To the Jejunostomiae technique

1930 ◽  
Vol 26 (10) ◽  
pp. 1055-1055
Author(s):  
I. Tsimkhes
Keyword(s):  
Abdominal Wall ◽  
Mucous Membrane ◽  
Muscle Tissue ◽  
Abdominal Cavity ◽  
Intestinal Loop ◽  
Incision Site ◽  
Distal Corner

Abstracts. Surgery. To the Jejunostomiae technique. Winckelbauer (Zntrlbl. F. Chir. 1929 No. 34) proposes in the production of jejunostomiae to use a method similar to gastrostomy or the Coffey method for transplantation of the ureters into the colon. A 5 cm incision is made through the serosa and muscle tissue of the intestinal loop without opening the mucos'bi. In the distal corner of the wound, the muscles are stupidly divided, and the mucous membrane is opened. A catheter is inserted into this opening and is positioned between the muscles. The wound over the located catheter is sutured tightly with single knotty sutures. The intestine is fixed with a catheter to the abdominal wall of the incision site or to the side through a special opening of the abdominal cavity.

scholarly journals Canine Fetal Peritonitis

2017 ◽  
Vol 45 ◽  
pp. 4
Author(s):  
Andreia Regis De Assis ◽  
Marcus Antonio Rossi Feliciano ◽  
Gilberto Gonçalves Facco ◽  
Patricia Eri Ishii ◽  
Cláudia Matsunaga Martin ◽  
...  
Keyword(s):  
Mucous Membrane ◽  
Ultrasound Examination ◽  
Abdominal Cavity ◽  
Intestinal Loop ◽  
Alveolar Wall ◽  
Neonatal Deaths ◽  
Gestational Period ◽  
Clinical Complications ◽  
Cytological Smear ◽  
Vascular Congestion

Background: The occurrence of neonatal diseases and neonatal deaths in canines are considered higher in the first days of life of individuals and bacterial diseases are considered the second most common cause. Inflammation of the mesothelial lining of the abdominal cavity is referred peritonitis, which can be classified as primary or secondary and there is no description on the occurrence of canine fetal peritonitis in the veterinary literature. The objective of this study is to describe a case of canine fetus peritonitis, presenting abnormal sonographic findings of the fetus and abnormalities identified after birth that were not yet described in veterinary literature.Case: A female Poodle, six years of age, considered healthy and without clinical complications during the gestational period, was referred for sonographic evaluation at the end of the pregnancy, in order to evaluate of the fetal viability and estimate the gestational period. By ultrasound examination, two canine fetuses were identified and based on its morphogenesis and biparietal diameter, the estimated gestational age was approximately 58 days. On the individual examination of each of the fetus by ultrasound, it was found that one of them had normal sonographic findings and on the second canine fetus it was found an increase of the intra-abdominal echogenicity of tissues, loss of the sonographic definition of the intestinal loops and presence of laminar anechoic areas between the interfaces of organs, consistent with abdominal effusion. Parturition occurred the following day of the ultrasound examination no complications and with the birth of two canine fetuses. About six hours after birth, one of the neonates showed dyspnea, hypothermia, areas of ecchymosis, suffusion in the ventral abdominal region, icteric and pale mucous membrane and the presence of abdominal fluid and came to death about 30 min after. Cytological analysis of the sample revealed exuberant amount of erythrocytes, fibrin and leukocytes. Culture revealed infection by Staphylococccus aureus and Enterococcus sp. Presence of bloody fluid in the abdominal cavity was observed at necropsy, with yellowish parietal surface of the thoracic and abdominal cavities and petechiae on the lungs, heart, stomach surfaces and intestinal mucous membrane. Microscopically, the lungs showed extensive areas of parenchymal consolidation, vascular congestion and intense inflammatory infiltrate in the alveolar wall; the liver was characterized by vascular congestion, areas of degeneration of hepatocytes and presence of calcified foci, necrosis and inflammatory infiltrates. Associating the results and findings of the exams was possible to conclude the diagnostic of fetal peritonitis.Discussion: The visualization of abnormal findings in affected fetus by a gestational ultrasound exam makes this report inedited and relevant for veterinary obstetrics. This demonstrates the importance of ultrasound exam in pregnant bitches for early detection of maternal fetal diseases. Presence of abdominal fluid and increased mesenteric ochogenicity associated with loss of the intestinal loop definition corroborates with the clinical suspicion of peritonitis in fetus. Findings on the anatomopathological examination, cytology and culture allowed conclusion of the cause of death. Bacterial forms in the cytological smear supported the diagnostic suspicion of peritonitis. Gestational ultrasound exam performed in this report was essential for proper conduct of the pregnant bitch and viability of the fetuses, suggesting that the detected fetal abnormalities showed predictive value in the viability of diseased individual. This case report contributes with the description of canine fetal peritonitis.

