scholarly journals Resection and Abdominal Wall Reconstruction of a Desmoid Tumor with Endometrioma Features

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Jaqueline Majors ◽  
Nathaniel F. Stoikes ◽  
Reza Nejati ◽  
Jeremiah L. Deneve
Keyword(s):  
Abdominal Wall ◽  
Soft Tissue Tumor ◽  
Abdominal Mass ◽  
Abdominal Cavity ◽  
Abdominal Wall Reconstruction ◽  
Pathologic Finding ◽  
Desmoid Tumors ◽  
History Of ◽  
Well Differentiated ◽  
Palpable Abdominal Mass

Desmoid tumors are rare, musculoaponeurotic mesenchymal origin tumors arising from the proliferation of well-differentiated fibroblasts. Desmoid tumors may arise from any location with the abdominal cavity, abdominal wall and extremity locations being most frequent. We present the case of a 35-year-old female with a history of endometriosis who presented palpable abdominal mass and cyclic abdominal pain. Resection was performed for a presumed desmoid soft tissue tumor. Final pathology demonstrated desmoid histology admixed with abdominal wall endometriosis (endometrioma). This unique pathologic finding has only been rarely reported and is discussed with a brief review of the literature.

scholarly journals Ventral hernia from routine repairs to abdominal wall reconstruction: our initial experience

2020 ◽  
Vol 7 (10) ◽  
pp. 3348
Author(s):  
Sheetal Ishwarappagol ◽  
Rohit Krishnappa
Keyword(s):  
Abdominal Wall ◽  
Ventral Hernia ◽  
Abdominal Wall Reconstruction ◽  
Tobacco Consumption ◽  
Transversus Abdominis ◽  
Abdominal Pressure ◽  
Postural Stabilization ◽  
History Of ◽  
And Function ◽  
Ventral Hernias

Background: Loss of continuity of abdominal wall significantly affects the functions of protection of viscera, postural stabilization, and maintenance of intra-abdominal pressure. The newer understanding of abdominal wall reconstruction (AWR) aims at restoring abdominal wall anatomy and function, instead of simply patching the defect. We want to showcase the changing trends and results in hernia repair at a Medical Institution.Methods: This is an observational retrospective study conducted in RRMCH, Bengaluru from July 2018-2019 including all patients with ventral hernia undergoing the specified hernia repairs.Results: A total of 54 patients with ventral hernias undergoing routine hernia repairs/AWR surgeries were retrospectively analysed. The overall mean age was 46.62±12.44 year. Majority subjects were females (n=37; 68.5%), and overweight (Mean BMI=28.07±3.01/m2). 14 patients (25.92%), all males, had history of tobacco consumption. There were 38 (70.37%) primary ventral hernias and 7 recurrent hernias. Overall mean defect size was 10.2±0.4 cm. Most frequently performed was open retro rectus Hernioplasty (n=18; 33.33%), followed by open Preperitoneal Hernioplasty (n=17; 31.48%), laparoscopic intraperitoneal onlay mesh (IPOM) (n=16; 29.62%) and open transversus abdominis release (TAR) (n=3; 5.5%). On statistical analysis, it was found that Open repairs had higher post-operative pain (p=0.0005), longer hospitalization (p=0.0002) and higher incidence of surgical site events (p=0.0134) when compared to Laparoscopic repairs.Conclusion: As known already, minimally invasive techniques of hernia surgeries are shown to have acceptable outcomes when compared to radical open surgeries. Newer techniques of AWR are being employed to routine cases in larger numbers, and not just for complex reconstruction, at most centres with acceptable outcomes. 

Revising Recommendations and Outcome Measurements after Complex Open Abdominal Wall Reconstruction

2015 ◽  
Vol 81 (10) ◽  
pp. 955-960 ◽  
Author(s):  
Shawn Diamond ◽  
H. Gill Cryer
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Clinical History ◽  
Long Term Results ◽  
Functional Domain ◽  
Grading Systems ◽  
History Of ◽  
Grade Ii ◽  
Restricted Use

