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At least 631 records · Page 35Linked to original sources
PubMed1996

Prenatal diagnosis of fetal abdominal wall defects: a retrospective analysis of 44 cases.

Forty-four fetal abdominal wall defects, consisting of 31 omphalocoeles, 11 cases of gastroschisis, and two body stalk anomalies (which are excluded from further analysis), were diagnosed at 12-39 weeks (median 26 weeks) of gestation. In 10/31 (32 per cent) cases of omphalocoele and in 4/11 (36 per cent) cases of gastroschisis, multiple congenital anomalies were diagnosed. A normal amount of amniotic fluid was present in 39 cases; in three cases of omphalocoele an abnormal amount of amniotic fluid (polyhydramnios, n = 2; oligohydramnios, n = 1) was seen. Prenatally, intrauterine growth retardation (IUGR) was diagnosed in each type of anomaly only once, although the birth weight was below the tenth centile in 23 per cent of omphalocoeles and in 36 per cent of cases of gastroschisis. An abnormal prenatal karyotpye was established in 5/25 (20 per cent) cases of omphalocoele versus none in the gastroschisis group. In 36 cases an expectant obstetric management was followed, and in six cases of omphalocoele the pregnancies were terminated because of severe multiple anomalies (n = 3) or an abnormal prenatal karyotype (n = 3). The preterm delivery rate (excluding terminations) was 12/25 (48 per cent) in the omphalocoele subgroup versus 8/11 (73 per cent) in the gastroschisis subgroup. The Caesarean section rate was almost identical (19 versus 18 per cent) in both subgroups; the majority (n = 5) were performed to protect the abdominal wall defect. The overall survival rate was 39 per cent in the omphalocoele group; in all surviving infants this was the sole congenital anomaly and in each instance there was a normal karyotype. In the gastroschisis group, 8/11 (72 per cent) infants survived, of which two children also displayed unilateral hydronephrosis.

Abdominal Muscles↗
PubMed1970

Synovial sarcoma of the abdominal wall.

A case report is presented of a synovial sarcoma arising in the abdominal wall. This is the seventh such case to be reported. A brief review of the clinical and pathological features of synovial sarcoma is made.Pre-operative diagnosis of an abdominal wall synovial sarcoma is virtually impossible, but should be considered when a soft tissue swelling is found to show amorphous stippled calcification on X-ray.

Abdominal Muscles↗
PubMed2006

[Incision and closure of the abdominal wall].

Access to the abdominal cavity must be performed in such a way that surgical treatment procedures can be performed safely. For skin incision, scalpel and electrocautery are equivalent. Subcutaneous tissue and fascias must be divided by electrocautery to minimize blood loss. The best way to close the abdominal cavity is by an all layer, slowly absorbable, running suture with a suture: wound length ratio of at least 4:1. Closing the peritoneal layer is not necessary. Subcutaneous sutures and drains do not reduce the risk of wound complications. Staples should be used for closing the skin.

Abdominal Wall↗
PubMedDate not supplied

Late cutaneous fistulae after prosthetic hernia repair of the abdominal wall.

Late cutaneous fistulae, after a hernioplasty operation for a hernia in the abdominal wall, represent an unusual complication. They can appear a considerable time after a hernioplasty operation and feature the presence of a fistula between the prosthesis and the cutaneous wall. The Authors report the cases of five patients who developed late cutaneous fistulae after an operation for the repair of a hernia of the abdominal wall and the treatment established in the end to correct the existing complication. All five patients were subjected to a second operation to achieve recovery. In fact, conservative medical treatment, before the operation, using antibiotic-therapy for this purpose proved to be ineffective. Only one patient developed hernia recurrence after surgical treatment. Late cutaneous fistulae represent a complication that is difficult to deal with as their treatment has yet to be clearly identified.

Aged↗
PubMed1996

Intestine submucosa and polypropylene mesh for abdominal wall repair in dogs.

Continuing investigations of abdominal body wall reconstruction materials suggest that unacceptable implant complications continue and that the ideal material has not yet been found. This pilot study compared xenogeneic (porcine) small intestine submucosa (SIS) with polypropylene mesh (PPM) for repair of created partial-thickness (six dogs) and full-thickness (six dogs) abdominal wall defects. Postoperative clinical evaluation of all dogs showed no evidence of implant failure. Dogs were euthanized at 1, 2, and 4 months after surgery. The SIS implants were completely replaced by host tissue at 4 months as determined by immunohistochemistry. The resultant repair was well-organized, smooth, dense collagenous connective tissue that was well incorporated into the adjacent fascia and skeletal muscle fiber bundles. In the full-thickness defect dogs, omentum covered a significantly larger portion of PPM (P = 0.001) and was more firmly attached to PPM (P = 0.0001) compared to SIS/connective tissue repair. We conclude that xenogeneic SIS can be used as an abdominal body wall repair material in the dog and warrants further investigations.

