Biomedical subjects

T Tani

Publications and source records attributed to T Tani.

At least 91 records · Page 5Linked to original sources

PubMed2000

Bacterial translocation and tumor necrosis factor-alpha gene expression in experimental hemorrhagic shock.

OBJECTIVE: To investigate whether bacterial translocation is the causative mechanism underlying cytokine production during hemorrhagic shock. DESIGN: Prospective, randomized, unblinded animal study. SETTING: Surgical research laboratories of Shiga University of Medical Science. SUBJECTS: Male Sprague-Dawley rats. INTERVENTIONS: The rats were randomly divided into three groups. Each animal was anesthetized with pentobarbital, given a continuous infusion of 0.9% saline, and monitored for blood pressure. The normoxic and sham shock groups breathed room air, whereas the hyperoxic shock group was administered 100% oxygen. Except in the sham shock group, blood was withdrawn to induce a hemorrhagic shock state, then the shed blood was reinfused. Sixty minutes after the induction of hemorrhagic shock, arterial blood cultures were performed in all three groups. The animals were then killed, and their mesenteric lymph nodes (MLNs) were harvested for bacterial culture. The terminal ileum, liver, spleen, kidney, lung, and MLNs were also collected for histologic study by in situ hybridization. MEASUREMENTS AND MAIN RESULTS: In the bacteriologic study, the prevalence of bacterial translocation was 0% (0/11) in the hyperoxic shock group, 55% (6/11) in the normoxic shock group, and 0% (0/9) in the sham shock group. In the in situ hybridization study, tumor necrosis factor-alpha gene expression was detected only in the ileal tissue, MLNs, and spleens of the normoxic shock group. Blood cultures were sterile in all three groups. CONCLUSIONS: Bacterial translocation occurred in MLNs within 1 hr of hemorrhage. Hemorrhagic shock causes tumor necrosis factor-alpha gene expression as well as bacterial translocation in MLNs, but not in the liver, in this model. Bacterial translocation was prevented by hyperoxia early in the course of hemorrhagic shock. Hyperoxia also prevented tumor necrosis factor-alpha gene expression along the bacterial invasion route.

Animals↗

PubMed2000

Interleukin-8 as a predictor of the severity of bacteremia and infectious disease.

The relationship between cytokines and sepsis has been studied frequently in the intensive care unit (ICU). However, the determination of cytokines in patients as they enter the emergency department (ED) would be more meaningful in predicting the outcome of infection. This study investigated plasma interleukin-8 in the ED as the predictor of bacteremia and sepsis. One hundred patients admitted through the ED with signs of systemic inflammatory response syndrome were studied. Plasma IL-8, IL-6, and tumor necrosis factor (TNF) were assayed by enzyme-linked immunosorbent assay. Patient's data were evaluated using the APACHE II scoring system as predictive factors of morbidity and mortality. Plasma IL-8 (149 pg/mL) detected bacteremia with a positive predictive value of 90.9% and a specificity of 98.7%. Results indicated that the odds ratios (ORs) of bacteremia were 24.78 (P < 0.01, CI = 2.27-270.8), 5.42 (P < 0.05, CI = 1.37-21.4), and 6.05 (P < 0.05, CI = 1.36-26.8) for IL-8, IL-6, and APACHE II, respectively. Occurrence of bacteremia was highly correlated with increases in plasma IL-8 (P < 0.01). IL-8 (OR = 8.25, CI = 1.03-65.9) and APACHE II scores (OR = 12.6, CI = 2.24-70.4) were found to be significantly better predictive factors of mortality (P < 0.01) than IL-6 (OR = 3.60, CI = 0.57-22.7), TNF (OR = 0.24, CI = 0.01-11.0) and age (OR = 1.02, CI = 0.98-1.06). During bacteremia, IL-8 also correlated well with patient use of a ventilator (P < 0.01, OR = 2.43, CI = 2.41-311.19), use of vasopressors (P < 0.05, OR = 2.67, CI = 1.79-370.78), length of stay in the hospital (P < 0.01, OR = 3.14, CI = 1.87-988.31), and stay in the ICU (P < 0.01, OR = 2.51, CI = 2.98-449.80). Measuring IL-8 on patients in the ED with apparent bacterial infections appears to be a reliable predictor of bacteremia and the severity of disease.

APACHE↗

PubMed2000

Detection of peptidoglycan in human plasma using the silkworm larvae plasma test.

