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Results for “OBTURATOR FORAMEN”

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At least 19 recordsLinked to original sources

PubMed2006

A triplicate obturator foramen.

The obturator foramen is a large opening in the hip bone situated below and anterior to the acetabulum. The obturator foramen is enclosed by the obturator membrane, apart from the part above near the obturator groove, where the obturator vessels and nerve pass through. The present study reports multiple openings in the obturator foramen detected incidentally in a left hip bone specimen and discusses its clinical implications. To the best of our knowledge, the occurrence of multiple openings associated with the obturator foramen is rare and has not been reported in any standard textbook of anatomy or in any research study. Anatomical knowledge of the presence of such anomalies may be clinically important for radiologists interpreting skiagrams and surgeons performing operative procedures in the hip region.

Humans↗

PubMed1991

Crossover ilioprofunda reconstruction: an expanded role for obturator foramen bypass.

The standard obturator foramen bypass extends from the aorta or iliac artery to the ipsilateral superficial femoral or popliteal artery. This operation has been both effective and versatile as an indirect bypass procedure for circumventing difficult vascular problems in the femoral triangle. A case is presented of a patient whose limb was salvaged by an obturator foramen bypass from the contralateral iliac artery to the profunda femoris artery. This unique case is compared to other published cases to emphasize the potential advantages of the profunda femoris as the preferred graft outflow in selected cases of arterial reconstruction through the obturator foramen.

Aged↗

PubMed1993

Obturator foramen bypass in the management of infected prosthetic vascular grafts.

The obturator foramen bypass graft remains an excellent option for revascularizing the lower extremity when dealing with an infected prosthetic vascular graft in the groin. In this series, six obturator foramen bypass grafts were performed in five patients for infectious groin complications following vascular surgery. Conservative measures such as local antibiotic irrigation and abscess drainage designed to preserve the graft in situ had failed to eradicate the infection in all instances and was complicated by suture-line haemorrhage in three instances. An aggressive approach should be adopted, aimed at excision of the infected graft. The obturator foramen bypass graft remains a durable graft for limb salvage. Five out of six obturator foramen bypass grafts were patent after 11-26 months follow up.

Abscess↗

PubMedDate not supplied

[Bridges through the obturator foramen and suprapubic bridges].

Bridging through the obturator foramen and suprapubic cross-bridging are among the types of atypical bridging most frequently used in vascular reconstructive surgery. Suprapubic bridging, as with axillofemoral bridging, makes revascularization possible when there are contra-indications to a transperitoneal approach to the aortic bifurcation. Bridging through the obturator foramen makes it possible to avoid the edge of the scrapa, particularly when there is suppuration. These types of bridging, which are often the only way of avoiding amputation or of taking a grave risk, give results that are quite acceptable if not comparable to those obtained by the standard techniques.

Blood Vessel Prosthesis↗

PubMed1988

[Obturator foramen approach in vasovasostomy: studies on a cadaver].

We tested the obturator foramen approach first reported by Shafik in 1982, on an 84-year-old male cadaver. By this approach, the ductus deferens is by-passed through the obturator foramen for the reanastomosis in patients who require excision of a long segment of the ductus deferens. The length of the ductus deferens spared by this method was 10.5 cm. Preservation of the deferential artery and protection of the obturator nerve and vessels were considered to be essential in the operation. When the ductus deferens was cut more distal than the internal inguinal ring, this method was not feasible because the distal part of the vas was too short to come out to the upper scrotal region through the obturator foramen.

Aged↗

PubMed1981

The obturator foramen bypass: an alternative procedure in iliofemoral artery revascularization.

The obturator foramen bypass has been described as an alternative procedure to solve complicated vascular problems in the groin. This extra-anatomic bypass has been used successfully in cases of infection, mycotic aneurysms, traumatic lesions, irradiation ulcers, and excessive scar tissue in the femoral triangle. With this technique, the vascular continuity can be restored immediately. Although data on the long-term results of this operative procedure are not yet available, out report and a review of the literature suggest that the obturator foramen bypass is a very useful technique for saving a patient's leg and in some cases his life.

Femoral Artery↗

PubMed1982

Obturator foramen grafts: the preferable alternate route?

