrasonography and Computed Tomography. Imaging modalities can aid in the differential diagnosis of palpable abdominal wall masses and can help to define hernial contents such as fatty tissue, bowel, other organs or fluid. This work focuses on the main radiological findings of abdominal herniations. PMID:21860678

  5. Human acellular dermal matrix for repair of abdominal wall defects: review of clinical experience and experimental data.

    Science.gov (United States)

    Holton, Luther H; Kim, Daniel; Silverman, Ronald P; Rodriguez, Eduardo D; Singh, Navin; Goldberg, Nelson H

    2005-01-01

    The use of prosthetic mesh for the tension-free repair of incisional hernias has been shown to be more effective than primary suture repair. Unfortunately, prosthetic materials can be a suboptimal choice in a variety of clinical scenarios. In general, prosthetic materials should not be implanted into sites with known contamination or infection because they lack an endogenous vascular network and are thus incapable of clearing bacteria. This is of particular relevance to the repair of recurrent hernias, which are often refractory to repair because of indolent bacterial colonization that weakens the site and retards appropriate healing. Although fascia lata grafts and muscle flaps can be employed for tension-free hernia repairs, they carry the potential for significant donor site morbidity. Recently, a growing number of clinicians have used human acellular dermal matrix as a graft material for the tension-free repair of ventral hernias. This material has been shown to become revascularized in both animal and human subjects. Once repopulated with a vascular network, this graft material is theoretically capable of clearing bacteria, a property not found in prosthetic graft materials. Unlike autologous materials such as fascial grafts and muscle flaps, acellular dermal matrix can be used without subjecting the patient to additional morbidity in the form of donor site complications. This article presents a thorough review of the current literature, describing the properties of human acellular dermal matrix and discussing both animal and human studies of its clinical performance. In addition to the review of previously published clinical experiences, we discuss our own preliminary results with the use of acellular dermal matrix for ventral hernia repair in 46 patients.

  6. Activity of MMP-9 after repair of abdominal wall defects with acellular and crosslinked bovine pericardium in rabbit.

    Science.gov (United States)

    Singh, Himani; Kumar, Naveen; Sharma, A K; Kataria, Meena; Munjal, Ashok; Kumar, Amit; Dewangan, Rukmani; Kumar, Vineet; Devarathnam, J; Kumar, Sachin

    2014-02-01

    This study was undertaken for the identification of matrix metalloproteinases (MMPs) in extracts obtained from native, acellular and crosslinked bovine pericardium (in vitro), as well as in the plasma after implantation of these biomaterials in rabbits (in vivo). Native pericardium (NP) expressed a 72 kDa (MMP-2) band; whereas, in acellular pericardium (AP) two bands (10 kDa and 92 kDa) of MMPs were observed of which, 92 kDa band was very faint. AP crosslinked with glutaraldehyde did not show any gelatinase activity and thus reflects the creation of new additional chemical bonds between the collagen molecules which has been effectively removed. Gelatin zymography showed only one major band of 92 kDa in all the implanted and untreated rabbit plasma, but the relative amount of 92 kDa was 1-2 times higher in acellular bovine pericardium implanted rabbits as compared to crosslinked and native groups. In NP group, the 92 kDa band was the dullest among the three groups. This indicated that the level of MMP-9 corresponds to the degree of collagen degradation. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  7. Reconstruction of large-size abdominal wall defect using biodegradable poly-p-dioxanone mesh: an experimental canine study

    National Research Council Canada - National Science Library

    Huang, Kenan; Ding, Xinyu; Lv, Benbo; Wei, Linyun; Sun, Juxian; Xu, Zhifei; Qin, Xiong; Tang, Hua

    2014-01-01

    ...) mesh for reconstructing large-size AWDs in an experimental canine model. Eighteen experimental canines were randomly and equally divided into three groups, namely, a PDO group, a Marlex group and a control group (n = 6 each...

  8. Prevalence, timing of diagnosis and pregnancy outcome of abdominal wall defects after the introduction of a national prenatal screening program

    NARCIS (Netherlands)

    Fleurke-Rozema, Hanneke; van de Kamp, Karline; Bakker, Marian; Pajkrt, Eva; Bilardo, Caterina; Snijders, Rosalinde

    ObjectiveTo examine prevalence, time of diagnosis and outcome of fetuses with an exomphalos or gastroschisis, diagnosed since the introduction of a national prenatal screening program in 2007. MethodsA prospective cohort study was undertaken in two fetal medicine units in the Netherlands. Cases were

  9. Investigation of optimal thermal injection conditions and the capability of IR thermography for detecting wall-thinning defects in small-diameter piping components

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Weon, E-mail: jwkim@chosun.ac.kr [Department of Nuclear Engineering, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju 501-759 (Korea, Republic of); Yun, Kyung Won [Department of Advanced Part and Materials Engineering, Graduate School, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju 501-759 (Korea, Republic of); Jung, Hyun Chul [Department of Mechanical Design, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju 501-759 (Korea, Republic of)

    2013-09-15

    In this study, optimal thermal injection conditions and the detection capability of infrared (IR) thermography were investigated to confirm the applicability of active IR thermography for detecting wall-thinning defects in small-diameter nuclear piping components. IR thermography tests were conducted on pipe specimens, including elbow specimens, with artificial wall-thinning defects. Each specimen was thermally activated using two halogen lamps, and thermal images were captured via an IR camera. The thermal injection conditions that provided the best images of defects were dependent on the pipe diameter; the smaller the pipe diameter, the shorter the optimal object distance. Under the optimal conditions, active IR thermography was able to detect all wall-thinning defects with depth d/t ≥ 0.5 in a 500 mm specimen of pipe at one time, except for the defects with very short and narrow. However, wall-thinning defects with depth d/t = 0.25 could only be detected when they had suitable lengths and circumferential angles.

  10. INDICATIONS AND CHOICE OF TECHNOLOGY FOR POLYMERIC MATERIALS IMPLANTATION IN THE ABDOMINAL WALL FOR PREVENTION AND TREATMENT OF POSTOPERATIVE VENTRAL HERNIAS

    Directory of Open Access Journals (Sweden)

    B. S. Sukovatykh

    2016-01-01

    Full Text Available The absolute indication for primary covering a laparotomic wound with a synthetic prosthesis is complicated anatomic and functional insufficiency. There are relative indications for this surgery, such as old age, III–IV degree of obesity, repeated laparotomy in location of the same scar, covering a laparostoma in patients treated with programmed sanation of the abdominal cavity and laparotomy in patients treated with radiology or chemotherapy methods. Lowering of functional activity of ribosomal genes is a reason of the anterior abdominal cavity weakness, its progress causes lowering in skin and aponeuroses composition I–III types of collagen. We examined the speed of growing and differentiation of connective tissue after implantation endoprosthesis made of lavsan, polypropylene, polyvinylidene fluoride, polytetrafluoride ethylene. It was proved that the polyvinylidene fluoride mesh had the best biocompatibility. The progress of wound implantation process could be predicted by dynamics of cytokine profile, temperature, leukocyte and exudative reactions of a patient. The best insensitiveness to infection belonged to a standard polypropylene endoprosthesis, it could be used for covering a hernia defect in patients with strangulated hernias. The fact that urine poured into the operation wound during urinary system surgery combined with lateral hernias of abdomen was not a contraindication for endoprosthesis.

