Carbimazole-Related Gastroschisis

2003 ◽  
Vol 37 (6) ◽  
pp. 829-831 ◽  
Author(s):  
Anne-Maëlle Guignon ◽  
Michel P Mallaret ◽  
Pierre Simon Jouk
Keyword(s):  
Abdominal Wall ◽  
White Woman ◽  
Surgical Repair ◽  
Causality Assessment ◽  
In Utero ◽  
Abdominal Wall Defects ◽  
Rare Occurrence ◽  
Case Summary ◽  
The Relationship ◽  
Malformative Syndrome

OBJECTIVE: To report a case of gastroschisis in a newborn secondary to carbimazole exposure in utero. CASE SUMMARY: A 25-year-old white woman was treated for Graves disease with carbimazole throughout pregnancy. A boy was born prematurely by vaginal delivery, with a gastroschisis without associated malformative syndrome. Death occurred in the 25th hour of life after surgical repair. DISCUSSION: Carbimazole is completely metabolized to methimazole after absorption. Carbimazole or methimazole intake during pregnancy has been associated with an increased incidence of scalp aplasia. Abdominal wall defects secondary to carbimazole or methimazole exposure in utero seem to be a rare occurrence. However, other cases of abdominal wall defects have been reported in 4 newborns, 2 of them associated with scalp aplasia. An objective causality assessment revealed that the relationship between the gastroschisis and the exposure to carbimazole in utero was possible. CONCLUSIONS: It is important to emphasize the possible risk of abdominal wall defects in newborns to pregnant women taking carbimazole or methimazole.

scholarly journals Treatment of Ruptured Giant Omphalocele and Gastroschisis with Liver Herniation using a Wound Retractor as a Novel Approach

2020 ◽  
Vol 08 (01) ◽  
pp. e112-e116
Author(s):  
Jana Nelson ◽  
Robin Wachowiak ◽  
Manuela Siekmeyer ◽  
Matthias Knuepfer ◽  
Ulrich Thome ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Surgical Repair ◽  
Abdominal Cavity ◽  
Abdominal Wall Defects ◽  
Lethal Outcome ◽  
Total Liver ◽  
Novel Approach ◽  
Wound Retractor ◽  
Liver Herniation ◽  
Secondary Closure

AbstractRuptured giant omphaloceles (GO) and gastroschisis with total liver herniation are rare cases of exceptionally large abdominal wall defects. Many of these children have lethal outcome. The surgical and postsurgical management are complex. We report on two cases treated with staged surgical repair using a wound retractor as a silo. With this technique, the liver and intestines could be reduced into the abdomen with secondary closure of the abdominal cavity within the first 1 to 2 weeks of life.

Mechanisms for Linezolid-Induced Anemia and Thrombocytopenia

2003 ◽  
Vol 37 (4) ◽  
pp. 517-520 ◽  
Author(s):  
Wendy B Bernstein ◽  
Richard F Trotta ◽  
James T Rector ◽  
Jeffery A Tjaden ◽  
Anthony J Barile
Keyword(s):  
Heart Failure ◽  
Staphylococcus Epidermidis ◽  
White Woman ◽  
Causality Assessment ◽  
Drug Event ◽  
Ringed Sideroblasts ◽  
Case Summary ◽  
Immune Mediated ◽  
Linezolid Therapy ◽  
Rate Of Decline

