scholarly journals DRENAJE QUIRÚRGICO EXTRAPERITONEAL DE ABSCESO DEL PSOAS: FUNDAMENTO ANATÓMICO. Drenaje quirúrgico extraperitoneal de absceso del psoas: Fundamento anatómico

2016 ◽  
Vol 7 (2) ◽  
pp. 100-106
Author(s):  
Alejandro M Russo ◽  
Alejandra Garretano ◽  
Andrés Pouy ◽  
Gabriela Wagner ◽  
Juan M Costa ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Surgical Treatment ◽  
Emergency Room ◽  
Abdominal Wall ◽  
Peritoneal Cavity ◽  
Parietal Peritoneum ◽  
Complete Relief ◽  
Extraperitoneal Approach ◽  
Lateral Abdominal Wall ◽  
Formalin Fixed

El espacio extraperitoneal se encuentra delimitado por el peritoneo parietal y las paredes de la cavidad abdómino-pélvica. Al igual que la cavidad peritoneal este espacio puede ser asiento de diversas colecciones, como ser hematomas, tumores y supuración. Con el advenimiento de las nuevas técnicas de imagen, se ha contribuido no solo al mejor diagnóstico de estas patologías sino también a su mejor manejo. El objetivo de este trabajo es mostrar la anatomía del abordaje extraperitoneal del comparti-miento del psoas y su aplicación al tratamiento de un paciente. Para esto se utilizaron 5 cadáveres adultos fijados previamente en solución en base a formol. Se realizó disección bilateral de la pared antero-lateral del abdomen reclinando la bolsa peritoneal para a continuación abordar el compartimiento del músculo psoas. Este conocimiento fue utilizado en el tratamiento quirúrgico de una paciente que consultó por un absceso del compartimiento del psoas derecho. En las preparaciones cadavéricas, se observó cómo al rebatir el peritoneo parietal se expone la totalidad del compartimiento muscular del psoas. Este procedi-miento fue realizado a la paciente consiguiendo el drenaje completo de la cavidad abscedada, quien tuvo una buena evolución y fue dada de alta a los 7 días. Los hallazgos demuestran una vez más como el conocimiento anatómico sigue estando vigente en la práctica clínica, siendo la comprensión del espacio extraperitoneal fundamental no solo para el anatomista sino también para el cirujano.  The retroperitoneal space is bounded by the parietal peritoneum and the posterior abdominal wall. Just like the peritoneal cavity, this region can host multiple effusions such as hematomas, tumors and suppuration. With the development of new radiological technics, both diagnosis and management of these conditions has improved. The purpose of this paper is to demonstrate the anatomy of the extraperitoneal approach of the psoas compartment and its application to a patient´s surgical treatment. For this purpose 5 formalin-fixed adult cadavers were used. Bilateral dissection of the antero-lateral abdominal wall was performed in every specimen. Once the parietal peritoneum was mobilized the psoas compartment was approached. This knowledge was used during the surgical treatment of a patient who attended to the emergency room with a right psoas compartment abscess. In the cadaveric specimens, the psoas muscular compartment was approached after mobilizing the parietal peritoneum medially. This procedure was carried out in the patient resulting in complete drainage of the purulent effusion. The patient had complete relief of the symptoms and was discharged 7 days after the procedure. These findings show that the anatomic knowledge is still important in clinical practice. Understanding the extraperitoneal space is crucial for both anatomists and surgeons. 

scholarly journals Combination of autoplasty with autodermoplasty in the treatment of lateral abdominal hernias

2012 ◽  
Vol 93 (2) ◽  
pp. 250-255
Author(s):  
A A Botezatu ◽  
I N Nurmeev
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
State Institution ◽  
Case Histories ◽  
Treatment Results ◽  
Surgical Department ◽  
Lateral Abdominal Wall ◽  
New Methods ◽  
Abdominal Hernias

Aim. To improve the outcomes of treatment in patients with lateral abdominal hernias by combining autoplastic methods with autodermoplasty. Methods. 42 case histories of patients with lateral abdominal wall hernias, operated in the first surgical department of the State Institution «Republican Clinical Hospital», Tiraspol city, from 2001 to 2011 were subjected to retrospective analysis. In all of the cases surgical treatment was performed. Combined methods of hernioplasty, which combine autoplasty with autodermoplasty, were applied. The authors’ personal patented method of hernioplasty was also used among others. Results. According to the classification of Chevrel-Rath (2000) 23 (54.7%) of the patients had inferolateral hernias, 5 (11.9%) patients - supra-lateral hernias, 8 (19%) patients - lumbar hernias, there were also 2 (4.8%) patients each with transrectal, pararectal and paracolostomy hernias. Despite their small number in the total amount of postoperative hernias (17.5%), 26 (65%) patients had large and giant lateral hernias, while recurrences were present in 7 (16.7%) cases. Treatment results were satisfactory. Complications and recurrence occurred in 1 (2.9%) patient each. Conclusion. The combination of autoplasty with autodermoplasty is an effective method of treatment for inferolateral, supra-lateral, pararectal, transrectal, paracolostomy and lateral hernias; during lumbar hernias autodermoplasty even with two autodermal grafts was not as effective, and therefore justified is the search for new methods of hernioplasty.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

scholarly journals Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of abdominal wall, paraspinal, and chest wall blocks

