SEARCH · PubMed Health

Results for “ABDOMINAL WALL”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources

PubMed2005

Abdominal wall abscess associated with perforated jejunal diverticulitis: report of a case.

We report a case of abdominal wall abscess caused by diverticulitis of the jejunum penetrating through the abdominal wall. A 53-year-old Japanese woman visited a local hospital complaining of abdominal pain and a mass in the left lower abdomen. An abdominal computed tomography scan showed a tumor with isodensity in the left lower abdominal wall. Magnetic resonance imaging showed a mass in the abdominal wall with isointensity in the T1-intensified image and high intensity in the T2-intensified images. The mass was heterogeneous inside and protruded partially toward the intraperitoneal cavity. Ultrasound examination showed a heteroechoic mass extending into the intraperitoneal cavity. Laparotomy revealed a tumor in the abdominal wall with a fistulous tract extending to the jejunum. We resected the abdominal wall tumor with partial resection of the small intestine. The resected specimen contained a tumor with a fistulous tract passing through the abdominal wall. Histological examination revealed remarkable infiltration of neutrophils and a bacterial mass in the abdominal wall tumor, with a fistulous tract connected to the area adjacent to the mesenteric border of the jejunum. These findings suggested that diverticulitis of the jejunum had penetrated through the abdominal wall, leading to the formation of an abscess. We report this case to highlight the need for complete gastrointestinal evaluation with gastrointestinal barium studies and imaging analysis to examine extension of intra-abdominal lesions in patients with an unexplained abdominal wall abscess.

Abdominal Abscess↗

PubMed1994

The location of abdominal wall blood vessels in relationship to abdominal landmarks apparent at laparoscopy.

OBJECTIVE: Our purpose was to evaluate the location of the major blood vessels of the abdominal wall relative to landmarks apparent at laparoscopy. STUDY DESIGN: Abdominal computed tomographic images of 21 reproductive-aged women at an academic center were retrospectively reviewed to determine the location of the inferior epigastric, superficial epigastric, and superficial circumflex iliac arteries and the lateral rectus muscle margins in relation to the symphysis pubis, the umbilicus, and the abdominal midline. These locations were correlated with each other and with body mass index using Pearson's correlation coefficient. RESULTS: Above the symphysis the inferior and superficial epigastric arteries were 5.6 +/- 1.0 cm (mean +/- SD) and 5.5 +/- 2.0 cm from the midline, respectively. Although the location of these two vessels correlated (r = 0.6, p = 0.02), the mean difference in their location was 1.4 +/- 1.1 cm. Near the level of the umbilicus the superficial epigastric and circumflex iliac arteries and the lateral rectus muscle margin were 4.6 +/- 1.4 cm, 10.7 +/- 1.7 cm, and 7.6 +/- 1.5 from the midline, respectively. Only the lateral rectus muscle margin correlated with body mass index (r = 0.65, p = 0.004). CONCLUSION: When laparoscopic landmarks are not visible to guide placement, lateral trocars should be placed approximately 8 cm from the midline and at least 5 cm above the symphysis to minimize the risk of vessel injury.

Abdominal Muscles↗

PubMed2005

The pedicled rectus femoris muscle flap for reconstruction of complicated abdominal wall defects.

AIM OF THE STUDY: Large or complicated abdominal wall defects caused by recurrent incisional hernias, infections or tumor resections often require the use of prosthetic mesh, local tissue transposition or even distant muscle flaps for proper reconstruction. Due to the sometimes discouraging results of meshes muscle flaps are an appreciated alternative. We followed up a series of cases to assess the value of the pedicled rectus femoris muscle flap. METHODS: Follow up time ranged from 6 months to 4 years. 12 cases of reconstruction of the abdominal wall using pedicled rectus femoris muscle flaps after tumor resections, recurrent incisional hernias, and infection are presented. Abdominal wall stability was examined clinically. The aesthetic and the functional results were assessed using a standardized questionnaire. The loss of torque in the quadriceps muscle was evaluated using a dynamometer. RESULTS: In all but one patients a stable abdominal wall could be reconstructed. We saw no major complications. The loss of true muscular capacity in the quadriceps muscle of the operated leg was 19% compared to the nonoperated leg, but was tolerated very well. CONCLUSION: The donor site morbidity is moderate. The flap provides an easy and save possibility to reconstruct the abdominal wall. The rectus femoris muscle flap should be considered as an alternative for abdominal wall reconstruction.

