PubMed · 145447
Two patients who developed rectus sheath hematoma while on anticoagulants are presented. Ultrasound was the definitive method of establishing the diagnosis.
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H B Spitz, G M Wyatt. 1977. Rectus sheath hematoma.. https://doi.org/10.1002/jcu.1870050612
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Compression of the femoral nerve in the iliac fossa has been reported as a consequence of several pathologies, but never as a result of muscular compression. Aberrant slips of iliacus, however, have occasionally been reported to cover or split the femoral nerve. This study aimed to assess such variations as potential factors in femoral nerve compression. A large and homogeneous sample of 121 embalmed cadavers (242 specimens) was studied. Statistical comparisons were made using the chi-squared test. Muscular slips from iliacus and psoas, piercing or covering the femoral nerve, were found in 19 specimens (7.9%). No significant differences by sex or side were found. The more frequent variation was piercing of the femoral nerve by a muscular slip (17 specimens, 7.0%). The nerve then entered the thigh as one or more branches. The less frequent variation found was a muscular slip or sheet covering the femoral nerve as it lay on iliacus (2 specimens, 0.8%). Each disposition may be a potential risk for nerve entrapment.
The latissimus dorsi (LD) muscle has been previously described to repair diaphragmatic defects, but as a "reverse" flap, relying on secondary blood supply from the perforating lumbar vessels rather than primary inflow from the dominant thoracodorsal artery. We report resection of a retroperitoneal synovial sarcoma, with reconstruction of the hemidiaphragm using the LD rotated on its primary neurovascular bundle. By using the dominant pedicle, the vascularity of the flap is improved, minimizing the chance of flap tip loss. Maintaining an intact nerve supply prevents atrophy. As the distal origin of the LD is broad and flat, it is ideally suited for diaphragm repair. A latissimus-sparing thoracotomy incision is required to enable this method of diaphragm reconstruction.
STUDY DESIGN: Cross-sectional study of 50 individuals with nonspecific low back pain (LBP). OBJECTIVE: To evaluate the relationship between active and neural measurements in individuals with nonspecific LBP. SUMMARY OF BACKGROUND DATA: The Panjabi model for spinal stability consists of 3 interacting subsystems. Specific musculoskeletal measurements can be identified within the active and neural systems. The relationships among measures within this model have not been identified. METHODS: A total of 50 individuals with nonspecific LBP were evaluated for measures of the active and neural stability systems, and analyzed using a canonical correlation analysis, which is used to measure the relationship between 2 multidimensional variables. RESULTS: There were 2 significant relationships identified. The first identified a relationship among fatigue, flexion relation, and the feedforward abdominal response (r = 0.764, P < 0.001). The second relationship was between the Sorenson endurance test and feedforward abdominal response (r = 0.697, P = 0.006). CONCLUSION: Identification of relationships between back pain measurements may allow discrimination between individuals with different histology and pain levels. This process may assist the specificity of treatment programs prescribed for patients with back pain.