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Sample records for abdominal wall umbilicus

  1. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  2. Congenital lateral abdominal wall hernia.

    PubMed

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

    2016-08-01

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

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

    PubMed Central

    Kobayashi, Kosuke; Sasaki, Kazuhito; Iijima, Tatsuo; Yoshimi, Fuyo; Nagai, Hideo

    2016-01-01

    Introduction Here, we report the surgical excision of the urachal remnant using the abdominal wall-lift laparoscopy with a camera port in the umbilicus, combined with a small Pfannenstiel incision to optimally treat the bladder apex. Presentation of case A 21-year-old woman presented with periumbilical discharge and pain on urination. Contrast enhanced CT and MRI showed an abscess in the umbilical region that was connected to the bladder via a long tube-like structure. It was diagnosed as an infected urachal sinus. Partial excision of the umbilical fossa followed by dissection of the urachal remnant was easily performed using the abdominal wall-lift laparoscopy from the umbilicus down to the bladder without pneumoperitoneum or additional trocar placement. A Pfannenstiel incision was made above the pubis to get access to the junction between the urachal remnant and the bladder. Under direct vision, we succeeded in accurately dividing the remnant tract, and we adequately closed the bladder opening with absorbable sutures. This method has the advantage of easily closing peritoneal defects after excision of the urachal remnant with direct sutures under a laparoscopic view from the umbilicus. Cosmetic satisfaction was obtained postoperatively. 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. PMID:27064744

  4. [FUNCTIONAL PLASTIC OF ANTERIOR ABDOMINAL WALL HERNIAS].

    PubMed

    Grubnik, V V; Parfentyeva, N D; Parfentyev, R S

    2015-07-01

    In order to improve the treatment efficacy of postoperative anterior abdominal wall hernias the method of plastic with restoration of anatomical and physiological properties of the muscles of the anterior abdominal wall was used. After the intervention by the improved method, regardless of the location of the hernia defect yielded promising results for the conservation of anterior abdominal wall muscle function in 75% of cases completely restored functional ability of muscles recti abdomini. PMID:26591212

  5. Genetics Home Reference: abdominal wall defect

    MedlinePlus

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

  6. Acellular dermal matrix in abdominal wall reconstruction.

    PubMed

    Silverman, Ronald P

    2011-09-01

    Abdominal wall reconstruction is a complex and challenging surgical undertaking. While permanent prosthetic mesh is considered the gold standard for minimizing hernia recurrence, placement of synthetic mesh is sometimes imprudent due to contamination or risk of infection. Acellular dermal matrices (ADM) offer an exciting biologic alternative. This article provides a historical perspective on the evolution of complex ventral hernia repair leading up to and including the placement of ADM, an explanation of the biology of ADM as it relates to ventral hernia repair, and a description of the current indications, techniques, benefits, and shortcomings of its use in the abdominal wall.

  7. Myxoid Liposarcoma in the Abdominal Wall

    PubMed Central

    Fan, Zhe; Tian, Xiao Feng; Tang, Shun Xiong; Zhang, Ying Yi; Pan, Ji Yong; Wang, Shuang

    2014-01-01

    Abstract A liposarcoma is the most common type of soft tissue sarcoma, and most liposarcomas are malignant. The extremities are the most common site for liposarcomas. There are 5 histologic types of liposarcoma, as follows: well differentiated; myxoid; round cell; pleomorphic; and dedifferentiated. Myxoid liposarcomas (MLSs) represent a subgroup of liposarcomas. There has been no report of MLSs in the abdominal wall. We report a rare case of a MLS of a 43-year-old male who presented with tensile force on the abdominal wall. Computed tomography (CT) found a tumor in abdominal wall. There was no other abnormal symptom and the laboratory testing was also unusual. At last, the tumor was successfully excised, which was diagnosed MLSs in pathology. Following standard principles, after complete excision, the patient received radiotherapy. The patient was followed up for 8 month and no disease recurrence was identified. MLSs are rarely seen in the clinic, irrespective of the presenting signs, but also based on histologic features. The aim of this report was to present the differential diagnosis of an abdominal wall mass, and to remind us of MLSs. PMID:25526446

  8. Solitary fibrous tumor of the abdominal wall.

    PubMed

    Migita, Kazuhiro; Watanabe, Akihiko; Nakagawa, Kenji; Ohyama, Takao; Sekigawa, Susumu

    2009-12-01

    Solitary fibrous tumors (SFTs) are uncommon neoplasms of mesenchymal origin that usually arise from the pleura. SFTs of the abdominal wall are extremely rare, and only 12 cases have been reported in the English language literature. This report presents a new case of SFT of the abdominal wall in a 74-year-old female. Positron emission tomography demonstrated the heterogeneous 18F-fluorodeoxyglucose uptake of the tumor (the maximum standardized uptake value was 2.8). Histologically, the mitotic count was 1 to 2/10 high-power fields. The patient is alive without recurrence at 10 months after undergoing a surgical excision. We discuss the clinicopathological features and differential diagnosis and present a review of the pertinent literature.

  9. Mesh Sutured Repairs of Abdominal Wall Defects

    PubMed Central

    Lanier, Steven T.; Jordan, Sumanas W.; Miller, Kyle R.; Ali, Nada A.; Stock, Stuart R.

    2016-01-01

    Background: A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes. Methods: Strips of macroporous polypropylene mesh of 2 cm width were passed through the abdominal wall and tied as simple interrupted sutures. The surgical technique and surgical outcomes are presented. Results: One hundred and seven patients underwent a mesh sutured abdominal wall closure. Seventy-six patients had preoperative hernias, and the mean hernia width by CT scan for those with scans was 9.1 cm. Forty-nine surgical fields were clean-contaminated, contaminated, or dirty. Five patients had infections within the first 30 days. Only one knot was removed as an office procedure. Mean follow-up at 234 days revealed 4 recurrent hernias. Conclusions: Mesh sutured repairs reliably appose tissue under tension using concepts of force distribution and resistance to suture pull-through. The technique reduces the amount of foreign material required in comparison to sheet meshes, and avoids the shortcomings of monofilament sutures. Mesh sutured closures seem to be tolerant of bacterial contamination with low hernia recurrence rates and have replaced our routine use of mesh sheets and bioprosthetic grafts. PMID:27757361

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

    PubMed

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

    2016-01-01

    Hydatid cyst caused by Echinococcus granulosus demonstrates an endemic infection in several countries such as Middle Eastern countries. Liver is the most frequently involved organ, followed by the lung. The case we present is solitary primary localization of cyst in abdominal wall which is extremely rare. A 57-year-old woman presented with an abdominal wall lesion in umbilical area that had been evolving for about 2 years with recent complaint of pain and discomfort. We detected a midline abdominal mass 12⁎13 centimeters in diameter which was bulged out in umbilicus. Preoperative clinical diagnosis of incarcerated umbilical hernia was made due to its physical examination while surgical exploration disproved the primary diagnosis and we found cystic mass adherent to superficial fascia without any communication to peritoneal space. The cyst was excised completely without any injury or perforation of containing capsule. The diagnosis of hydatid cyst was confirmed by histopathological examination of specimen. The retrograde evaluation showed no involvement of other organs. The patient was followed for two years and no recurrence of hydatid disease has been observed. Hydatid cyst should be considered as a differential diagnosis of abdominal wall and umbilical lesions especially in endemic regions. PMID:27190669

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

    PubMed Central

    Hassan, Khairi A. F.; Elsharawy, Mohamed A.; Moghazy, Khaled; AlQurain, Abdulaziz

    2008-01-01

    Handlebar hernias are abdominal wall hernias resulting from direct trauma to the anterior abdominal wall. They usually result at weak anatomic locations of the abdominal wall. Such traumatic hernias are rare, requiring a high index of suspicion for a clinical diagnosis. We report the case of a handlebar hernia resulting from an injury sustained during a vehicular injury, and discuss the management of such injuries. PMID:19568493

  12. A New Rat Model for Orthotopic Abdominal Wall Allotransplantation

    PubMed Central

    Lao, William W.; Wang, Yen-Ling; Ramirez, Alejandro E.; Cheng, Hui-Yun

    2014-01-01

    Background: Abdominal wall, one of the most commonly transplanted composite tissues, is less researched and lacking animal models. Its clinical necessities were emphasized in multiple case series to reconstruct large abdominal defects. Previous animal models have only studied components of the abdominal wall transplant. We describe findings from a new model that more likely reflect clinical transplantation. Methods: Full-thickness hemiabdominal wall flap was procured from Brown Norway (BN) rats and transplanted to an orthotopic defect on Lewis rats. Three groups were studied: group 1: Lewis to Lewis syngeneic; group 2: BN to Lewis control; and group 3: BN to Lewis with postoperative cyclosporine. Vascular imaging and cross vessel section were performed along with full-thickness abdominal wall. Immune cell profiling with flow cytometry at different time points was studied in all groups. Results: Syngeneic group had no rejection. Control group consistently showed rejection around postoperative day 6. With cyclosporine treatment, however, transplant and recipient tissue integration was observed. Flow cytometry revealed that innate immunity is responsible for the initial inflammatory events following abdominal wall engraftment. Adaptive immunity cells, specifically interferon-γ-producing T helper (Th) 1 and interleukin-17-producing Th17 cells, dramatically and positively correlate with rejection progression of abdominal wall transplants. 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. PMID:25289329

  13. Case report: Leiomyoma of the anterior abdominal wall.

    PubMed

    Ernest Ong, C W; Siow, S L

    2016-04-01

    Leiomyomas are benign soft tissue swellings of smooth muscle origin, most commonly found in the uterus. Extra uterine leiomyomas presenting as an abdominal mass is often a diagnostic challenge as such occurrence is rare. We present a rare case of primary abdominal wall leiomyoma, and highlight the importance of laparoscopic approach in the diagnosis and treatment of such tumour. PMID:27326950

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

    PubMed Central

    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. PMID:27293982

  15. Advanced Gastric Cancer Perforation Mimicking Abdominal Wall Abscess

    PubMed Central

    Cho, Jinbeom; Park, Ilyoung; Lee, Dosang; Sung, Kiyoung; Baek, Jongmin

    2015-01-01

    Surgeons occasionally encounter a patient with a gastric cancer invading an adjacent organ, such as the pancreas, liver, or transverse colon. Although there is no established guideline for treatment of invasive gastric cancer, combined resection with radical gastrectomy is conventionally performed for curative purposes. We recently treated a patient with a large gastric cancer invading the abdominal wall, which was initially diagnosed as a simple abdominal wall abscess. Computed tomography showed that an abscess had formed adjacent to the greater curvature of the stomach. During surgery, we made an incision on the abdominal wall to drain the abscess, and performed curative total gastrectomy with partial excision of the involved abdominal wall. The patient received intensive treatment and wound management postoperatively with no surgery-related adverse events. However, the patient could not receive adjuvant chemotherapy and expired on the 82nd postoperative day. PMID:26468420

  16. Abdominal Wall Endometrioma after Laparoscopic Operation of Uterine Endometriosis.

    PubMed

    Vukšić, Tihomir; Rastović, Pejana; Dragišić, Vedran

    2016-01-01

    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. PMID:27340586

  17. Desmoid tumor of the abdominal wall: a case report

    PubMed Central

    2011-01-01

    Introduction Desmoid tumors are rare lesions without any metastatic potential but a strong tendency to invade locally and to recur. These tumors are associated with women of fertile age, especially during and after pregnancy. Case presentation The case of a desmoid tumor of the anterior abdominal wall in a 40-year-old Caucasian man with no relevant family history is presented, describing its appearance on computed tomography and ultrasonography. The patient, who presented with a painless mass in the left anterolateral abdomen, had a history of previous urgent abdominal surgery after a shotgun injury two years earlier. Radical resection of the affected abdominal wall musculature was performed, and the defect was reconstructed with polypropylene mesh. Conclusion The diagnosis of desmoid tumor should be strongly considered even in male patients with an abdominal mass and a history of previous abdominal surgery. The goal of its treatment is complete tumor excision and avoidance of the development of complications such as hernia. PMID:21787413

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

    PubMed

    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.

  19. Improving the Efficiency of Abdominal Aortic Aneurysm Wall Stress Computations

    PubMed Central

    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. PMID:25007052

  20. WSES guidelines for emergency repair of complicated abdominal wall hernias

    PubMed Central

    2013-01-01

    Emergency 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 Emergency Surgery with the goal of defining 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. PMID:24289453

  1. Tunnelled tensor fascia lata flap for complex abdominal wall reconstruction

    PubMed Central

    Wang, Frederick; Buonocore, Samuel; Narayan, Deepak

    2011-01-01

    This study describes the treatment of two patients with recurrent, infected abdominal wall defects using bilateral delayed and tunnelled pedicled tensor fascia lata (TFL) myofascial flaps. TFL flaps were elevated and delayed for 4 weeks in both cases. In the second case, Parietex Composite mesh was positioned underneath the TFL flap and allowed to incorporate. After a delay of 4 weeks, the flaps were harvested and tunnelled subcutaneously to repair the abdominal wall defect. Both patients have stable repairs but had donor site seromas requiring drainage. Cadaver dissection was also performed to identify structures related to TFL flap harvest. We identified a variant of lateral femoral cutaneous nerve that traversed the TFL flap, necessitating meticulous dissection during surgery. In summary, we describe a new technique of incorporating mesh into the TFL prior to flap harvest for reconstruction of complex abdominal wall. PMID:22707661

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

    PubMed Central

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

    2016-01-01

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

  3. Abdominal wall closure after a stomal reversal procedure.

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

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

    2015-11-01

    A 78 -year-old man with rectal cancer underwent abdominoperineal resection of the rectum. In the postoperative period, the patient experienced wound infection, leading to an abdominal wall hernia. Two years following surgery, a rise in the serum CEA level was seen. A metastatic tumor was detected in the right lung on chest CT. VATS right lung inferior lobe segmental resection was performed. After lobectomy, the serum CEA level continued to increase. Another metastatic tumor was detected in the right lung on chest CT. Chemotherapy with capecitabine, oxaliplatin, and bevacizumab was commenced. The erosive part of the abdominal wall scar hernia extended during the nine weeks of chemotherapy. The chemotherapy was then discontinued. In the follow-up CT scan, a right pleural recurrence, local recurrence in the pelvis, and a liver metastasis were detected. Chemotherapy was re-introduced 3 years after surgery. The erosive part of the abdominal wall hernia again began to spread with chemotherapy recommencement. Four months after restarting chemotherapy, the hernia ruptured, with a loop of the small intestine protruding out of it. The patient covered this with a sheet of vinyl and was taken by the ambulance to our hospital. The erosive part of the abdominal wall hernia had split by 10 cm, and a loop of the small intestine was protruding. As ischemia of the small intestine was not observed, we replaced it into the abdominal cavity, and performed a temporary suture repair of the hernia sac. Following this, bevacizumab was discontinued, and the erosive part reduced. We performed a radical operation for abdominal wall scar hernia repair 11 weeks after the discontinuation of bevacizumab. PMID:26805294

  6. Traumatic abdominal wall hernia with concealed colonic perforation.

    PubMed

    Pathak, D; Mukherjee, R; Das, P; Pathak, D; Gangopadhyay, A; Das, S

    2016-09-01

    Traumatic abdominal wall hernia (TAWH) is a rare clinical entity in terms of aetiology. It occurs following a blunt abdominal injury with energy high enough to cause disruption of the musculoaponeurotic layer but not the elastic skin layer. It is often associated with underlying intra-abdominal injuries, which can be diagnosed either clinically or radiologically. We report a case of TAWH in a young man with associated large bowel transection, which remained undiagnosed in the preoperative period owing to its masked features. He was managed surgically, with no recurrence to date. Considering the high volume of blunt abdominal trauma cases that present to the accident and emergency department, only few cases of TAWH have been reported in the literature. Confusion still exists regarding the timing and mode of management of this condition. PMID:27241601

  7. Can Abdominal Wall Reconstruction Be Safely Performed Without Drains?

    PubMed

    Ramshaw, Bruce; Dean, Jonathan; Forman, Brandie; Heidel, Eric; Gamenthaler, Andrew; Fabian, Michael

    2016-08-01

    The use of closed suction drains in the abdominal wall is a common practice in abdominal wall reconstruction (AWR) operations. Drains can be a conduit for bacteria and can cause pain and discomfort for patients after surgery. A single hernia program has implemented the principles of clinical quality improvement in an attempt to improve outcomes for hernia patients. An attempt at a process improvement was implemented to eliminate the use of drains in AWR by adapting the technique. A total of 102 patients undergoing AWR were included between 8/11 and 9/15 (49 months). Compared with the group before the attempt at eliminating the use of abdominal wall drains (8/11-9/13), the group of patients after the implementation of the attempted process improvement (9/13-9/15) had less wound and pulmonary complications, a shorter hospital stay, less time in the postanesthesia care unit, and less opioid use in the postanesthesia care unit as well as for the entire hospital stay. In this group of AWR patients, an attempt at process improvement that eliminated the use of drains led to improved outcomes. Abdominal wall drains may be able to be safely eliminated with appropriate technique adaptation for AWR. PMID:27657586

  8. In search of the ideal female umbilicus.

    PubMed

    Craig, S B; Faller, M S; Puckett, C L

    2000-01-01

    The umbilicus is essential to the aesthetic appearance of the abdomen. However, little research exists on what characterizes an aesthetically pleasing umbilicus. Often, the plastic surgeon is called on to reconstruct the umbilicus. Although a variety of reconstructive methods are available, no real standards define the appearance of an aesthetically pleasing umbilicus. To ascertain the characteristics of an aesthetically pleasing umbilicus, a photographic analysis was undertaken using 147 female participants between the ages of 18 and 62 years. Each subject's age, height, and weight were recorded. Photographs of each participant's umbilicus were then taken from 30 cm and 50 cm away. The photographs were reviewed by the authors, and each umbilicus was categorized on the basis of size, shape, hooding, or protrusion. The photographs were then reviewed by a panel and given a score between 1 and 10 to rate attractiveness. Using linear regression analysis, the effects of body mass index, shape, hooding, and umbilical protrusion on attractiveness were assessed. The T- or vertically shaped umbilicus with superior hooding consistently scored the highest in aesthetic appeal, whereas the presence of any degree of protrusion and a horizontal orientation or distorted shape detracted from the score. Those with a large umbilicus tended to score consistently lower than those with a smaller configuration. A desirable goal in umbilical reconstruction is, thus, to create a small T or vertically oriented umbilicus with the addition of a superior hood or shelf. PMID:10627008

  9. [Controversies in the current management of traumatic abdominal wall hernias].

    PubMed

    Moreno-Egea, Alfredo; Girela, Enrique; Parlorio, Elena; Aguayo-Albasini, José Luis

    2007-11-01

    The management of traumatic abdominal wall hernias is controversial. We performed a MEDLINE search and report a personal series of 10 patients. Cases were classified according to the cause of injury. Fifty-six percent were caused by car accidents and 14% by bicycle accidents. Diagnosis was clinical in 22% and surgical in 13% and intra-abdominal lesions were found in 67%. Treatment was delayed in 12%. In our series, 55% were lumbar hernias due to traffic accidents and all were associated with pelvic fracture. Treatment was delayed in 50%, including laparoscopic surgery with good results. In conclusion, traumatic hernias due to road traffic accidents are frequently associated with intra-abdominal lesions. The diagnostic technique of choice is computed tomography and delayed surgery (laparoscopy) is an effective option. PMID:18021624

  10. Asymptomatic abdominal wall endometrioma 15 years after cesarean section.

    PubMed

    Tica, V I; Tomescu, C L; Tomescu, Aneta; Micu, Luminiţa; Zaher, M; Bafani, S; Beghim, M; Serbănescu, L; Tica, Irina

    2006-01-01

    Abdominal wall endometriosis is rare and its diagnosis is difficult. However, the consequences may be serious, like recurrences or even malignant transformation. We report a rarer case of asymptomatic abdominal wall endometrioma, accidentally found during a surgical procedure for a second cesarean section, in a 39-years old patient, without any relevant history of endometriosis. The tumor was subcutaneous, 3/3 cm in size, located in the left angle of the incision from the 15 years previously performed cesarean section and freely mobile in relation with the skin and the fascia. It was excised, with clear margins (to prevent recurrences), during the procedure. The patient was discharged after five days. The postoperative period and the follow-up at one and three months were uneventful. The pathological examination clarified the diagnosis by revealing an endometrioma with decidual reaction. Such a condition may be, therefore, evoked before an abdominal wall tumor, even without specific symptoms, even in a 39-years old woman and longtime after the possible causal surgery. Pathological examination remains the ultimate diagnostic tool. Relevant prophylactic attitude at the end of the cesarean section may be considered.

  11. Current options in the management of complex abdominal wall defects.

    PubMed

    Ghazi, Bahair; Deigni, Olivier; Yezhelyev, Maksym; Losken, Albert

    2011-05-01

    The management of complex abdominal wall defects is challenging and often requires an individualized strategy with additional measures to minimize morbidity and recurrence. We retrospectively reviewed all patients who underwent reconstruction of complex abdominal wall defects at Emory Hospital by the senior author over a 7-year period. Abdominal hernia defects were categorized into primary, secondary, and tertiary hernias; infection; composite tumor defects; and dehiscence. Charts were queried for comorbidities, surgical technique, and outcome measures such as complications and recurrence. A total of 165 patients included in the series, with an average age of 52 years, and an average body mass index of 38 kg/m. Mesh was used in 81.8% of cases, 77% of those (mesh) being acellular dermal matrices (ADM). Component separation was performed in 75 patients (45.4%). The overall complication rate was 23.6% (39/165) including infection, delayed healing, skin necrosis, and fistulae, and was higher in patients with 2 or more comorbidities and those who required synthetic mesh reconstruction. The hernia recurrence or bulge was observed in 20.6% (34/165), and 29.4% of these patients required an additional, equally complex procedure. Hernia recurrence was significantly associated with a history of previous recurrent hernia, and hypertension (P < 0.04 and P = 0.001, respectively). Recurrence was higher in patients with 2 or more comorbidities (26% vs. 14%, P = 0.022). The recurrence rate was similar for synthetic and ADM reconstructions; however, the complication rates were higher when synthetic mesh was used. Attention to surgical technique, optimization of comorbidities, and the increased use of biologic meshes will minimize the need for operative intervention of complications following reconstruction of complex abdominal wall defects. Components separation and ADM have been very useful additions to the surgical management in these high-risk patients.

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

    NASA Astrophysics Data System (ADS)

    Lasheras, Juan

    2005-11-01

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

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

    NASA Astrophysics Data System (ADS)

    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.

  14. Abdominal wall fat index in neonates: correlation with birth size.

    PubMed

    Alves, J G; Silva, E; Didier, R; Bandeira, M; Bandeira, F

    2010-06-01

    Low birth weight is associated with obesity in later life and a more central fat distribution has a positive correlation with cardiovascular disease. However, the correlation between visceral adiposity in newborns and birth size is unknown. We measured the visceral adiposity in 118 newborns using the abdominal wall fat index (AFI), ratio between the maximum thickness of preperitoneal and the minimum thickness of subcutaneous fat evaluated by ultrasound. There was a weak negative correlation between AFI and birth weight (r = -0.197; P = 0.033) but not with birth length (r = -0.118; P = 0.201), body mass index (r = -0.138; P = 0.176) and abdominal circumference (r = 0.063; P = 0.497). In conclusion, we suggest that AFI is a useful parameter for evaluating the fat distribution in newborns and that visceral adiposity has a weak negative correlation with birth weight.

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

    PubMed

    Suleiman, Nergis Nina; Sandberg, Lars Johan Marcus

    2016-07-01

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

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

    PubMed Central

    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

  17. Congenital Anaplastic Rhabdomyosarcoma Presenting As Abdominal Wall Mass.

    PubMed

    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. PMID:26870149

  18. Changes in wall shear stresses in abdominal aortic aneurysms with increasing wall stiffness

    NASA Astrophysics Data System (ADS)

    Salsac, Anne-Virginie; Fernandez, Miguel

    2006-11-01

    During the growth of abdominal aortic aneurysms, local changes occur in the composition and structure of the diseased wall, resulting in its stiffening. A numerical simulation of the fluid structure interactions is performed in idealized models of aneurysms using a finite element method. A full coupling of the equations governing the pulsatile blood flow and the deformation of the compliant wall is undertaken. The effect of the progressive stiffening of the wall is analyzed at various stages in the growth of the aneurysm. Increasing the wall stiffness alters the distribution of wall shear stresses and leads to an increase in their magnitude. The wall compliance is shown to have a more pronounced effect on non-axisymmetric aneurysms, which sustain large displacements. The overall movement of the aneurysm models increases the three-dimensionality of the flow.

  19. Necrotizing Fasciitis of the Abdominal Wall Caused by Serratia Marcescens.

    PubMed

    Lakhani, Naheed A; Narsinghani, Umesh; Kumar, Ritu

    2015-04-15

    In this article, we present the first case of necrotizing fasciitis affecting the abdominal wall caused by Serratia marcescens and share results of a focused review of S. marcescens induced necrotizing fasciitis. Our patient underwent aorto-femoral bypass grafting for advanced peripheral vascular disease and presented 3 weeks postoperatively with pain, erythema and discharge from the incision site in the left lower abdominal wall and underwent multiple debridement of the affected area. Pathology of debrided tissue indicated extensive necrosis involving the adipose tissue, fascia and skeletal muscle. Wound cultures were positive for Serratia marcescens. She was successfully treated with antibiotics and multiple surgical debridements. Since necrotizing fasciitis is a medical and surgical emergency, it is critical to examine infectivity trends, clinical characteristics in its causative spectrum. Using PubMed we found 17 published cases of necrotizing fasciitis caused by Serratia marcescens, and then analyzed patterns among those cases. Serratia marcescens is prominent in the community and hospital settings, and information on infection presentations, risk factors, characteristics, treatment, course, and complications as provided through this study can help identify cases earlier and mitigate poor outcomes. Patients with positive blood cultures and those patients where surgical intervention was not provided or delayed had a higher mortality. Surgical intervention is a definite way to establish the diagnosis of necrotizing infection and differentiate it from other entities.

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

    PubMed

    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.

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

    PubMed

    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.

  2. An Abdominal Aorta Wall Extraction for Liver Cirrhosis Classification Using Ultrasonic Images

    NASA Astrophysics Data System (ADS)

    Hayashi, Takaya; Fujita, Yusuke; Mitani, Yoshihiro; Hamamoto, Yoshihiko; Segawa, Makoto; Terai, Shuji; Sakaida, Isao

    2011-06-01

    We propose a method to extract an abdominal aorta wall from an M-mode image. Furthermore, we propose the use of a Gaussian filter in order to improve image quality. The experimental results show that the Gaussian filter is effective in the abdominal aorta wall extraction.

  3. [Hematoma of the abdominal wall as differential diagnosis of cystic pelvic tumor].

    PubMed

    Marroquin-Nisch, J; Grüneberger, A; Hewel, T

    1995-02-01

    In a woman patient aged 80 years under anticoagulation with dicumarol (Marcumar), abdominal pain suddenly occurred which was located on the right side as well as signs of acute bleeding. Preoperative sonography and computer scan showed a large, cystic tumour, most likely originating from the right ovary with infiltration of the abdominal wall. Intraoperative diagnosis was a large haematoma of the abdominal wall and the retroperitoneum penetrating into the free abdomen.

  4. Bruises Around the Umbilicus in an Infant

    PubMed Central

    Hassan, Sam; Nakib, Ghassan; Saviour, Mary J.

    2016-01-01

    The most common causes of umbilical discharge in infancy are infection and umbilical granuloma that may be treated by antibiotics and topical application of silver nitrate subsequently. If the umbilical discharge persists or if there is any abnormal discoloration around the umbilicus, it is important to investigate for underlying congenital abnormality that may be cured by surgical intervention. Unusual presentation of omphalomesenteric duct cyst has been reported in literature. We report, for the first time as far as our search is concerned, a case of a 16-month-old infant who presented initially with persistent umbilical discharge and finally with bruising around the umbilicus in keeping with Cullen’s sign. A diagnosis of omphalomesenteric duct cyst containing pancreatic tissue was made on histopathological examination. This case emphasizes that, a persistent umbilical discharge and or discoloration around the umbilicus should be further investigated and an omphalomesenteric duct cyst can present as Cullen’s sign. PMID:27777702

  5. Postoperative fistula of the abdominal wall after laparascopic cholecystectomy due to lost gallstones.

    PubMed

    Weiler, H; Grandel, A

    2002-06-01

    Abdominal fistula caused by cholesterol gallstones, which remained in the abdominal wall after laparascopic cholecystectomy: a laparascopic cholecystectomy was performed in a 60-years-old man who was diagnosed as acute necrosing cholecystitis due to cholecystolithiasis. After removal of the gallbladder using an Endocath some gallstones remained in the excision channel of the abdominal wall. Therefore, a fistula developed in the excision channel postoperatively. As the wound healing was disturbed an investigation of the abdominal wall was performed by ultrasound. In the former excision channel several small, oval, formations with high echogenicity and faint ultrasound shadows were detected, corresponding to additional gallstones. After excision of granulation tissue and removal of the cholesterol stones, complete healing of the fistula in the abdominal wall was achieved. PMID:12044854

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

    PubMed Central

    Cornelissen, Maarten Philip; van Buijtenen, Jesse; van den Heuvel, Baukje; Bloemers, Frank; Geeraedts Jr., Leo

    2016-01-01

    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. PMID:27331068

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

    PubMed

    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.

  8. The surface landmarks of the abdominal wall: a plea for standardization

    PubMed Central

    Cirocchi, Roberto; Boselli, Carlo; Renzi, Claudio; Cagini, Lucio; Boccolini, Andrea; Noya, Giuseppe; Fingerhut, Abe

    2014-01-01

    Despite centuries of anatomical studies, controversies and contradictions still exist in the literature regarding the definition, anatomical terminology and the limits of the abdominal wall. We conducted a systematic research of books published from 1901 until December 2012 in Google Books. After the index screening, 16 remaining books were further assessed for eligibility. We decided to exclude journals. The aim of the study was to focus on surface landmarks and borders of the abdominal cavity. After this revision of the literature, we propose that the surface landmarks of the abdominal wall should be standardized. PMID:25097589

  9. Abdominal wall pain in obese women: frequently missed and easily treated

    PubMed Central

    Mishriki, Yehia Yousri

    2009-01-01

    Chronic abdominal pain is a common symptom with an extensive differential diagnosis. The work-up is frequently costly, yet many patients elude definitive diagnosis. We describe 12 obese women with long-standing abdominal pain, many of whom eluded diagnosis but who met criteria for abdominal wall pain. Each patient underwent a focused history and physical examination which included checking for Carnett’s sign and performing a “pinch test”. All patients had positive Carnett’s sign and pinch tests. An injection of local anaesthetic, with or without corticosteroid, completely relieved the pain within 10 min. Of the six patients seen in follow-up, four remained pain free and two responded to a second injection of local anaesthetic. Abdominal wall pain is an under-appreciated cause of chronic abdominal pain. Diagnosis is often straightforward and treatment with a local injection of anaesthetic is both diagnostic and curative. PMID:21686788

  10. [Approaches to the abdominal cavity and closure of the abdominal wall].

    PubMed

    Dittmar, Y; Rauchfuss, F; Ardelt, M; Settmacher, U

    2011-12-01

    Although minimally invasive approaches to the abdominal cavity are becoming increasingly more important, open surgical techniques are still of essential interest and must be mastered by general and visceral surgeons. The choice of the particular approach depends on the specificity and location of the scheduled procedure. The following article is intended to give an overview on the current literature as well as experiences in the field of open surgical approaches to the abdominal cavity.

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

    PubMed

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

    2002-02-01

    During laparoscopic cholecystectomy, perforation of the gallbladder can occurs in < or = 20% of cases, while gallstone spillage occurs in < or = 6% of cases. In most cases, there are no consequences. Gallstones can be lost in the abdominal wall as well as the abdomen during extraction of the gallbladder. The fate of such lost gallstones, which can lead to the formation of an abscess, an abdominal wall mass, or a persistent sinus, has not been studied adequately. Herein we report the case of a persistent sinus of the abdominal wall after an emergent laparoscopic cholecystectomy in an 82-year-old woman with gangrenous cholecystitis and perforation of the friable wall in association with an empyema of the gallbladder. The culture of the obtained pus was positive for Escherichia coli. After a small leak of dirty fluid from the wound of the epigastric port site of 4 months' duration, surgical exploration under local anesthesia revealed that the sinus was caused by spilled gallstones impacting into the abdominal wall between the posterior sheath and left rectus abdominalis muscle. The removal of the stones resulted in complete healing. Long-term complications after laparoscopic cholecystectomy involving the abdominal wall are rare but important possible consequences that could be avoided. PMID:11967704

  12. Primary closure of the abdominal wall after "open abdomen" situation.

    PubMed

    Kääriäinen, M; Kuokkanen, H

    2013-01-01

    "Open abdomen" is a strategy used to avoid or treat abdominal compartment syndrome. It has reduced mortality both in trauma and non-trauma abdominal catastrophes but also has created a challenging clinical problem. Traditionally, open abdomen is closed in two phases; primarily with a free skin graft and later with a flap reconstruction. A modern trend is to close the abdomen within the initial hospitalization. This requires multi-professional co-operation. Temporary abdominal closure methods, e.g. negative pressure wound therapy alone or combined with mesh-mediated traction, have been developed to facilitate direct fascial closure. Components separation technique, mesh reinforcement or bridging of the fascial defect with mesh and perforator saving skin undermining can be utilized in the final closure if needed. These techniques can be combined. Choice of the treatment depends on the condition of the patient and size of the fascia and skin defect, and the state of the abdominal contents. In this paper we review the literature on the closure of an open abdomen and present the policy used in our institution in the open abdomen situations.

  13. Paragonimiasis mimicking chest cancer and abdominal wall metastaisis: A case report

    PubMed Central

    ZHOU, RONGXING; ZHANG, MINJIA; CHENG, NANSHENG; ZHOU, YONG

    2016-01-01

    Typical human paragonimiasis demonstrates an elevated eosinophil count, positive immunoblot, nodular shadows of the lung and pleural thickening with pleural effusion, and these symptoms may be confused with chest cancer. In the present case, a rare case of human paragonimiasis mimicking chest cancer and abdominal wall metastasis is described, the 39-year-old male patient was admitted in our hospital for cough, weight loss 5 kg and a firm mass in right upper abdominal wall. The laboratory test showed unremarkable hematology and biochemistry results. Chest X-ray, Plain computed tomography of the chest and abdomen showed right pleural effusion, several nodules in right lower lung and a mass in the right upper abdominal wall. The initial diagnosis was lung or chest cancer with abdominal wall metastasis, and the abdominal wall mass was resected for the final diagnosis. The biopsy revealed eosinophilic granuloma with Charcot-Leyden crystal formation infiltrated in the muscular fibers. Subsequent to assessment of the antibodies against parasites, the final diagnosis of paragonimiasis was made. PMID:27313691

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

    SciTech Connect

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

    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

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

    PubMed Central

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

    2013-01-01

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

  16. Testicular Ectopia in the Anterior Abdominal Wall of a Neonate: A Rare Site of Ectopic Testis

    PubMed Central

    Siddiqui, Salman Atiq; Marei, Tamer Ibrahim; Al-Makhaita, Ghada

    2016-01-01

    Patient: Male, 3-day Final Diagnosis: Ectopic right testis in anterior abdominal wall Symptoms: — Medication: — Clinical Procedure: Testicular ultrasound and MRI abdomen Specialty: Radiology Objective: Unusual clinical course Background: Abnormal testicular descent can either be undescended or, less commonly, ectopic. Most undescended testes complete the course of descent by the first year of life only if these remain in the normal path of descent. The deviation of the testis may occur to an ectopic location during the transinguinal phase. Of the known ectopic sites, the anterior abdominal wall is the rarest site of testicular ectopia and to our knowledge only 3 cases of this nature have been reported in the available literature to date. Case Report: This rare case of testicular ectopia occurred in a 3-day-old boy in whom the right scrotal sac was empty; on abdominal ultrasound, the right testis was found in the subcutaneous tissues of the right antero-lateral abdominal wall. These findings were confirmed on abdominal MRI, where the right testis was seen beneath the skin between the subcutaneous tissues and external oblique aponeurosis. No aponeurotic or muscular defect was appreciable under the abdominal wall. The neonate underwent orchiopexy at the age of 6 months and remained uneventful postoperatively. Conclusions: Preoperative imaging is recommended to detect and confirm the ectopic site as well as the morphology of testis, thereby increasing the chance of surveillance and preservation of an ectopic testis. Imaging can serve as preoperative road mapping to localize the exact site for surgical exploration of an ectopic testis if there is no apparent or palpable swelling over the anterior abdominal wall. PMID:27411886

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

    PubMed Central

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

    2015-01-01

    Background Incisional hernias are a complication in 10% of all open abdominal operations and can result in significant morbidity. The purpose of this study is to determine if inhibiting abdominal muscle contraction influences incisional hernia formation during laparotomy healing. We hypothesize that reducing abdominal musculature deformation reduces incisional hernia occurrence and size. Study Design Using an established rat model for incisional hernia, a laparotomy through the linea alba was closed with one mid-incision, fast-absorbing suture. Three groups were compared: a SHAM group (SHAM; n = 6) received no laparotomies while the Saline Hernia (SH; n = 6) and Botox Hernia (BH; n = 6) groups were treated once with equal volume saline or Botulinum Toxin (Botox®, Allergan) before the incomplete laparotomy closure. On post-operative day 14, the abdominal wall was examined for herniation and adhesions and contractile forces were measured for abdominal wall muscles. Results No hernias developed in SHAM rats. Rostral hernias developed in all SH and BH rats. Caudal hernias developed in all SH rats, but in only 50% of the BH rats. Rostral hernias in the BH group were 35% shorter and 43% narrower compared to those in the SH group (p < 0.05). The BH group had weaker abdominal muscles compared to the SHAM and SH groups (p < 0.05). Conclusions In our rat model, partial paralysis of abdominal muscles reduces the number and size of incisional hernias. These results confirm abdominal wall muscle contractions play a significant role in the pathophysiology of incisional hernia formation. PMID:25817097

  18. Polymicrobial abdominal wall necrotizing fasciitis after cesarean section.

    PubMed

    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.

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

    SciTech Connect

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

    2010-02-15

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

  20. Abdominal wall injuries: rectus abdominis strains, oblique strains, rectus sheath hematoma.

    PubMed

    Johnson, Rob

    2006-04-01

    Abdominal wall injuries are reported to be less common than actually perceived by sports medicine practitioners. National Collegiate Athletic Association injury statistics for 2004-2005 cite a high of 0.71 abdominal muscle injuries per 1000 player-hours in wrestling competition to a low of 0.01 injuries per 1000 player-hours in autumn football practices. British professional soccer clubs reported an incidence of "torso" injuries of up to 7% of all injuries over the course of several seasons. Injury definition is most likely the explanation for this discrepancy. The abdominal wall muscles (rectus abdominis, external and internal obliques, and transverse abdominis) are injured by direct blows to the abdomen or by sudden or repetitive trunk movement, either rotation or flexion/extension. With the exception of the rare rectus sheath hematoma that does not self-tamponade, the treatment for these problems is nonoperative with symptoms guiding rehabilitation and return to play decisions.

  1. QUALITY OF LIFE OF IN PATIENTS SUBMITTED TO ANTERIOR ABDOMINAL WALL LAPAROSCOPIC HERNIOPLASTY

    PubMed Central

    ABDALLA, Ricardo Zugaib; GARCIA, Rodrigo Biscuola; SAID, Danniel Frade; ABDALLA, Beatrice Martinez Zugaib

    2014-01-01

    Background The laparoscopic ventral hernia repair technique made possible surgeries with smaller skin incisions and smaller dissection of the soft tissue around the hernia, therefore with a better wound, a quicker postoperative recovery and a lower complication rate. Aim To evaluate the applicability of a quality of life survey based on the molds of the American Hernia Society, European Hernia Society and Carolinas Equation for Quality of Life, through telephone in patients submitted to laparoscopic hernioplasty by IPOM technique. Methods A retrospective cohort study was made to evaluate the quality of life of 21 patients that underwent anterior abdominal wall laparoscopic hernioplasty by intraperitoneal onlay mesh technique. Questionnaire was applied through telephone. Results Of the 21 patients, 19% felt that the hernia recurred. Also 19% passed through another abdominal wall surgery, and among these, 75% was related to the previously hernia correction. Finally, 81% of patients did not undergo any other abdominal wall surgery. Conclusion It was possible to apply the quality of life questionnary by telephone on patients who underwent an anterior abdominal wall. The results, in its turn, were satisfactory and showed that patients, in general, were satisfied with the surgical procedure. PMID:24676295

  2. US and MRI features in venous vascular malformation of the abdominal wall. A case report

    PubMed Central

    Alessandrino, F.; Maira, A.; Tarantino, C.C.

    2012-01-01

    Vascular anomalies are classified as vascular tumors and vascular malformations. Venous vascular malformations are the most common type of vascular malformation. They may be isolated or multiple and they rarely affect the trunk. The authors report a rare case of isolated venous vascular malformation of the abdominal wall with an emphasis on the related MRI and ultrasound (US) features. PMID:23450707

  3. Management of complex abdominal wall defects using acellular porcine dermal collagen.

    PubMed

    Chavarriaga, Luis Felipe; Lin, Edward; Losken, Albert; Cook, Michael W; Jeansonne, Louis O; White, Brent C; Sweeney, John F; Galloway, John R; Davis, S Scott

    2010-01-01

    Multiple techniques have been used for the repair of complex abdominal wall defects after recurrent incisional hernias with varying rates of success. Primary repair has been associated with high recurrence rates, and prosthetic mesh placement is contraindicated in contaminated surgical fields. The development of biologic prostheses has changed the approach to these difficult problems. This study evaluates the management of complex abdominal wall defects using acellular porcine dermal collagen. Between August 2006 and May 2007, 18 patients underwent abdominal wall reconstruction for complex defects with acellular porcine dermal collagen (CollaMend; Bard Inc., Warwick, RI). Patient demographics, preoperative risk factors, previous herniorrhaphy attempts, postoperative complications, recurrences, and long-term results were retrospectively reviewed. Records were reviewed at a mean follow up of 7.3 months; the recurrence rate was 44.4 per cent. A total of 38.9 per cent (seven of 18) developed a postoperative wound complications, including infection in 22.2 per cent (four of 18). All of the patients with infection required prosthesis removal as a result of encapsulation rather than incorporation of the biologic prosthesis. Acellular porcine dermal collagen has the potential for reconstruction of abdominal wall defects with postoperative wound occurrences comparable with other biologic materials. Encapsulation of the material was a major problem in cases with wound infection that required graft removal rather than local wound measures. Hernia recurrence and dehiscence of the graft were problems in noncompromised surgical fields.

  4. [Prophylactics and treatment of postoperative hernias of the lateral abdominal walls using polypropylene endoprosthesis].

    PubMed

    Sukovatykh, B S; Valuĭskaia, N M; Pravednikova, N V; Netiaga, A A; Kas'ianova, M A; Zhukovskiĭ, V A

    2011-01-01

    An analysis of complex examination and treatment of 151 patients after planned and performed surgical interventions on organs of the retroperitoneal space was made. The patients were divided into 4 groups. The first group (of comparison) included 46 patients who were treated by lumbotomy for different diseases of organs of the urinary system. In 35 patients of the second group (prophylactics) the indications were determined and in 20 patients preventive endoprosthesis of the lateral abdominal wall using polypropylene endoprosthesis was fulfilled. Herniotomy with plasty of the lateral abdominal wall using local tissues was fulfilled in 30 patients. Prosthesing hernioplasty of the lateral abdominal wall was fulfilled in 40 patients of the main group. It was found that preventive endoprosthesis of the lateral abdominal wall allowed prevention of progressing anatomo-functional i/isufficiency and the appearance of postoperative hernias. The application of polypropylene endoprosthesis for the treatment of postoperative hernias allows obtaining 36.4% more good results as compared with the control group, 21.7% decreased number of satisfactory results and no recurrent hernias.

  5. Closure of the abdominal wall with acellular dermal allograft in intestinal transplantation.

    PubMed

    Mangus, R S; Kubal, C A; Tector, A J; Fridell, J A; Klingler, K; Vianna, R M

    2012-12-01

    Loss of abdominal domain is a common problem in intestinal transplantation. Several surgical options are available perioperatively for abdominal wall reconstruction. This study reports the management and complications for intestinal transplant patients with abdominal wall closure either primarily or with foreign material. This single center study reviews the records of intestinal transplant patients between 2004 and 2010. Study outcomes included reoperation for dehiscence, hernia or enterocutaneous fistula. There were 37 of 146 patients (25%) who required implantation of foreign material at transplant. Of these 37, 30 (81%) had implantation of acellular dermal allograft (ADA) and 7 (19%) implantation of another mesh. Perioperative dehiscence was rare with 2/109 (2%) for primary closure, 0/30 (0%) for ADA and 1/7 (14%) for other mesh. There were 12/146 (8%) patients who underwent ventral hernia repair: primary closure 7/109 (6%), ADA 3/30 (10%) and other mesh 2/7 (28%). There were 4/146 (3%) patients who required surgery for enterocutaneous fistulas: 2/109 (2%) primary closure, 1/30 (3%) ADA and 1/7 (14%) synthetic mesh. Abdominal wall reconstruction with ADA biologic mesh provides an expeditious means of performing a tension-free closure of the fascial layer after intestinal transplantation with complications similar to those seen for primary closure.

  6. Use of absorbable mesh as an aid in abdominal wall closure in the emergent setting.

    PubMed

    Buck, J R; Fath, J J; Chung, S K; Sorensen, V J; Horst, H M; Obeid, F N

    1995-08-01

    A surgeon has many options available to aid in the closure of abdominal wall defects in the elective setting. In the emergent setting, active infection or contamination increases the likelihood of infection of permanent prosthetic material and limits the surgical options. In such settings, we have used absorbable mesh (Dexon) as an adjunct to fascial closure until the acute complications resolve. To evaluate the effectiveness of this technique, we reviewed the outcome of such closures in 26 critically ill patients. Between July 1987 and June 1993, 26 patients were identified who had placement of absorbable mesh as part of an emergent laparotomy at a major urban trauma center. Through a retrospective chart review, the incidence of complications and outcome of the closure were tabulated. Seven patients were initially operated on for trauma. Two of the patients had mesh placement at their initial procedure secondary to fascial loss from trauma. The remainder of the patients hd mesh placement during a subsequent laparotomy for complications related to their initial procedure. Indications for these laparotomies included combinations of wound dehiscence, intra-abdominal abscess, anastomotic disruption, and perforation. Mesh placement in patients with intra-abdominal infection created effectively open abdominal wounds that allowed continued abdominal drainage, but required extensive wound care. Despite the absorbable nature of the mesh and often prolonged hospital stay in these ill patients, none of them required reoperation for dehiscence, recurrence of intra-abdominal abscess, or infection of the mesh.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Surgical approach to abdominal wall defects: history and new trends.

    PubMed

    Basile, Francesco; Biondi, Antonio; Donati, Marcello

    2013-01-01

    We briefly outline the history of hernia surgery development from the Ebers Papyrus to modern prosthetic repairs. The rapid evolution of anatomical, physiological and pathogenetic concepts has involved the rapid evolution of surgical treatments. From hernia sack cauterization to sack ligation, posterior wall repair (Bassini), and prosthetic reinforcement there has been an evident improvement in surgical treatment results that has stimulated surgeons to find new technical solutions over time. The introduction of prosthetic repair, the laparoscopic revolution, the impact of local anesthesia and the diffusion of day surgery have been the main advances of the last 50 years. Searching for new gold standards, the introduction of new devices has also led to new complications and problems. Research of the last 10 years has been directed to overcome prosthetic repair complications, introducing every year new meshes and materials. Lightweight meshes, composite meshes and biologic meshes are novelties of the last few years. We also take a look at future trends. PMID:24380545

  8. Traumatic disruption of the abdominal wall: lap-belt injuries in children.

    PubMed

    Moremen, Jacob R; Nakayama, Don K; Ashley, Dennis W; Astin, Matthew; Nolan, Tracy L

    2013-04-01

    Traumatic abdominal wall hernia (TAWH) from high speed mechanism is a unique finding in adult trauma, and exceedingly rare in pediatrics. The majority of reports are of low-speed "handlebar" hernias associated with direct injury by bicycle handlebars. We report a series of three pediatric patients in motor vehicle collisions (MVC) who experienced TAWH by lap-belt and associated intra-abdominal injuries necessitating immediate operative intervention. Different operative approaches were used in each case to manage the varying types of disruptions. This adds to the pediatric literature the largest series of its kind.

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

    PubMed Central

    Downey, Susan; Agullo, Frank; Lehfeldt, Max R.; Kind, Gabriel M.; Palladino, Humberto; Marshall, Deirdre; Jewell, Mark L.; Mathur, Anshu B.; Bengtson, Bradley P.

    2014-01-01

    Background: Preclinical studies have demonstrated that macroporous silk fibroin protein scaffolds are capable of promoting physiologically durable supportive tissue, which favors application of these engineered tissues for clinical implantation. The safety and effectiveness of a long-lasting, transitory, 510(k)-cleared purified silk fibroin biologic scaffold (SBS) are investigated for soft-tissue support and repair of the abdominal wall. Methods: We conducted a multicenter retrospective review of all consecutive patients who underwent abdominal wall soft-tissue reinforcement with an SBS device between 2011 and 2013. Indications, comorbid conditions, surgical technique, complications, and outcomes were evaluated. Results: We reviewed the records of 172 consecutive patients who received an SBS for soft-tissue support. Of those, 77 patients underwent abdominal wall fascial repair, with a mean follow-up of 18.4 ± 7.5 months. Procedures using an SBS included reinforcement of an abdominal-based flap donor site (31.2%), ventral hernia repair (53.2%), and abdominoplasty (15.6%). The overall complication rate was 6.5%, consisting of 2 wound dehiscences, 1 with device exposure, 1 seroma, 1 infection with explantation, and a perioperative bulge requiring reoperation. There were no reports of hernia. 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. PMID:25506529

  10. Histological characteristics of the abdominal aortic wall in patients with vascular chronic Q fever

    PubMed Central

    Hagenaars, Julia C J P; Koning, Olivier H J; van den Haak, Ronald F F; Verhoeven, Bart A N; Renders, Nicole H M; Hermans, Mirjam H A; Wever, Peter C; van Suylen, Robert Jan

    2014-01-01

    The aim of this study was to describe specific histological findings of the Coxiella burnetii-infected aneurysmal abdominal aortic wall. Tissue samples of the aneurysmal abdominal aortic wall from seven patients with chronic Q fever and 15 patients without evidence of Q fever infection were analysed and compared. Chronic Q fever was diagnosed using serology and tissue PCR analysis. Histological sections were stained using haematoxylin and eosin staining, Elastica van Gieson staining and immunohistochemical staining for macrophages (CD68), T lymphocytes (CD3), T lymphocyte subsets (CD4 and CD8) and B lymphocytes (CD20). Samples were scored by one pathologist, blinded for Q fever status, using a standard score form. Seven tissue samples from patients with chronic Q fever and 15 tissue samples from patients without Q fever were collected. Four of seven chronic Q fever samples showed a necrotizing granulomatous response of the vascular wall, which was characterized by necrotic core of the arteriosclerotic plaque (P = 0.005) and a presence of high numbers of macrophages in the adventitia (P = 0.007) distributed in typical palisading formation (P = 0.005) and surrounded by the presence of high numbers of T lymphocytes located diffusely in media and adventitia. Necrotizing granulomas are a histological finding in the C. burnetii-infected aneurysmal abdominal aortic wall. Chronic Q fever should be included in the list of infectious diseases with necrotizing granulomatous response, such as tuberculosis, cat scratch disease and syphilis. PMID:24953727

  11. Abdominal Wall Endometriosis on the Right Port Site After Laparoscopy: Case Report and Literature Review

    PubMed Central

    Cozzolino, Mauro; Magnolfi, Stefania; Corioni, Serena; Moncini, Daniela; Mattei, Alberto

    2015-01-01

    Background Endometriosis can be intrapelvic or, rarely, extrapelvic. Endometriosis involving the rectus abdominis muscle on the trocar port site is a rare event; until now, only 16 cases have been reported in the literature. The majority of cases were associated with previous abdominal surgery such as diagnostic laparoscopy, cyst excision, appendectomy, myomectomy, or cholecystectomy. We review all the reported cases of this unusual form of extrapelvic endometriosis. Case Report We report a new case of abdominal wall endometriosis at the trocar port site in the rectus abdominis muscle in a woman who had undergone 2 laparoscopies for endometriosis in the 3 years before coming to our attention. The diagnosis was made by sonography. We performed a surgical resection of the lesion with a free macroscopic margin of 5-10 mm. Conclusion Endometriosis should be considered in the differential diagnosis of any abdominal swelling. In our experience, surgery is the treatment of choice. PMID:26412997

  12. What's new in medical management strategies for raised intra-abdominal pressure: evacuating intra-abdominal contents, improving abdominal wall compliance, pharmacotherapy, and continuous negative extra-abdominal pressure.