Although the femoral canal is the standard entrance route for vascular grafts to the lower extremity, several situations may arise that preclude the use of this route. In these circumstances an alternate pathway for revascularization is required. Experience in our center with the use of obturator foramen grafts for revascularization of nine limbs in eight patients is reported and underscores the value of this pathway as an alternative route for limb revascularization. The obturator foramen was employed to circumvent an infected arterial prosthesis at the groin level in seven patients (eight limbs) from 12 days to 4.5 years after the initial vascular procedure. The organisms responsible for graft infection included Staphylococcus aureus, Enterobacter cloacae, and Bacteroides fragilis. The final patient required iliac to superficial femoral artery bypass via the obturator foramen to manage occlusion and autolysis of the femoral artery by a mycotic embolus containing beta-hemolytic Streptococcus. Graft material used for these remedial procedures, included saphenous vein (three), Gore-Tex (three), and Dacron (three). Revascularization was satisfactory in each case. Each groin infection healed. Two patients died of unrelated causes at 1.5 and 5 months after operation. The seven remaining grafts at risk (six patients) remained patent 12 months in each case. Four grafts were doing well at 18, 36, 50, and 52 months. Three grafts failed at 13, 19, and 28 months; one was revised successfully, one was re-done and failed again. Obturator foramen bypass grafting provides satisfactory and durable revascularization when an alternate route to the lower extremity is required.

Adult↗

PubMed2005

[Anatomy of obturated foramen. Application to trans-obturator slings].

The development of the trans-obturator sling in the treatment of female incontinence created a renewal of interest for the study of the anatomy of the obturator region, as shows the recent anatomical studies published on the subject. The objective being to consider the risks of bladder and vasculo-nervous injuries of this new way. The risk of wound of the bladder is small as concerns this technique of the mode of insetion of the sling (outside inside or inside outside) because the sling is in a strictly perineal way. The risk of damage caused in the vasculo-nervous elements of the obturator region is weak considering the position of the sling with regard to the main pedicles. These are either for distance of the sling for the obturator and femoral vessels and the saphenous vein, or protected by the obturator bone frame for the pudendal pedicle and the anterior branch of the obturator artery, or they are reduced to the state of capillaries or nerve ending. The trans-obturator sling presents the advantage to allow a strictly perineal, horizontal situation of the sling, which restores the system of a natural sub-urethral vaginal sling, avoiding complications due to the penetration of the Retzius space and of the pelvian cavity.

Female↗

PubMedDate not supplied

[Obturator foramen bypass for revascularization of the leg with infection of the femoral area. A clinical case].

Infection of the femoral artery together with limb acute ischemia represent for the vascular surgeon a challenging condition to manage. To solve this complicated vascular problem in the groin, the obturator foramen bypass has been described as an alternative procedure for ischemic limb salvage. The authors report their experience with a diabetic patient admitted in critical conditions with an ischemic leg and sepsis of the femoral area due to an infected extra-anatomical crossover femoro-femoral bypass complicated by hemorrhagia and which was partially removed in another Hospital. Limb revascularization was achieved by an obturator foramen PTFE expanded iliopopliteal bypass. The residual infected prosthesic stump was, thereafter, removed from the groin wound. The post-operative period was uneventful and the patient was discharged in the XIII post operative day. At follow-up, latest control at 10 months (July 1993) documented a patent graft and an ankle pressure index > 1. This experience, and a review of the literature, confirm the validity of the obturator foramen bypass as a route of choice for infected femoral artery and ischemic limb salvage.

Anastomosis, Surgical↗

PubMed2006

Locked overlapping dislocation of the pubic symphysis into the obturator foramen: a case report.

A 20-year-old man sustained an overlapping dislocation of the pubic symphysis following a low velocity side-to-side compression injury. Such injuries are rare in the literature. This case, where the pubis was locked into the obturator foramen, may be the first of its kind to be reported. The pubic symphysis was successfully reduced by levering, with difficulty, the locked pubic body out of the left obturator foramen. As the reduction was unstable, the pubic symphysis was fixed with 2 reconstruction plates. The patient was able to mobilise fully after 3 months and returned to work. At 18 months' follow-up he was able to void urine normally after urethral repair.

Adult↗

PubMedDate not supplied

Cross over ileo-popliteal bypass through the obturator foramen: an additional route for extra-anatomic limb blood supply.