  11. 老年腹外疝50例临床诊疗体会%Clinical effects in tension-free hernioplasty for hernias of abdominal wall

    Institute of Scientific and Technical Information of China (English)

    赵付全

    2015-01-01

    Objective To summarize the clinical features,diagnosis and treatments of abdominal wall, so as to help the surgeons avoid mistakes in practice.MethodsClinical data of 50 patients with hernias of abdominal wall treated from January 2009 to January 2014 were retrospectively analyzed. And differential diagnosis and treatment were discussed.ResultsThe 50 patients were cured. without recurrence during from in half a year to 5 years follow-up.ConclusionBy asking medical history, physical examination, radiological examination, To maintain a high degree of vigilance and less misdiagnosis. The methods of tention-free hernioplasty is reliable,with less pain,quicker recovery, lower recurrent rate,and Simple operation,Especially suitable fo primary hospitals.%目的:总结腹外疝的临床特征和诊疗方法,以减少临床工作中的失误。方法回顾性分析2009年1月~2014年1月我院收治的腹股沟疝患者50例的临床资料,并进行鉴别诊断及治疗讨论。结果50例患者均治愈出院。随访6个月~5年均无复发。结论询问病史、体格检查、放射学检查是诊断腹外疝的基础,保持高度警惕少误诊,无张力疝修补术疗效可靠,恢复快,复发率低,且操作简单,尤其适宜在基层医院推广。

  12. How should an infected perinephric haematoma be drained in a tetraplegic patient with baclofen pump implanted in the abdominal wall? – A case report

    Directory of Open Access Journals (Sweden)

    Watt John WH

    2002-09-01

    Full Text Available Abstract Background We present a case to illustrate controversies in percutaneous drainage of infected, perinephric haematoma in a tetraplegic patient, who had implantation of baclofen pump in anterior abdominal wall on the same side as perinephric haematoma. Case presentation A 56-year-old male with C-4 tetraplegia had undergone implantation of programmable pump in the anterior abdominal wall for intrathecal infusion of baclofen to control spasticity. He developed perinephric haematoma while he was taking warfarin as prophylactic for deep vein thrombosis. Perinephric haematoma became infected with a resistant strain of Pseudomonas aeruginosa, and required percutaneous drainage. Positioning this patient on his abdomen without anaesthesia, for insertion of a catheter from behind, was not a realistic option. Administration of general anaesthesia in this patient in the radiology department would have been hazardous. Results and Conclusion Percutaneous drainage was carried out by anterior approach under propofol sedation. The site of entry of percutaneous catheter was close to cephalic end of baclofen pump. By carrying out drainage from anterior approach, and by keeping this catheter for ten weeks, we took a risk of causing infection of the baclofen pump site, and baclofen pump with a resistant strain of Pseudomonas aeruginosa. The alternative method would have been to anaesthetise the patient and position him prone for percutaneous drainage of perinephric collection from behind. This would have ensured that the drainage track was far away from the baclofen pump with minimal risk of infection of baclofen pump, but at the cost of incurring respiratory complications in a tetraplegic subject.

  13. Domain wall pinning on strain relaxation defects in FePt(001)/Pt thin films

    Energy Technology Data Exchange (ETDEWEB)

    Attane, J. P.; Samson, Y.; Marty, A.; Halley, D.; Beigne, C.

    2001-08-06

    Thin FePt (001) films, grown by molecular-beam epitaxy on Pt(001), exhibit a very large perpendicular magnetic anisotropy (K{sub u}=5 x 10{sup 6}Jm{sup -3}) and a 100% magnetic remanence in perpendicular field. The lattice misfit between FePt and Pt (1.5%) relaxes through the pileup of a/6 <112> partial dislocations along {l_brace}111{r_brace} planes, leading to the formation of microtwins. Atomic force microscopy images demonstrate that this process induces a spontaneous rectangular nanostructuration of the sample, while magnetic force microscopy shows that the microtwins act as pinning sites for the magnetic walls. This leads to square magnetic domains and explains the large coercivity associated with the domain wall propagation. {copyright} 2001 American Institute of Physics.

  14. Domain wall pinning on strain relaxation defects in FePt(001)/Pt thin films

    Science.gov (United States)

    Attané, J. P.; Samson, Y.; Marty, A.; Halley, D.; Beigné, C.

    2001-08-01

    Thin FePt (001) films, grown by molecular-beam epitaxy on Pt(001), exhibit a very large perpendicular magnetic anisotropy (Ku=5×106J m-3) and a 100% magnetic remanence in perpendicular field. The lattice misfit between FePt and Pt (1.5%) relaxes through the pileup of a/6 partial dislocations along {111} planes, leading to the formation of microtwins. Atomic force microscopy images demonstrate that this process induces a spontaneous rectangular nanostructuration of the sample, while magnetic force microscopy shows that the microtwins act as pinning sites for the magnetic walls. This leads to square magnetic domains and explains the large coercivity associated with the domain wall propagation.

  15. 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

  16. CT对腹壁韧带样瘤的诊断价值%The diagnosis value of CT to abdominal wall ligament type lump

    Institute of Scientific and Technical Information of China (English)

    严骏燕; 刘金有

    2014-01-01

    Objective To investigate the CT performance of abdominal wall desmoid tumor and improve the clinical diagnosis of the disease.Methods From October 2006 to March 201 3,Twenty-one pathologically confirmed cases of abdominal desmoid tumor CT data were retrospectively analyzed in Huangshan Shoukang Hospital.Results All the cases of patients with pathologically confirmed in all cases are single lesions in the rectus abdominis.The maxium mass of spindle-shaped or oval lumps was 3.8 cm × 7.4 cm with a mean of 2.1 cm ×3.9 cm with clear boundary,and unclear muscle tissue boundaries.Mass unenhanced density equaled to or was lower than the density of the muscle tissue.Densities in Sixteen tumors were even and 5 tumors with uneven images and enhanced.Conclusions The abdominal wall syndesmoma CT performance has the characteristic value which are important for disease diagnosis and distinction diagnosis.%目的:探讨腹壁韧带样瘤的CT表现,提高临床对该病的诊断率。方法回顾性分析2006年10月至2013年3月,黄山首康医院经过手术病理证实的腹壁韧带样瘤21例患者的CT资料。结果21例病理证实的患者中,均为单发,病变发生于腹直肌,肿块呈梭形或类圆形,肿块最大为3.8 cm ×7.4 cm,肿块边界清晰,与肌肉组织分界欠清。肿块平扫时的密度等于或低于肌肉组织的密度,16个肿块密度均匀,5个肿块密度欠均匀,增强后病灶呈明显强化。结论腹壁韧带瘤的CT表现具有特征性,对该病的诊断和鉴别诊断有重要价值。