Silkworm larvae plasma (SLP) reagent, which is prepared from the body fluid of the silkworm, reacts with peptidoglycan (PG), a fragment of both the Gram-positive and Gram-negative bacterial cell wall, as well as with beta-glucan, a component of fungi. We developed a quantitative method for the detection of PG in human plasma from cases with bacterial infection using the SLP reagent. Tested in this way, the SLP method showed 86.2% sensitivity, 90.6% specificity, 89.3% positive predictive value, and 88.5% efficiency. The SLP method provides a valuable tool for the diagnosis of systemic infection using patients' blood.

Animals↗

PubMed2000

Chorea resulting from paraneoplastic striatal encephalitis.

A 73 year old man presented with progressive choreic movement and dementia. An antineuronal antibody that recognised a 68 kDa band on a western blot was found in the patient's serum; this antibody immunolabelled neuronal somata in rat brain. Postmortem examination showed a small cell lung cancer and severe neuronal loss with lymphocytic infiltration in the striatum that was more severe in the caudate head. This is thought to be the first pathologically proved case of paraneoplastic chorea with striatal encephalitis.

Aged↗

PubMed2000

New method for the detection of bacterial translocation using intestinal permeability with polyethylene glycol 4000.

BACKGROUND: Currently, there is no method of accurately diagnosing bacterial translocation (BT) in humans. BT may be related to changes in intestinal permeability. In this study, we examined the correlation between intestinal permeability using polyethylene glycol (PEG) 4000 and BT. MATERIALS AND METHODS: Under general anesthesia, laparotomy was done in rats, and PEG4000 was administered to the small intestine. We prepared models of invasive stimulation in which lipopolysaccharide (LPS) was intravenously administered, and a hemorrhagic shock model in which blood pressure was decreased to 30 mm Hg. Blood PEG4000 levels were measured. We also measured blood PEG levels in a model in which oxygen was administered to treat hemorrhagic shock. In all models, the presence or absence of BT development was evaluated. RESULTS: In groups given LPS, mean blood PEG levels were significant higher than in the group treated with saline solution. In the hemorrhagic shock group, the mean PEG level was increased but was slightly inhibited by oxygen administration. In the LPS and hemorrhagic shock groups, the incidene of BT was significantly greater than in the control group. In the hemorrhagic shock group, the incidence of BT was 0% after oxygen administration. There was a correlation between the incidence of BT and changes in the intestinal permeability of PEG4000 (R(2) = 0.824). CONCLUSIONS: LPS stimulation enhanced intestinal permeability in a dose-dependent manner. An increase in intestinal permeability was correlated with the incidence of BT. Blood PEG4000 levels correlated positively with the grade of invasion and the incidence of BT.

Animals↗

PubMed2000

Periodic tension development in the membrane of the in vitro contractile vacuole of Paramecium multimicronucleatum: modification by bisection, fusion and suction.

The contractile vacuole of the freshwater protozoan Paramecium multimicronucleatum is a membrane-bound exocytotic vesicle that expels excess cytosolic water. The in vitro contractile vacuole isolated from P. multimicronucleatum along with a small amount of cytosol and confined under mineral oil showed periodic rounding and slackening at fairly regular intervals. Activity lasted for over 30 min at room temperature (24-27 degrees C). The rounding of the in vitro contractile vacuole corresponded to the increased membrane tension of the in vivo contractile vacuole that occurs immediately before fluid expulsion. Unlike the in vivo contractile vacuole, the in vitro contractile vacuole did not expel fluid, since it lacked a mechanism to form a pore. The subsequent slackening of the in vitro contractile vacuole corresponded to the fluid-filling phase of the in vivo contractile vacuole that occurs at decreased membrane tension. Fluid filling occurred in the in vitro contractile vacuole only when it was isolated together with its radial arms. In vitro membrane-bound vesicles obtained by 'bisecting' (although the two parts were not always identical in size) an in vitro contractile vacuole established their own independent rounding-slackening cycles. In vitro contractile vacuole vesicles could fuse again when the vesicles slackened. The fused vesicle then showed a rounding-slackening cycle with a period closer to that of the vesicle that exhibited the shorter cycle period. An additional rounding phase of the in vitro contractile vacuole could be induced by applying suction to a portion of its membrane with a micropipette when the contractile vacuole was in its slackened phase. This suggests that maximum tension development in the contractile vacuole membrane can be triggered when tension is increased in any part of the contractile vacuole membrane. The time from the start of an extra rounding phase to the next spontaneous rounding and for subsequent rounding-slackening cycles was nearly the same as that before the extra rounding phase. This implies that there is no master pacemaker to control the rounding-slackening cycle in the contractile vacuole membrane. Severed radial arms also became vesiculated and, like contractile vacuole membranes, these in vitro vesicles showed independent rounding-slackening cycles and vesicle-vesicle fusions. Thus, membrane derived from the radial arm seems to be identical in its tension-developing properties with the contractile vacuole membrane. ATP was found to be required for contractile vacuole rounding but inhibitors of actin or tubulin polymerization, such as cytochalasin B and Nocodazole, had no effect on the in vitro contractile vacuole's rounding-slackening cycle.