Abdominal Muscles↗
PubMed1998

Serial lung volume measurements during the perinatal period in infants with abdominal wall defects.

METHODS: Daily measurements of lung volume (functional residual capacity, FRC) were made during the perinatal period in eight infants (median gestational age, 37 weeks; range, 34 to 38 weeks) with abdominal wall defects. RESULTS: On the first day of life and before surgical intervention, four infants had FRCs below the reference range; the occurrence of low lung volumes was not significantly related to gestational age or diagnosis. Lung volume was further, but only temporarily, impaired by surgical closure of the abdominal wall defect, with a reduction in the median FRC from 25 mL/kg (range, 18 to 36) preoperatively to 12 mL/kg (range, 5 to 19) on the first postoperative day (P < .02). CONCLUSION: These data are consistent with abnormal antenatal lung growth in certain infants with abdominal wall defects.

Abdominal Muscles↗
PubMed2006

Infection on polypropylene mesh implantation site in the abdominal wall of rats with induced bacterial peritonitis.

PURPOSE: Evaluate incidence of bacterial growth on implanted meshes in the abdominal wall of rats after to induce bacterial peritonitis. METHODS: 36 rats were used. They were allocated in two groups: group B, experiment group (n =18) and group S, control group (n =18). They were submitted to the implant of polypropylene meshes on the abdominal wall, at the preperitoneal space. Then, in the animals of the experiment group, the induction of peritonitis was made through the inoculation in the peritoneal cavity of standardized solution of Escherichia coli. In the animals of the control group it was made through the inoculation of physiologic solution. The animals of both groups were reallocated in three subgroups of six animals and observed until the reoperations time, for evaluation of the implantation sites, collection of the meshes for cultures, evaluation of the abdominal cavity and peritoneal lavage for cultures. The reoperations occurred in 24, 48 and 72 hours. RESULTS: All the animals of the experiment group presented clinical symptoms of peritonitis. The cultures of the meshes taken off from the implantation sites were positive in 83% of the animals when the moment of the evaluations was of 24 hours, decreasing to 33% in 48 hours and 17% in 72 hours. Globally, it was of 44%. In the animals of the control group there was no case of positive culture neither in the meshes, nor in the peritoneal lavages. CONCLUSIONS: The experimental model used was effective, producing 100% of peritonitis. The incidence of bacterial growth on the implanted polypropylene meshes was 83% in 24 hours, decreasing with the time.

Abdominal Wall↗
PubMed2002

Povidone-iodine spray technique versus traditional scrub-paint technique for preoperative abdominal wall preparation.

OBJECTIVE: The study was conducted to compare povidone-iodine spray and traditional scrub-paint techniques in reducing abdominal wall bacteria during preoperative preparation. STUDY DESIGN: Sixty patients scheduled to undergo vaginal surgery were recruited for study. Cultures of the abdominal skin were performed before and after preparation with two techniques: A traditional 5-minute iodophor soap scrub-paint on one half and povidone-iodine aqueous spray on the other. Multiple pairwise comparisons were performed with the Wilcoxon signed rank test. A P value of.05 was considered statistically significant in all analyses. RESULTS: The mean number of colonies for spray after 1 minute was 1.83 +/- 3.16, for spray after 3 minutes was 0.40 +/- 1.15, and after 5-minute scrub was 0.87 +/- 2.97. Both techniques, the spray after 3 minutes and the 5-minute scrub, were statistically more effective at reducing bacterial counts than the spray after 1 minute. There was no statistically significant difference between the spray after 3 minutes and the scrub techniques. CONCLUSION: Povidone-iodine applied as a spray and left to dry for 3 minutes appears as effective as the traditional scrub-paint technique in reducing abdominal wall bacteria before abdominal surgery.

Abdomen↗
PubMed1997

[Functional evaluation of the abdominal wall after raising a rectus abdominis myocutaneous flap].