  17. 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

    Science.gov (United States)

    Cha, Jong Hyun; Moon, Myeong Ho; Lee, Yong Hae; Koh, In Chang; Kim, Kyu Nam; Kim, Chang Gyun

    2017-01-01

    Background The 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. Methods This 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. Results Varying 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%). Conclusions Both 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. PMID:28194344

  18. Acquired Abdominal Intercostal Hernia: A Case Report and Literature Review

    Science.gov (United States)

    Tripodi, Giuseppe

    2014-01-01

    Acquired abdominal intercostal hernia (AAIH) is a rare disease phenomenon where intra-abdominal contents reach the intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. We discuss a case of a 51-year-old obese female who arrived to the emergency room with a painful swelling between her left 10th rib and 11th rib. She gave a history of a stab wound to the area 15 years earlier. A CT scan revealed a fat containing intercostal hernia with no diaphragmatic defect. An open operative approach with a hernia patch was used to repair this hernia. These hernias are difficult to diagnose, so a high clinical suspicion and thorough history and physical exam are important. This review discusses pathogenesis, clinical presentation, complications, and appropriate treatment strategies of AAIH. PMID:25197605

  19. Muscle-derived Decellularised Extracellular Matrix Improves Functional Recovery in a Rat Latissimus Dorsi Muscle Defect Model

    Science.gov (United States)

    2013-12-01

    Piccolo R, et al. Experimental abdominal wall defect repaired with acellular matrix. Pediatr Surg Int 2002;18:327e31. 28. Willett NJ, Li MT, Uhrig BA...matrix (M-ECM). Methods: Ten percent of the mass of the latissimus dorsi (LD) was excised. Three groups were examined: 1) no repair of defect (DEF), 2...to develop therapies for ex- tremity10,11 or abdominal muscle repair.16 For the devel- opment of potential therapies for craniofacial muscle repair

  20. M型超声检测腹主动脉前后壁运动的初步研究%Primary studies of anteroposterior abdominal aortic wall motion with M-mode ultrasound

    Institute of Scientific and Technical Information of China (English)

    辛群; 蔡珠虹; 包俊敏; 梅志军; 景在平

    2011-01-01

    Objective To find out the characteristics of anteroposterior abdominal aortic wall motion and to consider the potential implications of such variations. Methods M-mode ultrasound was used to measure abdominal aortic wall motion in human (n=20) and 2 animal species [dogs (n=8), and pigs (n=5)]. Anterior wall displacement (da),posterior wall displacement (dp), and diastolic diameter (Da) were measured. The ratio of displacement to the diameter was calculated (da/Dd. and dp/Dd). Results Aortic diameter varied from to (6.34±0.84) mm (dog) to (13.76±1.11) mm (human).Anterior wall displacement was about 3 times greater than the posterior among the species studied. The ratio of wall displacement to diastolic diameter were similar for the anterior and posterior walls. Wall displacement increased linearly with the diameter. Conclusions Abdominal aortic wall dynamics are similar in humans and animals regardless of the aortic size, with more anterior than posterior wall motion. These data suggest increased .dynamic strain of the anterior wall,which may help explain why human abdominal aortic aneurysms initially develop anteriorly. Haemodynamies plays an important role in the abdominal aortic aneurysm pathogenesis.%目的:应用M型超声观测正常腹主动脉前后壁运动的特征.方法:采集健康人组、健康犬组、健康猪组腹主动脉的M型超声图像,测量动脉前壁和后壁振幅(da和dP)、舒张期动脉直径(Dd),取其平均值;并分别计算各组数值:前壁振幅/舒张期动脉直径(da/Dd),后壁振幅/舒张期动脉直径(dp/Dd).结果:三组结果显示腹主动脉前壁振幅高于后壁振幅,差异有统计学意义(P<0.01).各组中管壁振幅与管径呈正相关.da/Dd和dp/Dd组间比较,差异无统计学意义.结论:正常腹主动脉前、后壁的运动差异与腹主动脉瘤的形成有一定关系,提示血液动力学因素在腹主动脉瘤发病机制中起着重要作用.

  1. Defective Pollen Wall is Required for Anther and Microspore Development in Rice and Encodes a Fatty Acyl Carrier Protein Reductase

    Energy Technology Data Exchange (ETDEWEB)

    Shi, J.; Shanklin, J.; Tan, H.; Yu, X.-H.; Liu, Y.; Liang, W.; Ranathunge, K.; Franke, R. B.; Schreiber, L.; Wang, Y.; Kai, G.; Ma, H.; Zhang, D.

    2011-06-01

    Aliphatic alcohols naturally exist in many organisms as important cellular components; however, their roles in extracellular polymer biosynthesis are poorly defined. We report here the isolation and characterization of a rice (Oryza sativa) male-sterile mutant, defective pollen wall (dpw), which displays defective anther development and degenerated pollen grains with an irregular exine. Chemical analysis revealed that dpw anthers had a dramatic reduction in cutin monomers and an altered composition of cuticular wax, as well as soluble fatty acids and alcohols. Using map-based cloning, we identified the DPW gene, which is expressed in both tapetal cells and microspores during anther development. Biochemical analysis of the recombinant DPW enzyme shows that it is a novel fatty acid reductase that produces 1-hexadecanol and exhibits >270-fold higher specificity for palmiltoyl-acyl carrier protein than for C16:0 CoA substrates. DPW was predominantly targeted to plastids mediated by its N-terminal transit peptide. Moreover, we demonstrate that the monocot DPW from rice complements the dicot Arabidopsis thaliana male sterile2 (ms2) mutant and is the probable ortholog of MS2. These data suggest that DPWs participate in a conserved step in primary fatty alcohol synthesis for anther cuticle and pollen sporopollenin biosynthesis in monocots and dicots.

