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At least 109 records · Page 6Linked to original sources
PubMed2003

Abdominal wall endometriomas.

BACKGROUND: The diagnosis of abdominal wall endometriomas is often confused with other surgical conditions. METHODS: A retrospective study was made of 12 patients presenting with an abdominal wall mass, which proved to be endometrioma. RESULTS: Of a total of 297 patients of endometriosis treated in our hospital over a 7-year period, 12 (4%) had isolated abdominal wall endometriomas. Their mean age was 29.4 years. The presenting symptoms were abdominal mass (n = 12), cyclical (n = 5) or noncyclic pain (n = 7), dyspareunia and dysmenorrhea (n = 1). All patients had a history of gynecologic operations and presented, after an average of 1.9 years, with a tender mass (average 4 cm) at the previous incision site. Preoperative diagnosis was correct in 4 patients (33%) who presented with a cyclically painful abdominal mass. The others were diagnosed as incisional hernia (n = 4), "abdominal wall tumor" (n = 2), and inguinal hernia (n = 2). All patients underwent wide excision of their endometrioma; 2 required polytetrafluoroethylene patch grafting for the resulting fascial defect. The diagnosis was confirmed at frozen section or conventional histological examination in all patients. At follow-up, ranging from 4 months to 3 years, there was no recurrence of endometrioma. CONCLUSIONS: Scar endometrioma commonly presents as an abdominal mass with noncyclical symptoms. Imaging techniques are nonspecific and needle biopsy may confirm the diagnosis. Wide excision is the treatment of choice for abdominal wall endometrioma as well as for recurrent lesions.

Abdominal Pain↗
PubMed1996

Postoperative abdominal wall defects with enterocutaneous fistulae.

BACKGROUND: Abdominal wall dehiscence with an associated enterocutaneous fistula is a surgical complication with high morbidity and mortality. Management of the abdominal wall defect is complicated by the continued emergence of liquid bowel contents. PATIENTS AND METHODS: Large abdominal wall wounds of 10 patients with postoperative abdominal wall dehiscence and active enterocutaneous fistulae were managed with early skin grafting directly onto the granulated abdominal viscera. RESULTS: Skin graft take averaged 93 +/- 12%, and there were no perioperative complications related to the skin grafting procedure. Overall mortality was 1 out of 10 patients. Enterocutaneous fistula output did not prove overly injurious to the skin grafts. Wound care was simplified in all but 1 patient with fitting of an ostomy appliance. CONCLUSION: Temporary abdominal wall wound closure with skin grafts improved patient comfort and simplified wound care in a staged reconstructive approach to this surgical complication.

Abdominal Injuries↗
PubMed1997

[Limb-body wall malformation complex: an unusual developmental abnormality of the abdominal wall. Case report, clinicopathological and etiological implications].

Anterior abdominal wall defects are not too rare between developmental abnormalities. A case of abdominal wall defect associated with complex malformations diagnosed prenatally is reported in the paper. In the present case of limb-body wall complex a right sided abdominoschisis was associated with rotational abnormality of the lower limbs, clubfoot, scoliosis, meningomyelocele, lack of developed pelvic organs, consecutive dilatation of the upper urinary tract, anal atresia, lack of external genitalia, lack of diaphragm and hypoplastic lungs. Review of the pertinent literature has revealed over 100 cases that clearly indicate the possible phenotypic variation of the limb-body wall complex. These data add further evidence to support the existence of two different phenotypes and possibly pathogenesis under the heading of limb-body wall complex. The three principal theories on the possible aetiology of the complex are also discussed. Because the limb-body wall complex is incompatible with life, it is important to diagnose the lesions prenatally, and to differentiate them from other anterior abdominal wall defects. Serum alpha-fetoprotein measurement, and ultrasonographic examination are the key to prenatal diagnosis.

Abdominal Muscles↗
PubMed1993

Expanded polytetrafluoroethylene patch versus polypropylene mesh for the repair of contaminated defects of the abdominal wall.