Breast reconstruction with transverse rectus abdominis muscle (TRAM) flap raises two contradictory questions: the vascular safety of the flap and the late abdominal wall sequellae. In order to analyse these sequellae, 71 patients with TRAM flap breast reconstruction at the Institut Curie had a late postoperative evaluation by both a physiotherapist and a surgeon, an average 28 months after their reconstruction. 12 had had a double pedicled TRAM (DPT) and 59 a single pedicled TRAM (SPT). Hernias and bulges were systematically recorded, and all patients had an evaluation of their abdominal wall function by questioning (subjective evaluation) and muscular testing (objective evaluation). The overall hernia rate (including bulges) was 5.6%. This rate was 2.5% when mesh was used, and 9.5% when direct closure was performed. This hernia rate was not influenced by the type of TRAM (SPT or DPT). 20% of patients complained of residual abdominal pain, and 36% of a decrease of their abdominal strength after SPT. Both these figures were 75% after DPT. Testing showed that these sequellae were related to an impairment of the supraombilical portion of the rectus, this impairment being much higher after DPT than SPT: none of the 12 patients with DPT were able, from a lying position, to sit down without using their hands (not reaching 4 in Lacote's test), whereas 47% of the SPT could do it. The oblique muscles were also impaired, as less than 20% of patients reached Lacote 4. However, this impairment was not influenced by the type of flap harvested. Testing was also equivalent after both techniques of SPT (standart or "supercharged"). The post-operative hernia rate was not higher for DPT and seemed related to the technique used for abdominal wall closing (mesh vs direct closure). However, the functional sequellae (pain, muscle strength decrease) were much higher after DPT than SPT. It thus confirms us in our attitude to restrict the indications of DPT, when feasible, to the profit of microsurgical flaps.

Abdominal Muscles↗
PubMed1996

Incidence and effect on survival of abdominal wall metastases at trocar or puncture sites following laparoscopy or paracentesis in women with ovarian cancer.

The aim of this retrospective study was to examine the incidence and prognostic significance of abdominal wall metastases in patients with ovarian cancer present at the primary debulking at the entry sites of previous laparoscopy or paracentesis. The clinical records of 219 patients were studied. In 7 of 43 patients (16%) who had undergone laparoscopy and 3 of 30 patients (10%) who had undergone paracentesis previous to the primary debulking, an abdominal wall metastasis had developed at the entry sites. All metastases occurred in patients with FIGO stage IIIC-IV including ascites. Survival analysis using the Cox proportional hazards model showed that after adjustment for age, FIGO stage, histology, grade, ascites, and residual disease after primary debulking, the presence of abdominal wall metastases in the entry sites of previous laparoscopy or paracentesis was negatively, although not statistical significantly, correlated with survival (P = 0.14).

Abdominal Neoplasms↗
PubMedDate not supplied

[Unusual case of malignant pleomorphic fibrohistiocytoma of the abdominal wall].

The authors report their experience with a case of a voluminous malignant pleomorphic histiocytoma of the anterior abdominal wall occurring in an 81-year-old female patient. She presented with a one-year history of a non-painful, poorly mobile tumefaction which had grown in size over the 2 months prior to admission. A preoperative CT scan confirmed the presence of a 10-cm mass located in the anterior abdominal wall. The patient underwent resection of the tumour and was discharged on postoperative day 15. A 12-month follow-up has so far revealed no evidence of recurrence. The authors go on to examine the diagnostic and therapeutic treatments of these rare neoplasms with reference to the international scientific literature. They confirm the validity of radiotherapy but stress the elective role of surgical treatment.

Abdominal Wall↗
PubMed1998

Autologous closure of giant abdominal wall defects.

Split-thickness skin graft coverage of exposed and granulating intestines within large abdominal wall defects provides a life-saving permanent biologic dressing. The resultant abdominal wall defect often is closed with mesh, which may infect and fistulize. This report describes bilateral advancement flaps of the external oblique and recti muscles in 11 patients treated over 3 years. The defects, which averaged 16 x 24 cm, were due to necrotizing fasciitis subsequent to trauma with bowel perforation (3 patients), multiple ventral herniorrhaphies (2 patients), perforated diverticulitis (4 patients), and perforated peptic ulcer (2 patients). Eight patients were initially treated elsewhere where closure was achieved by split-thickness skin graft in five patients or mesh in 3 patients; 3 developed enterocutaneous fistulae and were transferred for closure while receiving long-term antibiotic and total parenteral nutrition therapy. All 11 patients had successful primary closure. The 8 patients operated on electively had primary healing; 2 developed seromas. Two of the three patients operated on urgently developed superficial wound infections; both healed by second intent without compromise of the primary closure. The following conclusions can be drawn: (1) the linea alba survives despite necrotizing fasciitis, (2) a tension-free primary closure is feasible; (3) morbidity is minimal, and (4) the long-term result is excellent.

Fasciitis, Necrotizing↗
PubMed2005

[Collagen synthesis after the implantation of polypropylene nets in the abdominal wall of young and old rats].