  2. Clinical analysis on 43 cases with abdominal wall and perineal endometriosis%43例腹壁会阴子宫内膜异位症的临床分析

    Institute of Scientific and Technical Information of China (English)

    任黔川; 伍宗惠; 李晓斌

    2011-01-01

    目的:探讨腹壁、会阴子宫内膜异位症的诊断和治疗.方法:对1993~2008年收治的43例腹壁、会阴内异症病例进行同顾性分析.结果:根据临床表现和病理检查,43例均诊断正确.29例腹壁切口内异症均有剖宫产史,14例会阴内异症均有会阴撕裂或侧切史.腹壁内异症完整切除29例,会阴内异症完整切除13例,随访2~5年无复发.结论:根据典型的病史和体检,可以对腹壁、会阴内异症做出正确诊断;手术切除为主要治疗方法.%Objective; To explore the diagnosis and treatment of abdominal wall and perinea] endometriosis. Methods: 43 patients with abdominal wall and perineal endometriosis treated in the hospital from 1993 to 2008 were analyzed retrospectively. Results: 43 cases were diagnosed correctly according to clinical manifestations and pathological evidences. 29 cases with abdominal wall endometriosis had history of cesarean section, 14 cases with perineal endometriosis had history of perineal tear and episiotomy. 29 cases with abdominal wall endometriosis and 13 cases with perineal endometriosis were excised totally. All the cases were followed up for 2 ~5 years, no recurrence occurred. Conclusion; The patients with abdominal wall and perineal endometriosis can be diagnosed correctly according to typical medical history and physical examination. Surgical excision is the first choice for treatment

  3. Trapping of defect point to improve response time via controlled azimuthal anchoring in a vertically aligned liquid crystal cell with polymer wall

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Gyun; Kim, Sung Min; Kim, Youn Sik; Lee, Hee Kyu; Lee, Seung Hee [Polymer BIN Fusion Research Center, School of Advanced Materials Engineering, Chonbuk National University, Chonju, Chonbuk 561-756 (Korea, Republic of); Lyu, Jae-Jin; Kim, Kyeong Hyeon [AMLCD Division, Samsung Electronics, Kiheung, Kyunggi-Do 449-711 (Korea, Republic of); Lu, Ruibo; Wu, Shin-Tson [College of Optics and Photonics, University of Central Florida, Orlando FL 32816 (United States)], E-mail: lsh1@chonbuk.ac.kr

    2008-03-07

    Conventional multi-domain vertically aligned liquid crystal (LC) cells have defect points due to the collision of LC directors during the formation of multiple domains. In addition, the location of defects changes with time resulting in a slow response time. This paper proposes a robust vertically aligned LC cell, where the LCs are locked by polymer walls, and the azimuthal anchoring on the surface of the alignment layer is controlled by the polymerization of a UV curable reactive mesogen monomer. As a result, the defect points are trapped at a single position, resulting in a greatly improved response time.

  4. Fetal bladder wall regeneration with a collagen biomatrix and histological evaluation of bladder exstrophy in a fetal sheep model

    NARCIS (Netherlands)

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

    2008-01-01

    Objectives: To evaluate histological changes in an animal model for bladder exstrophy and fetal repair of the bladder defect with a molecular-defined dual-layer collagen biomatrix to induce fetal bladder wall regeneration. Methods: In 12 fetal lambs the abdominal wall and bladder were opened by a mi

  5. 腹壁子宫内膜异位症的磁共振成像表现%Magnetic Resonance Imaging Features of Abdominal Wall Endometriosis

    Institute of Scientific and Technical Information of China (English)

    梁文华; 陆菁菁

    2014-01-01

    目的:探讨腹壁子宫内膜异位症的磁共振成像( magnetic resonance imaging, MRI)表现特点。方法回顾性分析北京协和医院2008年1月至2013年1月经手术病理证实且行MRI检查的7例腹壁子宫内膜异位症患者的临床资料和MRI检查结果。结果7例腹壁子宫内膜异位症患者中5例单发,2例多发;7例患者共发现病灶10处,7处病灶位于左侧,2处位于正中,1处位于右侧;5处位于皮下及筋膜、未侵及腹壁肌层,4处侵及腹壁肌层,1处累及皮下、筋膜及腹壁肌层;2处病灶与盆腔内部脏器粘连。10处病灶中,9处病灶呈实性, T1WI及T2WI上以等信号或稍高信号为主;1处病灶呈囊性, T1WI呈高信号, T2WI可见“阴影”现象。7例患者有5例合并子宫疾病。结论对于腹壁子宫内膜异位症, MRI不但能准确定位,还能显示病变范围,是术前检查及术后随访的重要方法。%Objective To explore the characteristics of abdominal wall endometriosis (AWE) on magnetic resonance imaging (MRI).Methods The clinical and MRI data of 7 patients with pathologically confirmed AWE in Peking Union Medical College Hospital from January 2008 to January 2013 were retrospectively collected and ana-lyzed.Results Five of the AWE lesions were single and two were multifocal .Ten AWE lesions were found in 7 patients .Seven out of 10 lesions were located in the left , two in the middle , and one in the right .Five lesions were located in the subcutaneous tissue and fascia , the abdominal muscles were invaded in four lesions , and one was lo-cated in the subcutaneous tissue , fascia, and muscle.Endometrial invasion from the scar into the abdominal cavity was observed in two patients , with anterior wall and fundus of the uterus for one patient and anterior wall of bladder for another.Nine lesions were solid and mainly showed isointense or hyperintense signal on T 1WI and T2WI com-pared with muscle with foci of

  6. Tuberculosis abdominal Abdominal tuberculosis

    OpenAIRE

    Rubio, T.; M. T. Gaztelu; Calvo, A.; 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...

  7. Defect Characterization in a Thin Walled Composite RP-1 Tank: A Case Study

    Science.gov (United States)

    Langsing, Matthew D.; Walker, James L., II; Russell, Samual S.

    2000-01-01

    A full scale thin walled composite tank, designed and fabricated for the storage of pressurized RP- I rocket fuel, was fully inspected with digital infrared thermography (IR) during assembly and prior to proof testing. The tank featured a "pill capsule" design with the equatorial bondline being overwrapped on both the inner and outer surfaces. A composite skirt was bonded to the aft dome of the tank to serve as a structural support when the tank was stood on end in service. Numerous anomalies were detected and mapped prior to proof testing, some along bondlines and some scattered throughout the acreage. After the tank was intentionally burst, coupons were cut from the regions including thermographic anomalies. These coupons were again inspected thermographically to document the growth of any indications due to proof testing. Ultrasonic inspections (UT) were also performed on the coupons for comparison to thermography. Several coupons were dissected and micrographed. Relationships between IR and UT indications and the physical nature of the dissected material are presented.

  8. Ventral hernia repair in patients with abdominal loss of domain: an observational study of one institution's experience.

    Science.gov (United States)

    Azar, F K; Crawford, T C; Poruk, K E; Farrow, N; Cornell, P; Nadra, O; Azoury, S C; Soares, K C; Cooney, C M; Eckhauser, F E

    2017-04-01

    Abdominal wall hernias are a common problem. The success of abdominal wall reconstruction decreases with increasing hernia size. This study summarizes the outcomes of one surgeon's experience using a "sandwich" technique for hernia repair in patients with loss of abdominal domain. We reviewed our ventral hernia repair (VHR) experience from 2008 to 2015 among patients with loss of domain, as defined by a hernia defect greater than 300 cm(2). The percent of herniation through the defect, defined by a hernia sac-to-abdominal cavity volume ratio, was measured on preoperative CT scans by four independent reviewers and averaged. Outcomes were compared among those with giant ventral hernias (hernia sac-to-abdominal cavity volume >30%) and those with smaller defect ratios. Over the study period, 21 patients underwent VHR. In 17 patients (81%), a "sandwich" technique was utilized. Ten patients had hernia sac-to-abdominal cavity defects less than 30%, and 11 had defects greater than 30%. Preoperative characteristics were similar in both groups with the exception of a higher ASA score in those with giant ventral hernias and more Ventral Hernia Working Group Grade 3 hernias in those without giant ventral hernias. Postoperative outcomes were similar in both groups. There were no mortalities. There were two recurrences (18%) in the giant VHR group and none in the smaller defect group (p = 0.16). Surgical site occurrences were noted in 48% of patients and did not differ between giant and non-giant VHR groups (50 vs 45%, p = 0.84). Average postoperative length of stay was significantly longer in the giant VHR group (31 vs. 17 days, p = 0.03). Our results suggest that the "sandwich" technique for VHR is a safe and durable method to restore abdominal wall integrity in those with LOD, even in patients with giant ventral hernias.