Contaminated defects of the abdominal wall continue to be a significant problem for patients and surgeons. The lack of sufficient tissue may require the insertion of a prosthetic material. Polypropylene (PP) mesh is still the most widely used material for this purpose, although the propensity to induce extensive visceral adhesions and erosion of the skin or intestine is a well-known drawback. Expanded polytetrafluoroethylene (PTFE) patch has better mechanical properties and has a low potential for infection. Therefore, we used expanded PTFE patch to repair contaminated abdominal wall defects in three patients. In one patient, the postoperative course was uneventful. In the other two patients, the patch had to be removed for ongoing wound sepsis and because the patch disintegrated. In an experimental study, contaminated abdominal wall defects created in Wistar rats were repaired with expanded PTFE patch (PTFE group, n = 21) or PP (PP group, n = 21). Wound infection occurred in 16 rats in the PTFE group and in 14 rats in the PP group. Two rats in each group died. Two rats in the PTFE group died as a result of peritonitis, one rat in the PP group died as a result of ileus and one as a result of peritonitis. Incisional hernia was found to be significantly more frequent in the PTFE group (n = 13) than in the PP group (n = 3). Fistula formation was only found in three rats in the PP group. Adhesion formation was more pronounced in rats in the PP group. It is concluded that the expanded PTFE is unsuitable for the reconstruction of contaminated abdominal wall defects and that PP mesh is more suitable, although this material has a high risk of complications.

Abdominal Muscles↗
PubMed2001

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

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

Abdominal Muscles↗
PubMed2002

[Surgical strategies in the treatment of postoperative abdominal wall hernia complicated by other abdominal diseases in patients with morbid obesity].

Experience of stimultant operations performance in 113 patients with morbid obesity, coexistant with postoperative abdominal wall hernia (POAWH), was summarized. In the planned order 108 patients were operated on and for urgent indications--5. The approach was proposed for the choice of method and volume of operative intervention. The substantiated performance of stimultant operations for POAWH in patients with morbid obesity and other diseases of abdominal cavity organs constitutes the perspective trend in surgery, secures high medical-social and economic efficacy.

Abdominal Muscles↗
PubMed2003

Unusual congenital abdominal wall defect and review.

Abdominal wall defects distant from the umbilicus are very unusual. We describe a patient with a congenital defect adjacent and external to the lateral border of the recti muscles, rounded in shape, bilateral and symmetrical, but affecting different structures in each side, musculocutaneous agenesis in the left side and only muscle agenesis in the right one. The morphologic characteristics of the defect and the absence of associated anomalies, suggest that this anomaly may be the result of an event acting during phenogenesis. We consider that this defect is different from other structural abnormalities of the anterior abdominal wall which occur much earlier at certain periods of the embryogenesis. Though the etiology is speculative, we could postulate a disruptive origin of the defect of unknown cause.

Abdominal Wall↗
PubMed1995

Abdominal wall hernias in patients with abdominal aortic aneurysmal versus aortoiliac occlusive disease.

BACKGROUND: This study was undertaken to determine the incidence of ventral incisional hernias (VIHs) and inguinal hernias (IHs) in patients with abdominal aortic aneurysmal (AAA) versus those with aortoiliac occlusive disease (AIOD). PATIENTS AND METHODS: The medical records of 193 patients (128 with AAA and 65 with AIOD) who had undergone elective aortic reconstruction were reviewed to determine the number and location of abdominal wall hernias (AWHs). RESULTS: Forty-one AWHs (28 IHs and 13 VIHs) were detected in patients with AAA compared to 13 (11 IHs and 2 VIHs) in patients with AIOD. There was a significantly greater incidence of VIHs in patients with AAA versus patients with AIOD (10% versus 3%, P < 0.05) and recurrent AWHs (28% versus 19%, P < 0.01), but not of IHs (22% versus 17%). CONCLUSION: Patients with AAA have a higher incidence of VIHs and recurrent AWHs--without a corresponding increase in patient-related risk factors--than patients without aneurysm, suggesting that as yet unidentified etiologic factors may contribute to the development of AWHs in these patients.

