• Title/Summary/Keyword: Abdomen wall

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Abdominal Wall Closure Using Artificial Mesh for Patients with an Open Abdomen (복부개방(Open abdomen) 환자에서 인공막(Artificial Mesh)를 이용한 근막봉합술)

  • Cha, Sung Whan;Shim, Hong Jin;Jang, Ji Young;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.172-177
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    • 2012
  • Purpose: After damage control surgery, abdominal wall closure may be impossible due to increased intra-abdominal pressure (IAP), and primary closure may induce abdominal compartment syndrome. The purpose of this study was to investigate changes in the IAP and the feasibility of abdominal wall closure using artificial mesh. Methods: From July 2010 to July 2011, 8 patients with intra-abdominal hypertension underwent abdominal wall closure using artificial mesh. Medical data such as demographics, diagnosis, operation, IAP, postoperative complications, mortality and length of hospital stays were collected and reviewed, retrospectively. One patient was excluded because of inadequate measurement of the IAP. Results: Seven patients, 4 males and 3 females, were enrolled, and the mean age was 54.1 years old. Causes of operations were six traumatic abdominal injuries and one intra-abdominal infection. The IAP was reduced from $21.9{\pm}6.6mmHg$ before opening the abdomen to $15.1{\pm}7.1mmHg$ after fascial closure. Fascial closure was done on $14.9{\pm}17.5$ days after the first operation. The mean lengths of the hospital and the intensive care unit (ICU) stays were 49.6 days and 29.7 days respectively. Operations were performed $3.1{\pm}1.5$ times in all patients. Two patients expired, and one was transferred in a moribund state. Three patients suffered from complications, such as retroperitoneal abscesses, enterocutaneous fistulas, and bleeding that was related to the negative pressure wound therapy. Conclusion: After abdominal wall closure using artificial mesh, intra-abdominal pressure was well controlled, and abdominal compartment syndrome does not occur. When the abdominal wall in patients who have intra-abdominal hypertension is closed, artificial mesh may be useful for maintaining a lower abdominal pressure. However, when negative pressure wound therapy is used, the possibility of serious complications must be kept in mind.

Visualization of the Gastric Calcification due to Cancer on Tc-99m DPD and Abdominal CT Images (Tc-99m DPD 골스캔과 복부 CT 영상에서 보이는 위암의 석회화)

  • Jeong, Young-Jin;Kang, Do-Young
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.5
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    • pp.344-346
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    • 2004
  • A 69-year-old woman was presented with progressed dysphagia, gastric soreness and weight loss during 2 months. She was performed abdomen x-ray, EGDS and abdomen CT. Abdomen x-ray demonstrated punctuate calcification on LUQ. EGDS showed an ulceroinfiltrative mass with bleeding on cardia to antrum of stomach. And CT showed diffuse gastric wall thickness with multiple calcifications. Biopsy of the stomach and esophagus during EGDS examination revealed an adenocarcinoma, with signet ring cell type, infiltrating the wall of the stomach and the distal esophagus. Then acne scan was performed a few days later. It revealed intense uptake in LUQ, corresponding to the calcium containing neoplasm seen on the abdomen x-ray, EGDS and abdomen CT. And there was no evidence of any metastatic lesion and thyroid uptake on the bone scan. There are many reports about accumulation of the tracer in extraosseous lesion, but only a few literatures were reported about gastric calcification in stomach cancer. More over, no reports showed CT images. We are performed many diagnostic examinations and found well correlation between them. The reason of gastric calcification is considered with calcium deposition within extracellular space due to hemorrhage or necrosis. Other possibility offered to explain gastric calcification have been increased blood flow and/or increased neovascularity with capillary leaks of tracer, and specific enzymatic (phosphatases) receptor binding of tracer. So, it was happened ion exchange between intracellular calcium and phosphate groups of tracer.