Grading systems developed by the Ventral Hernia Working Group (VHWG) for complex open abdominal wall reconstruction rely on limited outcomes: surgical site occurrence (SSO) and hernia recurrence. This does not account for the longitudinal restoration of a functional abdominal wall and the ability to correct complications. We performed a single-site, retrospective review of consecutive complex open abdominal wall reconstruction interventions with 24-month minimum follow-up to establish reoperation rates and compare long-term results to the VHWG. About 125 midline hernia repairs (>200 cm2) were studied. All had loss of functional domain and 47-month average follow-up. Demographics included: mean age 57 years, 47 per cent male, 63 per cent obese, and 34 per cent with contamination. Rates of SSO per VHWG grade were 9 per cent grade I, 45 per cent grade II, and 55 per cent grade III. Forty-three of 59 patients who developed complications were eventually successful after reoperation leading to an 87 per cent restoration rate. Select factors independently associated with reoperation included biological mesh and clinical history of infection. Although rates of SSO were higher than the VHWG published, we experienced high salvage rates except in patients who underwent biologic repair. We recommend restricted use of biologic mesh in contaminated and clean fields as well as modifications to the VHWG grading and recommendations.

scholarly journals Intra-Operative Total Bowel Washing: A New Method to Improve the Outcome of Gastroschisis Primary Repair

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Ahmad Mohammadipour ◽  
Mehran Hiradfar ◽  
Reza Shojaeian
Keyword(s):  
Gastrointestinal Tract ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Primary Repair ◽  
Abdominal Cavity ◽  
Abdominal Wall Reconstruction ◽  
Operation Time ◽  
Oral Feeding ◽  
Main Challenge ◽  
Significant Difference

Background: Gastroschisis is an abdominal wall defect that is managed by surgical reduction of herniated bowel into the abdominal cavity and abdominal wall reconstruction. Loss of abdominal domain is the main challenge that may complicate the process of gastroschisis management. Objectives: This article is about innovative manure called total bowel washing (TBW) that may improve the outcome of gastroschisis primary repair. Methods: All neonates with gastroschisis who met the study inclusion criteria between 2006 - 2019 were enrolled and divided into two groups of conventional and TBW method of gastroschisis management. In TBW group, bowls were washed with warm saline and after a gentle enterolysis, the whole gastrointestinal tract was irrigated via a gastric tube and evacuated completely from thick meconium until the watery stool started to come out of anus slightly. Primary abdominal wall closure was performed after loop by loop bowel reduction. Gastroschisis management outcome was compared between the two groups. Results: 15 neonates were allocated in each group. Demographic and anthropometric variables were compared and any significant difference wasn’t reported between the two groups. We observed a significantly better outcome in terms of faster GI rehabilitation, shorter time to oral feeding tolerance, less need to silo placement and shorter NICU and hospital stay in TBW method. Operation time was slightly longer in TBW group while the difference was not significant statistically. Conclusions: Total bowel washing and complete evacuation of gastrointestinal tract from thick meconium will increase the success rate of primary repair and improve the outcome of gastroschisis management.

scholarly journals Treatment of Abdominal Wall Soft Tissue Tumor: Abdominal Wall Reconstruction following Tumor Resection

2008 ◽  
Vol 57 (2) ◽  
pp. 324-327
Author(s):  
Masashi Kamikawa ◽  
Toshitake Yakushiji ◽  
Hiroo Satoh ◽  
Kiyoshi Oka ◽  
Hiroshi Mizuta
Keyword(s):  
Soft Tissue ◽  
Abdominal Wall ◽  
Soft Tissue Tumor ◽  
Tumor Resection ◽  
Abdominal Wall Reconstruction ◽  
Tissue Tumor

Abdominal Elephantiasis: A Case Report

2004 ◽  
Vol 8 (4) ◽  
pp. 229-232 ◽  
Author(s):  
Dominique Hanna ◽  
Richard Cloutier ◽  
Roch Lapointe ◽  
Antoine Desgagné
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
French Literature ◽  
Abdominal Mass ◽  
External Genitalia ◽  
Lymph Drainage ◽  
History Of ◽  
Subcutaneous Tissues ◽  
Abdominal Lipectomy ◽  
End Stage

