Ultrasound guided transverse fascial plane block (TFPB) via the superior lumbar triangle: Description of a new modified technique

AbstractLiver abscess requiring drainage is conventionally managed by interventional radiology-guided percutaneous drainage (PCD). Radiologically inaccessible abscesses are managed with laparoscopic or open surgery, which carries high rates of morbidity and mortality.EUS-guided transluminal liver abscess drainage is minimally invasive and can be an alternative approach for caudate lobe, segment 4, and left lateral segment abscesses. We report on three consecutive patients with radiologically inaccessible left lobe liver abscess involving the caudate lobe, segment 4, and lateral segment in whom EUS-guided transluminal drainage using a modified technique was successful.

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Ultrasound‐guided fascial plane blocks of the chest wall

Anaesthesia ◽

10.1111/anae.15435 ◽

2021 ◽

Author(s):

S. Q. Tighe

Keyword(s):

Chest Wall ◽

Ultrasound Guided ◽

Fascial Plane

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Ultrasound‐guided fascial plane blocks of the chest wall: a state‐of‐the‐art review

Anaesthesia ◽

10.1111/anae.15276 ◽

2021 ◽

Vol 76 (S1) ◽

pp. 110-126 ◽

Cited By ~ 2

Author(s):

K. J. Chin ◽

B. Versyck ◽

A. Pawa

Keyword(s):

Chest Wall ◽

State Of The Art ◽

Ultrasound Guided ◽

Fascial Plane

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Concurrent Spigelian and Grynfeltt-Lesshaft Hernias

The American Surgeon ◽

10.1177/00031348211056275 ◽

2021 ◽

pp. 000313482110562

Author(s):

Ryan M. Huttinger ◽

Matthew S. Kazaleh ◽

Dylan J. Skinner ◽

Marsha C. Nelson

Keyword(s):

Computed Tomography ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Synthetic Mesh ◽

Accurate Diagnosis ◽

Spigelian Hernia ◽

Lower Quadrant ◽

Superior Lumbar Triangle ◽

Lumbar Triangle ◽

Right Lower Quadrant

Only 0.12% to 2% of diagnosed hernias are Spigelian type. Even less frequently encountered—Grynfeltt-Lesshaft hernias—hernias have unknown incidence. A Spigelian hernia is encountered along the Spigelian fascia and Grynfeltt-Lesshaft hernias are bounded by the superior lumbar triangle. These unique hernias can both be intermuscular, given their anatomical borders which allow concealment and preclusion of accurate diagnosis. Here, an 86-year-old male presented with symptoms consistent with small bowel obstruction. On physical exam, a right lower quadrant hernia and right posterior flank mass were appreciated. Computed tomography revealed obstruction secondary to bowel incarceration within Spigelian hernia and additional Grynfeltt-Lesshaft hernia. The patient underwent reduction and repair of Spigelian hernia with synthetic mesh, while repair of asymptomatic hernia was deferred. These unusual hernias are difficult to distinguish, given their negligible occurrence and unreliable exam findings. Clinicians must remain cognizant of their features to aid in diagnosis and mitigate potential sequelae.

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