A Case of Severe Cough-induced Abdominal Wall Hematoma (심한 기침에 의해 발생한 복벽 혈종 1예)

  • Son, Jun-Hyuk;Baik, Jae-Joong;Yang, Keum-Yeoi;Ryu, Kwang-Won;Joo, Young-Jin;Choi, Seung-Min;Kim, Sang-Cheol;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.5
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    • pp.462-465
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    • 2001
  • Severe cough may contribute to serious complications such as pneumothorax, pneumomediastinum, rib fracture, subconjunctival hemorrhage, subdural hemorrhage and cough syncope. However abdominal wall hematoma is a rare complication. Because it usually presents with abdomianal pain, abdominal wall hematoma needs to be differentiated from the acute surgical abdomen. A 78-year old woman was admitted with right lower quadrant abdominal pain and a palpable mass for several days. She experienced abdominal pain after violent coughing associated with an upper respiratory tract infection. Abdominal computed tomography revealed an approximately $7{\times}4cm$ sized, ill-defined, soft tissue density lesion in the right lower posterolateral abdominal wall. An abdominal wall hematoma was diagnosed. After admission, she had persistent right lower abdominal pain and an increasing mass. The mass was surgically removed and she was discharged without complications. In summary, when a patient complains of abdominal pain after severe coughing, an abdominal wall hematoma as a differential diagnosis must be considered.

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Traumatic Abdominal Wall Hernia: A Case Report

  • Yang, Youngro;Kim, Kwangsig
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.70-73
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    • 2017
  • Traumatic abdominal wall hernia is a rare condition that can follow any blunt trauma to the abdomen. Generally there has been an increase in the incidence of blunt abdominal trauma, although the case of traumatic abdominal wall hernias are rare. Probably due to the elasticity of the abdominal wall for resisting the shear forces generated by a traumatic impacts. In this case, we are reporting 1 rare case, diagnosed as an abdominal wall hernia associated with herniation of bowel loops due to blunt trauma without intra-abdominal injury including peritoneum.

F-18 FDG Uptake in Respiratory Muscle Mimicking Metastasis in Patients with Gastric Cancer (위암 환자에서 전이로 오인된 호흡근의 F-18 FDG 섭취)

  • Choi, Seung-Jin;Kim, Jeong-Ho;Hyun, In-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.4
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    • pp.233-236
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    • 2006
  • A 67-year-old man with a history of chronic obstructive pulmonary disease (COPD) underwent F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for staging of gastric cancer. The projection images of F-18 FDG PET/CT showed intensely increased F-18 FDG uptake in the anterior neck, chest wall, and upper abdomen. We suspected distant metastases of cervical lymph nodes, ribs, and peritoneum in gastric canter. However, the transaxial images of F-18 FDG PET/CT showed abnormal F-18 FDG uptake in scalene muscles of anterior neck, intercostal muscles of chest wall, and diaphragm of upper abdomen. Patients with COPD use respiratory muscles extensively on the resting condition. These excessive physiologic use of respiratory muscles causes increased F-18 FDG uptake as a result of increased glucose metabolism. The F-18 FDG uptake in respiratory muscles of gastric cancer patient with COPD mimicked distant metastases in cervical lymph nodes, ribs, and peritoneum.

Walled-off Pancreatic necrosis in a Dog

  • Hwang, Tae-sung;Park, Su-jin;Lee, Jae-hoon;Jung, Dong-in;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.35 no.4
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    • pp.146-149
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    • 2018
  • A 7-year-old, castrated, male Maltese dog presented with hyporexia and depression for 3 days. Elevated serum amylase, lipase activities, and liver enzyme values were found upon blood examination. An abdominal mass was seen on radiographs caudal to the gastric body in the left middle abdomen. In the left middle abdomen, abdominal ultrasonography also revealed a massive, irregularly marginated, heterogeneous mass of unknown origin, and in the right cranial abdomen, heterogeneously hypoechoic pancreatic tissue and hyperechoic change of adjacent mesenteric fat were observed. Contrast-enhanced computed tomography showed an irregular contour of the left pancreatic limb as well as heterogeneously enhanced parenchyma. A low-attenuating peripancreatic fluid collection with a thin and irregular wall was also seen. Based on these findings, an atypical pancreatic abscess with necrotizing pancreatitis which manifested as walled-off necrosis was suspected. The mass was excised, and the pancreatic abscess was confirmed by histopathologic examination. No complications were found in the patient after two months of follow-up examination.