Background: Elephantiasis is a well-known condition in dermatology usually affecting the legs and external genitalia. It is characterized by chronic inflammation and obstruction of the lymphatic channels and by hypertrophy of the skin and subcutaneous tissues. The etiology is either idiopathic or caused by a variety of conditions such as chronic filarial disease, leprosy, leishmaniasis, and chronic recurrent cellulites. ObjectiveElephantiasis of the abdominal wall is very rare. A complete review of the English and French literature showed only two cases reported in 1966 and 1973, respectively. We report a third case of abdominal elephantiasis and we briefly review this entity. Methods: We present the case of a 51-year-old woman who had progressively developed an enormous pediculated abdominal mass hanging down her knees. The skin was thickened, hyperpigmented, and fissured. She had a history of multiple abdominal cellulites. ResultsShe underwent an abdominal lipectomy. Histopathology of the specimen confirmed the diagnosis of abdominal elephantiasis. Conclusion: Abdominal elephantiasis is a rare disease that represents end-stage failure of lymph drainage. Lipectomy should be considered in the management of this condition.

scholarly journals The Role of STSG and Delayed Midline Approximation In Abdominal Wall Reconstruction

1970 ◽  
Vol 1 (2) ◽  
Author(s):  
Denny Irwansyah ◽  
Gentur Sudjatmiko
Keyword(s):  
Abdominal Wall ◽  
Tumor Resection ◽  
Abdominal Wall Reconstruction ◽  
Previous History ◽  
Perforated Appendicitis ◽  
Wound Dehiscence ◽  
Skin Grafting ◽  
Abdominal Wall Defects ◽  
Reconstructive Option ◽  
History Of

Acquired abdominal wall defects can result from previous surgery, trauma, infection and tumor resection. Complex abdominal wall defects challenge both general and plastic reconstructive surgeons. Skin grafting of abdominal viscera was originally described by Horton in 1953, demonstrated in dogs that STSG placed on the parietal peritoneum of abdominal viscera and buried in the peritoneal cavity would take well and survive. In 1994, Baker and Millard Jr reported serial cases of abdominal midline wound dehiscence which was treated with two stage abdominal wall reconstruction.Data was taken from medical and surgical records of patients consulted to the plastic surgery division with and acquired abdominal defect. We are reporting, Male, 42 yo, previous history of Perforated appendicitis with general peritonitis. We performed 2 stage reconstruction of abdominal wall for this patient.Treatment for an abdominal defect is selected on the basis of several factors, including the medical status of the patient, wound bed preparedness, depth, size and location of the defect. The goals of  abdominal reconstruction are restoration of function and integrity of the musculo-fascial abdominal wall, prevention of visceral eventeration and provision of dynamic muscle support.Skin grafting and delayed midline approximation are one of the reconstructive option available and deserve to be considered in the high risk, septic patient without compromising the patient final reconstructive result.

Independent Predictors for Surgical Site Infections in Patients Undergoing Complex Abdominal Wall Reconstruction

2021 ◽  
Author(s):  
Matthew McGuirk ◽  
Agon Kajmolli ◽  
Mahir Gachabayov ◽  
Abbas Smiley ◽  
David Samson ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Regression Models ◽  
Care Center ◽  
Abdominal Wall Reconstruction ◽  
Surgical Site Infections ◽  
Common Procedure ◽  
Abdominal Infection ◽  
History Of ◽  
Multivariable Regression ◽  
Abdominal Infections

Introduction: Complex abdominal wall reconstruction (CAWR) in patients with large abdominal defects have become a common procedure. The aim of this study was to identify independent predictors of surgical site infections (SSI) in patients undergoing CAWR. Materials and Methods: This was an ambidirectional cohort study of 240 patients who underwent CAWR with biologic mesh between 2012 and 2020 at an academic tertiary/quaternary care center. Prior superficial SSI, deep SSI, organ space infections, enterocutaneous fistulae, and combined abdominal infections were defined as prior abdominal infections. Univariable and multivariable logistic regression models were performed to determine independent risk factors for SSI. Results: There were a total of 39 wound infections, with an infection rate of 16.3%. Forty percent of patients who underwent CAWR in this study had a history of prior abdominal infections. In the multivariable regression models not weighted for length of stay (LOS), prior abdominal infection (odds ratio [OR]: 2.49, p=0.013) and higher body mass index (BMI) (OR: 1.05, p=0.023) were independent predictors of SSI. In the multivariable regression model weighted for LOS, prior abdominal infection (OR: 2.2, p=0.034), higher BMI (OR: 1.05, p=0.024), and LOS (OR: 1.04, p=0.043) were independent predictors of SSI. Conclusion: The history of prior abdominal infections, higher BMI, and increased LOS are important independent predictor of SSI following CAWR.