    PubMed

    De Keulenaer, Bart; Regli, Adrian; De Laet, Inneke; Roberts, Derek; Malbrain, Manu L N G

    2015-01-01

    In the future, medical management may play an increasingly important role in the prevention and management of intra-abdominal hypertension (IAH). A review of different databases was used (PubMed, MEDLINE and EMBASE) with the search terms 'Intra-abdominal Pressure' (IAP), 'IAH', ' Abdominal Compartment Syndrome' (ACS), 'medical management' and 'non-surgical management'. We also reviewed all papers with the search terms 'IAH', 'IAP' and 'ACS' over the last three years, only extracting those papers which showed a novel approach in the non-surgical management of IAH and ACS.IAH and ACS are associated with increased morbidity and mortality. Non-surgical management is an important treatment option in critically ill patients with raised IAP. There are five medical treatment options to be considered to reduce IAP: 1) improvement of abdominal wall compliance; 2) evacuation of intra-luminal contents; 3) evacuation of abdominal fluid collections; 4) optimisation of fluid administration; and 5) optimisation of systemic and regional perfusion. This paper will review the first three treatment arms of the WSACS algorithm: abdominal wall compliance; evacuation of intra-luminal contents and evacuation of abdominal fluid collections. Emerging medical treatments will be analysed and finally some alternative specific treatments will be assessed. Other treatment options with regard to optimising fluid administration and systemic and regional perfusion will be described elsewhere, and are beyond the scope of this review. Medical management of critically ill patients with raised IAP should be instigated early to prevent further organ dysfunction and to avoid progression to ACS. Many treatment options are available and are often part of routine daily management in the ICU (nasogastric, rectal tube, prokinetics, enema, sedation, body position). Some of the newer treatments are very promising options in specific patient populations with raised IAP. Future studies are warranted to confirm

  13. Use of bovine pericardium graft for abdominal wall reconstruction in contaminated fields

    PubMed Central

    D’Ambra, Luigi; Berti, Stefano; Feleppa, Cosimo; Magistrelli, Prospero; Bonfante, Pierfrancesco; Falco, Emilio

    2012-01-01

    AIM: To employ, in such conditions, a biological graft such as bovine pericardium that offers resistance to infection. METHODS: In our surgical department, from January 2006 to June 2010, 48 patients underwent abdominal wall reconstruction using acellular bovine pericardium; of these 34 patients had a contaminated wound due to diffuse peritonitis (complicated diverticulitis, bowel perforation, intestinal infarction, strangled hernia, etc.) and 14 patients had hernia relapse on infected synthetic mesh. RESULTS: In our series, one patient died of multi-organ failure 3 d after surgery. After placement of the pericardium mesh four cases of hernia relapse occurred. CONCLUSION: Recurrence rate is similar to that of prosthetic mesh repair and the application of acellular bovine pericardium (Tutomesh®, Tutogen Medical Gmbh Germany) is moreover a safe and feasible option that can be employed to manage complicated abdominal wall defects where prosthetic mesh is unsuitable. PMID:22905285

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

    PubMed

    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.

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

    PubMed Central

    Krentel, H.; Tchartchian, G.; De Wilde, R. L.

    2012-01-01

    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. PMID:22778752

  16. The Use of an Anterior Abdominal Wall Peritoneal Flap in the Laparoscopic Repair of Vesicouterine Fistula

    PubMed Central

    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. PMID:25216441

  17. Lateral Abdominal Wall Defects: The Importance of Anatomy and Technique for a Successful Repair

    PubMed Central

    Pulikkottil, Benson J.; Pezeshk, Ronnie A.; Daniali, Lily N.; Bailey, Steven H.; Mapula, Steven

    2015-01-01

    Summary: Flank and lateral abdominal wall defects can be an extremely challenging phenomenon for surgeons to undertake. Their rarity and specific idiosyncrasies in regard to embryologic and anatomical characteristics must be taken into consideration when formulating an operative plan. We will discuss these cardinal points including technical recommendations by notable experts in the field to gain a better understanding in the diagnosis and treatment of this infrequent but morbid occurrence. PMID:26495194

  18. Evolution of the wall shear stresses during the progressive enlargement of symmetric abdominal aortic aneurysms

    NASA Astrophysics Data System (ADS)

    Salsac, A.-V.; Sparks, S. R.; Chomaz, J.-M.; Lasheras, J. C.

    2006-08-01

    The changes in the evolution of the spatial and temporal distribution of the wall shear stresses (WSS) and gradients of wall shear stresses (GWSS) at different stages of the enlargement of an abdominal aortic aneurysm (AAA) are important in understanding the aetiology and progression of this vascular disease since they affect the wall structural integrity, primarily via the changes induced on the shape, functions and metabolism of the endothelial cells. Particle image velocimetry (PIV) measurements were performed in in vitro aneurysm models, while changing their geometric parameters systematically. It has been shown that, even at the very early stages of the disease, i.e. increase in the diameter ≤ 50%, the flow separates from the wall and a large vortex ring, usually followed by internal shear layers, is created. These lead to the generation of WSS that drastically differ in mean and fluctuating components from the healthy vessel. Inside the AAA, the mean WSS becomes negative along most of the aneurysmal wall and the magnitude of the WSS can be as low as 26% of the value in a healthy abdominal aorta.

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

    PubMed

    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.

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

    PubMed Central

    Bury, Kamil; Śmietański, Maciej

    2015-01-01

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

  1. [Indications and results of preventive endoprosthezing of the abdominal wall during operations on organs of the abdominal cavity and retroperitoneal space].

    PubMed

    Sukovatykh, B S; Valuĭskaia, N M; Netiaga, A A; Zhukovskiĭ, V A; Pravednikova, N V; Kas'ianova, M A

    2011-01-01

    Complex examination and treatment of 120 patients with anatomo-functional insufficiency of the abdominal wall was made after operations on organs of the abdominal cavity and retroperitoneal space. In the 1st group (60 patients) the abdominal wall was sutured by traditional methods. In the 2nd group (60 patients) laparotomy was followed by implantation of polypropylene endoprosthesis by over-aponeurotic method, and suturing of the lateral wall--by sub-aponeurotic method. At the long-term postoperative period the postoperative ventral hernias were formed in 21.6% of patients of the 1st group, in the 2nd group of patients hernias were not detected. Physical component of quality of life of the 2nd group was 1.5 times, and mental component 1.7 times higher than in the 1st group.

  2. Use of computerized tomography of the abdominal wall in the diagnosis of partial post-operative wound dehiscence.

    PubMed Central

    Smith-Behn, J.; Arnold, M.; Might, J.

    1986-01-01

    A patient had occult post-operative partial wound dehiscence which was accurately diagnosed by performing a CT scan of the abdomen. It is suggested that CT scan of the abdominal wall is useful for early diagnosis of occult abdominal wound dehiscence. Images Figure 1 Figure 2 PMID:2946035

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  5. Local influence of calcifications on the wall mechanics of abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    de Putter, Sander; van de Vosse, Frans N.; Breeuwer, Marcel; Gerritsen, Frans A.

    2006-03-01

    Finite element wall stress simulations on patient-specific models of abdominal aortic aneurysm (AAA) may provide a better rupture risk predictor than the currently used maximum transverse diameter. Calcifications in the wall of AAA lead to a higher maximum wall stress and thus may lead to an elevated rupture risk. The reported material properties for calcifications and the material properties actually used for simulations show great variation. Previous studies have focused on simplified modelling of the calcification shapes within a realistic aneurysm shape. In this study we use an accurate representation of the calcification geometry and a simplified model for the AAA. The objective of this approach is to investigate the influence of the calcification geometry, the material properties and the modelling approach for the computed peak wall stress. For four realistic calcification shapes from standard clinical CT images of AAA, we performed simulations with three distinct modelling approaches, at five distinct elasticity settings. The results show how peak wall stress is sensitive to the material properties of the calcifications. For relatively elastic calcifications, the results from the different modelling approaches agree. Also, for relatively elastic calcifications the computed wall stress in the tissue surrounding the calcifications shows to be insensitive to the exact calcification geometry. For stiffer calcifications the different modelling approaches and the different geometries lead to significantly different results. We conclude that an important challenge for future research is accurately estimating the material properties and the rupture potential of the AAA wall including calcifications.

  6. Impact of calcifications on patient-specific wall stress analysis of abdominal aortic aneurysms.

    PubMed

    Maier, A; Gee, M W; Reeps, C; Eckstein, H-H; Wall, W A

    2010-10-01

    As a degenerative and inflammatory desease of elderly patients, about 80% of abdominal aortic aneurysms (AAA) show considerable wall calcification. Effect of calcifications on computational wall stress analyses of AAAs has been rarely treated in literature so far. Calcifications are heterogeneously distributed, non-fibrous, stiff plaques which are most commonly found near the luminal surface in between the intima and the media layer of the vessel wall. In this study, we therefore investigate the influence of calcifications as separate AAA constituents on finite element simulation results. Thus, three AAAs are reconstructed with regard to intraluminal thrombus (ILT), calcifications and vessel wall. Each patient-specific AAA is simulated twice, once including all three AAA constituents and once neglecting calcifications as it is still common in literature. Parameters for constitutive modeling of calcifications are thereby taken from experiments performed by the authors, showing that calcifications exhibit an almost linear stress-strain behavior with a Young's modulus E ≥ 40 MPa. Simulation results show that calcifications exhibit significant load-bearing effects and reduce stress in adjacent vessel wall. Average stress within the vessel wall is reduced by 9.7 to 59.2%. For two out of three AAAs, peak wall stress decreases when taking calcifications into consideration (8.9 and 28.9%). For one AAA, simulated peak wall stress increases by 5.5% due to stress peaks near calcification borders. However, such stress singularities due to sudden stiffness jumps are physiologically doubtful. It can further be observed that large calcifications are mostly situated in concavely shaped regions of the AAA wall. We deduce that AAA shape is influenced by existent calcifications, thus crucial errors occur if they are neglected in computational wall stress analyses. A general increase in rupture risk for calcified AAAs is doubted.

  7. Impact of calcifications on patient-specific wall stress analysis of abdominal aortic aneurysms.

    PubMed

    Maier, A; Gee, M W; Reeps, C; Eckstein, H-H; Wall, W A

    2010-10-01

    As a degenerative and inflammatory desease of elderly patients, about 80% of abdominal aortic aneurysms (AAA) show considerable wall calcification. Effect of calcifications on computational wall stress analyses of AAAs has been rarely treated in literature so far. Calcifications are heterogeneously distributed, non-fibrous, stiff plaques which are most commonly found near the luminal surface in between the intima and the media layer of the vessel wall. In this study, we therefore investigate the influence of calcifications as separate AAA constituents on finite element simulation results. Thus, three AAAs are reconstructed with regard to intraluminal thrombus (ILT), calcifications and vessel wall. Each patient-specific AAA is simulated twice, once including all three AAA constituents and once neglecting calcifications as it is still common in literature. Parameters for constitutive modeling of calcifications are thereby taken from experiments performed by the authors, showing that calcifications exhibit an almost linear stress-strain behavior with a Young's modulus E ≥ 40 MPa. Simulation results show that calcifications exhibit significant load-bearing effects and reduce stress in adjacent vessel wall. Average stress within the vessel wall is reduced by 9.7 to 59.2%. For two out of three AAAs, peak wall stress decreases when taking calcifications into consideration (8.9 and 28.9%). For one AAA, simulated peak wall stress increases by 5.5% due to stress peaks near calcification borders. However, such stress singularities due to sudden stiffness jumps are physiologically doubtful. It can further be observed that large calcifications are mostly situated in concavely shaped regions of the AAA wall. We deduce that AAA shape is influenced by existent calcifications, thus crucial errors occur if they are neglected in computational wall stress analyses. A general increase in rupture risk for calcified AAAs is doubted. PMID:20143120

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

    PubMed

    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.

  9. A simulation framework for estimating wall stress distribution of abdominal aortic aneurysm.

    PubMed

    Qin, Jing; Zhang, Jing; Chui, Chee-Kong; Huang, Wei-Min; Yang, Tao; Pang, Wai-Man; Sudhakar, Venkatesh; Chang, Stephen

    2011-01-01

    Abdominal aortic aneurysm (AAA) rupture is believed to occur when the mechanical stress acting on the wall exceeds the strength of the wall tissue. In endovascular aneurysm repair, a stent-graft in a catheter is released at the aneurysm site to form a new blood vessel and protect the weakened AAA wall from the pulsatile pressure and, hence, possible rupture. In this paper, we propose a framework to estimate the wall stress distribution of non-stented/stented AAA based on fluid-structure interaction, which is utilized in a surgical simulation system (IRAS). The 3D geometric model of AAA is reconstructed from computed tomography angiographic (CTA) images. Based on our experiments, a combined logarithm and polynomial strain energy equation is applied to model the elastic properties of arterial wall. The blood flow is modeled as laminar, incompressible, and non-Newtonian flow by applying Navier-Stokes equation. The obtained pressure of blood flow is applied as load on the AAA meshes with and without stent-graft and the wall stress distribution is calculated by fluid-structure interaction (FSI) solver equipped in ANSYS. Experiments demonstrate that our analytical results are consistent with clinical observations. PMID:22254456

  10. The influence of intraluminal thrombus on noninvasive abdominal aortic aneurysm wall distensibility measurement.

    PubMed

    Metaxa, Eleni; Kontopodis, Nikolaos; Vavourakis, Vasileios; Tzirakis, Konstantinos; Ioannou, Christos V; Papaharilaou, Yannis

    2015-04-01

    Abdominal aortic aneurysm wall distensibility can be estimated by measuring pulse pressure and the corresponding sac volume change, which can be obtained by measuring wall displacement. This approach, however, may introduce error if the role of thrombus in assisting the wall in bearing the pulse pressure loading is neglected. Our aim was to introduce a methodology for evaluating and potentially correcting this error in estimating distensibility. Electrocardiogram-gated computed tomography images of eleven patients were obtained, and the volume change between diastole and systole was measured. Using finite element procedures, we determined the equivalent pulse pressure loading that should be applied to the wall of a model where thrombus was digitally removed, to yield the same sac volumetric increase caused by applying the luminal pulse pressure to the model with thrombus. The equivalent instead of the measured pulse pressure was used in the distensibility expression. For a relative volumetric thrombus deposition (V ILT) of 50 %, a 62 % distensibility underestimation resulted when thrombus role was neglected. A strong linear correlation was observed between distensibility underestimation and V ILT. To assess the potential value of noninvasive wall distensibility measurement in rupture risk stratification, the role of thrombus on wall loading should be further investigated. PMID:25548097

  11. [Gastrointestinal stromal tumor of the abdominal wall. An unusual localization of a rare tumor].

    PubMed

    Thalheimer, A; Meyer, D; Gattenlöhner, S; Timmermann, W; Thiede, A

    2004-07-01

    Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. We describe here for the first time a patient with a huge GIST of the abdominal wall without any relation to the gastrointestinal tract, omentum, or mesentery. With regard to the size of 24 cm and a low mitotic index, this GIST is considered an intermediate risk for metastasis. Radical surgical resection was performed with negative pathologic resection margins. The classic immunohistochemical phenotype of the tumor described facilitates the differential diagnosis to exclude abdominal desmoid tumor and solitary fibrous tumor (SFT). In the case of metastasis, therapeutic nihilism no longer seems justified with the availability of imatinib, a tyrosine kinase inhibitor, which shows encouraging results in the therapy of metastatic GIST.

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

    PubMed

    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.

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

    PubMed Central

    Jung, Sharon Jiyoon; Kim, Min-Suk; Lee, Jin-Kyu; Kim, Young-Jae; Soh, Kwang-Sup

    2016-01-01

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

  14. Use of human and porcine dermal-derived bioprostheses in complex abdominal wall reconstructions: a literature review and case report.

    PubMed

    Baillie, Daniel R; Stawicki, S Peter; Eustance, Nicole; Warsaw, David; Desai, Darius

    2007-05-01

    The goal of abdominal wall reconstruction is to restore and maintain abdominal domain. A PubMed(R) review of the literature (including "old" MEDLINE through February 2007) suggests that bioprosthetic materials are increasingly used to facilitate complex abdominal wall reconstruction. Reported results (eight case reports/series involving 137 patients) are encouraging. The most commonly reported complications are wound seroma (18 patients, 13%), skin dehiscence with graft exposure without herniation (six, 4.4%), superficial and deep wound infections (five, 3.6%), hernia recurrence (four, 2.9%), graft failure with dehiscence (two), hematoma (two), enterocutaneous fistula (one), and flap necrosis (one). Two recent cases are reported herein. In one, a 46-year-old woman required open abdominal management after gastric remnant perforation following a Roux-en-Y gastric bypass procedure. Porcine dermal collagen combined with cutaneous flaps was used for definitive abdominal wall reconstruction. The patient's condition improved postoperatively and she was well 5 months after discharge from the hospital. In the second, a 54-year-old woman underwent repair of an abdominal wall defect following resection of a large leiomyosarcoma. Human acellular dermis combined with myocutaneous flaps was used to reconstruct the abdominal wall defect. The patient's recovery was uncomplicated and 20 weeks following surgery she was doing well with no evidence of recurrence or hernia. The results reported to date and the outcomes presented here suggest that bioprosthetic materials are safe and effective for repair of large abdominal wall defects. Prospective, randomized, controlled studies are needed to compare the safety and efficacy of other reconstructive techniques as well as human and porcine dermal-derived bioprostheses.

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

    SciTech Connect

    Bossi, Alberto . E-mail: alberto.bossi@uz.kuleuven.ac.be; De Wever, Ivo; Van Limbergen, Erik; Vanstraelen, Bianca

    2007-01-01

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

  16. [Late metastases of cutaneous malignant melanoma on the abdominal wall to the small and large bowel].

    PubMed

    Füredi, Gábor; Altorjay, Aron; Varga, István; Illés, Iván; Kovács, Csaba; Békefi, Péter; Molnár, Anna

    2005-08-01

    We describe the case of a 56 years old man, who was operated on with abdominal wall skin malignant melanoma 5 years ago. He received postoperative DTIC + Intron A treatment. Five years later he presented with complaints of epigastric pain, melena, hematochezia, anorexia and fatigue. Upper gastrointestinal tract endoscopy showed a tumour mass in the duodeno-jejunal flexure and colonoscopy showed a tumour in the large bowel. Histology verified anaplastic carcinoma. The patient was operated on. We found metastases in the small and the large bowel The patient underwent resection of the jejunum and right hemicolectomy. We describe the different types of metastases of malignant melanomas symptoms, therapies and prognosis.

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

    PubMed

    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.

  18. [Assessment of velocity of deformation of abdominal aorta wall with the help of the multivox working station].

    PubMed

    Sandrikov, V A; Fisenko, E P; Gavrilov, A V; Lozhkevich, A A; Platova, E N; Arkhipov, I V

    2013-01-01

    Most frequent cause of abnormalities of elastic properties of walls of abdominal aorta is development of atherosclerosis resulting in replacement of elastin by simpler fibrillar proteins and collagen. This subsequently leads to dilation of the aorta and formation of aneurism. Increase of collagen content in the aortic wall correlates with growth of aneurism dimensions. Main method of treatment of aneurisms is implantation of abdominal aortic prosthesis. Detailed preoperative assessment of functional state of the aortic wall is necessary in preoperative period but none of modern imaging instrumental methods including ultrasound study allows to realize this assessment. In this article we present first experience of assessment of aortic wall deformation velocity analyzing results of ultrasound study with the help of the Multivox working station in 36 patients 16 of whom were operated because of aneurism of abdominal aorta. PMID:24654437

  19. [Reconstruction of an abdominal wall defect with a superior epigastric perforator propeller flap: case report].

    PubMed

    Lepivert, J-C; Alet, J-M; Michot, A; Pélissier, P; Pinsolle, V

    2014-10-01

    Perforators flaps take a special place in reconstructive surgery. These flaps can be dissected and turned as a propeller blade on its pedicule axis. We report the case of a 54-year-old man presenting a recurrence of a dermatofibrosarcoma in the right hypochondrium. Tumor resection caused a large abdominal wall defect taking the anterior aponeurosis of the rectus abdominis. An angioscanner was realized in preoperative to locate the perforators of the deep superior epigastric artery. We realized a propeller flap based on a perforator of the left superior epigastric artery who allowed to cover the wall defect. We set up a patch of Vicryl® to reconstruct the aponeurosis plan at the same operative time. We didn't note any necrosis and complete healing occurred in 2 weeks. The margins were healthy. The cosmetic result and the low morbidity make this flap a good therapeutic option. This flap seems reliable, arteries perforators are constant with good diameter.

  20. Laparoscopic Treatment of Ventral Abdominal Wall Hernias: Preliminary Results in 100 Patients

    PubMed Central

    Martín del Olmo, Juan Carlos; Blanco, Jose Ignacio; de la Cuesta, Carmen; Martín, Fernando; Toledano, Miguel; Perna, Christiam; Vaquero, Carlos

    2000-01-01

    Objective: The laparoscopic treatment of eventrations and ventral hernias has been little used, although these hernias are well suited to a laparoscopic approach. The objective of this study was to investigate the usefulness of a laparoscopic approach in the surgical treatment of ventral hernias. Methods: Between January 1994 and July 1998, a series of 100 patients suffering from major abdominal wall defects were operated on by means of laparoscopic techniques, with a mean postoperative follow-up of 30 months. The mean number of defects was 2.7 per patient, the wall defect was 93 cm2 on average. There were 10 minor hernias (<5 cm), 52 medium-size hernias (5-10 cm), and 38 large hernia (>10 cm). The origin of the wall defect was primary in 21 cases and postsurgical in 79. Three access ports were used, and the defects were covered with PTFE Dual Mesh measuring 19 × 15 cm in 54 cases, 10 x 15 cm in 36 cases, and 12 × 8 cm in 10 cases. An additional mesh had to be added in 21 cases. In the last 30 cases, PTFE Dual Mesh Plus with holes was employed. Results: Average surgery time was 62 minutes. One procedure was converted to open surgery, and only one patient required a second operation in the early postoperative period. Minor complications included 2 patients with abdominal wall edema, 10 seromas, and 3 subcutaneous hematomas. There were no trocar site infections. Two patients developed hernia relapse (2%) in the first month after surgery and were reoperated with a similar laparoscopic technique. Oral intake and mobilization began a few hours after surgery. The mean stay in hospital was 28 hours. Conclusions: Laparoscopic technique makes it possible to avoid large incisions, the placement of drains, and produces a lower number of seromas, infections and relapses. Laparoscopic access considerably shortens the time spent in the hospital. PMID:10917121

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

    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.

  3. Whole Abdominal Wall Segmentation using Augmented Active Shape Models (AASM) with Multi-Atlas Label Fusion and Level Set

    PubMed Central

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

    2016-01-01

    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. PMID:27127333

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

    PubMed

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

    2014-12-01

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

  5. Efficacy and safety of hyaluronate membrane in the rabbit cecum-abdominal wall adhesion model

    PubMed Central

    Kim, Jae Young; Cho, Wan Jin; Kim, Jun Ho; Lim, Sae Hwan; Kim, Hyun Jung; Lee, Young Woo

    2013-01-01

    Purpose Tissue adhesion is a well-known postsurgical phenomenon, causing pain, functional obstruction, and difficult reoperative surgery. To overcome these problems, various synthetic and natural polymer membranes have been developed as postoperative tissue adhesion barriers. However, limitation in their use has hindered its actual application. We prepared a hyaluronate membrane (HM) to evaluate its efficacy and safety as an adhesion barrier compared to a commercialized product (Interceed, Ethicon). Methods To evaluate the antiadhesion effect, a cecum-abdominal wall abrasion model was adopted in a rabbit. The denuded cecum was covered by Interceed or HM or neither and apposed to the abdominal wall (each, n = 10). Four weeks after surgery, the level of adhesion was graded. Acute and chronic toxicity of the three groups were also evaluated. Results Blood samples drawn to evaluate acute toxicity at postoperative day 3 and 7 showed no significant difference among the three groups. The grade and area of adhesion were significantly lower in the HM compared to those of the control and Interceed at four weeks after surgery. Histologic evaluations, which was carried out to estimate tissue reactions at the site of application, as well as to assess chronic toxicity for the major organs, were not significantly different in the three groups. Conclusion This study showed that the antiadhesion efficacy of HM was superior to commercialized antiadhesion membrane, Interceed. Low inflammatory response and nontoxicity were also demonstrated. From these results, we suggest that the HM is a good candidate as a tissue adhesion barrier. PMID:23908960

  6. Villar's nodule: a case report and systematic literature review of endometriosis externa of the umbilicus.

    PubMed

    Victory, Rahi; Diamond, Michael P; Johns, D Alan

    2007-01-01

    We report a case of umbilical endometriosis externa and systematically review the literature regarding this finding. In our case report, a 47-year-old woman with cyclic umbilical bleeding, pelvic pain, and no previous umbilical surgery developed a spontaneous umbilical endometrioma, cured by surgical resection and bilateral salpingo-oophorectomy. In our review, 122 patients with documented umbilical endometriomas from 1966 to the present and 109 cases reported before 1953 were analyzed. Procedures used for diagnosis and/or therapeutic intervention included umbilical biopsy or resection, abdominal wall repair, diagnostic and/or operative laparoscopy, adhesiolysis, hysterectomy, and bilateral salpingo-oophorectomy. Variables included patient age; race; medical and surgical history; past use of oral contraceptives; history of umbilical pain, bleeding, or swelling; duration of signs and symptoms; size and color of the lesion; diagnostic evaluations; and medical or surgical management. Mean age of the study population was 37.7 +/- 0.98 years. Up to 40% of patients with extrapelvic endometriosis present with umbilical endometriomas, with symptoms occurring an average of 17.8 +/- 3.9 months before presentation. Lesions averaged 2.3 +/- 0.2 cm in diameter; were predominantly brown (19.1%), blue (13.2%), or purple (10.3%); and patients frequently had with pain (77.93%), cyclical bleeding (47.1%), and swelling (88.2%). Most patients had no history of endometriosis (73.1%), and laparoscopic, umbilical trocar-related seeding was identified in only 5 patients. Three patients received medical management, and surgical management was invariably curative, though 1 patient required repeat surgical therapy. Umbilical endometriosis is a common manifestation of external endometriosis, representing primary or secondary endometriosis, with a typical presentation that has little variation. Laparoscopic endometrioid tissue excision can result in iatrogenic seeding to the umbilicus

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

    PubMed Central

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

    2012-01-01

    The objective of this study was to determine the inter- and intra-examiner reliability of pain pressure threshold algometry at various points of the abdominal wall of healthy women. Twenty-one healthy women in menacme with a mean age of 28 ± 5.4 years (range: 19-39 years) were included. All volunteers had regular menstrual cycles (27-33 days) and were right-handed and, to the best of our knowledge, none were taking medications at the time of testing. Women with a diagnosis of depression, anxiety or other mood disturbances were excluded. Women with previous abdominal surgery, any pain condition or any evidence of inflammation, hypertension, smoking, alcoholism, or inflammatory disease were also excluded. Pain perception thresholds were assessed with a pressure algometer with digital traction and compression and a measuring capacity for 5 kg. All points were localized by palpation and marked with a felt-tipped pen and each individual was evaluated over a period of 2 days in two consecutive sessions, each session consisting of a set of 14 point measurements repeated twice by two examiners in random sequence. There was no statistically significant difference in the mean pain threshold obtained by the two examiners on 2 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. PMID:22527127

  8. Metachronous carcinoma of rectum with reconstruction of a full-thickness abdominal wall defect using a pedicled anterolateral thigh flap

    PubMed Central

    Kok, Amy Siu Yan

    2016-01-01

    Reconstruction of large, complex defects of the abdominal wall after resection of malignant tumors can be challenging. The transfer of an anterolateral thigh (ALT) flap is a feasible and effective option. However, no report has been published on the use of ALT flap after metachronous colonic tumor resection so far. We present an original case of resection of metachronous carcinoma of rectum with reconstruction of the abdominal wall defect using an ALT flap harvested with its aponeurosis. The postoperative course was uncomplicated. Functional and esthetic results were satisfactory. There was no postoperative incisional hernia or tumor recurrence. We conclude that abdominal wall defects of large sizes can be successfully reconstructed using an appropriately designed ALT flap; a simple, single-stage effective reconstruction. PMID:27161142

  9. Evaluation of porcine dermal collagen (Permacol) used in abdominal wall reconstruction.

    PubMed

    Hsu, Patrick W; Salgado, Christopher J; Kent, Kathryn; Finnegan, Matthew; Pello, Mark; Simons, Robert; Atabek, Umur; Kann, Brian

    2009-11-01

    Various methods have been employed to reconstruct complex abdominal wall defects. Structural prosthetic materials such as polypropylene mesh and ePTFE (expanded polytetrafluoroethylene) have been widely used to close these large fascial defects, however, complications with infection and adhesions have led to the recent use of more biocompatible implants. Permacol (acellular porcine dermis) is used as a dermal scaffold, which eventually becomes vascularised and remodelled to reconstruct the abdominal wall in these complex patients. A retrospective review was performed of all patients who underwent consecutive abdominal wall reconstruction with Permacol at our institution in the year 2006. Twenty-eight patients were identified and included in our study. Factors evaluated were: body mass index, relevant co-morbidities, aetiology of hernia, hernia defect size based on CT scan and intraoperative measurement, size of Permacol implant, length of hospital stay, and postoperative complications. Surgical technique was standardised among six surgeons and involved a single layer of acellular porcine dermis as a subfascial 'underlay' graft under moderate tension upon maximal hernia reduction. Tissue expanders were not required for skin closure. Out of 28 patients, 12 were male and 16 were female. Mean intraoperative hernia size was 150 cm(2) (range of 10 cm(2) to 600 cm(2)). Mean age was 55 years with an average body mass index (BMI) of 34 (largest BMI of 61.4). Defects were attributed to either a previous laparotomy incision or open abdomen. Mean hospital stay was 9.67 days. At a mean follow-up of sixteen months, there were three recurrent hernias (10.7%) based on physical examination and postoperative CT scan evaluation. One patient developed a superficial wound dehiscence which was successfully treated with local wound care and one patient developed a cellulitis which was successfully treated with antibiotic therapy. Four patients (14.3%) developed a chronic, non

  10. Automatic electrical stimulation of abdominal wall muscles increases tidal volume and cough peak flow in tetraplegia.

    PubMed

    Gollee, H; Hunt, K J; Allan, D B; Fraser, M H; McLean, A N

    2008-01-01

    Paralysis of the respiratory muscles in people with tetraplegia affects their ability to breathe and contributes to respiratory complications. Surface functional electrical stimulation (FES) of abdominal wall muscles can be used to increase tidal volume (V_{T}) and improve cough peak flow (CPF) in tetraplegic subjects who are able to breathe spontaneously. This study aims to evaluate the feasibility and effectiveness of a novel abdominal FES system which generates stimulation automatically, synchronised with the subjects' voluntary breathing activity. Four subjects with complete tetraplegia (C4-C6), breathing spontaneously, were recruited. The automatic stimulation system ensured that consistent stimulation was achieved. We compared spirometry during unassisted and FES-assisted quiet breathing and coughing, and measured the effect of stimulation on end-tidal CO_2 (EtCO_2) during quiet breathing. The system dependably recognised spontaneous respiratory effort, stimulating appropriately, and was well tolerated by patients. Significant increases in V_T during quiet breathing (range 0.05-0.23 L) and in CPF (range 0.04-0.49 L/s) were observed. Respiratory rate during quiet breathing decreased in all subjects when stimulated, whereas minute ventilation increased by 1.05-2.07 L/min. The changes in EtCO_2 were inconclusive. The automatic stimulation system augmented spontaneous breathing and coughing in tetraplegic patients and may provide a potential means of respiratory support for tetraplegic patients with reduced respiratory capacity.

  11. Echinococcus multilocularis infection of the liver presenting as abdominal wall fistula.

    PubMed

    Juodeikis, Zygimantas; Poskus, Tomas; Seinin, Dmitrij; Strupas, Kestutis

    2014-01-01

    Echinococcus multilocularis causes infection where the most commonly affected organ is the liver, followed by the lung, kidney, bone and the brain. Other sites such as the heart, spleen, pancreas and soft tissues are very rarely affected. Surgical treatment combined with chemotherapy using various technical approaches remains the main therapeutic modality for echinococcal liver disease. To the best of our knowledge there are less than five clinical cases of cutaneous presentation of liver alveolar echinococcosis described. We present a unique case of liver echinococcosis presenting as recurrent abdominal wall fistula and abscess in a 29-year-old man. Diagnosis was based on CT imaging, serological analysis and histological findings from the fistula. Medical treatment with albendazole was initiated and liver resection was performed. The patient has no symptoms and signs of recurrence 1 year after operation, while still on albendazole therapy. This case description highlights the importance of early suspicion and treatment of unusual echinococcosis clinical presentations.

  12. Cutaneous squamous cell carcinoma in the lateral abdominal wall of local Libyan ewes

    PubMed Central

    Tmumen, S.K.; Al-Azreg, S.A.; Abushhiwa, M.H.; Alkoly, M.A.; Bennour, E.M.; Al­Attar, S.R.

    2016-01-01

    Gross and histopathological features of surgically excised squamous cell carcinomas (SCC) observed in thirteen local Libyan ewes were reported. The age of the ewes enrolled in the current study ranged from 2 to 3 years. The cases were admitted to private veterinary clinics in south-western region of Tripoli, Libya, during the period between July 2014 and October 2015. All lesions were located in the right and left lateral abdominal wall (caudo-ventrally) with a size range of 8 to 11cm in diameter. The tumor masses have been removed by surgical excision. The histopathological examination of surgically excised masses has revealed the characteristic cell nests of SCC showing central keratinization and hyalinization with presence of apoptotic bodies, fattened keratinocytes, and a heavy interstitial infiltration of neutrophils and lymphocytes. The follow up of the cases showed no signs of tumor reoccurrence. In conclusion, SCC in Libyan sheep affects mainly the woolless areas and can be successfully removed by surgical excision.

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

    PubMed

    Sabanis, Nikos; Paschou, Eleni; Gavriilaki, Eleni; Mourounoglou, Maria; Vasileiou, Sotirios

    2015-01-01

    Autosomal Dominant Polycystic Kidney Disease (ADPKD) is one of the most common monogenic disorders and the leading inheritable cause of end-stage renal disease worldwide. Cystic and noncystic extrarenal manifestations are correlated with variable clinical presentations so that an inherited disorder is now considered a systemic disease. Kidney and liver cystic infections are the most common infectious complications in ADPKD patients. Furthermore, it is well known that ADPKD is commonly associated with colonic diverticular disease which recently has been reported to be linked to increased risk of infection on hemodialysis patients. Herein, we present a case of anterior abdominal wall abscess caused by Enterococcus faecalis in a patient with ADPKD undergoing hemodialysis. Although the precise pathway of infection remains uncertain, the previous medical history as well as the clinical course of our patient led us to hypothesize an alternative route of infection from the gastrointestinal tract through an aberrant intestinal barrier into the bloodstream and eventually to an atypical location. PMID:26301109

  14. Repair of Abdominal Wall Defects with Biodegradable Laminar Prostheses: Polymeric or Biological?

    PubMed Central

    Pascual, Gemma; Sotomayor, Sandra; Rodríguez, Marta; Pérez-Köhler, Bárbara; Bellón, Juan M.

    2012-01-01

    Introduction Biological and synthetic laminar absorbable prostheses are available for the repair of hernia defects in the abdominal wall. They share the important feature of being gradually degraded in the host, resulting in place the formation of a neotissue. This study was designed to assess the host tissue’s incorporation of collagen bioprostheses and a synthetic absorbable prosthesis. Methods Partial defects were created in the abdominal walls of 72 New Zealand rabbits and repaired using collagen bioprostheses Tutomesh® and Strattice® or a synthetic prosthesis Bio-A®. Specimens were collected for light microscopy, collagens gene and protein expression, macrophage response and biomechanical resistance at 14, 30, 90 and 180 days post-implantation. Results Tutomesh® and Bio-A® were gradually infiltrated by the host tissue and almost completely degraded by 180 days post-implantation. In contrast, Strattice® exhibited material encapsulation, no prosthetic degradation and low cell infiltration at earlier timepoints, whereas at later study time, collagen deposition could be observed within the mesh. In the short term, Bio-A® exhibited higher level of collagen 1 and 3 mRNA expression compared with the two other biological prostheses, which exhibited two peaks of higher expression at 14 and 90 days. The expression of collagen III was homogeneous throughout the study and collagen I deposition was more evident in Strattice®. Macrophage response decreased over time in biomeshes. However, in the synthetic mesh remained high and homogeneous until 90 days. The biomechanical analysis demonstrated the progressively increasing tensile strength of all biomaterials. Conclusions The tissue infiltration of laminar absorbable prostheses is affected by the structure and composition of the mesh. The synthetic prosthesis exhibited a distinct pattern of tissue incorporation and a greater macrophage response than did the biological prostheses. Of all of the laminar, absorbable

  15. Morphological and Mechanical Characteristics of the Reconstructed Rat Abdominal Wall Following use of a Wet Electrospun Biodegradable Polyurethane Elastomer Scaffold

    PubMed Central

    Hashizume, Ryotaro; Fujimoto, Kazuro L.; Hong, Yi; Amoroso, Nicholas J.; Tobita, Kimimasa; Miki, Toshio; Keller, Bradley B.; Sacks, Michael S.; Wagner, William R.

    2011-01-01

    Although a variety of materials are currently used for abdominal wall repair, general complications encountered include herniation, infection, and mechanical mismatch with native tissue. An approach wherein a degradable synthetic material is ultimately replaced by tissue mechanically approximating the native state could obviate these complications. We report here on the generation of biodegradable scaffolds for abdominal wall replacement using a wet electrospinning technique in which fibers of a biodegradable elastomer, poly(ester urethane)urea (PEUU), were concurrently deposited with electrosprayed serum-based culture medium. Wet electrospun PEUU (wet ePEUU) was found to exhibit markedly different mechanical behavior and to possess an altered microstructure relative to dry processed ePEUU. In a rat model for abdominal wall replacement, wet ePEUU scaffolds (1 × 2.5 cm) provided a healing result that developed toward approximating physiologic mechanical behavior at 8 wks. An extensive cellular infiltrate possessing contractile smooth muscle markers was observed together with extensive extracellular matrix (collagens, elastin) elaboration. Control implants of dry ePEUU and expanded polytetrafluoroethylene did not experience substantial cellular infiltration and did not take on the native mechanical anisotropy of the rat abdominal wall. These results illustrate the markedly different in vivo behavior observed with this newly reported wet electrospinning process, offering a potentially useful refinement of an increasingly common biomaterial processing technique. PMID:20138661

  16. [Case of a Plasmacytoid Urothelial Carcinoma Identified Due to the Hardening of the Abdominal Wall].

    PubMed

    Yanagisawa, Masahiro; Kawakami, Toshifumi; Suzuki, Kotaro; Nakayama, Takashi

    2016-02-01

    The patient was a 75 year-old male. Noticing areas of hardening in the lower abdomen, and consequently feelings of systemic fatigue and difficulty in walking, the patient visited a clinic and was diagnosed with kidney failure prior to the visit to our clinic. Computed tomography and magnetic resonance imaging showed thickness of the rectus abdominis muscle and the bladder wall, and bilateral hydronephrosis was also identified. As no explicit tumor was identified in the bladder, the patient underwent biopsies of the abdominal wall and bladder membrane mucous, and was diagnosed with a plasmacytoid urothelial carcinoma primarily developed in the bladder. The patient displayed a poor general state of health and died five months after the diagnosis. It is known that plasmacytoid urothelial carcinomas progress rapidly and the prognosis is poorer than for the micropapillary variant. It is important to obtain a tissue specimen in the early stage of this disease because there are cases in which no explicit tumor can be identified. Furthermore, the value of carbohydrate antigen (CA) 19-9 of the patient was much higher than would be expected as normal at the first visit. It kept rising during the follow-up and was useful as a marker to indicate the progress of the disease.

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

    PubMed Central

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

    2016-01-01

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

  18. [A case of fixing an anastomotic site to the abdominal wall out of the abdominal cavity for a small intestinal perforation during chemotherapy].

    PubMed

    Takahashi, Kazutaka; Harano, Masao; Kato, Takuya; Yoshida, Kazuhiro; Sato, Daisuke; Choda, Yasuhiro; Tokumoto, Noriaki; Kanazawa, Takashi; Matsukawa, Hiroyoshi; Ojima, Yasutomo; Idani, Hitoshi; Shiozaki, Shigehiro; Okajima, Masazumi; Ninomiya, Motoki

    2014-11-01

    A 53-year-old man presented with a continuous high fever and was diagnosed with diffuse large B-cell lymphoma with metastasis to the lung, spleen, and mesenterium. He was treated with cyclophosphamide and prednisolone followed by administration of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy 20 days later. Two days after initiation of CHOP therapy, the patient complained of severe abdominal pain. Perforative peritonitis was diagnosed using abdominal computed tomography. A perforation of the small intestine approximately 160 cm distal to the Treitz ligament was uncovered during emergency laparotomy. The risk of leakage was considered too high for anastomosis of the small intestine to be performed. Further, construction of an intestinal stoma could result in a high-output syndrome that could lead to difficulty in resuming chemotherapy. Based on these considerations, we fixed the anastomotic region to the abdominal wall using a technique similar to construction of an intestinal stoma. Post-operative anastomotic leakage did not occur. Nine days later, a perineal hernia was noted near the anastomotic site and a second operation was performed. The anastomotic site was placed back into the abdominal cavity during this operation. CHOP therapy was resumed 16 days after the first operation.

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

    PubMed

    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. PMID:26905037

  20. 3-D segmentation and quantitative analysis of inner and outer walls of thrombotic abdominal aortic aneurysms

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

    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.

  2. Basal Cell Carcinoma of the Umbilicus: A Comprehensive Literature Review

    PubMed Central

    Cohen, Philip R

    2016-01-01

    Basal cell carcinoma (BCC) typically occurs in sun-exposed sites. Only 16 individuals with umbilical BCC have been described in the literature, and the characteristics of patients with umbilical BCC are summarized. PubMed was used to search the following terms: abdomen, basal cell carcinoma, basal cell nevus syndrome, and umbilicus. Papers with these terms and references cited within these papers were reviewed. BCC of the umbilicus has been reported in five men and 11 women; one man had two tumors. Two patients had basal cell nevus syndrome (BCNS). Other risk factors for BCC were absent. The tumor most commonly demonstrated nodular histology (64%, 9/14); superficial and fibroepithelioma of Pinkus variants were noted in three and two patients, respectively. The tumor was pigmented in eight individuals. Treatment was conventional surgical excision (87%, 13/15) or Mohs micrographic surgery (13%, 2/15); either adjuvant laser ablation or radiotherapy was performed in two patients. The prognosis after treatment was excellent with no recurrence or metastasis (100%, 16/16). In conclusion, BCC of the umbilicus is rare. It usually presents as a tumor with a non-aggressive histologic subtype in an individual with no risk factors for this malignancy. There has been no recurrence or metastasis following excision of the cancer. PMID:27738570

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

    PubMed

    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.

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

    PubMed Central

    Jayanth, S.T.; Pulimood, Anna; Abraham, Deepak; Rajaram, A.; Paul, M.J.; Nair, Aravindan

    2015-01-01

    Background Abdominal wall defects and hernias are commonly repaired with synthetic or biological materials. Adhesions and recurrences are a common problem. A study was conducted to compare Chitosan coated polypropylene mesh and a polypropylene–polydioxanone composite with oxidized cellulose coating mesh (Proceed™) in repair of abdominal wall defect in a Rabbit hernia model. Methods A randomized controlled experimental study was done on twelve New Zealand white rabbits. A ventral abdominal defect was created in each of the rabbits. The rabbits were divided into two groups. In one group the defect was repaired with Chitosan coated polypropylene mesh and Proceed mesh™ in the other. The rabbits were operated in two phases. They were followed up at four weeks and twelve weeks respectively after which the rabbits were sacrificed. They were evaluated by open exploration and histopathological examination. Their efficacy in reducing adhesion and ability of remodeling and tissue integration were studied. Results There was no statistical significance in the area of adhesion, the force required to remove the adhesions, tissue integration and remodeling between Chitosan and Proceed™ group. Histological analysis revealed that the inflammatory response, fibrosis, material degradation and remodeling were similar in both the groups. There were no hernias, wound infection or dehiscence in any of the studied animals. Conclusion Chitosan coated polypropylene mesh was found to have similar efficacy to Proceed™ mesh. Chitosan coated polypropylene mesh, can act as an anti adhesive barrier when used in the repair of incisional hernias and abdominal wall defects. PMID:26594357

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

    PubMed Central

    Hemingway, A; Herrington, L; Blower, A

    2003-01-01

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

  6. [Quality of life after operations in the abdominal and retroperitoneal cavities: the influence of the abdominal wall anatomic-functional insufficiency].

    PubMed

    Sukovatykh, B S; Valuĭskaia, N M; Netiaga, A A; Zhukovskiĭ, V A; Pravednikova, N V; Kas'ianova, M A

    2009-01-01

    120 patients with abdominal wall anatomic-functional insufficiency were examined and treated. All patients were divided in 2 similar groups 60 patients each. Patients of the first group had traditional laparotomy wound closure, whereas patients of the second group overcame polypropylene mesh implantation. 21.6% of patients from the first group revealed postoperative ventral hernias at follow-up, none of the second group faced such a problem. Physical component of the quality of live was 3.2 times, and psychological component - 2,6 times higher in patients of the second group.

  7. Rib fracture patterns predict thoracic chest wall and abdominal solid organ injury.

    PubMed

    Al-Hassani, Ammar; Abdulrahman, Husham; Afifi, Ibrahim; Almadani, Ammar; Al-Den, Ahmed; Al-Kuwari, Abdulaziz; Recicar, John; Nabir, Syed; Maull, Kimball I

    2010-08-01

    Blunt trauma patients with rib fractures were studied to determine whether the number of rib fractures or their patterns were more predictive of abdominal solid organ injury and/or other thoracic trauma. Rib fractures were characterized as upper zone (ribs 1 to 4), midzone (ribs 5 to 8), and lower zone (ribs 9 to 12). Findings of sternal and scapular fractures, pulmonary contusions, and solid organ injures (liver, spleen, kidney) were characterized by the total number and predominant zone of ribs fractured. There were 296 men and 14 women. There were 38 patients with scapular fracture and 19 patients with sternal fractures. There were 90 patients with 116 solid organ injuries: liver (n = 42), kidney (n = 27), and spleen (n = 47). Lower rib fractures, whether zone-limited or overlapping, were highly predictive of solid organ injury when compared with upper and midzones. Scapular and sternal fractures were more common with upper zone fractures and pulmonary contusions increased with the number of fractured ribs. Multiple rib fractures involving the lower ribs have a high association with solid organ injury, 51 per cent in this series. The increasing number of rib fractures enhanced the likelihood of other chest wall and pulmonary injuries but did not affect the incidence of solid organ injury. PMID:20726423

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

    PubMed

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

    2016-08-01

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

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

    PubMed

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

    2016-08-01

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

  10. Cutaneous squamous cell carcinoma in the lateral abdominal wall of local Libyan ewes

    PubMed Central

    Tmumen, S.K.; Al-Azreg, S.A.; Abushhiwa, M.H.; Alkoly, M.A.; Bennour, E.M.; Al­Attar, S.R.

    2016-01-01

    Gross and histopathological features of surgically excised squamous cell carcinomas (SCC) observed in thirteen local Libyan ewes were reported. The age of the ewes enrolled in the current study ranged from 2 to 3 years. The cases were admitted to private veterinary clinics in south-western region of Tripoli, Libya, during the period between July 2014 and October 2015. All lesions were located in the right and left lateral abdominal wall (caudo-ventrally) with a size range of 8 to 11cm in diameter. The tumor masses have been removed by surgical excision. The histopathological examination of surgically excised masses has revealed the characteristic cell nests of SCC showing central keratinization and hyalinization with presence of apoptotic bodies, fattened keratinocytes, and a heavy interstitial infiltration of neutrophils and lymphocytes. The follow up of the cases showed no signs of tumor reoccurrence. In conclusion, SCC in Libyan sheep affects mainly the woolless areas and can be successfully removed by surgical excision. PMID:27622155

  11. Cutaneous squamous cell carcinoma in the lateral abdominal wall of local Libyan ewes.

    PubMed

    Tmumen, S K; Al-Azreg, S A; Abushhiwa, M H; Alkoly, M A; Bennour, E M; Al Attar, S R

    2016-01-01

    Gross and histopathological features of surgically excised squamous cell carcinomas (SCC) observed in thirteen local Libyan ewes were reported. The age of the ewes enrolled in the current study ranged from 2 to 3 years. The cases were admitted to private veterinary clinics in south-western region of Tripoli, Libya, during the period between July 2014 and October 2015. All lesions were located in the right and left lateral abdominal wall (caudo-ventrally) with a size range of 8 to 11cm in diameter. The tumor masses have been removed by surgical excision. The histopathological examination of surgically excised masses has revealed the characteristic cell nests of SCC showing central keratinization and hyalinization with presence of apoptotic bodies, fattened keratinocytes, and a heavy interstitial infiltration of neutrophils and lymphocytes. The follow up of the cases showed no signs of tumor reoccurrence. In conclusion, SCC in Libyan sheep affects mainly the woolless areas and can be successfully removed by surgical excision. PMID:27622155

  12. Application of "cinch/tie" technique to robotic-assisted nephropexy for posterior abdominal wall fixation.

    PubMed

    Castle, Scott M; Karnjanawanichkul, Watid; Leveillee, Raymond J

    2012-06-01

    Nephropexy remains standard for symptomatic nephroptosis, and several minimally-invasive techniques have been described. Triangulation sutures placed between the abdominal wall and the renal capsule are often difficult to tie tightly due to the confined working space. We propose a technique modification to fixate the kidney utilizing the da Vinci Surgical System robot and Lapra-Ty absorbable suture clips. Four female patients with symptomatic nephroptosis diagnosed via kidney hypermobility demonstrated on intravenous urography (IVU) underwent robotic-assisted laparoscopic nephropexy (RALNP) from February 2008 to April 2010. After complete mobilization and stripping of perirenal fat, several 0 Vicryl sutures were placed in a "figure of eight" fashion and tied loosely. Subsequently we utilized a Lapra-Ty to tighten the stitch serially and fixate the kidney. The mean age was 46 years (43-52); one patient underwent simultaneous pyeloplasty and one underwent partial nephrectomy in the ipsilateral kidney. There were no intraoperative complications and two postoperative complications, both Clavien grade I. All patients were asymptomatic postoperatively at a mean follow-up of 9.2 months (1-28), and had no evidence of kidney hypermobility on upright IVU or diuretic renal scintigraphy (RS) scan at 6 weeks postoperatively. RALNP is a viable option in the treatment of symptomatic nephroptosis. Secure placement of several "pexing" sutures helps to ensure appropriate security of these itinerant kidneys. Our technique modification corrects kidney hypermobility while improving symptoms related to nephroptosis. PMID:27628279

  13. Simultaneous Prosthetic Mesh Abdominal Wall Reconstruction with Abdominoplasty for Ventral Hernia and Severe Rectus Diastasis Repairs

    PubMed Central

    Cheesborough, Jennifer E.

    2015-01-01

    Background: Standard abdominoplasty rectus plication techniques may not suffice for severe cases of rectus diastasis. In the authors’ experience, prosthetic mesh facilitates the repair of severe rectus diastasis with or without concomitant ventral hernias. Methods: A retrospective review of all abdominal wall surgery patients treated in the past 8 years by the senior author (G.A.D.) was performed. Patients with abdominoplasty and either rectus diastasis repair with mesh or a combined ventral hernia repair were analyzed. Results: Thirty-two patients, 29 women and three men, underwent mesh-reinforced midline repair with horizontal or vertical abdominoplasty. Patient characteristics included the following: mean age, 53 years; mean body mass index, 26 kg/m2; average width of diastasis or hernia, 6.7 cm; and average surgery time, 151 minutes. There were no surgical-site infections and two surgical-site occurrences—two seromas treated with drainage in the office. After an average of 471 days’ follow-up, none of the patients had recurrence of a bulge or a hernia. Conclusions: For patients with significant rectus diastasis, with or without concomitant hernias, the described mesh repair is both safe and durable. Although this operation requires additional dissection and placement of prosthetic mesh in the retrorectus plane, it may be safely combined with standard horizontal or vertical abdominoplasty skin excision techniques to provide an aesthetically pleasing overall result. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. PMID:25539311

  14. Patient-specific models of wall stress in abdominal aortic aneurysm: a comparison between MR and CT

    NASA Astrophysics Data System (ADS)

    de Putter, Sander; Breeuwer, Marcel; van de Vosse, Frans N.; Kose, Ursula; Gerritsen, Frans A.

