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At least 595 records · Page 33Linked to original sources
PubMed1982

Biomechanical studies of rabbit abdominal wall. Part II.--The mechanical properties of specimens in relation to length, width, and fibre orientation.

In a biomechanical investigation of tractus iliotibialis and abdominal wall tissue from rabbits, an analysis was made of the influence that the fibre orientation in specimens as well as the length and width of specimens has on the measured parameters. The mechanical testing was performed with a materials testing machine (Alvetron). The investigation showed that the mechanical characteristics of specimens, when the width was kept constant, depended upon the fibre orientation in the specimens and the length of the specimens. The investigation further demonstrated that in intact abdominal wall no proportionality exists between, on the one side, the width of specimens (2, 4, 6 and 8 mm) and, on the other, the breaking strength, the energy absorption, and the elastic stiffness, respectively. For the 6 day old abdominal wall wounds a proportionality, however, could be demonstrated between the 4 and 8 mm broad specimens on the one side and the breaking strength, the energy absorption, and the elastic stiffness on the other. A possible explanation of the difference between the mechanical characteristics of short and long specimens can be given by the theoretical possibility that the short specimens contain relatively more fibres running all the way through the specimen from clamp to clamp than do the long specimens. The consequences on biomechanical investigations rendered by the result of the analyses are discussed.

Abdominal Muscles↗
PubMed2000

Late complication following percutaneous cholecystostomy: retained abdominal wall gallstone.

A case of recurrent abdominal wall abscess following percutaneous cholecystostomy (PC) is presented. Transperitoneal PC was performed in an 82-year-old female with calculous cholecystitis. Symptoms resolved and the catheter was removed 29 days later. The patient came back 5 months later with a superficial abscess that was drained and 8 months post PC with a fistula discharging clear fluid. Ultrasonography revealed the tract adjacent to an area of inflammation containing a calculus, whereas CT failed to depict the stone. Subsequent surgery confirmed US findings. To our knowledge, this is the first report of a dislodged bile stone following percutaneous cholecystostomy.

Abdominal Abscess↗
PubMed1982

Surgical treatment of isolated abdominal wall metastasis in colorectal cancer.

Isolated abdominal wall recurrence, following resection of a primary large bowel adenocarcinoma, is an infrequent finding. Over a ten year period, 22 patients were submitted to en bloc resection of such localized neoplastic foci. In 13 cases, recurrent tumor was located in a previous midline or para median incision. Nine patients underwent palliative radiotherapy and/or chemotherapy once the recurrent disease was identified, and were operated on when uncontrolled progression was clinically evident. In all cases, 4-5 cm disease-free margins were obtained. In eight patients it was possible to close the defect primarily and 14 patients required marlex mesh. Twelve patients were alive at two years and ten patients at five-years follow-up mark. Mucin-producing or poorly differentiated adenocarcinoma had the worse prognosis. Synthetic prosthesis allowed for adequate resections with little morbidity and acceptable cosmesis. Symptomatic relief and long-term palliation can be achieved with aggressive surgery. The role of adjuvant chemotherapy and radiation therapy still needs to be evaluated. The aggressiveness of poorly differentiated and the mucin producing adenocarcinoma should temper radical surgical exercises.

Abdominal Muscles↗
PubMedDate not supplied

New anatomic repair of midline abdominal wall incisions extending to suprapubic region.

This article describes a new technique to close infraumbilical midline abdominal wall incisions extending to the suprapubic region. This repair is technically easy to perform, saves time, reduces the risk of bowel and bladder injury and takes into consideration the anatomical landmarks of the peritoneum, the rectus sheath and the arcuate line. Abdominal wall closure with this repair is especially useful in obese patients. Furthermore, with this repair the pelvic cavity is lined with smooth peritoneum, which may reduce postoperative adhesions in the pelvis. Technically easy to perform and saves time Very useful technique for obese patients Reduced risk of bowel and bladder injury Anatomical in nature Potentially minimizes postoperative adhesions.

Abdominal Wall↗
PubMed1987

Perinatal management of the fetus with an abdominal wall defect.

