scholarly journals Necrotising Fasciitis of lower anterior abdominal wall post lower segment ceaserian section

2018 ◽  
Vol 5 (11) ◽  
pp. 3760
Author(s):  
Mahmood A. Makhdoomi ◽  
Abdelhamid Haraga ◽  
Moly Joseph ◽  
Yasser Al Habeeb
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Good Condition ◽  
Necrotising Fasciitis ◽  
Uneventful Recovery ◽  
Lower Segment ◽  
Surgical Teams ◽  
The One ◽  
Secondary Closure

Necrotising fasciitis is a rapidly progressive inflammatory infection of the fascia with secondary necrosis of the subcutaneous tissue. The speed of spread is directly proportional to the thickness of the subcutaneous layer. It moves along the fascial plane. We are presenting a case report of 27 years old Saudi female with status post Lower segment caesarian section of 10 days’ duration presented with bluish discoloration of the lower anterior abdominal wall around the surgical scar with necrotic patches and surrounding induration with foul smelling discharge from the one pocket within this area. She underwent successful simultaneous incision and wide debridement of gross necrotic tissues; together with evacuation of the pus followed by secondary closure. Both general and plastic surgical teams were involved. Patient made uneventful recovery and discharged home in good condition.

Amyand’s hernia causing necrotising fasciitis of the anterior abdominal wall

Hernia ◽  
2005 ◽  
Vol 9 (4) ◽  
pp. 381-383 ◽  
Author(s):  
C. D. Marron ◽  
M. Khadim ◽  
D. McKay ◽  
E. J. Mackle ◽  
J. W. R. Peyton
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Necrotising Fasciitis ◽  
Amyand’S Hernia

scholarly journals Necrotising fasciitis secondary to a colocutaneous fistula

2016 ◽  
Vol 98 (7) ◽  
pp. e130-e132 ◽  
Author(s):  
N Husnoo ◽  
S Patil ◽  
A Jackson ◽  
M Khan
Keyword(s):  
Abdominal Wall ◽  
Diverticular Disease ◽  
Anterior Abdominal Wall ◽  
English Literature ◽  
Previous History ◽  
Necrotising Fasciitis ◽  
Preoperative Imaging ◽  
Sigmoid Colectomy ◽  
Midline Laparotomy ◽  
Colocutaneous Fistula

Colocutaneous fistulae secondary to diverticular disease are rare, especially spontaneous fistulae. We report a case of a 74-year-old lady, with no previous history of diverticular disease, presenting with necrotising fasciitis of the anterior abdominal wall in the left iliac fossa, without any other symptoms. Urgent surgery was performed. An initial diagnostic laparoscopy demonstrated a perforated sigmoid diverticulum forming a fistula to the anterior abdominal wall. Following soft tissue debridement, a sigmoid colectomy was performed through a midline laparotomy. Gastrointestinal pathology should be considered as a potential cause of abdominal wall necrotising fasciitis. Our approach of using laparoscopic visualisation to assess for intra-abdominal sources in this context (in the absence of preoperative imaging when imaging could delay treatment) has not been described before. To our knowledge, only two cases of abdominal wall necrotising fasciitis secondary to diverticular disease with a colocutaneous fistula have been reported in the English literature.

scholarly journals Pleural Mesothelioma Presenting as Periumbilical Metastasis: The First Clinical Documentation

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
R. F. Falkenstern-Ge ◽  
M. Kimmich ◽  
S. Bode-Erdmann ◽  
G. Friedel ◽  
G. Ott ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Systemic Chemotherapy ◽  
Clinical Presentation ◽  
Pleural Cavity ◽  
Anterior Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Pleural Mesothelioma ◽  
Fatty Tissue ◽  
Clinical Documentation ◽  
Subcutaneous Fatty Tissue

Introduction. Pleural mesothelioma with metastasis to the subcutaneous tissue of the abdominal wall at first diagnosis and without penetration into the peritoneum is an extremely rare clinical presentation.Methods. Patients with pleural mesothelioma have low survival rate. Usually, the disease at presentation is confined to its site of origin (most often the pleural cavity). A 55-year-old man was referred to our center due to increasing dyspnea and a painful periumbilical mass in the anterior abdominal wall. CT scan revealed both advanced mesothelioma of the pleura and a tumor mass confined to the subcutaneous fatty tissue without penetration through the peritoneum.Results. Video-assisted thoracoscopy confirmed the diagnosis of epithelioid pleural mesothelioma, which was also confirmed by a biopsy of the periumbilical mass. Systemic chemotherapy with cisplatin and pemetrexed was initiated. Under the ongoing systemic chemotherapy, the evaluation revealed partial remission of pleura mesothelioma and its subcutaneous manifestation of the abdominal wall.Conclusion. Mesothelioma of the pleura with a simultaneous metastasis to the subcutaneous fatty tissue of the abdominal wall at presentation without penetration of peritoneum is a rare clinical presentation of mesothelioma disease. The knowledge of its natural history is very limited. This is the first ever clinical documentation of a patient with pleura mesothelioma and simultaneous subcutaneous manifestation of abdominal wall.