Actins↗

PubMed2000

Reverse redistribution of thallium-201 myocardial single photon emission tomography and contractile reserve.

The present study investigated the contractile reserve of myocardium exhibiting reverse redistribution (RRD) of thallium-201 (201Tl) after acute myocardial infarction. Forty patients experiencing their first acute myocardial infarction underwent resting 201Tl single-photon emission computed tomography (SPECT) and low-dose (5-10 microgxkg(-1)xmin(-1)) dobutamine stress echocardiography (DSE) within 4 weeks after the onset of infarction. The left ventricle was divided into 13 segments for analysis. The severity of defects in 201Tl SPECT and the extent of wall motion abnormality in DSE were visually assessed and scored. The sum of each defect score and wall motion score of infarct-related segments were defined as total defect score (TDS) and total wall motion score (TWM), respectively. Quantitative analysis of 201Tl uptake was also performed. Resting 201Tl SPECT revealed RRD in 16 patients (group RRD), fixed defect (FIX) in 23 patients (group FIX), and redistribution in one. There was a significant difference in improvement of TWM between rest and stress in TWM in both the RRD and FIX groups (p<0.0001, each case). The improvement of TWM with dobutamine was significantly greater in RRD than in FIX (1.6+/-1.0 vs 0.6+/-0.7, p=0.001). There was a positive correlation between the magnitude of RRD and improvement of TWM with dobutamine (r=0.48, p=0.002). Myocardium exhibiting RRD on 201Tl SPECT in patients with acute myocardial infarction has greater contractile reserve than that exhibiting a fixed defect.

Adult↗

PubMed2000

Intraoperative electroneurography in the assessment of the level of operation for cervical spondylotic myelopathy in the elderly.

We treated 31 patients aged 65 years or more with cervical spondylotic myelopathy by microsurgical decompression and fusion at a single most appropriate level, in spite of MRI evidence of compression at several levels. Spinal cord potentials evoked at operation localised the level responsible for the principal lesion at C3-4 in 18 patients, C4-5 in 11 and at C5-6 in two. Despite the frequent coexistence of other age-related conditions, impairing ability to walk, the average Nurick grade improved from 3.5 before operation to 2.2 at a mean follow-up of 48 months. There was also good recovery of finger dexterity and sensitivity. Operation at a single optimal level, as opposed to several, has the advantage of minimising complications, of particular importance in this age group.

Aged↗

PubMed2000

The prevention of bile duct injury during laparoscopic cholecystectomy from the point of view of anatomic variation.

The aim of this study was to evaluate ways to prevent bile duct injury during laparoscopic cholecystectomy in patients with anomalous biliary tract anatomy. The biliary tract was studied using cholangiograms of 511 patients who had gallbladder disease and was dissected in 92 cadaveric specimens. The authors classified confluent forms of the cystic duct and the bile duct into five different types, including four anomalous types. Sixteen instances (3.13%) of anatomic variation of the biliary tract were found among the patients, and four cases (4.35%) were found in the cadavers. Among the 511 patients, there were 495 cases of type C anatomy, three cases of type A, seven cases of type R, six cases of type P, and zero cases of type L; among the 92 cadaveric specimens, there were 88 cases of type C anatomy, one case of type R, two cases of type P, and one case of type L. For anatomic types A, P, and R, there is a high probability of risk of cutting the wrong duct. Therefore, it is important to clarify the anatomy of the biliary tract by preoperative examination and to carefully dissect the cystic duct close to the neck of the gallbladder during laparoscopic cholecystectomy. Anatomic variation of the biliary tract is common and can create a rare pitfall during laparoscopic cholecystectomy.

Adolescent↗

PubMed2000

Cloning of calves from various somatic cell types of male and female adult, newborn and fetal cows.