  9. 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

  10. wall

    Directory of Open Access Journals (Sweden)

    Irshad Kashif

    2016-01-01

    Full Text Available Maintaining indoor climatic conditions of buildings compatible with the occupant comfort by consuming minimum energy, especially in a tropical climate becomes a challenging problem for researchers. This paper aims to investigate this problem by evaluating the effect of different kind of Photovoltaic Trombe wall system (PV-TW on thermal comfort, energy consumption and CO2 emission. A detailed simulation model of a single room building integrated with PV-TW was modelled using TRNSYS software. Results show that 14-35% PMV index and 26-38% PPD index reduces as system shifted from SPV-TW to DGPV-TW as compared to normal buildings. Thermal comfort indexes (PMV and PPD lie in the recommended range of ASHARE for both DPV-TW and DGPV-TW except for the few months when RH%, solar radiation intensity and ambient temperature were high. Moreover PVTW system significantly reduces energy consumption and CO2 emission of the building and also 2-4.8 °C of temperature differences between indoor and outdoor climate of building was examined.

  11. Bone regeneration in 3D printing bioactive ceramic scaffolds with improved tissue/material interface pore architecture in thin-wall bone defect.

    Science.gov (United States)

    Shao, Huifeng; Ke, Xiurong; Liu, An; Sun, Miao; He, Yong; Yang, Xianyan; Fu, Jianzhong; Liu, Yanming; Zhang, Lei; Yang, Guojing; Xu, Sanzhong; Gou, Zhongru

    2017-03-13

    Three-dimensional (3D) printing bioactive ceramics have demonstrated alternative approaches to bone tissue repair, but an optimized materials system for improving the recruitment of host osteogenic cells into the bone defect and enhancing targeted repair of the thin-wall craniomaxillofacial defects remains elusive. Herein we systematically evaluated the role of side-wall pore architecture in the direct-ink-writing bioceramic scaffolds on mechanical properties and osteogenic capacity in rabbit calvarial defects. The pure calcium silicate (CSi) and dilute Mg-doped CSi (CSi-Mg6) scaffolds with different layer thickness and macropore sizes were prepared by varying the layer deposition mode from single-layer printing (SLP) to double-layer printing (DLP) and then by undergoing one-, or two-step sintering. It was found that the dilute Mg doping and/or two-step sintering schedule was especially beneficial for improving the compressive strength (~25‒104 MPa) and flexural strength (~6‒18 MPa) of the Ca-silicate scaffolds. The histological analysis for the calvarial bone specimens in vivo revealed that the SLP scaffolds had a high osteoconduction at the early stage (4 weeks) but the DLP scaffolds displayed a higher osteogenic capacity for a long time stage (8~12 weeks). Although the DLP CSi scaffolds displayed somewhat higher osteogenic capacity at 8 and 12 weeks, the DLP CSi-Mg6 scaffolds with excellent fracture resistance also showed appreciable new bone tissue ingrowth. These findings demonstrate that the side-wall pore architecture in 3D printed bioceramic scaffolds is required to optimize for bone repair in calvarial bone defects, and especially the Mg doping wollastontie is promising for 3D printing thin-wall porous scaffolds for craniomaxillofacial bone defect treatment.

  12. Linear abdominal trauma.

    Science.gov (United States)

    Danto, L A; Wolfman, E F

    1976-03-01

    Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury.

  13. Comparison of application of transthoracic abdominal wall vein and peripheral vein indwelling needleplacement%经胸腹壁静脉与外周静脉置入留置针的应用比较

    Institute of Scientific and Technical Information of China (English)

    魏彬彬; 靳亚斌; 陈燕玲

    2015-01-01

    Objective To investigate the in peripheral venous puncture difficulties,through the comparison of thoracic and abdominal wall vein puncture effect. Methods 80 cases of neonatal routinely using the peripheral vein group ( scalp vein,limbs vein indwelling needle ) set,chest and abdominal wall vein group ( thoraco abdominal wall vein indwelling needle ) implantation,compared two groups of vein one-time success rate, incidence of complications, indwelling time. Results The chest and abdominal wall vein puncture success rate and retention time was significantly better than that of peripheral vein group two (Note:one time puncture success rate comparison,χ2=9.038,P<0.01). Conclusion the thoracic and abdominal wall vein puncture success rate high,vascular retention time is long, the peripheral group venous retention time of (2+1)days,thoracic and abdominal group venous retention time was(2.5+1.5) days,vascular complications and low. Ensure NICU in neonatal venous channels unblocked,the various drugs and nutrition can timely input.%目的:比较外周静脉穿刺与经胸腹壁静脉穿刺的应用效果。方法将80例新生儿按常规采用外周静脉组(头皮静脉、四肢静脉等)置留置针,胸腹壁静脉组(胸腹壁静脉)置入留置针,比较2组的一次性成功率、留置时间、并发症发生率。结果胸腹壁静脉穿刺成功率及保留时间显著优于外周静脉组(P<0.01),并发症少于外周静脉组(P<0.01)。结论经胸腹壁静脉穿刺成功率高,血管保留时间长,并发症发生率低,保证了新生儿重症监护室(NICU)新生儿静脉通道的畅通,使各种药物及营养成分能及时输入。

  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. The use of a polycaprolactone-tricalcium phosphate scaffold for bone regeneration of tooth socket facial wall defects and simultaneous immediate dental implant placement in Macaca fascicularis.

