[SO-CALLED SPONTANEOUS HEMATOMAS OF THE ABDOMINAL WALL (DESCRIPTION OF 2 CASES)].
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To obtain a valuable treatment of congenital muscle defect, cell-matrix constructs composed of satellite cell-derived myoblasts (XY karyotype) seeded on muscle acellular matrices were used to repair a previously created full-thickness defect of abdominal wall of 18 1-month-old female Lewis rats. Acellular abdominal matrices, obtained by a detergent-enzymatic method, were positive for both basic fibroblast growth factor and transforming growth factor-beta, and were able to support in vitro cell adhesion. All animals survived the surgery, without signs of infection or implant rejection, and were humanely killed at 1, 3, or 9 months after surgery. The implants appeared well preserved, were integrated in the host tissue, and maintained their original dimension and thickness until 9 months. Vesicular acetylcholine transporter was expressed on the surface of muscle fibers from 1 month postsurgery. Finally, implanted male myoblasts were present inside the patches until 9 months, as demonstrated by the expression of SrY mRNA and by the presence of Y chromosome probe signal. These results allow us to conclude that cell-matrix constructs could represent a promising approach to the repair of muscle defects, because they are repopulated in vivo by skeletal muscle cells and nervous elements and maintain their structural integrity over the long term.
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Children who are too ill to await a liver graft of suitable size may be transplanted with a relatively oversized graft by leaving the abdominal wound partially open, the defect reduced being bridged with polypropylene mesh and the mesh reduced in stages until it can be removed and the wound directly closed. This technique has been used in seven children who received nine grafts (five reduced and four full size). Their mean age was 7.3 (range 0.5-11) months and mean weight 5.8 (range 2.3-7.2) kg. Progressive reduction in the size of the transplanted liver made primary closure possible in survivors in up to four stages. Over a follow-up period of 3 to 58 months, five of the nine grafts and five of the seven patients survived. No significant complications attributable to the technique were encountered. The technique of delayed primary abdominal wall closure may be of benefit in children at risk of graft failure because of a size-mismatched graft.
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A technique to minimize injury to the bowel and its associated mesentery during difficult stoma creation is presented. A penrose drain is used to ensheathe the terminal segment of bowel, creating a uniform "tube" of intestine, protecting and facilitating delivery of the bowel through the abdominal wall.
Closure of wounds of the abdomen with a minimal amount of foreign material is still the preferred method. However, in those instances in which loss of tissue is too great to effect closure or in which closure will place the suture line under tension, the use of a synthetic plastic mesh is an effective alternative. As described, the technique avoids the risks of further necrosis of the tissue, infection and dehiscence. In those instances of extensive loss of tissue, it is frequently the only practical method available to reconstruct the abdominal wall.
This article describes the causes, course, and treatment options for surgical repair of umbilical epigastric and incisional hernias. Special attention is paid to the full-thickness abdominal wall defects, which are particularly difficult wounds to close. A method of closure with Marlex mesh, followed by myocutaneous flap coverage, is discussed.
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The association between pelvic actinomycosis and the use of intrauterine devices is well established. However, abdominal wall actinomycosis without clinical involvement of the pelvic organs has been reported only once in the literature. The authors present a second case, which occurred in a 24-year-old woman who was using a copper 7 intrauterine device.
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An accurate and reproducible technique was employed for the determination of the resistivity of excised portions of the anterior abdominal wall of rats. Resistivity decreased linearly (r = -0.93; P < 0.001) from 1438 +/- 131 omega.cm, immediately following death, to 360 +/- 144 omega.cm at a postmortem interval of 36 h. These changes are believed to reflect the morphological and/or chemical changes which occur at the cellular level during the early postmortem period.
Endometriosis of the superficial soft tissues is an uncommon lesion that may occur in the absence of other evidence of pelvic endometriosis. An example of an endometrioma arising in the rectus sheath is reported here. To our knowledge, this is the first CT description of an anterior abdominal wall endometrioma.
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