Twenty-four calves were cloned from six somatic cell types of female and male adult, newborn and fetal cows. The clones were derived from female cumulus (n = 3), oviduct (n = 2) and uterine (n = 2) cells, female and male skin cells (n = 10), and male ear (n = 5) and liver (n = 2) cells. On the basis of the number of cloned embryos transferred (n = 172) to surrogate cows, the overall rate of success was 14%, but based on the number of surrogate mothers that became pregnant (n = 50), the success rate was 48%. Cell nuclei from uterus, ear and liver cells, which have not been tested previously, developed into newborn calves after nuclear transfer into enucleated oocytes. To date, seven female and six male calves have survived: six of the females were from adult cells (cumulus (n = 3), oviduct (n = 2) and skin (n = 1) cells) and one was from newborn skin cells, whereas the male calves were derived from adult ear cells (n = 3), newborn liver and skin cells (n = 2), and fetal cells (n = 1). Clones derived from adult cells frequently aborted in the later stages of pregnancy and calves developing to term showed a higher number of abnormalities than did those derived from newborn or fetal cells. The telomeric DNA lengths in the ear cells of three male calves cloned from the ear cells of a bull aged 10 years were similar to those of the original bull. However, the telomeric DNA lengths from the white blood cells of the clones, although similar to those in an age-matched control, were shorter than those of the original bull, which indicates that telomeric shortening varies among tissues.

Abortion, Spontaneous↗

PubMed1999

Effect of cilostazol, a phosphodiesterase III inhibitor, on experimental thrombosis in the porcine carotid artery.

Thrombus formation in the carotid artery is one of the common causes of transient ischemic attacks and stroke. Platelet aggregation seems to be an essential component in these processes. The present study was conducted to determine the ability of cilostazol, a phosphodiesterase III inhibitor, to prevent formation of totally occlusive thrombus in a porcine carotid artery, in comparison with ticlopidine. Castrated male Yorkshire pigs were allocated to control (n=8), cilostazol (30 mg/kg, twice a day [b.i.d] for 2 days, n=8), and ticlopidine (50 mg/kg, b.i.d. for 3 days, n=7) groups. The endothelium of the right common carotid artery was injured with electrical stimulation (150 microA) without constriction and blood flow in this region was monitored by Doppler flow probe. Arterial blood was sampled during electrical stimulation for the measurement of platelet aggregation. Total occlusion rates within 240 minutes were 87.5% (7:8), 37.5% (3:8), and 85.7% (6:7) in the control, cilostazol, and ticlopidine groups, respectively. Compared with the control group, the time to total occlusion was significantly prolonged in the cilostazol group, but not in the ticlopidine group. Consistently, platelet aggregation was significantly inhibited only in the cilostazol group. Because ticlopidine increases blood flow in the intact carotid artery before injury to a greater extent than cilostazol, direct antiplatelet action is thought to be responsible for cilostazol's beneficial effect in preventing thrombotic occlusion. These results suggest that cilostazol may be useful for the inhibition of the thrombus formation in the carotid artery and for the prevention of cerebral ischemic events.

3',5'-Cyclic-AMP Phosphodiesterases↗

PubMed1999

Comparative study of antiplatelet drugs in vitro: distinct effects of cAMP-elevating drugs and GPIIb/IIIa antagonists on thrombin-induced platelet responses.

Among various categories of antiplatelet drugs, cAMP-elevating agents and GP IIb/IIIa antagonists have been reported to inhibit platelet aggregation stimulated by a wide variety of platelet agonists. To clarify the qualitative difference between these two agents, their effects on various platelet responses in washed platelets evoked by thrombin (0.05 U/mL) were compared in vitro. Two types of cAMP-elevating drugs, cilostazol (a phosphodiesterase III inhibitor) and prostaglandin E1 (an adenylate cyclase activator), both inhibited platelet aggregation, thromboxane A2 formation, and platelet factor 4 release in a concentration-dependent manner. In addition, both agents suppressed intracellular Ca++ elevation induced by thrombin. However, two classes of GP IIb/IIIa antagonists, abciximab (Fab fragment of antibody) and tirofiban (a synthetic compound), showed no inhibitory effects against thromboxane A2 formation and platelet factor 4 release, although these drugs inhibited platelet aggregation. Essentially the same results were obtained in platelet-rich plasma stimulated with high concentration (100 microM) of thrombin receptor activating peptide. In contrast to these different profiles on thromboxane A2 formation and release reaction, both cAMP-elevating agents and GP IIb/IIIa antagonists potently suppressed procoagulant activity in thrombin-stimulated platelets. These results suggest that the development of platelet procoagulant activity induced by thrombin is exclusively dependent on platelet aggregation or aggregation-dependent processes. These observations also indicate that cAMP-elevating agents possess wider inhibitory effects on platelet responses evoked by strong agonists than GP IIb/IIIa antagonists.