The antenatal diagnosis of abdominal wall defects has allowed improved perinatal management. For fetuses with associated anomalies, the options of elective termination or minimal intervention can be offered. Our ability to predict the extent of bowel damage in gastroschisis based on the ultrasound findings enables us to offer early delivery to those fetuses who are at high risk. The data are not clear at the present time whether cesarean section offers any advantage. These fetuses should, however, be delivered at a center which is capable of providing high level medical and surgical care to these potentially ill infants. Initial resuscitation of these neonates requires early insertion of an intravenous line and a nasogastric tube, the administration of antibiotics, sterile coverage of the eviscerated bowel, and careful attention to temperature instability. Neonates with gastroschisis should be operated on as soon as they are stable, whereas infants with omphalocele can be investigated for associated anomalies prior to surgery. Primary fascial closure is performed whenever possible. Where this is not possible, a staged repair using a silastic chimney achieves closure within 3-6 days. Skin coverage alone or nonoperative management is reserved for the few cases with giant omphalocele, associated anomalies, or poor operative risk. Decisions about primary versus delayed closure, while usually dictated by clinical judgement, can be aided by indirect measurement of intraabdominal pressure. Postoperative ventilation, and consideration of long-term nutritional needs, are also important parts of the perioperative management.

Abdominal Muscles↗
PubMed2006

[Abdominal wall hernias of unusual presentation].

INTRODUCTION: Abdominal wall hernias (AWH) of unusual presentation include Spigelian hernia (SH), obturator hernia (OH), lumbar hernia (LH) and intraparietal hernia (IPH), among others. Their diagnosis requires of a high index of suspicion and frequent use of imaging studies. PATIENTS AND METHOD: We performed a retrospective review of the AWH treated between 1990 and 2004. Of a total of 2,973 hernias, 16 (0.53%) were in infrequent locations: 12 SH (0.4%), 2 OH (0.06%), 1 LH (0.03%), 1 IPH (0.03%). All the SH showed a palpable mass. They were more frequent in men (7 men and 5 women). Emergency surgery was performed in 25%. When imaging studies were carried out, ultrasonography confirmed only 20% while computed tomography (CT) confirmed 100%. In all patients who underwent surgery for HS, the diagnosis was made preoperatively. Seven small defects were repaired by simple closure (with 1 recurrence); 5 were repaired by a polypropylene mesh cone through the anterior extraperitoneal route. Fifty percent were associated with other AWH. Two OH presented with intestinal obstruction and preoperative diagnosis was made by CT. One IPH also presented with intestinal obstruction and preoperative diagnosis was made by ultrasonography; in 2 patients intestinal resections were performed with mesh repair. The LH had a preoperative diagnosis of lipoma by CT. CONCLUSIONS: AWH of unusual presentation can present as acute complications. Treatment is indicated after diagnosis. Surgical repair can be performed by primary closure or mesh repair through the open or laparoscopic route. The most suitable repair technique for each type of hernia should be selected.

Aged↗
PubMed1997

[Ventrolateral hernias of the abdominal wall. The anatomicopathologic, clinical and therapeutic considerations].

Ventral lateral hernias of the abdominal wall are rare. On the basis of their location we can classify them as follows: hernias of the aponeurosis of the transversus muscle, hernias of the rectal sheath and transmuscular hernias of the iliac region. In a group of 3134 hernias of the abdominal wall observed in a period of 16 years, 11 ventral lateral hernias have been encountered (0.3%). The diagnosis often presents great difficulties as the symptoms and the clinical findings are not typical. They must be differentiated from hematomas of the rectus sheath, abscess or intra-abdominal processes. Echography and Computed Tomography have an important role in their detection. Nevertheless in some patients the true diagnosis is reached only intraoperatively. The treatment generally consists in surgical correction by layer closure of the fascial or muscular defect. In selected cases the use of prosthetic material and video laparoscopic repair are indicated.

Adult↗
PubMed2006

Abdominal-wall postherpetic pseudohernia.

Herpes zoster affects 10-20% of the general population. Motor complications sometimes occur in the segments corresponding to the involved sensory dermatomes causing abdominal wall pseudohernias. We present a case of a 57-year-old woman with herpes zoster characteristical rash following T11-T12 right dermatomes. Ten days after dermatologic manifestations onset, she had developed a protrusion at the abdominal wall on the right flank. The electroneuromyography confirmed axonal motor commitment, and morphological defects were ruled out by ultrasonography. The bulge totally disappeared after 4 months of observation. Postherpetic pseudohernia must be suspected when a patient develops signs and symptoms of motor dysfunction that coincide with or follow a herpes zoster eruption resulting in abdominal-wall herniation. A review of the literature concerning these extremely exceptional sequelae of herpes zoster is presented.

Diagnosis, Differential↗
PubMed1991

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

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

Abdominal Muscles↗
PubMed1995

Traumatic abdominal wall hernia.

Two cases of traumatic abdominal wall hernia, produced by impaction of the motorcycle handlebars, are reported. The mechanism of injury, clinical and radiologic diagnosis are discussed. Because of the high incidence of other associated intraabdominal injuries, early exploration and repair through a midline incision is advocated. Adequate debridement and solid repair of fascial planes with non-absorbable sutures are required to prevent recurrence. Primary closure of the musculofascial defect was performed in both reported cases and the recovery was uneventful.