scholarly journals Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoki Enomoto ◽  
Kazuhiko Yamada ◽  
Daiki Kato ◽  
Shusuke Yagi ◽  
Hitomi Wake ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Abdominal Cavity ◽  
Three Dimensional ◽  
Simulation Software ◽  
3D Simulation ◽  
Diaphragmatic Defect ◽  
Intestinal Malrotation ◽  
Intestinal Loop ◽  
Bochdalek Hernia ◽  
The Right

Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.

scholarly journals Comparative study of inflammatory response and adhesions formation after fixation of different meshes for inguinal hernia repair in rabbits

2005 ◽  
Vol 20 (5) ◽  
pp. 347-352 ◽  
Author(s):  
Alberto Goldenberg ◽  
Jacques Matone ◽  
Wagner Marcondes ◽  
Fernando Augusto Mardiros Herbella ◽  
José Francisco de Mattos Farah
Keyword(s):  
Inflammatory Response ◽  
Abdominal Wall ◽  
Peritoneal Cavity ◽  
Abdominal Cavity ◽  
Mesh Fixation ◽  
Rabbit Model ◽  
Laparoscopic Approach ◽  
Preperitoneal Space ◽  
Similar Amount ◽  
The Right

PURPOSE: Compare, in a rabbit model, the inflammatory response and adhesions formation following surgical fixation of polypropilene and Vypro mesh in the inguinal preperitoneal space. METHODS: Fourteen male New Zealand rabbits, weighing between 2.000 to 2.500 g were used. A midline incision was made and the peritoneal cavity was exposed. The 2,0X1,0 cm polypropylene mesh was fixed in the left flank and secured to the margins with 3-0 prolene in a separate pattern. In the right flank, a 2,0X1,0 cm Vypro II mesh was sewn in the same way. After the post surgical period, the animals were again anesthetized and underwent laparoscopic approach, in order to identify and evaluate adhesions degree. Both fixed prosthesis were excised bilaterally with the abdominal wall segment, including peritoneum, aponeurosis and muscle and sent to a pathologist RESULTS: Operative time ranged from 15 to 25 minutes and no difficulties in applying the mesh were found. From the 14 polypropylene meshes fixed to the intact peritoneum, 11 had adhesions to the abdominal cavity (78,6%). Concerning Vypro mesh, 12 animals developed adhesions from the 14 with mesh fixation (85,7%). Histological examination of tissues harvested revealed fibroblasts, collagen, macrophages and lymphocytes between the threads of the mesh. CONCLUSION: Polypropylene and Vypro mesh, when implanted in the peritoneal cavity of rabbits provoke similar amount of adhesions. Vypro mesh tissues had higher fibrosis resulting in better mesh incorporation to the abdominal wall.

scholarly journals Gastric duplication cyst with localization in the pancreas in children

2020 ◽  
Vol 10 (1) ◽  
pp. 35-42
Author(s):  
Yurii Yu. Sokolov ◽  
Artem M. Efremenkov ◽  
Aleksandr P. Zykin ◽  
Elena L. Tumanova ◽  
Zhanna R. Omarova ◽  
...  
Keyword(s):  
Mucous Membrane ◽  
Clinical Observation ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Duplication Cyst ◽  
The Body ◽  
Recurrent Bleeding ◽  
Gastric Duplication ◽  
Gastric Duplication Cyst ◽  
Gastric Type

Introduction. Gastric duplication cyst is a rare clinical observation. More often, these cysts are localized in the fundus or body of the stomach and have a common muscle layers and blood supply. Even more rarely, duplication cysts are not anatomically connected to the stomach and are located in other parts of the abdominal cavity or in the retroperitoneal space. Cystic duplication of the gastrointestinal tract, which are localized in the pancreas, is extremely rare. The aim of the study is to demonstrate the possibility of using laparoscopy for this disease. Materials and methods. The paper describes three rare clinical observations of gastric duplication cyst topographically associated with the pancreas. In the first clinical observation, gastric duplication cyst was combined with mediastinal duplication cysts, an esophageal bronchial fistula, and extralobar pulmonary sequestrations. In the second observation, a duplication cyst had communication with the pancreatic duct system and was clinically manifested by recurrent bleeding. In the third case, a duplication cyst is diagnosed behind the body and tail of the pancreas. Results. In all cases, surgical treatment was carried out by the laparoscopic method, leading to complete recovery. Histological examination in all the described observations confirmed the gastric type of epithelium of the mucous membrane of the cysts. The article provides a review of the literature. Conclusion. Thus, the efficiency of laparoscopic interventions in children with gastric duplications topographically associated with the pancreas was demonstrated. The described rare clinical manifestations, a combination of defects, as well as the possible presence of heterotopy of the mucous membrane of the duplication cyst confirm the need for surgical correction of the disease.