Abciximab↗

PubMed1999

Expression of laminins 1 and 10 in carcinoma cells and comparison of their roles in cell adhesion.

The expression pattern of laminin (Ln) alpha1 chain has been a controversial topic due to discrepancies between mRNA and protein studies. Recently it was reported that the monoclonal antibody 4C7, previously thought to recognize Ln alpha1 chain, actually detects Ln alpha5 chain. This finding makes it necessary to reestimate the role of Ln alpha1 chain and to compare the expression and functions of Ln alpha1 and alpha5 chains. We studied the expression of Ln alpha1 and alpha5 chains and production of Ln-1 and Ln-10 in cultured human carcinoma cells. Ln alpha1 chain mRNA was detected in JAR choriocarcinoma cells and in all four renal cell carcinoma cell lines studied. In contrast, pancreatic, colon, and lung alveolar carcinoma cell lines did not express or produce Ln alpha1 chain, suggesting that Ln-1 (alpha1 beta1 gamma1) is produced only by certain carcinoma cells. Ln alpha5 chain mRNA was expressed in all carcinoma cells, but was not incorporated into extracellular matrix in vitro, as shown with JAR cells. Immunoprecipitation of metabolically labeled cells showed that cells expressing Ln alpha1 mRNA also produced 400-kDa Ln alpha1 chain, whereas all cells produced 380-kDa Ln alpha5 chain. Adhesion to Ln-1 was inhibited by a functionally blocking antibody against alpha6-integrin subunit, whereas adhesion to Ln-10 was inhibited by an antibody against alpha6-integrin in JAR cells and by an antibody against alpha3-integrin in PANC-1 cells. The results suggest that Ln-10 is a ubiquitously expressed Ln isoform in carcinoma cells, and the mechanism of adhesion to Ln-10 is cell-type specific.

Blotting, Northern↗

PubMed1999

Peripheral administration of an N-methyl-D-aspartate receptor antagonist (MK-801) changes dorsal horn neuronal responses in rats.

Due to the discovery of peripheral N-methyl-D-aspartate (NMDA) receptors, the effects of peripherally administrated MK-801, a non-competitive NMDA receptor antagonist, and phosphate buffered saline were tested by using the response changes of wide-dynamic range cells in the lumbar enlargement of the spinal cord in Sprague-Dawley rats. MK-801 (1 microM, 50 microl) administered directly into the subcutaneous tissue of the receptive field (n = 7), produces a reversible reduction of responses to noxious and innocuous stimuli by a peripheral action. There was no change in the responses to cutaneous stimuli following injection of phosphate buffered saline (n = 7) or following administration of MK-801 into the contralateral foot (n = 7). The present study suggests that MK-801 produces a local anesthetic like effect in the peripheral tissue.

Analgesia↗

PubMed1999

Motor-evoked potentials elicited from human erector spinae muscles by transcranial magnetic stimulation.

STUDY DESIGN: The compound muscle action potentials elicited from the erector spinae muscles by transcranial magnetic stimulation was studied in 15 healthy adults. OBJECTIVE: To describe the recording procedure for consistent compound muscle action potentials elicited from the human erector spinae by transcranial magnetic stimulation and to establish the normal latency ranges of the responses, at respective spinal levels, for the practical use of this test. SUMMARY OF BACKGROUND DATA: Although recording of the compound muscle action potentials from limb muscles after transcranial magnetic stimulation has been extensively studied, the use of the erector spinae as the target muscle has not, probably because of the difficulty of consistently evoking compound muscle action potentials. METHODS: Compound muscle action potentials from the erector spinae muscles were recorded with the subject prone during tonic voluntary background contraction of the back extensor muscles at approximately 20% of maximum effort. The compound muscle action potentials were recorded concurrently at multiple levels after magnetic stimulation to the brain with a round coil centered over the vertex. RESULTS: The onset and peak latencies (mean +/- SD) of the major negative potential increased progressively toward the caudal level from 13.4 +/- 2.2 msec and 17.6 +/- 2.2 msec at T5-T6 to 20.8 +/- 1.5 msec and 26.3 +/- 3.0 msec at L4-L5 in healthy subjects. The latencies changed significantly between two adjacent segments from T5-T6/T6-T7 through T12-L1/L1-L2. CONCLUSIONS: The compound muscle action potential was elicited from the voluntarily contracted erector spinae at all spinal levels from T5-T6 through L4-L5 in all subjects tested. This noninvasive test has potential for evaluating the functional integrity of the motor pathway in the thoracic spinal cord, the spinal nerves, or both.