Abdominal Wall↗

PubMed2006

Reconstruction of the abdominal wall for incisional hernia repair.

BACKGROUND: Abdominal wall reconstruction with mobilization of autologous tissue has evolved as a reliable option for patients with incisional hernias. METHODS: With the aim of evaluating morbidity and recurrence rates in patients who underwent abdominal wall reconstruction for incisional hernia repair, we retrospectively reviewed the charts of 188 patients treated between 1996 and 2003. RESULTS: Primary approximation of the fascial defect was achieved in 77% and was reinforced by either mesh placement or rectus muscle advancement. The remaining 23% were reconstructed either by mesh placement, components separation, or distant flap mobilization. Median follow-up was 15 months. Overall morbidity rate was 38%; recurrence rate was 13%. Dimensions of the hernia and intraoperative enterotomies were associated with postoperative complications. Lack of complete restoration of the myofascial abdominal wall continuity was associated with recurrence. CONCLUSIONS: In patients with incisional hernias, techniques involving autologous tissue mobilization are safe and associated with low recurrence rates.

Abdominal Wall↗

PubMed1996

Soft tissue sarcoma of the anterior abdominal wall: review of reconstruction techniques.

Tumors of the abdominal wall excised with inadequately wide margins have a high local recurrence rate. The surgeon's fear of iatrogenic defects of the abdominal wall should not outweigh the need for wide resection margins to prevent tumor recurrence when excising primary and secondary malignancies. Appropriate monobloc excision of abdominal wall malignancies can be satisfactorily accomplished through a wide array of modalities. The authors describe successful abdominal wall reconstruction with the use of polypropylene mesh after excision of a recurrent soft tissue sarcoma. They review various methods of abdominal wall reconstruction to assist the surgeon in choosing the appropriate reconstruction technique.

Abdominal Muscles↗

PubMed2005

Bicycle-handlebar hernia: a rare traumatic abdominal wall hernia.

Handlebar hernia is a rare, traumatic, abdominal wall hernia caused by high-velocity direct trauma. It involves disruption of the abdominal wall muscles, with bowel loop herniated through the defect in the abdominal wall, and may have major or even lethal complications. We report a case of bicycle-handlebar hernia in a 9-year-old boy who had all layers of his abdominal wall disrupted by a fall when bicycling; however, his skin and intra-abdominal organs were completely intact. Computed tomography demonstrated subcutaneous intestinal loops protruding through the rent. Primary repair was performed, and his postoperative course was uneventful.

Abdominal Injuries↗

PubMed2006

A new biocompatible material (Lyoplant) for the therapy of congenital abdominal wall defects: first experimental results in rats.

Congenital abdominal wall defects are impressive and dramatic malformations. Common surgical therapy for omphalocele and gastroschisis is to place the herniated viscera back into the abdomen and to close the fascia. Small defects can be closed directly by surgical treatment. In large defects, resorbable and non-resorbable artificial materials are necessary to close the fascia. The aim of this study is to find out whether new biocompatible materials might be suitable for the treatment of such abdominal wall defects. A median laparotomy was performed in young Wistar rats with a body weight of 75-100 g. Then a full thickness defect was created by excising a 1.5 x 2.5 cm segment including fascia, muscles and peritoneum. These defects were then closed by implantation of a PTFE mesh (Dual-Mesh, n = 6), a PPP mesh (Prolene, n = 6) or a new biocompatible mesh (NBM; Lyoplant, n = 6). Each rat was examined daily after treatment. Bodyweight was determined and the possible development of a hernia was monitored. After 6 weeks, the abdomen was opened again. Adhesions to the intestine were measured and the abdominal wall was removed for histological and tensiometric examination. (1) Compared to the untreated controls, all animals showed physiologic growth and normal bodyweight curve. (2) Only in one rat (Prolene) did an abdominal hernia develop. (3) In contrast to PTFE and PPP mesh, NBM showed only minimal adhesion to the intestine. (4) Tensiometry revealed high stability for non-resorbable materials. However, the characteristics of NBM were very similar to untreated abdominal wall. Our initial results indicate that biocompatible materials can also be used for the therapy of congenital abdominal wall defects.

Abdominal Wall↗

PubMed2006

[Conceptual reformulation of the double mesh repair technique: a simple solution for highly complex abdominal wall defects].