    Science.gov (United States)

    Goh, Bee Tin; Chanchareonsook, Nattharee; Tideman, Henk; Teoh, Swee Hin; Chow, James Kwok Fai; Jansen, John A

    2014-05-01

    Bone regeneration and aesthetic outcomes may be compromised when immediate implants are placed at extraction sites with dehiscence defects. The aim of this study was to compare, in a monkey model, peri-implant bone regeneration and implant stability after immediate implant placement into tooth sockets with facial wall defects in two treatment groups. In eight control monkeys, the bony defect was reconstructed with autogenous particulate bone, whereas in 10 test monkeys a polycaprolactone-tricalcium phosphate (PCL-TCP) scaffold was used. The monkeys were sacrificed after 6 months and the specimens were analyzed by histology and histomorphometry. Better maintenance of facial bone contour was noted in the test group; however, bone regeneration was seen only at areas adjacent to a bony wall of the defect. The mean bone-to-implant contact was 27.6 ± 19.1% (control group) versus 6.8 ± 7.9% (test group). The mean bone area percentage was 11.8 ± 10.1% (control group) versus 6.8 ± 6.9% (test group). Implant survival was 100% at 6 months for both the groups. It was concluded that although the use of a PCL-TCP scaffold showed better maintenance of the alveolar contour as compared to autogenous particulate bone at 6 months, there was minimal bone regeneration within the defect.

  16. Ventral Abdominal Hernia

    Directory of Open Access Journals (Sweden)

    Georgi Tchernev

    2017-08-01

    Full Text Available A 63-year-old Caucasian female patient presented with redness of the both foot and lower legs, as well as edema of the left lower leg, accompanied by subjective complaints of burning. Fever was not reported. Well-circumscribed oval shaped tumor formation was revealed also on the abdominal wall, with hyperpigmented and depigmented areas on its ulcerated surface, measuring approximately 10/10cm in diameter, with soft-elastic texture on palpation.  The lesion occurred in 2011, according to the patient’s history. No subjective complaints were reported in association. The performed ultrasonography revealed intestinal loops in the hernial sac, without incarceration. The diagnosis of ventral abdominal hernia without mechanical ileus was made. The patient was referred for planned surgical procedure, because of her refusal on this stage.The clinical manifestation of the tumor formation on the abdominal wall, required wide spectrum of differential diagnosis, including aneurysm of the abdominal aorta, abdominal tumor, subcutaneous tumor or metastasis or hernia. In the presented cases, the abdominal wall mass was a sporadic clinical finding in the framework of the total-body skin examination in patient with erysipelas. The lack of subjective symptoms, as well as the reported history for hysterectomy and previously abscessus were not enough indicative symptoms for the correct diagnosis. The diagnosis of non-complicated hernia was made via ultrasonography, while the clinical differentiation between hernia and other life-threatening conditions as aneurysms or tumor was not possible.

  17. Unexpected multiple intra-abdominal injuries after projectile fragmentation: report of three cases.

    Science.gov (United States)

    Unlü, Aytekin; Petrone, Patrizio; Karşıdağ, Tamer; Asensio, Juan A

    2012-11-01

    Explosives create and energize particles that act as projectiles prone to further fragmentation or create other secondary missiles in the body. These fragments may result in secondary injuries. This has been repeatedly described in the orthopedic and neurosurgical literature. We report the same process for abdominal injuries after fascial penetration in the military setting. This is an observational case series study. Local wound exploration as a standard approach was performed in conscious patients who sustained abdominal wall injuries. Patients with negative physical examination were excluded from the study. An intraperitoneal injury was assumed in those with a full-thickness fascial defect, and laparotomy was performed. Twenty patients met the study eligibility criteria. Of those 20 patients, 12 had negative wound exploration and were excluded from the study, while abdominal organ injuries were found in eight (40%) patients. During laparotomy, projectile-induced injuries in a sprayed distribution were found in three (38%) of these patients. These injuries were far from the predictable trajectory and in the absence of bone fragmentation. The overall mean number of peritoneal defects was 1.7, and a mean 6.8 intra-abdominal injuries for each peritoneal defect were found when through-and-through injuries were excluded.Despite a single peritoneal defect, there may be multiple intraperitoneal injuries due to further fragmentation of the projectile. Under mass casualties, wound exploration with a full-thickness fascial defect could serve as an indicator of possible intra-abdominal injuries, and consequently indicate exploratory laparotomy.

  18. Study on the strength of abdominal wall after TRAM flap for breast reconstruction%TRAM皮瓣乳房再造术后腹壁张力的研究

    Institute of Scientific and Technical Information of China (English)

    顾建英; 亓发芝; 吴坤南; 徐剑炜; 施越冬; 张学军

    2001-01-01

    目的 研究TRAM皮瓣术后腹壁张力的情况。方法 采用调查表,运动测试和腹直肌形态CT扫描作手术前后对照。结果 手术初期(1~6周)腹壁张力下降,尤其以双蒂皮瓣者为甚,3个月后已无明显差异;运动测试显示术后运动不如术前;而CT扫描示腹直肌形态保持良好。结论 TRAM皮瓣乳房再造术后腹直肌肌力有下降,而腹壁张力无明显改变。%Objective To study the strength of abdominal wall after TRAM flap. Methods We made results by questionaire, examination test and CT scanning of rectus abdominis muscles. Results The strength of abdominal wall decreased in initial stage, especially in double-pedicle flap, but there was no significant difference after 3 months, examination tests show decreased strength after operation yet morphology of rectus abdominis muscle remained well. Conclusion The strength of abdominal wall shows no significant change after TRAM flap.

  19. Evaluation of inflammatory cells in abdominal aortic aneurysmal wall by tomography emission positron; Anevrisme de l aorte abdominale et inflammation vasculaire: place de la tomographie par emission de positons

    Energy Technology Data Exchange (ETDEWEB)

    Sakalihasan, N. [Service de chirurgie cardiovasculaire et thoracique, CHU de liege, domaine universitaire du Sart Tilman, batimant B-35, 4000 liege 1, (Belgium); Hustinx, R. [Service de medecine nucleaire, CHU de Liege, (Belgium); Gomez, P.; Defraigne, J.O. [Departement de medecine nucleaire, CHU de Liege, (Belgium)

    2009-05-15

    The objective was to identify the methods of functional imaging and the molecular markers that could help to predict the imminence of a rupture in abdominal aortic aneurysm. The potential of the PET was studied to detect a hyper-metabolic state in the aneurysm wall and this information was connected with the evolution of the disease. An uptake of F.D.G. in the aneurysm wall reflects the presence of a great density of inflammatory cells (macrophages, lymphocytes, polymorphonuclear cells). It has been observed an accumulation of polymorphonuclear cells accompanying a dense infiltration of macrophages and lymphocytes only in the site of break. Our preliminary study and our most recent observations (not yet published) suggest a possible relationship between the F.G.D. captation by the aneurysm wall and the start of the activity of the matrix metallo-proteinases leading to the break. The PET scan could be useful for high risk patients because a positive PET imaging stigmatizes a greater risk of break. consequently, the positive PET imaging represents a diagnosis argument to proceed to a surgical operation, despite the age of the patient, the size of the abdominal aorta aneurysm and the higher operative risk. however, more data to better define the criteria of using the PET/T.D.M. in the evaluation of abdominal aorta aneurysm and to determine its exact contribution in the treatment determination. (N.C.)

  20. A comparative study on treatment of two and three walled periodontal bony defects utilizing open flap debridement with and without enamel matrix derivatives

    Directory of Open Access Journals (Sweden)

    Soleimani Shayesteh Y.