Metastasis of missed cholangiocarcinoma in the left lobethrough abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: case report and literature review

2020 ◽  
Author(s):  
Lesheng Huang ◽  
Hongyi Li ◽  
Jun Chen ◽  
Jinghua Jiang ◽  
Wanchun Zhang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Wall ◽  
Malignant Tumor ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Left Lobe ◽  
Port Site ◽  
Laparoscopic Port ◽  
Missed Diagnosis ◽  
Upper Abdominal

Abstract Introduction: Laparoscopic cholecystectomy (LC) has been widely used by surgeons. However, a serious but rare condition may be happened, which is the missed diagnosis of intraperitoneal malignant tumor. If the malignancy exists, the changes of the abdominal environment or the laparoscopic operation might brought the cancer cells to the abdominal cavity or the abdominal wall. The missed laparoscopic malignant tumors are prone to metastasis, especially at the laparoscopic port-site. More extreme condition will be located in the navel, which is known as Sister Mary Joseph’s nodule(SMJN).Case presentation: A 63-year-old female who had undergone cholecystectomy and choledocholithotomy ten months ago was hospitalized for upper abdominal pain. Laboratory examination indicated that the most of tumor markers were increased. CT scan revealed that there was a diffused irregular and progressively enhanced mass around the left lobe bile duct, multiple enlarged lymph nodes in the abdominal cavity and multiple nodular lesions were found under the costal margin of the right upper abdominal wall, right lower abdominal wall and the umbilicus. Biopsy of the nodules under the original surgical scar showed an infiltrative or metastatic middle differentiated adenocarcinoma. So the diagnosis was left lobe cholangiocarcinoma of the liver, multiple lymph nodes metastasis in the abdominal cavity and multiple implant metastasis in abdominal wall laparoscopic port-site and umbilical.Conclusion: In laparoscopic cholecystectomy, surgeons should not only focus on the local lesions, like gallstone in biliary system, but also look around other the tissues and organs to avoid missing the abdominal malignant tumor or other lesions. When atypical symptoms or abnormalities have been found pre-operation, all abdominal organs should be evaluated in detail to avoid missed diagnosis of potential malignant tumors. On the other hand, when there is a nodule in the umbilicus, all the organs and tissues in abdomen should be examined to find the potential malignant tumor. Finally, multiple cholelithiasis in the left lobe of the liver should be regarded as a high risk factor for cholangiocarcinoma.

scholarly journals Limb Body Wall Complex: A Rare Anomaly

2018 ◽  
Vol 16 (2) ◽  
pp. 56-58
Author(s):  
Unan Sultana ◽  
Md Qumrul Ahsan
Keyword(s):  
Early Diagnosis ◽  
Abdominal Wall ◽  
Umbilical Cord ◽  
Early Pregnancy ◽  
Body Wall ◽  
Abdominal Cavity ◽  
Abdominal Wall Defects ◽  
Proper Management ◽  
Vascular Disruption ◽  
Abdominal Organs

Body stalk anomalies are a group of massively disfiguring abdominal wall defects in which the abdominal organs lie outside of the abdominal cavity in a sac of amnioperitoneum with absence of or very small umbilical cord. Various hypotheses proposed to explain the pathogenesis of limb body wall complex include early amnion disruptions, embryonic dysplasia, and vascular disruption in early pregnancy. Body stalk anomaly is an accepted fatal anomaly and, hence, its early diagnosis aids in proper management of the patient. We present a case of LBWC, exhibiting combined cranial, abdominal & limb features.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 56-58

Surgical Anatomy of the Retroperitoneal Spaces Part II: The Architecture of the Retroperitoneal Space

2010 ◽  
Vol 76 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Petros Mirilas ◽  
John E. Skandalakis
Keyword(s):  
Urinary Bladder ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Anterior Part ◽  
Abdominal Cavity ◽  
Surgical Anatomy ◽  
Preperitoneal Space ◽  
Renal Fascia ◽  
Pelvic Wall ◽  
Prevesical Space

The extraperitoneal space extends between peritoneum and investing fascia of muscles of anterior, lateral and posterior abdominal and pelvic walls, and circumferentially surrounds the abdominal cavity. The retroperitoneum, which is confined to the posterior and lateral abdominal and pelvic wall, may be divided into three surgicoanatomic zones: centromedial, lateral (right and left), and pelvic. The preperitoneal space is confined to the anterior abdominal wall and the subperitoneal extraperitoneal space to the pelvis. In the extraperitoneal tissue, condensation fascias delineate peri- and parasplanchnic spaces. The former are between organs and condensation fasciae, the latter between this fascia and investing fascia of neighboring muscles of the wall. Thus, perirenal space is encircled by renal fascia, and pararenal is exterior to renal fascia. Similarly for the urinary bladder, paravesical space is between the umbilical prevesical fascia and fascia of the pelvic wall muscles—the prevesical space is its anterior part, between transversalis and umbilical prevesical fascia. For the rectum, the “mesorectum” describes the extraperitoneal tissue bound by the mesorectal condensation fascia, and the pararectal space is between the latter and the muscles of the pelvic wall. Perisplanchnic spaces are closed, except for neurovascular pedicles. Prevesical and pararectal (presacral) and posterior pararenal spaces are in the same anatomical level and communicate. Anterior to the anterior layer of the renal fascia, the anterior interfascial plane (superimposed and fused mesenteries of pancreas, duodenum, and colon) permits communication across the midline. Thus parasplanchnic extraperitoneal spaces of abdomen and pelvis communicate with each other and across the midline.

