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Intraperitoneal haemorrhage from anterior abdominal wall varices.

Patients with oesophageal varices frequently present with gastrointestinal haemorrhage but bleeding from varices at other sites is rare. We present a patient with hepatitis C-induced cirrhosis and partial portal vein occlusion who developed spontaneous haemorrhage from anterior abdominal wall varices into the rectus abdominus muscle and peritoneal cavity.

Abdominal Muscles↗

Evaluation of a collagen-based biosynthetic material for the repair of abdominal wall defects.

A collagen tissue polymer composite manufactured in sheep and prepared in two different forms (wet and dry) was compared to polypropylene mesh and to a control group for effectiveness in the repair of an abdominal wall defect in a rabbit model. The wet and dry patches were shown to differ significantly in their pore size. The wet material was shown to retain its natural porosity and promoted neovascularization, tissue integration, cellular infiltration, and neomatrix formation compared to the dry collagen-polymer patch. This material was superior to the polypropylene mesh implant, which was associated with significant adhesions. The appearance of type VI collagen was the earliest sign of new cell infiltration and neomatrix formation within the implant. New deposition of type VI collagen was apparent throughout the thickness of the implant within 4 weeks, followed by type III collagen accumulation. Decreased porosity of the collagen component in the dry patches resulted in a totally nonintegrated implant. This induced a foreign-body capsule with minimal cellular tissue infiltration and no deposition of collagen types VI and III within the implant.

Abdominal Muscles↗

An epidemiologic study of congenital malformations of the anterior abdominal wall in more than half a million consecutive live births.

The records of an ongoing health surveillance registry that utilizes multiple sources of ascertainment were used to study the incidence rate of congenital malformations of the anterior abdominal wall in live-born children in British Columbia during the period 1964--1978 inclusive. No overall increase in incidence rate of these anomalies was detected during the study period. The estimated live-born incidence rates were: one in 4,175 live births for omphalocoele, one in 12,328 live births for gastroschisis, and one in 29,231 live births for prune belly. The data were analyzed with regard to sex and associated anomalies. Some practical implications regarding assessment of these infants are discussed.

Abdominal Muscles↗

Sirenoid monopodia with defects of right abdominal wall and lower limb associated with chromosome abnormality.

We have experienced a case of sirenoid monopodia with extreme deformity, which was studied pathoanatomically and genetically. The pathoanatomical studies revealed complicated deformities such as absence of the right abdominal wall, sacrum, right side of the os coxae and lower extremity, etc., and a chromosome study revealed 46XX, t (1 p-, Xq+), -8, +M. Various authors have discussed the genetic factors of anomaly of vascular development and concluded that all cases except for a few familial types would appear to be sporadic. In the present paper we report on an extreme type of sirenoid monopodia with right lower limb defect associated with chromosome abnormality. It is supposed that impoverished blood supply to the right lower portion of the body may have been the cause of this case, but the involvement of genetic factors is still unknown.

Abdominal Muscles↗

Diagnosis of metastasis of ovarian clear cell carcinoma to the peritoneum of the abdominal wall by positron emission tomography with (fluorine-18)-2-deoxyglucose.

A 43-year old woman, operated on for ovarian clear cell carcinoma (stage IIc) four years previously was found to have a small mass under the abdominal wall in the right lower quadrant of the abdomen. Neither diagnostic imaging (ultrasonography and MRI) nor tumor markers showed any evidence of recurrence, but positron emission tomography revealed a hot spot area, and it was diagnosed as recurrence of the ovarian carcinoma. The postoperative histopathological diagnosis was metastasis of ovarian carcinoma to the peritoneal wall.

Adenocarcinoma, Clear Cell↗

Abdominal wall hernia repair: a long-term comparison of Sepramesh and Dualmesh in a rabbit hernia model.