Complications and morbidity associated with vascular graft infections continue to be a major clinical problem. Ischemia and gangrene are consequences of limb circulation failure, especially in extra-anatomic, occluded and infected bypass prostheses. Infection of the tissue bed of such prostheses should be prevented. When it occurs, the use of the contralateral obturator foramen represents an alternative route in cases in which it is impossible to use the ipsilateral vessels. Prosthetic crossover reconstruction through the obturator foramen may be considered a safe and effective solution for patients with a limb threatening infection of the extra-anatomic graft and a damaged blood supply.

Aged↗

PubMed1982

Obturator foramen approach. II. A new surgical approach for management of the short-pedicled undescended testicle.

A new approach for the management of the short-pedicled undescended testicle is presented. It was used in four patients with the testicle lying deep to the internal inguinal ring after all methods of cord elongation failed to bring the testicle down to the scrotum. The technique consists of passing the testicle through the obturator foramen to the scrotum. No complications were encountered, and the results have been satisfactory. Normally the vas deferens and testicular vessels describe a loop along their inguinal and pelvic course. The obturator foramen approach shunts this loop, which may be lacking in the undescended testicle lying deep to the internal inguinal ring.

Adolescent↗

PubMed1988

Obturator foramen bypass--the alternative route for sepsis in the femoral triangle.

Obturator foramen bypass has successfully been used to replace an infected groin graft in eight patients. Early replacement of an infected graft is recommended because of the poor results and risks associated with conservative management.

Aged↗

PubMed2004

[Traumatic obturator foramen hip dislocation: a case report and review of the literature].

We report a case of traumatic anteroinferior (obturator foramen) hip dislocation in an adult. Femoral neck fracture occurred during reduction of the dislocation. Cephalic necrosis required total hip arthroplasty. We call attention to the difficult reduction of traumatic obturator formaen dislocation. We reviewed the literature concerning prognostic factors and propose a therapeutic attitude.

Adult↗

PubMed1983

Computed tomographic diagnosis of obturator foramen hernia.

Computed tomography was performed on a patient presenting with cryptic small bowel obstruction. A correct preoperative diagnosis of obturator foramen hernia was arrived at based on the recognition of a loop of ileum protruding between the pectineus and external obturator muscles.

Aged↗

PubMed2004

Cystocele repair by a synthetic vaginal mesh secured anteriorly through the obturator foramen.

OBJECTIVE: Our aim was to assess the feasibility and short-term results of cystocele repair by the placement of a synthetic subvesical mesh secured anteriorly through the obturator foramen. STUDY DESIGN: Between 1 November 2001 and 31 July 2002, 30 consecutive patients with a grade 2 (n = 18, 60%) or 3 (n =12, 40%) cystocele were prospectively included in the study. RESULTS: The obturator route was feasible in all cases. No intraoperative complications arose. After a mean follow-up of 6.7 months (range: 2-12), 90% (n = 27) of the patients were cystocele grade 0, 7% (n = 2) grade 1 and failure was observed in a young patient (3%) treated without hysterectomy. Two vaginal erosions (7%) were observed at six and nine months. For the 14 patients (47%) who had sexual relations after surgery, 2 (14%) complained of anterior dyspareunia. CONCLUSION: The obturator approach is a simple and sure technique for placing a polypropylene synthetic subvesical mesh. The long term stability and tolerance of the results must be confirmed.

Adult↗

PubMed1982

Arterial grafting through the obturator foramen in secondary hemorrhage from the femoral vessels.

Secondary hemorrhage from the groin is a life-threatening situation with a high risk of amputation if the limb is not revascularized after controlling the bleeding. Three cases are described in which grafting via the obturator foramen was used to achieve iliofemoral bypass in patients with secondary hemorrhage from the femoral vessels. Obturator bypass has previously mainly been used in the management of infective complications in the groin after arterial grafting procedures. The previously reported cases are reviewed with special reference to the indications for the procedure in situations unrelated to previous reconstructive vascular surgery.

Aged↗

PubMed1979

Obturator foramen bypass in the management of infected vascular prostheses.

Seven patients with infected vascular prostheses in the femoral region were treated by removal of the prosthesis and extraanatomic reconstruction by way of the obturator foramen. Because the operation avoided entry into the infected area, it was considered the best surgical treatment for these patients. Although catastrophic hemorrhage and systemic sepsis were averted, amputation was eventually necessary in five patients, usually because of severe arteriosclerotic disease in distal arteries. Short-term benefit was gained by only two patients. The prevention of infection demands intensive preoperative preparation using prophylactic antibiotics and meticulous operating room technic.

Amputation, Surgical↗