2021 ◽  
Vol 46 (7) ◽  
pp. 571-580
Author(s):  
Kariem El-Boghdadly ◽  
Morné Wolmarans ◽  
Angela D Stengel ◽  
Eric Albrecht ◽  
Ki Jinn Chin ◽  
...  
Keyword(s):  
Education Research ◽  
Clinical Practice ◽  
Abdominal Wall ◽  
Chest Wall ◽  
Round Table Discussion ◽  
Anesthetic Techniques ◽  
Delphi Consensus ◽  
International Consensus ◽  
Strong Consensus ◽  
Regional Anesthetic

BackgroundThere is heterogeneity in the names and anatomical descriptions of regional anesthetic techniques. This may have adverse consequences on education, research, and implementation into clinical practice. We aimed to produce standardized nomenclature for abdominal wall, paraspinal, and chest wall regional anesthetic techniques.MethodsWe conducted an international consensus study involving experts using a three-round Delphi method to produce a list of names and corresponding descriptions of anatomical targets. After long-list formulation by a Steering Committee, the first and second rounds involved anonymous electronic voting and commenting, with the third round involving a virtual round table discussion aiming to achieve consensus on items that had yet to achieve it. Novel names were presented where required for anatomical clarity and harmonization. Strong consensus was defined as ≥75% agreement and weak consensus as 50% to 74% agreement.ResultsSixty expert Collaborators participated in this study. After three rounds and clarification, harmonization, and introduction of novel nomenclature, strong consensus was achieved for the names of 16 block names and weak consensus for four names. For anatomical descriptions, strong consensus was achieved for 19 blocks and weak consensus was achieved for one approach. Several areas requiring further research were identified.ConclusionsHarmonization and standardization of nomenclature may improve education, research, and ultimately patient care. We present the first international consensus on nomenclature and anatomical descriptions of blocks of the abdominal wall, chest wall, and paraspinal blocks. We recommend using the consensus results in academic and clinical practice.

scholarly journals Period prevalence and identification challenges of viral haemorrhagic fever suspect cases in a tertiary referral hospital in Guinea: a cross-sectional, retrospective study of triage and emergency room patient profiles

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Manuel Raab ◽  
Lisa M. Pfadenhauer ◽  
Vinh-Kim Nguyen ◽  
Dansira Doumbouya ◽  
Michael Hoelscher ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Emergency Room ◽  
Retrospective Chart Review ◽  
Laboratory Diagnostics ◽  
Haemorrhagic Fever ◽  
Case Definitions ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Viral Haemorrhagic Fever ◽  
Suspect Case

Abstract Background A functioning Viral Haemorrhagic Fever (VHF) surveillance system in countries at risk for outbreaks can reduce early transmission in case of an outbreak. Surveillance performance depends on the application of suspect case definitions in daily clinical practice. Recommended suspect case criteria during outbreaks are designed for high sensitivity and include general symptoms, pyrexia, haemorrhage, epidemiological link and unexplained death in patients. Non-outbreak criteria are narrower, relying on the persistence of fever and the presence of haemorrhagic signs. Methods This study ascertains VHF suspect case prevalence based on outbreak and non-outbreak criteria in a Guinean regional hospital for a period of three months. The study further describes clinical trajectories of patients who meet non-outbreak VHF suspect case criteria in order to discuss challenges in their identification. We used cross-sectional data collection at triage and emergency room to record demographic and clinical data of all admitted patients during the study period. For the follow-up study with description of diagnostic trajectories of VHF suspect cases, we used retrospective chart review. Results The most common symptoms of all patients upon admission were fever, tiredness/weakness and abdominal pain. 686 patients met EVD outbreak criteria, ten adult patients and two paediatric patients met study-specific non-outbreak VHF suspect case criteria. None of the suspect cases was treated as VHF suspect case and none tested positive for malaria upon admission. Their most frequent discharge diagnosis was unspecific gastrointestinal infection. The most common diagnostic measures were haemoglobin level and glycaemia for both adults and for children; of the requested examinations for hospitalized suspect cases, 36% were not executed or obtained. Half of those patients self-discharged against medical advice. Conclusions Our study shows that the number of VHF suspect cases may vary greatly depending on which suspect case criteria are applied. Identification of VHF suspect cases seems challenging in clinical practice. We suggest that this may be due to the low use of laboratory diagnostics to support certain diagnoses and the non-application of VHF suspect case definitions in clinical practice. Future VHF suspect case management should aim to tackle such challenges in comparable hospital settings.