Surgeons are faced with a wide variety of mesh products, which they can use to perform tension-free abdominal wall hernia repair. The purpose of this study is to compare Sepramesh (SM) and Dualmesh (DM) in terms of strength of tissue incorporation, mesh shrinkage, and adhesiogenesis. We conducted a prospective, randomized trial using 24 New Zealand White rabbits. Each animal underwent creation of a standardized ventral hernia defect and was randomized to receive either SM or DM repair. There were 12 animals in each study arm. Five months postoperatively, the animals were sacrificed and the hernia repairs were analyzed. Specimens were evaluated for strength of incorporation (SOI), mesh shrinkage, as well as the type and amount of adhesions. SOI for DM was not statistically different from SM (37.2N vs 40.8N). DM underwent significantly more shrinkage than did SM (50.8% vs 32.6%, P < 0.0001). Adhesions were predominantly omental in nature. DM demonstrated a greater amount of adhesed area as a percentage of the mesh (30.7% vs 25.2%), but fewer adhesions in terms of absolute area involved (636 mm2 vs 717 mm2). This difference was not statistically significant. Previous studies, terminated at 30 days, demonstrated an increased SOI for SM as compared to DM. This study shows that SOI for DM continues to increase over time such that it is equivalent to DM at 5 months. Though there is increased mesh shrinkage for DM, adhesions to the two materials are equivalent.

Animals↗

Abdominal wall repair with polypropylene mesh in pregnancy.

A woman in her 34th week of gestation required emergency appendectomy for perforation, with postoperative wound dehiscence secondary to fasciitis and tension on the suture line. Polypropylene mesh was used to repair the abdominal wall. Fetal distress necessitated a cesarean section. The mother and child both survived without functional impairment. The indications, the disadvantages, and the unresolved issues concerning the use of polypropylene mesh during pregnancy are presented.

Abdominal Muscles↗

Biomaterials for abdominal wall hernia surgery and principles of their applications.

This article focuses special attention on the porosity, cellular permeability and molecular permeability of biomaterials and their effect on infection, host tissue incorporation and seroma formation when mesh is used for the repair of abdominal wall hernias. Furthermore, the general principles of the application of biomaterials, regardless of the technique used for their employment, is discussed.

Abdominal Muscles↗

Clear cell sarcoma of the abdominal wall with peritoneal sarcomatosis: CT features.

Clear cell sarcoma, also called malignant melanoma of soft parts, is an uncommon neoplasm that involves tendons or aponeuroses of the lower extremity. The CT features of a clear cell sarcoma arising from the abdominal wall with later peritoneal dissemination are described. Peritoneal sarcomatosis from soft tissue sarcomas is a very rare condition previously unreported in the radiologic literature. Metastases to peritoneal surfaces must therefore be considered a possible site for systemic dissemination of soft tissue sarcomas.

Abdominal Muscles↗

Soft-tissue response to clinically retrieved titanium cover screws reimplanted in the rat abdominal wall.

Clinically retrieved titanium implant cover screws (Brånemark implant system), rinsed in saline or subjected to ultrasonic cleaning and sterilization, as well as unused sterile screws were studied by scanning electron microscopy and implanted in the rat abdominal wall for 6 weeks. Irrespective of cleaning procedure, the heads of the clinically retrieved screws were covered by numerous contaminants not present on the unused screws. The reimplanted screws elicited a different tissue response than the unused screws. The tissue response to the contaminated screws was characterized by a significantly thicker fibrous capsule and by a significantly larger number of macrophages located close to the implant. Moreover, judging from their ultrastructure, studied with transmission electron microscopy, the macrophages appeared to be in a more active state when compared to those located adjacent to unused screws.

Animals↗

[The antenatal diagnosis before 20 weeks of an omphalocoele and a failure of development of the abdominal wall (author's transl)].

We report 2 cases of malformations occuring in the region of the umbilicus which were diagnosed by amniocenteses before the 20th week of pregnancy (with levels of alphafetoprotein) and echography. Failure of development of the abdominal wall was only diagnosed for certain after the therapeutic abortion had been carried out. The omphalocoele was diagnosed for certain by echography at the 19th week after anencephaly and spina bifida had been eliminated in spite of an abnormally high rise in the level of amniotic fluid alphafetoprotein (100.000 microgram/l). We have not found any similar cases in the literature at this gestational age. These observations prove the value of combining the estimation of alphafetoprotein level in the amniotic fluid when making antenatal diagnoses because of the age of the mother (after the age of 38), with echography specially directed to searching for such apparent morphological abnormalities.

Abdominal Muscles↗