    2006-08-01

    Full Text Available Background and Aim: Intrabony periodontal defects are important problems in periodontology and up to now several ways have been suggested for their treatment .Treatment with enamel matrix derivatives (EMD has been shown to enhance periodontal regeneration. There is limited information available from clinical trials regarding the performance of EMD in the treatment of periodontal intrabony defects. This study was designed to compare the clinical and radiographic effects of EMD treatment to that of open flap debridment (OFD for two and three walled intrabony defects. Materials and Methods: 18 patients were included in this clinical trial which have 24 two and/ or three intrabony defects. Defects were randomly divided into two groups (test and control. Defects in test group were treated with flap surgery plus EMD and in control group with open flap debridment. At baseline and at 3 and 6 months follow up, clinical and radiographic measurements were performed. Data were analyzed using Greenhouse-Geisser test with p<0.05 as the limit of significance. Results: At 3 and 6 months, mean probing pocket depth reduction was greater in the test group (EMD (4.33 mm and 4.70 mm compared to the OFD group (2.54 mm and 3.09 mm. Mean values for clinical attachment gain in the EMD group after 3 and 6 months were 4.29 mm and 4.98 mm, and in OFD group were 2.83 and 2.82 mm respectively. Radiographic bone gain measured by radiovisiography technique was greater in the EMD group compared to the OFD group (4.66 mm in EMD and 1.11 mm in OFD group after 3 months and 5.78 mm in EMD and 1.39 mm in OFD group after 6 months. Conclusion: Based on the results of this study, treatment with flap surgery and EMD compared to open flap debridment, produced more favorable clinical improvements in two and three walled intrabony defects.

  1. [Abdominal actinomycosis with IUD].

    Science.gov (United States)

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A

    1997-01-01

    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  2. 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.

  3. Omphalocele, exstrophy of cloaca, imperforate anus and spinal defect (OEIS Complex) with overlapping features of body stalk anomaly (limb body wall complex)

    Science.gov (United States)

    Mandrekar, Suresh R. S.; Amoncar, Sangeeta; Banaulikar, Siddhartha; Sawant, Vishal; Pinto, R. G. W.

    2014-01-01

    OEIS is an extremely rare constellation of malformations, which includes omphalocele, exstrophy of cloaca, imperforate anus, and spinal defect. We report here autopsy findings in a case of OEIS complex, which apart from the major anomalies of the complex had bilateral club foot that is, congenital talipes equinovarus, right hydroureter, and body stalk anomaly. The umbilical cord was absent, and the umbilical vessels were embedded in an amniotic sheet, which connected the skin margin of the anterior body wall defect to the placenta, this feature being the hallmark of limb body wall complex (LBWC). This case further supports the view that OEIS and LBWC represent a continuous spectrum of abnormalities rather than separate conditions and may share a common etiology and pathogenetic mechanism as proposed by some authors. PMID:25400352

  4. Growth and trends in publications about abdominal wall hernias and the impact of a specific journal on herniology: a bibliometric analysis.

    Science.gov (United States)

    Kulacoglu, H; Oztuna, D

    2011-12-01

    The aim of this systematic review was to determine the exact volume and growth pattern of articles on abdominal wall hernias, in particular the effect of the journal Hernia on publications about hernias. A PubMed search was performed for every year between 1965 and 2010, using the title words "inguinal hernia," "incisional hernia," and "umbilical hernia." Then, two consecutive 10-year periods were chosen for a systematic PubMed search, before and after 2001--the year in which Hernia began to be indexed in PubMed. The main keywords used were as follows: "inguinal hernia" "incisional hernia" "umbilical hernia" "mesh" "laparoscopic" and "experimental." The number of all articles indexed in PubMed increased 1.6-fold between the periods 1991-2000 and 2001-2010. The number of articles with the title word "inguinal hernia" increased 1.7-fold, whereas the rises for incisional and umbilical hernias were more prominent: 3.9- and 2.6-fold. Article titles with the combined keywords "hernia and mesh" and "hernia and laparoscopic" increased 2.8- and 2.4-fold. The most striking combined search was for "umbilical hernia and mesh" with a 20.5-fold rise. The percentage of articles published in the journal Hernia among all articles in all 25 selected journals, including Hernia was 30% on average. Hernia, Surgical Endoscopy and the British Journal of Surgery were the leading journals for publications for inguinal hernia in the last decade. Growth in hernia papers is greater than the overall growth in PubMed. Articles on incisional hernia increased faster than did those on inguinal and umbilical hernias. The establishment and indexing of Hernia decreased the proportion of hernia publications in other journals. The core journals for herniology are Hernia, Surgical Endoscopy, and the British Journal of Surgery.

  5. Complex abdominal wall reconstruction in the setting of active infection and contamination: a systematic review of hernia and fistula recurrence rates.

    Science.gov (United States)

    Hodgkinson, J D; Maeda, Y; Leo, C A; Warusavitarne, J; Vaizey, C J

    2017-04-01

    Minimal evidence exists to guide surgeons on the risk of complications when performing abdominal wall reconstruction (AWR) in the presence of active infection, contamination or enterocutaneous fistula. This study aims to establish the outcomes of contaminated complex AWR. Analysis was conducted according to PRISMA guidelines. Systematic search of the MEDLINE, EMBASE and Pubmed databases was performed. Studies reporting exclusively on single-staged repair of contaminated complex AWR were included. Pooled data were analysed to establish rates of complications. Sixteen studies were included, consisting of 601 contaminated complex AWRs, of which 233 included concurrent enterocutaneous fistula repair. The average follow-up period was 26.7 months. There were 146 (24.3%) reported hernia recurrences. When stratified by repair method, suture repair alone had the lowest rate of recurrence (14.2%), followed by nonabsorbable synthetic mesh reinforcement (21.2%), biological mesh (25.8%) and absorbable synthetic mesh (53.1%). Hernia recurrence was higher when fascial closure was not achieved. Of the 233 enterocutaneous fistula repairs, fistula recurrence was seen in 24 patients (10.3%). Suture repair alone had the lowest rate of recurrence (1.6%), followed by nonbiological mesh (10.3%) and biological mesh reinforcement (12%). Forty-six per cent of patients were reported as having a wound-related complication and the mortality rate was 2.5%. It is feasible to perform simultaneous enterocutaneous fistula repair and AWR as rates of recurrent fistula are comparable with series describing enterocutaneous fistula repair alone. Hernias recurred in nearly a quarter of cases. This analysis is limited by a lack of comparative data and variability of outcome reporting. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  6. Effects of prokinetic drugs on the abdominal wall wound healing of rats submitted to segmental colectomy and colonic anastomosis Efeitos de drogas procinéticas na cicatrização da parede abdominal de ratos submetidos à colectomia segmentar e anastomose no cólon esquerdo

    Directory of Open Access Journals (Sweden)