Aorta, Abdominal↗
PubMed1990

Endometriosis of the abdominal wall.

Endometriosis of the abdominal wall typically occurs as a painful mass in a lower abdominal incision from previous cesarean section or hysterectomy. Most patients are young and in their active reproductive years. The histologic diagnosis requires a combination of either endometrial-like glands, endometrial stroma, or hemosiderin pigment. The diagnosis must be considered in any woman with an abdominal wall mass and a history of transabdominal gynecologic surgery. Wide excision offers the best chance to prevent recurrence.

Abdominal Muscles↗
PubMed1997

Simulation of ultrasonic pulse propagation through the abdominal wall.

Ultrasonic pulse propagation through the abdominal wall has been simulated using a model for two-dimensional propagation through anatomically realistic tissue cross sections. The time-domain equations for wave propagation in a medium of variable sound speed and density were discretized to obtain a set of coupled finite-difference equations. These difference equations were solved numerically using a two-step MacCormack scheme that is fourth-order accurate in space and second-order accurate in time. The inhomogeneous tissue of the abdominal wall was represented by two-dimensional matrices of sound speed and density values. These values were determined by processing scanned images of abdominal wall cross sections stained to identify connective tissue, muscle, and fat, each of which was assumed to have a constant sound speed and density. The computational configuration was chosen to simulate that of wavefront distortion measurements performed on the same specimens. Qualitative agreement was found between those measurements and the results of the present computations, indicating that the computational model correctly depicts the salient characteristics of ultrasonic wavefront distortion in vivo. However, quantitative agreement was limited by the two-dimensionality of the computation and the absence of detailed tissue microstructure. Calculations performed using an asymptotic straight-ray approximation showed good agreement with time-shift aberrations predicted by the full-wave method, but did not explain the amplitude fluctuations and waveform distortion found in the experiments and the full-wave calculations. Visualization of computed wave propagation within tissue cross sections suggests that amplitude fluctuations and waveform distortion observed in ultrasonic propagation through the abdominal wall are associated with scattering from internal inhomogeneities such as septa within the subcutaneous fat. These observations, as well as statistical analysis of computed and observed amplitude fluctuations, suggest that weak fluctuation models do not fully describe ultrasonic wavefront distortion caused by the abdominal wall.

Abdomen↗
PubMed1995

Abdominal wall endometriosis: sonographic diagnosis.

Abdominal wall endometriosis (AWE) often occurs in the surgical scar of a previous Caesarean section. In females with unexplained lower abdominal and pelvic pain who have had a C-section, the abdominal wall should be carefully examined to rule out AWE.

Abdominal Muscles↗
PubMed2006

Primary anterior abdominal wall actinomycosis.

Actinomycosis of the anterior abdominal wall is rare. We report a 50-year-old diabetic man who presented with a left hypochondrial mass of three weeks duration associated with fever. Abdominal computed tomography showed a 2 x 4 cm mass projecting from the internal abdominal wall associated with surrounding inflammation. The mass did not decrease after a week of intravenous antibiotics. Excision of the mass and primary closure of the abdominal wall were performed. The mass involved the deep muscles of anterior abdominal wall. The omentum was adherent to the parietal peritoneum underneath the mass. Microscopical examination of the mass was consistent with actinomycosis. The postoperative period was uneventful and the patient recovered completely. The patient received penicillin for six months.

Abdominal Muscles↗
PubMed1996

Experience with three prosthetic materials in temporary abdominal wall closure.