Accidents, Traffic↗
PubMedDate not supplied

Elective repair of abdominal wall hernias in decompensated cirrhosis.

BACKGROUND/AIMS: Abdominal wall hernia is a common feature of decompensated cirrhosis. However, literature on elective hernia repair in these patients is limited. Here we report the experience of our center. METHODOLOGY: Eleven hernias (seven umbilical, three inguinal and one incisional) in nine patients with decompensated cirrhosis were repaired. The indication for operation was repeated incarceration in two patients and significant pain in four; three patients with umbilical hernias had ulceration and necrosis of the overlying skin. Pre-operatively, medical therapy of ascites was conducted at the hepatology unit. Umbilical hernias were treated with the classic Mayo repair; in all cases but two, this was buttressed with a prolene graft. One inguinal hernia was repaired with the plication-darn technique; the other two and the incisional hernia were repaired with prolene grafts. RESULTS: There was no mortality. One patient had a scrotal hematoma; two patients had leakage of ascites into the wound. Seven patients were followed up. Four patients died without recurrence after a median period of 12 months (range 6-22). The other patients have no recurrence at 1, 10 and 40 months post-operatively. CONCLUSIONS: Umbilical and inguinal hernias in patients with decompensated cirrhosis may be repaired safely on an elective basis. Control of ascites is vital for success.

Adult↗
PubMed2002

The use of three different mesh materials in the treatment of abdominal wall defects.

Various prosthetic materials have been proposed for the repair of abdominal wall defects. These materials offer tension-free repair and significantly lower recurrence rate. Their respective properties are related to such complications as seroma, infection, fistula formation, intestinal adhesions and removal. We compared the final outcome in treating abdominal wall defects in 56 patients with three different prosthetic materials: conventional polypropylene in a preperitoneal location, expanded polytetrafluoroethylene mesh, and hydrophilic membrane coated polyester mesh in an intraperitoneal location. The hydrophilic coated polyester group exhibited the lowest complication rate and the polypropylene group the highest.

Abdominal Muscles↗
PubMed1997

Cavernous sinus thrombosis secondary to abdominal wall abscess.

An 84-year-old Japanese woman had cavernous sinus thrombosis (CST) due to abdominal wall abscess. The diagnosis was delayed because abdominal wall abscess is an unfamiliar cause of CST, but a definite diagnosis was reached with the use of magnetic resonance imaging. We started intravenous antibiotic therapy against gram-positive and gram-negative organisms and the patient responded well, although the diagnosis was delayed.

Abdominal Abscess↗
PubMed2004

A rare left-sided abdominal wall defect.

A 4-hour-old boy is presented here, who was born with a large abdominal wall defect situated in the left flank. Silo closure was necessary due to the large size of the defect. A Medline search up to December 2002 revealed only 2 other left-sided abdominal wall defects distant from the umbilicus. The possible embryology of this anomaly is discussed.

Abdominal Wall↗
PubMedDate not supplied

Abdominal wall retraction during laparoscopic cholecystectomy.

Laparoscopic cholecystectomy has represented a potentially more morbid procedure than open cholecystectomy. Some of this morbidity has been due to complications associated with pneumoperitoneum. We have developed a technique that employs abdominal wall retraction during laparoscopic cholecystectomy and allows access to the right upper part of the abdomen without maintenance of pneumoperitoneum. Among 151 patients who underwent laparoscopic cholecystectomy using abdominal wall retraction there were no recognized adverse effects. Abdominal wall retraction enables the surgeon to minimize the risk of serious complications associated with pneumoperitoneum during laparoscopic cholecystectomy.

Abdominal Muscles↗
PubMed2006

The biology of hernias and the abdominal wall.

The fundamental mechanism for hernia formation is loss of the mechanical integrity of abdominal wall structural tissue that results in the inability to offset and contain intra-abdominal forces during valsalva and loading of the torso. There is evidence that genetic or systemic extracellular matrix disorders may predispose patients to hernia formation. There is also evidence that acute laparotomy wound failure leads to hernia formation and increases the risk of recurrent hernia disease. It may be that hernia formation is a heterogeneous disease, not unlike cancer, where one population of patients express an extracellular matrix defect leading to primary hernia disease, while other subsets of patients acquire a defective, chronic wound phenotype following failed laparotomy and hernia repairs. It is evident that an improved understanding of structural tissue matrix biology will lead to improved results following abdominal wall reconstructions.

Animals↗