scholarly journals PREVENTION AND TREATMENT OF INFECTION WOUND COMPLICATIONS AT PROSTHETIC HERNIA REPAIR

2015 ◽  
Vol 1 (2) ◽  
pp. 16-23
Author(s):  
A. G. Sonis ◽  
B. D. Grachev ◽  
E. A. Stolyarov ◽  
I. V. Ishutov
Keyword(s):  
Abdominal Wall ◽  
Blood Supply ◽  
Anterior Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Cellular Tissue ◽  
Infectious Complications ◽  
Occurrence Rate ◽  
Wound Complications ◽  
Prevention And Treatment ◽  
Deep Layers

Purpose – development of practical recommendations for prevention and treatment of infectious wound complications at prosthetic hernioplasty, based on the peculiarities of blood supply of the front abdominal wall. Materials and methods. 851 surgeries of prosthetic hernioplasty were made in Propaedeutic Surgery Clinic of Samara State Medical University throughout 2010–2013. The most of infectious complications developed after tension-free hernioplasty of big postoperative ventral hernias, with size of hernia orifice of 10 cm and more (W3–W4, Chevrel–Rath, 1999). 118 hernia repairs have been done for such hernias. These surgeries are peculiar by wide mobilization of cutaneous fat flaps and implant contact with the subcutaneous tissue. The imaging of blood vessels in median masses of the anterior abdominal wall was carried out using anatomic material. Results. Very interesting results were obtained with respect to peculiarities of blood supply to the skin and subcutaneous tissues of anterior abdominal wall, upon pumping of zinc sulfide and lead acetate to the epigastric arteries. The infectious wound complications after prosthetic hernioplasty are mostly concerned with the ischemia of cutaneous and subcutaneous flaps, which wide mobilization causes considerable blood supply disturbance and cellular tissue hemorrhages. In cases of hernia orifices size of 10 cm and more, the occurrence rate of infectious wound complications was 13,6 %. Conclusions. In case of wide mobilization of cutaneous fat flaps, the excision of deep layers of subcutaneous cellular tissue is possible and the aspiration drainage is mandatory. The ischemic genesis of complications causes a possibility of restricted surgical activity. Even development of infectious complications does not prevent the implant survival. 

scholarly journals OBSTETRIC GYNECOLOGICAL SOCIETY IN BERLIN Meeting on November 27, 1891

2020 ◽  
Vol 6 (4) ◽  
pp. 398-402
Author(s):  
V. N. Massen
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Cavity ◽  
Anterior Wall ◽  
Lower Segment ◽  
Complete Rupture ◽  
One To One ◽  
Rupture Site

Winter showed a postpartum uterus with a complete rupture in its lower segment. The rupture passed very obliquely through the anterior wall of the uterus and extended from the ring of contraction almost to the external uterine pharynx. The peritoneum was separated above the gap to the line of tight attachment in such a way that a connection with the abdominal cavity 10 cm long was formed. When opened: the uterus was lying in a strong bend forward; bowel loops and the anterior abdominal wall delimited the rupture site from the abdominal cavity; all intestines were very red and covered with a light coating; in the abdominal cavity there were about one to one and a half liters of liquid and coagulated blood.

scholarly journals Case report: Embedded Continuous glucose monitor sensor

2021 ◽  
Author(s):  
Femi Adeniyi ◽  
James Akinlua ◽  
Shailendra Rajput
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Rare Complication ◽  
Rare Condition ◽  
Surgical Removal ◽  
Parental Anxiety ◽  
Continuous Glucose Monitor ◽  
Rare Presentation

INTRODUCTIONIn Children with Type 1 diabetes mellitus, embedment of Continuous glucose monitor sensor wire is a rare complication. Case Report We herein report a rare presentation of embedment of continuous glucose monitor sensor wire in a 5year old girl known to have T1DM. She presented after 1year 2month of being on the CGM with a 2-days history of a lump under the skin of her anterior abdominal wall which was confirmed on ultrasound scan as embedded sensor wire in the subcutaneous tissue of anterior abdominal wall. She was discussed with surgeon due to parental anxiety who reviewed her with the images and offered surgical removal of the sensor wire. She was discharged following a day case removal of the sensor wire with no follow up arranged.METHODSInformation for the report was retrieved from medical records after obtaining informed consent from the parents. DISCUSSIONThe definitive management of embedded CGM sensor is often conservative. Surgical retrieval of the sensor is recommended if suspicious of infection or portion of the sensor that is visible above the skin. In our case it was decided to remove the sensor wire surgically because of parental anxiety and choice.1904 The 8th Congress of the European Academy of Paediatric Societies - EAPS 2020Poster PresentationCONCLUSIONContinuous glucose monitoring sensor break and imbedded under the skin is a rare condition and management is often conservative. It worth being aware of the indications for investigation and possible surgical intervention such as overlie infection, visible part of the sensor above the skin, painful lump or patient’s choice.

