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Traumatic abdominal wall hernia--four cases and a review of the literature.

OBJECTIVE: To review blunt traumatic abdominal wall hernias (TAWHs) in our institution. METHOD: Retrospective review of blunt abdominal trauma cases over a 6-month period. RESULTS: Four patients with TAWH were identified. The mean age was 36 years. Three had been involved in vehicular collisions, and 1 had been assaulted with a large stone. All were diagnosed on presentation, 3 by computed tomography scan and 1 clinically. Two were repaired as emergencies, and 1 was repaired after 4 months. The 4th patient refused surgery. CONCLUSION: This uncommon injury requires a high index of suspicion and a low threshold for intervention. CT scan offers the best imaging potential.

Abdominal Injuries↗

Abdominal wall anatomy: the key to a successful inguinal hernia repair.

Over the past century, there has been a significant increase in the understanding of abdominal wall anatomy as it relates to inguinal and ventral hernia repairs. Since the initial reports of successful primary inguinal herniorrhaphy, recurrence rates have dramatically decreased because of the improved understanding of the pathologic defect. This article will review the important nomenclature of the groin region, briefly review the bony and tissue anatomy of the groin, and describe the anatomic hole from which the pathologic hole (hernia) originates.

Abdominal Wall↗

Magnetic resonance imaging and abdominal wall hernias in aortic surgery.

BACKGROUND: The aim of this study was to evaluate the incidence of abdominal wall hernias (AWH) in patients operated on for abdominal aortic aneurysm (AAA) compared with patients treated for aortoiliac occlusive disease. The efficacy of MRI in early diagnosis of AWH also was studied. STUDY DESIGN: One hundred fourteen patients operated for either AAA (51 patients, group A) or aortoiliac occlusive disease (63 patients, group B) constitute the study. The presence of AWH onset was evaluated by clinical observation followed by ultrasonography. Data acquired by ultrasonography were compared with those obtained by MRI to determine the efficacy of this diagnostic tool in all 114 patients. The prevalence of inguinal hernias in both groups also was determined. RESULTS: A significant difference was found in the incidence of AWH. AWH developed in 31.7% (16 of 51) of group A patients and 17.4% (11 of 63) of group B patients (p < 0.03). A significant prevalence ofinguinal hernias was detected in group A (p < 0.01). The Cox hazard regression analysis revealed as independent predictors of postoperative AWH only the presence of AAA and a history of laparotomy. CONCLUSIONS: Ours and other studies recall collagen synthesis disorders to explain the statistical association observed among AAA, inguinal hernias, and AWH. MRI, especially in patients at risk, appears to be an effective diagnostic approach to early detection of AWH.

Aorta, Abdominal↗

Lateral meningocele and defect of abdominal wall.

A case of lateral meningocele associated with deficiency of the thoraco-abdominal wall is reported. It is suggested that both of these defects are due to interference with the development of the paraxial mesoderm by a single injury.

Abdominal Muscles↗

[Venous and intragastral pressure measurements in surgical correction of abdominal wall defects].

Our own experiences with venous and intragastral pressure measurements when correcting abdominal wall defects and their consecutive symptoms are shown. The exact measurement of pressure in the V. cava inf. is a good method for the assessment of the intraabdominal pressure ratios. The intragastral pressure measurement is demonstrated as an alternative measuring technique. As a non-invasive method, it is without risk; it is easy to perform and correlates with the intra-abdominal pressure.

Abdominal Muscles↗

[Desmoid tumor of the abdominal wall. Echographic and CT aspects].

Desmoid tumors are rare tumors of the anterior abdominal wall. They are easily accessible to sonography and computed tomography because of their superficial situation. We must know the signs which can call up this diagnosis, particularly sonographic signs. We report one case with usual radiologic aspects of these tumors.

Abdominal Muscles↗

Abdominal wall cellulitis and sepsis secondary to percutaneous cecostomy.

We report 1 case of abdominal wall cellulitis and sepsis which developed following percutaneous placement of a Cope catheter for cecal decompression in a patient with Ogilvie's syndrome. This case highlights that further laboratory investigation and clinical evaluation are needed to determine the safest and most efficacious technique of percutaneous drainage.

Abdominal Muscles↗

[New developments in abdominal wall closure].

A perspective on the newer techniques and techniques and recommendations in abdominal wall closure as described in the English-language literature is given. Primary closure of midline incision with running suture should be performed with a suture length to wound length ratio in the range of 4-5 to 1; this appears to be the most important step the surgeon can take to avoid dehiscence and/or hernia. The choice of suture material does not appear to be crucial with regard to the prevention of wound failure. Anecdotal experience has suggested that the specific technique of mesh placement in incisional herniography is important to prevent recurrence. Difficult abdominal closure can be handled by one of a number of temporary abdominal closure techniques.

Abdominal Muscles↗

Postoperative abdominal wall hematomas have a distinctive appearance on ultrasonography.

In six patients a large abdominal wall hematoma developed 1 1/2 to 6 months after operation. In each case differentiation of incisional hernia from hematoma was difficult, but the distinctive appearance on ultrasonography of an ovoid mass with thick straight internal septae, characteristic of hematoma, was noted in all. Ultrasonography also showed the multilocular nature of the lesion which made percutaneous aspiration difficult.

Abdominal Muscles↗

Abdominal wall haematoma in anti-coagulated patients: the role of imaging in diagnosis.

Abdominal wall haematomas are uncommon, difficult to diagnose clinically and often associated with systemic anti-coagulation. Seven cases together with the imaging results are presented and the characteristic features and potential pitfalls are discussed. Ultrasound is the first line investigation but the results can be misleading and computed tomography (CT) is often required to confirm the diagnosis.

Abdominal Muscles↗