    2006-03-01

    Finite element method based patient-specific wall stress in abdominal aortic aneurysm (AAA) may provide a more accurate rupture risk predictor than the currently used maximum transverse diameter. In this study, we have investigated the sensitivity of the wall stress in AAA with respect to geometrical variations. We have acquired MR and CT images for four patients with AAA. Three individual users have delineated the AAA vessel wall contours on the image slices. These contours were used to generate synthetic feature images for a deformable model based segmentation method. We investigated the reproducibility and the influence of the user variability on the wall stress. For sufficiently smooth models of the AAA wall, the peak wall stress is reproducible for three out of the four AAA geometries. The 0.99 percentiles of the wall stress show excellent reproducibility for all four AAAs. The variations induced by user variability are larger than the errors caused by the segmentation variability. The influence of the user variability appears to be similar for MR and CT. We conclude that the peak wall stress in AAA is sensitive to small geometrical variations. To increase reproducibility it appears to be best not to allow too much geometrical detail in the simulations. This could be achieved either by using a sufficiently smooth geometry representation or by using a more robust statistical parameter derived from the wall stress distribution.

  15. Successful Treatment of Mesenteric Varices After Living Donor Liver Transplantation with Retrograde Transvenous Obliteration Via an Abdominal Wall Vein

    SciTech Connect

    Ikeda, Osamu Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki; Okajima, Hideaki; Asonuma, Katsuhiro; Inomata, Yukihiro

    2010-06-15

    Balloon-occluded retrograde transvenous obliteration is an established treatment for gastric varices; it has been used more rarely to treat mesenteric varices. We report a 12-year-old girl who had received a living donor liver transplant and suffered melena due to ruptured mesenteric varices. We addressed treatment of the mesenteric varices by retrograde transvenous obliteration of an abdominal wall collateral vein detected by superior mesenteric arteriography.

  16. Intrathoracic Desmoid Tumor Presenting as Multiple Lung Nodules 13 Years after Previous Resection of Abdominal Wall Desmoid Tumor.

    PubMed

    Koo, Gun Woo; Chung, Sung Jun; Kwak, Joo Hee; Oh, Chang Kyo; Park, Dong Won; Kwak, Hyeon Jung; Moon, Ji-Yong; Kim, Sang-Heon; Sohn, Jang Won; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Oh, Young-Ha; Pyo, Ju Yeon; Kim, Tae-Hyung

    2015-07-01

    Desmoid tumors are rare soft tissue tumors considered to have locally infiltrative features without distant metastasis until now. Although they are most commonly intraabdominal, very few cases have extra-abdominal locations. The origin of intrathoracic desmoid tumors is predominantly the chest wall with occasional involvement of pleura. True intrathoracic primary desmoid tumors with no involvement of the chest wall or pleura are extremely rare. We recently experienced a case of true intrathoracic desmoid tumor presenting as multiple lung nodules at 13 years after resection of a previous intraabdominal desmoid tumor.

  17. Anatomy and embryology of umbilicus in newborns: a review and clinical correlations.

    PubMed

    Hegazy, Abdelmonem A

    2016-09-01

    Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular ones. This article aimed to address the basic knowledge of the umbilicus in relation to clinical disorders under one integrated topic to aid physicians and surgeons in assessing newborns and infants. The umbilicus appears as early as the fourth week of fetal life when the folding of the embryonic plate occurs. The umbilicus appears initially as a primitive umbilical ring on the ventral aspect of the body. The primitive umbilicus contains the connecting stalk, umbilical vessels, vitelline duct and vessels, allantois, and loop of the intestine. Changes occur to form the definitive cord, which contains three umbilical vessels, namely, "one vein and two arteries," embedded in Wharton's jelly. After birth, the umbilical vessels inside the body obliterate and gradually form ligaments. Congenital disorders at the umbilicus include herniation, bleeding, and discharge of mucous, urine, or feces. Some of these disorders necessitate emergent surgical interference, whereas others may be managed conservatively. The umbilicus has many embryological remnants. Thus, the umbilicus is prone to various clinical disorders. Detecting these disorders as early as possible is essential to prevent or minimize possible complications. PMID:27473223

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

    PubMed Central

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

    2015-01-01

    Key Clinical Message A surgical technique, materials used for abdominal wall reconstruction, and postoperative care are important for patient outcomes. We report the first case of neonate with Cantrell's pentalogy surviving early reconstruction of abdominal, diaphragmal and pericardial defects. Several recent investigations suggest that intraabdominal pressure monitoring may improve outcomes in this patient category. PMID:25678967

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

    PubMed

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

    2015-01-01

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

  20. Effects of the Transient Blood Flow-Wall Interaction on the Wall Stress Distribution in Abdominal Aortic Aneurysm (AAA)

    NASA Astrophysics Data System (ADS)

    Tang, Rubing; Geindreau, Christian; Lasheras, Juan

    2006-11-01

    Our static finite element analysis (FEA) of both idealized and real clinical models has shown that the maximum diameter and asymmetry have substantial influence on the AAA wall stress distribution. The thrombus inside the AAA was also found to reduce the magnitude of the wall stresses. To achieve a better understanding of the wall stress distribution in real AAAs, a dynamic FEA was also performed. We considered models, both symmetric and non-symmetric, in which the aorta is assumed isotropic with nonlinear material properties. For the limiting case of rigid walls, the evolution of the flow pattern and the wall shear stresses due to fluid flow at different stages of cardiac cycle predicted by our simulations are compared with experimental results obtained in in-vitro models. A good agreement is found between both results. Finally, we have extended the analysis to the physiologically correct case of deformable walls and characterized the transient effects on the wall stresses.

  1. Repair of Abdominal Wall Defects In Vitro and In Vivo Using VEGF Sustained-Release Multi-Walled Carbon Nanotubes (MWNT) Composite Scaffolds

    PubMed Central

    Yang, Jianjun; Liu, Zhengni; Peng, Zhiyou; Tang, Rui; Gu, Yan

    2013-01-01

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

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

    PubMed Central

    2012-01-01

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

  3. [Effect of jiang-zhi jian-fei yao on gastro-intestinal movement and adipose cell of abdominal wall].

    PubMed

    Jin, H M; Jiao, D H

    1994-04-01

    Jiang-Zhi Jian-Fei Yao (JZJFY), an obesity-reducing drug, its active principle is the refined Rhubarb, the mechanism of its obesity-reducing effect was studied. JZJFY was injected intragastrically. The results showed that there was no significant increased of body weight, but a reduction of food intake, prolongation of stomach evacuation time, acceleration of intestinal movement 6 days after medication in rats. Meanwhile the adipose cells in abdominal wall were varied in size, and with Sudan III stain the color of adipose cells was light. Authors suggest that the obesity-reducing effect of JZJFY was relevant to above-mentioned changes.

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

    PubMed Central

    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

  5. Development of the ventral body wall in the human embryo.

    PubMed

    Mekonen, Hayelom K; Hikspoors, Jill P J M; Mommen, Greet; Köhler, S Eleonore; Lamers, Wouter H

    2015-11-01

    Migratory failure of somitic cells is the commonest explanation for ventral body wall defects. However, the embryo increases ~ 25-fold in volume in the period that the ventral body wall forms, so that differential growth may, instead, account for the observed changes in topography. Human embryos between 4 and 10 weeks of development were studied, using amira reconstruction and cinema 4D remodeling software for visualization. Initially, vertebrae and ribs had formed medially, and primordia of sternum and hypaxial flank muscle primordium laterally in the body wall at Carnegie Stage (CS)15 (5.5 weeks). The next week, ribs and muscle primordium expanded in ventrolateral direction only. At CS18 (6.5 weeks), separate intercostal and abdominal wall muscles differentiated, and ribs, sterna, and muscles began to expand ventromedially and caudally, with the bilateral sternal bars fusing in the midline after CS20 (7 weeks) and the rectus muscles reaching the umbilicus at CS23 (8 weeks). The near-constant absolute distance between both rectus muscles and approximately fivefold decline of this distance relative to body circumference between 6 and 10 weeks identified dorsoventral growth in the dorsal body wall as determinant of the 'closure' of the ventral body wall. Concomitant with the straightening of the embryonic body axis after the 6th week, the abdominal muscles expanded ventrally and caudally to form the infraumbilical body wall. Our data, therefore, show that the ventral body wall is formed by differential dorsoventral growth in the dorsal part of the body. PMID:26467243

  6. Development of the ventral body wall in the human embryo.

    PubMed

    Mekonen, Hayelom K; Hikspoors, Jill P J M; Mommen, Greet; Köhler, S Eleonore; Lamers, Wouter H

    2015-11-01

    Migratory failure of somitic cells is the commonest explanation for ventral body wall defects. However, the embryo increases ~ 25-fold in volume in the period that the ventral body wall forms, so that differential growth may, instead, account for the observed changes in topography. Human embryos between 4 and 10 weeks of development were studied, using amira reconstruction and cinema 4D remodeling software for visualization. Initially, vertebrae and ribs had formed medially, and primordia of sternum and hypaxial flank muscle primordium laterally in the body wall at Carnegie Stage (CS)15 (5.5 weeks). The next week, ribs and muscle primordium expanded in ventrolateral direction only. At CS18 (6.5 weeks), separate intercostal and abdominal wall muscles differentiated, and ribs, sterna, and muscles began to expand ventromedially and caudally, with the bilateral sternal bars fusing in the midline after CS20 (7 weeks) and the rectus muscles reaching the umbilicus at CS23 (8 weeks). The near-constant absolute distance between both rectus muscles and approximately fivefold decline of this distance relative to body circumference between 6 and 10 weeks identified dorsoventral growth in the dorsal body wall as determinant of the 'closure' of the ventral body wall. Concomitant with the straightening of the embryonic body axis after the 6th week, the abdominal muscles expanded ventrally and caudally to form the infraumbilical body wall. Our data, therefore, show that the ventral body wall is formed by differential dorsoventral growth in the dorsal part of the body.

  7. Abdominal wall hernia and aortic injury secondary to blunt trauma: Case report and review of the literature

    PubMed Central

    Ballard, David H.; Kaskas, Nadine M.; Hamidian Jahromi, Alireza; Skweres, Justin; Youssef, Asser M.

    2014-01-01

    INTRODUCTION Traumatic abdominal wall hernia (TAWH) and traumatic abdominal aortic injury (TAAI) are two uncommon complications secondary to blunt trauma. In both TAWH and TAAI, reported cases are often associated with poly-trauma. TAWH may be initially missed if more pressing issues are identified during the patient's primary survey. TAAI may be an incidental finding on imaging or, if severe, a cause of an acute abdomen and hemodynamic abnormality. PRESENTATION OF CASE A 54-year-old white male suffered a TAWH and TAAI (pseudoaneurysm) due to severe blunt trauma. TAWH was apparent on physical exam and the TAAI was suspected on computed tomography (CT). The patient's TAWH was managed with a series of abdominal explorations and the TAAI was repaired with endovascular stenting. DISCUSSION TAWH and TAAI are commonly due to severe blunt trauma from motor vehicle collisions. Diagnosis is made through physical exam, imaging studies, or surgical exploration. A variety of surgical techniques achieve technical success. CONCLUSION The patient with blunt trauma to the abdomen is at risk for TAWH and TAAI, which are often associated with other injuries. Investigations should include thorough clinical exam through secondary survey and radiologic imaging in the hemodynamically normal patient. PMID:25437685

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

    PubMed Central

    Jundziłł, Arkadiusz; Nazarewski, Łukasz; Kotela, Andrzej; Kloskowski, Tomasz; Skopińska-Wisniewska, Joanna; Łukasiewicz, Aleksander; Nazarewski, Sławomir; Kotela, Ireneusz; Pokrywczyńska, Marta; Marszałek, Andrzej; Drewa, Tomasz

    2015-01-01

    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. PMID:25705696

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

    PubMed

    Liu, Zhengni; Feng, Xueyi; Wang, Huichun; Ma, Jun; Liu, Wei; Cui, Daxiang; Gu, Yan; Tang, Rui

    2014-01-01

    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-MWNT-PSIS) contributed to early vascularization from 2-12 weeks postimplantation and obtained more effective collagen deposition and exhibited improved tensile strength at 24 weeks postimplantation compared to PSIS or PSIS scaffolds, incorporating MWNT without VEGF165 loading (MWNT-PSIS).

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

    PubMed

    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 < 0.0001). Also, the extracellular connective tissue matrix provided a stiffening effect and enhanced the resistance to lengthening at long muscle lengths. Titin molecular mass was significantly less in TrA compared to each of the other three muscles (p < 0.0009), but this difference did not correspond to hypothesized differences in stiffness.

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

    SciTech Connect

    Nakamura, Katsumasa . E-mail: nakam@radiol.med.kyushu-u.ac.jp; Shioyama, Yoshiyuki; Nomoto, Satoru; Ohga, Saiji; Toba, Takashi; Yoshitake, Tadamasa; Anai, Shigeo; Terashima, Hiromi; Honda, Hiroshi

    2007-05-01

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

  12. [Ancient literature on the heat control of umbilicus fumigation method and the modern clinical research].

    PubMed

    Zhang, Xiaoning; Guo, Xin; Yu, Baoluo; Zhang, Na; Ma, Yuxia

    2016-01-01

    In order to improve the clinical efficacy of the umbilicus fumigation method, the ancient literature with the heat control of umbilicus fumigation method involved is collected extensively and analyzed systematically, and the heat control, precautions and contraindications of this method are discussed. In association with the cases and the present clinical experience, the main factors to the heat control are introduced, such as preparation of doughnuts, filling quantity, size of moxa cone and numbers of moxa cones so that the clinical application of the umbilicus fumigation method can be promoted and enhanced.

  13. The quasi-static failure properties of the abdominal aortic aneurysm wall estimated by a mixed experimental-numerical approach.

    PubMed

    Forsell, Caroline; Swedenborg, Jesper; Roy, Joy; Gasser, T Christian

    2013-07-01

    Assessing the risk for abdominal aortic aneurysm (AAA) rupture is critical in the management of aneurysm patients and an individual assessment is possible with the biomechanical rupture risk assessment. Such an assessment could potentially be improved by a constitutive AAA wall model that accounts for irreversible damage-related deformations. Because of that the present study estimated the elastic and inelastic properties of the AAA wall through a mixed experimental-numerical approach. Specifically, finite element (FE) models of bone-shaped tensile specimens were used to merge data from failure testing of the AAA wall with their measured collagen orientation distribution. A histo-mechanical constitutive model for collagen fibers was employed, where plastic fibril sliding determined not only remaining deformations but also weakening of the fiber. The developed FE models were able to replicate the experimentally recorded load-displacement property of all 16 AAA wall specimens that were investigated in the study. Tensile testing in longitudinal direction of the AAA defined a Cauchy strength of 569(SD 411) kPa that was reached at a stretch of 1.436(SD 0.118). The stiffness and strength of specimens decreased with the wall thickness and were elevated (p = 0.018; p = 0.030) in patients with chronic obstructive pulmonary disease (COPD). Smoking affected the tissue parameters that were related to the irreversible deformation response, and no correlation with gender and age was found. The observed effects on the biomechanical properties of the AAA wall could have long-term consequences for the management of aneurysm patients, i.e., specifically they might influence future AAA rupture risk assessments. However, in order to design appropriate clinical validation studies our findings should firstly be verified in a larger patient cohort. PMID:23263935

  14. Reduction of aneurysm pressure and wall stress after endovascular repair of abdominal aortic aneurysm in a canine model.

    PubMed

    Marston, W A; Criado, E; Baird, C A; Keagy, B A

    1996-03-01

    A canine model was designed to evaluate the changes in abdominal aortic aneurysm (AAA) pressure and wall stress after endovascular repair. Eight canines underwent laparotomy and creation of an AAA. The aneurysm was then excluded with a transluminally placed endovascular graft (TPEG) inserted through the right femoral artery and deployed across the AAA to exclude the infrarenal aortic branches from aortic perfusion. Blood pressure and flow data were recorded for 6 hours. The AAA blood pressure decreased from 135 +/- 9.3 mm Hg before exclusion to 45 +/- 17.6 mm Hg at 10 minutes after exclusion (p < 0.001). At 6 hours, AAA blood pressure had declined further to 26 +/- 12.5 mm Hg. Blood flow in the excluded iliac artery decreased from a baseline of 242 +/- 58 ml/min to 41 +/- 29 ml/min 10 minutes after TPEG placement (p < 0.001). At 6 hours, flow was reduced to 12 +/- 3.5 ml/min (p < 0.05 compared with that at 10 minutes). Aortic wall stress was significantly reduced by TPEG placement but was only slightly lower than baseline aortic wall stress before AAA creation. The lumbar arteries were patent with retrograde flow in all cases and were found to be the major contributors to postexclusion aneurysm pressure. Endovascular AAA exclusion results in an immediate decrease in blood pressure and wall stress within the excluded aneurysm, but the aneurysm remains perfused by retrograde flow through the lumbar arteries, which resulted in near-baseline levels of aneurysm wall stress in this canine model. Embolization of patient lumbar vessels at prosthesis placement may further reduce the risk of late rupture. PMID:8733869

  15. [A case of Paragonimiasis westermani with pleural effusion eight months after migrating subcutaneous induration of the abdominal wall].

    PubMed

    Mizuki, M; Mitoh, K; Miyazaki, E; Tsuda, T

    1992-06-01

    Patients with Paragonimiasis westermani show a typical ring form or nodular shadow on chest X-ray, cough, sputum, and hemosputum. Recently, case reports of Paragonimiasis westermani, accompanied by pneumothorax and pleural effusion, as for Paragonimiasis miyazakii, have been increasing. Paragonimus westermani often causes an ectopic infection in various organs such as the peritoneal cavity, pleural cavity, pericardium, liver, adrenal gland and brain. Cutaneous paragonimiasis is considered one of the typical forms of ectopic infection in its earlier phase, but a few unexpected cases of cutaneous Paragonimiasis westermani have also been reported. A 68-year old man, who had never eaten fresh-water crab or raw sliced meat of wild boar, noticed subcutaneous induration of the abdominal wall. The induration had been gradually moving upwards and to the right from the infraumbilical region for over 20 days, and then disappeared at the right upper lateral abdominal wall. Eight months later, he developed severe pain in the right lower chest, and a chest X-ray showed right pleural effusion. Laboratory examinations revealed eosinophilia (WBC 3940/mm3, eosinophil 9%), elevated ESR, and an elevated serum total IgE level (5517 IU/ml). Ouchterlony's double diffusion test performed with the patient's serum in agarose showed strong bands toward Paragonimus westermani antigen, compared to Paragonimus miyazakii antigen. Immunoelectrophoresis with the patient's serum showed specific bands toward Paragonimus westermani antigen. This patient was finally diagnosed as having Paragonimiasis westermani infection, and he responded to praziquantel administration. The clinical course of this patient appears to be rare in cases of Paragonimiasis westermani infection. The clinical course of this case resembled some cases of Paragonimiasis miyazakii infection.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Subcutaneous Splenosis of the Abdominal Wall: Report of a Case and Review of the Literature

    PubMed Central

    Papakonstantinou, Evangelia; Kalles, Vasileios; Papapanagiotou, Ioannis; Piperos, Theodoros; Karakaxas, Dimitrios; Bonatsos, Vasileios; Tsoumakas, Konstantinos; Orfanos, Filotheos; Mariolis-Sapsakos, Theodoros

    2013-01-01

    Splenosis is a common benign condition that occurs after splenic rupture via trauma or surgery. The mechanism behind splenic cell autotransplantation begins with the splenic rupture, either from trauma or surgical removal. Splenosis is usually found incidentally and, unless symptomatic, surgical therapy is not indicated. Subcutaneous splenosis is an extremely rare form of splenosis, mostly observed in abdominal surgical scars. We report a case of subcutaneous splenosis, as well as a comprehensive review of the literature. In our case, a 43-year-old woman who had splenectomy after traumatic splenic rupture at the age of 7 years old presented for plastic reconstruction of her postoperative scar. Upon surgery, two asymptomatic subcutaneous nodules were incidentally discovered. The presence of splenic tissue was confirmed by the histological study. The nodules were not excised, as the patient was not symptomatic. PMID:23401837

  17. Relationship between intra-abdominal pressure and vaginal wall movements during Valsalva in women with and without pelvic organ prolapse: technique development and early observations

    PubMed Central

    Spahlinger, D. M.; Newcomb, L.; Ashton-Miller, J. A.; DeLancey, J. O. L.; Chen, Luyun

    2014-01-01

    Objectives To develop and test a method for measuring the relationship between the rise in intra-abdominal pressure and sagittal plane movements of the anterior and posterior vaginal walls during Valsalva in a pilot sample of women with and without prolapse. Methods Mid-sagittal MRI images were obtained during Valsalva while changes in intra-abdominal pressure were measured via a bladder catheter in 5 women with cystocele, 5 women with rectocele, and 5 controls. The regional compliance of the anterior and posterior vagina wall support systems were estimated from the ratio of displacement (mm) of equidistant points along the anterior and posterior vaginal walls to intra-abdominal pressure rise (mmHg). Results The compliance of both anterior and posterior vaginal wall support systems varied along different regions of vaginal wall for all three groups, with the highest compliance found near the vaginal apex and the lowest near the introitus. Women with cystocele had more compliant anterior and posterior vaginal wall support systems than women with rectocele. The movement direction differs between cystocele and rectocele. In cystocele, the anterior vaginal wall moves mostly toward the vaginal orifice in the upper vagina, but in a ventral direction in the lower vagina. In rectocele, the direction of the posterior vaginal wall movement is generally toward the vaginal orifice. Conclusions Movement of the vaginal wall and compliance of its support is quantifiable and was found to vary along the length of the vagina. Compliance was greatest in the upper vagina of all groups. Women with cystocele demonstrated the most compliant vaginal wall support. PMID:24474605

  18. Changes in the wall shear stresses (WSS) during the enlargement of Abdominal Aortic Aneurysms (AAA)

    NASA Astrophysics Data System (ADS)

    Salsac, Anne-Virginie; Sparks, Steven R.; Chomaz, Jean-Marc; Lasheras, Juan C.

    2004-11-01

    The changes in the evolution of the spatial and temporal distribution of the WSS and gradients of WSS at different stages of the enlargement of AAAs are important to understand the etiology and progression of this vascular disease, since they affect the wall structural integrity, primarily via the changes induced on the shape, functions and metabolism of the endothelial cells. PIV measurements were performed in aneurysm models, while changing systematically their geometric parameters. We show that, even at very early stages of the disease (dilatation > 30%), the flow separates from the wall and the formation of a large vortex ring followed by internal shear layers leads to the generation of WSS that drastically differ from the healthy vessel. Inside the AAA, the mean WSS decreases to zero and the magnitude of the WSS can be as low as 26% of the value in a healthy vessel. Two regions with distinct patterns of WSS were identified. The region of flow detachment, with oscillatory WSS of very low mean, and the region of flow reattachment, located distally, where large, negative WSS and sustained gradients of WSS are produced as a result of the impact of the vortex ring on the wall.

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

    PubMed Central

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

    2013-01-01

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

  20. Initial experience with the use of porcine acellular dermal matrix (Strattice) for abdominal wall reinforcement after transverse rectus abdominis myocutaneous flap breast reconstruction.

    PubMed

    Cicilioni, Orlando; Araujo, Gerson; Mimbs, Nancy; Cox, Matthew D

    2012-03-01

    Reestablishing anterior rectus fascial integrity remains a clinical challenge after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. The main concerns include herniation and bulging due to abdominal weakness. Mesh-assisted closure of the fascial defect has improved bulging and herniation rates but infection, extrusion, and encapsulation are serious concerns with mesh use. Biologic tissue matrices may overcome some of these mesh-related complications. The initial experience of using Strattice for fascial closure after TRAM flap procedure is described in this article. Strattice was in-lain and sutured between the anterior and posterior layers of the rectus fascia, at the rectus muscle donor site. The abdominal wall was closed with progressive tension sutures. Postoperative complications at the donor site were assessed. A total of 16 unilateral and 9 bilateral reconstructions were performed in 25 patients. Length of hospital stay was 2 to 3 days which is shorter than with mesh repair (typically 4-5 days). During a mean follow-up period of 14.0 months, complications occurred in 7 patients (28%): seroma formation (2), minor skin separation (2), superficial skin infection (2), and superficial wound dehiscence (1). Complications were not directly related to Strattice and all, except one (superficial skin infection), were resolved without surgical intervention. In all patients, routine abdominal functions were restored 4 months postoperatively. Strattice is a safe, alternative option to synthetic mesh for fascial repair following TRAM flap breast reconstruction. When used in conjunction with progressive tension suture closure of the abdominal wall, dynamic reconstruction of the abdominal wall with resumption of abdominal function is possible with Strattice.

  1. Early imaging of integration response to polypropylene mesh in abdominal wall by environmental scanning electron microscopy: comparison of two placement techniques and correlation with tensiometric studies.

    PubMed

    Ferrando, J M; Vidal, J; Armengol, M; Huguet, P; Gil, J; Manero, J M; Planell, J A; Segarra, A; Schwartz, S; Arbos, M A

    2001-07-01

    The repair of incisional hernias has taken advantage of the strength provided by prosthetic mesh grafts, but the best position for inserting the materials has not been conclusively established. Environmental scanning electron microscopy (ESEM) provides imaging of biologic samples with minimal manipulation. We used ESEM for early imaging of the integration response to polypropylene meshes placed in two anatomic positions in the abdominal wall and correlated results with tensiometric studies. Two macroporous polypropylene prostheses were implanted in a rat model--one on the abdominal aponeurotic layer and one on the peritoneal surface--without creating a wall defect. Studies were performed over implantation intervals of 7, 15, and 30 days in strips obtained from the polypropylene fiber-receptor repair tissue interface. Microscopic appearance, tensile strength, percent elongation, and stiffness were evaluated. Meshes implanted on the abdominal aponeurotic layer showed better early tissue incorporation (higher collagen deposition, capillary density, cell accumulation) and increased tensile strength, reflecting tighter anchorage to the abdominal wall. The percent elongation increased from day 7 to day 30 after implantation, mainly in the deep stratum. The ESEM images correlated well with biomechanical results, indicating the potential of this technique as a powerful, effective tool for use in wound-healing studies.

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

    PubMed

    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. PMID:15154379

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

    PubMed Central

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

    2016-01-01

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

  4. Reconstruction of the Abdominal Wall in Anatomical Plans. Pre- and Postoperative Keys in Repairing “Cold” Incisional Hernias

    PubMed Central

    POPA, FLORINA; ROSCA, OANA; GEORGESCU, ALEXANDRU; CANNISTRA, CLAUDIO

    2016-01-01

    Background and aims The clinical results of the vertical “vest-over-pants” Mayo repair were evaluated, and the risk factors for incisional hernia recurrence were studied. The purpose of this study is to point out the importance of reducing pre and post operative risk factors in the incisional hernia repair process in order to achieve a physiologically normal abdominal wall. Methods Twenty patients diagnosed with incisional hernia underwent an abdominal reconstruction procedure using the Mayo (Paletot) technique at Bichat Claude Bernard Hospital between 2005 and 2015. All procedures were performed by a single surgeon and all patients were pre-operatively prepared, identifying all coexisting conditions and treating them accordingly before undergoing surgery. Results All patients underwent at least one surgical operation before the hernia repair procedure and a quarter had experienced at least three, prior to this one. Nine patients had a body mass index of >30 kg/m2. Additional risk factors and comorbidities included obesity in 45%, diabetes mellitus in 10%, smoking in 55%, and high blood pressure in 40%. Hernia defect width was from 3 cm (25% F) to 15 cm (5% M) of which nine patients (45%) had a 10 cm defect. Most of the patients had an average hospitalization of 7 days. The patients were carefully monitored and were called on periodic consultations after 3, 6, and 12 months from the moment of the procedure. Patient feedback regarding hernia recurrence and complaints about the scar were noted. Physical examination is essential in determining the hernia recurrence therefore the scar was examined for any abnormalities that may have occurred, which was defined as any palpable or detected fascial defect located within seven centimeters of the hernia repair. Post-operative complications: seroma formation, wound hematoma, superficial and deep wound infection, recurrences and chronic pain were followed and no complications were registered during the follow-up period

  5. Surgery for Abdominal Wall Pain Caused by Cutaneous Nerve Entrapment in Children-A Single Institution Experience in the Last 5 Years

    PubMed Central

    Žganjer, Mirko; Bojić, Davor; Bumči, Igor

    2013-01-01

    Background Chronic abdominal pain (CAP) is a serious medical condition which needs to be approached with great attention. Chronic abdominal pain may be caused by entrapment of cutaneous branches of intercostal nerves (ACNES). Objectives The aim of this study is the surgery for abdominal wall pain which caused by cutaneous nerve entrapment in children during last 5 years. Materials and Methods In all children with ACNES, we tried conservative treatment with anesthetic and steroid injections. In children who were refractory to conservative treatment, we received surgical procedure like sectioning the entrapped nerve to obtain relief. Results In 12 pediatric patients with chronic abdominal pain, we diagnosed ACNES. Each presented with abdominal pain and a positive Carnett sign. Local nerve blocks using anesthetic and steroid injections are the treatment. In all patients, we tried with local nerve block. In 3 patients, pain improvement occurs in the few minutes, and they were without pain after 5 days. In other 4 patients required a reinjection for pain recurrence. In one patients pain was gone. The maximum reinjection was 3. In other 5 patients, we did operative treatment like sectioning the entrapped nerve. Conclusions Some children with CAP have ACNES. In all children with ACNES, we recommended local nerve blocks. If the local block in 3 times is not helping, neurectomy of the peripheral nerve is method of choice. PMID:23682329

  6. SMAD3 deficiency promotes vessel wall remodeling, collagen fiber reorganization and leukocyte infiltration in an inflammatory abdominal aortic aneurysm mouse model

    PubMed Central

    Dai, Xiaohua; Shen, Jianbin; Priyanka Annam, Neeraja; Jiang, Hong; Levi, Edi; Schworer, Charles M.; Tromp, Gerard; Arora, Anandita; Higgins, Mary; Wang, Xiao-Fan; Yang, Maozhou; Li, Hui J.; Zhang, Kezhong; Kuivaniemi, Helena; Li, Li

    2015-01-01

    TGF-β signaling plays critical roles in the pathogenesis of aneurysms; however, it is still unclear whether its role is protective or destructive. In this study, we investigate the role of SMAD3 in the pathogenesis of calcium chloride (CaCl2)-induced abdominal aortic aneurysms (AAA) in Smad3−/−, Smad3+/− and Smad3+/+ mice. We find that loss of SMAD3 drastically increases wall thickening of the abdominal aorta. Histological analyses show significant vessel wall remodeling with elastic fiber fragmentation. Remarkably, under polarized light, collagen fibers in the hyperplastic adventitia of Smad3−/− mice show extensive reorganization accompanied by loosely packed thin and radial collagen fibers. The expressions of matrix metalloproteinases including MMP2, MMP9, and MMP12 and infiltration of macrophage/T cells are drastically enhanced in the vascular wall of Smad3−/− mice. We also observe marked increase of NF-κB and ERK1/2 signaling as well as the expression of nuclear Smad2, Smad4 and TGF-β1 in the vessel wall of Smad3−/− mice. In addition, we find that SMAD3 expression is reduced in the dedifferentiated medial smooth muscle-like cells of human AAA patients. These findings provide direct in vivo evidence to support the essential roles of SMAD3 in protecting vessel wall integrity and suppressing inflammation in the pathogenesis of AAAs. PMID:25985281

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

    PubMed

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

    2014-05-01

    Hernias are defects in which an anatomical fascia is breached resulting in ectopic positioning of an organ into an orifice which routinely does not contain it. Intervention often involves repositioning translocated organs and repair of damaged fascia using exogenous grafts. Despite hernia prevalence, repairs can still fail due to postoperative complications, such as chronic pain and decreased mobility. This study compared repair capacities and characterized the foreign body response elicited by a number of hernia repair grafts to deduce their bulk inflammatory properties while also concluding the point in their fabrication when these are inferred. Materials derived from human dermis (Alloderm(®) ), porcine dermis (Permacol™, patch A, patch D and Strattice(®) ), porcine small-intestinal submucosa (Surgisis™) and a synthetic (multifilament Surgipro™) were implanted into a rat full-thickness abdominal wall excision model, incubated for up to 2 years and characterized histopathologically. Surgisis™ resorbed the fastest of the materials tested (1-3 months) resulting in a mechanically stable parietal peritoneum. Decellularization using sodium dodecyl sulfate (patch A) stimulated a large early inflammatory response which ultimately may have contributed to increased resorption of porcine dermal matrix however the remaining materials typically persisted throughout the 2-year incubation. Cross-linking porcine dermis using 1,6-hexamethylene disocyanate (vs. an identical noncross-linked counterpart) showed no difference in cell recruitment or material integration over 2 years. Typically Strattice(®) and Alloderm(®) recruited larger early populations of cells than Permacol™; however, over extended periods of time in vivo this response normalized. PMID:24155173

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

    PubMed

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

    2014-05-01

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

  9. Abdominal wall surgery

    MedlinePlus

    ... skin. Abdominoplasty can be helpful when: Diet and exercise have not helped improve muscle tone, such as in women who have had more than one pregnancy. Skin and muscle cannot regain its normal tone. ...

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

    PubMed Central

    2011-01-01

    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

  11. Does mechanical massage of the abdominal wall after colectomy reduce postoperative pain and shorten the duration of ileus? Results of a randomized study.

    PubMed

    Le Blanc-Louvry, Isabelle; Costaglioli, Bruno; Boulon, Catherine; Leroi, Anne-Marie; Ducrotte, Philippe

    2002-01-01

    The aim of this study was to determine the effectiveness of mechanical abdominal massage on postoperative pain and ileus after colectomy. We hypothesized that parietal abdominal stimulation could counteract induced pain and postoperative ileus, through common spinal-sensitive pathways, with nociceptive visceral messages. After preoperative randomization, 25 patients (age 52 +/- 5 years) underwent active mechanical massage by intermittent negative pressure on the abdominal wall resulting in aspiration (Cellu M50 device, LPG, Valence, France), and 25 patients (age 60 +/- 6 years) did not receive active mechanical massage (placebo group). Massage sessions began the first day after colectomy and were performed daily until the seventh postoperative day. In the active-massage group, amplitude and frequency were used, which have been shown to be effective in reducing muscular pain, whereas in the placebo group, ineffective parameters were used. Visual analogue scale (VAS) pain scores, doses of analgesics (propacetamol), and delay between surgery and the time to first passage of flatus were assessed. Types and dosages of the anesthetic drugs and the duration of the surgical procedure did not differ between groups. From the second and third postoperative days, respectively, VAS pain scores (P < 0.001) and doses of analgesics (P < 0.05) were significantly lower in patients receiving active massage compared to the placebo group. Time to first passage of flatus was also significantly shorter in the active-massage group (1.8 +/- 0.3 days vs. 3.6 +/- 0.4 days, P < 0.01). No adverse effects were observed. These results suggest that mechanical massage of the abdominal wall may decrease postoperative pain and ileus after colectomy. PMID:11986017

  12. Bladder sparing robot-assisted laparoscopic en bloc resection of urachus and umbilicus for urachal adenocarcinoma.

    PubMed

    Aoun, Fouad; Peltier, Alexandre; van Velthoven, Roland

    2015-06-01

    Urachal adenocarcinoma is a rare and aggressive form of bladder cancer that arises from the urachus. An en bloc resection of the urachus and umbilicus is recommended with either a total or partial cystectomy. However, there is no standard laparoscopic or robotic surgical technique for the operative management of these tumors. In the present report, we describe our robotic-assisted laparoscopic technique for the treatment of a primary malignant urachal tumor. PMID:26531120

  13. Omental infarction and its mimics: imaging features of acute abdominal conditions presenting with fat stranding greater than the degree of bowel wall thickening.

    PubMed

    Tonerini, Michele; Calcagni, Francesca; Lorenzi, Silvia; Scalise, Paola; Grigolini, Alessandro; Bemi, Pietro

    2015-08-01

    The segmental omental infarction is a rare self-limited disorder presenting with aspecific clinical symptoms that may mimic several acute abdominal conditions. Therefore, a correct noninvasive diagnosis is important because treatment approaches range from monitoring to surgery. As omental infarction results in an important fat stranding that is much greater than the degree of bowel wall thickening, it suggests a narrower differential diagnosis: appendicitis, diverticulitis, epiploic appendagitis, and mesenteric panniculitis. In this pictorial essay, we point out the importance of imaging in identifying this typical sign allowing alternate diagnoses such as segmental omental infarction that can be conservatively managed.

  14. Abdominal hollowing and lateral abdominal wall muscles' activity in both healthy men & women: An ultrasonic assessment in supine and standing positions.

    PubMed

    Manshadi, Farideh Dehghan; Parnianpour, Mohamad; Sarrafzadeh, Javad; Azghani, Mahmood Reza; Kazemnejad, Anooshirvan

    2011-01-01

    The objective of this study was to investigate the effects of Abdominal Hollowing (AH) maneuver on External Oblique (EO), Internal Oblique (IO) and Transversus Abdominis (TrA) muscles in both healthy men and women during the two postures of supine and upright standing. The study was conducted on 43 asymptomatic volunteers (22 males and 21 females) aged 19-44 (27.8±6.4) years. Rehabilitative Ultrasonic Imaging (RUSI) was simultaneously performed to measure muscle thickness in both rest and during AH maneuvers while activation of the TrA during AH was controlled by Pressure Biofeedback (PBF) device. Mixed-model ANOVA with repeated measures design, and Pearson correlation tests were used to analyze the data. Muscle thickness of all muscles was significantly higher for male subjects (F>6.2, p<0.017). The interaction effect of gender and muscle status was significant only for IO (F=7.458, p=0.009) indicating that AH maneuver increased the thickness of IO in men. Interaction effect of posture and muscle status on muscular thickness indicated that changing position only affects the resting thickness of TrA (F=5.617, p=0.023). Standing posture significantly affected the TrA contraction ratio (t=3.122, p=0.003) and TrA preferential activation ratio (t=2.76, p=0.008). There was no relationship between age and muscle thickness (r=0.262, p=0.09). The PBF has been introduced as a clinical and available device for monitoring TrA activity, while RUSI showed that both TrA and IO muscles had activated after AH maneuver. We recommend performing further investigations using electromyography and RUSI simultaneously at more functional postures such as upright standing.

  15. The use of flow perfusion culture and subcutaneous implantation with fibroblast-seeded PLLA-collagen 3D scaffolds for abdominal wall repair.

    PubMed

    Pu, Fanrong; Rhodes, Nicholas P; Bayon, Yves; Chen, Rui; Brans, Gerben; Benne, Remco; Hunt, John A

    2010-05-01

    Highly cellularised 3D-tissue constructs designed to repair large, complex abdominal wall defects were prepared using poly (lactic acid) (PLLA)-collagen scaffolds in vitro using a flow perfusion bioreactor. The PLLA-collagen scaffolds had a unique structure consisting of a collagen sponge formed within the pores of a mechanically stable knitted mesh of PLLA. The effect of the flow perfusion bioreactor culturing conditions was investigated in vitro for 0, 7, 14 and 28 days on scaffolds seeded with dermal fibroblasts. The cultured constructs were subsequently studied subcutaneously (SC) in an in vivo animal model. The results of in vitro studies demonstrated that the perfusion system facilitated increased cell proliferation and homogenous distribution in the PLLA-collagen scaffolds compared to static conditions. A highly cellularised 3D-tissue construct was formed by 7 days incubation under perfusion conditions, with increased cellularity by the 28 day time point. The in vivo model demonstrated that implanting constructs with high cellularity resulted in exceptional cell stabilisation, with the survival of implanted cells and expression of the phenotypically-relevant extracellular matrix proteins collagen types I and III, studied by fluorescence in situ hybridisation (FISH) and immunohistochemistry. The implantation of this porous PPLA-collagen scaffold seeded with dermal fibroblasts following in vitro maturation using a flow perfusion bioreactor system suggests a significant advance over current state-of-the-art procedures for the reconstruction of large, complex abdominal wall tissue defects. PMID:20219244

  16. Mechanical strength vs. degradation of a biologically-derived surgical mesh over time in a rodent full thickness abdominal wall defect.

    PubMed

    Costa, A; Naranjo, J D; Turner, N J; Swinehart, I T; Kolich, B D; Shaffiey, S A; Londono, R; Keane, T J; Reing, J E; Johnson, S A; Badylak, S F

    2016-11-01

    The use of synthetic surgical mesh materials has been shown to decrease the incidence of hernia recurrence, but can be associated with undesirable effects such as infection, chronic discomfort, and adhesion to viscera. Surgical meshes composed of extracellular matrix (i.e., biologically-derived mesh) are an alternative to synthetic meshes and can reduce some of these undesirable effects but are less frequently used due to greater cost and perceived inadequate strength as the mesh material degrades and is replaced by host tissue. The present study assessed the temporal association between mechanical properties and degradation of biologic mesh composed of urinary bladder matrix (UBM) in a rodent model of full thickness abdominal wall defect. Mesh degradation was evaluated for non-chemically crosslinked scaffolds with the use of (14)C-radiolabeled UBM. UBM biologic mesh was 50% degraded by 26 days and was completely degraded by 90 days. The mechanical properties of the UBM biologic mesh showed a rapid initial decrease in strength and modulus that was not proportionately associated with its degradation as measured by (14)C. The loss of strength and modulus was followed by a gradual increase in these values that was associated with the deposition of new, host derived connective tissue. The strength and modulus values were comparable to or greater than those of the native abdominal wall at all time points. PMID:27619242

  17. The hypertrophy of the lateral abdominal wall and quadratus lumborum is sport-specific: an MRI segmental study in professional tennis and soccer players.

    PubMed

    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.

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

    PubMed

    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.

  19. Abdominal tap

    MedlinePlus

    Peritoneal tap; Paracentesis; Ascites - abdominal tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap ... abdominal cavity ( most often cancer of the ovaries ) Cirrhosis of the liver Damaged bowel Heart disease Infection ...

  20. Electromyography study of the portions of the abdominal rectus muscle.

    PubMed

    Negrao Filho, R de F; Bérzin, F; Souza, G da C

    1997-01-01

    This study objective was to verify the behavior of three portions of the abdominal rectus muscle through a quantitative analysis of the electromyographic signal in different types of abdominal exercises. Ten young male between 16 and 27 years old were studied and they had no previous history of muscle and joint illness. They were well-trained and did seven abdominal exercises chosen considering the types of contraction (isotonic and isometric) as well as the muscle fixation points. The electric activity of the superior, medium (above umbilicus) and inferior (below umbilicus) portions at the left side of the abdominal rectus muscle was taken using Beckman type surface mini-electrodes. The registers were collected from computerized 8-channel Nicholet electromyography equipment, model Viking II. The signals were quantified using the MVA (Maximum Volunteer Activity) software, being considered for analysis the values of RMS (Root Mean Square). The obtained data were submitted to a parametric analysis using the variance analysis (F test) and also the Tukey test, besides a descriptive graphic analysis starting from the average RMS values of each muscle portion. This study results suggest that for the majority of the subjects, the functional activities of the abdominal rectus muscle are performed with electric activity differences among their portions, showing a tendency of producing more electric activity in the superior portion than in the medium and inferior portions. The experiment also demonstrated an absence of a common behavior pattern in the three portions of the ten tested subjects. PMID:9444489

  1. Open repair of large abdominal wall hernias with and without components separation; an analysis from the ACS-NSQIP database

    PubMed Central

    Desai, Nirav K.; Leitman, I. Michael; Mills, Christopher; Lavarias, Valentina; Lucido, David L.; Karpeh, Martin S.

    2016-01-01

    Background Components separation technique emerged several years ago as a novel procedure to improve durability of repair for ventral abdominal hernias. Almost twenty-five years since its initial description, little comprehensive risk adjusted data exists on the morbidity of this procedure. This study is the largest analysis to date of short-term outcomes for these cases. Methods The ACS-NSQIP database identified open ventral or incisional hernia repairs with components separation from 2005 to 2012. A data set of cohorts without this technique, matched for preoperative risk factors and operative characteristics, was developed for comparison. A comprehensive risk-adjusted analysis of outcomes and morbidity was performed. Results A total of 68,439 patients underwent open ventral hernia repair during the study period (2245 with components separation performed (3.3%) and 66,194 without). In comparison with risk-adjusted controls, use of components separation increased operative duration (additional 83 min), length of stay (6.4 days vs. 3.8 days, p < 0.001), return to the OR rate (5.9% vs. 3.6%, p < 0.001), and 30-day morbidity (10.1% vs. 7.6%, p < 0.001) with no increase in mortality (0.0% in each group). Conclusions Components separation technique for large incisional hernias significantly increases length of stay and postoperative morbidity. Novel strategies to improve short-term outcomes are needed with continued use of this technique. PMID:27158489

  2. The soft tissue response to contaminated and cleaned titanium surfaces using CO2 laser, citric acid and hydrogen peroxide. An experimental study in the rat abdominal wall.

    PubMed

    Mouhyi, J; Sennerby, L; Van Reck, J

    2000-04-01

    The soft tissue response to clinically retrieved and decontaminated cover screws was evaluated in a rat model. The cover screws were cleaned by using citric acid, sterile water, hydrogen peroxide and CO2 laser alone or with a combination of these. In addition, decontaminated but not cleaned and unused cover screws were used as negative and positive controls, respectively. After cleaning the cover screws were implanted in the abdominal wall of the rat for 6 weeks. The thickness of the fibrous capsule and the number of macrophages within the capsule were measured by means of light microscopical morphometry. As compared to the negative control, CO2 laser on dry surface, CO2 laser + hydrogen peroxide and the positive control had statistically significant thinner fibrous capsules. As compared to the positive, only laser alone resulted in a similar tissue response. It is concluded that CO2 laser used alone or in combination with hydrogen peroxide may be used clinically for sufficient decontamination of titanium surfaces.

  3. Anterior vaginal wall repair

    MedlinePlus

    ... your health care provider may have you learn pelvic floor muscle exercises ( Kegel exercises ), use estrogen cream in ... GM. Anatomic defects of the abdominal wall and pelvic floor: abdominal and inguinal hernias, cystocele, urethrocele, enterocele, rectocele, ...

  4. Management of voluminous abdominal incisional hernia.

    PubMed

    Bouillot, J-L; Poghosyan, T; Pogoshian, T; Corigliano, N; Canard, G; Veyrie, N

    2012-10-01

    Incisional hernia is one of the classic complications after abdominal surgery. The chronic, gradual increase in size of some of these hernias is such that the hernia ring widens to a point where there is a loss of substance in the abdominal wall, herniated organs can become incarcerated or strangulated while poor abdominal motility can alter respiratory function. The surgical treatment of small (<5 cm) incisional hernias is safe and straightforward, by either laparotomy or laparoscopy. For large hernias, surgical repair is often difficult. After reintegration of herniated viscera into the abdominal cavity, the abdominal wall defect must be closed anatomically in order to restore the function to the abdominal wall. Prosthetic reinforcement of the abdominal wall is mandatory for long-term successful repair. There are multiple techniques for prosthetic hernia repair, but placement of Dacron mesh in the retromuscular plane is our preference. PMID:23137643

  5. Robotic-assisted partial cystectomy with en bloc excision of the urachus and the umbilicus for urachal adenocarcinoma.

    PubMed

    Correa, Jose J; Hakky, Tariq S; Spiess, Philippe E; Chuang, Tian; Sexton, Wade J

    2010-01-01

    We report two cases of urachal adenocarcinoma managed with robotic-assisted partial cystectomy. A detailed description of the robotic technique including methods used to resect the tumor, urachus, and umbilicus en bloc is described. A review of the management of urachal adenocarcinoma is presented. The robotic approach is technically feasible and safe, and is an attractive alternative to traditional open or laparoscopic-assisted partial cystectomy for this uncommon genitourinary malignancy. PMID:27628636

  6. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  7. [Abdominal approaches and drainages of the abdominal cavity].

    PubMed

    Hagel, C; Schilling, M

    2006-04-01

    Appropriate access to the abdominal cavity is the first and crucial step for successful abdominal surgical intervention. In planning the incision, several variables have to be considered, such as anatomy of the abdominal wall, localization of the target organ, and individual conditions (previous incisions, minimal access surgery, etc). Medial laparotomy is the preferred incision for emergency cases and ill-defined pathologies, allowing access and hence exploration to all quadrants. Transverse laparotomies give superior access to the dorsal and right aspects of the liver and cause less pain in patients unfit for regional anesthetic procedures. Draining of the abdominal cavity is used after various resective and reconstructive procedures, but there is little evidence for its use in a number of operations such as gastric, hepatic, and colorectal resections. Advantages and disadvantages of different abdominal wall incisions and drainages are discussed.

  8. Laparoscopic excision of intra-abdominal paragonimiasis.

    PubMed

    Kim, Jun-Young; Kang, Chang-Moo; Choi, Gi-Hong; Yang, Woo-Ick; Sim, Seo-Bo; Kwon, Ji-Eun; Kim, Kyung-Sik; Choi, Jin-Sub; Lee, Woo-Jung; Kim, Byong-Ro

    2007-12-01

    Lung fluke, Paragonimus westermani of Paragonimus species usually are accompanied by a persistent cough, hemoptysis, and chest pain. Extrapulmonary paragonimiasis caused by ectopic parasites in aberrant locations such as the abdominal wall, abdominal organs, and brain has been reported and the most commonly involved extrapulmonary organ is the brain. We present a case of 56-year-old male patient with intra-abdominal paragonimiasis who underwent laparoscopic excision of abdominal granuloma caused by parasite infection. An intra-abdominal mass associated with eosinophilia might be related to parasite infection. A laparoscopic approach is the most appropriate treatment modality in such benign abdominal pathology.

  9. Effect of alpha lipoic acid co-administration on structural and immunohistochemical changes in subcutaneous tissue of anterior abdominal wall of adult male albino rat in response to polypropylene mesh implantation

    PubMed Central

    Mazroa, Shireen A; Asker, Samar A; Asker, Waleed; Abd Ellatif, Mohamed

    2015-01-01

    Polypropylene mesh is commonly used in the treatment of abdominal hernia. Different approaches were addressed to improve their tissue integration and consequently reduce long-term complications. This study aimed to investigate the effect of alpha-lipoic acid (ALA) co-administration on structural and immunohistochemical (IHC) changes in the subcutaneous tissues of the anterior abdominal wall of the adult rat in response to polypropylene mesh implantation. Forty adult male albino rats were divided into: group I (control), group II (receiving ALA), group III (polypropylene mesh implantation) and group IV (mesh implantation + ALA co-administration). After 4 weeks, subcutaneous tissue samples were prepared for light microscopy and IHC study of CD34 as a marker for angiogenesis. In groups I and II rats, positive CD34 expression was demonstrated by IHC reaction, localized to endothelial cells lining small blood vessels. Group III showed an excess inflammatory reaction, deposition of both regular and irregularly arranged collagen fibres around mesh pores and few elastic fibres. CD34-positive was detected not only in cells lining small blood vessels but also in other cells scattered in the connective tissue indicating angiogenesis. In group IV, ALA co-administration resulted in less inflammatory reaction, regular collagen deposition, enhanced elastic fibres synthesis and a significant increase in CD34-positive cells and small blood vessels reflecting improved angiogenesis. ALA co-administration with polypropylene mesh implantation controlled the inflammatory reaction, helped regular collagen deposition, enhanced elastic fibres synthesis and improved angiogenesis in the subcutaneous tissue of anterior abdominal wall of adult albino rats, suggesting a possible role of ALA in optimizing mesh integration in subcutaneous tissue. PMID:25891652

  10. Effect of alpha lipoic acid co-administration on structural and immunohistochemical changes in subcutaneous tissue of anterior abdominal wall of adult male albino rat in response to polypropylene mesh implantation.