BACKGROUND: Linezolid has been associated with anemia and thrombocytopenia. Mechanisms for neither have been elucidated. OBJECTIVE: To propose mechanisms for linezolid-induced anemia and thrombocytopenia. CASE SUMMARY: A 78-year-old white woman with Staphylococcus epidermidis endocarditis was treated with linezolid after developing resistance to multiple antibiotic regimens. After 7 days of linezolid therapy, she developed thrombocytopenia, while an anemia present since admission remained unchanged. A bone marrow biopsy was performed, primarily looking for a mechanism for the thrombocytopenia. Histopathology revealed adequate megakaryocytes, ringed sideroblasts, and vacuolated pronormoblasts. A course of immune globulin (IVIG) was administered, with slowing in the rate of decline in platelets. She died 24 hours after her last dose of IVIG of congestive heart failure. DISCUSSION: The presence of ringed sideroblasts and vacuolated pronormoblasts suggests that linezolid-induced anemia is secondary to a chloramphenicol-like suppression of erythropoiesis. The presence of adequate, normal-appearing megakaryocytes suggests immune-mediated thrombocytopenia, not marrow suppression. Although the response to IVIG is difficult to interpret because of the patient's death, there was a slowing in the rate of decline of the platelet count, further supporting immune-mediated thrombocytopenia. An objective causality assessment indicated that the adverse drug event was probably due to linezolid. CONCLUSIONS: There appear to be 2 distinct mechanisms for linezolid-induced cytopenias. While anemia is reversible and manageable with transfusions, thrombocytopenia can be a treatment-limiting toxicity. The ability to treat through an immune-mediated cytopenia with IVIG may be beneficial for critically ill patients with few therapeutic options.

FURTHER INVESTIGATIONS WHEN ABDOMINAL WALL DEFECTS ARE DIAGNOSED IN UTERO

The Lancet ◽  
1983 ◽  
Vol 322 (8358) ◽  
pp. 1083-1084 ◽  
Author(s):  
Maurizio Clementi ◽  
Romano Tenconi ◽  
Licia Turolla ◽  
Andrew Czeizel
Keyword(s):  
Abdominal Wall ◽  
In Utero ◽  
Abdominal Wall Defects

scholarly journals Lateral Abdominal Wall Reconstruction

2018 ◽  
Vol 32 (03) ◽  
pp. 141-146 ◽  
Author(s):  
Sahil Kapur ◽  
Charles Butler
Keyword(s):  
Abdominal Wall ◽  
Iliac Crest ◽  
Surgical Repair ◽  
Abdominal Wall Reconstruction ◽  
Abdominal Wall Defects ◽  
Costal Margin ◽  
Challenging Problem ◽  
Muscle Denervation ◽  
Careful Planning ◽  
Lateral Abdominal Wall

AbstractLateral abdominal wall defects, while rare, present a more challenging problem than commonly encountered ventral defects due to the complexity of the anatomy, physiologic forces, and impact of muscle denervation. The lateral abdominal wall encompasses a large surface area ranging from the costal margin superiorly to the iliac crest inferiorly and from the linea semilunaris anteriorly to the paraspinous musculature posteriorly. The ratio of muscle to fascia/aponeurosis is much higher, which makes repair through muscle tissue versus fascia less secure. Furthermore, these defects are subject to asymmetric forces caused by the independent contraction of anterior and posterior muscle units, which lead to unbalanced strain and hernia progression. These features necessitate the use of wide underlay mesh load bearing repairs supported by the static pillars of the abdominal wall. Management can be further complicated when defects extend beyond the defined boundaries, requiring surgical repair to be adapted based on the border structures involved. Primary fascial coaptation may not be as easily accomplished, and therefore careful planning is important to ensure stable coverage of exposed mesh.

scholarly journals Timing of repair and mesh use in traumatic abdominal wall defects: a systematic review and meta-analysis of current literature

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Steffi Karhof ◽  
Rianne Boot ◽  
Rogier K. J. Simmermacher ◽  
Karlijn J. P. van Wessem ◽  
Luke P. H. Leenen ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Current Literature ◽  
Mesh Repair ◽  
Surgical Repair ◽  
Pooled Analysis ◽  
Hernia Recurrence ◽  
Cochrane Library ◽  
Abdominal Wall Defects ◽  
Delayed Repair ◽  
Mesh Augmentation