scholarly journals 97 A Case Report: Necrotising Leukocytoclastic Vasculitis (NLV) Of the Breast Mimicking Necrotising Fasciitis (NF)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P R Chew ◽  
K Munro
Keyword(s):  
Chest Wall ◽  
Lower Limb ◽  
Leukocytoclastic Vasculitis ◽  
Subcutaneous Tissue ◽  
Kidney Injury ◽  
Left Breast ◽  
Acute Onset ◽  
Necrotising Fasciitis ◽  
Uneventful Recovery ◽  
Small Vessels

Abstract Leukocytoclastic vasculitis (LV) is an inflammation of the small vessels in the dermis characterised by the deposition of immunocomplexes in the involved vessel walls. It commonly manifests as palpable purpura, limited to the skin and predominantly of the lower limb. We report a rare case of necrotising LV (NLV) affecting bilateral breast, manifesting clinical features of necrotising fasciitis (NF), and emphasizes the potential diagnostic challenges that markedly influence the treatment and survival of patients. A 48-year-old female presented with an acute onset left breast skin necrosis and discolouration that rapidly progressed to the contralateral breast with surrounding erythema and oedema of the chest wall yet spared the intermammary cleft. Some non-blanching purpuric rash were also noted on upper abdomen and left lower limb. COVID-19 test was negative. CT scan showed extensive bilateral breast fat stranding and oedema. Patient became clinically septic with a moderately raised CRP and mild acute kidney injury. Radical mastectomies and chest wall excision were performed with intra-operative findings of cloudy fluid and easily peeled away subcutaneous tissue from fascia. Urgent gram stain and culture showed no organisms. Tissue biopsies subsequently showed the diagnosis of NLV. Chest wall defect was then reconstructed with split skin grafts, NLV treated with corticosteroids and patient made an uneventful recovery. This case highlights the incidence of a rare and aggressive manifestation of NLV on the breast that mimics NF, emphasizing the clinical differentiation that may lead to catastrophic results and significant cosmetic defect, if a differential diagnosis cannot be determined at the time.

scholarly journals Macroglossia and Beckwith-Wiedemann syndrome

2011 ◽  
Vol 139 (5-6) ◽  
pp. 366-369 ◽  
Author(s):  
Dragan Krasic ◽  
Predrag Radovic ◽  
Nikola Buric ◽  
Dragana Krasic ◽  
Zoran Pesic ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Leydig Cell ◽  
Umbilical Hernia ◽  
Anterior Abdominal Wall ◽  
Good Condition ◽  
Clinical Signs ◽  
Muscular Hypotonia ◽  
Cell Hyperplasia ◽  
Clinical Criteria ◽  
Swallowing Difficulties

Introduction. In 1963 Beckwith presented a report on the first patient with extreme cytomegaly of adrenal cortex, hyperplasia of kidneys and pancreas and Leydig cell hyperplasia. Wiedemann completed description of the new syndrome by adding umbilical hernia and macroglossia. The diagnosis is made based on the clinical signs of omphalocele or some other umbilical deformity, macroglossia, congenital asymmetry, visceromegaly (liver, pancreas, and kidneys). Case Outline. A 16-month-old male child was admitted for examination because of macroglossia. He underwent examination on several occasions by an endocrinologist due to recurrent hypoglycaemic crisis. The patient was observed by a paediatric neurophysicatrist for disorders of mental development. Hypoglycaemia, muscular hypotonia of the anterior abdominal wall with umbilical hernia and macroglossia were observed by clinical examination. Inratraoral examination revealed macroglossia with microstomia, suckling and swallowing difficulties, hypotonia of the perioral muscles with increased salivation. It was therefore decided to perform surgical reduction of the prominent tongue and develop good condition for nutrition, speech function and the development of orofacial system. Conclusion. The diagnosis of macroglossia is based on subjective clinical criteria such as the morphology and amount of protrusion of the tongue, difficulty in articulating sounds, breathing, and hypersalivation. Some authors have suggested that the tongue size may be analyzed radiographically with a cephalogram. Treatment of macroglossia is controversial because of the absence of objective clinical criteria.

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