    PubMed

    Mazroa, Shireen A; Asker, Samar A; Asker, Waleed; Abd Ellatif, Mohamed

    2015-06-01

    Polypropylene mesh is commonly used in the treatment of abdominal hernia. Different approaches were addressed to improve their tissue integration and consequently reduce long-term complications. This study aimed to investigate the effect of alpha-lipoic acid (ALA) co-administration on structural and immunohistochemical (IHC) changes in the subcutaneous tissues of the anterior abdominal wall of the adult rat in response to polypropylene mesh implantation. Forty adult male albino rats were divided into: group I (control), group II (receiving ALA), group III (polypropylene mesh implantation) and group IV (mesh implantation + ALA co-administration). After 4 weeks, subcutaneous tissue samples were prepared for light microscopy and IHC study of CD34 as a marker for angiogenesis. In groups I and II rats, positive CD34 expression was demonstrated by IHC reaction, localized to endothelial cells lining small blood vessels. Group III showed an excess inflammatory reaction, deposition of both regular and irregularly arranged collagen fibres around mesh pores and few elastic fibres. CD34-positive was detected not only in cells lining small blood vessels but also in other cells scattered in the connective tissue indicating angiogenesis. In group IV, ALA co-administration resulted in less inflammatory reaction, regular collagen deposition, enhanced elastic fibres synthesis and a significant increase in CD34-positive cells and small blood vessels reflecting improved angiogenesis. ALA co-administration with polypropylene mesh implantation controlled the inflammatory reaction, helped regular collagen deposition, enhanced elastic fibres synthesis and improved angiogenesis in the subcutaneous tissue of anterior abdominal wall of adult albino rats, suggesting a possible role of ALA in optimizing mesh integration in subcutaneous tissue.

  11. Abdominal Pain

    MedlinePlus

    ... can help the overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] ... related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, ...

  12. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  13. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  14. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  15. Abdominal thrusts

    MedlinePlus

    ... call 911 . If the person loses consciousness, start CPR . If you are not comfortable performing abdominal thrusts, ... American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ... Red Cross; 2014. Berg RA, Hemphill R, Abella BS, et al. Part 5: ...

  16. [Differential surgical treatment of victims with damage to the small and large intestines in a closed abdominal injury combined, depending on the prediction of traumatic disease course and morphological changes of the intestinal wall].

    PubMed

    Zaruts'kyĭ, Ia L; Denysenko, V M; Khomenko, I P; Levkivskyĭ, R H

    2013-08-01

    Use of differentiated surgical approach to the management of surgical treatment, depending on the degree of violation of systemic hemodynamics, the timing and volume of surgical procedures, depending on the prognosis of traumatic disease course of cardiac index, interventions in the small and large intestine depending on morphological changes of the intestinal wall by cardiac and stroke indexes, put method extra-enteric anastomosis in patients with damage to the small intestine and colon combined with closed abdominal injury permitted to reduce the rate of postoperative complications from 22.2 to 10.1%, mortality at 2.1 times in shock period (from 19.3 to 9.2%) and the overall mortality from 33.3 to 21.1%.

  17. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  18. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  19. Retrospective analysis of a VACM (vacuum-assisted closure and mesh-mediated fascial traction) treatment manual for temporary abdominal wall closure - results of 58 consecutive patients.

    PubMed

    Beltzer, Christian; Eisenächer, Alexander; Badendieck, Steffen; Doll, Dietrich; Küper, Markus; Lenz, Stefan; Krapohl, Björn Dirk

    2016-01-01

    Einleitung: Das optimale Behandlungskonzept eines temporären Bauchdeckenverschlusses (temporary abdominal closure, TAC) bei kritisch kranken viszeralchirurgischen Patienten mit offenem Abdomen („open abdomen“, OA) ist weiterhin unklar. Durch eine VACM-Therapie (vacuum-assisted closure and mesh-mediated fascial traction) scheinen sich gegenüber anderen Verfahren des TAC höhere Faszienverschlussraten (delayed primary fascial closure rate, FCR) realisieren zu lassen. Material und Methoden: Patienten unserer Klinik (n=58), welche in den Jahren 2005 bis 2008 mittels eines VAC/VACM-Behandlungsmanuals behandelt wurden, wurden retrospektiv analysiert. Ergebnisse: Die FCR aller Patienten betrug insgesamt 48,3% (95%-Konfidenzintervall: 34,95–61,78). Bei Patienten, bei denen im Verlauf ein Vicryl-Netz auf Faszienebene implantiert wurde (VACM-Therapie), konnte eine FCR von 61,3% realisiert werden. Die Letalität der mittels VACM therapierten Patienten betrug 45,2% (95%-KI: 27,32–63,97).Schlussfolgerung: Die Ergebnisse der eigenen Untersuchung bestätigen bisherige Studienergebnisse, die eine akzeptable FCR bei non-trauma-Patienten durch Anwendung der VACM-Therapie zeigen konnten. Die VACM-Therapie scheint aktuell Therapiekonzept der ersten Wahl bei Patienten mit OA und Indikation zum TAC zu sein.

  20. Retrospective analysis of a VACM (vacuum-assisted closure and mesh-mediated fascial traction) treatment manual for temporary abdominal wall closure – results of 58 consecutive patients

    PubMed Central

    Beltzer, Christian; Eisenächer, Alexander; Badendieck, Steffen; Doll, Dietrich; Küper, Markus; Lenz, Stefan; Krapohl, Björn Dirk

    2016-01-01

    Introduction: The optimal treatment concept for temporary abdominal closure (TAC) in critically ill visceral surgery patients with open abdomen (OA) continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction) therapy seems to permit higher delayed primary fascial closure rates (FCR) than other TAC procedures. Material and methods: Patients of our clinic (n=58) who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed. Results: The overall FCR of all patients was 48.3% (95% confidence interval: 34.95–61.78). An FCR of 61.3% was achieved in patients who had a vicryl mesh implanted at the fascial level (VACM therapy) in the course of treatment. Mortality among patients treated with VACM therapy was 45.2% (95% CI: 27.32–63.97). Conclusions: The results of our own study confirm the results of previous studies which showed an acceptable FCR among non-trauma patients who were treated with VACM therapy. VACM therapy currently appears to be the treatment regime of choice for patients with OA requiring TAC. PMID:27547691

  1. Effects of the changes in the wall shear stresses (WSS) acting on endothelial cells (EC) during the enlargement of Abdominal Aortic Aneurysms (AAA)

    NASA Astrophysics Data System (ADS)

    Salsac, Anne-Virginie

    2005-03-01

    The changes in the spatial and temporal distribution of the WSS and gradients of WSS during the enlargement of AAAs are important to understand the etiology and progression of this vascular disease, since they affect the wall structural integrity, primarily via the changes induced on the shape, functions and metabolism of the endothelial cells. PIV measurements were performed in aneurysm models, while changing systematically their size and geometry. Two regions with distinct patterns of WSS were identified. The region of flow detachment extends over the proximal half and is characterized by oscillatory WSS of very low mean. The region of flow reattachment, located distally, is dominated by large, negative WSS and sustained gradients of WSS that result from the impact of the vortex ring on the wall. Cultured EC were subjected to these two types of stimuli in vitro. The permeability of the endothelium was found to be largely increased in the flow detachment region. Endothelium cell-cell adhesion, proliferation and apoptosis were also affected by the high gradients of WSS.

  2. Abdominal actinomycosis mimicking acute appendicitis.

    PubMed

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  3. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  4. [The abdominal drop flap].

    PubMed

    Bodin, F; Liverneaux, P; Seigle-Murandi, F; Facca, S; Bruant-Rodier, C; Dissaux, C; Chaput, B

    2015-08-01

    The skin between the mastectomy scar and the future infra-mammary fold may be managed in different ways in delayed breast reconstruction using a DIEP (deep inferior epigastric perforator). Conserving this skin and positioning the flap skin paddle in the middle of the breast usually highlights skin color disparity because of two visible transition zones. Resection of the entire skin under the scar may be more aesthetic but limits direct closure possibility in case of flap failure. In order to benefit from both aesthetic result and safe surgical method, we propose the abdominal drop flap. The inferior thoracic skin flap is detached from the thoracic wall beyond the future infra-mammary fold, preserved and pushed under the breast.

  5. Two adjacent individual fibroepithelioma of Pinkus of the umbilicus-one pink, one pigmented-a case report and review of the literature.

    PubMed

    Inskip, Mike; Longo, Caterina; Haddad, Afaf

    2016-04-01

    We present a unique case of separate and independent adjacent fibroepitheliomas of Pinkus (FeP) arising from the umbilicus in an 83-year-old man. Of further interest, one is pigmented and the other nonpigmented. Clinical, dermatoscopic and histopathological images are provided. A review of the published literature is undertaken to attempt to assess the incidence of pigmented versus nonpigmented FeP. Of 24 published FeP cases, 10 (41.7%) have been pigmented. Thus to date pigmented FeP comprise approaching one-half of all reported cases. PMID:27222767

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

    PubMed

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

    2015-02-01

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

  7. Understanding noninguinal abdominal hernias in the athlete.

    PubMed

    Cabry, Robert J; Thorell, Erik; Heck, Keith; Hong, Eugene; Berkson, David

    2014-01-01

    Abdominal hernias are common with over 20 million hernia repairs performed worldwide. Inguinal hernias are the most common type of hernia. Inguinal and sports hernia have been discussed at length in recent literature, and therefore, they will not be addressed in this article. The noninguinal hernias are much less common but do occur, and knowledge of these hernias is important when assessing the athlete with abdominal pain. Approximately 25% of abdominal wall hernias are noninguinal, and new data show the order of frequency as umbilical, epigastric, incisional, femoral, and all others (i.e., Spigelian, obturator, traumatic). Return-to-play guidelines need to be tailored to the athlete and the needs of their sport. Using guidelines similar to abdominal strain injuries can be a starting point for the treatment plan. Laparoscopic repair is becoming more popular because of safety and efficacy, and it may lead to a more rapid return to play. PMID:24614421

  8. Magnetic Surgical Instruments for Robotic Abdominal Surgery.

    PubMed

    Leong, Florence; Garbin, Nicolo; Natali, Christian Di; Mohammadi, Alireza; Thiruchelvam, Dhan; Oetomo, Denny; Valdastri, Pietro

    2016-01-01

    This review looks at the implementation of magnetic-based approaches in surgical instruments for abdominal surgeries. As abdominal surgical techniques advance toward minimizing surgical trauma, surgical instruments are enhanced to support such an objective through the exploration of magnetic-based systems. With this design approach, surgical devices are given the capabilities to be fully inserted intraabdominally to achieve access to all abdominal quadrants, without the conventional rigid link connection with the external unit. The variety of intraabdominal surgical devices are anchored, guided, and actuated by external units, with power and torque transmitted across the abdominal wall through magnetic linkage. This addresses many constraints encountered by conventional laparoscopic tools, such as loss of triangulation, fulcrum effect, and loss/lack of dexterity for surgical tasks. Design requirements of clinical considerations to aid the successful development of magnetic surgical instruments, are also discussed.

  9. Breast reconstruction with single-pedicle TRAM flap in breast cancer patients with low midline abdominal scar

    PubMed Central

    Wu, Jun-Dong; Huang, Wen-He; Qiu, Si-Qi; He, Li-Fang; Guo, Cui-Ping; Zhang, Yong-Qu; Zhang, Fan; Zhang, Guo-Jun

    2016-01-01

    Breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap is challenging in patients with low midline abdominal scar. In this study, we aimed to investigate the clinical feasibility of immediate breast reconstruction using single-pedicle TRAM (SP-TRAM) flaps in patients with low midline abdominal scar. There were 4 strict selection criteria: 1) presence at least 3 perforators on the pedicle side; 2) perforators with regional average flow velocity of >20 cm/s; 3) upper edge of the abdominal scar at least 4 cm from the umbilicus; and 4) scar age >1 year. Eight breast cancer patients with low midline abdominal scar (scar group) and 20 without (control group) underwent immediate breast reconstruction with SP-TRAM flaps consisting of zone I and III and zone II tissues. Flap complications, donor-site complications, and cosmetic results were compared between the two groups. All flaps survived and both groups presented similar flap and donor site complications, including fat necrosis, seroma, hematoma, infection, delayed wound healing, and abdominal hernia, and patients in both groups had similar aesthetic results (p > 0.05). Thus, the study demonstrated that breast reconstruction using SP-TRAM flap was a safe approach in carefully selected patients with low midline abdominal scar. PMID:27406872

  10. Abdominal cerebrospinal fluid pseudocysts.

    PubMed

    Erşahin, Y; Mutluer, S; Tekeli, G

    1996-12-01

    Abdominal cerebrospinal fluid pseudocyst in an infrequent complication of ventriculoperitoneal (VP) shunts. We reviewed ten patients with abdominal pseudocyst. There were five girls and five boys, aged between 4 months and 14 years. The number of shunt procedures prior to the presentation varied between one and five. Only one patient had had a previous shunt infection. No patients had undergone prior abdominal surgery other than VP shunting. The time from the last shunting procedure to the development of abdominal pseudocyst ranged from 3 weeks to 5 years. Presenting symptoms and signs were mainly related to abdominal complaints in all patients. Three patients also had signs of shunt malfunction. The diagnosis was made by ultrasound in all patients. Shunt infection was determined in six patients. Repositioning if the peritoneal catheter seemed to have a higher rate of recurrence. The diagnosis of abdominal pseudocyst should be considered in VP-shunted patients presenting with abdominal complaints.

  11. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  12. Pleuropulmonary and abdominal paragonimiasis: CT and ultrasound findings

    PubMed Central

    Shim, S S; Kim, Y; Lee, J K; Lee, J H; Song, D E

    2012-01-01

    Objectives The purpose of this study was to review radiological images of patients with Paragonimus westermani (PW) that simultaneously involved the chest and abdomen. Methods Our study included four patients with serologically and histopathologically confirmed paragonimiasis. Abdomen CT (n=3) and chest CT (n=3) scans were available, and abdominal wall ultrasonography was performed in all patients. We retrospectively reviewed the clinical, radiological and histopathological findings of these patients. Results The most common abdominal CT findings were ascites and intraperitoneal or abdominal wall nodules. Low-attenuated serpentine lesions of the liver were another common and relatively specific feature. Conclusion Radiologists should consider the possibility of PW when these abdominal CT findings are noted, especially with pleural effusion or subpleural nodules in patients with initial abdominal symptoms. PMID:22457403

  13. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot

    PubMed Central

    Koulas, Spyridon; Tsimoyiannis, Ioannis

    2016-01-01

    Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically. PMID:27525150

  14. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot.

    PubMed

    Stefanou, Christos; Zikos, Nicolaos; Pappas-Gogos, George; Koulas, Spyridon; Tsimoyiannis, Ioannis

    2016-01-01

    Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically. PMID:27525150

  15. Cardiopulmonary monitoring in intra-abdominal hypertension.

    PubMed

    Malbrain, Manu L N G; Ameloot, Koen; Gillebert, Carl; Cheatham, Michael L

    2011-07-01

    Cardiopulmonary dysfunction and failure are commonly encountered in the patient with intra-abdominal hypertension (IAH) or abdominal compartment syndrome. Accurate assessment and optimization of preload, contractility, and afterload in conjunction with appropriate goal-directed resuscitation and assessment of fluid responsiveness are essential to restore end-organ perfusion. In patients with IAH, the traditional "barometric" preload indicators such as pulmonary artery occlusion pressure and central venous pressure are erroneously increased. Volumetric monitoring techniques have been proven to be superior in directing the appropriate resuscitation together with targeted abdominal perfusion pressure. If such limitations are not recognized, misinterpretation of the patient's cardiac status is likely, resulting in inappropriate and potentially detrimental therapy. IAH also markedly affects the mechanical properties of the chest wall and consequently also the respiratory function. Altered mechanical properties of the chest wall may limit ventilation, influence the work of breathing, affect the interaction between the respiratory muscles, hasten the development of respiratory failure, and interfere with gas exchange. Pulmonary monitoring is important to understand the relationships between intra-abdominal pressure and chest wall mechanics and the impact of IAH on ventilator-induced lung injury, lung distention, recruitment, and lung edema. PMID:21944448

  16. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  17. [Abdominal compartment syndrome].

    PubMed

    Pottecher, T; Segura, P; Launoy, A

    2001-04-01

    French physicians dealing with abdominal emergencies are not very familiar with the abdominal compartment syndrome (ACS). Increased abdominal pressure has deleterious consequences on local (intestine, liver, kidney) circulation, leading to death in the absence of correct treatment. Abdominal trauma and ruptured aortic aneurism are the main causes of ACS. Clinical presentation may be misleading: respiratory failure, oliguria or circulatory symptoms are often predominant. Abdominal palpation is inefficient for evaluating intra-abdominal pressure (IAP); only measurement of cystic pressure allows precise evaluation of IAP. Abdominal decompression is the treatment of choice. It must be performed as soon as IAP exceeds 25 mmHg. The procedure may be risky with a high incidence of severe complications when ischaemic territories are reperfused. Recent data underline the importance of compensation of hypovolemia before decompression. Abdominal closure may necessitate various techniques (aponevrotomy, Bogota bags, etc.). At any rate, IAP must remain low at the end of the procedure. In case of suspicion of ACS, early measurement of IAP is mandatory. If pressure is over 25 mmHg, a decompressive procedure must be initiated. PMID:11340703

  18. [Semeiotics of abdominal tuberculosis].

    PubMed

    Guseĭnov, G K; Ramazanova, A M; Guseĭnov, A G

    1984-01-01

    Examination of 119 patients with abdominal tuberculosis permitted the description of the characteristic semiotics of the illness. Today the patients with abdominal tuberculosis are mainly women of child-bearing age with a long-term tuberculosis catamnesis and intoxication, with a history of tuberculosis of different sites, those suffering from tuberculosis or its sequels at present (64%), those with pains (94%), discomfort or swelling of the abdomen (79%), malfunction of the gastrointestinal tract (65%), weight loss (86%), malnutrition (72%), anemia (63%), not infrequently with inflammatory induration (43%) or ascites in the abdominal cavity (39%). In addition to this characteristic semiotics, the patients with abdominal tuberculosis may demonstrate the most different and unexpected symptoms up to acute abdomen (23%). To make differential diagnosis of abdominal tuberculosis, one has often to resort to diagnostic laparotomy, laparoscopy, Koch's test and to trial therapy.

  19. Melanoma of the Umbilicus: A Patient Report, Precaution in Operative Strategy, and the First Histopathological Review of Published Cases

    PubMed Central

    Suzuki, Shuji; Yoshida, Yuichi; Shiomi, Tatsushi; Yanagihara, Shigeto; Kimura, Ryoko; Yamamoto, Osamu

    2016-01-01

    Umbilical melanoma is extremely rare. Among the past English reports on umbilical melanoma, there are only 8 reports in which histopathology was described in detail, and there has been no report with a review of the histopathology of previously reported cases. We experienced a case of umbilical melanoma and reviewed previously reported cases including our case. Because of the anatomical location, it is difficult to become aware of the umbilical melanoma unless there are some concomitant symptoms such as discharge or swelling. Even with these symptoms, patients tend to postpone a hospital visit for unknown reasons, resulting in increased risk of tumor growth and metastasis. When performing resection of umbilical melanoma, a portion of the peritoneum should also be removed. Sentinel lymph nodes can be axilla or inguinal lymph nodes. There is a possibility of metastasis to the preoperative abdominal cavity or to nearby skin through hematogenous spread. Preoperative evaluation of tumor spread and postoperative observation are important for umbilical melanoma in order to detect recurrence or metastasis because of its unique anatomical location. PMID:27493491

  20. [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].

    PubMed

    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.

  1. Ultrasound evaluation of abdominal masses in Ethiopian child patients.

    PubMed

    Kebede, Assefa Getachew; Nigussie, Yared

    2011-07-01

    The aim of this study was to assess the pattern of abdominal masses and evaluate the value of ultrasound in paediatric abdominal masses. We used a cross-sectional study of abdominal masses in children attending a university teaching hospital. The common abdominal masses were: Wilms' tumour, 12 (14.8%); lymphoma, 11 (13.6%); appendiceal mass/abscess, 11 (13.6%); neuroblastoma, 7 (8.6%); TB, 6 (7.4%); hydronephrosis, 5 (6.2%); abdominal wall abscess, 6 (7.4%); hydatidcyst, 4 (4.9%); mesenteric cyst, 3 (3.7%); and intussusceptions, 3 (3.7%). Identification of a purely cystic mass was suggestive of benign lesion (odds ratio [OR] = 118, P = 0.0001) and masses found in the <5 years age group tend to be malignant (OR = 2.77). The most common sites of origin were kidneys, retroperitoneal extra renal and gastrointestinal tract. The overall diagnostic accuracy of ultrasound was 88.9%.

  2. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  3. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  4. Characteristics of colorectal cancer diagnosed with screening abdominal ultrasonography

    PubMed Central

    TOMIZAWA, MINORU; SHINOZAKI, FUMINOBU; HASEGAWA, RUMIKO; FUGO, KAZUNORI; SHIRAI, YOSHINORI; MOTOYOSHI, YASUFUMI; SUGIYAMA, TAKAO; YAMAMOTO, SHIGENORI; KISHIMOTO, TAKASHI; ISHIGE, NAOKI

    2016-01-01

    Patient records were retrospectively analyzed to elucidate the characteristics of patients with colorectal cancer (CRC) diagnosed with screening abdominal ultrasound (US). Patients diagnosed with CRC using abdominal US [localized irregular wall thickening (W) or a hypoechoic mass with a hyperechoic mass (M)] were enrolled. The patients were subjected to colonoscopy and treated surgically between March, 2010 and January, 2015. A total of 5 men (aged 74.0±0.8 years) and 10 women (aged 73.0±12.0 years) were analyzed. Stratification was analyzed with abdominal US. The threshold value of wall thickness to diagnose CRC was investigated with receiver operating characteristic (ROC) curve analysis. The average wall thickness was 2.8±0.4 mm in the surrounding normal tissue and 12.7±5.2 mm in CRC (one-way analysis of variance, P<0.0001). The wall was significantly thicker in CRC compared with the normal colonic wall. The calculated threshold value was 4.3 mm for the diagnosis of CRC. Stratification was preserved in W, while it was lost in M (Chi-squared test, P=0.0196). The hemoglobin concentration was lower, while the C-reactive protein, carcinoembryonic antigen and carbohydrate antigen 19-9 levels were elevated above normal values. The threshold value was 4.3 mm for the diagnosis of CRC with abdominal US. PMID:27330768

  5. Abdominal Compartment Syndrome Secondary to Chronic Constipation

    PubMed Central

    Flageole, Helene; Ouahed, Jodie; Walton, J. Mark; Yousef, Yasmin

    2011-01-01

    Abdominal compartment syndrome (ACS) is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not. PMID:22606517

  6. [Abdominal actinomycosis: four cases].

    PubMed

    Ghannouchi Jaafoura, N; Kaabia, N; Khalifa, M; Ben Jazia, I; Hachfi, W; Braham, A; Letaief, A; Bahri, F

    2008-12-01

    The abdominal actinomycosis (AA) is a rare and often unrecognised suppurative chronic illness. It is caused by an anaerobic Gram positive bacteria, Actinomyces israelii. Abdominal actinomycosis is responsible for pseudotumoral syndrome often leading, to a large and mutilating surgery whereas a prolonged treatment by antibiotics would have permitted to cure the disease. The diagnosis is obtained generally from anatomopathologic exam. We report four cases of abdominal actinomycosis being revealed by a pseudotumoral syndrome. The diagnosis was only made after surgery. In spite of an active treatment by antibiotics during several months, two of our patients had a relapse of the infectious process. These four observations confirm the diagnostic and therapeutic difficulties previously reported by other authors.

  7. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  8. Predictive factors of abdominal compartment syndrome in neonatal age.

    PubMed

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

    2014-01-01

    In the pediatric population, abdominal compartment syndrome (ACS) is a known complication of abdominal wall defect repair. However, there are only few reports on ACS in newborns and only a proposal of critical intra-abdominal pressure value (IAP) in term newborns, absent in preterm newborns. Although the prevalent clinical sign is tense abdominal distension, it may be difficult to distinguish ACS from pathologies that will not require decompression. The purpose of this study was to identify predictors for ACS and therefore morbidity or mortality indicators. We reviewed newborns presenting with tense abdominal distension and end organ failure. Anamnestic, clinical, laboratory, and instrumental investigations were analyzed to extrapolate predictors. Outcomes were compared with a control group. The incidence of ACS in our neonatal intensive care unit was 5% in the overall population of babies, 16% in tracheal-ventilated newborns, and 57% in infants with abdominal wall defects. We found that, with onset of acidosis or high gastric residuals, the lactate values will be predictive for mortality. We can also suggest paying particular attention to high lactate values just at the onset of distension, in infants with more advanced gestational age, with previously surgical repair, to determine early surgical intervention independently of a specific IAP measurement.

  9. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  10. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

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

    PubMed

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

    2012-09-01

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

  12. Mouse bladder wall injection.

    PubMed

    Fu, Chi-Ling; Apelo, Charity A; Torres, Baldemar; Thai, Kim H; Hsieh, Michael H

    2011-07-12

    Mouse bladder wall injection is a useful technique to orthotopically study bladder phenomena, including stem cell, smooth muscle, and cancer biology. Before starting injections, the surgical area must be cleaned with soap and water and antiseptic solution. Surgical equipment must be sterilized before use and between each animal. Each mouse is placed under inhaled isoflurane anesthesia (2-5% for induction, 1-3% for maintenance) and its bladder exposed by making a midline abdominal incision with scissors. If the bladder is full, it is partially decompressed by gentle squeezing between two fingers. The cell suspension of interest is intramurally injected into the wall of the bladder dome using a 29 or 30 gauge needle and 1 cc or smaller syringe. The wound is then closed using wound clips and the mouse allowed to recover on a warming pad. Bladder wall injection is a delicate microsurgical technique that can be mastered with practice.

  13. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  14. Abdominal emergencies during pregnancy.

    PubMed

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.

  15. Impact of prior abdominal surgery on the outcomes after robotic - assisted laparoscopic radical prostatectomy: single center experience

    PubMed Central

    Kishimoto, Nozomu; Takao, Tetsuya; Yamamichi, Gaku; Okusa, Takuya; Taniguchi, Ayumu; Tsutahara, Koichi; Tanigawa, Go; Yamaguchi, Seiji

    2016-01-01

    ABSTRACT Purpose: To evaluate the influence of prior abdominal surgery on the outcomes after robotic-assisted laparoscopic radical prostatectomy (RALP). Materials and Methods: We retrospectively analyzed patients with prostate cancer who underwent RALP between June 2012 and February 2015 at our institution. Patients with prior abdominal surgery were compared with those without prior surgery while considering the mean total operating, console, and port-insertion times; mean estimated blood loss; positive surgical margin rate; mean duration of catheterization; and rate of complications. Results: A total of 203 patients who underwent RALP during the study period were included in this study. In all, 65 patients (32%) had a prior history of abdominal surgery, whereas 138 patients (68%) had no prior history. The total operating, console, and port-insertion times were 328 and 308 (P=0.06), 252 and 242 (P=0.28), and 22 and 17 minutes (P=0.01), respectively, for patients with prior and no prior surgery. The estimated blood losses, positive surgical margin rates, mean durations of catheterization, and complication rates were 197 and 170 mL (P=0.29), 26.2% and 20.2% (P=0.32), 7.1 and 6.8 days (P=0.74), and 12.3% and 8.7% (P=0.42), respectively. Furthermore, whether prior abdominal surgery was performed above or below the umbilicus or whether single or multiple surgeries were performed did not further affect the perioperative outcomes. Conclusions: Our results suggest that RALP can be performed safely in patients with prior abdominal surgery, without increasing the risk of complications. PMID:27622285

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

    PubMed

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

    2008-09-01

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

  17. Abdominal breathing manoeuvre reduces passive drag acting on gliding swimmers.

    PubMed

    Maruyama, Yusuke; Yanai, Toshimasa

    2015-01-01

    The purpose of this study was to test the hypothesis that the passive drag acting on a gliding swimmer is reduced if the swimmer adopts an abdominal breathing manoeuvre (expanding the abdominal wall) rather than chest breathing manoeuvre (expanding the rib cage). Eleven male participants participated in this study. A specialised towing machine was used to tow each participant with tension set at various magnitudes and to record time series data of towing velocity. Participants were asked to inhale air by expanding the abdominal wall or the rib cage and to maintain the same body configuration throughout gliding. The steady-state velocity was measured and the coefficient of drag was calculated for each towing trial to compare between the breathing manoeuvres. The results showed that the towing velocity was increased by 0.02 m/s with a towing force of 34.3 N and by 0.06 m/s with a towing force of 98.1 N. The coefficient of drag was reduced by 5% with the abdominal breathing manoeuvre, which was found to be statistically significant (p < 0.05). These results indicate that adopting the abdominal breathing manoeuvre during gliding reduces the passive drag and the hypothesis was supported.

  18. Infected abdominal aortic aneurysm due to Morganella morganii: CT findings.

    PubMed

    Kwon, Oh Young; Lee, Jong Seok; Choi, Han Sung; Hong, Hoon Pyo; Ko, Young Gwan

    2011-02-01

    An infected aortic aneurysm, or mycotic aneurysm, is a rare arterial dilatation due to destruction of the infected vessel wall. Common pathogens resulting in an infected aortic aneurysm are Salmonella and Clostridium species, as well as Staphylococcus aureus; Morganella morganii, on the other hand, is very rare. An infected abdominal aortic aneurysm has tendencies to grow rapidly and to rupture. The mortality rate is high in patients undergoing emergent surgical intervention. We report the case of a 65-year-old man who presented with an infected abdominal aortic aneurysm caused by M. morganii. A high index of suspicion and imaging tests are necessary in order to diagnose an infected aortic aneurysm.

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

    PubMed

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

    1990-12-01

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

  20. Leaking mycotic abdominal aortic aneurysm.

    PubMed

    Sing, T M; Young, N; O'Rourke, I C; Tomlinson, P

    1994-11-01

    A case of leaking mycotic abdominal aortic aneurysm is reported, with a brief review of the literature. A 58 year old female presented with shoulder and abdominal pain associated with diarrhoea, vomiting and fever with leucocytosis. Computed tomography of the abdomen showed pooling of contrast in the retroperitoneum anterior to a non-dilated abdominal aorta. There was considerable retroperitoneal blood accumulating in a mass-like lesion in the right lower abdomen and pelvis obstructing the right renal collecting system. Laparotomy revealed a 4 cm diameter saccular aneurysm of the abdominal aorta, with a 1 cm diameter neck. Culture of the thrombus grew Streptococcus pyogenes. PMID:7993259

  1. Hypnosis for functional abdominal pain.

    PubMed

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  2. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  3. Role of tissue expanders in patients with loss of abdominal domain awaiting intestinal transplantation.

    PubMed

    Watson, Melissa J; Kundu, Neilendu; Coppa, Christopher; Djohan, Risal; Hashimoto, Koji; Eghtesad, Bijan; Fujiki, Masato; Diago Uso, Teresa; Gandhi, Namita; Nassar, Ahmed; Abu-Elmagd, Kareem; Quintini, Cristiano

    2013-12-01

    Abdominal closure is a complex surgical problem in intestinal transplant recipients with loss of abdominal domain, as graft exposure results in profound morbidity. Although intraoperative coverage techniques have been described, this is the first report of preoperative abdominal wall augmentation using tissue expanders in patients awaiting intestinal transplantation. We report on five patients who received a total of twelve tissue expanders as a means to increase abdominal surface area. Each patient had a compromised abdominal wall (multiple prior operations, enterocutaneous fistulae, subcutaneous abscesses, stomas) with loss of domain and was identified as high risk for an open abdomen post-transplant. Cross-sectional imaging and dimensional analysis were performed to quantify the effect of the expanders on total abdominal and intraperitoneal cavity volumes. The overall mean increase in total abdominal volume was 958 cm(3) with a mean expander volume of 896.5 cc. Two expanders were removed in the first patient due to infection, but after protocol modification, there were no further infections. Three patients eventually underwent small bowel transplantation with complete graft coverage. In our preliminary experience, abdominal tissue expander placement is a safe, feasible, and well-tolerated method to increase subcutaneous domain and facilitate graft coverage in patients undergoing intestinal transplantation. PMID:24118196

  4. Great Walls.

    ERIC Educational Resources Information Center

    Blackburn, Steve; Moore, Tim

    1996-01-01

    Explains why installing a well-designed indoor climbing wall can draw new users to an athletic facility. Climbing-wall design elements and gear are discussed and a checklist for working with contractors is provided.(GR)

  5. Pulsatile blood flow in Abdominal Aortic Aneurysms

    NASA Astrophysics Data System (ADS)

    Salsac, Anne-Virginie; Lasheras, Juan C.; Singel, Soeren; Varga, Chris

    2001-11-01

    We discuss the results of combined in-vitro laboratory measurements and clinical observations aimed at determining the effect that the unsteady wall shear stresses and the pressure may have on the growth and eventual rupturing of an Abdominal Aortic Aneurysm (AAA), a permanent bulging-like dilatation occurring near the aortic bifurcation. In recent years, new non-invasive techniques, such as stenting, have been used to treat these AAAs. However, the development of these implants, aimed at stopping the growth of the aneurysm, has been hampered by the lack of understanding of the effect that the hemodynamic forces have on the growth mechanism. Since current in-vivo measuring techniques lack the precision and the necessary resolution, we have performed measurements of the pressure and shear stresses in laboratory models. The models of the AAA were obtained from high resolution three-dimensional CAT/SCANS performed in patients at early stages of the disease. Preliminary DPIV measurements show that the pulsatile blood flow discharging into the cavity of the aneurysm leads to large spikes of pressure and wall shear stresses near and around its distal end, indicating a possible correlation between the regions of high wall shear stresses and the observed location of the growth of the aneurysm.

  6. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  7. Solitary fibrous tumors arising in abdominal wall hernia sacs.

    PubMed

    Lee, J R; Hancock, S M; Martindale, R G

    2001-06-01

    Solitary fibrous tumor (SFT) of the peritoneum is an unusual spindle-cell neoplasm. SFT was originally described in the pleura; however it is now diagnosed in multiple extrathoracic sites. Most believe that the tumor is of mesenchymal origin and should be classified as a variant of fibroma. SFT of the pleura and peritoneum have also been called fibrous mesothelioma, and the cell of origin is felt to be a pluripotential submesothelial mesenchymal cell. Primary tumors arising in hernia sacs are rare, and we report on two patients with hernia SFT. The first is a 67-year-old man who had a diffusely thickened distal left inguinal hernia sac. Within the sac was copious myxoid material mimicking pseudomyxoma peritonei. Herniorrhaphy and orchiectomy were performed. The second is a 44-year-old woman with a midepigastric mass attached to a ventral hernia. Wide local excision was performed. Both tumors demonstrated plump spindle cells, one with myxoid background and the other with keloidal collagen. Calretinin immunostaining was positive in both tumors, whereas CD34 was negative. This suggests tumor origin from a submesothial pluripotential cell that maintains potential for mesothelial differentiation. Surgical excision is the treatment of choice with the degree of resectability being a powerful predictor of outcome.

  8. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  9. [Radiofrequency ablation of an unresectable abdominal tumor].

    PubMed

    Sézeur, Alain; Fritsch, Sylvie; Louvet, Christophe; Kujas, Albert; Mosnier, Henri; Talbot, Jean-Noël; Grimberg, Sylvie

    2003-02-01

    Remnant malignant tissue is left behind after conventional surgery for an unresectable intraperitoneal malignant tumor. Standard radiotherapy or chemotherapy rarely enables good tumor control. We report the case of a 74-year-old man who developed a local recurrence of a sigmoid tumor located 5 to 6 cm from the anus. The tumor was fixed to the pelvic wall and could not be totally eradicated with conventional surgery. Preoperative peroperative assessment confirmed the absence of metastatic spread. Radiotherapy could not be performed due to risk of bowel injury. Peroperative radiofrequency ablation was followed by surgical colorectal resection without restoration of intestinal continuity, leaving only tumor tissue destroyed by radiofrequency. No adjuvant treatment was proposed because of intolerance to chemotherapy. Clinical assessment and thoracic and abdominal CT scan confirmed the absence of recurrence 26 months after radiofrequency ablation. Serum markers remained normal.

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

    SciTech Connect

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

    1988-06-01

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

  11. [ENDOVASCULAR ABDOMINAL AORTIC ANEURISM REPAIR].

    PubMed

    Maĭstrenko, D N; Generalov, M I; Tarazov, P G; Zherebtsov, F K; Osovskikh, V V; Ivanov, A S; Oleshchuk, A N; Granov, D A

    2015-01-01

    The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stent-grafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn't necessary to use a conversion to open surgery. The follow-up period consisted of 44,6?2,1 months. Control ultrasound and computer tomography studies hadn't revealed an increase of aneurism sack sizes or "eakages". A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stent-graft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group. PMID:26234059

  12. Functional Abdominal Pain in Children

    MedlinePlus

    ... At low doses, these medicines can be excellent pain relievers for some children. A fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological treatments that help children cope with functional abdominal pain ...

  13. Abdominal ultrasonography, 2nd Ed

    SciTech Connect

    Goldberg, B.B.

    1984-01-01

    This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy.

  14. Abdominal crush injury in the Sichuan earthquake evaluated by multidetector computed tomography

    PubMed Central

    Chen, Tian-Wu; Yang, Zhi-Gang; Dong, Zhi-Hui; Shao, Heng; Chu, Zhi-Gang; Tang, Si-Shi

    2011-01-01

    AIM: To investigate the features of abdominal crush injuries resulting from an earthquake using multidetector computed tomography (MDCT). METHODS: Fifty-one survivors with abdominal crush injuries due to the 2008 Sichuan earthquake underwent emergency non-enhanced scans with 16-row MDCT. Data were reviewed focusing on anatomic regions including lumbar vertebrae, abdominal wall soft tissue, retroperitoneum and intraperitoneal space; and types of traumatic lesions. RESULTS: Fractures of lumbar vertebrae and abdominal wall soft tissue injuries were more common than retro- and intraperitoneal injuries (P < 0.05). With regard to the 49 lumbar vertebral fractures in 24 patients, these occurred predominantly in the transverse process (P < 0.05), and 66.67% of patients (16/24) had fractures of multiple vertebrae, predominantly two vertebrae in 62.5% of patients (10/16), mainly in L1-3 vertebrae in 81.63% of the vertebrae (40/49). Retroperitoneal injuries occurred more frequently than intraperitoneal injuries (P < 0.05), and renal and liver injuries were most often seen in the retroperitoneum and in the intraperitoneal space, respectively (all P < 0.05). CONCLUSION: Transverse process fractures in two vertebrae among L1-3 vertebrae, injury of abdominal wall soft tissue, and renal injury might be features of earthquake-related crush abdominal injury. PMID:21666819

  15. Different Anti-Contractile Function and Nitric Oxide Production of Thoracic and Abdominal Perivascular Adipose Tissues.

    PubMed

    Victorio, Jamaira A; Fontes, Milene T; Rossoni, Luciana V; Davel, Ana P

    2016-01-01

    Divergent phenotypes between the perivascular adipose tissue (PVAT) surrounding the abdominal and the thoracic aorta might be implicated in regional aortic differences, such as susceptibility to atherosclerosis. Although PVAT of the thoracic aorta exhibits anti-contractile function, the role of PVAT in the regulation of the vascular tone of the abdominal aorta is not well defined. In the present study, we compared the anti-contractile function, nitric oxide (NO) availability, and reactive oxygen species (ROS) formation in PVAT and vessel walls of abdominal and thoracic aorta. Abdominal and thoracic aortic tissue from male Wistar rats were used to perform functional and molecular experiments. PVAT reduced the contraction evoked by phenylephrine in the absence and presence of endothelium in the thoracic aorta, whereas this anti-contractile effect was not observed in the abdominal aorta. Abdominal PVAT exhibited a reduction in endothelial NO synthase (eNOS) expression compared with thoracic PVAT, without differences in eNOS expression in the vessel walls. In agreement with this result, NO production evaluated in situ using 4,5-diaminofluorescein was less pronounced in abdominal compared with thoracic aortic PVAT, whereas no significant difference was observed for endothelial NO production. Moreover, NOS inhibition with L-NAME enhanced the phenylephrine-induced contraction in endothelial-denuded rings with PVAT from thoracic but not abdominal aorta. ROS formation and lipid peroxidation products evaluated through the quantification of hydroethidine fluorescence and 4-hydroxynonenal adducts, respectively, were similar between PVAT and vessel walls from the abdominal and thoracic aorta. Extracellular superoxide dismutase (SOD) expression was similar between the vessel walls and PVAT of the abdominal and thoracic aorta. However, Mn-SOD levels were reduced, while CuZn-SOD levels were increased in abdominal PVAT compared with thoracic aortic PVAT. In conclusion, our results

  16. Different Anti-Contractile Function and Nitric Oxide Production of Thoracic and Abdominal Perivascular Adipose Tissues

    PubMed Central

    Victorio, Jamaira A.; Fontes, Milene T.; Rossoni, Luciana V.; Davel, Ana P.

    2016-01-01

    Divergent phenotypes between the perivascular adipose tissue (PVAT) surrounding the abdominal and the thoracic aorta might be implicated in regional aortic differences, such as susceptibility to atherosclerosis. Although PVAT of the thoracic aorta exhibits anti-contractile function, the role of PVAT in the regulation of the vascular tone of the abdominal aorta is not well defined. In the present study, we compared the anti-contractile function, nitric oxide (NO) availability, and reactive oxygen species (ROS) formation in PVAT and vessel walls of abdominal and thoracic aorta. Abdominal and thoracic aortic tissue from male Wistar rats were used to perform functional and molecular experiments. PVAT reduced the contraction evoked by phenylephrine in the absence and presence of endothelium in the thoracic aorta, whereas this anti-contractile effect was not observed in the abdominal aorta. Abdominal PVAT exhibited a reduction in endothelial NO synthase (eNOS) expression compared with thoracic PVAT, without differences in eNOS expression in the vessel walls. In agreement with this result, NO production evaluated in situ using 4,5-diaminofluorescein was less pronounced in abdominal compared with thoracic aortic PVAT, whereas no significant difference was observed for endothelial NO production. Moreover, NOS inhibition with L-NAME enhanced the phenylephrine-induced contraction in endothelial-denuded rings with PVAT from thoracic but not abdominal aorta. ROS formation and lipid peroxidation products evaluated through the quantification of hydroethidine fluorescence and 4-hydroxynonenal adducts, respectively, were similar between PVAT and vessel walls from the abdominal and thoracic aorta. Extracellular superoxide dismutase (SOD) expression was similar between the vessel walls and PVAT of the abdominal and thoracic aorta. However, Mn-SOD levels were reduced, while CuZn-SOD levels were increased in abdominal PVAT compared with thoracic aortic PVAT. In conclusion, our results

  17. [A rare variant of enterocele entrapment in the abdominal cavity of a woman].

    PubMed

    Vinnik, Yu S; Prusov, I A; Serova, E V; Shirokobokov, A O; Berdnikov, S I; Struzik, A S; Loginovsky, A S

    2015-01-01

    Abdominal enterocele is a result of entering abdominal organs into peritoneal pockets and folds through the holes in mesenterium or into the adjoining cavities through defects in their walls. Enteroceles are localized at the sites where one segment of the gastrointestinal tract passes into another, in a pocket behind the cecum and sigmoid, between mesenteric layers of small intestine and colon, in the holes of mesenterium of vermiform appendage, gastrocolic and falciform ligaments, pockets and holes of broad ligament of the uterine, omental foramen, rectouterine excavation, and diaphragmal defects. We observed a 26 year old woman with enterocele entrapment in the abdominal cavity complicated by necrosis of part of the small intestine.

  18. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  19. Insulin resistance as a predictor of gains in body fat, weight, and abdominal fat in nondiabetic women: a prospective study.

    PubMed

    Tucker, Larry A; Tucker, Jared M

    2012-07-01

    The purpose was to determine the relationship between insulin resistance (IR) and risk of gaining body fat percentage (BF%), body weight, and abdominal fat over 18 months. A prospective cohort study was conducted using a sample of 226 women. IR was assessed using fasting blood insulin and glucose levels to calculate homeostatic model assessment (HOMA). Participants were divided into High (4th quartile) Moderate (2nd and 3rd quartiles), and Low (1st quartile) HOMA categories. BF% was estimated using plethysmography (Bod Pod), weight was measured in a standard swimsuit, and abdominal fat was indexed using the average of two circumferences taken at the umbilicus. Participants wore accelerometers and completed weighed food logs for 7 consecutive days to control for the effect of physical activity (PA) and energy intake, respectively. On average, women in the High HOMA group decreased in BF% (-0.48 ± 3.60), whereas those in the Moderate (0.40 ± 3.66) and Low HOMA (1.17 ± 3.15) groups gained BF% (F = 5.4, P = 0.0211). Changes in body weight showed a similar dose-response relationship (F = 4.7, P = 0.0317). However, baseline IR was not predictive of changes in abdominal fat (F = 0.8, P = 0.3635). Controlling for several covariates had little effect on gains in BF% and weight, but adjusting for initial BF% and/or initial weight nullified changes in BF% and weight across the IR groups. In conclusion, women with High HOMA tend to gain significantly less BF% and weight than women with low or moderate HOMA. The decreased risk appears unrelated to several covariates, except initial BF% and weight levels, which seem to play key roles in the relationships.

  20. Conservative management of abdominal injuries

    PubMed Central

    Okuş, Ahmet; Sevinç, Barış; Ay, Serden; Arslan, Kemal; Karahan, Ömer; Eryılmaz, Mehmet Ali

    2013-01-01

    Objective: Non-operative management of abdominal injuries has recently become more common. Especially non-operative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt penetrating) is discussed. Material and Methods: All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results: The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion: Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring. PMID:25931868

  1. [Gas in the abdominal cavity--due to cholecystitis caused by gas-producing bacteria].

    PubMed

    Miettinen, Simo; Hakkarainen, Timo; Reinikainen, Matti; Hakala, Tapio

    2010-01-01

    In most cases, gas in the abdominal cavity indicates perforation of the gastrointestinal wall. We describe a patient, in whom the cause of abdominal gas detected in computed tomography turned out to be emphysematous cholecystitis caused by gas-producing bacteria. It is a rare disease characterized by accumulation of gas into the gall bladder or its wall. The gas can be easily observed in computed tomography. The disease easily becomes complicated and is associated with high mortality. Prompt cholecystectomy and antibiotic therapy are the cornerstones of the treatment.

  2. Wonderful Walls

    ERIC Educational Resources Information Center

    Greenman, Jim

    2006-01-01

    In this article, the author emphasizes the importance of "working" walls in children's programs. Children's programs need "working" walls (and ceilings and floors) which can be put to use for communication, display, storage, and activity space. The furnishings also work, or don't work, for the program in another sense: in aggregate, they serve as…

  3. Abdominal aortic grafting for spontaneous infrarenal abdominal aortic dissection.

    PubMed

    Iwasaki, Hiroto; Shibuya, Takashi; Shintani, Takashi; Uenaka, Hisazumi; Suehiro, Shigefumi; Satoh, Hisashi

    2010-02-01

    This case report concerns a 62-year-old woman with spontaneous infrarenal abdominal aortic dissection, which developed into claudication and rest pain in the lower extremity. Multi-row detector computed tomography showed the entry site of the abdominal aortic dissection at the second lumbar artery, while the reentry site was found intraoperatively at the median sacral artery, indicating that the false lumen had progressed and compressed the true lumen. A direct approach involving grafting appears to be an effective procedure for resolving mesenteric and lower extremity hypoperfusion due to aortic dissection with a dilated false channel, even during the acute period. PMID:19879731

  4. Abdominal Kaposiform Hemangioendothelioma Associated With Lymphangiomatosis Involving Mesentery and Ileum

    PubMed Central

    Dong, Aisheng; Zhang, Ling; Wang, Yang; He, Tianlin; Zuo, Changjing

    2016-01-01

    Abstract Kaposiform hemangioendothelioma (KH) is a rare vascular tumor of intermediate malignancy that occurs mainly in the childhood. Adult patients with KH are rare. Imaging findings of KH have rarely been reported before. We present magnetic resonance imaging (MRI), computed tomography (CT), and fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT findings in an adult patient with KH associated with lymphangiomatosis involving mesentery and ileum. A 22-year-old female complained of a 9-month history of intermittent melena, weakness, and palpitation. Laboratory tests revealed anemia and hypoproteinemia. Fecal occult blood test was positive. Abdominal enhanced MRI and CT showed a large abdominal mass involving mesentery and ileum. On enhanced MRI, there were many hypervascular nodules in the mass. On FDG PET/CT, the mass and the nodules showed slight FDG uptake. Small bowel capsule endoscopy showed numerous grape-shaped red nodules in the luminal wall of the involved ileum. The patient underwent resection of the abdominal mass and a segment of the ileum invaded by the abdominal mass. KH arising within lymphangiomatosis involving mesentery and ileum was confirmed by pathology. After surgery, the patient's symptoms improved. This is the first case of KH associated with lymphangiomatosis involving mesentery and ileum. In this case, the lymphangiomatosis overshadowed the small tumor nodules resulting in unusual imaging findings. Familiarity with these imaging findings is helpful for diagnosis and differential diagnosis of KH. PMID:26871848

  5. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  6. Abdominal aortic aneurysms: case report

    PubMed Central

    Hadida, Camille; Rajwani, Moez

    1998-01-01

    A 71-year-old male presented to a chiropractic clinic with subacute low back pain. While the pain appeared to be mechanical in nature, radiographic evaluation revealed an abdominal aortic aneurysm, which required the patient to have vascular surgery. This case report illustrates the importance of the history and physical examination in addition to a thorough knowledge of the features of abdominal aortic aneurysms. The application of spinal manipulative therapy in patients with (AAA) is also discussed. ImagesFigure 1Figure 2Figure 3

  7. Recurrent abdominal pain during childhood.

    PubMed Central

    Scott, R. B.

    1994-01-01

    Recurrent abdominal pain is a common presenting complaint among children. A thorough history and physical examination and limited laboratory investigation should enable a physician to make a positive diagnosis of "functional" recurrent abdominal pain in 90% to 95% of cases; an organic cause is identified in only 5% to 10%. The care and thoroughness of the history and physical examination establish the physician's credibility; explaining the clinical basis for the diagnosis and educating the child and parents on what is known about the condition reassures the parents. PMID:8199511

  8. Abdominal Bloating: Pathophysiology and Treatment

    PubMed Central

    Seo, A Young; Oh, Dong Hyun

    2013-01-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  9. Radiological management of abdominal abscess.

    PubMed Central

    Mac Erlean, D P; Gibney, R G

    1983-01-01

    Forty-two abdominal and retroperitoneal abscesses were drained percutaneously under ultrasound guidance. A success rate of 85.7% was achieved. Subsequent surgery was required in only 5 patients. Postoperative and spontaneous abscesses did equally well. Most intra-abdominal and retroperitoneal abscesses are amenable to this form of percutaneous drainage. The procedure requires only local anaesthesia and is well tolerated. Surgical management should probably now be reserved for those cases which are considered unsuitable for percutaneous drainage or which fail to resolve following this procedure. PMID:6842496

  10. Wall Turbulence.

    ERIC Educational Resources Information Center

    Hanratty, Thomas J.

    1980-01-01

    This paper gives an account of research on the structure of turbulence close to a solid boundary. Included is a method to study the flow close to the wall of a pipe without interferring with it. (Author/JN)

  11. The reverse abdominal reduction and the 'waistcoating' procedure for the correction of the fixated Pfannenstiel incision.

    PubMed

    Harrison, Douglas H

    2016-05-01

    The principles of a standard abdominal reduction are well understood; this technique has been used for many years. However, a reverse abdominal reduction may be considered in some cases, for example, continued weight loss, and thus skin redundancy on the upper abdomen in patients who have already undergone abdominal reduction and upper abdomen improvement in patients requiring a mastopexy or breast reduction simultaneously. Reverse abdominal reduction is rarely mentioned in the medical literature, but it can prove successful; although the scar across the lower sternum has often been considered to be unsatisfactory, often it does not prove to be so. Thus, this procedure can be proven to be successful in suitable cases. Secondly, the Pfannenstiel incision, if not satisfactorily repaired in the first instance, can become fixated to the abdominal wall; this fixation along with the inevitable migration of skin and fat at its cephalic edge causes a rather displeasing contour defect when wearing tight-fitting swimwear. The principle of the waistcoating procedure is essentially to chamfer the fat cephalically; this procedure is employed for removing the Pfannenstiel scar from the abdominal wall. The principle is simple and effective and can be applied in cases with fixated scars. These two aforementioned principles are not commonly used, but they can prove particularly effective in suitable cases. We illustrate the principles. PMID:26966077

  12. The reverse abdominal reduction and the 'waistcoating' procedure for the correction of the fixated Pfannenstiel incision.

