Traumatic abdominal wall herniation: case series review and discussion

2013 ◽  
Vol 84 (3) ◽  
pp. 160-165 ◽  
Author(s):  
Ian Gutteridge ◽  
Keith Towsey ◽  
Cliff Pollard
Keyword(s):  
2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Erling Oma ◽  
Jan Kim Christensen ◽  
Jorge Daes ◽  
Lars Nannestad Jorgensen

Abstract Aim Effects of component separation (CS) on abdominal wall musculature have only been investigated in smaller case series. The study aimed to compare abdominal wall alterations following endoscopic anterior component separation (EACS) or transverse abdominis release (TAR). Material and Methods Computed tomography scans were evaluated in patients who underwent open ventral hernia repair with TAR or EACS. Lateral abdominal wall muscle thickness and displacement were compared with preoperative images after bilateral CS and the undivided side postoperatively after unilateral CS. Results In total, 105 patients were included. The mean defect width was 12.2 cm. Fifty-five (52%) and 15 (14%) underwent bilateral and unilateral EACS, respectively. Five (5%) and 14 (13%) underwent bilateral and unilateral TAR, respectively. Sixteen (15%) underwent unilateral EACS and contralateral TAR. Complete fascial closure was achieved in 103 (98%) patients. The external oblique and transverse abdominis muscles were significantly laterally displaced with a mean of 2.74 cm (95% CI 2.29-3.19 cm) and 0.82 cm (0.07-1.57 cm) after EACS and TAR, respectively. The combined thickness of the lateral muscles was significantly decreased after EACS (mean decrease 10.5% [5.8-15.6%]) and insignificantly decreased after TAR (mean decrease 2.6% [-4.8-9.5%]), mean reduction difference EACS versus TAR 0.22 cm (-0.01-0.46 cm). One (1%) patient developed an iatrogenic linea semilunaris hernia after EACS. The recurrence rate was 19% after mean 1.7 years follow-up. Conclusions The divided muscle was significantly more laterally displaced after EACS compared with TAR. The thickness of the lateral muscles was slightly decreased after EACS and unchanged after TAR.


2012 ◽  
Vol 77 (S2) ◽  
pp. 253-256 ◽  
Author(s):  
Prabhdeep Singh Nain ◽  
Harish Matta ◽  
Kuldip Singh ◽  
Deepinder Chhina ◽  
Munish Trehan ◽  
...  
Keyword(s):  

2015 ◽  
Vol 50 (3) ◽  
pp. 456-461 ◽  
Author(s):  
Stephanie D. Talutis ◽  
Oliver J. Muensterer ◽  
Samir Pandya ◽  
Whitney McBride ◽  
Gustavo Stringel

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Newall ◽  
C Jones ◽  
W Ho ◽  
A Curnier

Abstract Introduction The pedicled anterolateral thigh (ALT) flap is considered as a suitable option in complex abdominal wall reconstruction. Its use as a reconstructive option is infrequent in the literature, and to date, there has been no systematic review evaluating its long-term outcomes. We report our experience with the pedicled anterolateral thigh flap for abdominal wall reconstruction in high-risk patients. Method A prospective database was created for patients with abdominal wall defects treated with pedicled ALT with extended fascia lata flaps between 2014 and 2017. Patient demographics, aetiology, size, location of defect and post-operative results were reviewed. Abdominal defects were classified into the following zones: 1A, upper midline; 1B, lower midline; 2, upper quadrant; 3, lower quadrant. A systematic review of the literature was conducted using PUBMED and EMBASE. Results 4 patients (mean age 59.5 years, range 50-65 years) underwent reconstruction with pedicled ALT flaps. 3 flaps developed partial necrosis secondary to infection; 1 flap required surgical debridement, and 2 were managed conservatively. There was one flap failure, due to avulsion of the pedicle during inset. At mean follow up of 2.75 years (range 1 to 4 years) 3 patients have clinical bulging or herniation. Conclusions Review of the literature demonstrated 52 patients from 17 case series or reports. The overall infection and partial flap loss rates were both 6%. There were no reported flap failures. Our study demonstrates that the pedicled anterolateral thigh flap is an effective flap option for the repair of large defects of the abdominal wall in high-risk patients.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Chloe Theodorou ◽  
Zia Moinuddin ◽  
David Van Dellen

Abstract Aims Incisional hernias are a common complication after surgery that cause significant patient morbidity. Symptomatic patients are offered repair but many surgical techniques exist, with abdominal wall reconstruction becoming preferable for large complex defects. This paper describes our experience of abdominal wall reconstruction using a dual mesh technique. Method 22 patients underwent incisional hernia repair between March 2019 and September 2020. All patients received dual mesh, placed in retrorectus or transversalis fascial/retromuscular space. Absorbable BIO-A GORE mesh was used with a polypropylene mesh above. All patients were followed up to assess for complications and recurrence. Results No patients experienced fistula formation, long-term pain or obstructive symptoms. We report one true hernia recurrence (4.5%) and one case of infected mesh (4.5%), these both await further treatment. One patient had a proven wound infection which resolved with conservative treatment. 4 patients (18.2%) experienced seromas, 3 of these resolved spontaneously, one requiring image-guided drainage. Conclusion Incisional hernia repair using combination polypropylene and bio-absorbable mesh provides a safe and effective repair with low recurrence and incidence of surgical site occurrences in the short term. Longer follow up and further studies are needed to evaluate this mesh technique to support ongoing use of absorbable meshes in complex hernia repair.


Pain Medicine ◽  
2021 ◽  
Author(s):  
Hesham Elsharkawy ◽  
Sree Kolli ◽  
Loran Mounir Soliman ◽  
John Seif ◽  
Richard L Drake ◽  
...  

Abstract Study Objective We report a modified block technique aimed at obtaining upper midline and lateral abdominal wall analgesia: the external oblique intercostal (EOI) block. Design A cadaveric study and retrospective cohort study assessing the potential analgesic effect of the EOI block. Setting Cadaver lab and operating room. Patients Two unembalmed cadavers and 22 patients. Interventions Bilateral ultrasound-guided EOI blocks on cadavers with 29 ml of bupivacaine 0.25% with 1 ml of India ink; single-injection or continuous EOI blocks in patients. Measurements Dye spread in cadavers and loss of cutaneous sensation in patients. Main Results In the cadaveric specimens, we identified consistent staining of both lateral and anterior branches of intercostal nerves from T7–T10. We also found consistent dermatomal sensory blockade of T6–T10 at the anterior axillary line and T6–T9 at the midline in patients receiving the EOI block. Conclusions We demonstrate the potential mechanism of this technique with a cadaveric study that shows consistent staining of both lateral and anterior branches of intercostal nerves T7–T10. Patients who received this block exhibited consistent dermatomal sensory blockade of T6–T10 at the anterior axillary line and T6–T9 at the midline. This block can be used in multiple clinical settings for upper abdominal wall analgesia.


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