Desmoid-type Fibromatosis of the Mesentery: A Case Report

2017 ◽  
Vol 10 (1) ◽  
pp. 58-62
Author(s):  
Tatyana M. Betova ◽  
Savelina L. Popovska ◽  
Radoslav G. Trifonov ◽  
Konstantina S. Karakadieva ◽  
Genoveva B. Valcheva ◽  
...  
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
Multidisciplinary Approach ◽  
Abdominal Cavity ◽  
Metastatic Potential ◽  
Surgical Method ◽  
Anatomical Position ◽  
Abdominal Organs ◽  
Mesenchymal Neoplasm

SummaryDesmoid-type fibromatosis is a rare mesenchymal neoplasm with locally aggressive, infiltrating and destructive growth that is not characterized by a metastatic potential. According to their anatomical position, desmoid-type fibromatoses can be divided into three groups: extra-abdominal, intra-abdominal, and fibromatoses of the abdominal wall. Mesenteric fibromatoses account for 8% of the intra-abdominal ones. The latter are characterized by myofibroblastic proliferation and infiltration of both the pelvic and abdominal organs. We report a 26-year-old woman who complained of abdominal enlargement, feeling of heaviness, discomfort and reflux, which symptoms dated back 1-2 months prior to hospitalization. The patient underwent laparotomy due to subocclusive symptoms. Intraoperatively, a tumor sized 30 cm in diameter was found. The tumor originated from the mesentery and infiltrated in the jejunum, the entire ileum, and part of the caecum with perforation towards the abdominal cavity. The histological and immunohistochemical examinations are important for clarification of the diagnosis. The treatment requires a multidisciplinary approach, in which the surgical method has the key role.

Entral feeding tube insertion after esophagectomy: Technique via transgastric conduit or transduodenal.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 210-210
Author(s):  
Takashi Ogata ◽  
Tetsushi Nakajima ◽  
Kazuki Kano ◽  
Yukio Maezawa ◽  
Kousuke Ikeda ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Internal Hernia ◽  
Gastric Tube ◽  
Abdominal Cavity ◽  
Feeding Tube ◽  
Gastric Conduit ◽  
Round Ligament ◽  
Insertion Point ◽  
Tube Insertion ◽  
Gastric Tube Reconstruction

210 Background: We always used early enteral feeding after esophagectomy as perioperative management. The common procedure for feeding tube insertion is jejunostomy, but sometimes complication such as internal hernia was occurred. In case of retrosternal gastric tube reconstruction, we usually inserted feeding tube through gastric conduit. But in case of posterior mediastinal gastric tube reconstruction, this procedure was not available because of the distance between abdominal wall and gastric tube. So we have developed the new procedure for feeding tube insertion using the mobilized round ligament of liver. Methods: The aims of the study is to clarify the safety of these procedures. In case of retrosternal reconstruction, we usually inserted feeding tube from prepylorus of gastric conduit, and feeding tube was delivered through pyloric ring to 3rd portion of duodenum(Procedure A). Insertion point of the tube was always close to abdominal wall, and easy to be guided to extra-abdomen. On the other hand, in case of posterior reconstruction, we used the new procedure as below(Procedure B). At first, the round ligament of liver was cut at the liver edge. Next, feeding tube was inserted 15~20cm from anterior wall of 2nd portion of duodenum with Witzel suture fixation. After that, feeding tube was led to outside of the abdominal wall through in the mobilized round ligament. The cut edge of round ligament was fixed to the duodenum wall with 4-point suture at tube insertion point, and finally feeding tube completely surrounded by round ligament without direct exposure to the abdominal cavity. And to prevent internal hernia, the space between abdominal wall and mobilized round ligament was covered by omental fat. Results: From January 2012 to December 2014, 126 cases were inserted by procedure A, and from June 2015 to February 2016, 35 cases were done by procedure B. There was no trouble derived from the feeding tube insertion such as intra-operative bleeding, leakage of digestive juice, infectious complication, ileus, and there was no trouble in removal at outpatients in both procedures. Conclusions: Both procedures were safe, so we can manage the feeding tube insertion route by the reconstruction route after esophagectomy.

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