INTRODUCTION: Repair of complex abdominal wall defects remains a challenge for the general surgeon. The aim of the present study was to validate the double mesh repair technique in complex hernias. MATERIAL AND METHOD: We performed a prospective study of 15 patients with complex abdominal wall defects who underwent surgery in a university hospital. All patients were evaluated in a multidisciplinary unit. Indications consisted of incisional hernias with multiple recurrences (> 3 times), prior mesh complicated by fistula and chronic infection, giant diffuse lumbar hernia, and ventral hernia (associated with parastomal hernia or occurring after bariatric surgery with associated dermolipectomy). The surgical technique used was double intra-abdominal and supra-aponeurotic mesh repair without associated plasty techniques. Clinical, surgical and follow-up data were analyzed. RESULTS: Nine defects were lateral, three were lumbar, one was parapubic, and two were located in the mid-line (one associated with giant parastomal hernia and one occurring after bariatric surgery). Eight showed significant tissue loss, five showed trophic skin lesions, and two showed chronic suppurative infection. The mean size of the defects was 17.5 cm. Seroma occurred in three patients and limited cutaneous necrosis occurred in one patient. The mean length of hospital stay was 4.3 days (range 2-7 days). No complications, recurrences or mortality were detected during follow-up. CONCLUSION: Complex abdominal wall defects can be corrected through double repair using mesh only. This technique is simple to learn and perform and can be applied in many anatomical sites and types of defect, as well as in the presence of tissue destruction.

Abdominal Wall↗

PubMed2001

The abdominal wall: an overlooked source of pain.

When abdominal pain is chronic and unremitting, with minimal or no relationship to eating or bowel function but often a relationship to posture (i.e., lying, sitting, standing), the abdominal wall should be suspected as the source of pain. Frequently, a localized, tender trigger point can be identified, although the pain may radiate over a diffuse area of the abdomen. If tenderness is unchanged or increased when abdominal muscles are tensed (positive Carnett's sign), the abdominal wall is the likely origin of pain. Most commonly, abdominal wall pain is related to cutaneous nerve root irritation or myofascial irritation. The pain can also result from structural conditions, such as localized endometriosis or rectus sheath hematoma, or from incisional or other abdominal wall hernias. If hernia or structural disease is excluded, injection of a local anesthetic with or without a corticosteroid into the pain trigger point can be diagnostic and therapeutic.

Abdominal Muscles↗

PubMed1990

"Components separation" method for closure of abdominal-wall defects: an anatomic and clinical study.

Closure of large abdominal-wall defects usually requires the transposition of remote myocutaneous flaps or free-tissue transfers. The purpose of this study was to determine if separation of the muscle components of the abdominal wall would allow mobilization of each unit over a greater distance than possible by mobilization of the entire abdominal wall as a block. The abdominal walls of 10 fresh cadavers were dissected. This demonstrated that the external oblique muscle can be separated from the internal oblique in a relatively avascular plane. The rectus muscle with its overlying rectus fascia can be elevated from the posterior rectus sheath. The compound flap of the rectus muscle, with its attached internal oblique-transversus abdominis muscle, can be advanced 10 cm around the waistline. The external oblique has limited advancement. These findings were utilized clinically in the reconstruction of abdominal-wall defects in 11 patients, ranging in size from 4 x 4 to 18 x 35 cm. This study suggests that large abdominal-wall defects can be reconstructed with functional transfer of abdominal-wall components without the need for resorting to distant transposition of free-muscle flaps.

Abdominal Muscles↗

PubMedDate not supplied

Anterior abdominal wall hernias: findings in barium studies.

Findings of anterior abdominal wall hernias at computed tomography and magnetic resonance imaging are well documented; however, little information is available about the depiction and characterization of such hernias in barium studies, primarily in small-bowel follow-through examinations. Such examinations are performed frequently, and radiologists should be familiar with the hernia features that may be observed. Anterior abdominal wall hernias are best recognized in profile on lateral spot images from a small-bowel follow-through study when one or more loops of bowel extend beyond the fascial planes of the anterior abdominal wall, with luminal narrowing at the entry or exit site of the hernia or at both sites. In some patients, the hernia also can be recognized indirectly on a frontal view because of the displacement and, often, extrinsic compression or deformity of herniated bowel loops. In such cases, additional views should be obtained with the patient in the lateral position to confirm the presence of the hernia with direct visualization of the herniated loops in profile. The reducibility of bowel from an anterior abdominal wall hernia also can be assessed with manual palpation of the abdominal wall while the patient is in the lateral position. Manual palpation performed during fluoroscopy helps determine whether the bowel loops can be returned to the proper location or are fixed in the hernia, an important observation because of the higher risk of obstruction or strangulation when the bowel is incarcerated. Fluoroscopy therefore is a useful technique for the detection and characterization of anterior abdominal wall hernias in barium studies.

