Managing a Colonoscopic Perforation in a Patient with No Abdominal Wall

We describe the case of a 37-year-old gentleman with Crohn’s disease and a complex surgical history including a giant incisional hernia with no abdominal wall. He presented on a Sunday to the general surgical on-call with a four-day history of generalised abdominal pain, nausea, and decreased stoma output following colonoscopy. After CT imaging, he was diagnosed with a large colonic perforation. Initially, he was worked up for theatre but following early senior input, a conservative approach with antibiotics was adopted. The patient improved significantly and is currently awaiting plastic surgery input for the management of his abdominal wall defect.

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INTRAABDOMINAL, PREPERITONEAL AND INTERSTITIAL HERNIOPLASTY OF INCISIONAL HERNIA AFTER KIDNEY TRANSPLANTATION IS SAFE AND EFFECTIVE EVEN WHEN THE ABDOMINAL WALL DEFECT IS LARGE

Transplantation Journal ◽

10.1097/01.tp.0000700576.16502.73 ◽

2020 ◽

Vol 104 (S3) ◽

pp. S392-S393

Author(s):

Helena Genberg ◽

Ulf Fränneby ◽

John Sandberg ◽

Johan Nordström ◽

Torbjörn Lundgren ◽

...

Keyword(s):

Kidney Transplantation ◽

Incisional Hernia ◽

Abdominal Wall ◽

Abdominal Wall Defect ◽

Wall Defect

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Amniotic Membrane-Coated Polypropylene Mesh for the Repair of Incisional Hernia: An Experimental Study In a Rat Model of Abdominal Wall Defect

Iranian Red Crescent Medical Journal ◽

10.5812/ircmj.62788 ◽

2018 ◽

Vol 20 (3) ◽

Author(s):

Sinan Soylu ◽

Caglar Yildiz ◽

Birkan Bozkurt ◽

Savas Karakus ◽

Begum Kurt ◽

...

Keyword(s):

Experimental Study ◽

Incisional Hernia ◽

Abdominal Wall ◽

Amniotic Membrane ◽

Rat Model ◽

Polypropylene Mesh ◽

Abdominal Wall Defect ◽

Wall Defect

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Cadaver as an experimental a model for the study of midline incisional hernia

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502011000400011 ◽

2011 ◽

Vol 26 (4) ◽

pp. 310-313 ◽

Cited By ~ 7

Author(s):

Romar Ângelo Barbato Silveira ◽

Fábio Xerfan Nahas ◽

Bernardo Hochman ◽

Felix Carlos Ocariz Bazzano ◽

Carlos Roberto Amorim ◽

...

Keyword(s):

Incisional Hernia ◽

Abdominal Wall ◽

Abdominal Wall Defect ◽

Tensile Force ◽

Rectus Abdominis ◽

Rectus Abdominis Muscle ◽

Wall Defect ◽

Linea Alba ◽

Force Application ◽

Tensile Forces

PURPOSE: To describe a cadaver model and to compare different techniques to correct midline incisional hernia using the tension at the musculoaponeurotic layer as a parameter. METHODS: Twenty-four male cadavers were used to characterize the model. The tensile force applied to the anterior layers of the rectus abdominis muscle was measured after the linea alba was resected to create an abdominal wall defect. A dynamometer was used to measure the tensile force necessary to cause a 10-mm displacement of the tissues towards the midline. An index that allows comparison of tensile forces from different points was calculated by dividing the tensile force by the distance between the point of force application at the aponeurosis and the midline. RESULTS: Cadaver is a good model for the study of midline incisional hernia. CONCLUSION: Cadaver can be used effectively as a model to evaluate tension of the abdominal wall when tissue advancement and musculoaponeurotic flaps are performed in the repair of midline incisional hernia.

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Pyloric Stenosis after Gastroschisis Closure

The American Surgeon ◽

10.1177/000313481307900925 ◽

2013 ◽

Vol 79 (9) ◽

pp. 896-896

Author(s):

Stephanie M. Streit ◽

Jennifer A Dixon ◽

André Hebra

Keyword(s):

Abdominal Surgery ◽

Abdominal Wall ◽

Pyloric Stenosis ◽

Abdominal Wall Defect ◽

Hypertrophic Pyloric Stenosis ◽

Wall Defect ◽

Birth History ◽

History Of ◽

Normal Gestation

Hypertrophic pyloric stenosis is a very common surgical problem in infants. It occurs most often in otherwise well babies with normal gestation and birth history. Rarely, pyloric stenosis has been described in babies with history of prior abdominal surgery. Below we discuss the management of hypertrophic pyloric stenosis in a child who remained hospitalized, recovering from repair of a congenital abdominal wall defect.