    PubMed

    Harrison, Douglas H

    2016-05-01

    The principles of a standard abdominal reduction are well understood; this technique has been used for many years. However, a reverse abdominal reduction may be considered in some cases, for example, continued weight loss, and thus skin redundancy on the upper abdomen in patients who have already undergone abdominal reduction and upper abdomen improvement in patients requiring a mastopexy or breast reduction simultaneously. Reverse abdominal reduction is rarely mentioned in the medical literature, but it can prove successful; although the scar across the lower sternum has often been considered to be unsatisfactory, often it does not prove to be so. Thus, this procedure can be proven to be successful in suitable cases. Secondly, the Pfannenstiel incision, if not satisfactorily repaired in the first instance, can become fixated to the abdominal wall; this fixation along with the inevitable migration of skin and fat at its cephalic edge causes a rather displeasing contour defect when wearing tight-fitting swimwear. The principle of the waistcoating procedure is essentially to chamfer the fat cephalically; this procedure is employed for removing the Pfannenstiel scar from the abdominal wall. The principle is simple and effective and can be applied in cases with fixated scars. These two aforementioned principles are not commonly used, but they can prove particularly effective in suitable cases. We illustrate the principles.

  13. Ultrasound Screening for Abdominal Aortic Aneurysm

    PubMed Central

    2006-01-01

    Executive Summary Objective The aim of this review was to assess the effectiveness of ultrasound screening for asymptomatic abdominal aortic aneurysm (AAA). Clinical Need Abdominal aortic aneurysm is a localized abnormal dilatation of the aorta greater than 3 cm. In community surveys, the prevalence of AAA is reported to be between 2% and 5.4%. Abdominal aortic aneurysms are found in 4% to 8% of older men and in 0.5% to 1.5% of women aged 65 years and older. Abdominal aortic aneurysms are largely asymptomatic. If left untreated, the continuing extension and thinning of the vessel wall may eventually result in rupture of the AAA. Often rupture may occur without warning, causing acute pain. Rupture is always life threatening and requires emergency surgical repair of the ruptured aorta. The risk of death from ruptured AAA is 80% to 90%. Over one-half of all deaths attributed to a ruptured aneurysm take place before the patient reaches hospital. In comparison, the rate of death in people undergoing elective surgery is 5% to 7%; however, symptoms of AAA rarely occur before rupture. Given that ultrasound can reliably visualize the aorta in 99% of the population, and its sensitivity and specificity for diagnosing AAA approaches 100%, screening for aneurysms is worth considering as it may reduce the incidence of ruptured aneurysms and hence reduce unnecessary deaths caused by AAA-attributable mortality. Review Strategy The Medical Advisory Secretariat used its standard search strategy to retrieve international health technology assessments and English-language journal articles from selected databases to determine the effectiveness of ultrasound screening for abdominal aortic aneurysms. Case reports, letters, editorials, nonsystematic reviews, non-human studies, and comments were excluded. Questions asked: Is population-based AAA screening effective in improving health outcomes in asymptomatic populations? Is AAA screening acceptable to the population? Does this affect the

  14. Intra-abdominal adhesions in ultrasound. Part II: The morphology of changes.

    PubMed

    Smereczyński, Andrzej; Starzyńska, Teresa; Kołaczyk, Katarzyna; Bojko, Stefania; Gałdyńska, Maria; Bernatowicz, Elżbieta; Walecka, Anna

    2013-03-01

    Despite their frequent appearance, intra-abdominal adhesions are rarely the subject of clinical studies and academic discussions. For many years the operators have been trying to reduce such unfavourable consequences of interventions in the abdominal structures. The aim of this article is to present the possibilities of intra-abdominal adhesion diagnostics by means of ultrasound imaging based on authors' own experience and information included in pertinent literature. The anatomy and examination technique of the abdominal wall were discussed in Part I of the article. In order to evaluate intraperitoneal adhesions, one should use a convex transducer with the frequency of 3.5-6 MHz. The article provides numerous examples of US images presenting intra-abdominal adhesions, particularly those which appeared after surgical procedures. The significance of determining their localisation and extensiveness prior to a planned surgical treatment is emphasized. Four types of morphological changes in the ultrasound caused by intra-abdominal adhesions are distinguished and described: visceroperitoneal adhesions, intraperitoneal adhesions, adhesive obstructions as well as adhesions between the liver and abdominal wall with a special form of such changes, i.e. hepatic pseudotumour. Its ultrasound features are as follows:The lesion is localised below the scar in the abdominal wall after their incision.The lesion is localised in the abdominal part of the liver segments III, IV and V.With the US beam focus precisely set, the lack of fascia - peritoneum complex may be noticed. An uneven liver outline or its ventral displacement appears.A hepatic adhesion-related pseudotumour usually has indistinct margins, especially the posterior one, and, gradually, from top to bottom, loses its hypoechogenic nature.In a respiration test, this liver fragment does not present the sliding movement - a neoplastic tumour rarely shows such an effect. The immobility of the liver is a permanent symptom of

  15. Intra-abdominal adhesions in ultrasound. Part II: The morphology of changes

    PubMed Central

    Starzyńska, Teresa; Kołaczyk, Katarzyna; Bojko, Stefania; Gałdyńska, Maria; Bernatowicz, Elżbieta; Walecka, Anna

    2013-01-01

    Despite their frequent appearance, intra-abdominal adhesions are rarely the subject of clinical studies and academic discussions. For many years the operators have been trying to reduce such unfavourable consequences of interventions in the abdominal structures. The aim of this article is to present the possibilities of intra-abdominal adhesion diagnostics by means of ultrasound imaging based on authors’ own experience and information included in pertinent literature. The anatomy and examination technique of the abdominal wall were discussed in Part I of the article. In order to evaluate intraperitoneal adhesions, one should use a convex transducer with the frequency of 3.5–6 MHz. The article provides numerous examples of US images presenting intra-abdominal adhesions, particularly those which appeared after surgical procedures. The significance of determining their localisation and extensiveness prior to a planned surgical treatment is emphasized. Four types of morphological changes in the ultrasound caused by intra-abdominal adhesions are distinguished and described: visceroperitoneal adhesions, intraperitoneal adhesions, adhesive obstructions as well as adhesions between the liver and abdominal wall with a special form of such changes, i.e. hepatic pseudotumour. Its ultrasound features are as follows:The lesion is localised below the scar in the abdominal wall after their incision.The lesion is localised in the abdominal part of the liver segments III, IV and V.With the US beam focus precisely set, the lack of fascia – peritoneum complex may be noticed. An uneven liver outline or its ventral displacement appears.A hepatic adhesion-related pseudotumour usually has indistinct margins, especially the posterior one, and, gradually, from top to bottom, loses its hypoechogenic nature.In a respiration test, this liver fragment does not present the sliding movement – a neoplastic tumour rarely shows such an effect. The immobility of the liver is a permanent

  16. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe ... kinds of pain: Generalized pain or pain over more than half ...

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

    PubMed

    Smereczyński, Andrzej; Starzyńska, Teresa; Kołaczyk, Katarzyna; Bojko, Stefania; Gałdyńska, Maria; Bernatowicz, Elżbieta; Walecka, Anna

    2012-12-01

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

  18. In vivo strain assessment of the abdominal aortic aneurysm.

    PubMed

    Satriano, Alessandro; Rivolo, Simone; Martufi, Giampaolo; Finol, Ender A; Di Martino, Elena S

    2015-01-21

    The only criteria currently used to inform surgical decision for abdominal aortic aneurysms are maximum diameter (>5.5 cm) and rate of growth, even though several studies have identified the need for more specific indicators of risk. Patient-specific biomechanical variables likely to affect rupture risk would be a valuable addition to the science of understanding rupture risk and prove to be a life saving benefit for patients. Local deformability of the aorta is related to the local mechanical properties of the wall and may provide indication on the state of weakening of the wall tissue. We propose a 3D image-based approach to compute aortic wall strain maps in vivo. The method is applicable to a variety of imaging modalities that provide sequential images at different phases in the cardiac cycle. We applied the method to a series of abdominal aneurysms imaged using cine-MRI obtaining strain maps at different phases in the cardiac cycle. These maps could be used to evaluate the distensibility of an aneurysm at baseline and at different follow-up times and provide an additional index to clinicians to facilitate decisions on the best course of action for a specific patient. PMID:25497379

  19. Implanting intra-abdominal radiotransmitters with external whip antennas in ducks

    USGS Publications Warehouse

    Korschgen, C.E.; Kenow, K.P.; Gendron-Fitzpatrick, A.; Green, W.L.; Dein, F.J.

    1996-01-01

    We developed and evaluated a surgical procedure for implanting intra-abdominal radiotransmitters with external whip antennas in captive mallards (Anas platyrhynchos). Transmitters were implanted in the abdominal cavity and the antennas exited through the caudal abdominal wall and skin. Birds with implanted transmitters developed mild to moderate localized air sac reactions. These reactions involved adhesions of the right anterior abdominal air sac to the liver with contractions around the transmitters and antenna catheters. The adhesions were reinforced by a proliferation of connective tissue and lined by multinucleated giant cells (foreign body reaction). Casual observation indicated that neither behavior nor activity of the birds was altered by the histological reaction to the transmitter implant. No increase in systemic lesions (particularly liver or kidney) could be correlated with the histological reactions. Our evaluations indicate that the procedure is a reliable method for radiomarking ducks and the technique has been successfully used in 2 field studies.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  2. Abdominal ultrasonography findings in patients with spinal cord injury in Korea.

    PubMed

    Shin, Ji Cheol; Park, Chang-il; Kim, Sang Hyun; Yang, Eun Joo; Kim, Eun Joo; Rha, Dong Wook

    2006-10-01

    This is a retrospective study of 500 patients with spinal cord injury who underwent abdominal ultrasonography as a routine screening test from 2000 to 2003. We analyzed the results according to the different abdominal organ systems. Among the 500 cases, 226 (45.2%) showed abnormal findings. 98 cases of abnormal findings in the liver included 75 of fatty liver and 13 of mass. The 88 cases of abnormal findings in the bladder included 56 of bladder wall thickening, 14 of cystitis and 10 of urinary stone. The 35 cases of abnormal findings in the kidney included 19 of renal cyst and 6 of pelvic dilatation. The 35 cases with gallbladder abnormalities included 19 with gallstones and 11 with biliary sludge. Excluding the cases with bladder wall thickening, there were still 170 cases with abnormal ultrasonographic findings. Abdominal sonography seems to be a useful tool in detecting hidden intraabdominal pathologies in patients with spinal cord injury.

  3. Abdominal cocoon secondary to disseminated tuberculosis

    PubMed Central

    Puppala, Radha; Sripathi, Smiti; Kadavigere, Rajagopal; Koteshwar, Prakashini; Singh, Jyoti

    2014-01-01

    Abdominal cocoon, also known as sclerosing encapsulating peritonitis, represents a rare entity where a variable length of the small bowel is enveloped by a fibrocollagenous membrane giving the appearance of a cocoon. It may be asymptomatic and is often diagnosed incidentally at laparotomy. We present a rare case of abdominal cocoon due to abdominal tuberculosis. PMID:25239980

  4. USE OF ALLOPLASTIC MESHES IN ABDOMINAL WOUNDS OF RATS WITH INDUCED PERITONITIS

    PubMed Central

    BARBUTO, Rafael Calvão; DUVAL-ARAUJO, Ivana; BARRAL, Sumara Marques; ROCHA, Raphael Grossi; BECHARA, Cristiane de Souza; BARBOSA, Alfredo José Afonso

    2014-01-01

    Background The use of alloplastic meshes has been historically contra-indicated in patients with infection. Aim To evaluate the use of polypropylene meshes in the treatment of abdominal wall defects in rats with peritonitis. Methods Twenty Wistar female rats were divided into two groups: induction of peritonitis (test group) and without peritonitis (control group). An abdominal wall defect was created in all animals, and polypropylene mesh was applied. The evaluation of the tensile strength of the mesh was carried out using tensiometer and microscopic analysis of the healing area was done. Results More adhesion of the mesh to the rat abdominal wall was observed in test group. The histopathological analyses showed prevalence of moderate to accentuated granulation tissue in both groups, without significant differences. Conclusion The use of the mesh coverage on abdominal wall defects of rats with induced peritonitis did not show worse results than its use in healthy animals, nor was its integration to the resident tissue any worse. PMID:24676294

  5. 'Stucco' Walls

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This projected mosaic image, taken by the microscopic imager, an instrument located on the Mars Exploration Rover Opportunity 's instrument deployment device, or 'arm,' shows the partial clotting or cement-like properties of the sand-sized grains within the trench wall. The area in this image measures approximately 3 centimeters (1.2 inches) wide and 5 centimeters (2 inches) tall.(This image also appears as an inset on a separate image from the rover's navigation camera, showing the location of this particular spot within the trench wall.)

  6. Deep digital burns treated with 2 abdominal flaps: case report.

    PubMed

    Wu, Choulang; Zhou, Lichun; Zhu, Lili; Zheng, Jinman

    2013-11-01

    We present the case of a 22-year-old man with third- to fourth-degree flame burns to all fingers of the right hand. After removing the necrotic tissues and amputating the carbonized distal segments of each finger, we covered the injured thumb with a paraumbilical tubular flap and covered the other fingers with an abdominal wall marsupial flap. Fifty days after injury, all the wounds healed, and the remaining fingers were salvaged. Four months after injury, the grip strength and the first web span of the right hand was 23.6 kg and 53°, and the patient could fulfill almost all the activities of daily living.

  7. Abdominal Distension and Vascular Collapse.

    PubMed

    Cosentino, Gina; Uwaifo, Gabriel I

    2016-04-01

    We present the case of a 43-year-old gentleman who presented to the emergency room with acute abdominal distension, confusion and vascular collapse. The emergent radiologic imaging obtained showed massive bilateral adrenal enlargement, but despite the initial clinical suspicion of possible overwhelming sepsis and/or massive abdominal/intralesional hemorrhage, lab tests based obtained rapidly confirmed the diagnosis of acute Addisonian crisis which responded dramatically to adrenocorticoid hormone replacement therapy and aggressive fluid resuscitation. The patient's established history of metastatic lung cancer confirmed this as a case of metastatic massive bilateral adrenal metastases with an initial presentation of acute adrenal insufficiency which is uncommon in the setting of metastatic carcinomatosis but more typically associated with lymphomas. Recognition of this clinical possibility is vital to enable rapid diagnosis and consequent life saving therapy. PMID:27328473

  8. [Abdominal bruit associated with hypertension].

    PubMed

    Fontseré, N; Bonet, J; Bonal, J; Romero, R

    2004-01-01

    First cause of secondary hypertension is renovascular hypertension which presents abdominal bruit in 16 to 20% of cases. This clinical sign is also associated with other vascular disease of the abdomen such as celiac trunk stenosis and/or aneurysms located on the pancreaticoduodenal or gastroduodenal arcs level, with little representation among aneurysm. They usually appear on a context of digestive complications like neoplasias, chronic pancreatitis or gastric obstructions possibly with obstructive icterus, hemorrhage and acute abdomen episodes. Its presentation in other contexts is rare and constitutes a diagnostic challenge. Diagnosis is made by abdominal arteriography which is the best method because you can locate the problem as well as intervene therapeutically with embolization of the aneurysme. We would like to emphasize the importance of a quick diagnosis due to the risk of rupture and the high morbi-mortality associated.

  9. [Abdominal cystic tumor revealing lymphangioleiomyomatosis].

    PubMed

    Barbier, L; Ebbo, M; Andrac-Meyer, L; Schneilitz, N; Le Treut, Y-P; Reynaud-Gaubert, M; Hardwigsen, J

    2009-02-01

    We report the case of a 39 year-old woman with many years of intermittent abdominal pain who was found to have cystic masses evocative of cystic lymphangioma involving the posterior mediastinal and retroperitoneum. Worsening abdominal pain led to a recommendation for laparoscopic unroofing and decompression of the cysts. During the postoperative period, hemorrhagic shock required reintervention with excision of the tumoral mass. Pathologic examination revealed lymphangioleiomyomatosis (LAM). On the 15th postoperative day, the patient developed a chylopneumothorax which required prolonged chest tube drainage. The presence of multiple polycystic lesions in the pulmonary parenchyma supported the diagnosis of diffuse LAM with primary extrapulmonary presentation. This diagnosis should be considered preoperatively since it modifies the treatment: a complete excision of the cystic lesions seems to be necessary in order to prevent bleeding and lymphatic extravasation.

  10. Hydatid cyst of the abdominal aorta and common iliac arteries complicated by a false aneurysm: a case report.

    PubMed

    Pulathan, Zerrin; Cay, Ali; Güven, Yaşar; Sarihan, Haluk

    2004-04-01

    The rupture of hydatid cysts into the abdominal aorta is an unusual and serious complication of the hydatid disease. The authors describe a case of a 12-year-old girl with hydatid disease presenting as a retroperitoneal mass invading the wall of the abdominal aortic bifurcation and complicated by a false aneurysm. Difficulties of preoperative diagnosis and operative management were discussed, and the literature was reviewed.

  11. Wall Covering

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The attractive wall covering shown below is one of 132 styles in the Mirror Magic II line offered by The General Tire & Rubber Company, Akron, Ohio. The material is metallized plastic fabric, a spinoff from space programs. Wall coverings are one of many consumer applications of aluminized plastic film technology developed for NASA by a firm later bought by King-Seeley Thermos Company, Winchester, Massachusetts, which now produces the material. The original NASA use was in the Echo 1 passive communications satellite, a "space baloon" made of aluminized mylar; the high reflectivity of the metallized coating enabled relay of communications signals from one Earth station to another by "bouncing" them off the satellite. The reflectivity feature also made the material an extremely efficient insulator and it was subsequently widely used in the Apollo program for such purposes as temperature control of spacecraft components and insulation of tanks for fuels that must be maintained at very low temperatures. I Used as a wall covering, the aluminized material offers extra insulation, reflects light and I resists cracking. In addition to General Tire, King-Seeley also supplies wall covering material to Columbus Coated Fabrics Division of Borden, Incorporated, Columbus, Ohio, among others.

  12. Wall Art

    ERIC Educational Resources Information Center

    McGinley, Connie Q.

    2004-01-01

    The author of this article, an art teacher at Monarch High School in Louisville, Colorado, describes how her experience teaching in a new school presented an exciting visual challenge for an art teacher--monotonous brick walls just waiting for decoration. This school experienced only minimal instances of graffiti, but as an art teacher, she did…

  13. Acute Abdominal Pain in Children.

    PubMed

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  14. Laparoscopic Management of Abdominal Pregnancy with Local Injection of Vasopressin Solution: A Case Report

    PubMed Central

    Hishikawa, Kenji; Fukuda, Takanori; Inoue, Hiromi; Kohata, Yutaka; Monma, Mika; Ochiai, Naomi; Kubo, Yuina; Watanabe, Remi; Ako, Shiho; Aihara, Yuri; Kusaka, Takeshi

    2016-01-01

    Patient: Female, 32 Final Diagnosis: Abdominal pregnancy Symptoms: Severe abdominal pain Medication: — Clinical Procedure: Laparoscopic treatment Specialty: Obstetrics and Gynecology Objective: Unusual or unexpected effect of treatment Background: Laparoscopic treatments of abdominal pregnancy have been reported; however, resection of an implanted gestational sac could lead to massive bleeding and treatment failure. Hemostasis of the resected stump is critical for the success of laparoscopic treatment. Case Report: A 32-year-old woman presented to the emergency department with severe abdominal pain. We suspected a ruptured ectopic pregnancy and performed urgent diagnostic laparoscopy. The gestational sac was implanted in the posterior wall of the uterus near the left uterosacral ligament, and bleeding from the gestational sac was noticed. We injected 3 ml of diluted vasopressin solution (0.4 U/ml) directly into the gestational sac and into the posterior uterine wall around the gestational sac. Thereafter, we could resect the gestational product using an ultrasonically activated scalpel. Additional hemostasis in the resected stump was not required. Conclusions: We believe that a local injection of a diluted vasopressin solution helps in maintaining the hemostasis after the laparoscopic resection of the implanted gestational sac in cases of abdominal pregnancy. PMID:27587187

  15. Fluid-structure interaction in abdominal aortic aneurysms: Structural and geometrical considerations

    NASA Astrophysics Data System (ADS)

    Mesri, Yaser; Niazmand, Hamid; Deyranlou, Amin; Sadeghi, Mahmood Reza

    2015-08-01

    Rupture of the abdominal aortic aneurysm (AAA) is the result of the relatively complex interaction of blood hemodynamics and material behavior of arterial walls. In the present study, the cumulative effects of physiological parameters such as the directional growth, arterial wall properties (isotropy and anisotropy), iliac bifurcation and arterial wall thickness on prediction of wall stress in fully coupled fluid-structure interaction (FSI) analysis of five idealized AAA models have been investigated. In particular, the numerical model considers the heterogeneity of arterial wall and the iliac bifurcation, which allows the study of the geometric asymmetry due to the growth of the aneurysm into different directions. Results demonstrate that the blood pulsatile nature is responsible for emerging a time-dependent recirculation zone inside the aneurysm, which directly affects the stress distribution in aneurismal wall. Therefore, aneurysm deviation from the arterial axis, especially, in the lateral direction increases the wall stress in a relatively nonlinear fashion. Among the models analyzed in this investigation, the anisotropic material model that considers the wall thickness variations, greatly affects the wall stress values, while the stress distributions are less affected as compared to the uniform wall thickness models. In this regard, it is confirmed that wall stress predictions are more influenced by the appropriate structural model than the geometrical considerations such as the level of asymmetry and its curvature, growth direction and its extent.

  16. Wall shear stress manifolds and near wall flow topology in aneurysms

    NASA Astrophysics Data System (ADS)

    Arzani, Amirhossein; Gambaruto, Alberto M.; Chen, Guoning; Shadden, Shawn C.

    2015-11-01

    Transport of atherogenic and thrombogenic chemicals near the vessel wall highly influences atherosclerosis and thrombosis. The high Schmidt number of these species leads to a thin concentration boundary layer near the wall. The wall shear stress (WSS) vector field can be scaled to obtain the near wall velocity in this region, thus providing first order approximation to near wall transport. In this study, the complex blood flow in patient-specific abdominal aortic aneurysms was considered. Lagrangian tracking of surface-bound tracers representing near wall species was employed to identify Lagrangian coherent structures (LCS) for the WSS surface vector field. The WSS LCS matched the stable and unstable manifolds of saddle type fixed points of the time-average WSS vector field, due to the quasi-steady nature of these near wall transport processes. A WSS exposure time measure is introduced to quantify the concentration of near wall species. The effect of diffusion and normal flow on these structures is investigated. The WSS LCS highly influence the concentration of near wall species, and provide a template for near-wall transport.

  17. Endovascular abdominal aortic aneurysm repair

    PubMed Central

    Norwood, M G A; Lloyd, G M; Bown, M J; Fishwick, G; London, N J; Sayers, R D

    2007-01-01

    The operative mortality following conventional abdominal aortic aneurysm (AAA) repair has not fallen significantly over the past two decades. Since its inception in 1991, endovascular aneurysm repair (EVAR) has provided an alternative to open AAA repair and perhaps an opportunity to improve operative mortality. Two recent large randomised trials have demonstrated the short and medium term benefit of EVAR over open AAA repair, although data on the long term efficacy of the technique are still lacking. This review aimed at providing an overview of EVAR and a discussion of the potential benefits and current limitations of the technique. PMID:17267674

  18. [Dirofilaria in the abdominal cavity].

    PubMed

    Révész, Erzsébet; Markovics, Gabriella; Darabos, Zoltán; Tóth, Ildikó; Fok, Eva

    2008-10-01

    Number of cases of filariasis have been recently reported in the Hungarian medical literature, most of them caused by Dirofilaria repens . Dirofilaria repens is a mosquito-transmitted filarioid worm in the subcutaneous tissue of dogs and cats. Human infection manifests as either subcutaneous nodules or lung parenchymal disease, which may even be asymptomatic. The authors report a human Dirofilaria repens infection of the abdominal cavity in a 61-year-old man,who underwent laparotomy for acute abdomen. Intraoperatively, local peritonitis was detected caused by a white nemathhelminth, measured 8 cm in size. Histocytology confirmed that the infection was caused by Dirofilaria repens.

  19. [Abdominal pain, constipation and anemia].

    PubMed

    Barresi, Fabio; Kunz Caflish, Isabel; Bayly-Schinzel, Leena; Dressel, Holger

    2016-03-30

    We present the case of a 42-year old man who went to the emergency department because of spasmodic abdominal pain. The abdomen was soft. A gastroscopy and a colonoscopy were without pathological findings. The laboratory analyses indicated anemia. The differential blood count showed basophilic granules in the red blood cells. The blood lead level was elevated. A lead poisoning was diagnosed. The cause was the oral intake of an ayurvedic medication which the patient had received in Bangladesh to treat his vitiligo. PMID:27005735

  20. Treatment of neonatal abdominal cysts.

    PubMed

    Dénes, J; Lukäcs, F V; Léb, J; Bognár, M

    1974-01-01

    Intraperitoneal or retroperitoneal cystic structures in the newborn appear with a variable clinical picture and in the case of intra-abdominal cysts, surgery is performed mostly on an emergency basis. In such cases the exact preoperative diagnosis is difficult and is seldom made. With early laparotomy, extensive small bowel resection can usually be avoided. Retroperitoneal lesions are mostly of renal origin; in such cases, preoperative diagnosis is easy, being based on specific examinations. In the year 1973, 5 newborns with an intraperitoneal or retroperitoneal cyst have been treated surgically. In this series, one infant died after resection of 90% of the small bowel.

  1. Abdominal Closure after TRAM Flap Breast Reconstruction with Transversus Abdominis Muscle Release and Mesh

    PubMed Central

    Avendano-Peza, Héctor; Novitsky, Yuri W.

    2016-01-01

    Summary: Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction. PMID:27757337

  2. Hemodynamic Influences on Abdominal Aortic Aneurysm Disease: Application of Biomechanics to Aneurysm Pathophysiology

    PubMed Central

    Dua, Monica M.; Dalman, Ronald L.

    2010-01-01

    “Atherosclerotic” abdominal aortic aneurysms (AAAs) occur with the greatest frequency in the distal aorta. The unique hemodynamic environment of this area predisposes it to site-specific degenerative changes. In this review, we summarize the differential hemodynamic influences present along the length of the abdominal aorta, and demonstrate how alterations in aortic flow and wall shear stress modify AAA progression in experimental models. Improved understanding of aortic hemodynamic risk profiles provides an opportunity to modify patient activity patterns to minimize risk of aneurysmal degeneration. PMID:20347049

  3. [Internationalization and innovation of abdominal acupuncture].

    PubMed

    Wang, Yong-Zhou

    2013-09-01

    Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture.

  4. Measurement of intra-abdominal pressure in large incisional hernia repair to prevent abdominal compartmental syndrome

    PubMed Central

    ANGELICI, A.M.; PEROTTI, B.; DEZZI, C.; AMATUCCI, C.; MANCUSO, G.; CARONNA, R.; PALUMBO, P.

    2016-01-01

    Introduction The repair of large incisional hernias may occasionally lead to a substantial increase in intra-abdominal pressure (IAP), and rarely to abdominal compartmental syndrome (ACS) with subsequent respiratory, vascular, and visceral complications. Measurement of the IAP has recently become a common practice in monitoring critical patients, even though such measurements were obtained in the early 1900s. Patients and Methods A prospective study involving 54 patients undergoing elective abdominal wall gap repair (mean length, 17.4 cm) with a tension-free technique after incisional hernia was conducted. The purpose of the study was to determine whether or not urinary pressure for indirect IAP measurement is a reliable method for the early identification of patients with a higher risk of developing ACS. IAP measurements were performed using a Foley catheter connected to a HOLTECH® medical manometer. IAP values were determined pre-operatively, after anesthetic induction, upon patient awakening, upon patient arrival in the ward after surgery, and 24 h after surgery before removing the catheter. All patients were treated by the same surgical team using a prosthetic composite mesh (PARIETEX®). Results Incisional hernia repair caused an increase in the mean IAP score of 2.68 mmHg in 47 of 54 patients (87.04%); the IAP was decreased in two patients (3.7%) and remained equal in five patients before and 24 h after surgery (9.26%). FEV-1, measured 24 h after surgery, increased in 50 patients (92.6%), remained stable in two patients (3.7%), and decreased in two patients (3.7%). The mean increase in FEV-1 was 0.0676 L (maximum increase = 0.42 L and minimum increase = 0.01 L) in any patient who developed ACS. Conclusions Measurement of urinary bladder pressure has been shown to be easy to perform and free of complications. Measurement of urinary bladder pressure can also be a useful tool to identify patients with a higher risk of developing ACS. PMID:27142823

  5. Advanced techniques in abdominal surgery.

    PubMed Central

    Monson, J R

    1993-01-01

    Almost every abdominal organ is now amenable to laparoscopic surgery. Laparoscopic appendicectomy is a routine procedure which also permits identification of other conditions initially confused with an inflamed appendix. However, assessment of appendiceal inflammation is more difficult. Almost all colonic procedures can be performed laparoscopically, at least partly, though resection for colonic cancer is still controversial. For simple patch repair of perforated duodenal ulcers laparoscopy is ideal, and inguinal groin hernia can be repaired satisfactorily with a patch of synthetic mesh. Many upper abdominal procedures, however, still take more time than the open operations. These techniques reduce postoperative pain and the incidence of wound infections and allow a much earlier return to normal activity compared with open surgery. They have also brought new disciplines: surgeons must learn different hand-eye coordination, meticulous haemostasis is needed to maintain picture quality, and delivery of specimens may be problematic. The widespread introduction of laparoscopic techniques has emphasised the need for adequate training (operations that were straight-forward open procedures may require considerable laparoscopic expertise) and has raised questions about trainee surgeons acquiring adequate experience of open procedures. Images FIG 9 p1347-a p1347-b p1349-a p1350-a p1350-b PMID:8257893

  6. Mechanical ventilation in abdominal surgery.

    PubMed

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery.

  7. Cooling wall

    SciTech Connect

    Nosenko, V.I.

    1995-07-01

    Protecting the shells of blast furnaces is being resolved by installing cast iron cooling plates. The cooling plates become non-operational in three to five years. The problem is that defects occur in manufacturing the cooling plates. With increased volume and intensity of work placed on blast furnaces, heat on the cast iron cooling plates reduces their reliability that limits the interim repair period of blast furnaces. Scientists and engineers from the Ukraine studied this problem for several years, developing a new method of cooling the blast furnace shaft called the cooling wall. Traditional cast iron plates were replaced by a screen of steel tubes, with the area between the tubes filled with fireproof concrete. Before placing the newly developed furnace shaft into operation, considerable work was completed such as theoretical calculations, design, research of temperature fields and tension. Continual testing over many years confirms the value of this research in operating blast furnaces. The cooling wall works with water cooling as well as vapor cooling and is operating in 14 blast furnaces in the Ukraine and two in Russia, and has operated for as long as 14 years.

  8. Mycotic Abdominal Aneurysm Caused by Campylobacter Fetus: A Case Report for Surgical Management

    PubMed Central

    Noda, Yukihiro; Sawada, Ko-ichiro; Yoshida, Syu-hei; Nishida, Satoru; Yamamoto, Shinichiro; Otake, Yuji; Watanabe, Go

    2011-01-01

    We report a rare case of mycotic abdominal aortic aneurysm associated with Campylobacter fetus. A 72-year-old male admitted to the hospital because of pain in the right lower quadrant with pyrexia. The enhanced abdominal computed tomography (CT) examination showed abdominal aortic aneurysm (AAA) measuring 50 mm in maximum diameter and a high-density area of soft tissue density from the right lateral wall to the anterior wall of the aorta. However, since the patient showed no significant signs of defervescence after antibiotics administration, so we performed emergency surgery on the patient based on the diagnosis of impending rupture of mycotic AAA. The aneurysm was resected in situ reconstruction using a bifurcated albumin-coated knitted Dacron graft was performed. The cultures of blood and aneurysmal wall grew Campylobacter fetus, allowing early diagnosis and appropriate surgical management in this case, and the patient is making satisfactory progress. This is the fifth report of mycotic AAA characterizing culture positive for Campylobacter fetus in blood and tissue culture of the aortic aneurysm wall. PMID:23555431

  9. Puerperal endometritis after abdominal twin delivery.

    PubMed

    Suonio, S; Huttunen, M

    1994-04-01

    The infectious complications of 122 consecutive abdominal twin deliveries over the period 1984-1989 were analyzed in a prospective clinical study, comparing them with 761 singleton abdominal deliveries over the period 1984-1986. The incidence of endometritis was nearly three-fold after twin deliveries and the incidence of abdominal wound infections nearly two-fold compared with singleton abdominal pregnancies (13.1/4.7% and 5.6/3.0%). The risk of amnionitis was increased ten-fold, 6 hours after rupture of the membranes in abdominal twin delivery, but no connection was found between amnionitis and endometritis, as in singleton abdominal deliveries. Multiple regression analysis indicated only two risk factors as regards puerperal endometritis after abdominal twin delivery: age under 25 years (odds ratio 6.9, 95% confidence limits 1.9-24.8), an association also seen in singleton abdominal deliveries, and a period of more than 6 hours from rupture of membranes to delivery (odds ratio 7.8, 95% confidence limits 2.1-28.5). Multiple pregnancy appears to be associated with an increased risk of endometritis. The etiological factors remain unknown, but a large placental bed and/or immunological factors may be implicated. PMID:8160537

  10. Pediatric Abdominal Pain: An Emergency Medicine Perspective.

    PubMed

    Smith, Jeremiah; Fox, Sean M

    2016-05-01

    Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. PMID:27133248

  11. Laparoscopic resection of an intra-abdominal esophageal duplication cyst: a case report and literature review.

    PubMed

    Watanobe, Ikuo; Ito, Yuzuru; Akimoto, Eigo; Sekine, Yuuki; Haruyama, Yurie; Amemiya, Kota; Kawano, Fumihiro; Fujita, Shohei; Omori, Satoshi; Miyano, Shozo; Kosaka, Taijiro; Machida, Michio; Kitabatake, Toshiaki; Kojima, Kuniaki; Sakaguchi, Asumi; Ogura, Kanako; Matsumoto, Toshiharu

    2015-01-01

    Duplication of the alimentary tract is a rare congenital malformation that occurs most often in the abdominal region, whereas esophageal duplication cyst develops typically in the thoracic region but occasionally in the neck and abdominal regions. Esophageal duplication cyst is usually diagnosed in early childhood because of symptoms related to bleeding, infection, and displacement of tissue surrounding the lesion. We recently encountered a rare adult case of esophageal duplication cyst in the abdominal esophagus. A 50-year-old man underwent gastroscopy, endoscopic ultrasonography, computed tomography, and magnetic resonance imaging to investigate epigastric pain and dysphagia that started 3 months earlier. Imaging findings suggested esophageal duplication cyst, and the patient underwent laparoscopic resection followed by intraoperative esophagoscopy to reconstruct the esophagus safely and effectively. Histopathological examination of the resected specimen revealed two layers of smooth muscle in the cystic wall, confirming the diagnosis of esophageal duplication cyst. PMID:25883826

  12. Feasibility of Laser Doppler Vibrometry as potential diagnostic tool for patients with abdominal aortic aneurysms.

    PubMed

    Schuurman, T; Rixen, D J; Swenne, C A; Hinnen, J-W

    2013-04-01

    The application of laser measurements in medical applications makes it possible to measure even very small vibrations without contacting the skin surface. In the present work we investigate the use of a scanning vibrometer to measure the mechanical wave of the abdominal wall caused by the heart beat and blood pressure pulse. A Laser Doppler Vibrometer, triggered by cardiac signals, is used to scan points on a grid positioned on the abdomen of human subjects. The proposed procedure is intended for detecting anomalies in the abdominal cavity such as aortic aneurysms. Here, we outline the technical setup used in our preliminary in vivo experiments and present some preliminary results. This feasibility study shows that the proposed measurement procedure allows for measuring the skin motion, that the skin motion measured is related to the heart activity, and that there are indication that the presence of an abdominal aortic aneurysm significantly modifies the relation between blood pressure pulsations and skin motion on the abdomen.

  13. Abdominal tuberculosis of the gastrointestinal tract: Revisited

    PubMed Central

    Debi, Uma; Ravisankar, Vasudevan; Prasad, Kaushal Kishor; Sinha, Saroj Kant; Sharma, Arun Kumar

    2014-01-01

    Abdominal tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of abdominal tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required only in a minority of cases. Imaging plays an important role in diagnosis of abdominal tuberculosis because early recognition of this condition is important. We reviewed our experience with the findings on various imaging modalities for diagnosis of this potentially treatable disease. PMID:25356043

  14. A fibromatosis case mimicking abdominal aorta aneurysm.

    PubMed

    Tasdemir, Arzu; Kahraman, Cemal; Tasdemir, Kutay; Mavili, Ertugrul

    2013-01-01

    Retroperitoneal fibrosis is a rare fibrosing reactive process that may be confused with mesenteric fibromatosis. Abdominal aorta aneurysm is rare too and mostly develops secondary to Behcet's disease, trauma, and infection or connective tissue diseases. Incidence of aneurysms occurring as a result of atherosclerotic changes increases in postmenopausal period. Diagnosis can be established with arteriography, tomography, or magnetic resonance imaging associated with clinical findings. Tumors and cysts should be considered in differential diagnosis. Abdominal ultrasound and contrast-enhanced computerized tomography revealed an infrarenal abdominal aorta aneurysm in a 41-year-old woman, but, on surgery, retroperitoneal fibrosis surrounding the aorta was detected. We present this interesting case because retroperitoneal fibrosis encircling the abdominal aorta can mimic abdominal aorta aneurysm radiologically.

  15. 2D FSI determination of mechanical stresses on aneurismal walls.

    PubMed

    Veshkina, Natalia; Zbicinski, Ireneusz; Stefańczyk, Ludomir

    2014-01-01

    In this study, a fluid-structure interaction analysis based on the application of patient-specific mechanical parameters of the aneurismal walls was carried out to predict the rupture side during an abdominal aortic aneurysm (AAA). Realistic geometry of the aneurysm was reconstructed from CT data acquired from the patient, and patient-specific flow conditions were applied as boundary conditions. A newly developed non-invasive methodology for determining the mechanical parameters of the patient-specific aortic wall was employed to simulate realistic aortic wall behaviors. Analysis of the results included time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and von Mises stress (VMS). Results of the TAWSS, OSI, and VMS were compared to identify the most probable region of the AAA's rupture. High OSI, which identified the region of wall degradation, coincided with the location of maximum VMS, meaning that the anterior part of the aneurismal wall was a potential region of rupture. PMID:25226953

  16. ABDOMINAL PREGNANCY IN A SERVAL (LEPTAILURUS SERVAL) SECONDARY TO UTERINE RUPTURE.

    PubMed

    Bryan, Laura K; Blue-McLendon, Alice; Hoffmann, Aline Rodrigues

    2015-06-01

    A 14-yr-old female serval (Leptailurus serval) died unexpectedly after 2 wk of inappetence and lethargy. Necropsy revealed a pyoabdomen with a full-term, well-developed fetus in the caudal abdomen covered by a mesenteric sac. The mesenteric sac communicated with a tear in the wall of the right uterine horn, supporting a diagnosis of secondary abdominal pregnancy. The uterine wall had evidence of adenomyosis at the rupture site with no evidence of pyometra. The fetus, supporting mesentery, and peritoneum were coated with mixed bacteria, which may have ascended through an open cervix to the site of uterine rupture. This is the first case of abdominal pregnancy related to uterine rupture reported in a large felid species.

  17. Abdominal exploration in captive collared peccaries (Tayassu tajacu) by ultrasonography.

    PubMed

    Peixoto, G C X; Oliveira, I R S; Alves, N D; Oliveira, M F; Silva, A R

    2012-08-01

    This study determines the morphology and ultrasound features of the abdominal organs in male, nestling and healthy collared peccaries. The bladder wall is hyperechogenic, with a thickness of 0.2 ± 0.08 cm. The kidneys present a well-defined cortex, medulla and pelvis, and the dimensions are 2.56 ± 0.3 × 4.6 ± 0.8 cm for the left and 2.51 ± 0.4 × 4.86 ± 1.1 cm for the right kidney. The spleen has a uniform echotexture over its entire surface. The largest dimensions of the liver are 2.0 ± 0.57 cm for the left lobe and 1.42 ± 0.66 cm for the caudate lobe. The liver presents a homogeneous echotexture in the majority of cases, but sometimes some hyperechoic spots are present. The stomach wall has a thickness of 0.42 ± 0.28 cm. The bowel loops show alternate hyperechoic and hypoechoic layers with a uniform diameter and a wall thickness of 0.19 ± 0.07 cm.

  18. Abdominal aortic aneurysm: from clinical imaging to realistic replicas.

    PubMed

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

    2014-01-01

    The goal of this work is to develop a framework for manufacturing nonuniform wall thickness replicas of abdominal aortic aneurysms (AAAs). The methodology was based on the use of computed tomography (CT) images for virtual modeling, additive manufacturing for the initial physical replica, and a vacuum casting process and range of polyurethane resins for the final rubberlike phantom. The average wall thickness of the resulting AAA phantom was compared with the average thickness of the corresponding patient-specific virtual model, obtaining an average dimensional mismatch of 180 μm (11.14%). The material characterization of the artery was determined from uniaxial tensile tests as various combinations of polyurethane resins were chosen due to their similarity with ex vivo AAA mechanical behavior in the physiological stress configuration. The proposed methodology yields AAA phantoms with nonuniform wall thickness using a fast and low-cost process. These replicas may be used in benchtop experiments to validate deformations obtained with numerical simulations using finite element analysis, or to validate optical methods developed to image ex vivo arterial deformations during pressure-inflation testing.

  19. Intra-abdominal pressure during swimming.

    PubMed

    Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y

    2014-02-01

    The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4 m · s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P < 0.05). However, there was no significant difference in stroke length by velocity. Significant within-subject correlations between intra-abdominal pressure and stroke rate or stroke length (P < 0.01) were observed, although there were no significant correlations between intra-abdominal pressure and stroke indices when controlling for swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure. PMID:23868677

  20. Intra-abdominal pressure during swimming.

    PubMed

    Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y

    2014-02-01

    The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4 m · s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P < 0.05). However, there was no significant difference in stroke length by velocity. Significant within-subject correlations between intra-abdominal pressure and stroke rate or stroke length (P < 0.01) were observed, although there were no significant correlations between intra-abdominal pressure and stroke indices when controlling for swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure.

  1. Thoracic Disk Herniation, a not Infrequent Cause of Chronic Abdominal Pain

    PubMed Central

    Lara, F.J. Pérez; Berges, A. Ferrer; Quesada, J. Quintero; Ramiro, J.A. Moreno; Toledo, R. Bustamante; Muñoz, H. Oliva

    2012-01-01

    This study assesses the proportion of patients presenting with nonvisceral chronic abdominal pain who have thoracic disk herniation as a possible cause. We designed a descriptive transversal study of patients attending our offices between February 2009 and October 2010, with a complaint of chronic abdominal pain of suspected abdominal wall source (positive Carnett sign). Nuclear magnetic resonance (NMR) of the spinal column was performed on all patients. When the NMR showed thoracic disk herniation the patients were treated according to their etiology. We also evaluated the symptoms in patients with thoracic disk herniation and their response to the applied treatment. Twenty-seven patients with chronic abdominal pain were evaluated. The NMR results in 18 of these 27 patients (66.66%) showed evidence of disk herniation. We report on the results of these 18 patients, emphasizing that the symptoms are florid and varied. Many patients had been previously diagnosed with irritable bowel syndrome. Thoracic disk herniation may account for chronic abdominal pain in many patients who remain undiagnosed or are diagnosed with irritable bowel syndrome. Thus, this possibility needs to be taken into account to achieve a correct diagnosis and a suitable mode of treatment. PMID:23101998

  2. Enhanced production of the chemotactic cytokines interleukin-8 and monocyte chemoattractant protein-1 in human abdominal aortic aneurysms.

    PubMed Central

    Koch, A. E.; Kunkel, S. L.; Pearce, W. H.; Shah, M. R.; Parikh, D.; Evanoff, H. L.; Haines, G. K.; Burdick, M. D.; Strieter, R. M.

    1993-01-01

    Inflammatory leukocytes play a central role in the pathogenesis of human atherosclerotic disease, from early atherogenesis to the late stages of atherosclerosis, such as aneurysm formation. We have shown previously that human abdominal aortic aneurysms are characterized by the presence of numerous chronic inflammatory cells throughout the vessel wall (Am J Pathol 1990, 137: 1199-1213). The signals that attract lymphocytes and monocytes into the aortic wall in aneurysmal disease remain to be precisely defined. We have studied the production of the chemotactic cytokines interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) by aortic tissues obtained from 47 subjects. We compared the antigenic production of these cytokines by explants of: 1) human abdominal aneurysmal tissue, 2) occlusive (atherosclerotic) aortas, and 3) normal aortas. IL-8, which is chemotactic for neutrophils, lymphocytes, and endothelial cells was liberated in greater quantities by abdominal aortic aneurysms than by occlusive or normal aortas. Using immunohistochemistry, macrophages, and to a lesser degree endothelial cells, were found to be positive for the expression of antigenic IL-8. Similarly, MCP-1, a potent chemotactic cytokine for monocytes/macrophages, was released by explants from abdominal aortic aneurysms in greater quantities than by explants from occlusive or normal aortas. Using immunohistochemistry, the predominant MCP-1 antigen-positive cells were macrophages and to a lesser extent smooth muscle cells. Our results indicate that human abdominal aortic aneurysms produce IL-8 and MCP-1, both of which may serve to recruit additional inflammatory cells into the abdominal aortic wall, hence perpetuating the inflammatory reaction that may result in the pathology of vessel wall destruction and aortic aneurysm formation. Images Figure 2 Figure 3 Figure 4 Figure 5 PMID:8494046

  3. Epithelioid Angiosarcoma With Metastatic Disease After Endovascular Therapy of Abdominal Aortic Aneurysm

    SciTech Connect

    Schmehl, Joerg; Scharpf, Marcus; Brechtel, Klaus; Kalender, Guenay; Heller, Stephan; Claussen, Claus D.; Lescan, Mario

    2012-02-15

    Malignancies of the aortic wall represent a rare condition, and only a few reports have covered cases of sarcomas arising at the site of a prosthesis made of Dacron. A coincidence with endovascular repair has only been reported in one case to date. We report a patient with epithelioid angiosarcoma and metastatic disease, which was found in an aneurysmal sac after endovascular aortic repair for abdominal aortic aneurysm.

  4. Laparoscopic repair of abdominal incisional hernia

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Abdominal incisional hernia is a common complication after open abdominal operations. Laparoscopic procedures have obvious mini-invasive advantages for surgical treatment of abdominal incisional hernia, especially to cases with big hernia defect. Laparoscopic repair of incisional hernia has routine mode but the actual operations will be various according to the condition of every hernia. Key points of these operations include design of the position of trocars, closure of defects and fixation of meshes. The details of these issues and experiences of perioperative evaluation and treatment will be talked about in this article. PMID:27761446

  5. Chylous Ascites after Abdominal Aortic Aneurysm Repair.

    PubMed

    Ohki, Shinichi; Kurumisawa, Soki; Misawa, Yoshio

    2016-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  6. [Internationalization and innovation of abdominal acupuncture].

    PubMed

    Wang, Yong-Zhou

    2013-09-01

    Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture. PMID:24298780

  7. Isolate abdominal bronchogenic cyst: a case report.

    PubMed

    Cetinkurşun, S; Oztürk, H; Celasun, B; Sakarya, M T; Sürer, I

    1997-04-01

    Isolated abdominal bronchogenic cysts are rare abnormalities. They are usually asymptomatic unless secondarily infected or large enough to cause compression of other vital structures. The authors report on a 20-month-old girl who had an abdominal bronchogenic cyst and presented with a history of recurrent urinary tract infections. The evaluation and treatment of this patient is presented as well as a review of the ten previously reported cases. A literature review showed only four cases in the pediatric age group. Excision is recommended to establish diagnosis and alleviate any symptoms. Abdominal bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal masses.

  8. The Effects of Neuromuscular Electrical Stimulation Training on Abdominal Strength, Endurance, and Selected Anthropometric Measures

    PubMed Central

    Porcari, John P.; Miller, Jennifer; Cornwell, Kelly; Foster, Carl; Gibson, Mark; McLean, Karen; Kernozek, Tom

    2005-01-01

    We studied the effects of self-administered neuromuscular electrical stimulation (NMES) on changes in strength, endurance, selected anthropometric measures, and subject’s perceived shape and satisfaction of the abdominal wall. Twenty-four adults (experimental group) stimulated their abdominals 5 days per week (20-40 minutes per session) for 8 weeks and refrained from engaging in any additional exercise during the study. A control group (N=16) refrained from exercising the abdominals or engaging in any other exercise training during the study. Subjects were tested at the beginning, mid-point, and end of the study. Isometric strength of the abdominal muscles was tested using a isokinetic dynamometer, endurance was measured using the ACSM curl-up test, abdominal circumference was measured using a steel tape measure, and body shape and satisfaction were assessed via questionnaire. The stimulation group had a 58% increase in abdominal strength, whereas the control group did not change. The stimulation group also had a 100% increase in abdominal endurance versus a 28% increase in the control group. Waist circumference decreased by of 3.5 cm in the stimulation group compared to no significant change in the control group. All 24 subjects in the stimulation group felt that their midsections were more “toned” and “firmed” and 13/24 (54%) felt that their posture had improved as a result of the stimulation. None of the control group subjects reported changes in these parameters. There were no significant differences in body weight, BMI, or skinfold thickness over the course of the study in either group. NMES, as used in the current study, resulted in significant improvements in the muscular strength and endurance of the abdominal region, as well as subject’s perceived shape and satisfaction of the mid-section. Key Points Electrical muscle stimulation (EMS) was effective in increasing muscle strength and endurance All subjects perceived their abdominal muscles to be

  9. Keratinocyte Growth Factor Combined with a Sodium Hyaluronate Gel Inhibits Postoperative Intra-Abdominal Adhesions

    PubMed Central

    Wei, Guangbing; Zhou, Cancan; Wang, Guanghui; Fan, Lin; Wang, Kang; Li, Xuqi

    2016-01-01

    Postoperative intra-abdominal adhesion is a very common complication after abdominal surgery. One clinical problem that remains to be solved is to identify an ideal strategy to prevent abdominal adhesions. Keratinocyte growth factor (KGF) has been proven to improve the proliferation of mesothelial cells, which may enhance fibrinolytic activity to suppress postoperative adhesions. This study investigated whether the combined administration of KGF and a sodium hyaluronate (HA) gel can prevent intra-abdominal adhesions by improving the orderly repair of the peritoneal mesothelial cells. The possible prevention mechanism was also explored. The cecum wall and its opposite parietal peritoneum were abraded after laparotomy to induce intra-abdominal adhesion formation. Animals were randomly allocated to receive topical application of HA, KGF, KGF + HA, or normal saline (Control). On postoperative day 7, the adhesion score was assessed with a visual scoring system. Masson’s trichrome staining, picrosirius red staining and hydroxyproline assays were used to assess the magnitude of adhesion and tissue fibrosis. Cytokeratin, a marker of the mesothelial cells, was detected by immunohistochemistry. The levels of tissue plasminogen activator (tPA), interleukin-6 (IL-6), and transforming growth factor β1 (TGF-β1) in the abdominal fluid were determined using enzyme-linked immunosorbent assays (ELISAs). Western blotting was performed to examine the expression of the TGF-β1, fibrinogen and α-smooth muscle actin (α-SMA) proteins in the rat peritoneal adhesion tissue. The combined administration of KGF and HA significantly reduced intra-abdominal adhesion formation and fibrin deposition and improved the orderly repair of the peritoneal mesothelial cells in the rat model. Furthermore, the combined administration of KGF and HA significantly increased the tPA levels but reduced the levels of IL-6, tumor necrosis factor α (TNF-α) and TGF-β1 in the abdominal fluid. The expression

  10. Keratinocyte Growth Factor Combined with a Sodium Hyaluronate Gel Inhibits Postoperative Intra-Abdominal Adhesions.

    PubMed

    Wei, Guangbing; Zhou, Cancan; Wang, Guanghui; Fan, Lin; Wang, Kang; Li, Xuqi

    2016-01-01

    Postoperative intra-abdominal adhesion is a very common complication after abdominal surgery. One clinical problem that remains to be solved is to identify an ideal strategy to prevent abdominal adhesions. Keratinocyte growth factor (KGF) has been proven to improve the proliferation of mesothelial cells, which may enhance fibrinolytic activity to suppress postoperative adhesions. This study investigated whether the combined administration of KGF and a sodium hyaluronate (HA) gel can prevent intra-abdominal adhesions by improving the orderly repair of the peritoneal mesothelial cells. The possible prevention mechanism was also explored. The cecum wall and its opposite parietal peritoneum were abraded after laparotomy to induce intra-abdominal adhesion formation. Animals were randomly allocated to receive topical application of HA, KGF, KGF + HA, or normal saline (Control). On postoperative day 7, the adhesion score was assessed with a visual scoring system. Masson's trichrome staining, picrosirius red staining and hydroxyproline assays were used to assess the magnitude of adhesion and tissue fibrosis. Cytokeratin, a marker of the mesothelial cells, was detected by immunohistochemistry. The levels of tissue plasminogen activator (tPA), interleukin-6 (IL-6), and transforming growth factor β1 (TGF-β1) in the abdominal fluid were determined using enzyme-linked immunosorbent assays (ELISAs). Western blotting was performed to examine the expression of the TGF-β1, fibrinogen and α-smooth muscle actin (α-SMA) proteins in the rat peritoneal adhesion tissue. The combined administration of KGF and HA significantly reduced intra-abdominal adhesion formation and fibrin deposition and improved the orderly repair of the peritoneal mesothelial cells in the rat model. Furthermore, the combined administration of KGF and HA significantly increased the tPA levels but reduced the levels of IL-6, tumor necrosis factor α (TNF-α) and TGF-β1 in the abdominal fluid. The expression

  11. Flow dynamics in anatomical models of abdominal aortic aneurysms: computational analysis of pulsatile flow.

    PubMed

    Finol, Ender A; Amon, Cristina H

    2003-01-01

    Blood flow in human arteries is dominated by time-dependent transport phenomena. In particular, in the abdominal segment of the aorta under a patient's average resting conditions, blood exhibits laminar flow patterns that are influenced by secondary flows induced by adjacent branches and in irregular vessel geometries. The flow dynamics becomes more complex when there is a pathological condition that causes changes in the normal structural composition of the vessel wall, for example, in the presence of an aneurysm. An aneurysm is an irreversible dilation of a blood vessel accompanied by weakening of the vessel wall. This work examines the importance of hemodynamics in the characterization of pulsatile blood flow patterns in individual Abdominal Aortic Aneurysm (AAA) models. These patient-specific computational models have been developed for the numerical simulation of the momentum transport equations utilizing the Finite Element Method (FEM) for the spatial and temporal discretization. We characterize pulsatile flow dynamics in AAAs for average resting conditions by means of identifying regions of disturbed flow and quantifying the disturbance by evaluating wall pressure and wall shear stresses at the aneurysm wall. PMID:14515766

  12. [Churg-Strauss abdominal manifestation].