Barium Sulfate↗

PubMed2005

Abdominal wall neuroma pain after breast reconstruction with a transverse abdominal musculocutaneous flap: cause and treatment.

Breast reconstruction with either a pedicled or microvascular transfer of the transverse rectus abdominus musculocutaneous flap, whether with or without the muscle, is now the standard of care when patients choose an autologous form of reconstruction. Complications related to flap loss and abdominal wall weakness have been well described. Complications related to painful neuromas of the intercostal nerves, ilioinguinal and iliohypogastric nerves have not been described previously. The diagnosis and treatment of pain related to neuromas of the abdominal wall is discussed in this paper.

Abdominal Neoplasms↗

PubMed2006

Closure of massive abdominal wall defects: a case report using the abdominal reapproximation anchor (ABRA) system.

Closure of massive abdominal wounds can be a challenging surgical problem. Presented here is a novel technique for reconstitution of the abdominal wall after severe internal injuries complicated by sepsis required a prolonged period of open abdominal dressing changes. By using an innovative and effective progressive tension band system, the fascial edges could be reapproximated over time allowing primary wound closure. This system is recommended as an effective instrument to accomplish closure of these difficult wounds.

Abdominal Injuries↗

PubMed2003

[Reconstruction of large defects of the abdominal wall using dermal and synthetic grafts].

Large defects of abdominal wall (greater than 8 cm in diameter) related to different cause, are still difficult problem of modern surgery. The best results in order to obtain safe and permanent anatomical and functional abdominal wall integrity are reached by autogenous dermal and synthetic grafts. Controversies concerning quality of these procedures are still presents. Our work is based on two equal experimental groups of 20 Vister rats each, with large artificial abdominal wall defects: one treated with autogenous dermal graft, another with synthetic Mersilene mesh graft. The animals from both groups were sacrificed in previous planned time intervals (3rd, 7th, 14th and 48th days). Afterwards detailed microscopic and gross examination of abdominal wall reparation and quality of reconstructed abdominal wall defects had been performed. According to our results both methods are easy to be performed and safety surgical procedures. Overestimated usage of synthetic grafts should be diminished because of advantages of autologous dermal graft--availability, substitution of firmly fibrosis tissue and endurance against infection.

Abdominal Wall↗

PubMed1997

[A case of the tuberculous abscess in the abdominal wall].

A case of the tuberculous abscess in the abdominal wall is reported. A 84-year-old female was admitted to our hospital with evaluation of soft tumor at the left lower abdomen. She has a mass in the abdominal wall measuring 4 cm in diameter, and abscess in the abdominal wall was detected by ultrasonogram and CT. The confirmed diagnosis of abdominal wall tuberculosis was made by means of bacterial culture and polymerase chain reaction (PCR method) of the aspirated fluid from a mass. Multiple calcified lesions on the abdominal X-ray were seen, which were thought to past history of tuberculous peritonitis. Antituberculosis therapy of three-drug regimens was not effective. Four month later, resection of the abscess was then performed. Adhesion was demonstrated between greater omentum and peritoneum, therefore the abscess in the abdominal wall was considered to arise and advance directly from the abdominal cavity.

Abdominal Muscles↗

PubMed2003

Abdominal wall endometriosis. An overlooked diagnosis.

OBJECTIVE: To study the incidence of abdominal wall endometriosis after cesarean section and its presentation to the general surgeon. METHODS: Fourteen patients were treated for abdominal wall endometriosis during the period June 1997 to May 2002 at Princess Basma Teaching Hospital and King Abdulla University Hospital, Irbid, Jordan. The patient's files were reviewed to see their way and time of presentation after cesarean section, provisional diagnosis made and operative procedures performed. Symptoms suggestive of and investigations carried out to detect pelvic endometriosis were also looked for and recorded. RESULTS: Fourteen patients were treated within 5 years; all had painful scar-related mass. The pain was exacerbating during menstruation in 5. The clinical diagnosis was stitch granuloma in 3; incisional hernia in 3, abdominal wall tumor in 3 and abdominal wall endometrioma in 5 patients. The mean time for the mass to be noticed by the patient was 2 years. They were treated with wide local excision. Histopathological examination proved the diagnosis of abdominal wall endometriosis. None had evidence of pelvic endometriosis and none of them had recurrence. The incidence of the disease is around 0.2% of the cesarean sections performed during the same period. CONCLUSION: The treating physician should keep in mind abdominal wall endometriosis as a possible cause of post cesarean section scar-related masses.