PURPOSE: Some investigators have stated that collagen synthesis is slower in elderly individuals, others have reported a reduction of collagen I and III synthesis, and still others have reported normal synthesis. The objective of the present study was to determine the collagen deposition occurring through the pores of a propylene net implanted in the abdominal wall of young adult rats compared to old rats. METHODS: Ten male rats aged 100 to 120 days and 10 rats aged 850 to 900 days were used. Under inhalatory anesthesia, a median incision was made in the ventral abdominal wall and a 4 cm2 gap was formed. The muscle-aponeurosis plane was removed and the peritoneal plane was maintained. The gap was corrected with a polypropylene mesh fixed with separate 5.0 polypropylene sutures and the skin margins were joined. The animals were sacrificed 30 days later and the ventral abdominal wall with the prosthesis was removed. The flap with the graft was divided into 2 parts, one for the traction assay and the other for histopathological study. The sections obtained were stained with hematoxylin-eosin and Sirius-red and examined under a polarized light microscope using the Image Plus software. RESULTS: The traction assay did not demonstrate a significant difference in resistance between groups. An acute-chronic inflammatory reaction with large quantities of giant foreign body cells was present at similar intensity in both groups, the same being observed for total collagen concentration (p=0.1440) and type I collagen concentration (p=0.3981). In contrast, type III collagen concentration was higher in the sections from old animals (p=0.0364). CONCLUSIONS: These results permit us to conclude that aging does not impair the resistance gain or collagen deposition, although a delayed tissue maturation occurs.

Abdominal Wall↗
PubMed1987

Herniorrhaphy in the elderly. Benefits of a clinic for the treatment of external abdominal wall hernias.

Elective abdominal herniorrhaphy carries morbidity and mortality rates of 26 percent and 1.5 percent, respectively, in patients over 65 years of age. These figures climb to 55 percent and 15 percent during emergent surgery. Our purpose was to investigate if standardization of treatment could improve such results. Our program stressed centralization of care in a hernia clinic; early operation of patients at risk of incarceration; optimization of underlying systemic disorders by consultative services; operation under local anesthesia; preoperative, operative, and postoperative protocol; and continuity of care by senior personnel. Over a 4 year period, we have performed 241 abdominal herniorrhaphies in patients over 65 years of age (median age 71.5 years old) who exhibited an 84 percent incidence of significant preoperative systemic disorders. Since the inception of our program, our rate of emergent operation has decreased significantly from 7 percent to 2 percent (chi-square less than or equal to 0.05). Our rate of systemic complications after elective operation was 1.2 percent and 0 after emergent operation. These data are statistically better than those reported in the literature (chi-square less than or equal to 0.05). These results suggest that the creation of a hernia clinic significantly improves the care of herniated patients.

Age Factors↗
PubMed1986

The prenatal diagnosis of ventral abdominal wall defects.

Ventral abdominal defects are frequently diagnosed by prenatal ultrasonography. This review of 47 infants with ventral defects was designed to determine the effect of prenatal diagnosis on neonatal outcome. All nine infants with prenatal diagnosis were delivered by cesarean section at tertiary level hospitals. Only 13 (34%) of 38 infants with unsuspected defects were delivered by cesarean section and 15 (39%) were delivered at tertiary level hospitals. There was no difference in mortality between infants with prenatal diagnosis (44%) and those with unsuspected defects (37%). Increased mortality correlated with the presence of other major anomalies (79% mortality), with birth weight less than 1500 gm (80%), and with omphaloceles (65%). We conclude that infants with other associated defects or with birth weight less than 1500 gm have poor outcomes and cesarean section may not be justifiable. However, in larger infants without other anomalies, prenatal diagnosis was followed by cesarean section and a good prognosis.

Abdominal Muscles↗
PubMed1981

Traumatic abdominal wall hernia.

Traumatic abdominal hernias are uncommon. A case is presented of a 49-year-old man who struck his abdomen on the handlebars of a snowmobile. Local pain, bruising, and reducible swelling with cough impulse suggest the diagnosis. Lateral or oblique X-rays and use of contrast material are recommended. Differentiation from a preexisting hernia may be important medicolegally. Incision, if necessary, should be very carefully made. In the present case surgical repair was followed by uneventful recovery.

Abdominal Injuries↗
PubMed1987

Graft reconstruction to treat disease of the abdominal aorta in patients with colostomies, ileostomies, and abdominal wall urinary stomata.

Abdominal aortic reconstruction combined with colon or urinary tract operations is generally not acceptable because of a supposed greater incidence of graft infection. Similar fears exist regarding aortic reconstruction in the presence of colostomies, ileostomies, and permanent urinary diversion stomata. In fact, the presence of a colostomy has been reported to be a contraindication for abdominal aortic reconstruction. This report is concerned with vascular operations in 13 such patients with aortic disease referred to us for fear of these complications. Eleven patients had abdominal aortic aneurysms and two had atherosclerotic occlusion of the aorta and iliac arteries. Twelve patients had colostomies, ileostomies, or both and one patient had permanent tube cystostomy. All had good renal function and the disease for which the diversion procedure was performed was either cured or under good control. All patients survived the vascular reconstructive procedures without significant complications and long-term follow-up revealed that late graft infection did not occur.

Abdominal Muscles↗