    PubMed

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo

    2014-01-01

    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  13. Lymphangioleiomyomatosis: pulmonary and abdominal findings with pathologic correlation.

    PubMed

    Pallisa, Esther; Sanz, Pilar; Roman, Antonio; Majó, Joaquim; Andreu, Jordi; Cáceres, José

    2002-10-01

    Lymphangioleiomyomatosis (LAM) is a rare disease characterized by pulmonary cysts at computed tomography (CT) and proliferation of abnormal smooth muscle cells at lung biopsy. Almost all patients are female, and all have pulmonary cysts at high-resolution CT. Although the presence of cysts may be suggested at conventional CT or chest radiography, high-resolution CT is superior for cyst detection and is essential for diagnosis. The cysts are typically round; in most cases, the cyst wall is barely seen at thin-section CT. They are typically diffusely distributed throughout the central and peripheral lung parenchyma. The lung bases are affected in all patients. Some patients also have increased lung attenuation or a reticular pattern. Expiratory CT shows no air trapping between the cysts, and most of the cysts decrease in size. Pneumothorax, pleural effusion, and chylothorax are complications of LAM. Certain abdominal findings may provide additional corroborative evidence of the diagnosis. Renal angiomyolipomas, the most frequent abdominal lesions, usually manifest as asymptomatic, small, bilateral tumors of fat attenuation in the renal cortex. Lymphangiomas are cystic retroperitoneal masses that occur in up to 20% of patients. Other CT findings are hypo- or hyperattenuating lymph nodes, a dilated thoracic duct, and ascites.

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

    PubMed

    Gökkuş, Kemal; Akin, Tolgay; Sagtas, Ergin; Saylik, Murat; Aydın, Ahmet Turan

    2014-01-01

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

  15. The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex

    NASA Technical Reports Server (NTRS)

    Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)

    1993-01-01

    The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

  16. The abdominal compartment syndrome: review, experience report and description of an innovative biological mesh application.

    PubMed

    Parmeggiani, Domenico; Gubitosi, Adelmo; Ruggiero, Roberto; Docimo, Giovanni; Atelli, Pietro Francesco; Avenia, Nicola

    2011-12-01

    Intra abdominal hypertension (IAH) is defined as an intra-abdominal pressure (IAP) >12 mmHg. Abdominal compartment syndrome (ACS) is defined as an IAP above 20 mmHg with evidence of organ dysfunction/failure. The real incidence of the ACS is not clear, because there are few perspective studies. The origin of ACS can be divided into retroperitoneal, intraperitoneal, parietal and intestinal, and the diagnostic algorithm includes base and toxicological laboratory examinations, thorax X-ray, abdomen X-ray, abdomen TC, peritoneal washing, abdomen ultrasonography, diagnostic laparoscopy, and measurement of IAP. To allow a suitable decompression and avoid the damages to the abdominal organs, abdominal wall normally is not sutured primarily but secondarily and there are many methods of temporary closing: absorbable net, non-absorbable nets, 'Bogota bag', 'vacuum pack ice', gradual approximation of side cutaneous edges on the half-way line with permanence of an ample ventral hernia that could be subsequently repaired, and the use of 'skin expanders'. Since January 2000, until December 2008, eight patients were submitted to laparostomy, four of them for re-laparotomy, with mortality incidence of 37.5%. The defective size to fill was on the average 300 cm as reported by Bradley and Bradley (J Clin Invest 26:1010-1015, 1947). The abdominal wall reconstruction was performed using ample muscle edges derived from the slip in medial sense of the rectus muscle of the abdomen 'unmoored' through an incision 1 cm distant from semi-lunar line, and using absorbable prosthesis to cover the solution of continuity, thus allowing the closing of defects over 30 cm. We have found median post surgical hernia in one patient corrected in accordance with the time using polypropylene prosthesis. In one patient with parietal disaster and multiple traumatic splanchnic ruptures, we have used a pure pork-derived acellular collagen mesh (Permacol(®)) to close the wound, leaving enough space between

  17. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    PubMed

    Polzer, Stanislav; Gasser, T Christian

    2015-12-01

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. PMID:26631334

  18. Spontaneous rupture of the abdominal aorta.

    PubMed Central

    Williams, T. G.

    1977-01-01

    Fatal spontaneous rupture of the lower abdominal aorta in a previously healthy 61-year-old woman is reported; the possibility that she had the Ehlers-Danlos syndrome is discussed. Images Fig. 1 PMID:870895

  19. Abdominal Obesity and Association With Atherosclerosis Risk Factors: The Uberlândia Heart Study.

    PubMed

    Roever, Leonardo S; Resende, Elmiro S; Diniz, Angélica L D; Penha-Silva, Nilson; Veloso, Fernando C; Casella-Filho, Antonio; Dourado, Paulo M M; Chagas, Antonio C P

    2016-03-01

    Ectopic visceral fat (VF) and subcutaneous fat (SCF) are associated with cardiovascular risk factors. Gender differences in the correlations of cardiovascular disease risk factors and ectopic fat in the Brazilian population still lacking. Cross-sectional study with 101 volunteers (50.49% men; mean age 56.5 ± 18, range 19-74 years) drawn from the Uberlândia Heart Study underwent ultrasonography assessment of abdominal visceral adipose tissue with convex transducer of 3.5 MHz of frequency. The thickness of VF was ultrasonographically measured by the distance between the inner face of the abdominal muscle and the posterior face of abdominal aorta, 1 cm above the umbilicus. The SCF thickness was measured with a 7.5 MHz linear transducer transversely positioned 1 cm above the umbilical scar. The exams were always performed by the same examiner. Ectopic fat volumes were examined in relation to waist circumference, blood pressure, and metabolic risk factors. The VF was significantly associated with the levels of triglycerides (P < 0.01, r = 0.10), HDL cholesterol (P < 0.005, r = 0.15), total cholesterol (P < 0.01, r = 0.10), waist circumference (P < 0.0001, r = 0.43), systolic blood pressure (P < 0.001, r = 0.41), and diastolic blood pressure (P < 0.001, r = 0.32) in women, and with the levels of triglycerides (P < 0.002, r = 0,14), HDL cholesterol (P < 0.032, r = 0.07), glucose (P < 0.001, r = 0.15), alanine aminotransferase (ALT) (P < 0.008, r = 0.12), gamma-GT (P < 0.001, r = 0.30), waist circumference (P < 0.001, r = 0.52), systolic blood pressure (P < 0.001, r = 0.32), and diastolic blood pressure (P < 0.001, r = 0.26) in men. SCF was significantly associated with the levels of triglycerides (P < 0.01, r = 0.34), LDL cholesterol (P < 0.001, r = 0.36), total cholesterol (P < 0.05, r = 0.36), waist circumference (P

  20. [Intestinal occlusion and abdominal compartment syndrome (ACS)].

    PubMed

    Stagnitti, Franco

    2009-01-01

    Intestinal occlusion is defined as an independent predictive factor of intra-abdominal hypertension (IAH) which represents an independent predictor of mortality. Baggot in 1951 classified patients operated with intestinal occlusion as being at risk for IAH ("abdominal blow-out"), recommending them for open abdomen surgery proposed by Ogilvie. Abdominal surgery provokes IAH in 44.7% of cases with mortality which, in emergency, triples with respect to elective surgery (21.9% vs 6.8%). In particular, IAH is present in 61.2% of ileus and bowel distension and is responsible for 52% of mortality (54.8% in cases with intra-abdominal infection). These patients present with an increasing intra-abdominal pressure (IAP) which, over 20-25 mmHg, triggers an Abdominal Compartment Syndrome (ACS) with altered functions in some organs arriving at Multiple Organ Dysfunction Syndrome (MODS). The intestine normally covers 58% of abdominal volume but when there is ileus distension, intestinal pneumatosis develops (third space) which can occupy up to 90% of the entire cavity. At this moment, Gastro Intestinal Failure (GIF) can appear, which is a specific independent risk factor of mortality, motor of "Organ Failure". The pathophysiological evolution has many factors in 45% of cases: intestinal pneumatosis is associated with mucosal and serous edema, capillary leakage with an increase in extra-cellular volume and peritoneal fluid collections (fourth space). The successive loss of the mucous barrier permits a bacterial translocation which includes bacteria, toxins, pro-inflammatory factors and oxygen free radicals facilitating the passage from an intra-abdominal to inter-systemic vicious cyrcle. IAH provokes the raising of the diaphragm, and vascular and visceral compressions which induce hypertension in the various spaces with compartmental characteristics. These trigger hypertension in the renal, hepatic, pelvic, thoracic, cardiac, intracranial, orbital and lower extremity areas, giving

  1. Management of abdominal contusion in polytraumatized children.

    PubMed

    Canarelli, J P; Boboyono, J M; Ricard, J; Doidy, L; Collet, L M; Postel, J P

    1991-01-01

    Management of abdominal contusion in polytraumatized children is based on the conservative treatment of spleen and liver lesions when it is possible. Ultrasonography and CTScan can give a good evaluation of splenic, liver, pancreas or kidney lesions. In some cases, if the haemodynamic conditions are good, a non-operative treatment may be proposed. We report our experience of conservative management of intra abdominal lesions in children, about 91 cases in ten years. PMID:1869385

  2. Abdominal Aortic Aneurysmectomy in Renal Transplant Patients

    PubMed Central

    Jebara, Victor A.; Fabiani, Jean-Noël; Moulonguet-Deloris, L.; Acar, Christophe; Debauchez, Mathieu; Chachques, J.C.; Glotz, Denis; Duboust, Alain; Langanay, Thierry; Carpentier, Alain

    1990-01-01

    Because renal transplantation is allowing an increased number of patients to survive for prolonged periods, abdominal aortic aneurysms can be expected to occur with growing frequency in these patients. Surgical management of such cases involves the provision of allograft protection. To date, the literature contains 15 reports of abdominal aortic aneurysms in renal allograft recipients. We describe a 16th case and discuss the management of these patients. (Texas Heart Institute Journal 1990;17:240-4) Images PMID:15227179

  3. Abdominal apoplexy resulting in small bowel obstruction

    PubMed Central

    Le, Don; Guileyardo, Joseph; Casanova, Mark

    2016-01-01

    Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death. PMID:27695177

  4. Computed tomography of the postoperative abdominal aorta

    SciTech Connect

    Hilton, S.; Megibow, A.J.; Naidich, D.P.; Bosniak, M.A.

    1982-11-01

    Computed tomography (CT) of the abdomen was performed on 46 patients who had undergone graft replacement of abdominal aortic aneurysms. Twelve post-operative complications were found in nine patients. They included hemorrhage, infection, anastomotic pseudoaneurysms, major vessel occlusion, postoperative pancreatitis, and others. The varied apperance of the normal postoperative graft is also presented. It is concluded that CT is a rapid, sensitive, and noninvasive method for detecting or excluding postoperative complications of abdominal aortic surgery.

  5. A focus on intra-abdominal infections

    PubMed Central

    2010-01-01

    Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as

  6. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  7. Abdominal apoplexy resulting in small bowel obstruction

    PubMed Central

    Le, Don; Guileyardo, Joseph; Casanova, Mark

    2016-01-01

    Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death.

  8. [Late primary abdominal pregnancy. Case report].

    PubMed

    Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández

    2008-09-01

    Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.

  9. Factors associated with abdominal obesity in children

    PubMed Central

    Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

  10. Earthquake-related Crush Injury versus Non-Earthquake Injury in Abdominal Trauma Patients on Emergency Multidetector Computed Tomography: A Comparative Study

    PubMed Central

    Chen, Tian-wu; Dong, Zhi-hui; Chu, Zhi-gang; Tang, Si-shi; Deng, Wen

    2011-01-01

    The aim of this study was to investigate features of abdominal earthquake-related crush traumas in comparison with non-earthquake injury. A cross sectional survey was conducted with 51 survivors with abdominal crush injury in the 2008 Sichuan earthquake, and 41 with abdominal non-earthquake injury, undergoing non-enhanced computed tomography (CT) scans, serving as earthquake trauma and control group, respectively. Data were analyzed between groups focusing on CT appearance. We found that injury of abdominal-wall soft tissue and fractures of lumbar vertebrae were more common in earthquake trauma group than in control group (28 vs 13 victims, and 24 vs 9, respectively; all P < 0.05); and fractures were predominantly in transverse process of 1-2 vertebrae among L1-3 vertebrae. Retroperitoneal injury in the kidney occurred more frequently in earthquake trauma group than in control group (29 vs 14 victims, P < 0.05). Abdominal injury in combination with thoracic and pelvic injury occurred more frequently in earthquake trauma group than in control group (43 vs 29 victims, P < 0.05). In conclusion, abdominal earthquake-related crush injury might be characteristic of high incidence in injury of abdominal-wall soft tissue, fractures of lumbar vertebrae in transverse process of 1-2 vertebrae among L1-3 vertebrae, retroperitoneal injury in the kidney, and in combination with injury in the thorax and pelvis. PMID:21394315

  11. Genes and Abdominal Aortic Aneurysm

    PubMed Central

    Hinterseher, Irene; Tromp, Gerard; Kuivaniemi, Helena

    2010-01-01

    Abdominal aortic aneurysm (AAA) is a multifactorial disease with a strong genetic component. Since first candidate gene studies were published 20 years ago, nearly 100 genetic association studies using single nucleotide polymorphisms (SNPs) in biologically relevant genes have been reported on AAA. The studies investigated SNPs in genes of the extracellular matrix, the cardiovascular system, the immune system, and signaling pathways. Very few studies were large enough to draw firm conclusions and very few results could be replicated in another sample set. The more recent unbiased approaches are family-based DNA linkage studies and genome-wide genetic association studies, which have the potential of identifying the genetic basis for AAA, if appropriately powered and well-characterized large AAA cohorts are used. SNPs associated with AAA have already been identified in these large multicenter studies. One significant association was of a variant in a gene called CNTN3 which is located on chromosome 3p12.3. Two follow-up studies, however, could not replicate the association. Two other SNPs, which are located on chromosome 9p21 and 9q33 were replicated in other samples. The two genes with the strongest supporting evidence of contribution to the genetic risk for AAA are the CDKN2BAS gene, also known as ANRIL, which encodes an antisense RNA that regulates expression of the cyclin-dependent kinase inhibitors CDKN2A and CDKN2B, and DAB2IP, which encodes an inhibitor of cell growth and survival. Functional studies are now needed to establish the mechanisms by which these genes contribute to AAA pathogenesis. PMID:21146954

  12. Predictive Factors in the Outcome of Surgical Repair of Abdominal Rectus Diastasis

    PubMed Central

    Clay, Leonard; Stark, Birgit; Gunnarsson, Ulf

    2016-01-01

    Background: The aim of this study was to define the indicators predicting improved abdominal wall function after surgical repair of abdominal rectus diastasis (ARD). Preoperative subjective assessment quantified by the validated Ventral Hernia Pain Questionnaire (VHPQ) was related to relative postoperative functional improvement in abdominal muscle strength. Methods: Fifty-seven patients undergoing surgery for ARD completed the VHPQ before surgery. Preoperative pain assessment results were compared with the relative improvement in muscle strength measured with the BioDex system 4. Results: There was a correlation between the relative improvement in muscle strength measured by the BioDex System 4 for flexion at 30 degrees (P = 0.046) and 60 degrees per second (P = 0.004) and the preoperative question, “Do you find it painful to sit for more than 30 minutes?” There was also a correlation between BioDex improvement for flexion at 30 degrees (P = 0.022) and for isometric work load (P = 0.038) and the preoperative question, “Has abdominal pain limited your ability to perform sports activities?” The VHPQ responses also formed a pattern with a fairly good correlation between other BioDex modalities (with the exception of extension at 60 degrees per second) and the response to the question regarding complaints when performing sports. Postoperative visual analog scale ratings of abdominal wall stability correlated to the questions regarding complaints when sitting (P = 0.040) and standing (P = 0.047). No other correlation was seen. Conclusion: VHPQ ratings concerning pain while being seated for more than 30 minutes and pain limiting the ability to perform sports are promising indicators in the identification of patients likely to benefit from surgical correction of their ARD. PMID:27579227

  13. Chest wall kinematics and respiratory muscle action in ankylosing spondylitis patients.

    PubMed

    Romagnoli, I; Gigliotti, F; Galarducci, A; Lanini, B; Bianchi, R; Cammelli, D; Scano, G

    2004-09-01

    No direct measurements of the pressures produced by the ribcage muscles, the diaphragm and the abdominal muscles during hyperventilation have been reported in patients with ankylosing spondylitis. Based on recent evidence indicating that abdominal muscles are important contributors to stimulation of ventilation, it was hypothesised that, in ankylosing spondylitis patients with limited ribcage expansion, a respiratory centre strategy to help the diaphragm function may involve coordinated action of this muscle with abdominal muscles. In order to validate this hypothesis, the chest wall response to a hypercapnic/hyperoxic rebreathing test was assessed in six ankylosing spondylitis patients and seven controls by combined analysis of: 1) chest wall kinematics, using optoelectronic plethysmography, this system is accurate in partitioning chest wall expansion into the contributions of the ribcage and the abdomen; and 2) respiratory muscle pressures, oesophageal, gastric and transdiaphragmatic (Pdi); the pressure/volume relaxation characteristics of both the ribcage and the abdomen allowed assessment of the peak pressure of both inspiratory and expiratory ribcage muscles, and of the abdominal muscles. During rebreathing, chest wall expansion increased to a similar extent in patients to that in controls; however, the abdominal component increased more and the ribcage component less in patients. Peak inspiratory ribcage, but not abdominal, muscle pressure was significantly lower in patients than in controls. End-inspiratory Pdi increased similarly in both groups, whereas inspiratory swings in Pdi increased significantly only in patients. No pressure or volume signals correlated with disease severity. The diaphragm and abdominal muscles help to expand the chest wall in ankylosing spondylitis patients, regardless of the severity of their disease. This finding supports the starting hypothesis that a coordinated response of respiratory muscle activity optimises the efficiency of

  14. Wall surveyor project report

    SciTech Connect

    Mullenhoff, D.J.; Johnston, B.C.; Azevedo, S.G.

    1996-02-22

    A report is made on the demonstration of a first-generation Wall Surveyor that is capable of surveying the interior and thickness of a stone, brick, or cement wall. LLNL`s Micropower Impulse Radar is used, based on emitting and detecting very low amplitude and short microwave impulses (MIR rangefinder). Six test walls were used. While the demonstrator MIR Wall Surveyor is not fieldable yet, it has successfully scanned the test walls and produced real-time images identifying the walls. It is planned to optimize and package the evaluation wall surveyor into a hand held unit.

  15. A Case of Secondary Abdominal Pregnancy after in Vitro Fertilization Pre-Embryo Transfer (IVF-ET)

    PubMed Central

    Angelova, Mariya Angelova; Kovachev, Emil Georgiev; Kozovski, Ivan; Kornovski, Yavor Dimitrov; Kisyov, Stefan Vasilev; Ivanova, Vilislava Robert

    2015-01-01

    The authors describe a rare case of secondary abdominal pregnancy after in vitro fertilization pre-embryo transfer (IVF-ET). Ultrasonography was applied to image ectopic gestational sac containing a yolk vesicle and located adjacent to the anterior uterine wall and left adnexa. Laparoscopy was done on the same day followed by sinistral salpingectomy due to tubal abortion indications. Intraabdominal examination showed chorionic structures penetrating pl. vesicouterina. Histological tests confirmed the EP diagnosis in the second material, i.e. indications of secondary abdominal pregnancy. PMID:27275263

  16. Chronic contained rupture of an abdominal aortic aneurysm presenting as a Grynfeltt lumbar hernia. A case report.

    PubMed

    Dobbeleir, J; Fourneau, I; Maleux, G; Daenens, K; Vandekerkhof, J; Nevelsteen, A

    2007-06-01

    We report a unique case of chronic contained thoraco-abdominal aneurysm rupture presenting as a Grynfeltt lumbar hernia. A 79-year-old man presented with backpain and a bluish swelling in the left lumbar region in the presence of a non tender aortic aneurysm. CT scan confirmed contained rupture of a type IV thoraco-abdominal aortic aneurysm. The peri-aortic haematoma protruded through the lumbar wall causing a Grynfeltt lumbar hernia. The aneurysm was replaced through a thoraco-phreno-lumbotomy. The patient survived and is doing well six months postoperatively.

  17. Possible Dual Role of Decorin in Abdominal Aortic Aneurysm

    PubMed Central

    Ueda, Koshiro; Yoshimura, Koichi; Yamashita, Osamu; Harada, Takasuke; Morikage, Noriyasu; Hamano, Kimikazu

    2015-01-01

    Abdominal aortic aneurysm (AAA) is characterized by chronic inflammation, which leads to pathological remodeling of the extracellular matrix. Decorin, a small leucine-rich repeat proteoglycan, has been suggested to regulate inflammation and stabilize the extracellular matrix. Therefore, the present study investigated the role of decorin in the pathogenesis of AAA. Decorin was localized in the aortic adventitia under normal conditions in both mice and humans. AAA was induced in mice using CaCl2 treatment. Initially, decorin protein levels decreased, but as AAA progressed decorin levels increased in all layers. Local administration of exogenous decorin prevented the development of CaCl2-induced AAA. However, decorin was highly expressed in the degenerative lesions of human AAA walls, and this expression positively correlated with matrix metalloproteinase (MMP)-9 expression. In cell culture experiments, the addition of decorin inhibited secretion of MMP-9 in vascular smooth muscle cells, but had the opposite effect in macrophages. The results suggest that decorin plays a dual role in AAA. Adventitial decorin in normal aorta may protect against the development of AAA, but macrophages expressing decorin in AAA walls may facilitate the progression of AAA by up-regulating MMP-9 secretion. PMID:25781946

  18. The effect of flow recirculation on abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    Taib, Ishkrizat; Amirnordin, Shahrin Hisham; Madon, Rais Hanizam; Mustafa, Norrizal; Osman, Kahar

    2012-06-01

    The presences of flow recirculation at the abdominal aortic aneurysm (AAA) region yield the unpredictable failure of aneurismal wall. The failure of the aneurismal wall is closely related to the hemodynamic factor. Hemodynamic factor such as pressure and velocity distribution play a significance role of aneurysm growth and rupture. By using the computational approach, the influence of hemodynamic factor is investigated using computational fluid dynamic (CFD) method on the virtual AAA model. The virtual 3D AAAs model was reconstructed from Spiral Computed Tomography scan (CT-scan). The blood flow is assumed as being transient, laminar and Newtonian within a rigid section of the vessel. The blood flow also driven by an imposed of pressure gradient in the form of physiological waveform. The pulsating blood flow is also considered in this simulation. The results on pressure distribution and velocity profile are analyzed to interpret the behaviour of flow recirculation. The results show the forming of vortices is seen at the aneurysm bulge. This vortices is form at the aneurysm region then destroyed rapidly by flow recirculation. Flow recirculation is point out much higher at distal end of aneurysm closed to iliac bifurcation. This phenomenon is managed to increase the possibility of aneurysm growth and rupture.

  19. 3D image analysis of abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    Subasic, Marko; Loncaric, Sven; Sorantin, Erich

    2001-07-01

    In this paper we propose a technique for 3-D segmentation of abdominal aortic aneurysm (AAA) from computed tomography angiography (CTA) images. Output data (3-D model) form the proposed method can be used for measurement of aortic shape and dimensions. Knowledge of aortic shape and size is very important in planning of minimally invasive procedure that is for selection of appropriate stent graft device for treatment of AAA. The technique is based on a 3-D deformable model and utilizes the level-set algorithm for implementation of the method. The method performs 3-D segmentation of CTA images and extracts a 3-D model of aortic wall. Once the 3-D model of aortic wall is available it is easy to perform all required measurements for appropriate stent graft selection. The method proposed in this paper uses the level-set algorithm for deformable models, instead of the classical snake algorithm. The main advantage of the level set algorithm is that it enables easy segmentation of complex structures, surpassing most of the drawbacks of the classical approach. We have extended the deformable model to incorporate the a priori knowledge about the shape of the AAA. This helps direct the evolution of the deformable model to correctly segment the aorta. The algorithm has been implemented in IDL and C languages. Experiments have been performed using real patient CTA images and have shown good results.

  20. If walls could talk

    NASA Technical Reports Server (NTRS)

    Braam, J.; McIntire, L. V. (Principal Investigator)

    1999-01-01

    The plant cell wall is very complex, both in structure and function. The wall components and the mechanical properties of the wall have been implicated in conveying information that is important for morphogenesis. Proteoglycans, fragments of polysaccharides and the structural integrity of the wall may relay signals that influence cellular differentiation and growth control. Furthering our knowledge of cell wall structure and function is likely to have a profound impact on our understanding of how plant cells communicate with the extracellular environment.

  1. Abdominal sarcoidosis: cross-sectional imaging findings

    PubMed Central

    Gezer, Naciye Sinem; Başara, Işıl; Altay, Canan; Harman, Mustafa; Rocher, Laurence; Karabulut, Nevzat; Seçil, Mustafa

    2015-01-01

    Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%–70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis. PMID:25512071

  2. Functional bowel disorders and functional abdominal pain

    PubMed Central

    Thompson, W; Longstreth, G; Drossman, D; Heaton, K; Irvine, E; Muller-Lissner, S

    1999-01-01

    The Rome diagnostic criteria for the functional bowel disorders and functional abdominal pain are used widely in research and practice. A committee consensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatment recommendations, based on research results. The terminology was clarified and the diagnostic criteria and management recommendations were revised. A functional bowel disorder (FBD) is diagnosed by characteristic symptoms for at least 12 weeks during the preceding 12 months in the absence of a structural or biochemical explanation. The irritable bowel syndrome, functional abdominal bloating, functional constipation, and functional diarrhea are distinguished by symptom-based diagnostic criteria. Unspecified FBD lacks criteria for the other FBDs. Diagnostic testing is individualized, depending on patient age, primary symptom characteristics, and other clinical and laboratory features. Functional abdominal pain (FAP) is defined as either the FAP syndrome, which requires at least six months of pain with poor relation to gut function and loss of daily activities, or unspecified FAP, which lacks criteria for the FAP syndrome. An organic cause for the pain must be excluded, but aspects of the patient's pain behavior are of primary importance. Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be beneficial, depending on the symptoms and psychological features.


Keywords: functional bowel disorder; functional constipation; functional diarrhea; irritable bowel syndrome; functional abdominal pain; functional abdominal bloating; Rome II PMID:10457044

  3. Methods of Patient Warming during Abdominal Surgery

    PubMed Central

    Shao, Li; Zheng, Hong; Jia, Feng-Ju; Wang, Hui-Qin; Liu, Li; Sun, Qi; An, Meng-Ying; Zhang, Xiu-Hua; Wen, Hao

    2012-01-01

    Background Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. Methods Patients (n = 160) scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients’ nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. Results When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. Discussion The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed. PMID:22808045

  4. Hydatidemesis: a bizarre presentation of abdominal hydatidosis.

    PubMed

    Thomas, S; Mishra, M C; Kriplani, A K; Kapur, B M

    1993-06-01

    A 31 year old male presented with high grade fever and abdominal pain of 20 days duration. At the age of 9 he had been operated on for a solitary retroperitoneal hydatid cyst and had been asymptomatic until the age of 21 when he sustained a blunt injury to the abdomen. An exploratory laparotomy for splenic rupture revealed multiple intra-abdominal hydatid cysts, which were removed. The patient remained well until the present episode. An ultrasound examination revealed multiple intra-abdominal hydatid cysts. Seven days after admission, the patient developed hydatidemesis (hydatid cysts and membranes in the vomitus) and hydatidenteria (passage of hydatid membranes in the stools), and his pain and fever subsided. A Gastrografin study and a computerized tomography (CT) scan revealed hydatid cysts communicating with the stomach and duodenum. In view of his disseminated recurrent abdominal hydatidosis, he was treated with high dose, long-term albendazole along with regular follow up. This is the first documented case of disseminated abdominal hydatidosis presenting with a cystogastric fistula and hydatidemesis.

  5. The Pilates Method increases respiratory muscle strength and performance as well as abdominal muscle thickness.

    PubMed

    Giacomini, Mateus Beltrame; da Silva, Antônio Marcos Vargas; Weber, Laura Menezes; Monteiro, Mariane Borba

    2016-04-01

    The aim of this study was to verify the effects of the Pilates Method (PM) training program on the thickness of the abdominal wall muscles, respiratory muscle strength and performance, and lung function. This uncontrolled clinical trial involved 16 sedentary women who were assessed before and after eight weeks of PM training. The thickness of the transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) muscles was assessed. The respiratory muscle strength was assessed by measuring the maximum inspiratory (MIP) and expiratory (MEP) pressure. The lung function and respiratory muscle performance were assessed by spirometry. An increase was found in MIP (p = 0.001), MEP (p = 0.031), maximum voluntary ventilation (p = 0.020) and the TrA (p < 0.001), IO (p = 0.002) and EO (p < 0.001) thickness after the PM program. No alterations in lung function were found. These findings suggest that the PM program promotes abdominal wall muscle hypertrophy and an increase in respiratory muscle strength and performance, preventing weakness in abdominal muscles and dysfunction in ventilatory mechanics, which could favor the appearance of illnesses. PMID:27210841

  6. Laparoscopic Management of Abdominal Pregnancy with Local Injection of Vasopressin Solution: A Case Report.

    PubMed

    Hishikawa, Kenji; Fukuda, Takanori; Inoue, Hiromi; Kohata, Yutaka; Monma, Mika; Ochiai, Naomi; Kubo, Yuina; Watanabe, Remi; Ako, Shiho; Aihara, Yuri; Kusaka, Takeshi

    2016-01-01

    BACKGROUND Laparoscopic treatments of abdominal pregnancy have been reported; however, resection of an implanted gestational sac could lead to massive bleeding and treatment failure. Hemostasis of the resected stump is critical for the success of laparoscopic treatment. CASE REPORT A 32-year-old woman presented to the emergency department with severe abdominal pain. We suspected a ruptured ectopic pregnancy and performed urgent diagnostic laparoscopy. The gestational sac was implanted in the posterior wall of the uterus near the left uterosacral ligament, and bleeding from the gestational sac was noticed. We injected 3 ml of diluted vasopressin solution (0.4 U/ml) directly into the gestational sac and into the posterior uterine wall around the gestational sac. Thereafter, we could resect the gestational product using an ultrasonically activated scalpel. Additional hemostasis in the resected stump was not required. CONCLUSIONS We believe that a local injection of a diluted vasopressin solution helps in maintaining the hemostasis after the laparoscopic resection of the implanted gestational sac in cases of abdominal pregnancy. PMID:27587187

  7. Propeller flap reconstruction of abdominal defects: review of the literature and case report.

    PubMed

    Scaglioni, Mario F; Giuseppe, Alberto Di; Chang, Edward I

    2015-01-01

    The abdominal wall is perfused anteriorly by the superior and deep epigastric vessels with a smaller contribution from the superficial system. The lateral abdominal wall is perfused predominantly from perforators arising from the intercostal vessels. Reconstruction of soft tissue defects involving the abdomen presents a difficult challenge for reconstructive surgeons. Pedicle perforator propeller flaps can be used to reconstruct defects of the abdomen, and here we present a thorough review of the literature as well as a case illustrating the perforasome propeller flap concept. A patient underwent resection for dermatofibrosarcoma protuberans resulting in a large defect of the epigastric soft tissue. A propeller flap was designed based on a perforator arising from the superior deep epigastric vessels and was rotated 90° into the defect allowing primary closure of the donor site. The patient healed uneventfully and was without recurrent disease 37 months following reconstruction. Perforator propeller flaps can be used successfully in reconstruction of abdominal defects and should be incorporated into the armamentarium of reconstructive microsurgeons already facile with perforator dissections.

  8. The Pilates Method increases respiratory muscle strength and performance as well as abdominal muscle thickness.

    PubMed

    Giacomini, Mateus Beltrame; da Silva, Antônio Marcos Vargas; Weber, Laura Menezes; Monteiro, Mariane Borba

    2016-04-01

    The aim of this study was to verify the effects of the Pilates Method (PM) training program on the thickness of the abdominal wall muscles, respiratory muscle strength and performance, and lung function. This uncontrolled clinical trial involved 16 sedentary women who were assessed before and after eight weeks of PM training. The thickness of the transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) muscles was assessed. The respiratory muscle strength was assessed by measuring the maximum inspiratory (MIP) and expiratory (MEP) pressure. The lung function and respiratory muscle performance were assessed by spirometry. An increase was found in MIP (p = 0.001), MEP (p = 0.031), maximum voluntary ventilation (p = 0.020) and the TrA (p < 0.001), IO (p = 0.002) and EO (p < 0.001) thickness after the PM program. No alterations in lung function were found. These findings suggest that the PM program promotes abdominal wall muscle hypertrophy and an increase in respiratory muscle strength and performance, preventing weakness in abdominal muscles and dysfunction in ventilatory mechanics, which could favor the appearance of illnesses.

  9. Psychosocial factors and childhood recurrent abdominal pain.

    PubMed

    Boey, Christopher Chiong-Meng; Goh, Khean-Lee

    2002-12-01

    Recurrent abdominal pain in children is not a single condition but a description of a wide spectrum of clinical manifestations, some of which fit into a definite pattern, such as the irritable bowel syndrome, while others do not. Organic disorders may be present, but in the majority of children they cannot be detected. Although children with recurrent abdominal pain do not generally have psychological or psychiatric illness, there is a growing body of evidence to suggest that psychosocial stress plays an important role in this condition. This review will look into some of this evidence. The precise pathophysiology that results in abdominal pain is still not clearly understood, but the current belief is that visceral hypersensitivity or hyperalgesia and changes in the brain-gut axis linking the central and enteric nervous systems are important mechanisms. PMID:12423267

  10. Thoracic and abdominal blastomycosis in a horse.

    PubMed

    Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

    1999-05-01

    A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

  11. [Differential diagnosis of abdominal cysts in children].

    PubMed

    Józsa, Gergő; Mohay, Gabriella; Pintér, András; Vástyán, Attila

    2015-09-13

    19 children were diagnosed with abdominal cysts of different origin in the Surgical Unit of the Department of Pediatrics, Medical University of Pécs, Hungary between 2010 and 2013. The authors discuss the details of representative cases of a parovarial cyst, an intestinal duplication, and an omental cyst with emphasis on the clinical symptoms, diagnostic tools, and surgical interventions. The authors conclude that abdominal cysts often cause mild symptoms only, and they are discovered accidentally by ultrasound imaging performed for other reasons. In some cases, the cyst can cause severe complaints or even acute abdomen requiring emergency surgery. Laporoscopy may be a valuable method both in diagnosis and surgical therapy. Abdominal CT or MRI are not required in the majority of the patients.

  12. Abdominal Sarcoidosis May Mimic Peritoneal Carcinomatosis

    PubMed Central

    Gorkem, Umit; Gungor, Tayfun; Bas, Yılmaz; Togrul, Cihan

    2015-01-01

    Sarcoidosis is a multisystem inflammatory disorder of unknown etiology. It shows a great variety of clinical presentation, organ involvement, and disease progression. Lungs and lymphoid system are the most common sites involved with a frequency of 90% and 30%, respectively. Extrapulmonary involvement of sarcoidosis is reported in 30% of patients and abdomen is the most frequent site. Furthermore, peritoneal involvement is extremely rare in sarcoidosis. The case presented here described peritoneal manifestations of sarcoidosis without involvement of lungs. A 78-year-old woman possessing signs of malignancy on blood test and abdominal magnetic resonance imaging underwent laparatomy with a suspicion of ovarian malignancy. The macroscopic interpretation during surgery was peritoneal carcinomatosis. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal biopsies, total omentectomy, and appendectomy were performed. Final histopathological result revealed the diagnosis of sarcoidosis. Clinicians must keep in mind that peritoneal sarcoidosis can mimic intra-abdominal malignancies. PMID:26558122

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

    PubMed

    Kelly, Sinead; O'Rourke, Malachy

    2012-04-01

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

  14. Decompressive laparotomy for abdominal compartment syndrome

    PubMed Central

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.

    2016-01-01

    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  15. An abdominal extraskeletal osteosarcoma: A case report

    PubMed Central

    WU, ZHIMING; CHU, XIUFENG; MENG, XINGCHENG; XU, CHAOYANG

    2013-01-01

    Primary abdominal extraskeletal osteosarcoma (EOS) is a rare carcinoma. The present study reports a case of a primary abdominal EOS involving the greater omentum and also presents a review of the literature on the etiology, diagnosis, differential diagnosis, pathological features, treatment and prognosis of the disease. The patient in the present study underwent laparoscopic surgery. A pathological examination revealed that the tumor tissues contained malignant and primitive spindle cells with varying amounts of neoplastic osteoid and osseous or cartilaginous tissue. The post-operative follow-up appointments were scheduled at three-month intervals for two years. The tumor recurred three months after the surgery. PMID:24137451

  16. An unusual cause of abdominal pain.

    PubMed

    Terneu, S; Verhelst, D; Thys, F; Ketelslegers, E; Hantson, P; Wittebole, X

    2003-01-01

    A 36-year-old woman presented to the Emergency Room because of abdominal pain associated with hematuria and red blood blending to stool. On admission, the physical examination revealed abdominal tenderness and diffuse cutaneous hematoma. The laboratory findings showed abnormal clotting tests with high International Normalised Ratio (INR) and prolonged activated partial thromboplastin time. Hemoperitoneum and ureteral hematoma were noted on the abdomen computed tomography. The patient confessed she had ingested difenacoum for several weeks. All the symptoms resolved with fresh frozen plasma perfusion and vitamin K. PMID:14635532

  17. [Penetrating abdominal wounds. Apropos of 330 cases].

    PubMed

    Nejjar, M; Bennani, S; Zerouali, O N

    1991-01-01

    Penetrating abdominal wounds are frequent and serious. 330 cases have been treated in the Department of Emergencies and visceral Surgery at Averroes Hospital of Casablanca from 1980 to 1990. The predominance of male sex is noted, and these wounds are always the result of aggression by white arm. All patients have been operated, the white laparotomy rate is of 36%. The classic interventionist attitude is still recommended in spite of this high rate, because our present conditions can't permit us a rigorous watching. According to abdominal lesions, the different interventions are reviewed, and their indications are detailed. PMID:1960187

  18. [Abdominal migraine as a cause of chronic recurrent abdominal pain in a 9-years-old girl--case report].

    PubMed

    Kwiecień, Jarosław; Piasecki, Leszek; Kasner, Jacek; Karczewska, Krystyna

    2005-08-01

    Abdominal migraine is a rarely recognized functional intestinal disorder, manifesting as recurrent paroxysmal abdominal pain of neurogenic origin. The authors describe the 9-years old girl referred to the hospital because of chronic paroxysmal abdominal pain. She did not improve after medication used commonly in functional abdominal disorders (drotaverine, mebeverine, trimebutine). On the ground of various investigations organic causes of abdominal pain were excluded. Carefully completed anamnesis, as well as precise description of the clinical picture of abdominal pain attacks, has lead to the diagnosis of abdominal migraine. According to advice of neurologist the treatment with amitriptyline was introduced. Thereafter a significant improvement was observed. Abdominal migraine has to be taken in to account when diagnosing chronic abdominal pain in children. PMID:16245431

  19. Fluidized wall for protecting fusion chamber walls

    SciTech Connect

    Maniscalco, J.A.; Meier, W.R.

    1982-08-17

    Apparatus for protecting the inner wall of a fusion chamber from microexplosion debris, x-rays, neutrons, etc. Produced by deuterium-tritium (DT) targets imploded within the fusion chamber. The apparatus utilizes a fluidized wall similar to a waterfall comprising liquid lithium or solid pellets of lithiumceramic, the waterfall forming a blanket to prevent damage of the structural materials of the chamber.

  20. The use of laparoscopy in the diagnosis and treatment of abdominal complications of ventriculo-peritoneal shunts in children.

    PubMed

    Esposito, C; Porreca, A; Gangemi, M; Garipoli, V; De Pasquale, M

    1998-07-01

    Ventriculo-peritoneal shunts (VPS) are the most frequent operative procedures used to treat hydrocephalic children. Abdominal complications of VPS are now a rare event; however, their frequency varies from 5% to 47% according to reports. Anything that causes an obstruction or impediment of the VP derivation system will lead to intracranial hypertension, which requires immediate surgery. From 1985 to 1995 at the Division of Pediatric Surgery of the Federico II University of Naples, ten laparoscopies were performed in ten children with VPS complications. Cerebrospinal fluid pseudocysts were found in four infants. There was one case of abdominal wall perforation by the tip of the catheter at the umbilical level, two bowel obstructions, and one catheter was lost in the abdominal cavity. Finally, two children had malfunctioning of the peritoneal limb of the catheter. The laparoscopic technique was curative in all ten cases, thus avoiding a conventional laparotomy and the consequent risk of adhesions, which could cause further complications.

  1. Cystic Fibrosis below the Diaphragm: Abdominal Findings in Adult Patients.

    PubMed

    Lavelle, Lisa P; McEvoy, Sinead H; Ni Mhurchu, Elaine; Gibney, Robert G; McMahon, Colm J; Heffernan, Eric J; Malone, Dermot E

    2015-01-01

    Cystic fibrosis (CF) is the most common lethal autosomal recessive disease in the white population. Mutation of the CF transmembrane conductance regulator gene on chromosome 7 results in production of abnormally viscous mucus and secretions in the lungs of patients with CF. A similar pathologic process occurs in the gastrointestinal tract, pancreas, and hepatobiliary system. Inspissated mucus causes luminal obstruction and resultant clinical and radiologic complications associated with the disease process. Pancreatic involvement can result in exocrine and endocrine insufficiency, pancreatic atrophy, fatty replacement, or lipomatous pseudohypertrophy. Acute and chronic pancreatitis, pancreatic calcification, cysts, and cystosis also occur. Hepatic manifestations include hepatic steatosis, focal biliary and multilobular cirrhosis, and portal hypertension. Biliary complications include cholelithiasis, microgallbladder, and sclerosing cholangitis. The entire digestive tract can be involved. Distal ileal obstruction syndrome, intussusception, appendicitis, chronic constipation, colonic wall thickening, fibrosing colonopathy, pneumatosis intestinalis, gastroesophageal reflux, and peptic ulcer disease have been described. Renal manifestations include nephrolithiasis and secondary amyloidosis. The educational objectives of this review are to reveal the abdominal manifestations of CF to facilitate focused analysis of cross-sectional imaging in adult patients. Life expectancy in patients with CF continues to improve because of a combination of aggressive antibiotic treatment, improved emphasis on nutrition and physiotherapy, and development of promising new CF transmembrane conductance regulator modulators. As lung function and survival improve, extrapulmonary conditions, including hepatic and gastrointestinal malignancy, will be an increasing cause of morbidity and mortality. Awareness of the expected abdominal manifestations of CF may assist radiologists in identifying

  2. Immersive virtual reality for visualization of abdominal CT

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

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

  3. Hypoperfusion of the Adventitial Vasa Vasorum Develops an Abdominal Aortic Aneurysm

    PubMed Central

    Sasaki, Takeshi; Sano, Masaki; Yamamoto, Naoto; Saito, Takaaki; Inuzuka, Kazunori; Hayasaka, Takahiro; Goto-Inoue, Naoko; Sugiura, Yuki; Sato, Kohji; Kugo, Hirona; Moriyama, Tatsuya; Konno, Hiroyuki; Setou, Mitsutoshi; Unno, Naoki

    2015-01-01

    The aortic wall is perfused by the adventitial vasa vasorum (VV). Tissue hypoxia has previously been observed as a manifestation of enlarged abdominal aortic aneurysms (AAAs). We sought to determine whether hypoperfusion of the adventitial VV could develop AAAs. We created a novel animal model of adventitial VV hypoperfusion with a combination of a polyurethane catheter insertion and a suture ligation of the infrarenal abdominal aorta in rats. VV hypoperfusion caused tissue hypoxia and developed infrarenal AAA, which had similar morphological and pathological characteristics to human AAA. In human AAA tissue, the adventitial VV were stenotic in both small AAAs (30–49 mm in diameter) and in large AAAs (> 50 mm in diameter), with the sac tissue in these AAAs being ischemic and hypoxic. These results indicate that hypoperfusion of adventitial VV has critical effects on the development of infrarenal AAA. PMID:26308526

  4. Mycotic Saccular Abdominal Aortic Aneurysm in an Infant after Cardiac Catheterization: A Case Report.

    PubMed

    Benrashid, Ehsan; McCoy, Christopher C; Rice, Henry E; Shortell, Cynthia K; Cox, Mitchell W

    2015-10-01

    Abdominal aortic aneurysms (AAAs) are a rare entity in the pediatric population. Children with mycotic (infectious) AAA in particular are at risk of life-threatening rupture due to their rapid expansion coupled with aortic wall thinning and deterioration. Here, we present the case of a 10-month-old infant with prior 2-staged repair for hypoplastic left heart syndrome that was incidentally discovered to have a mycotic AAA on abdominal ultrasound (US) for evaluation of renovascular hypertension. Before the time of evaluation with US, the infant had developed methicillin-resistant Staphylococcus aureus bacteremia 3 days after cardiac catheterization with percutaneous thoracic aortic balloon angioplasty. She had normal aortic contours on contrasted computed tomography scan of the abdomen approximately 2 weeks before the aforementioned US evaluation. This infant subsequently underwent open aneurysmorrhaphy with cryopreserved vein patch angioplasty with resolution of her aneurysmal segment.

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

    PubMed

    Ashok, R; Anuradha, K; Babu, S S; Bheerappa, N; Sastry, R A; Lakshmi, V

    2004-01-01

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

  6. [Albert Einstein and his abdominal aortic aneurysm].

    PubMed

    Cervantes Castro, Jorge

    2011-01-01

    The interesting case of Albert Einstein's abdominal aortic aneurysm is presented. He was operated on at age 69 and, finding that the large aneurysm could not be removed, the surgeon elected to wrap it with cellophane to prevent its growth. However, seven years later the aneurysm ruptured and caused the death of the famous scientist.

  7. Childhood functional abdominal pain: mechanisms and management.

    PubMed

    Korterink, Judith; Devanarayana, Niranga Manjuri; Rajindrajith, Shaman; Vlieger, Arine; Benninga, Marc A

    2015-03-01

    Chronic abdominal pain is one of the most common clinical syndromes encountered in day to day clinical paediatric practice. Although common, its definition is confusing, predisposing factors are poorly understood and the pathophysiological mechanisms are not clear. The prevailing viewpoint in the pathogenesis involves the inter-relationship between changes in hypersensitivity and altered motility, to which several risk factors have been linked. Making a diagnosis of functional abdominal pain can be a challenge, as it is unclear which further diagnostic tests are necessary to exclude an organic cause. Moreover, large, well-performed, high-quality clinical trials for effective agents are lacking, which undermines evidence-based treatment. This Review summarizes current knowledge regarding the epidemiology, pathophysiology, risk factors and diagnostic work-up of functional abdominal pain. Finally, management options for children with functional abdominal pain are discussed including medications, dietary interventions, probiotics and psychological and complementary therapies, to improve understanding and to maximize the quality of care for children with this condition. PMID:25666642

  8. Physical activity and abdominal obesity in youth.

    PubMed

    Kim, YoonMyung; Lee, SoJung

    2009-08-01

    Childhood obesity continues to escalate despite considerable efforts to reverse the current trends. Childhood obesity is a leading public health concern because overweight-obese youth suffer from comorbidities such as type 2 diabetes mellitus, nonalcoholic fatty liver disease, metabolic syndrome, and cardiovascular disease, conditions once considered limited to adults. This increasing prevalence of chronic health conditions in youth closely parallels the dramatic increase in obesity, in particular abdominal adiposity, in youth. Although mounting evidence in adults demonstrates the benefits of regular physical activity as a treatment strategy for abdominal obesity, the independent role of regular physical activity alone (e.g., without calorie restriction) on abdominal obesity, and in particular visceral fat, is largely unclear in youth. There is some evidence to suggest that, independent of sedentary activity levels (e.g., television watching or playing video games), engaging in higher-intensity physical activity is associated with a lower waist circumference and less visceral fat. Several randomized controlled studies have shown that aerobic types of exercise are protective against age-related increases in visceral adiposity in growing children and adolescents. However, evidence regarding the effect of resistance training alone as a strategy for the treatment of abdominal obesity is lacking and warrants further investigation.

  9. Laparoscopic management of an abdominal pregnancy.

    PubMed

    Srinivasan, Aarthi; Millican, Suzanne

    2014-01-01

    Background. Ectopic pregnancy is one of the leading causes of significant maternal morbidity and mortality. Abdominal surgeries increase the risk of postoperative adhesions. We here present a case of omental ectopic pregnancy in a patient with a prior history of cesarean section. Case. A 20-year-old female presented with a two-day history of crampy lower abdominal pain. Patient was hemodynamically stable with a beta HCG of 1057 mI/mL. Transvaginal ultrasound did not show an intrauterine pregnancy but revealed an ill-defined mass in the midline pelvis extending to the right of the midline. Diagnostic laparoscopy revealed large clots in the pelvis with normal uterus and adnexa. Intra-abdominal survey revealed an omental adhesion close to the right adnexa with a hematoma. Partial omentectomy was completed and the portion of the omentum with the hematoma was sent to pathology for confirmation. Final pathology confirmed the presence of chorionic villi consistent with products of conception. Conclusion. Omental ectopic pregnancy is a rare diagnosis and often missed. We recommend careful intra-abdominal survey for an ectopic pregnancy in the presence of hemoperitoneum with normal uterus and adnexa. This can be safely achieved using laparoscopy in early gestational ages when the patient is hemodynamically stable. PMID:25478262

  10. [Two cases of abdominal bronchogenic cyst].

    PubMed

    Takeshita, K; Watabe, N; Sato, A; Watanabe, I; Yamaguchi, M; Tezuka, H; Abe, H; Sakamoto, K

    1990-09-01

    Two cases of abdominal bronchogenic cyst were reported. In the first case, the cyst was communicated with gastric fundus and existed as gastric abscess. In the second case, the cyst showed high CT number and chemical analysis of the contents revealed high range of Ca, Fe and Amylase levels.

  11. Effects of a multidisciplinary body weight reduction program on static and dynamic thoraco-abdominal volumes in obese adolescents.

