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Results for “OBTURATOR FORAMEN”

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PubMed1983

[Passage from the thigh to the retroperitoneum through the obturator foramen of an enormous recurrent lipoma].

The authors refer to an enormous lipoma relapsing from the thigh and the retro-peritoneum space which they have observed. Underlying the rarity of the case, they reveal their reasons whereby one must consider the origin of this lipoma the medial region of the thigh, and the foramen obturatorium the passage-way of the same lipoma from the thigh to the retroperitoneum. Furthermore considering the frequent impossibility of complete removal of these extremely developed lipomas rendering a reserved quod vitam prognosis.

Humans↗
PubMed2002

Obturator bypass: a classic approach for the treatment of contemporary groin infection.

As the number of cardiac and interventional radiologic procedures has risen, the frequency with which surgeons are called to treat groin complications has increased. Infectious groin problems that often involve foreign prosthetic material or remnants of percutaneous femoral closure devices are particularly challenging and require control of bleeding, removal of foreign material, wide debridement, and sometimes arterial resection. Management of the consequential limb ischemia in such cases is controversial. The purpose of this study is to review the utility of extra-anatomic common femoral bypass through the obturator foramen (obturator bypass) as a method of treating limb ischemia after arterial groin infection. From July 1992 through June 2001 a total of 12 patients (six male) presented with severe vascular infections of the groin and underwent obturator bypass. Infections occurred as a consequence of an isolated vascular graft infection (nine) or after a percutaneous interventional femoral access procedure (three). Patients presented with systemic sepsis and a draining sinus (six), infected pseudoaneurysm (two), or hemorrhage (four). Treatment included debridement of the groin wound, sartorius muscle flap coverage of the femoral vessels, antibiotics and synthetic (eight polytetrafluoroethylene and four Dacron) obturator bypass via a lower abdominal extraperitoneal incision from an aortobifemoral bypass graft limb to the superficial femoral artery (six), native iliac to femoral artery (three), iliac to popliteal artery (two), and aortobifemoral bypass limb to the popliteal artery (one). Graft patency and limb salvage were assessed by Kaplan-Meier life table analysis. There were two (17%) deaths (multisystem organ failure at postoperative days 9 and 6) and four major complications (25%) requiring reoperation in the first 30 days. Ten patients (83%) survived, healed their groin wounds, and are infection free. With a mean follow-up of 37 months graft patency and limb salvage at 60 months were 80 and 60 per cent, respectively. There were no late graft infections. We conclude that the obturator bypass is an effective and durable means of revascularization in the presence of the septic groin. This procedure belongs in the armamentarium of all surgeons managing these complications.

Blood Vessel Prosthesis↗
PubMedDate not supplied

Pelvic remodeling after Salter osteotomy.

Salter innominate osteotomy is a widely used operative procedure to redirect the acetabulum in cases of acetabular dysplasia. The effectiveness of this redirection is indicated by the change in the appearance of the obturator foramen after the procedure. This is usually accompanied by an increase in the center edge (CE) angle with an effective decrease in the forces transmitted across the hip joint. In a prospective study of 20 Salter innominate osteotomies performed on two different age groups, one mature and one immature, we studied the change in the deformity of the obturator foramen with time after this procedure. In the immature pelvis, the asymmetric appearance of the obturator foramen remodeled gradually during the 6 months after the procedure. However, in the mature patient, no such remodeling potential was demonstrable during the study period. This finding has clinical implications regarding the advice for performing Salter innominate osteotomies in mature and immature patients.

Acetabulum↗
PubMed2000

Tendinous arch of the pelvic fascia: application to the technique of paravaginal colposuspension.

The authors give a description of the anatomy and topography of the tendinous arch of the pelvic fascia (TAPF), in order to facilitate its location during surgery. 35 TAPF in 25 female cadavers were dissected. The reproducibility of the landmarks was then verified at laparotomy. The TAPF can be easily identified and its resistance remains constant, even when the pelvic floor is hypotrophic. Its anterior extremity (d2) is at about 46 mm on a line perpendicular to the anterior edge of the pectineal ligament (35-55 mm), next to the pubovesical ligament. Its median part (dl) is perpendicular to the obturator foramen at a site located at an average of 30 mm below the obturator foramen (25-50 mm). Its posterior end is located at the ischial spine. These anterior landmarks, the only ones useful during surgery, allow its very easy location with the palmar surface of the finger. Testard and Delancey demonstrated the major role of the TAPF in stabilising the urethra submitted to strain. Richardson described a technique of paravaginal suspension for curing paravaginal fascial defect. The TAPF has never been well described, but his work allows its easy location during surgery. The suture of the vagina to the TAPF allows a more physiologic and stronger suspension of the bladder neck than other classical techniques.

Cadaver↗
PubMed1995

Obturator hernia: diagnosis through medical imaging.

A rare case of obturator hernia is presented in a patient with persistent small bowel obstruction. There was a paucity of specific signs and poor general health which caused a delay in diagnosis. Ultimately delayed films from a barium follow through showed barium-filled bowel in the region of the right obturator foramen: A computed tomography scan then confirmed the diagnosis by demonstrating the barium-filled small bowel herniating through the right obturator foramen. Other imaging modalities such as herniography, barium enemas and ultrasound have also been successfully employed to diagnose obturator hernias.

Aged↗