Abstract Background Traumatic abdominal wall hernias or defects (TAWDs) after blunt trauma are rare and comprehensive literature on this topic is scarce. Altogether, there is no consensus about optimal methods and timing of repair, resulting in a surgeon’s dilemma. The aim of this study was to analyze current literature, comparing (1) acute versus delayed repair and (2) mesh versus no mesh repair. Methods A broad and systematic search was conducted in PubMed, EMBASE, and the Cochrane Library. The selected articles were assessed on methodological quality using a modified version of the CONSORT 2010 Checklist and the Newcastle-Ottawa scale. Primary endpoint was hernia recurrence, diagnosed by clinical examination or CT. Random effects meta-analyses on hernia recurrence rates after acute versus delayed repair, and mesh versus no mesh repair, were conducted separately. Results In total, 19 studies were evaluated, of which 6 were used in our analysis. These studies reported a total of 229 patients who developed a TAWD, of whom a little more than half underwent surgical repair. Twenty-three of 172 patients (13%) who had their TAWD surgically repaired developed a recurrence. In these studies, nearly 70% of the patients who developed a recurrence had their TAWD repaired primarily without a mesh augmentation and mostly during the initial hospitalization. Pooled analysis did not show any statistically significant favor for either use of mesh augmentation or the timing of surgical repair. Conclusion Although 70% of the recurrences occurred in patients without mesh augmentation, pooled analysis did not show significant differences in either mesh versus no mesh repair, nor acute versus delayed repair for the management of traumatic abdominal wall defects. Therefore, a patient’s condition (e.g., concomitant injuries) should determine the timing of repair, preferably with the use of a mesh augmentation.

Lipoabdominoplasty in correction of abdominal wall defects

2018 ◽  
Vol 0 (4) ◽  
pp. 13-17
Author(s):  
O. V. Panchuk ◽  
V. G. Mishalov ◽  
I. M. Leschishin ◽  
V. F. Simonov ◽  
E. G. Donets ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defects

Negative Pressure Therapy in the Surgical Treatment of Diabetic Foot

2017 ◽  
Vol 68 (7) ◽  
pp. 1648-1651
Author(s):  
Bogdan Mihnea Ciuntu ◽  
Ciprian Vasiluta ◽  
Robert Negru ◽  
Roxana Hultoana ◽  
Roxana Ciuntu ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Bacterial Load ◽  
Abdominal Wall Defects ◽  
Negative Pressure Therapy ◽  
Simultaneous Application ◽  
Average Hospital ◽  
Pressure Therapy ◽  
Days Of Therapy

The study aims to assess the significance of negative pressure therapy in the treatment of diabetic foot.The objectives intend to evaluate the healing time required after applying the method and the functional consequences for the patient. A prospective study was conducted on a sample of 37 patients with diabetic foot were monitored their clinical course between September 2014 - April 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the wound, while complying with specified settings (negative pressure, time of use of a kit) in accordance with patients� outcome.There were monitored changes in wound size (planimetric and volumetric measurement), their bacterial load and duration of treatment. Healing was obtained in all cases, to an average hospital stay of 27.3 days and 8 days of therapy application.The negative result of microbial cultures was obtained after an average of 6.45 days by simultaneous application of negative pressure and antibiotic treatment according to the antibiogram. Skin grafts were necessary to close the defect in 4 cases. After basic treatment of the wound, auxiliary methods such as negative pressure contribute to the healing.In patients with diabetic foot who were required surgical intervention, the use of negative pressure therapy yielded a significant benefit in the preservation of the affected limb, after minimal excision.The results we obtained throughout our experience recommend use of NPTW technique as indication for abdominal wall surgery in closing abdominal wall defects, compartment syndrome and surgical site infection after prosthetic mesh.

Current postnatal outcomes of infants with abdominal wall defects

2008 ◽  
Vol 84 ◽  
pp. S112
Author(s):  
Olivia Williams ◽  
Benedicte Michel ◽  
Graham Hutchings ◽  
Pierre Bernard ◽  
Christian Debauche
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defects
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