There are circumstances that make abdominal wall closure unsafe and technically impossible after laparotomy for trauma. In these difficult cases, prosthetic materials may be necessary to temporarily close the abdominal wall. To determine the optimal prosthetic in these instances, a retrospective chart review was conducted in our urban Level I trauma center. Twenty-five patients received 31 abdominal wall prostheses over a 4-year period. There were 7, 8, and 10 patients with 7 Marlex, 9 Dexon, and 15 Goretex prostheses, respectively. Each patient had only one type of prosthesis placed. The average age was 30.7 +/- 12.0 years, injury severity score was 20.3 +/- 7.4, and abdominal trauma index was 35.9 +/- 18.0; there was no significant difference in these values between groups. Eight patients died soon after the prosthesis was placed (average, 12.9 days) secondary to ongoing shock or multiple organ failure. Three of the seven surviving Goretex patients (43%) were intentionally left with small hernias. Three of the six Dexon patients (50%) were left with hernias; one of these eviscerated on day 150 and subsequently died, and the others have disabling gigantic hernias. Three of the four Marlex patients (75%) developed fistulae as a result of erosion into the small bowel or colon. One Marlex patient suffered with a chronically draining abdominal wound for 398 days prior to definitive closure. Goretex appears to be the best prosthetic for temporary abdominal wall closure because it causes less inflammatory reaction because of its smooth surface. It is therefore easier to retrieve at the time of definitive closure and carries less risk of fistula formation than other prostheses. Our Dexon patients suffered with gigantic hernias and one died because of complications of evisceration. We have abandoned the use of Marlex in abdominal wall closure because of the high incidence of fistula formation. We advocate the use of Goretex in temporary abdominal wall closure in this challenging group of patients.

Abdominal Injuries↗
PubMed2001

[A plastic surgery method in vast defects of the anterior abdominal wall].

The developed method of plastic repair of anterior abdominal wall's vast defects is intended for use in reconstructive-plastic herniology for closure in layers of total defects of the abdominal wall without reduction of abdominal cavities volume, in oncology and traumatology--for repair of abdominal wall's integrity after excision of massive tumors or damaged tissues. In correction by this method of large muscular-aponeurotic defects of abdominal wall the own tissues of the patient (greater omentum, hernial sac) and lavsan explants of author's construction are used maximally. New abdominal white line is formed, all the loted or insufficient tissues of abdominal wall are replaced. 88 patients with defects of anterior abdominal wall of different origin were operated by this method. Long-term results were followed up for 11 years, there was no recurrence, in 3 patients moderate relaxation in the area of hernioplasty was revealed, due to nonobservance of recommendations in early postoperative period. Patients with large hernias and defects of anterior abdominal wall should be operated in specialized surgical clinics.

Abdominal Muscles↗
PubMedDate not supplied

Abdominal wall CT: a pictorial essay.

Abdominal CT demonstrates clearly the anatomy of the abdominal wall. This radiographic technique may provide valuable information when pathology is suspected in this region or in the adjacent peritoneum. The muscles, subcutaneous tissues and vascular structures of the abdominal wall should be examined thoroughly when reading routine abdominal CT films. This paper reviews abnormalities identified involving the abdominal wall including hernias, masses, vessels, hematomas, abscesses, ascites, neuromuscular diseases and miscellaneous entities.

Abdominal Muscles↗
PubMed2004

Vascular tumors of the abdominal wall.

BACKGROUND: Vascular tumors of the abdominal wall are rare, benign congenital malformations that may cause pain or cosmetic disfigurement and are of significance for their ability to mimic more clinically aggressive tumors. There have been no previous reports of vascular tumors of the abdominal wall. This investigation reports the clinical presentation, diagnosis, and treatment of three patients with vascular tumors of the abdominal wall. METHODS: Magnetic resonance angiography (MRA) was used to identify feeding and draining vessels and to aid in operative planning for two patients; in a third patient, standard magnetic resonance imaging revealed the feeding vessels. RESULTS: MRA accurately identified the feeding and draining vessels and aided in operative planning, thus facilitating complete tumor resection. To date, patients have not experienced tumor recurrence. CONCLUSIONS: These cases suggest that MRA can be employed as a noninvasive imaging technique and should be the standard preoperative modality to plan the operative approach to vascular tumors of the abdominal wall.

Abdominal Wall↗
PubMed1990

Total abdominal wall reconstruction.

Total abdominal wall loss results in a difficult reconstructive problem. To obtain stable, durable soft-tissue coverage and restore fascial integrity, a number of reconstructive techniques are frequently required. Use of these techniques can achieve a functional and cosmetically acceptable reconstruction.

Abdominal Muscles↗