    Pedro Henrique Alves de Morais

    2012-07-01

    Full Text Available PURPOSE: To assess the effect of prokinetic agents on abdominal wall wound healing in rats submitted to segmental colectomy and colonic anastomosis. METHODS: Sixty rats were randomly allocated into three groups according to the agents they would receive in the postoperative period: M (metoclopramide; B (bromopride; and C (control, saline 0.9%. Surgical procedures were performed identically in all animals, and consisted of a midline laparotomy followed by resection of a 1-cm segment of large bowel with end-to-end anastomosis. The abdominal wall was closed in two layers with running stitches. Abdominal wall samples were collected on the 3rd or 7th postoperative day for measurement of breaking (tensile strength and histopathological assessment. RESULTS: There were no statistically significant differences in tensile strength of the abdominal wall scar between groups M, B, and C, nor between the three and seven days after surgery subgroups. On histopathological assessment, there were no statistically significant between-group differences in collagen deposition or number of fibroblasts at the wound site CONCLUSION: Use of the prokinetic drugs metoclopramide or bromopride had no effect on abdominal wall healing in rats submitted to segmental colectomy and colonic anastomosis.OBJETIVO: Avaliar os efeitos do uso de drogas prócinéticas na cicatrização da parede abdominal de ratos submetidos à colectomia segmentar e anastomose no cólon esquerdo. MÉTODOS: Foram utilizados 60 ratos, alocados aleatoriamente em três grupos para receberem as seguintes medicações no período pós-operatório: M (metoclopramida; B (bromoprida e C (solução salina a 0,9%. Os procedimentos cirúrgicos foram idênticos em todos os animais. Foi realizada laparotomia mediana, seguida de colectomia segmentar de 1-cm e anastomose colônica. O fechamento da parede abdominal foi feito em dois planos de sutura contínua. No 3° ou no 7° dia pós-operatório foram coletadas

  7. A Theoretical Study of the Interactions of In+ and In+3 with a Stone-Wales Defect Single-Walled Carbon Nanotubes.

    Energy Technology Data Exchange (ETDEWEB)

    Simeon, T; Balasubramanian, K; Leszczynski, J

    2008-10-02

    Experimental techniques [1] have demonstrated the controllable, reversible and mass transport exchange of indium nanocrystals along surfaces of multi-walled carbon nanotubes (MWCNTs). In particular, at certain sites robust nucleation occurs suggesting preferred locations for controlled manipulation. We believe these site locations represent structural defects, like rehybridization, incomplete bonding and topological defects within the carbon network. Although minute, these defects can drastically modify the electrical, chemical and mechanical properties of CNTs. This study was devoted to understand the role of structural defects, specifically a Stone-Wales (SW) defect in the surface transport and interaction properties of the In{sup +1} and In{sup +3} for both the singlet and triplet state. The effects of CNT surface curvature on In+1 and In{sup +3} is also studied and compared to graphite. Geometries of complexes were optimized at the B3LYP level. The standard 6-31G(d) basis set was used for carbon and hydrogen atoms while an effective core potential (ECP) was used for indium. All calculations were performed using the Gaussian 03 suite of programs. The computed Mulliken charges and HOMOLUMO gap energies, interactions and interaction energy (corrected by the basis set superposition error) of the systems have been studied and will be discussed. Figure 1 represents the comparison of the molecular electrostatic potential maps for (a) In{sup +} and (b) In{sup +3} with a SW defect CNT.

  8. 16-Slice CT Diagnostic Value in Adult Non- traumatic Abdominal Wall Hernia%成人非创伤性腹壁疝的16层螺旋CT诊断价值

    Institute of Scientific and Technical Information of China (English)

    丁长青; 孙迎迎; 史志卫; 王文生; 谢光彤

    2012-01-01

    目的:探讨成人非创伤性腹壁疝的16层螺旋CT诊断价值。方法:回顾性分析手术或临床随访证实的37例成人非创伤性腹壁疝16层螺旋CT资料。结果:腹壁切口疝13例,股沟斜疝10例,腰疝4例,半月线疝3例,壁造瘘口疝3例,白线疝2例,脐疝2例。疝囊直径小于5cm者23例,6~10cm者11例,大于10cm者3例。疝内容可为大网膜、肠管甚至邻近的器官。结论:多层CT及后处理是非创伤性腹壁疝较佳的诊断方法,可为进一步手术治疗提供可靠依据。%Objective: To investigate 16 layer spiral CT diagnosis value in adult non traumatic abdominal wall hernia. Methods: A retrospective analysis of 37 cases data of adult non traumatic abdominal wall hernia confirmed by operation or clinical follow-up with 16 slice spiral CT. Results: Abdominal wall incisional hernia in 13 cases, inguinal indirect hernia in 10 cases, lumbar hernia in 4 cases, spigelian hernia in 3 cases, abdominal wall stoma hernia in 3 cases, white line hernia in 2 cases, umbilical hernia in 2 cases. Hernia sac diameter less than 5 cm in 23 cases, 6-10 cm in 11 cases, greater than 10 cm in 3 cases. The hernial contents are the greater omentum, bowel and adjacent organs. Conclusion: It is a better diagnosis method with multi-layer CT and post-processing for non traumatic abdominal wall hernia, which could provide a reliable basis for further treatment.

  9. Ventricular septal defect (image)

    Science.gov (United States)

    Ventricular septal defect is a congenital defect of the heart, that occurs as an abnormal opening in ... wall that separates the right and left ventricles. Ventricular septal defect may also be associated with other ...

  10. Abdominal Actinomycetoma With Lymphnode Involvement

    Directory of Open Access Journals (Sweden)

    Damisetty Rajetha

    2004-01-01

    Full Text Available Actinomycotic mycetoma of the anterior abdominal wall with inguinal lymphnode involvement, an exceedingly rare entity is described here with mycological histological features. Remarkable therapeutic response was noted with Welsh regimen.

  11. A prospective, controlled evaluation of the abdominal reapproximation anchor abdominal wall closure system in combination with VAC therapy compared with VAC alone in the management of an open abdomen.

    Science.gov (United States)

    Long, Kristin L; Hamilton, David A; Davenport, Daniel L; Bernard, Andrew C; Kearney, Paul A; Chang, Phillip K

    2014-06-01

    Dramatic increases in damage control and decompressive laparotomies and a significant increase in patients with open abdominal cavities have resulted in numerous techniques to facilitate fascial closure. We hypothesized addition of the abdominal reapproximation anchor system (ABRA) to the KCI Abdominal Wound Vac™ (VAC) or KCI ABThera™ would increase successful primary closure rates and reduce operative costs. Fourteen patients with open abdomens were prospectively randomized into a control group using VAC alone (control) or a study group using VAC plus ABRA (VAC-ABRA). All patients underwent regular VAC changes; patients receiving VAC-ABRA also underwent concomitant daily elastomer adjustment of the ABRA system. Primary end points included abdominal closure, number of operating room (OR) visits, and OR time use. Eight pat