Adult↗

PubMed1999

Renal cell carcinomas and pancreatic adenocarcinomas produce nidogen in vitro and in vivo.

The production of nidogen by four renal cell carcinoma (RCC) and three pancreatic adenocarcinoma (PAc) cell lines has been studied in cell culture and in xenografted tumours in nude mice. In RCC cells, immunoreactivity for nidogen was seen only after exposure to monensin to induce cytoplasmic accumulation of secretory proteins. In PAc cells, immunoreaction was also detectable in control cells. Immunoblotting of control and monensin-exposed cells and immunoprecipitation of culture media of radioactively labelled cells demonstrated the production of nidogen polypeptide of Mr ca. 150000 by six of the seven cell lines. Basement membranes (BMs) and stroma of the xenografted tumours derived from these six cell lines demonstrated immunoreactivity for both human and mouse nidogen, as revealed with species-specific antibodies. The ability of the cells to produce nidogen in vitro and deposit in vivo was positively correlated with high histological grade of the xenografted tumours, although the small number of cell lines studied calls for further studies to confirm this. The distribution of nidogen in human RCC and PAc specimens was also studied by immunohistochemistry. There was strong immunoreactivity for nidogen in tumour stroma, BM of carcinoma cell nests, and endothelial basal lamina, but no conclusions could be drawn regarding histological grade and immunostaining patterns, because stromal production could not be ruled out. The results show that nidogen is produced by human carcinoma cells both in vitro and in vivo.

Adenocarcinoma↗

PubMed1999

Effects of deletion-type human hepatocyte growth factor on murine septic model.

BACKGROUND: Sepsis is known to be the main cause of multiple organ failure. The liver especially is vulnerable to the stress of infection. In this study, the effects of deletion-type human hepatocyte growth factor (dHGF) on a murine septic model were studied. MATERIALS AND METHODS: Sepsis was induced in male adult Sprague-Dawley rats by cecal ligation and puncture method (CLP). Controls were given a sham operation. Intravenous injection of 1000 micrograms/kg dHGF or the same volume of vehicle was given every 12 h for 3 days before and/or after the CLP from a central vein catheter inserted 1 week prior to the operation. The daily percentage of survival after CLP was followed up for 1 week, and blood samples and liver specimens were collected from the surviving animals 72 h after CLP or sham operation. RESULTS: The survival rate, the degree of liver damage and liver protein synthesis, and coagulation function were all favorable in the dHGF-treated animals compared to the untreated animals. Immunohistochemical staining showed that dHGF prevented the disappearance of thrombomodulin (TM) in liver sinusoid endothelium. CONCLUSIONS: dHGF appears to prevent liver injury caused by disturbance of microcirculation through preservation of TM expression and the antithrombotic function in the endothelium of sinusoids. dHGF also facilitates repair of damaged hepatic tissue by stimulating regeneration of the cells and by preserving hepatic functions such as protein synthesis. dHGF exerts protective effects on even quiescent hepatocytes, but is most effective on injured but competent hepatocytes.

Animals↗

PubMed1999

Handlebar hernia with intra-abdominal extraluminal air presenting as a novel form of traumatic abdominal wall hernia: report of a case.

An 18-year-old male was admitted to our Emergency Department with a traumatic abdominal wall hernia (TAWH) of the left lower quadrant (LLQ) after suffering hypogastric blunt injury and urogenital lacerations in a motorcycle accident. Upright chest X-ray showed a small amount of right infradiaphragmatic free air, and a computed tomographic (CT) scan demonstrated an abdominal wall hernia. At surgery, no impairment was found in the digestive tract, and an abdominal herniorrhaphy was performed. It is suggested that the free air had passed through a connection between the scrotal laceration and the contralateral abdominal defect via the subcutaneous space and was palpated as emphysema. This is a new type of TAWH, which suggests that blunt abdominal trauma may result in negative pressure in the subcutaneous and peritoneal cavity, and this could reflect the pathophysiology of TAWH.

Abdominal Muscles↗