    PubMed

    LoMauro, Antonella; Cesareo, Ambra; Agosti, Fiorenza; Tringali, Gabriella; Salvadego, Desy; Grassi, Bruno; Sartorio, Alessandro; Aliverti, Andrea

    2016-06-01

    The objective of this study was to characterize static and dynamic thoraco-abdominal volumes in obese adolescents and to test the effects of a 3-week multidisciplinary body weight reduction program (MBWRP), entailing an energy-restricted diet, psychological and nutritional counseling, aerobic physical activity, and respiratory muscle endurance training (RMET), on these parameters. Total chest wall (VCW), pulmonary rib cage (VRC,p), abdominal rib cage (VRC,a), and abdominal (VAB) volumes were measured on 11 male adolescents (Tanner stage: 3-5; BMI standard deviation score: >2; age: 15.9 ± 1.3 years; percent body fat: 38.4%) during rest, inspiratory capacity (IC) maneuver, and incremental exercise on a cycle ergometer at baseline and after 3 weeks of MBWRP. At baseline, the progressive increase in tidal volume was achieved by an increase in end-inspiratory VCW (p < 0.05) due to increases in VRC,p and VRC,a with constant VAB. End-expiratory VCW decreased with late increasing VRC,p, dynamically hyperinflating VRC,a (p < 0.05), and progressively decreasing VAB (p < 0.05). After MBWRP, weight loss was concentrated in the abdomen and total IC decreased. During exercise, abdominal rib cage hyperinflation was delayed and associated with 15% increased performance and reduced dyspnea at high workloads (p < 0.05) without ventilatory and metabolic changes. We conclude that otherwise healthy obese adolescents adopt a thoraco-abdominal operational pattern characterized by abdominal rib cage hyperinflation as a form of lung recruitment during incremental cycle exercise. Additionally, a short period of MBWRP including RMET is associated with improved exercise performance, lung and chest wall volume recruitment, unloading of respiratory muscles, and reduced dyspnea. PMID:27175804

  12. Talk to Your Doctor about Abdominal Aortic Aneurysm

    MedlinePlus

    ... español Talk to Your Doctor about Abdominal Aortic Aneurysm Browse Sections The Basics Overview What is AAA? ... doctor about getting screened (tested) for abdominal aortic aneurysm (AAA). If AAA isn't found and treated ...

  13. The Lamportian cell wall

    SciTech Connect

    Keiliszewski, M.; Lamport, D. )

    1991-05-01

    The Lamportian Warp-Weft hypothesis suggests a cellulose-extensin interpenetrating network where extensin mechanically couples the load-bearing cellulose microfibrils in a wall matrix that is best described as a microcomposite. This model is based on data gathered from the extensin-rich walls of tomato and sycamore cell suspension culture, wherein extensin precursors are insolubilized into the wall by undefined crosslinks. The authors recent work with cell walls isolated from intact tissue as well as walls from suspension cultured cells of the graminaceous monocots maize and rice, the non-graminaceous monocot asparagus, the primitive herbaceous dicot sugar beet, and the gymnosperm Douglas Fir indicate that although extensins are ubiquitous to all plant species examined, they are not the major structural protein component of most walls examined. Amino acid analyses of intact and HF-treated walls shows a major component neither an HRGP, nor directly comparable to the glycine-rich wall proteins such as those associated with seed coat walls or the 67 mole% glycine-rich proteins cloned from petunia and soybean. Clearly, structural wall protein alternatives to extensin exist and any cell wall model must take that into account. If we assume that extracellular matrices are a priori network structures, then new Hypless' structural proteins in the maize cell wall raise questions about the sort of network these proteins create: the kinds of crosslinks involved; how they are formed; and the roles played by the small amounts of HRGPs.

  14. Halogenation of microcapsule walls

    NASA Technical Reports Server (NTRS)

    Davis, T. R.; Schaab, C. K.; Scott, J. C.

    1972-01-01

    Procedure for halogenation of confining walls of both gelatin and gelatin-phenolic resin capsules is similar to that used for microencapsulation. Ten percent halogen content renders capsule wall nonburning; any higher content enhances flame-retardant properties of selected internal phase material. Halogenation decreases permeability of wall material to encapsulated materials.

  15. Combined Gastric and Duodenal Perforation Through Blunt Abdominal Trauma

    PubMed Central

    Kaur, Adarshpal; Singla, Archan Lal; Kumar, Ashwani; Yadav, Manish

    2015-01-01

    Blunt abdominal traumas are uncommonly encountered despite their high prevalence, and injuries to the organ like duodenum are relatively uncommon (occurring in only 3%-5% of abdominal injuries) because of its retroperitoneal location. Duodenal injury combined with gastric perforation from a single abdominal trauma impact is rarely heard. The aim of this case report is to present a rare case of blunt abdominal trauma with combined gastric and duodenal injuries. PMID:25738037

  16. Fluid Characteristics in Abdominal Aortic Aneurysms (AAAs) and Its Correlation to Thrombus Formation

    NASA Astrophysics Data System (ADS)

    Tang, Rubing; Bar-Yoseph, Pinhas Z.; Lasheras, Juan

    2008-11-01

    It has been observed that most large Abdominal Aortic Aneurysms (AAAs) develop an intraluminal thrombus as they progressively enlarge. Previous studies have suggested that the build up of the thrombus may be associated with the altered hemodynamic patterns that arise inside the AAA. We have performed a parametrical computational study of the flow patterns inside enlarging AAA to investigate the possible mechanism controlling the thrombus formation. Pulsatile blood flows were simulated in idealized models of fusiform aneurysms with different dilatation ratios and the effects of shear-activated platelet accumulation and platelet/wall interaction were evaluated based on the calculated flow fields. The platelet activation level (PAL) was determined by computing the integral over time of flow shear stresses exerted over the platelets as they are transported throughout the aneurysm. Our results have shown that the values of PAL in AAAs are in fact smaller than the maximum value obtained in a healthy abdominal aorta. However, we show that the transportation of blood cells towards the wall and the formation of stagnation points on the aneurysm's wall play more significant roles in thrombus formation than PAL.

  17. Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans

    PubMed Central

    Michel, Jean-Baptiste; Martin-Ventura, José-Luis; Egido, Jesus; Sakalihasan, Natzi; Treska, Vladislav; Lindholt, Jes; Allaire, Eric; Thorsteinsdottir, Unnur; Cockerill, Gillian; Swedenborg, Jesper

    2011-01-01

    Aneurysm of the abdominal aorta (AAA) is a particular, specifically localized form of atherothrombosis, providing a unique human model of this disease. The pathogenesis of AAA is characterized by a breakdown of the extracellular matrix due to an excessive proteolytic activity, leading to potential arterial wall rupture. The roles of matrix metalloproteinases and plasmin generation in progression of AAA have been demonstrated both in animal models and in clinical studies. In the present review, we highlight recent studies addressing the role of the haemoglobin-rich, intraluminal thrombus and the adventitial response in the development of human AAA. The intraluminal thrombus exerts its pathogenic effect through platelet activation, fibrin formation, binding of plasminogen and its activators, and trapping of erythrocytes and neutrophils, leading to oxidative and proteolytic injury of the arterial wall. These events occur mainly at the intraluminal thrombus–circulating blood interface, and pathological mediators are conveyed outwards, where they promote matrix degradation of the arterial wall. In response, neo-angiogenesis, phagocytosis by mononuclear cells, and a shift from innate to adaptive immunity in the adventitia are observed. Abdominal aortic aneurysm thus represents an accessible spatiotemporal model of human atherothrombotic progression towards clinical events, the study of which should allow further understanding of its pathogenesis and the translation of pathogenic biological activities into diagnostic and therapeutic applications. PMID:21037321

  18. Can release of urinary retention trigger abdominal aortic aneurysm rupture?

    PubMed

    Luhmann, Andreas; Powell-Bowns, Matilda; Elseedawy, Emad

    2013-04-04

    Only 50% of abdominal aortic aneurysms present with the classic triad of hypotension, back pain and a pulsatile abdominal mass. This variability in symptoms can delay diagnosis and treatment. We present the case of a patient presenting with a unique combination of symptoms suggesting that decompression of urinary retention can lead to abdominal aortic aneurysm rupture.

  19. 2013 WSES guidelines for management of intra-abdominal infections

    PubMed Central

    2013-01-01

    Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections. PMID:23294512

  20. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Abdominal decompression chamber. 884.5225 Section... Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike device used to reduce pressure on the pregnant patient's abdomen for the relief...

  1. Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises.

    ERIC Educational Resources Information Center

    Willett, Gilbert M.; Hyde, Jennifer E.; Uhrlaub, Michael B.; Wendel, Cara L.; Karst, Gregory M.

    2001-01-01

    Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA muscle groups, there were…

  2. Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Abdominal pain is the most common indication for OGD in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. We conducted the current study to examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and ...

  3. The role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 2: measurement techniques and management recommendations.

    PubMed

    Malbrain, Manu L N G; De Laet, Inneke; De Waele, Jan J; Sugrue, Michael; Schachtrupp, Alexander; Duchesne, Juan; Van Ramshorst, Gabrielle; De Keulenaer, Bart; Kirkpatrick, Andrew W; Ahmadi-Noorbakhsh, Siavash; Mulier, Jan; Pelosi, Paolo; Ivatury, Rao; Pracca, Francisco; David, Marcelo; Roberts, Derek J

    2014-01-01

    The recent definitions on intra-abdominal pressure (IAP), intra-abdominal volume (IAV) and abdominal compliance (Cab) are a step forward in understanding these important concepts. They help our understanding of the pathophysiology, aetiology, prognosis, and treatment of patients with low Cab. However, there is still a relatively poor understanding of the different methods used to measure IAP, IAV and Cab and how certain conditions may affect the results. This review will give a concise overview of the different methods to assess and estimate Cab; it will list important conditions that may affect baseline values and suggest some therapeutic options. Abdominal compliance (Cab), defined as a measure of the ease of abdominal expansion, is measured differently than IAP. The compliance of the abdominal wall is only a part of the total abdominal pressure-volume (PV) relationship. Measurement or estimation of Cab is difficult at the bedside and can only be done in a case of change (removal or addition) in IAV. The different measurement techniques will be discussed in relation to decreases (ascites drainage, haematoma evacuation, gastric suctioning) or increases in IAV (gastric insufflation, laparoscopy with CO₂ pneumoperitoneum, peritoneal dialysis). More specific techniques using the interactions between the thoracic and abdominal compartment during positive pressure ventilation will also be discussed (low flow PV loop, respiratory IAP variations, respiratory abdominal variation test, mean IAP and abdominal pressure variation), together with the concept of the polycompartment model. The relation between IAV and IAP is linear at low IAV and becomes curvilinear and exponential at higher volumes. Specific conditions in relation to increased (previous pregnancy or laparoscopy, gynoid fat distribution, ellipse-shaped internal abdominal perimeter) or decreased Cab (obesity, fluid overload, android fat distribution, sphere-shaped internal abdominal perimeter) will be discussed

  4. Fluidized wall for protecting fusion chamber walls

    DOEpatents

    Maniscalco, James A.; Meier, Wayne R.

    1982-01-01

    Apparatus for protecting the inner wall of a fusion chamber from microexplosion debris, x-rays, neutrons, etc. produced by deuterium-tritium (DT) targets imploded within the fusion chamber. The apparatus utilizes a fluidized wall similar to a waterfall comprising liquid lithium or solid pellets of lithium-ceramic, the waterfall forming a blanket to prevent damage of the structural materials of the chamber.

  5. Wall of fundamental constants

    SciTech Connect

    Olive, Keith A.; Peloso, Marco; Uzan, Jean-Philippe

    2011-02-15

    We consider the signatures of a domain wall produced in the spontaneous symmetry breaking involving a dilatonlike scalar field coupled to electromagnetism. Domains on either side of the wall exhibit slight differences in their respective values of the fine-structure constant, {alpha}. If such a wall is present within our Hubble volume, absorption spectra at large redshifts may or may not provide a variation in {alpha} relative to the terrestrial value, depending on our relative position with respect to the wall. This wall could resolve the contradiction between claims of a variation of {alpha} based on Keck/Hires data and of the constancy of {alpha} based on Very Large Telescope data. We derive the properties of the wall and the parameters of the underlying microscopic model required to reproduce the possible spatial variation of {alpha}. We discuss the constraints on the existence of the low-energy domain wall and describe its observational implications concerning the variation of the fundamental constants.

  6. [Primary mycotic aneurysm of the abdominal aorta from salmonella injection. A new case successfully operated upon (author's transl)].

    PubMed

    Jaillard, J; Carré, A; Marteau, D; Mizon, F; Warembourg, H

    1979-01-01

    A double aneurism, located in the abdominal aorta and left common iliac was found complicating a salmonella typhimurium infection which had been present for 7 months. A by-pass operation between the inaffected iliac arteries was followed by resection of the two aneurisms. Cultures taken from the walls of the aneurisms showed the presence of salmonella typhimurium. The authors stress the particular seriousness of the spontaneous evolution of such mycotic aneurisms. PMID:373564

  7. Intra-abdominal abscess demonstrating an unusually large intra-abdominal pattern on an indium-111 leukocyte scan

    SciTech Connect

    Black, R.R.; Fernandez-Ulloa, M.; ter Penning, B.; Yellin, J.

    1988-12-01

    Indium-111 WBC imaging of a patient with occult septicemia revealed a large focal pattern of radiopharmaceutical distribution within the abdominal cavity at 24 hours post radiopharmaceutical administration. This finding was felt to represent a large intra-abdominal abscess. A five liter peritoneal abscess was found at surgery. This case illustrates an unusual presentation of an intra-abdominal abscess.

  8. Numerical analysis of the hemodynamics of an abdominal aortic aneurysm repaired using the endovascular chimney technique.

    PubMed

    Ben Gur, Hila; Kosa, Gabor; Brand, Moshe

    2015-08-01

    This paper presents a numerical analysis of the hemodynamics in an abdominal aorta (AA) with an aneurysm repaired by a stent graft (SG) system using the chimney technique. Computational fluid dynamics (CFD) simulations were conducted in a model of an AA repaired with a chimney stent graft (CSG) inserted into a renal artery parallel to an aortic SG and a model of a healthy AA. Comparing the simulation results of these two cases suggests that the presence of the CSG in the AA causes changes in average wall shear stress (WSS), potentially damaging recirculation zones, and additional changes in flow patterns. PMID:26736427

  9. Expanding current EVAR indications to include small abdominal aortic aneurysms: a glimpse of the future.

    PubMed

    Georgakarakos, Efstratios; Ioannou, Christos V; Georgiadis, George S; Kapoulas, Konstantinos; Schoretsanitis, Nikolaos; Lazarides, Miltos

    2011-08-01

    The traditional criterion of maximum transverse diameter is not sufficient to differentiate the small abdominal aortic aneurysms (AAAs) that are either prone to rupture or prone to enlarge rapidly. Wall stress may be a more reliable indicator with respect to these tasks. We review the importance of geometric features in rupture- or growth-predictive models and stress the need for further evaluation and validation of geometric indices. This study may lead to identifying those small AAAs that could justify early endovascular intervention. PMID:21422056

  10. 73-year-old woman with abdominal pain in the right lower quadrant

    SciTech Connect

    Bond, J.R.

    1987-03-20

    A 73-year-old woman presented with a six-day history of abdominal pain that had started in the epigastrium, but recently had become more intense in the right lower quadrant. Peptic ulcer had been diagnosed three years prior to presentation and had been managed medically. On physical examination, epigastric tenderness as well as guarding and rebound tenderness in the right lower quandrant were present. Mild leukocytosis was reported. Computed tomography demonstrated a 5-cm retrocecal mass with low attenuation (fluid content) surrounded by an irregularly thickened uncalcified wall. Multiple areas of tissue debris were seen extending into the mass, but no true separation was present.

  11. [Retroperitoneal benign cyst with osseous metaplasia as the cause of abdominal pain].

    PubMed

    Hassan, Mohamed Ali; Clausen, Marianne Engell; Achiam, Michael

    2014-12-15

    A 27-year-old female patient with no previous medical history, presented a computed tomography displaying a calcified retroperitoneal cyst. The patient had experienced occasional abdominal pain in her right side. The tumour was found in the retroperitoneum, was non-adherent to neighbouring organs and was excised laparoscopically without postoperative complications. Histology revealed a benign, cystic mass, with calcification and osseous metaplasia in the cyst wall, and no epithelia. The material of the cyst was amorphic and necrotic. No other retroperitoneal masses alike has been described in the literature.

  12. A Generalized Wall Function

    NASA Technical Reports Server (NTRS)

    Shih, Tsan-Hsing; Povinelli, Louis A.; Liu, Nan-Suey; Potapczuk, Mark G.; Lumley, J. L.

    1999-01-01

    The asymptotic solutions, described by Tennekes and Lumley (1972), for surface flows in a channel, pipe or boundary layer at large Reynolds numbers are revisited. These solutions can be extended to more complex flows such as the flows with various pressure gradients, zero wall stress and rough surfaces, etc. In computational fluid dynamics (CFD), these solutions can be used as the boundary conditions to bridge the near-wall region of turbulent flows so that there is no need to have the fine grids near the wall unless the near-wall flow structures are required to resolve. These solutions are referred to as the wall functions. Furthermore, a generalized and unified law of the wall which is valid for whole surface layer (including viscous sublayer, buffer layer and inertial sublayer) is analytically constructed. The generalized law of the wall shows that the effect of both adverse and favorable pressure gradients on the surface flow is very significant. Such as unified wall function will be useful not only in deriving analytic expressions for surface flow properties but also bringing a great convenience for CFD methods to place accurate boundary conditions at any location away from the wall. The extended wall functions introduced in this paper can be used for complex flows with acceleration, deceleration, separation, recirculation and rough surfaces.

  13. Liquid Wall Chambers

    SciTech Connect

    Meier, W R

    2011-02-24

    The key feature of liquid wall chambers is the use of a renewable liquid layer to protect chamber structures from target emissions. Two primary options have been proposed and studied: wetted wall chambers and thick liquid wall (TLW) chambers. With wetted wall designs, a thin layer of liquid shields the structural first wall from short ranged target emissions (x-rays, ions and debris) but not neutrons. Various schemes have been proposed to establish and renew the liquid layer between shots including flow-guiding porous fabrics (e.g., Osiris, HIBALL), porous rigid structures (Prometheus) and thin film flows (KOYO). The thin liquid layer can be the tritium breeding material (e.g., flibe, PbLi, or Li) or another liquid metal such as Pb. TLWs use liquid jets injected by stationary or oscillating nozzles to form a neutronically thick layer (typically with an effective thickness of {approx}50 cm) of liquid between the target and first structural wall. In addition to absorbing short ranged emissions, the thick liquid layer degrades the neutron flux and energy reaching the first wall, typically by {approx}10 x x, so that steel walls can survive for the life of the plant ({approx}30-60 yrs). The thick liquid serves as the primary coolant and tritium breeding material (most recent designs use flibe, but the earliest concepts used Li). In essence, the TLW places the fusion blanket inside the first wall instead of behind the first wall.

  14. Vertebral destruction due to abdominal aortic aneurysm

    PubMed Central

    Jiménez Viseu Pinheiro, J.F.; Blanco Blanco, J.F.; Pescador Hernández, D.; García García, F.J.

    2014-01-01

    Introduction Low back pain is a common cause of medical consultation, and usually supposes a non-malignant prognostic. Presentation of case We report an atypical appearance of low back pain associated to shock and pulsatile abdominal mass that made us diagnose an abdominal aortic aneurysm as reason of vertebral lysis and pain. Discusion Surgical repair of contained AAA should be directed to secondary re-rupture prevention, with an approximate survival near to 100% at selected patients for elective surgery. Consequently, orthopedic surgery for back spine stabilization has to be elective in those cases when vertebral destruction is above 30% and clinic is directly related to spine instability. Conclusion We should consider AAA as other cause of low back pain and routinely examine the abdomen and seek complementary imaging proves when risk factors for AAA are present. PMID:25569196

  15. [Normal abdominal ultrasound anatomy. Examination procedure].

    PubMed

    Salcedo Joven, I; Segura Grau, A; Rodríguez Lorenzo, A; Segura Cabral, J M

    2014-01-01

    To carry out an abdominal ultrasound examination with the highest degree of accuracy and thoroughness, it is essential to have a good knowledge of the anatomy and the normal measurements of the different organs. In this way, we can determine their normal condition and identify the pathology and its location more easily. It is very important to adopt a correct examination procedure, systematically sweeping the scan in the same direction and not leaving any organ unexamined. We suggest a procedure consisting of longitudinal, cross-sectional and oblique scans to view all the abdominal organs, starting the examination in the epigastric region, scanning first the right upper quadrant, then the left upper quadrant, both iliac fossa, and lastly the hypogastric region.

  16. Atrophic coarctation of the abdominal aorta.

    PubMed Central

    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F

    1980-01-01

    Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453

  17. Color Doppler ultrasonography of the abdominal aorta

    PubMed Central

    Battaglia, S.; Danesino, G.M.; Danesino, V.; Castellani, S.

    2010-01-01

    Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations. PMID:23396814

  18. [Adrenal injury in blunt abdominal trauma].

    PubMed

    Abakumov, M M; Smoliar, A N; Barmina, T G; Boĭko, A V; Shalimova, I G

    2009-01-01

    10 patients with adrenal damage were observed during 2.5 years. It amounted 0.93% of all patients with closed abdominal injuries. The right adrenal gland was traumatized in all cases evidently due to it's compression between right lobe of liver and vertebral column. Adrenal damage is observed quite often in combination with injuries of right liver lobe, right kidney and retroperitoneal hematoma formation. 5 patients underwent laparotomy on account of intra-abdominal bleeding, but adrenal damage was never revealed. Ultrasound and tomographic semiotics of adrenal damage was worked out, which allowed ascertaining diagnosis in 80% on application of ultrasound study and in 100% at computer tomography. Injury of one adrenal gland was not accompanied by adrenal failure and did not require hormonal replacement therapy.

  19. Abdominal calcifications in infants and children.

    PubMed

    Pintér, A B; Weisenbach, J; Szemlédy, F

    1984-12-01

    Abdominal and pelvic calcifications are usually incidental findings and require further measures to determine their origin. Most laboratory investigations are of little help. Plain anteroposterior and lateral x-rays are essential. The time of appearance and localisation of a calcification is of diagnostic importance. Amorphous, granular and irregular calcification can be an early sign of malignancy. Mobility of a calcification also helps to clarify its origin. Over the past 15 years abdominal and pelvic calcifications, excluding urological radiodensities, have been found in 63 patients up to fourteen years of age at our institute. A migrating deposit in the omentum, a spontaneously amputated calcified ovary mimicking a vesical calculus and a congenital retroperitoneal xanthofibroma caused the greatest difficulty in establishing a preoperative diagnosis.

  20. Retroperitoneal lymphocele after abdominal aortic surgery.

    PubMed

    Garrett, H E; Richardson, J W; Howard, H S; Garrett, H E

    1989-09-01

    Lymphoceles may occur as a result of lymphatic injury during abdominal aortic surgery. These lymphatic collections may occur as a retroperitoneal mass or as groin lymphoceles. Four cases are presented in which persistent retroperitoneal lymphoceles were discovered 2 to 8 years after surgery. Reexploration of the groin and repeated aspirations of lymphatic fluid failed to control the drainage. Reexploration of the retroperitoneum documented lymphatic injury, which was controlled by ligation of the lymphatics with suture. A review of the literature discloses five similar reported cases of retroperitoneal lymphocele and 12 cases of chylous ascites after abdominal aortic surgery. Clearly, avoiding lymphatic injury or immediate repair of any lymphatic injuries will prevent this problem. Once a persistent lymphocele has developed, aspiration will establish the diagnosis. Our experience would suggest that reexploration of the retroperitoneum is required to control the drainage and to prevent possible graft infection.

  1. [Traumatic and iatrogenic lesions of abdominal vessels].

    PubMed

    Farah, I; Tarabula, P; Voirin, L; Magne, J L; Delannoy, P; Gattaz, F; Guidicelli, H

    1997-01-01

    Gravity of abdominal vessels traumatisms is secondary to multiple factors. It depends on the type of injured vessels, aetiology and associated lesions. Between September 1984 and March 1995, 22 abdominal vessel traumatisms in 16 patients (mean age: 39 years) were treated. At surgical exploration, 4 aortic and 2 renal vein lesions, 7 iliac artery and 3 renal artery contusions, 2 superior mesenteric artery dissections; 3 infra-renal vena cava ruptures and 1 superior mesenteric vein dilaceration were found. All lesions were caused by penetrant wounds secondary to firearm or blade injury or secondary to injuries due to ski or traffic accidents. In 5 cases, lesions were iatrogenic. There was no mortality in the post-operative period, 14 patients out of the 16 patients operated on have been followed during a period from 1 to 120 months.

  2. Abdominal obesity, muscle composition, and insulin resistance in premenopausal women.

    PubMed

    Ross, Robert; Freeman, Jennifer; Hudson, Robert; Janssen, Ian

    2002-11-01

    The independent relationships between visceral and abdominal sc adipose tissue (AT) depots, muscle composition, and insulin sensitivity were examined in 40 abdominally obese, premenopausal women. Measurements included glucose disposal by euglycemic clamp, muscle composition by computed tomography, abdominal and nonabdominal (e.g. leg) AT by magnetic resonance imaging and cardiovascular fitness. Glucose disposal rates were negatively related to visceral AT mass (r = -0.42, P < 0.01). These observations remained significant (P < 0.01) after control for nonabdominal and abdominal sc AT, muscle attenuation, and peak oxygen uptake. Total, abdominal, or leg sc AT or muscle attenuation was not significantly (P > 0.10) related to glucose disposal. Subdivision of abdominal sc AT into anterior and posterior depots did not alter the observed relationships. Further analysis matched two groups of women for abdominal sc AT but with low and high visceral AT. Women with high visceral AT had lower glucose disposal rates compared with those with low visceral AT (P < 0.05). A similar analysis performed on two groups of women matched for visceral AT but high and low abdominal sc AT revealed no statistically different values for insulin sensitivity (P > 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal, abdominal sc AT, muscle composition, and cardiovascular fitness. Subdivision of abdominal sc AT did not provide additional insight into the relationship between abdominal obesity and metabolic risk.

  3. [Vaginal hysterectomy following previous abdominal and gynecologic surgery].

    PubMed

    Draca, P; Vuleta, P; Miljković, S

    1976-01-01

    The authors analyse 125 cases of vaginal histerectomy (V.H.) preceded by vaginal and abdominal operations (15.3% of a total of 817 V.H.) There were 95 cases of previous abdominal operations and 30 cases of previous gynecological operations (19 vaginal and 11 abdominal). The most frequent previously performed vaginal operation was anterior and posterior colporrhaphy. The authors have come to the conclusion that neither previous abdominal nor previous gynecological surgical interventions make the carrying out of vaginal histerectomy more difficult. Only Doleris's operation, among abdominal ones, may represent a relative contraindication for V.H. In one case the authors had to complete the already started histerectomy abdominally owing to some technical difficulties. The authors maintain that it would be good to use vaginal histerectomy more frequently after previously applied gynecological, vaginal, and abdominal operations.

  4. Focal epilepsy with ictal abdominal pain: a case report.

    PubMed

    Cerminara, Caterina; El Malhany, Nadia; Roberto, Denis; Curatolo, Paolo

    2013-01-01

    Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed us to make a diagnosis of focal epilepsy with ictal abdominal pain. This is a rare epileptic phenomenon that should be suspected in patients with unexplained paroxysmal abdominal pain and migraine-like symptoms. We suggest that, after the exclusion of more common etiologies, focal epilepsy with ictal abdominal pain should be considered in patients with paroxysmal abdominal pain and ictal EEG abnormalities. PMID:24321431

  5. [Role of surgery in closed abdominal trauma].

    PubMed

    Panis, Y; Charbit, L; Valleur, P

    1997-05-01

    Over the past twenty years, nonoperative management has increasingly been recommended for the care of patients with blunt abdominal trauma. Emergency laparotomy remains the rule in patients with hemodynamic instability or in those with peritonitis due to intestinal perforation. Surgical treatment of liver and splenic lesions tends to be more conservative. After assessment of the lesions by computed tomography, nonoperative management in intensive care unit is allowed in the majority of patients. PMID:9208689

  6. Endovascular repair of abdominal aortic aneurysms.

    PubMed

    Arnaoutakis, Dean J; Zammert, Martin; Karthikesalingam, Alan; Belkin, Michael

    2016-09-01

    Endovascular repair of abdominal aortic aneurysms is an important technique in the vascular surgeon's armamentarium, which has created a seismic shift in the management of aortic pathology over the past two decades. In comparison to traditional open repair, the endovascular approach is associated with significantly improved perioperative morbidity and mortality. The early survival benefit of endovascular abdominal aortic aneurysm repair is sustained up to 3 years postoperatively, but longer-term life expectancy remains poor regardless of operative modality. Nonetheless, most abdominal aortic aneurysms are now repaired using endovascular stent grafts. The technology is not perfect as several postoperative complications, namely endoleak, stent-graft migration, and graft limb thrombosis, can develop and therefore lifelong imaging surveillance is required. In addition, a postoperative inflammatory response has been documented after endovascular repair of aortic aneurysms; the clinical significance of this finding has yet to be determined. Subsequently, the safety and applicability of endovascular stent grafts are likely to improve and expand with the introduction of newer-generation devices and with the simplification of fenestrated systems. PMID:27650343

  7. [Abdominal multi-organ transplantation in dogs].

    PubMed

    Kumagae, T

    1988-07-01

    Abdominal multi-organ transplantation including the liver, gallbladder, spleen, pancreas, kidneys, adrenal glands and gastrointestinal tract was attempted in 8 dogs. Each experiment was discontinued when the recipient deteriorated. Immersion hypothermia was introduced in both the donor and recipient until the esophageal temperature reached 27-30 degrees C. Whole abdominal organs of the donor were removed in an en-bloc fashion at 20 degrees C of the graft temperature after additional cooling by ice slush scattering into the abdominal cavity. Transplantation was carried out orthotopically in the following sequence: (1) the proximal aorta, (2) suprahepatic vena cava, (3) distal aorta, (4) infrahepatic vena cava. The alimentary tract was reconstructed by gastro-gastrostomy and colo-colostomy. The ureters were implanted in the bladder. Cold ischemic time of the graft was about 40 minutes. Heparin was not used throughout the procedure. Five out of eight dogs were alive for more than 24 hours and two of them survived for 60 hours with good recovery. No immunosuppressant was given. Though the result in the present study was far from satisfaction, the experiment may provide a possibility of a new experimental model for transplantation, especially regarding pathophysiology and interrelationship of the transplanted complex organs.

  8. [Abdominal aortic aneurysm: an uncommon presentation].

    PubMed

    Taborda, Lúcia; Pereira, Laurinda; Amona, Eurides; Pinto, Erique Guedes; Rodrigues, Joaquim

    2011-01-01

    Most abdominal aortic aneurysms are asymptomatic, being accidentally found on physical examination or in routinely performed imaging studies. They only require surveillance (which is variable according to the aneurism size) and medical therapy in order to achieve risk factor reduction. However, in certain situations, according to the risk of aneurism rupture, elective surgery or endovascular procedure may be necessary. About 80% of the cases of aneurism rupture occur into the retroperitoneal space, with a high mortality rate. There are uncommon presentations of aneurism rupture as the aorto-caval fistula, which also require fast diagnosis and intervention. The authors present the case of a 71-year-old man, with the previous diagnosis of hypertension, acute myocardial infarction 2 months earlier (undergone primary Percutaneous Coronary Intervention) and tabagism, who was admitted at the emergency department with intense 24-hour-evolution epigastric pain. On physical examination, the Blood Pressure values measured at the lower limbs were about half the ones measured at the upper limbs and there was an abdominal pulsatile mass, with a high-intensity murmur. As the authors suspected aortic dissection, aneurysm, coarctation or thrombosis, it was done a Computed Tomography scanning with intravenous contrast, which revealed a ruptured abdominal aorta aneurysm with a mural thrombus. The doppler ultrasound confirmed the presence of a high debit aorto-caval fistula. The patient was immediately transferred to the Vascular Surgery. However he died 2 hours later, during surgery. PMID:22525642

  9. [Hereditary angioedema: strange cause of abdominal pain].

    PubMed

    Salas-Lozano, Nereo Guillermo; Meza-Cardona, Javier; González-Fernández, Coty; Pineda-Figueroa, Laura; de Ariño-Suárez, Mauricio

    2014-01-01

    Antecedentes: el angioedema hereditario es un trastorno inflamatorio episódico, que se hereda de manera autosómica dominante y se caracteriza por episodios de edema periférico. Los pacientes pueden tener edema de la pared de cualquier víscera hueca, incluido el intestino. Caso clínico: se comunica el caso de un paciente masculino de 33 años de edad, sin antecedentes de importancia, con dolor abdominal, localizado en el epigastrio, irradiado al cuadrante inferior derecho, acompañado de 5 vómitos. La tomografía abdominal mostró engrosamiento de la pared de la segunda y tercera porción del duodeno, con infiltración de grasa y líquido libre. Los exámenes de laboratorio mostraron: concentraciones bajas del complemento C4 (5.5 mg/dL) y actividad del inhibidor de C1 del complemento de 30%. Conclusiones: el angioedema hereditario es consecuencia de la deficiencia (tipo I) o disfunción (tipo II) del inhibidor C1 del complemento. El dolor abdominal asociado con angioedema es de inicio súbito, como dolor cólico, recurrente y de intensidad moderada. En la actualidad existen dos medicamentos aprobados por la Food and Drug Administration para el tratamiento de pacientes con esta afección.

  10. Quantification of abdominal aortic deformation after EVAR

    NASA Astrophysics Data System (ADS)

    Demirci, Stefanie; Manstad-Hulaas, Frode; Navab, Nassir

    2009-02-01

    Quantification of abdominal aortic deformation is an important requirement for the evaluation of endovascular stenting procedures and the further refinement of stent graft design. During endovascular aortic repair (EVAR) treatment, the aortic shape is subject to severe deformation that is imposed by medical instruments such as guide wires, catheters, and, the stent graft. This deformation can affect the flow characteristics and morphology of the aorta which have been shown to be elicitors for stent graft failures and be reason for reappearance of aneurysms. We present a method for quantifying the deformation of an aneurysmatic aorta imposed by an inserted stent graft device. The outline of the procedure includes initial rigid alignment of the two abdominal scans, segmentation of abdominal vessel trees, and automatic reduction of their centerline structures to one specified region of interest around the aorta. This is accomplished by preprocessing and remodeling of the pre- and postoperative aortic shapes before performing a non-rigid registration. We further narrow the resulting displacement fields to only include local non-rigid deformation and therefore, eliminate all remaining global rigid transformations. Finally, deformations for specified locations can be calculated from the resulting displacement fields. In order to evaluate our method, experiments for the extraction of aortic deformation fields are conducted on 15 patient datasets from endovascular aortic repair (EVAR) treatment. A visual assessment of the registration results and evaluation of the usage of deformation quantification were performed by two vascular surgeons and one interventional radiologist who are all experts in EVAR procedures.

  11. In vivo hypertensive arterial wall uptake of radiolabeled liposomes

    SciTech Connect

    Hodis, H.N.; Amartey, J.K.; Crawford, D.W.; Wickham, E.; Blankenhorn, D.H. )

    1990-06-01

    Using five sham-operated and seven aortic coarctation-induced hypertensive New Zealand White rabbits intravenously injected with neutral small unilamellar vesicles loaded with (111In)nitrilotriacetic acid, we demonstrated in vivo that the normal aortic arterial wall participates in liposome uptake and that this uptake is increased in the hypertensive aortic wall by approximately threefold (p less than or equal to 0.0001). Among the three regions examined, aortic arch, thoracic aorta, and lower abdominal aorta, the difference in uptake between the normotensive and hypertensive arterial walls was significantly different, p less than or equal to 0.05, p less than or equal to 0.0001, and p less than 0.05, respectively. The uptake by the different regions of the hypertensive arterial wall is consistent with the pathological changes present in these areas. Furthermore, the extent of liposome uptake by the aortic wall is strongly correlated with the height of the blood pressure (r = 0.85, p = 0.001, n = 11). We conclude that neutral small unilamellar liposomes can be used to carry agents into the arterial wall in vivo in the study of hypertensive vascular disease and could be especially useful for the delivery of pharmacologically or biologically active agents that would otherwise be inactivated within the circulation or are impermeable to the arterial wall.

  12. Prostaglandin receptor EP4 in abdominal aortic aneurysms.

    PubMed

    Cao, Richard Y; St Amand, Tim; Li, XinZhi; Yoon, Sung-Hee; Wang, Carol P; Song, Hui; Maruyama, Takayuki; Brown, Peter M; Zelt, David T; Funk, Colin D

    2012-07-01

    Abdominal aortic aneurysm (AAA) pathogenesis is distinguished by vessel wall inflammation. Cyclooxygenase (COX)-2 and microsomal prostaglandin E synthase-1, key components of the most well-characterized inflammatory prostaglandin pathway, contribute to AAA development in the 28-day angiotensin II infusion model in mice. In this study, we used this model to examine the role of the prostaglandin E receptor subtype 4 (EP4) and genetic knockdown of COX-2 expression (70% to 90%) in AAA pathogenesis. The administration of the prostaglandin receptor EP4 antagonist AE3-208 (10 mg/kg per day) to apolipoprotein E (apoE)-deficient mice led to active drug plasma concentrations and reduced AAA incidence and severity compared with control apoE-deficient mice (P < 0.01), whereas COX-2 genetic knockdown/apoE-deficient mice displayed only a minor, nonsignificant decrease in incidence of AAA. EP4 receptor protein was present in human and mouse AAA, as observed by using Western blot analysis. Aortas from AE3-208-treated mice displayed evidence of a reduced inflammatory phenotype compared with controls. Atherosclerotic lesion size at the aortic root was similar between all groups. In conclusion, the prostaglandin E(2)-EP4 signaling pathway plays a role in the AAA inflammatory process. Blocking the EP4 receptor pharmacologically reduces both the incidence and severity of AAA in the angiotensin II mouse model, potentially via attenuation of cytokine/chemokine synthesis and the reduction of matrix metalloproteinase activities.

  13. Abdominal aortic aneurysm and histological, clinical, radiological correlation.

    PubMed

    Rodella, Luigi Fabrizio; Rezzani, Rita; Bonomini, Francesca; Peroni, Michele; Cocchi, Marco Angelo; Hirtler, Lena; Bonardelli, Stefano

    2016-04-01

    To date, the pathogenesis of abdominal aortic aneurism (AAA) still remains unclear. As such, the aim of this study was to evaluate changes of the aortic structure during AAA. We analysed the microscopic frame of vessels sections, starting from the primum movens leading to abnormal dilatation. AAA samples were collected and processed through various staining methods (Verhoeff-Van Gieson, Masson Goldner, Sirius Red). Subsequently, the vessel morphology and collagenic web of the tunica media and adventitia were determined and the amount of type I and type III collagen was measured. We also applied immune-histochemistry markers for CD34 and PGP 9.5 in order to identify vascular and nerve structures in the aorta. Immune-positivity quantification was used to calculate the percentage of the stained area. We found increasing deposition of type I collagen and reduced type III collagen in both tunica media and adventitia of AAA. The total amount of vasa vasorum, marked with CD34, and nerva vasorum, marked with PGP 9.5, was also higher in AAA samples. Cardiovascular risk factors (blood pressure, dyslipidemia, cigarette smoking) and radiological data (maximum aneurism diameter, intra-luminal thrombus, aortic wall calcification) increased these changes. These results suggest that the tunica adventitia may have a central role in the pathogenesis of AAA as clearly there are major changes characterized by rooted inflammatory infiltration. The presence of immune components could explain these modifications within the framework of the aorta. PMID:26858185

  14. Cell wall integrity

    PubMed Central

    Pogorelko, Gennady; Lionetti, Vincenzo; Bellincampi, Daniela; Zabotina, Olga

    2013-01-01

    The plant cell wall, a dynamic network of polysaccharides and glycoproteins of significant compositional and structural complexity, functions in plant growth, development and stress responses. In recent years, the existence of plant cell wall integrity (CWI) maintenance mechanisms has been demonstrated, but little is known about the signaling pathways involved, or their components. Examination of key mutants has shed light on the relationships between cell wall remodeling and plant cell responses, indicating a central role for the regulatory network that monitors and controls cell wall performance and integrity. In this review, we present a short overview of cell wall composition and discuss post-synthetic cell wall modification as a valuable approach for studying CWI perception and signaling pathways. PMID:23857352

  15. Metallic Wall Hall Thrusters

    NASA Technical Reports Server (NTRS)

    Goebel, Dan Michael (Inventor); Hofer, Richard Robert (Inventor); Mikellides, Ioannis G. (Inventor)

    2016-01-01

    A Hall thruster apparatus having walls constructed from a conductive material, such as graphite, and having magnetic shielding of the walls from the ionized plasma has been demonstrated to operate with nearly the same efficiency as a conventional non-magnetically shielded design using insulators as wall components. The new design is believed to provide the potential of higher power and uniform operation over the operating life of a thruster device.

  16. The Role of Geometric and Biomechanical Factors in Abdominal Aortic Aneurysm Rupture Risk Assessment

    PubMed Central

    Raut, Samarth S.; Chandra, Santanu; Shum, Judy; Finol, Ender A.

    2013-01-01

    The current clinical management of abdominal aortic aneurysm (AAA) disease is based to a great extent on measuring the aneurysm maximum diameter to decide when timely intervention is required. Decades of clinical evidence show that aneurysm diameter is positively associated with the risk of rupture, but other parameters may also play a role in causing or predisposing the AAA to rupture. Geometric factors such as vessel tortuosity, intraluminal thrombus volume, and wall surface area are implicated in the differentiation of ruptured and unruptured AAAs. Biomechanical factors identified by means of computational modeling techniques, such as peak wall stress, have been positively correlated with rupture risk with a higher accuracy and sensitivity than maximum diameter alone. The objective of this review is to examine these factors, which are found to influence AAA disease progression, clinical management and rupture potential, as well as to highlight on-going research by our group in aneurysm modeling and rupture risk assessment. PMID:23508633

  17. Septic pleuritis and abdominal abscess formation caused by Rhodococcus equi in a foal.

    PubMed

    Valdes, Alejandro; Johnson, Jill R

    2005-09-15

    A 3-month-old female Arabian horse was evaluated because of fever, respiratory distress, lethargy, and decreased appetite of 5 days' duration. Pleural effusion was diagnosed on the basis of ultrasonographic and radiographic examinations. Cytologic examination of pleural fluid collected via thoracocentesis revealed septic inflammation; bacteriologic culture of a sample of that fluid yielded Rhodococcus equi. A large intra-abdominal mass adjacent to the body wall was identified ultrasonographically. A specimen of the mass was collected via aspiration; the specimen was identified cytologically as purulent exudate that contained large numbers of rod-shaped bacteria, which confirmed abdominal abscess formation. Bacteriologic culture of a sample of the exudate also yielded R. equi. The foal was treated with azithromycin (10 mg/kg [4.5 mg/lb], PO, q 24 h for 5 days then q 48 h) and rifampin (5 mg/kg [2.3 mg/lb], PO, q 12 h) for 8 weeks and metronidazole (15 mg/kg [6.8 mg/lb], PO, q 8 h) for 3 weeks. Clinically, the foal responded to antimicrobial treatment within 2 weeks. At 8 weeks after the initial evaluation, ultrasonographic examination of the foal revealed resolution of the pleural effusion and abdominal abscess. In foals, R. equi infection typically results in pyogranulomatous pneumonia, and pleural effusion is an uncommon clinical sign. The combination of azithromycin and rifampin appears to be an effective treatment for R. equi infection in foals. PMID:16190597

  18. Simulation of bifurcated stent grafts to treat abdominal aortic aneurysms (AAA)

    NASA Astrophysics Data System (ADS)

    Egger, J.; Großkopf, S.; Freisleben, B.

    2007-03-01

    In this paper a method is introduced, to visualize bifurcated stent grafts in CT-Data. The aim is to improve therapy planning for minimal invasive treatment of abdominal aortic aneurysms (AAA). Due to precise measurement of the abdominal aortic aneurysm and exact simulation of the bifurcated stent graft, physicians are supported in choosing a suitable stent prior to an intervention. The presented method can be used to measure the dimensions of the abdominal aortic aneurysm as well as simulate a bifurcated stent graft. Both of these procedures are based on a preceding segmentation and skeletonization of the aortic, right and left iliac. Using these centerlines (aortic, right and left iliac) a bifurcated initial stent is constructed. Through the implementation of an ACM method the initial stent is fit iteratively to the vessel walls - due to the influence of external forces (distance- as well as balloonforce). Following the fitting process, the crucial values for choosing a bifurcated stent graft are measured, e.g. aortic diameter, right and left common iliac diameter, minimum diameter of distal neck. The selected stent is then simulated to the CT-Data - starting with the initial stent. It hereby becomes apparent if the dimensions of the bifurcated stent graft are exact, i.e. the fitting to the arteries was done properly and no ostium was covered.

  19. [Massive hemorrhage during abdominal total hysterectomy in a patient with placenta percreta].

    PubMed

    Morita, Yoshihisa; Mizuno, Ju; Takada, Shinji; Yunokawa, Seki; Morita, Shigeho

    2009-08-01

    A 33-year-old pregnant woman, who had undergone three previous cesarean sections and suspected of having placenta accrete, was scheduled for artificial abortion and abdominal total hysterectomy at 15 weeks gestation because of a probable high mortality rate. The general anesthesia was induced using fentanyl, propofol, and vecuronium and maintained with sevoflurane, fentanyl, and vecuronium, in combination with epidural anesthesia using ropivacaine. During the operation, we found that the placenta had penetrated into the posterior abdominal peritoneum and bladder wall. Sudden, massive hemorrhage was encountered when attempting to separate the placenta percreta. The massive hemorrhage, up to 11,054 ml, was controlled by transfusion, infusion, and temporary clamping of the bilateral common iliac arteries. Rapid infuser LEVEL1 and autologous blood recovery systems Electa were also used. After the surgery, the patient was transferred to the intensive care unit intubated and was discharged on the 16th posteroperative day without any complications. Anesthesiologists should be prepared for massive hemorrhage in cases of abdominal total hysterectomy with suspected placenta percreta.

  20. Chest wall mechanics in sustained microgravity

    NASA Technical Reports Server (NTRS)

    Wantier, M.; Estenne, M.; Verbanck, S.; Prisk, G. K.; Paiva, M.; West, J. B. (Principal Investigator)

    1998-01-01

    We assessed the effects of sustained weightlessness on chest wall mechanics in five astronauts who were studied before, during, and after the 10-day Spacelab D-2 mission (n = 3) and the 180-day Euromir-95 mission (n = 2). We measured flow and pressure at the mouth and rib cage and abdominal volumes during resting breathing and during a relaxation maneuver from midinspiratory capacity to functional residual capacity. Microgravity produced marked and consistent changes (Delta) in the contribution of the abdomen to tidal volume [DeltaVab/(DeltaVab + DeltaVrc), where Vab is abdominal volume and Vrc is rib cage volume], which increased from 30.7 +/- 3. 5 (SE)% at 1 G head-to-foot acceleration to 58.3 +/- 5.7% at 0 G head-to-foot acceleration (P < 0.005). Values of DeltaVab/(DeltaVab + DeltaVrc) did not change significantly during the 180 days of the Euromir mission, but in the two subjects DeltaVab/(DeltaVab + DeltaVrc) was greater on postflight day 1 than on subsequent postflight days or preflight. In the two subjects who produced satisfactory relaxation maneuvers, the slope of the Konno-Mead plot decreased in microgravity; this decrease was entirely accounted for by an increase in abdominal compliance because rib cage compliance did not change. These alterations are similar to those previously reported during short periods of weightlessness inside aircrafts flying parabolic trajectories. They are also qualitatively similar to those observed on going from upright to supine posture; however, in contrast to microgravity, such postural change reduces rib cage compliance.

  1. Ventilation distribution and chest wall mechanics in microgravity

    NASA Technical Reports Server (NTRS)

    Paiva, M.; Wantier, M.; Verbanck, S.; Engel, L. A.; Prisk, G. K.; Guy, H. J. B.; West, J. B.

    1997-01-01

    The effect of gravity on lung ventilation distribution and the mechanisms of the chest wall were investigated. The following tests were performed with the respiratory monitoring system of the Anthorack, flown onboard Spacelab D2 mission: single breath washout (SBW), multiple breath washout (MBW) and argon rebreathing (ARB). In order to study chest wall mechanisms in microgravity, a respiratory inductive plethysmograph was used. The SBW tests did not reach statistical significance, while the ARB tests showed that gravity independent inhomogeneity of specific ventilation is larger than gravity dependent inhomogeneity. In which concerns the chest wall mechanisms, the analysis on the four astronauts during the normal respirations of the relaxation maneuver showed a 40 percent increase on the abdominal contribution to respiration.

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

    PubMed

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

    2015-01-01

    Limb body wall complex (LBWC) is characterized by multiple severe congenital malformations including an abdominal and/or thoracic wall defect covered by amnion, a short or absent umbilical cord with the placenta almost attached to the anterior fetal wall, intestinal malrotation, scoliosis, and lower extremity anomalies. There is no consensus about the etiology of LBWC and many cases with abnormal facial cleft do not meet the requirements for the true complex. We describe a series of four patients with LBWC and other malformations in an attempt to explain their etiology. There are several reports of fetuses with LBWC and absent gallbladder and one of our patients also had polysplenia. Absent gallbladder and polysplenia are associated with laterality genes including HOX, bFGF, transforming growth factor beta/activins/BMP4, WNT 1-8, and SHH. We postulate that this severe malformation may be due to abnormal genes involved in laterality and caudal development. PMID:26111189

  3. [Intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain].

    PubMed

    Campos-Muñoz, Manuel Alejandro; Villarreal-Ríos, Enrique; Chimal-Torres, Mariano; Pozas-Medina, Josué Atila

    2016-01-01

    Introducción: la presión intraabdominal es el estado de equilibrio de la presión de la cavidad abdominal en reposo y puede presentar cambios durante la ventilación mecánica o espontánea. El objetivo fue determinar la presión intraabdominal como predictor de cirugía en el paciente con dolor abdominal agudo. Métodos: se llevó a cabo un estudio de casos y controles anidado en una cohorte de pacientes con dolor abdominal agudo en el servicio de urgencias de un hospital de segundo nivel, en el periodo comprendido entre abril y diciembre de 2013. Se incluyeron 37 pacientes, todos fueron intervenidos quirúrgicamente con previa toma de la presión intraabdominal. Se formaron los grupos con el resultado del estudio anatomopatológico: con evidencia de proceso inflamatorio abdominal agudo (n = 28) y sin evidencia de proceso inflamatorio abdominal agudo (n = 9). Resultados: en los casos el 100 % presentó presión intraabdominal alta con una p = 0.01, RM: 5 (IC 95 %: 2.578-9.699). En los casos la media de la presión intraabdominal fue de 11.46 y en los controles de 9.2 (p = 0.183). Conclusiones: el dolor abdominal que requiere cirugía para su resolución tiene relación directa con una presión intraabdominal > 5 mmHg.

  4. Abdominal compliance: A bench-to-bedside review.

    PubMed

    Blaser, Annika Reintam; Björck, Martin; De Keulenaer, Bart; Regli, Adrian

    2015-05-01

    Abdominal compliance (AC) is an important determinant and predictor of available workspace during laparoscopic surgery. Furthermore, critically ill patients with a reduced AC are at an increased risk of developing intra-abdominal hypertension and abdominal compartment syndrome, both of which are associated with high morbidity and mortality. Despite this, AC is a concept that has been neglected in the past.AC is defined as a measure of the ease of abdominal expansion, expressed as a change in intra-abdominal volume (IAV) per change in intra-abdominal pressure (IAP):AC = ΔIAV / ΔIAPAC is a dynamic variable dependent on baseline IAV and IAP as well as abdominal reshaping and stretching capacity. Whereas AC itself can only rarely be measured, it always needs to be considered an important component of IAP. Patients with decreased AC are prone to fulminant development of abdominal compartment syndrome when concomitant risk factors for intra-abdominal hypertension are present.This review aims to clarify the pressure-volume relationship within the abdominal cavity. It highlights how different conditions and pathologies can affect AC and which management strategies could be applied to avoid serious consequences of decreased AC.We have pooled all available human data to calculate AC values in patients acutely and chronically exposed to intra-abdominal hypertension and demonstrated an exponential abdominal pressure-volume relationship. Most importantly, patients with high level of IAP have a reduced AC. In these patients, only small reduction in IAV can significantly increase AC and reduce IAPs.A greater knowledge on AC may help in selecting a better surgical approach and in reducing complications related to intra-abdominal hypertension.

