scholarly journals INFECTED URACHAL CYST IN AN ADULT

2021 ◽  
Vol 29 (4) ◽  
pp. 504-509
Author(s):  
V.S. Zhukovskiy ◽  
◽  
M.V. Pankiv ◽  
V.V. Chaplyk ◽  
V.S. Kozopas ◽  
...  

Urachus is a tubular formation originating from the top of the urinary bladder and directed to the umbilicus between the peritoneum and the transverse fascia of the abdomen. In an embryo, it serves to divert primary urine to the amniotic fluid. In case, if obliteration of the duct does not occur until the birth, various pathological processes can develop in it. The most common abnomalies of urachus reported in adults are an infected urachal cyst and urachal carcinoma. These diagnoses are not always easy to make due to atypical symptoms of their manifestation and the rarity of these diseases - just two cases per 100,000 hospitalizations of adults. A 22-year-old man with a subcutaneous abscess and anexternal fistula located in theumbilical region with redness of the surrounding skin. 16 hours after dissection and drainaging of the abscess, the patient’s condition worsened, pain in the lower parts of the abdomen began, muscle tension of the anterior abdominal wall and inflammatory changes in blood tests were revealed. The patient was operated on for peritonitis. A two-chambered urachus cyst of the «hourglass» type, with the formation of a dense consistency calculus in one of the cavities, which perforated into the abdominal cavity This clinical case is of the great interest from the point of view of the atypical course and the treatment of a rather rare anomaly in adults. The publication will remind emergency medicine physicians about the possibility of infected urachus in patients with symptoms of acute abdomen.

Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
K. Y. Linevska

For over a thousand years, Hippocrates and Galen have been the Alpha and Omega of medical knowledge. Despite the importance of their contributions to clinical and theoretical medicine, they lacked a true understanding of anatomy and physiology. Hippocrates is commonly associated with proposing the doctrine of «tissue fluids», or humoral pathology, and his book, «On the Nature of Man», promotes this point of view. Galen became inherited the knowledge of Hippocrates. Ultimately, he was recognized as one of the most influential physicians of all time. The number of his works was enormous: he wrote more than a hundred books, which were widely distributed. One of Galen’s main commandments was the rule of harmony: all body systems are balanced; disease is a result of an imbalance. As one might expect, some of his ideas, however, were erroneous. Aristotle considered the pancreas, due to its location in the abdominal cavity, as an organ which only task was to protect the adjacent vessels. In an era when unknown diseases wreaked havoc, the concept of known causes of diseases led to the fascination with the study of food poisons and their antidotes. This was common among aristocracy who felt particularly vulnerable to this kind of threats. According to legend, one of the most famous connoisseurs of poisons was Mithridates VI. Pedanius Dioscorides was a Greek who served in the Roman army during the reign of the emperor Nero. The wandering nature of life led him to study a large number of diseases and medicines. The catalogue of his medicinal herbs and plants became the basis for the study and understanding of the medicinal properties of plants. Liver was considered the source of divine prophecy in many ancient cultures. The anatomy of liver was well known in ancient Babylon: a huge number of clay tablets and objects were left, which testify to the importance of «hepatoscopy» in the Middle East as a form of prediction. Those who used the insides of animals for divination (e.g., haruspices — divine interpreters of the future, using the liver as a prediction tool), could be considered the first official anatomists, since the understanding of the future depended on accurate knowledge and interpretation of certain liver components. After the victory of the Assyrian king Sargon over the forces of Urartu and Zikirti in 718 BC, Sargon wanted to appease the gods by sacrificing animals; in doing so, he studied their livers for predictions. Although the concept of pancreas is rooted in ancient times, as evidenced by the comments of haruspices and priests, knowledge of the organ functions eluded humanity until the works by Danish physiologists Francis Sylvius and Regnier de Graaf. Prior to their studies of pancreatic secretion and the elucidation of the role of pancreas in digestion, described by van Helmont and Albrecht von Haller, most researchers focused on the anatomical description of the organ. If the ancient Assyrians and Mesopotamians did not believe that liver predicts the future, but believed that it was pancreas that did it, then pancreatology may have earlier origins. Maimonides, a Jewish scholar and humanist, was also influential in other fields: he condemned astrology and its attempts to calculate the time of the Messiah’s coming. In the field of medicine, he paid attention to prevention, and was interested in the treatment of diseases of the gastrointestinal tract. By the beginning of our era, ideas about digestion, diseases of the digestive tract and their treatment remained very vague. There was a long and difficult way ahead in this area.  


2010 ◽  
Vol 76 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Petros Mirilas ◽  
John E. Skandalakis

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.


2017 ◽  
Vol 4 (7) ◽  
pp. 2358
Author(s):  
Abhishek Katyal ◽  
Yash Patel

Synovial Sarcomas (synoviomas) are the fourth most common malignant soft-tissue tumours, and typically develop in para-articular locations of the extremities in close association with joint capsules, tendon sheaths, bursae and fascial structures. Other less common sites include the head and neck, abdominal wall, intra-abdominal cavity, and mediastinum. In this article, an interesting and rare case of a 25-year-old man with left upper abdominal lump is reported which was subsequently diagnosed as biphasic synovial sarcoma (spindle cell variety) of anterior abdominal wall. 