Abdominal Wall↗

PubMed1994

Reherniation after repair of the abdominal wall with expanded polytetrafluoroethylene.

Defects of the abdominal wall that are not amendable to primary closure have to be bridged by synthetic materials. The use of a nonabsorbable expanded polytetrafluoroethylene (ePTFE) soft-tissue patch is advocated for this purpose. To investigate the suitability of the ePTFE patch, abdominal wall defects in 30 rats were repaired with ePTFE and compared with polypropylene (PP) mesh. Herniations and adhesions were scored, qualitatively and quantitatively, eight weeks after implantation and the patches were histologically examined. Herniations, all observed at the fascia and patch interface, were significantly more frequent in abdominal wall defects repaired with ePTFE (60 percent) than with PP (zero percent) (p < 0.001, chi-square test). Adhesion formation was less frequently found in rats treated with ePTFE and adhesions were less strongly attached. Histologic examination revealed no ingrowth of fibro-collagenous tissue into the ePTFE patch, whereas the PP mesh was completely incorporated into fibrocollagenous tissue, which was continuous with the adjacent fascia. We conclude that this study confirms our clinical experience that reherniations at the fascia and patch interface in abdominal wall defects closed with an ePTFE soft-tissue patch are the result of insufficient ingrowth of fibrocollagenous tissue into the patch, which results in an insufficient anchorage of the patch to the fascia.

Abdominal Muscles↗

PubMed2003

Abdominal wall hernias: risk factors for infection and resource utilization.

BACKGROUND: Abdominal wall hernia repairs are common surgical procedures. Several recent reports have studied the outcomes of elderly patients undergoing inguinal hernia repair and documented a morbidity rate ranging from 5-57% and a mortality rate ranging from 1.6-14%. However, there has been limited data documenting the risk factors associated with postoperative morbidity and mortality from abdominal wall hernia repairs in general. Therefore, we sought to investigate the incidence of complications in patients undergoing abdominal wall hernia repair and to evaluate the risk factors for infection and resource utilization in these patients. METHODS: Prospective data (NSQIP) were collected on 6301 noncardiac surgical patients at the VA Maryland Healthcare System from 1995 to 2000. From this data set, 487 (7.7%) patients underwent abdominal wall hernia repairs and comprised the study cohort. Logistic and linear regression analyses were performed to identify risk factors for infection and hospital length of stay. RESULTS: The mean age of the study cohort was 60 +/- 14 and the mean ASA class was 2.4 +/- 0.7. Descriptive data revealed 99% were male, 43% used tobacco, 8.4% were diabetic, 7.4% used alcohol, 6.3% had chronic obstructive pulmonary disease (COPD), 2.1% were malnourished (defined as >/= 10% weight loss over prior 6 months), 1.6% used steroids, 1.2% had ascites, and 0.2% had coronary artery disease (CAD). The mortality rate was low at 1% but the morbidity rate was higher with a 4.3% incidence of wound infections and a 15.1% incidence of recurrent hernias. The mean preoperative serum albumin level was 4.1 +/- 0.6 g/dL, and the mean hospital length of stay was 1.4 +/- 4.8 days. Multiple logistic and linear regression analyses documented that CAD, COPD, low preoperative serum albumin, and steroid use were independent risk factors for increased postoperative wound infections (P < 0.05) and increased hospital length of stay (P < 0.05). CONCLUSIONS: Abdominal wall hernia repair is associated with significant morbidity in this predominantly elderly cohort but mortality rates were low. COPD and low preoperative serum albumin were independent predictors of wound infections and CAD, COPD, low preoperative serum albumin, and steroid use were independent predictors of increased hospital length of stay. Therefore, consideration should be given to optimizing patient's cardiopulmonary and nutritional status before abdominal wall hernia repair.

Abdominal Wall↗