Abdominal hollowing and lateral abdominal wall muscles' activity in both healthy men & women: An ultrasonic assessment in supine and standing positions

2011 ◽  
Vol 15 (1) ◽  
pp. 108-113 ◽  
Author(s):  
Farideh Dehghan Manshadi ◽  
Mohamad Parnianpour ◽  
Javad Sarrafzadeh ◽  
Mahmood reza Azghani ◽  
Anooshirvan Kazemnejad
Keyword(s):  
Abdominal Wall ◽  
Healthy Men ◽  
Lateral Abdominal Wall ◽  
Ultrasonic Assessment

Clinical Practice Guidelines for the Surgical Treatment of Patients With Lynch Syndrome

2017 ◽  
Vol 60 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Daniel O. Herzig ◽  
W. Donald Buie ◽  
Martin R. Weiser ◽  
Y. Nancy You ◽  
Janice F. Rafferty ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Surgical Treatment ◽  
Lynch Syndrome ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines

scholarly journals Abdominal Expansion versus Abdominal Drawing-In Strategy on Thickness and Electromyography of Lumbar Stabilizers in People with Nonspecific Low Back Pain: A Cross-Sectional Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4487
Author(s):  
Yi-Liang Kuo ◽  
Chieh-Yu Kao ◽  
Yi-Ju Tsai
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Abdominal Wall ◽  
Emg Activity ◽  
Abdominal Muscles ◽  
Low Back ◽  
Clinical Practices ◽  
Lumbar Multifidus ◽  
Lateral Abdominal Wall ◽  
Lumbar Stabilization

The abdominal expansion (AE) strategy, involving eccentric contraction of the abdominal muscles, has been increasingly used in clinical practices; however, its effects have not been rigorously investigated. This study aimed to investigate the immediate effects of the AE versus abdominal drawing-in (AD) strategy on lumbar stabilization muscles in people with nonspecific low back pain (LBP). Thirty adults with nonspecific LBP performed the AE, AD, and natural breathing (NB) strategies in three different body positions. Ultrasonography and surface electromyography (EMG) were, respectively, used to measure the thickness and activity of the lumbar multifidus and lateral abdominal wall muscles. The AE and AD strategies showed similar effects, producing higher EMG activity in the lumbar multifidus and lateral abdominal wall muscles when compared with the NB strategy. All muscles showed higher EMG activity in the quiet and single leg standing positions than in the lying position. Although the AE and AD strategies had similar effects on the thickness change of the lumbar multifidus muscle, the results of thickness changes of the lateral abdominal muscles were relatively inconsistent. The AE strategy may be used as an alternative method to facilitate co-contraction of lumbar stabilization muscles and improve spinal stability in people with nonspecific LBP.

Abdominal Wall Expanding System. Intraoperative Abdominal Wall Expansion as a Technique to Repair Giant Incisional Hernia and Laparostoma. New and Long-Term Results From a Three-Center Feasibility Study

2021 ◽  
pp. 155335062110414
Author(s):  
Dietmar Eucker ◽  
Nadine Rüedi ◽  
Clinton Luedtke ◽  
Oliver Stern ◽  
Henning Niebuhr ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Long Term Results ◽  
Anatomical Reconstruction ◽  
Time Saving ◽  
Lateral Abdominal Wall ◽  
Hernia Size ◽  
Midline Closure

Background The abdominal wall expanding system (AWEX) was first applied in 2012 and published in 2017. This novel technique was developed to reconstruct complex incisional hernias and residual skin-grafted laparostoma after treatment of an open abdomen, when primary midline closure was impossible. The main aim was the anatomical reconstruction of the abdominal wall and the avoidance of dissecting techniques (component separation). Methods Between 2012 and 2019, 33 patients underwent AWEX hernia repair in three certified hernia centers. The retracted abdominal wall was stretched with the AWEX system intraoperatively for approximately 30 min. Hernia size was measured preoperatively, on CT, and intraoperatively. The gain in length on the lateral abdominal wall (decrease in width of the defect) after stretching and any residual midline gap were determined in the OR. Results 33 patients underwent AWEX procedures. Six cases were evaluated separately because of additional procedures (TAR, four cases) and preoperative application of botulinum toxin (two cases). The median (95% confidence interval) measured width of hernia defects was 13 (12–16) cm, the median gain in length on the lateral abdominal wall was 12 (10–15) cm. After median follow-up of 29 (12–54) months, one recurrence from the broken mesh was observed. No method-related complications occurred. Conclusion Based on the 2017 and current results, the AWEX system represents an alternative or supplemental procedure to current techniques for complex abdominal wall reconstruction. The system proved again to be time-saving, safe, effective, and easy to learn. Further studies with enhanced technology are in progress.

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