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Incisional Hernia After Liver Transplantation: Analysis of Tailored Open Mesh Repair

International Surgery ◽

10.9738/intsurg-d-17-00046.1 ◽

2019 ◽

Vol 104 (5-6) ◽

pp. 226-231

Author(s):

Daniel Heise ◽

Andreas Kroh ◽

Roman Eickhoff ◽

Andreas Lambertz ◽

Marcel Binnebösel ◽

...

Keyword(s):

Liver Transplantation ◽

Incisional Hernia ◽

Abdominal Wall ◽

Mesh Repair ◽

Abdominal Wall Defect ◽

Wall Defect ◽

Abdominal Wall Repair ◽

Open Mesh Repair ◽

The Mean ◽

Open Mesh

Objective Incisional hernia is a frequent complication post liver transplantation (LT). The aim of this study was to compare divergent approaches to open abdominal wall repair post-LT. Summary of background data After liver transplantation (LT) via Mercedes incision (MSI) we observed an incidence of incisional hernia between 5% and 34%. Conventional repair consists of reopening the whole incision and reinforcement of the whole fascia using a mesh plastic in sublay position. This retrospective analysis compares open mesh repair with complete reinforcement of the Mercedes incision and open mesh repair of solely the abdominal wall defect. Methods Between 2010 and 2015, 218 orthotopic liver transplantations (LT) were performed at our institution, and 25 (11.5%) of those patients required an incisional hernia repair post-LT. One group received a local hernia repair (n = 15) while the other group obtained a reconstruction of the whole MSI (n = 10). We analyzed the preoperative status, causative factors for incisional hernia, operative details, and long-term outcome of these patients. Results Analyzing preoperative details no significant differences were found between the 2 groups. The mean time post-LT at which the abdominal wall defect appeared was 18 ± 12 months. The mean follow-up time after abdominal wall repair was 15 (11–19) months. Additionally, 1 (4%) patient developed a hernia recurrence without statistic significant difference between the 2 groups (P = 0.400). Conclusion Local mesh reinforcement seems to be feasible and safe in incisional hernia patients after Mercedes incision due to liver transplantation.

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A propósito de un caso: Resolución quirúrgica en dos tiempos de Pentalogía de Cantrell

Revista Médica del Hospital José Carrasco Arteaga ◽

10.14410/2020.12.3.cc.34 ◽

2020 ◽

Vol 12 (3) ◽

pp. 227-230

Author(s):

Andrea Karina Muñoz Mora ◽

María Soledad Ordóñez Velecela ◽

Luis Enrique Marcano Sanz ◽

Miurkys Endis Miranda

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Defect ◽

Unique Challenge ◽

Left Liver Lobe ◽

Pentalogy Of Cantrell ◽

Wall Defect ◽

Mortality Case ◽

History Of ◽

Cantrell's Pentalogy ◽

High Level

BACKGROUND: Cantrell’s pentalogy includes the presence of five birth defects that represent a great challenge for surgeons. Abnormalities of the heart, pericardium, diaphragm, sternumand anterior abdominal wall are the main findings. Its incidence is low, however, it is essential to identify Cantrell´s pentalogy timely to adopt an adequate therapy for all specific defects, since it has high mortality. CASE REPORT: The patient was a full- term male newborn, with a history of abdominal wall defect compatible with an omphalocele detected by prenatal ultrasound. After the caesarean section, the abdominal wall defect was notable, the left liver lobe, intestines and heart emerged through it, the sternum also had a low fissure. The echocardiogram revealed a permeable oval foramen, mild tricuspid regurgitation, and severe pulmonary hypertension. EVOLUTION: Immediate surgical management was decided. Silo was placed, with progressive closure of the midline in 7 days. During the second surgical procedure, the diaphragmatic and pericardial defect was corrected with a bovine pericardial prosthesis. Despite the adequate evolution after surgery, at day 28 he presented with sudden cyanosis and didn’t respond to cardiopulmonary resuscitation and died. CONCLUSIONS: Cantrell’s Pentalogy is a rare disease, with peculiar clinical, anatomical and embryological characteristics, it represents a unique challenge for surgeons. Early diagnosis, as well as follow-up during pregnancy, planning a cesarean section in a high-level center and immediate surgical approach with a multidisciplinary team, are the key components in the management of patients with Cantrell’s Pentalogy. KEY WORDS: PENTALOGY OF CANTRELL, ECTOPIA CORDIS, UMBILICAL HERNIA. CONGENITAL.

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