Traumatic abdominal wall hernia with hemoperitoneum caused by blunt injury: laparoscopic exploration with mini-laparotomy repair. A case report

  • Jeong, Euisung;Jang, Hyunseok;Jo, Younggoun;Park, Yunchul;Lee, Naa;Kim, Jungchul
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.61-65
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    • 2022
  • Traumatic abdominal wall hernia is a very rare clinical entity. Herein, we report the case of a patient who was transferred from a local clinic to the emergency department because of left lower abdominal pain. Initially, an intra-abdominal hematoma was observed on computed tomography and no extravasation was noted. Conservative treatment was initiated, and the patient's symptoms were slightly relieved. However, though abdominal pain was relieved during the hospital stay, bowel herniation was suspected in the left periumbilical area. Follow-up computed tomography showed traumatic abdominal wall hernia with hemoperitoneum in the abdomen. We performed a laparoscopic exploration of the injury site and hernia lesion. The anterior abdominal wall hernia was successfully closed.

Analyzing the factors that contribute to the development of embryological classical type of bladder exstrophy

  • Ria Margiana;Widya Juwita;Khoirul Ima;Zakiyatul Faizah;Supardi Supardi
    • Anatomy and Cell Biology
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    • v.56 no.4
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    • pp.421-427
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    • 2023
  • Bladder exstrophy is a rare congenital condition of the pelvis, bladder, and lower abdomen that opens the bladder against the abdominal wall, produces aberrant growth, short penis, upward curvature during erection, wide penis, and undescended testes. Exstrophy affects 1/30,000 newborns. The bladder opens against the abdominal wall in bladder exstrophy, a rare genitourinary condition. This study is vital to provide appropriate therapy choices as a basis to improve patient outcomes. This study may explain bladder exstrophy and provide treatment. Epispadias, secretory placenta, cloacal exstrophy, and other embryonic abnormalities comprise the exstrophy-spades complex. The mesenchymal layer does not migrate from the ectoderm and endoderm layers in the first trimester, affecting the cloacal membrane. Embryological problems define the exstrophy-aspidistra complex, which resembles epimedium, classic bladder, cloacal exstrophy, and other diseases. Urogenital ventral body wall anomalies expose the bladder mucosa, causing bladder exstrophy. Genetic mutations in the Hedgehog cascade pathway, Wnt signal, FGF, BMP4, Alx4, Gli3, and ISL1 cause ventral body wall closure and urinary bladder failure. External factors such as high maternal age, smoking moms, and high maternal body mass index have also been associated to bladder exstrophy. Valproic acid increases bladder exstrophy risk; chemicals and pollutants during pregnancy may increase bladder exstrophy risk. Bladder exstrophy has no identified cause despite these risk factors. Exstrophy reconstruction seals the bladder, improves bowel function, reconstructs the vaginal region, and restores urination.

Radiographic Diagnosis of Canine Gastric Dilatation-volvulus Syndrome (개에서 발생한 위확장-염전증후군의 방사선학적 진단)

  • Kim Sang-Ki;Lee Chai-Yong;Oh Ki-Seok
    • Journal of Veterinary Clinics
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    • v.11 no.1
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    • pp.383-387
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    • 1994
  • The purpose of this report is to describe the radiographic patterns of canine gastric dilatation-volvulus syndrome derived from a case. Radiographs showed the presence of a large amount of gas, fluid and ingesta within the stomach. The gas-filled pyloric antrum was present in the left cranial abdomen in the ventrodorsal view, and located dorsal and slightly cranial to the gas-filled fundus of the stomach in the right lateral recumbent and standing lateral view. On the right lateral recumbent view, the gas-filled stomach was compartmentalized by a soft-tissue dense band caused by the pyloric antral wall folding back and contacting the fundic wall. It was thought that the gastric volvulus in this case occurred In a clock. wise direction by radiographic findings.

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Delayed Colon Perforation after Palliative Treatment for Rectal Carcinoma with Bare Rectal Stent: A Case Report

  • Young Min Han;Jeong-Min Lee;Tae-Hoon Lee
    • Korean Journal of Radiology
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    • v.1 no.3
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    • pp.169-171
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    • 2000
  • In order to relieve mechanical obstruction caused by rectal carcinoma, a bare rectal stent was inserted in the sigmoid colon of a 70-year-old female. The procedure was successful, and for one month the patient made good progress. She then complained of abdominal pain, however, and plain radiographs of the chest and abdomen revealed the presence of free gas in the subdiaphragmatic area. Surgical findings showed that a spur at the proximal end of the bare rectal stent had penetrated the rectal mucosal wall. After placing a bare rectal stent for the palliative treatment of colorectal carcinoma, close follow-up to detect possible perforation of the bowel wall is necessary.

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