NEUMOPERITONEO PROGRESIVO PREOPERATORIO PARA REPARO DE HERNIA INCISIONAL CON PÉRDIDA DE DOMINIO: REPORTE DE UN CASO.

2020 ◽  
Vol 31 (1) ◽  
Author(s):  
Ronnal Vargas Córdova ◽  
Christian Rojas ◽  
Bolívar Cárdenas ◽  
Diana Naveda ◽  
David Narváez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Wall ◽  
Muscle Atrophy ◽  
Abdominal Sepsis ◽  
Lower Probability ◽  
Repair Technique ◽  
Surgical Recurrence ◽  
Abdominal Hypertension ◽  
Abdominal Compliance ◽  
Transverse Muscle

Incisional hernias with loss domain (HIPD), has a prevalence between 5 - 20%, due to its technical complexity are a challenge for abdominal wall surgeon, because decrease in abdominal compliance, for muscle atrophy and retraction, as well as complications associated with the procedure. We present the preoperative use of progressive pneumoperitoneum (NPP), as a technique for preparing the abdominal wall, by placing a multipurpose permanent catheter (pig tail type) guided by computed tomography, for a 69-year-old male patient, farmer, and colostomy carrier. by sigma volvulus, which presented abdominal sepsis secondary to anastomosis dehiscence, which led to a colostomy, and HIPD formation of 25 x 15 cm. The benefits of NPP are: it reduces the size of the second cavity formed, facilitates the placement of the mesh, reduces the tension in the closure of the abdominal wall and the development of intra-abdominal hypertension syndrome, therefore a lower probability of post-surgical recurrence. The repair technique used was release of the transverse muscle of the abdomen (TAR), which is indicated in HIPD. CONCLUSIONS. HIPD repair is technically difficult because compliance of the abdominal wall is affected, even more so in our case due to the presence of a colostomy. Optimization of the preoperative abdominal wall with the progressive pneumoperitoneum technique plus the TAR technique is one of the valid options available to achieve this goal.

Loss of abdominal domain: Is it the abdominal wall or contents?

Trauma ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 189-193
Author(s):  
Luke R Johnston ◽  
Shabnam Hafiz ◽  
Arnold Raizon ◽  
Jack A Sava
Keyword(s):  
Computed Tomography ◽  
Abdominal Wall ◽  
Open Abdomen ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Volume Changes ◽  
Cross Sectional ◽  
Abdominal Hypertension ◽  
Computed Tomography Scans ◽  
Abdominal Compartment

Background Intra-abdominal hypertension and abdominal compartment syndrome are significant sources of morbidity and mortality in the post-surgical and trauma patient. Several anatomic variables may contribute to the inability to close the abdomen such as retraction of the abdominal wall and intra-abdominal volume changes. This study seeks to quantify these changes and determined which predominates. Methods Retrospective analysis of computed tomography scans of patients whose abdomens could not be closed secondary to intra-abdominal hypertension. Patients were included who had computed tomography scans available with both an open abdomen and after primary abdominal wall closure. Abdominal wall lengths along with total abdominal, intra-peritoneal, and retroperitoneal cross-sectional areas were measured at two anatomic levels. Results Seven patients’ computed tomography scans were evaluated. The closed abdominal wall lengths averaged 2.3 cm and 2.1 cm longer after closure at each point of measurement (p = 0.002 and p = 0.03). Total abdominal cross-sectional area decreased post-closure by 14% for both measurements (p = 0.009 and p = 0.04). Conclusion Measurable increases in intra-abdominal cross-sectional area and decreases in abdominal wall length both contribute to the inability to safely close the abdomen in patients with intra-abdominal hypertension. These findings support the use of multimodal techniques in the management of the open abdomen.

scholarly journals A changing understanding in the presentation of patients with hepatoportal venous gas: a case report

2010 ◽  
Vol 92 (6) ◽  
pp. e9-e10 ◽  
Author(s):  
Jonathan Evans ◽  
Chris Craig
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Imaging Techniques ◽  
Abdominal Sepsis ◽  
Patient Assessment ◽  
Computed Tomography Imaging ◽  
Tomography Imaging ◽  
Prognostic Sign ◽  
Radiological Evidence

Often believed to be a poor prognostic sign, hepatoportal venous gas (HPVG) has been associated with massive intra-abdominal sepsis. It is more frequently detected as computed tomography imaging techniques improve. A patient presenting with radiological evidence of HPVG is discussed and the literature reviewed. This study aims to highlight the increasing understanding that HPVG may sometimes follow a more indolent course than previously believed. Patient assessment is the key in selecting those who need urgent laparotomy.

scholarly journals Computed Tomography Evidence of Psoas Muscle Atrophy Without Concomitant Tendon Wasting in Early Sepsis

2019 ◽  
Vol 234 ◽  
pp. 210-216
Author(s):  
Carrie A. Kubiak ◽  
Kavitha Ranganathan ◽  
Niki Matusko ◽  
Jon A. Jacobson ◽  
Stewart C. Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Muscle Atrophy ◽  
Psoas Muscle ◽  
Early Sepsis

scholarly journals Polynomial Regression Model Analysis of Abdominal Wall Tension and Intra-abdominal Pressure in Critically ill Patients