2013 ◽  
Vol 94 (2) ◽  
pp. 247-250
Author(s):  
N R Akramov ◽  
A K Zakirov

A clinical case and treatment of a disorder of sex development (46XX, ovotesticular type) who underwent a simultaneous surgery including diagnostic laparoscopy using the single access endoscopic surgery followed by gonadectomy and the single-stage feminizing genitoplasty, is described. Endocrinology service needs for determination of treatment approach in children with disorders of sex development are closely entwined with capabilities of endoscopic surgery, particularly laparoscopy. It’s necessary to quickly determine the gonadal structure due to the high risk of malignancies while examining these patients. The most useful method is the direct visualization of the gonads in the abdominal cavity by laparoscopy. In these cases the single access endoscopic surgery technique reduces the trauma and is welcomed in pediatrics. From our point of view, the preference for the patients with disorders of sex development management with expected gonadal dysgenesis must be given to a single access endoscopic surgery.


2021 ◽  
pp. 15-19
Author(s):  
O.K. Sliepov ◽  
N.Y. Zhylka ◽  
V.L. Veselskyi ◽  
N.Y. Skrypchenko ◽  
T.V. Avramenko ◽  
...  

Background. Despite the existence of numerous studies on the optimal delivery mode in gastroschisis (GS), their results remain controversial. Therefore, the presented study is focused on establishing the delivery mode impact on GS anatomy in newborns.Research objective. The study was conducted to determine the impact of the delivery mode on the features of GS anatomy in newborns.Materials and methods. A retrospective analysis of medical records of 135 pregnant women and 135 their newborns with GS born between 1987 and 2020 was conducted. All newborns are divided into 3 groups. Newborns delivered by caesarean section are included in group I (n = 80); children born exclusively naturally are included in groups II (n = 25) and III (n = 30). The following anatomical features of GS in newborns were studied: localization and size of the anterior abdominal wall defect, confluence with the abdominal cavity, the nature and frequency of the eventrated organs.Results. The size of the anterior abdominal wall defect was significantly smaller in children with GS delivered by caesarean section (3.02 ± 0.58 cm; p < 0.01) than in children born naturally (4.17 ± 0.3 cm in group II, 4.7 ± 0.29 cm in group III). The frequency of retroperitoneal organs eventration was significantly less (20.0%; p < 0.01) in caesarean delivery grope than in II and III groups (52% and 63.3%, respectively). There was no significant difference in frequency of other abdominal organs eventration, localization of the anterior abdominal wall defect and confluence with the abdominal cavity. Level of evidence – III. Conclusions. The mode of delivery affects the size of abdominal wall defect and frequency of the abdominal organs eventration in newborns with GS.


2020 ◽  
Vol 10 (4) ◽  
pp. 94-95
Author(s):  
Valery Nikolskiy ◽  
Ekaterina Titova ◽  
Yaroslav Feoktistov ◽  
Vladislav Kiselev

Our experimental study shows a morphological response of the anterior abdominal wall to implantation of a combined (bovine pericardium graft and polyester mesh) hernia prosthesis. For this purpose, fifteen chinchillas were operated on. A combined prosthesis was implanted intra-abdominally, where the pericardium graft adjoined the internal organs with the smooth side, while the synthetic material was facing the peritoneum. Morphological and morphometric assessment of the tissue in the area of implantation of the prosthesis was carried out. Morphology of tissues samples was evaluated in 2 weeks, in 1 month and in 2 months after surgery. Our study revealed that the combined prosthesis implanted in the anterior abdominal wall causes an acute inflammatory response, which progresses within a month after the surgery. However, the signs of inflammation reduced at the end of the second month of the experiment. A new connective tissue grew actively into the implant from the side of the polyester mesh. The pericardium graft adjacent to the abdominal cavity with the smooth side did not cause formation of connective tissue. Thus, the combined hernia prosthesis has protected the abdominal cavity from adhesions in the postoperative period.


2016 ◽  
Vol 12 (3) ◽  
pp. 134
Author(s):  
Hodonou Montcho Adrien ◽  
Allodé Salako Alexandre ◽  
Tamou sambo Bio ◽  
Ossé Martin ◽  
Moumouni Amina ◽  
...  

Bacground: The urachus is a fibrous remnant of the allantois. That connects the bladder dome to the anterior abdominal wall. After birth it is obliterated in general. In some cases it may persist as cyst , fistula , sinus or diverticulum. This persistence of the urachus often is signaled by a complication. Infection is the most common complication and the most dangerous is his degeneration. The infection can be misunderstood and confused with other pathologies of the navel. Methods: Our study reports three clinical cases of infected urachal cyst. Result: these report cases illustrate the need to think of this diagnosis before the painful of the navel and abdomen. The ultrasound examination can help for the diagnosis.


2020 ◽  
Vol 7 (12) ◽  
pp. 903-949
Author(s):  
K. F. Slaviansky

Both the methods of objective research and the results obtained by them, with cysts and cystomas of the ovary, seem to be very different, depending on the size that the tumor has reached. Therefore, from a practical point of view, it is very convenient to divide tumors into 3 categories of their sizes: 1) cysts of small volume, still located in the pelvic cavity, 2) larger tumors, which have already left it and are located in the abdominal cavity above the entrance to the pelvis, and their size does not exceed that of a pregnant uterus of six months and, finally, 3) cysts the size of a pregnant uterus on demolitions and even larger, reaching colossal sizes, displacing and squeezing all the abdominal insides to an extreme degree.


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