scholarly journals A Case Report of an Abdominal Wall Endometrioma

2021 ◽  
Vol 11 (11) ◽  
pp. 261-264
Author(s):  
Saima Najam ◽  
Messaoud Bounnah
Keyword(s):  
Abdominal Pain ◽  
Abdominal Wall ◽  
Abdominal Mass ◽  
Young Patients ◽  
Surgical Removal ◽  
Histopathological Diagnosis ◽  
Normal Delivery ◽  
Uterine Surgery ◽  
History Of ◽  
The Right

Abdominal wall endometrioma (AWE) is one of the rarest forms of the endometriosis, and usually found in the young patients, average age is 35years. The most common triad of the symptoms is, abdominal mass at or near the scar, cyclical pain and history of previous caesarean or any other gynecological surgery. Exact pathogenesis is unknown as average time of its presentation in the patients is highly variable from 3 months till 2 decades. It can be suspected on ultrasonography and CT scan and MRI are the modalities used to assess and stage the lesion prior to the surgery. Histopathological diagnosis is confirmatory. We are reporting 30 years old, Para 2, with history of first caesarean section 6 years ago followed by the normal delivery. She presented with the history of cyclical abdominal pain with the feeling of abdominal lump from last 3 months. On examination a slightly tender 5*4 cm extra abdominal mass was palpable above the right half of the previous transverse scar of the caesarean. After evaluation endometriosis was suspected and the patient opted for the surgical resection of the mass. The mass was removed in collaboration with the surgeons and the histopathology confirmed the diagnosis of the AWE. Conclusion: AWE is a dynamic yet incompletely known entity as a result of increasing number of the caesarean and gynecological procedures. It should be kept in the differential diagnosis of the patients coming with the cyclical abdominal pain and abdominal lump with the history of previous uterine surgery. Ultrasound and MRI are the main aiding modalities but the confirmation of the diagnosis is made only after histopathology. The surgical removal of the mass with negative margins represents the current best treatment. Key words: Abdominal wall, endometriosis, magnetic resonance imaging, ultrasonography.

scholarly journals Parasitic Myoma: A Very Rare Case Report aAnd Review of Literature

2019 ◽  
Vol 17 (1) ◽  
pp. 50-53
Author(s):  
Md Manir Hossain Khan ◽  
Jobaida Sultana
Keyword(s):  
Abdominal Wall ◽  
Blood Supply ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
Low Grade ◽  
Review Of Literature ◽  
Rare Case Report ◽  
History Of ◽  
The Right ◽  
Further Development

A 32 years old unmarried women presented with periumbilical colickey abdominal pain which shiftted to the right iliac fossa with anorexia, vomiting and low grade fever. She had history of open myomectomy 4 years back for menorrhagia with multiple fibroids (myomas). On examination, the pointing sign, Rovsing's sign, McBurney's sign &Blumberg's sign were positive. Then she was diagnosed as a case of acute appendicitis. Ultrasonography revealed nothing significant. Appendicectomy was done through right Grid Iron incision. Appendix was found inflammed, swollen and there was collection of fluid in the peritoneal cavity. During closure, incidentally a solid mass about 5 ><4 ><2.5 cm was found exterior to the peritoneum near the incision at the abdominal wall. The mass was excised. Subsequently histopathotology confirmed a leiomyoma (Myoma or parasitic fibroid). The parasitic myoma may develop spontaneously as pedanculatedsubcerousmyomaloose their uterine blood supply or iatrogenically from retained fragment of myoma from previous myomectomy or hysterectomy and get blood supply from abdominal wall. Even small bits displaced into the abdominal cavity can result in parasitic fibroids. This case is reported here to give emphasis on the surveilence of parasitic myoma during myomectomy or hysterectomy for fibroid uterus and all tissue pieces that are morcellated should be delligently removed for the prevention of further development of parasitic myoma. Journal of Surgical Sciences (2013) Vol. 17 (1) : 50-53

Abdominal wall reconstruction with intraperitoneal prosthesis in desmoid tumors surgery

2011 ◽  
Vol 64 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Gaetano Catania ◽  
Luca Ruggeri ◽  
Giuseppe Iuppa ◽  
Carla Di Stefano ◽  
Francesco Cardì ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Desmoid Tumors
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