  5. 'Stucco' Walls-2

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This image, taken by the microscopic imager, an instrument located on the Mars Exploration Rover Opportunity 's instrument deployment device, or 'arm,' shows the partial 'clodding' or cementation of the sand-sized grains within the trench wall. The area in this image measures approximately 3 centimeters (1.2 inches) across and makes up half of the projected 'Stucco Walls' image.

  6. Thin Wall Iron Castings

    SciTech Connect

    J.F. Cuttino; D.M. Stefanescu; T.S. Piwonka

    2001-10-31

    Results of an investigation made to develop methods of making iron castings having wall thicknesses as small as 2.5 mm in green sand molds are presented. It was found that thin wall ductile and compacted graphite iron castings can be made and have properties consistent with heavier castings. Green sand molding variables that affect casting dimensions were also identified.

  7. Domain wall filters

    SciTech Connect

    Baer, Oliver; Narayanan, Rajamani; Neuberger, Herbert; Witzel, Oliver

    2007-03-15

    We propose using the extra dimension separating the domain walls carrying lattice quarks of opposite handedness to gradually filter out the ultraviolet fluctuations of the gauge fields that are felt by the fermionic excitations living in the bulk. This generalization of the homogeneous domain wall construction has some theoretical features that seem nontrivial.

  8. Interactive Word Walls

    ERIC Educational Resources Information Center

    Jackson, Julie; Narvaez, Rose

    2013-01-01

    It is common to see word walls displaying the vocabulary that students have learned in class. Word walls serve as visual scaffolds and are a classroom strategy used to reinforce reading and language arts instruction. Research shows a strong relationship between student word knowledge and academic achievement (Stahl and Fairbanks 1986). As a…

  9. Differentiation of artery wall lesions using porphyrins and fiberoptic sensor in rabbits

    NASA Astrophysics Data System (ADS)

    Vari, Sandor G.; van der Veen, Maurits J.; Papazoglou, Theodore G.; Fishbein, Michael C.; Stavridi, Marigo; Papaioannou, Thanassis; Grundfest, Warren S.

    1994-02-01

    We investigated the ability of fluorescence spectroscopy, and photosensitizers to differentiate normal, hyperplastic and atherosclerotic arterial wall lesions in vivo. Hyperplastic lesions were induced in the abdominal aorta (AB) of 24 rabbits by balloon injury (BI). Atherosclerotic arterial wall lesions were induced by BI and diet. Fluorescence signals from thoracic n equals 16 and AB n equals 15 sites were analyzed by computer. A ratio was used as an index of drug presence. Use of PPS or BPD and LIFS may be a feasible, in vivo method for the differentiation between normal, hyperplastic and atherosclerotic arterial wall lesions.

  10. Therapeutic Prospect of Adipose-Derived Stromal Cells for the Treatment of Abdominal Aortic Aneurysm.

    PubMed

    Parvizi, Mojtaba; Harmsen, Martin C

    2015-07-01

    Aneurysm refers to the dilation of the vessel wall for more than 50%. Abdominal aortic aneurysm (AAA) refers to the dilation and weakening of all three layers of the abdominal aorta, which mostly occur infrarenally. The population aged above 50 years is at risk of AAA development, while a familiar history doubles the risk. Progression of AAA can cause immanent rupture of the vascular wall and has a high mortality and morbidity risk. They are additional risk factors for AAA development such as gender, smoking, and dyslipidemia. In general, pathological features of AAA include inflammation, degradation of the extracellular matrix (ECM), and smooth muscle cell apoptosis. The main pathophysiology of AAA development is still unknown. Besides available treatment modalities for large AAA, which associate with a high mortality risk, effective, alternative, and safer treatments are required, preferably already at an early stage of AAA. For the last decades, tissue engineering and regenerative medicine showed promising potential therapeutic effects for various (cardiovascular) diseases, including AAA. Adipose tissue-derived stromal cells (ADSC) are a candidate source of stem cells for regenerative medicine. ADSC are isolated from adipose tissue with low risk and are easily cultured and expanded while maintaining their multipotency. In addition, due to their differentiation capacity and trophic factor production, ADSC serve an important role in tissue engineering and regenerative medicine modalities. In this review, we will highlight the main pathobiology of AAA and introduce ADSC as a new promising therapeutic source for small AAA.

  11. An ear-worn sensor for the detection of gait impairment after abdominal surgery.

    PubMed

    Atallah, Louis; Aziz, Omer; Gray, Edward; Lo, Benny; Yang, Guang-Zhong

    2013-02-01

    Surgery to the trunk often results in a change of gait, most pronounced during walking. This change is usually transient, often as a result of wound pain, and returns to normal as the patient recovers. Quantifying and monitoring gait impairment therefore represents a novel means of functional postoperative home recovery follow-up. Until now, this type of assessment could only be made in a gait lab, which is both expensive and labor intensive to administer on a large scale. The objective of this work is to validate the use of an ear-worn activity recognition (e-AR) sensor for quantification of gait impairment after abdominal wall and perianal surgery. The e-AR sensor was used on 2 comparative simulated data sets (N = 32) of truncal impairment to observe walking patterns. The sensor was also used to observe the walking patterns of preoperative and postoperative surgical patients who had undergone abdominal wall (n = 5) and perianal surgery (n = 5). Methods for multiresolution feature extraction, selection, and classification are investigated using the raw ear-sensor data. Results show that the method demonstrates a good separation between impaired and nonimpaired classes for both simulated and real patient data sets. This indicates that the e-AR sensor may be used as a tool for the pervasive assessment of postoperative gait impairment, as part of functional recovery monitoring, in patients at their own homes.

  12. Optical pathology study of human abdominal aorta tissues using confocal micro resonance Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Liu, Cheng-hui; Boydston-White, Susie; Wang, Wubao; Sordillo, Laura A.; Shi, Lingyan; Weisberg, Arel; Tomaselli, Vincent P.; Sordillo, Peter P.; Alfano, Robert R.

    2016-03-01

    Resonance Raman (RR) spectroscopic technique has a high potential for label-free and in-situ detection of biomedical lesions in vivo. This study evaluates the ability of RR spectroscopy method as an optical histopathology tool to detect the atherosclerotic plaque states of abdominal aorta in vitro. This part demonstrates the RR spectral molecular fingerprint features from different sites of the atherosclerotic abdominal aortic wall tissues. Total 57 sites of five pieces aortic samples in intimal and adventitial wall from an autopsy specimen were examined using confocal micro Raman system of WITec 300R with excitation wavelength of 532nm. The preliminary RR spectral biomarkers of molecular fingerprints indicated that typical calcified atherosclerotic plaque (RR peak at 964cm-1) tissue; fibrolipid plaque (RR peaks at 1007, 1161, 1517 and 2888cm-1) tissue, lipid pool with the fatty precipitation cholesterol) with collagen type I (RR peaks at 864, 1452, 1658, 2888 and 2948cm-1) in the soft tissue were observed and investigated.

  13. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-01-01

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended. PMID:26698210

  14. The role of antidepressants in the treatment of abdominal obesity.

    PubMed

    Rosmond, R; Björntorp, P

    2000-06-01

    The pathophysiology of abdominal obesity is unclear and controversial. Recent evidence now suggests that inadequate cortisol secretion is associated with abnormalities in glucose, insulin and lipid metabolism, including hypertension, bringing the importance of the hypothalamic-pituitary-adrenal (HPA) axis in the pathogenesis of abdominal obesity to the forefront. In addition, abnormal gonadal steroid concentrations and impaired plasma growth hormone levels accompany the abdominally obese state. Since the reproductive and growth axes are inhibited at many levels by various components of the HPA axis, increasing cortisol levels results in further depression of testosterone and growth hormone concentrations. Over the last decade, antidepressant (serotoninergic) drugs have proved useful as equalizers of HPA axis hyperactivity. Such therapy may interrupt the vicious circle of a hyperactive HPA axis leading to increasing abdominal obesity and endocrine perturbations that, in turn, leads to progressive accumulation of abdominal fat. Additionally, preliminary results indicate that serotoninergic agents decrease abdominal fat mass with improvements in related risk factors.

  15. Functional Abdominal Pain: "Get" the Function, Loose the Pain.

    PubMed

    Draeger-Muenke, Reinhild

    2015-07-01

    Functional abdominal pain is a mind-body, psychosocial, and self-reinforcing experience with significant consequences for the sufferer and the surrounding support network. The occurrence of unpredictable symptoms and their severity add an element of dread and feeling out-of-control to daily life and often reduce overall functioning in a downward spiral. Two clinical presentations of functional abdominal pain are offered in this article (composites to protect confidentiality) dealing with abdominal pain syndrome and abdominal migraines. The treatment demonstrates the use of hypnotic principles for self-regulation, exploration, and meaning-making. Hypnosis treatment is conducted in combination with mindfulness-based interventions and Traditional Chinese Medicine's (TCM) teachings regarding abdominal health and illness. The clinical examples illustrate medical findings that suggest children with early life stress and an early onset of gastrointestinal somatization may not simply outgrow their functional abdominal pain but may suffer into adulthood. PMID:26046716

  16. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-12-23

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended.

  17. Haemodynamic and abdominal motor reflexes elicited by neurotensin in anaesthetized guinea-pigs.

    PubMed Central

    Rioux, F.; Lemieux, M.

    1992-01-01

    1. Single intraperitoneal (i.p.) injections of neurotensin (NT) (0.14- 140 nmol kg-1) in anaesthetized guinea-pigs were found to trigger transient abdominal wall contractions (TAWC) accompanied by relatively sustained increases of systemic blood pressure (BP) and heart rate (HR). The modification of the latter NT effects by various drugs and surgical manipulations was examined to obtain some insight into the nature of, and possible relationship between, these responses. 2. The abdominal motor response (i.e. TAWC) to i.p. NT (14 nmol kg-1) was inhibited by prior i.v. injection of the guinea-pigs with pancuronium (0.27 mumol kg-1), morphine (1.5 and 15 mumol kg-1), clonidine (0.34 mumol kg-1), by concomitant i.p. injection of procaine 2% w/v, or by acute spinalization. It was potentiated by naloxone (2.8 and 28 mumol kg-1), but not affected by i.v. injection of autonomic drugs (i.e. pentolinium, prazosin, yohimbine and atropine), by capsaicin desensitization, or by acute bilateral cervical vagotomy. In spinalized animals a sustained abdominal wall contraction (SAWC) was unmasked, which was resistant to i.v. morphine, clonidine or baclofen but suppressed by i.v. pancuronium or i.p. lignocaine 2% w/v. 3. Haemodynamic responses to i.p. NT were not affected by i.v. pancuronium, morphine, naloxone, atropine, or by vagotomy. They were inhibited by i.v. pentolinium or clonidine (BP, HR), i.v. prazosin (BP), i.p. procaine 2% w/v (BP, HR), capsaicin desensitization or acute spinalization (BP, HR). Yohimbine (i.v.) potentiated BP and HR increases caused by i.p. NT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1504727

  18. Surrogate Markers of Abdominal Aortic Aneurysm Progression.

    PubMed

    Wanhainen, Anders; Mani, Kevin; Golledge, Jonathan

    2016-02-01

    The natural course of many abdominal aortic aneurysms (AAA) is to gradually expand and eventually rupture and monitoring the disease progression is essential to their management. In this publication, we review surrogate markers of AAA progression. AAA diameter remains the most widely used and important marker of AAA growth. Standardized reporting of reproducible methods of measuring AAA diameter is essential. Newer imaging assessments, such as volume measurements, biomechanical analyses, and functional and molecular imaging, as well as circulating biomarkers, have potential to add important information about AAA progression. Currently, however, there is insufficient evidence to recommend their routine use in clinical practice. PMID:26715680

  19. Spinal ischemia following abdominal aortic surgery.

    PubMed

    Ferguson, L R; Bergan, J J; Conn, J; Yao, J S

    1975-03-01

    Serious spinal cord ischemia may follow infrarenal abdominal aortic surgery. Five cases are summarized and added to the 23 previously published cases in order to identify this syndrome, emphasize its importance, and draw attention to the possibility of spontaneous recovery which may occur. The multifactorial complex which comprises each patient's clinical picture clouds a precise and specific cause for paraplegia in these cases. However, neither hypotension, steal phenomena nor emboli are necessary for completion of the syndrome. The relevant spinal cord arterial anatomy indicates that the common anomalies which occur favor development of spinal cord ischemia in the arteriosclerotic population which requires aortic surgery. No means of prevention is possible at this time.

  20. [Abdominal pain and gastritis in children].

    PubMed

    Gottrand, Frédéric

    2011-05-01

    Gastritis, as gastric and duodenal ulcer, is associated with epigastric abdominal pain, influenced by meals, associated with nausea and vomiting and weight loss. Diagnosis s based upon upper gastrointestinal fibre endoscopy that allows direct visualisation of gastric lesions and realization of antral and fundic biopsies for anatomopathology and culture. Main etiologies are drug induced, stress and H. pylori infection. Looking for H. pylori is only justified in those children presenting with digestive symptoms requiring upper gastrointestinal endoscopy. Therefore non invasive test are only indicated for control of eradication. Treatment of H. pylori infection associates proton pump inhibitors and two antibiotics for 7 to 10 days.

  1. [Unusual abdominal complication of ventriculoperitoneal shunt].

    PubMed

    Guillén, A; Costa, J M; Castelló, I; Claramunt, E; Cardona, E

    2002-10-01

    The most common complications after CSF shunting to treat hydrocephalus are shunt infection and obstruction. Although ventriculoperitoneal (VP) diversion of the CSF using artificial shunt devices is an accepted method for the management of hydrocephalus, high rates of various complications have been reported, ranging from 24% to 47%. Among these, abdominal complications account for approximately 25%. The incidence of bowel perforation by shunt-catheter is known to be as low as 0.1-0.7%. We describe a case of migration af a peritoneal catheter through a congenital hernia of Morgagni.

  2. [Pheochromocytoma with retroperitoneal hemorrhage after abdominal trauma].

    PubMed

    Hayashi, Takuji; Nin, Mikio; Yamamoto, Yoshiyuki; Kamoto, Akihito; Ujike, Takeshi; Nishimura, Kensaku; Miyoshi, Susumu

    2009-11-01

    A 35-year-old man was delivered to the emergency room complaining of right flank pain because of blunt abdominal trauma sustained while playing baseball. Enhanced computed tomography (CT) revealed a right adrenal mass and fluid collection around the mass. We diagnosed the mass as pheochromocytoma by endocrinological examination and radioisotopical imaging test. After absorption of the hematoma three months after the injury, laparoscopic right adrenalectomy was performed. He had an uncomplicated postoperative course without supplementation of catecholamine. Pathological findings were compatible with pheochromocytoma. Eight months after the operation, he had no evidence of recurrence.

  3. Large posterior abdominal masses: computed tomographic localization.

    PubMed

    Engel, I A; Auh, Y H; Rubenstein, W A; Whalen, J P; Kazam, E

    1983-10-01

    Large posterior abdominal masses, particularly those in the right upper abdomen, may be difficult to localize correctly into the peritoneal or retroperitoneal compartments. The following signs were found to be reliable CT indicators of retroperitoneal location: obliteration of the perinephric fat outlining the psoas muscle; lateral displacement of the fat outlining the posterior right lobe of the liver; rotation of the intrahepatic portal veins to the left; anterior displacement of the inferior vena cava and renal veins; and anterior displacement of the ascending colon, descending duodenum, or pancreatic head.

  4. [Treatment of thoracic and abdominal cavity perforation complicated by Henoch-Schonlein purpura nephritis in a patient with high-voltage electric burn].

    PubMed

    Zhang, Wei; Xie, Wei-guo; Min, Wei-xiong; Wang, De-yun; Zhang, Jia; Wan, Shi-yong

    2013-10-01

    A 55-year-old male patient suffered from severe high-voltage electric burn with an area of 20%TBSA full-thickness injury. The injury involved the distal end of left upper limb, right trunk, and whole abdominal wall. Fracture of the 7th-10th ribs was found in the right side of chest, with perforation of abdominal cavity, and bilateral pleural effusion was found. Part of the small intestine was necrotic and exposed. At the early stage, xeno-acellular dermal matrix was grafted after debridement of abdominal wound; peritoneal lavage was performed; negative pressure drainage was performed in orificium fistula of intestine for promoting the adhesion between perforated intestine and abdominal scar. Two orificium fistulas formed after closure of abdominal granulation wound by autologous skin grafting. Eschar of chest wall and denatured ribs were retained. The risk of infection of thoracic cavity was decreased by promoting the adhesion between lung tissue and chest wall. During the treatment, the patient was diagnosed with Henoch-Schonlein purpura nephritis by renal biopsy, with the symptoms of purpura in the lower limbs, heavy proteinuria, severe hypoalbuminemia, edema, etc. After control of kidney damage by immunosuppressive treatment instead of glucocorticoid, alleviation of the levels of proteinuria and blood albumin, free latissimus dorsi myocutaneous flap was excised to repair chest wall, and free skin graft was excised to repair intestinal fistula. After all the wounds were successfully covered, the patient was treated with glucocorticoid combined with immunosuppressants for more than 1 year. The patient was followed up for 3 years, and his renal function was completely recovered with satisfactory clinical outcome.

  5. Abdominal Compartment Syndrome: Risk Factors, Diagnosis, and Current Therapy

    PubMed Central

    Luckianow, Gina M.; Ellis, Matthew; Governale, Deborah; Kaplan, Lewis J.

    2012-01-01

    Abdominal compartment syndrome's manifestations are difficult to definitively detect on physical examination alone. Therefore, objective criteria have been articulated that aid the bedside clinician in detecting intra-abdominal hypertension as well as the abdominal compartment syndrome to initiate prompt and potentially life-saving intervention. At-risk patient populations should be routinely monitored and tiered interventions should be undertaken as a team approach to management. PMID:22720147

  6. Cost and Reimbursement for Three Fibroid Treatments: Abdominal Hysterectomy, Abdominal Myomectomy, and Uterine Fibroid Embolization

    SciTech Connect

    Goldberg, Jay Bussard, Anne; McNeil, Jean; Diamond, James

    2007-02-15

    Purpose. To compare costs and reimbursements for three different treatments for uterine fibroids. Methods. Costs and reimbursements were collected and analyzed from the Thomas Jefferson University Hospital decision support database from 540 women who underwent abdominal hysterectomy (n 299), abdominal myomectomy (n = 105), or uterine fibroid embolization (UFE) (n = 136) for uterine fibroids during 2000-2002. We used the chi-square test and ANOVA, followed by Fisher's Least Significant Difference test, for statistical analysis. Results. The mean total hospital cost (US$) for UFE was $2,707, which was significantly less than for hysterectomy ($5,707) or myomectomy ($5,676) (p < 0.05). The mean hospital net income (hospital net reimbursement minus total hospital cost) for UFE was $57, which was significantly greater than for hysterectomy (-$572) or myomectomy (-$715) (p < 0.05). The mean professional (physician) reimbursements for UFE, hysterectomy, and myomectomy were $1,306, $979, and $1,078, respectively. Conclusion. UFE has lower hospital costs and greater hospital net income than abdominal hysterectomy or abdominal myomectomy for treating uterine fibroids. UFE may be more financially advantageous than hysterectomy or myomectomy for the insurer, hospital, and health care system. Costs and reimbursements may vary amongst different hospitals and regions.

  7. Intra-abdominal pulmonary secuestration as an exceptional cause of abdominal mass in the adult☆

    PubMed Central

    Moreno-Sanz, C.; Herrero Bogajo, M.L.; Picazo-Yeste, J.; Morandeira Rivas, A.; Manzanera-Diaz, M.; Sedano-Vizcaino, C.

    2013-01-01

    INTRODUCTION Pulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue isolated from the pulmonary system. PSs are classified into intralobar type and intra-abdominal PS that represents only 2.5% of cases. There are 20 cases of PS reported in adults and only two were managed by laparoscopic approach. We report a case of intra-abdominal PS mimicking a gastroesophageal duplication cyst in an adult. Besides its rarity, this is the first intra-abdominal PS in an adult managed by an anterior laparoscopic approach. PRESENTATION OF CASE A 60-year-old female patient had had epigastric and left upper quadrant pain for several days. Physical examination was normal. Image test were consistent with a gastroesophageal duplication. The patient was taken to the operating room for laparoscopic exploration and resection. The pathological diagnosis was extralobar pulmonary sequestration. DISCUSSION Less than 20 cases of PS have been reported in adults and only two cases were managed by a lateral laparoscopic approach. In contrast to these reports, we used an anterior approach due to the GEJ suspected origin of the mass. CONCLUSION Extralobar intra-abdominal PS is an extremely rare condition during adulthood but this diagnosis should be included in the differential diagnosis of a left-sided suprarenal mass. Due to the difficulty in achieving a definitive preoperative diagnosis, surgery is recommended. Laparoscopic resection is safe and effective but careful preoperative imaging studies are recommended in order to plan the most suitable approach. PMID:24091075

  8. Prevalence of abdominal migraine and recurrent abdominal pain in a Japanese clinic.

    PubMed

    Hikita, Toshiyuki

    2016-07-01

    Prevalence of abdominal migraine (AM) and recurrent abdominal pain (RAP) was evaluated in patients who visited Hikita Pediatric Clinic between May 2010 and April 2015. Patient data were collected prospectively using a questionnaire. Out of a total of 3611 cases, observed prevalence was 2.44% for repeated abdominal pain over a period of ≥3 months, 1.47% for RAP, and 0.19% for AM. Duration of abdominal pain was longer for AM than for non-AM RAP. Certain clinical features were significantly different between AM and non-AM RAP. No correlations were found among age at onset, frequency of attack, and duration of attack for various types of RAP. It was difficult to determine useful diagnostic criteria for distinguishing between AM and non-AM RAP. They did not appear to be separate disease entities but, instead, lie on a disease spectrum. The present prevalence of AM (0.19%) was lower than that in many previous studies from countries other than Japan. PMID:27460403

  9. 5. Detail of bin wall, showing the thinner exterior wall ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. Detail of bin wall, showing the thinner exterior wall next to the inner wall with its alternating courses of channel tile and hollow tile. - Saint Anthony Elevator No. 3, 620 Malcom Avenue, Southeast, Minneapolis, Hennepin County, MN

  10. 22. SIDE WALL CONSTRUCTION, NORTH TRAINING WALL, LOOKING WEST FROM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. SIDE WALL CONSTRUCTION, NORTH TRAINING WALL, LOOKING WEST FROM THE SAME POINT AS VIEW NO. 21. - Oakland Harbor Training Walls, Mouth of Federal Channel to Inner Harbor, Oakland, Alameda County, CA

  11. The effect of age on the distensibility of the abdominal aorta of man.

    PubMed

    Newman, D L; Lallemand, R C

    1978-08-01

    The variation with age in distensibility and the dimensions of the abdominal aorta at the bifurcation have been measured in 43 fresh human cadavers. The age range was from birth to 69 years, both sexes being represented. Patients with vascular disease were excluded. Barium sulfate infused into the aorta through an iliac artery enabled the change in diameter to be measured from a roentgenogram with change in pressure. Incremental strain value could thus be calculated. Strain value increased from 0.02 at birth to a maximum at the end of the first decade of life and then decreased to less than 0.01 by the age of 70 years. Aortas in the age group of four to 11 years showed less stiffness with increasing pressure than at other ages. Variations of strain with age correlate with alterations in the ratio of aortic wall collagen to elastin in the young. An increase in the thickness of the wall and an atheroma, in response to prolonged hemodynamic stress, account for increased stiffness in the older age groups. Other age and disease factors may play a part, but further work is required in man to examine the role of relative wall thickness, elastic modulus and alteration in wall structure in determining the variation of aortic distensibility with age reported herein.

  12. An Experimental and Numerical Comparison of the Rupture Locations of an Abdominal Aortic Aneurysm

    PubMed Central

    Doyle, Barry J.; Corbett, Timothy J.; Callanan, Anthony; Walsh, Michael T.; Vorp, David A.; McGloughlin, Timothy M.

    2009-01-01

    Purpose: To identify the rupture locations of idealized physical models of abdominal aortic aneurysm (AAA) using an in-vitro setup and to compare the findings to those predicted numerically. Methods: Five idealized AAAs were manufactured using Sylgard 184 silicone rubber, which had been mechanically characterized from tensile tests, tear tests, and finite element analysis. The models were then inflated to the point of rupture and recorded using a high-speed camera. Numerical modeling attempted to confirm these rupture locations. Regional variations in wall thickness of the silicone models was also quantified and applied to numerical models. Results: Four of the 5 models tested ruptured at inflection points in the proximal and distal regions of the aneurysm sac and not at regions of maximum diameter. These findings agree with high stress regions computed numerically. Wall stress appears to be independent of wall thickness, with high stress occurring at regions of inflection regardless of wall thickness variations. Conclusion: According to these experimental and numerical findings, AAAs experience higher stresses at regions of inflection compared to regions of maximum diameter. Ruptures of the idealized silicone models occurred predominantly at the inflection points, as numerically predicted. Regions of inflection can be easily identified from basic 3-dimensional reconstruction; as ruptures appear to occur at inflection points, these findings may provide a useful insight into the clinical significance of inflection regions. This approach will be applied to patient-specific models in a future study. PMID:19642790

  13. [Ruptured abdominal aortic aneurysm. A rare form of presentation].

    PubMed

    Rettedal, E A; Vennesland, O

    1993-05-10

    In most cases a ruptured abdominal aortic aneurism is dramatic, with rapid deterioration of the clinical condition of the patient. With abdominal and back pain, pulsatile tumour, and development of bleeding shock the diagnosis is obvious. In some cases the symptoms are not clear and the condition can be misinterpreted. The authors describe a case to illustrate this. A 74 year-old male was admitted to hospital with vague abdominal pain and left inguinal hernia. It later turned out that a ruptured abdominal aortic aneurism was the reason for his symptoms and signs. 14 similar cases are reported in the literature. PMID:8332976

  14. [Abdominal pseudocyst as a complication of ventriculoperitoneal shunt].

    PubMed

    Shakir, Shawnim; Hegelund, Sture

    2013-09-16

    The abdominal pseudocyst is an unfrequent complication in patients with ventriculoperitoneal shunts. Although many cases have been reported in children, it is rare in adult patients. However, a 47-year-old man with congenital hydrocephalus who had been treated with ventriculoperitoneal shunt since the age of three months, was admitted to hospital due to abdominal pain. He was eventually diagnosed radiologically as having an abdominal pseudocyst. Despite this complication being rare, especially in adults, it should be highly suspected whenever an abdominal cyst co-occurs with a ventriculoperitoneal shunt.

  15. Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings*

    PubMed Central

    Vermelho, Marli Batista Fernandes; Correia, Ademir Silva; Michailowsky, Tânia Cibele de Almeida; Suzart, Elizete Kazumi Kuniyoshi; Ibanês, Aline Santos; Almeida, Lanamar Aparecida; Khoury, Zarifa; Barba, Mário Flores

    2015-01-01

    Objective To evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis. Materials and Methods Retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis. Results Abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients. Conclusion Computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis. PMID:25987748

  16. Intra-abdominal bronchogenic cyst: report of five cases.

    PubMed

    Choi, Kang Kook; Sung, Ji-Youn; Kim, Jung-Sun; Kim, Min Jung; Park, Hyojun; Choi, Dong Wook; Choi, Seong Ho; Heo, Jin Seok

    2012-05-01

    An intra-abdominal bronchogenic cyst (BC) is a very rare congenital anomaly caused by abnormal budding of the developing tracheobronchial tree. Intra-abdominal BCs are reported as retroperitoneal masses in most cases, many of which are located on the left side of the midline, the perigastric area, the left adrenal gland, or the superior body of the pancreas. Intra-abdominal BCs are frequently misdiagnosed due to the rarity, location, and variable cystic content. We report five patients with intra-abdominal BCs who underwent surgery in a single institution.

  17. Necrotizing fasciitis of anterior abdominal wall following cesarean section in a low-risk patient

    PubMed Central

    Chhetry, Manisha; Banerjee, Basudeb; Subedi, Shanti; Koirala, Ashok

    2016-01-01

    We report a case of a mono-microbial post-cesarean necrotizing fasciitis caused by methicillin resistant Staphylococcus aureus, in a low-risk healthy woman who presented with acute fulminant infection, sepsis and features of multi-organ dysfunction syndrome on sixth post-operative day. Aggressive management with multiple surgical debridement and supportive therapy was the key to favorable outcome in this case. PMID:27402541

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

    PubMed

    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.

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

    PubMed

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

    2016-01-01

    Surgical wound healing applications require bioprosthetics that promote cellular infiltration and vessel formation, metrics associated with increased mechanical strength and resistance to infection. Porcine acellular lung matrix is a novel tissue scaffold known to promote cell adherence while minimizing inflammatory reactions. In this study, we evaluate the capacity of porcine acellular lung matrix to sustain cellularization and neovascularization in a rat model of subcutaneous implantation and chronic hernia repair. We hypothesize that, compared to human acellular dermal matrix, porcine acellular lung matrix would promote greater cell infiltration and vessel formation. Following pneumonectomy, porcine lungs were processed and characterized histologically and by scanning electron microscopy to demonstrate efficacy of the decellularization. Using a rat model of subcutaneou implantation, porcine acellular lung matrices (n = 8) and human acellular dermal matrices (n = 8) were incubated in vivo for 6 weeks. To evaluate performance under mechanically stressed conditions, porcine acellular lung matrices (n = 7) and human acellular dermal matrices (n = 7) were implanted in a rat model of chronic ventral incisional hernia repair for 6 weeks. After 6 weeks, tissues were evaluated using hematoxylin and eosin and Masson's trichrome staining to quantify cell infiltration and vessel formation. Porcine acellular lung matrices were shown to be successfully decellularized. Following subcutaneous implantation, macroscopic vessel formation was evident. Porcine acellular lung matrices demonstrated sufficient incorporation and showed no evidence of mechanical failure after ventral hernia repair. Porcine acellular lung matrices demonstrated significantly greater cellular density and vessel formation when compared to human acellular dermal matrix. Vessel sizes were similar across all groups. Cell infiltration and vessel formation are well-characterized metrics of incorporation associated with improved surgical outcomes. Porcine acellular lung matrices are a novel class of acellular tissue scaffold. The increased cell and vessel density may promote long-term improved incorporation and mechanical properties. These findings may be due to the native lung scaffold architecture guiding cell migration and vessel formation. Porcine acellular lung matrices represent a new alternative for surgical wound healing applications where increased cell density and vessel formation are sought. PMID:26977287

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

    PubMed Central

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

    2016-01-01

    Surgical wound healing applications require bioprosthetics that promote cellular infiltration and vessel formation, metrics associated with increased mechanical strength and resistance to infection. Porcine acellular lung matrix is a novel tissue scaffold known to promote cell adherence while minimizing inflammatory reactions. In this study, we evaluate the capacity of porcine acellular lung matrix to sustain cellularization and neovascularization in a rat model of subcutaneous implantation and chronic hernia repair. We hypothesize that, compared to human acellular dermal matrix, porcine acellular lung matrix would promote greater cell infiltration and vessel formation. Following pneumonectomy, porcine lungs were processed and characterized histologically and by scanning electron microscopy to demonstrate efficacy of the decellularization. Using a rat model of subcutaneou implantation, porcine acellular lung matrices (n = 8) and human acellular dermal matrices (n = 8) were incubated in vivo for 6 weeks. To evaluate performance under mechanically stressed conditions, porcine acellular lung matrices (n = 7) and human acellular dermal matrices (n = 7) were implanted in a rat model of chronic ventral incisional hernia repair for 6 weeks. After 6 weeks, tissues were evaluated using hematoxylin and eosin and Masson’s trichrome staining to quantify cell infiltration and vessel formation. Porcine acellular lung matrices were shown to be successfully decellularized. Following subcutaneous implantation, macroscopic vessel formation was evident. Porcine acellular lung matrices demonstrated sufficient incorporation and showed no evidence of mechanical failure after ventral hernia repair. Porcine acellular lung matrices demonstrated significantly greater cellular density and vessel formation when compared to human acellular dermal matrix. Vessel sizes were similar across all groups. Cell infiltration and vessel formation are well-characterized metrics of incorporation associated with improved surgical outcomes. Porcine acellular lung matrices are a novel class of acellular tissue scaffold. The increased cell and vessel density may promote long-term improved incorporation and mechanical properties. These findings may be due to the native lung scaffold architecture guiding cell migration and vessel formation. Porcine acellular lung matrices represent a new alternative for surgical wound healing applications where increased cell density and vessel formation are sought. PMID:26977287

  1. Deep burn of hand and forearm treated by abdominal wall flap. A case report.

    PubMed

    Chiummariello, Stefano; Del Torto, Giuseppe; Maffia, Romano; Pataia, Elisabetta; Alfano, Carmine

    2015-06-24

    Le ustioni della mano sono sempre state uno dei maggiori problemi per i chirurghi ricostruttori a causa della sua particolare anatomia e delle sue complesse funzioni. Una guarigione spontanea di lesioni profonde in queste aree può portare a risultati catastrofici: una copertura cutanea adeguata è fondamentale per tutte le funzioni. La copertura precoce dei tessuti molli residuanti è fondamentale al fine di evitare la formazione di contratture disabilitanti che con il tempo potrebbero determinare anchilosi articolare e retrazione tendinea. Escissione precoce e innesti cutanei rappresentano la terapia standard per le ustioni della mano; in alcuni casi quest’approccio è inapplicabile e, pertanto, il ricorso ai lembi diventa inevitabile. In questo articolo riportiamo un caso di ustione complessa del dorso della mano trattata in prima istanza con innesti cutanei e, quindi, con un lembo addominale, riuscendo ad ottenere un’ottima copertura ed un buon recupero delle funzioni.

  2. Pneumobilia After Penetrating Trauma Abdominal Wall with no Injury to the Biliary Tree- A Case Report.

    PubMed

    Sandhu, Sartaj Singh; Sampley, Sunil K; Chhabra, Kapil

    2013-06-01

    Pneumobilia denotes an abnormal connection between the gastrointestinal and the biliary tracts. In the absence of surgically created anastomosis between the bowel and the bile duct, the common causes for pneumobilia are gallstone obstruction, endoscopic interventions or emphysematous cholecystitis. We present the case of a young male with traumatic pneumobilia with gastric perforation and a tear in the mesentery of the small gut following penetrating trauma in the form of stab in the abdomen.

  3. [Percutaneous gastrostomy complicated with abdominal wall hematoma; severe anemia secondary to percutaneous endoscopic gastrostomy].

    PubMed

    Chu, D; Chamorro, S; Arrieta, F; Cobo, M E; Calañas, A; Botella, J I; Balsa, J; Zamarrón, I; Vázquez, C

    2012-01-01

    Endoscopic percutaneous gastrostomy (PEG) is a safe and effective procedure that offers clear advantages over nasogastric tube feeding to ensure adequate nutrition in patients with swallowing problems who have an intact digestive tract. With proper placement and monitoring methodology there are few complications in both the peritrack procedure as in the long run. However, despite being considered a safe technique it is not devoided of serious complications. We report a patient with dysphagia, requiring percutaneous endoscopic gastrostomy placement developing a severe anemia with severe subcutaneous hematoma, given the exceptional case and literature review.

  4. The anterolateral thigh flap for complicated abdominal wall reconstruction after giant incisional hernia repair.

    PubMed

    Berrevoet, F; Martens, T; Van Landuyt, K; de Hemptinne, B

    2010-01-01

    In the management of giant incisional hernias with loss of domain several surgical obstacles have to be addressed. Adequate coverage of the defect using mesh, sufficient local tissue advancement and prevention of wound and mesh infections are prerequisites for success. We present a case of a complicated giant incisional hernia repair after oncologic surgery, in which we chose for an intraabdominal mesh repair using a composite mesh. The patient developed a wound dehiscence and mesh infection, successfully treated with negative pressure therapy followed by a free ALT perforator flap. Several surgical techniques are discussed to manage these complicated hernias, such as progressive pneumoperitoneum, the component separation technique and the importance of soft tissue coverage (e.g. anterolateral thigh flap). In cases of wound complications, negative pressure therapy and new soft tissue coverage are discussed.

  5. Fatigue and cardiorespiratory function following abdominal surgery.

    PubMed

    Christensen, T; Bendix, T; Kehlet, H

    1982-07-01

    Subjective feelings of fatigue were assessed before operation and 10, 20 and 30 days after uncomplicated elective abdominal surgery in 16 otherwise healthy patients, using a constructed fatigue scale model. In addition, all patients had an orthostatic stress test performed at the same times. Six of the patients also underwent a bicycle ergometer test measuring heart rate and oxygen consumption. Subjective feelings of fatigue were increased (P less than 0.01) at all three postoperative observations, and only 5 of 16 patients returned to their preoperative level. The increased subjective feeling of fatigue correlated positively (RS = 0.53, P less than 0.001) with the increased pulse rate seen during orthostatic stress after operation. Heart rate was about 5 per cent higher (n.s.) after operation when bicycling at the same work loads, while oxygen consumption decreased by about 2 per cent (P less than 0.01) at all three postoperative bicycle tests. It is concluded that even electric uncomplicated abdominal surgery is followed by a pronounced feeling of fatigue, which may persist 1 month after surgery in about one-third of patients. The fatigue scale model seems applicable for future studies on the pathogenesis and treatment of the postoperative fatigue syndrome.

  6. Abdominal aneurysm and horseshoe kidney: a review.

    PubMed Central

    Bietz, D S; Merendino, K A

    1975-01-01

    Two patients with aortic abdominal aneurysms in association with horseshoe kidney are presented, making a total of 34 cases recorded in the literature. In 29 patients, the aneurysm was resected and five patients were non-resectable. Because of the abnormalities in vascular supply to the abnormal kidney, it is important to diagnose the combination of aneurysm and horseshoe kidney preoperatively. An error in diagnosis should be unusual if an intravenous pyelogram is routinely obtained on all patients. This study may reveal abnormalities which will allow the diagnosis of horseshoe kidney to be made or suspected. If the intravenous pyelogram is abnormal, it should be followed by an aortogram. This may substantiate the diagnosis of aneurysm and horseshoe kidney and provide the necessary detailed information regarding the pattern of blood supply and its relationship to functioning tissue. The amount and disposition of functioning renal parenchyma may be further amplified by renal scan. If this sequence is followed, the unanticipated combination of abdominal aneurysm and horseshoe kidney should be rare. PMID:1130850

  7. Methods for abdominal respiratory motion tracking.

    PubMed

    Spinczyk, Dominik; Karwan, Adam; Copik, Marcin

    2014-01-01

    Non-invasive surface registration methods have been developed to register and track breathing motions in a patient's abdomen and thorax. We evaluated several different registration methods, including marker tracking using a stereo camera, chessboard image projection, and abdominal point clouds. Our point cloud approach was based on a time-of-flight (ToF) sensor that tracked the abdominal surface. We tested different respiratory phases using additional markers as landmarks for the extension of the non-rigid Iterative Closest Point (ICP) algorithm to improve the matching of irregular meshes. Four variants for retrieving the correspondence data were implemented and compared. Our evaluation involved 9 healthy individuals (3 females and 6 males) with point clouds captured in opposite breathing phases (i.e., inhalation and exhalation). We measured three factors: surface distance, correspondence distance, and marker error. To evaluate different methods for computing the correspondence measurements, we defined the number of correspondences for every target point and the average correspondence assignment error of the points nearest the markers.

  8. Abdominal Drainage Following Appendectomy and Cholecystectomy

    PubMed Central

    Stone, H. Harlan; Hooper, C. Ann; Millikan, William J.

    1978-01-01

    Consecutive patients undergoing emergency appendectomy (283) or urgent cholecystectomy (51) were prospectively studied for the development of post-operative incisional or peritoneal sepsis. Severity of the original peritoneal infection was carefully recorded, while use of a Penrose dam to drain the peritoneum was randomized according to pre-assigned hospital number. Both aerobic and anaerobic cultures were taken from the abdomen at the time of operation as well as from all postoperative infectious foci. Results demonstrated no essential differences in incidence of wound and peritoneal infection following appendectomy for simple or suppurative appendicitis (187) or following cholecystectomy for acute cholecystitis (51). However, with gangrenous or perforative appendicitis (94), incisional and intra-abdominal infection rates were 43% and 45%, respectively, when a drain was used; yet only 29 and 13%, respectively, without a drain. These latter differences were significant (p < 0.001). In addition, intra-abdominal abscesses were three times as likely to drain through the incision than along any tract provided by the rubber conduit. Cultures revealed that hospital pathogens accounted for a greater proportion of wound and peritoneal sepsis after cholecystectomy and appendectomy for simple or suppurative appendicitis if a drain had been inserted than if managed otherwise. By contrast, a mixed bacterial flora was responsible for most infections following appendectomy for gangrenous or perforated appendicitis, irrespective as to use of a drain. PMID:646499

  9. Methods for abdominal respiratory motion tracking

    PubMed Central

    Karwan, Adam; Copik, Marcin

    2014-01-01

    Non-invasive surface registration methods have been developed to register and track breathing motions in a patient’s abdomen and thorax. We evaluated several different registration methods, including marker tracking using a stereo camera, chessboard image projection, and abdominal point clouds. Our point cloud approach was based on a time-of-flight (ToF) sensor that tracked the abdominal surface. We tested different respiratory phases using additional markers as landmarks for the extension of the non-rigid Iterative Closest Point (ICP) algorithm to improve the matching of irregular meshes. Four variants for retrieving the correspondence data were implemented and compared. Our evaluation involved 9 healthy individuals (3 females and 6 males) with point clouds captured in opposite breathing phases (i.e., inhalation and exhalation). We measured three factors: surface distance, correspondence distance, and marker error. To evaluate different methods for computing the correspondence measurements, we defined the number of correspondences for every target point and the average correspondence assignment error of the points nearest the markers. PMID:24720494

  10. Constipation Risk in Patients Undergoing Abdominal Surgery

    PubMed Central

    Celik, Sevim; Atar, Nurdan Yalcin; Ozturk, Nilgun; Mendes, Guler; Kuytak, Figen; Bakar, Esra; Dalgiran, Duygu; Ergin, Sumeyra

    2015-01-01

    Background: Problems regarding bowel elimination are quite common in patients undergoing abdominal surgery. Objectives: To determine constipation risk before the surgery, bowel elimination during postoperative period, and the factors affecting bowel elimination. Patients and Methods: This is a cross-sectional study. It was conducted in a general surgery ward of a university hospital in Zonguldak, Turkey between January 2013 and May 2013. A total of 107 patients were included in the study, who were selected by convenience sampling. Constipation Risk Assessment Scale (CRAS), patient information form, medical and nursing records were used in the study. Results: The mean age of the patients was found to be 55.97 ± 15.74 (year). Most of the patients have undergone colon (37.4%) and stomach surgeries (21.5%). Open surgical intervention (83.2%) was performed on almost all patients (96.3%) under general anesthesia. Patients were at moderate risk for constipation with average scores of 11.71 before the surgery. A total of 77 patients (72%) did not have bowel elimination problem during postoperative period. The type of the surgery (P < 0.05), starting time for oral feeding after the surgery (P < 0.05), and mobilization (P < 0.05) were effective on postoperative bowel elimination. Conclusions: There is a risk for constipation after abdominal surgery. Postoperative practices are effective on the risk of constipation. PMID:26380107

  11. Swimming Near the Wall

    NASA Astrophysics Data System (ADS)

    Quinn, Daniel; Moored, Keith; Dewey, Peter; Lauder, George; Smits, Alexander

    2012-11-01

    The aerodynamic loads on rectangular panels undergoing heave and pitch oscillations near a solid wall were measured using a 6-axis ATI sensor. Over a range of Strouhal numbers, reduced frequencies and flexibilities, swimming near the wall was found to increase thrust and therefore the self-propelled swimming speed. Experimental particle image velocimetry revealed an asymmetric wake structure with a momentum jet angled away from the wall. Both the thrust amplification and the asymmetric wake structure were verified and investigated further using an in-house inviscid panel method code. Supported by ONR MURI Grant N00014-08-1-0642.

  12. [Differential diagnosis and treatment of complex renal cysts detected by ultrasound screening of the abdominal cavity organs].

    PubMed

    Ukhal', M I; Ukhal', E M; Kvasha, A N

    2014-01-01

    Ultrasound screening of the abdominal cavity organs was performed in 98 patients, and renal cysts were revealed in 31 patientsare. 11 (26,6%) of 31 patients had renal cysts with complex structure. In 4 patients, complex cysts were located in parapelvic zone, in 7 patients - in different parts of the renal parenchyma. Pharmaco-Doppler sonography and computed tomography with bolus contrast enhancement in 7 patients with complex parenchymal cysts had revealed indirect signs of a malignant process - septums, thickening of the walls of cysts and septums, foci of calcination, increased blood circulation in the thickened renal cyst walls, venous stasis on the periphery of cysts and renal medulla, increasing the density of the thickened walls. Results of morphological studies have confirmed the presence of a malignant process in 5 of these 7 patients. In 4 patients with parapelvic cysts malignant process in ectomized layers was not revealed.

  13. Identification of rupture locations in patient-specific abdominal aortic aneurysms using experimental and computational techniques.

    PubMed

    Doyle, Barry J; Cloonan, Aidan J; Walsh, Michael T; Vorp, David A; McGloughlin, Timothy M

    2010-05-01

    In the event of abdominal aortic aneurysm (AAA) rupture, the outcome is often death. This paper aims to experimentally identify the rupture locations of in vitro AAA models and validate these rupture sites using finite element analysis (FEA). Silicone rubber AAA models were manufactured using two different materials (Sylgard 160 and Sylgard 170, Dow Corning) and imaged using computed tomography (CT). Experimental models were inflated until rupture with high speed photography used to capture the site of rupture. 3D reconstructions from CT scans and subsequent FEA of these models enabled the wall stress and wall thickness to be determined for each of the geometries. Experimental models ruptured at regions of inflection, not at regions of maximum diameter. Rupture pressures (mean+/-SD) for the Sylgard 160 and Sylgard 170 models were 650.6+/-195.1mmHg and 410.7+/-159.9mmHg, respectively. Computational models accurately predicted the locations of rupture. Peak wall stress for the Sylgard 160 and Sylgard 170 models was 2.15+/-0.26MPa at an internal pressure of 650mmHg and 1.69+/-0.38MPa at an internal pressure of 410mmHg, respectively. Mean wall thickness of all models was 2.19+/-0.40mm, with a mean wall thickness at the location of rupture of 1.85+/-0.33 and 1.71+/-0.29mm for the Sylgard 160 and Sylgard 170 materials, respectively. Rupture occurred at the location of peak stress in 80% (16/20) of cases and at high stress regions but not peak stress in 10% (2/20) of cases. 10% (2/20) of models had defects in the AAA wall which moved the rupture location away from regions of elevated stress. The results presented may further contribute to the understanding of AAA biomechanics and ultimately AAA rupture prediction.

  14. Flagellar propulsion near walls

    NASA Astrophysics Data System (ADS)

    Evans, Arthur; Lauga, Eric

    2010-11-01

    Confinement and wall effects are known to affect the kinematics and propulsive characteristics of swimming microorganisms. When a solid body is dragged through a viscous fluid at constant velocity, the presence of a wall increases fluid drag, and thus the net force required to maintain speed has to increase. In contrast, recent optical trapping experiments have revealed that the propulsive force generated by human spermatozoa is decreased by the presence of boundaries. Here we use simple models to analytically elucidate the propulsive effects of a solid boundary on passively actuated filaments and model eukaryotic flagella. We show that in some cases, the increase in fluid friction induced by the wall can lead to a change in the waveform expressed by the flagella which results in a decrease of their propulsive force near a no-slip wall.

  15. Elevated expression of runt-related transcription factors in human abdominal aortic aneurysm.

    PubMed

    Dubis, J; Litwin, M; Michalowska, D; Zuk, N; Szczepanska-Buda, A; Grendziak, R; Baczynska, D; Barc, P; Witkiewicz, W

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a multifactorial disease of unknown etiology. AAA is caused by segmental weakening of the aortic walls and progressive aortic dilation leading to the eventual rupture of the aorta, accompanied by intense inflammation. Additionally, studies have indicated a close relationship between the pathogenesis and progression of AAA and cellular immune responses in aneurysm wall tissue. The Runt-related genes (RUNX) encode multifunctional mediators of the of intracellular signal transduction pathways in vascular remodeling, endothelial function, immune response and inflammation. The aim of this study was to evaluate the expression level of RUNX regulatory genes in AAA tissues and to assess the correlations between them. The study was performed on AAA wall-tissue samples obtained from patients with AAA during open aneurysm repair and normal aortic tissues collected from healthy organ donors. There are no proven clinical management strategies or pharmaco-therapeutics to prevent AAA progression once an AAA has been detected. Moreover, so far no biomarkers have been established to indicate the disease status of AAA. Hence, understanding the pathogenesis of AAA has recently become an increasing priority in basic and translational vascular research. We identified significantly higher mRNA and protein level of all of three Runt-related genes in aneurysmal aorta compared to a normal aorta. Increased expression of RUNX2 was demonstrated for the first time in abdominal aortic aneurysm tissue. Additionally, relationships between the activity of RUNX genes in the pathological tissue were identified. The results of elevated expression of RUNX genes and their relationships in the AAA tissues suggest the involvement of conserved Runt-related genes in the pathophysiology of AAA development. PMID:27358138

  16. Henoch-Schönlein purpura with preceding abdominal pain.

    PubMed

    Toshihiko, Kakiuchi; Tomonobu, Aoki

    2015-06-01

    Diagnosing HSP can be difficult, especially when abdominal symptoms precede the onset of characteristic palpable purpura (Chen MJ et al. 2005, World Gastroenterol., 11, 2354). Therefore, it is necessary to consider the possibility of HSP in patients with prolonged strong abdominal pain, even in cases without purpura.

  17. Henoch–Schönlein purpura with preceding abdominal pain

    PubMed Central

    Toshihiko, Kakiuchi; Tomonobu, Aoki

    2015-01-01

    Key Clinical Message Diagnosing HSP can be difficult, especially when abdominal symptoms precede the onset of characteristic palpable purpura (Chen MJ et al. 2005, World Gastroenterol., 11, 2354). Therefore, it is necessary to consider the possibility of HSP in patients with prolonged strong abdominal pain, even in cases without purpura. PMID:26185663

  18. Henoch-Schönlein purpura with preceding abdominal pain.

    PubMed

    Toshihiko, Kakiuchi; Tomonobu, Aoki

    2015-06-01

    Diagnosing HSP can be difficult, especially when abdominal symptoms precede the onset of characteristic palpable purpura (Chen MJ et al. 2005, World Gastroenterol., 11, 2354). Therefore, it is necessary to consider the possibility of HSP in patients with prolonged strong abdominal pain, even in cases without purpura. PMID:26185663

  19. Postprandial abdominal pain owing to isolated enteric duplication cyst in the superior mesenteric artery root: sonographic and magnetic resonance imaging features.

    PubMed

    Ko, Sheung-Fat; Ng, Shu-Hang; Huang, Fu-Chen; Sung, Ming-Tse; Hsieh, Chie-Song

    2011-04-01

    A 7-year-old girl presented to the emergency department with postprandial abdominal pain. An abdominal sonogram revealed a retroperitoneal septated cystic lesion. Magnetic resonance imaging showed a septated cystic lesion in the superior mesenteric artery (SMA) root with a vessel originating from the proximal SMA supplying the cyst wall and a deformed adjacent aortic contour. A laparotomy was performed and confirmed the presence of an isolated enteric duplication cyst with its own blood supply from the SMA and marked perilesional adhesions to the duodenal loop and aorta. Histopathologic study was consistent with a duplication. To our knowledge, this is the first report of isolated enteric duplication cyst in the superior mesenteric root with perilesional adhesion leading to postprandial abdominal pain, which was successfully relieved after surgery.

  20. [Abdominal ischemia and lesions of the pancreas].

    PubMed

    Myshanych, T V; Moskal', O M; Arkhiĭ, E Ĭ; Sozoniuk, O V

    2014-01-01

    The analysis of the results of 50 patients with diseases of coronary heart disease (25 pers.) And chronic pancreatitis (25 people) are submitted. Along with the standard test from these patients underwent Doppler-ultrasonography of abdominal aorta and its visceral branches. Conclusions: A characteristic feature of Doppler indices in AIC is to reduce Vps and Ved, and PI BbA, increase Vps, Ved, IR and PI after exercise in chBA, chC and BbA. At patients with CP with IHD feature is the increase in Ved and IR in the chC, and Ved and PI in BbA under act of loading Bleed a feature at CP with IHD must be taken into account for optimization of treatment of IHD at CP. PMID:25796868