2021 ◽  
Author(s):  
Hao Tang ◽  
Dongchu Zhao ◽  
Chuan Zhang ◽  
Xiaoying Huang ◽  
Dong Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Model ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Polynomial Regression ◽  
Prognostic Indicators ◽  
Wall Tension ◽  
Abdominal Hypertension ◽  
Abdominal Compliance ◽  
Polynomial Regression Model

Abstract BackgroundAbdominal wall tension (AWT) plays an important role in the pathogenesis of abdominal compliance (AC). This study uses a polynomial regression model to analyze the correlation between intra-vesical pressure(IVP) and AWT in critically ill patients and provides new ideas for the diagnosis and treatment of critically ill patients with intra-abdominal hypertension（IAH）.MethodsA retrospective analysis was conducted in critically ill patients who met the inclusion criteria and were admitted to the Department of intensive care unit of Daping Hospital of Army Medical University from March 14, 2019, to May 23, 2020. According to the IVP on the first day of ICU admission and death within 28 days, the patients were divided into the IAH group (IVP ≥12 mmHg), the non-IAH group, the survival group and the nonsurvival group. The demographic and clinical data, prognostic indicators, AWT and IVP on days 1-7 after entering the ICU, IAH risk factors, and 28-day death risk factors were collected.ResultsA total of 100 patients were enrolled, with an average age of 45.59±11.4 years. There were 55 males (55%), 30 patients from departments of internal medicine (30%), 43 patients from surgery departments (43%), and 27 trauma patients (27%). In the IAH group, there were 50 patients (29 males, 58%), with an average age of 45.28±12.27 years; there were 50 patients (26 males, 52%) in the non-IAH group, with an average age of 45.90±10.58 years. The IVP on the 1st day and the average IVP within 7 days of the IAH group was 18.99（17.52，20.77）mmHg and 19.43（16.87，22.25）mmHg, respectively, which was higher than that of the non-IAH group [ 6.14（3.48，8.70）mmHg, 6.66（2.74，9.08）mmHg], p＜0.001. The AWT on the 1st day and the average AWT within 7 days of the IAH group was 2.89±0.32 N/mm and 2.82±0.46 N/mm, respectively, which was higher than that of the non-IAH group [(2.45±0.29)N/mm,(2.43±0.39)N/mm],p＜0.001.The polynomial regression models showed that the average AWT and IVP on the 1st day and within 7 days were AWTday1 = -2.450×10-3IVP2+9.695×10-2 IVP+2.046，r=0.667（p＜0.0001），and AWTmean = -2.293×10-3IVP2+9.273×10-2 IVP+2.081, respectively. The logistic regression analysis showed that AWTday1 of 2.73-2.97 N/mm increased the patient's 28-day mortality risk (OR: 6.834; 95%: 1.105-42.266, p=0.010).ConclusionsThere is a nonlinear correlation between AWT and IVP in critically ill patients, and a high AWT may indicate poor prognosis.

scholarly journals Tu1589 PREDICTIVE FACTORS OF INTRA ABDOMINAL HYPERTENSION ON COMPUTED TOMOGRAPHY IN PATIENTS WITH ACUTE PANCREATITIS

2020 ◽  
Vol 158 (6) ◽  
pp. S-1128
Author(s):  
Suhang Verma ◽  
Surinder S. Rana ◽  
Rajesh Gupta ◽  
Mandeep Kang ◽  
Ujjawal Gorsi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Factors ◽  
Abdominal Hypertension

scholarly journals ANTERIOR ABDOMINAL WALL ENDOMETRIOMA: A DIAGNOSTIC CHALLENGE

2016 ◽  
Vol 3 (2) ◽  
pp. 44-46
Author(s):  
Salamat Khan ◽  
Krishna Bhasyal ◽  
Bhusan Raj Timilsina
Keyword(s):  
Computed Tomography ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Lower Abdominal Pain ◽  
Radical Resection ◽  
Rectus Abdominis Muscle ◽  
Medical Sciences ◽  
Diagnostic Challenge ◽  
History Of

We are reporting a case of abdominal wall endometrioma (AWE) in a 32-year-old woman who had an 8 months history of lower abdominal pain and lump. The physical examination revealed an ill-defined mass without tenderness. Computed tomography (CT) showed an enhancing is odense mass at the level of umbilicus right to mid line in right rectus abdominis muscle. The patient was treated with a wide radical resection with a 1 cm margin. There was no postoperative complication. The histological examination confirmed endometriosis. The patient is now on regular follow-up and doing well without any recurrence, five months after her operation.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10Page: 44-46 

Applied Anatomy and Computed Tomography of the Abdominal Wall of the Dog

2017 ◽  
Vol 52 (1) ◽  
pp. 28 ◽  
Author(s):  
Basma Gomaa ◽  
Ashraf Karkoura ◽  
ElSaid Enany ◽  
Mohamed Alsafy ◽  
Samir Elgendy
Keyword(s):  
Computed Tomography ◽  
Abdominal Wall ◽  
Applied Anatomy
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