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Abdominal Wall Defects (abdominal + wall_defect)
Selected AbstractsDirect preputial hernia associated with a ventral abdominal wall defect in a two-year-old geldingEQUINE VETERINARY EDUCATION, Issue 7 2010T. O'Brien Summary The case of a 2-year-old gelding with acute onset of preputial swelling and prolapse is presented. After initiating conservative management using a penile repulsion device, the horse repeatedly displayed signs of mild abdominal discomfort with sudden deterioration to an episode of violent colic after 5 days of hospitalisation. Ultrasonographic examination of the preputial swelling at that time demonstrated the presence of small intestine between the internal and external laminae of the prepuce and led to the diagnosis of a direct preputial hernia. The contents of the hernia were readily reduced through a defect in the ventral abdominal wall after the anaesthetised horse was placed in dorsal recumbency. The historical information, clinical progression and surgical findings were supportive of an acquired ventral abdominal wall defect. To the authors' knowledge, this is the first reported case of a direct preputial hernia associated with an acquired ventral abdominal wall defect. [source] Exomphalos , a major or minor problem?PEDIATRIC ANESTHESIA, Issue 9 2002T. O'Neill Introduction The mortality and morbidity statistics associated with exomphalos major remain discouraging despite advances in management techniques (1). Congenital lung pathology, in particular pulmonary hypoplasia, and thoracic maldevelopment, have been strongly allied to this condition, accounting for the high incidence of pulmonary insufficiency necessitating prolonged ventilatory support in these infants (2). We discuss the respiratory issues in an infant with a particularly severe form of exomphalos major, and the impact of a comprehensive parental website devoted to the infants' management and progress. Case Report A female infant, born at 38 weeks' gestation, was referred for management of exomphalos major. Due to the extensive nature of the abdominal wall defect, primary surgical closure was impossible and initial management consisted of staged reduction by external compression of the exomphalos. This resulted in escalating cardiovascular and respiratory embarrassment, and was abandoned in favour of conservative treatment, whereby the sac was dressed and allowed to epithelialise. Thereafter the clinical course was characterised by chronic pulmonary insufficiency requiring prolonged ventilatory support. Ventilator dependence did not significantly decrease until lung growth occurred and the sitting position was adopted, enabling weaning from conventional ventilation to genuine BIPAP at 6 months. Currently, after 11 months, we are preparing her for entry into a home ventilation programme. Throughout this period, progress and realistic goals were discussed at multidisciplinary case conferences involving the parents. The interpreted medical management has subsequently been displayed by the parents on an elaborate, up-to-date website, which is part of a larger ,Mother Of Omphalocele' network. Although innovative, this highlights the fact that we the medical profession, should be vigilant with regard to potential public exposure of patient management. Whilst the Internet has become an integral part of our own continuing education, this case highlights a new aspect of how it may be used by our patients and their relatives to compare and contrast management policies in various institutions. [source] Patterns of severe abdominal wall defects: Insights into pathogenesis, delineation, and nomenclatureBIRTH DEFECTS RESEARCH, Issue 3 2007Liliana Vauthay Abstract BACKGROUND: During the last decade, descriptions of malformation complexes involving an abdominal wall defect (AWD) have repeatedly appeared in the literature, and there has been frequent confusion regarding nomenclature, definitions, and delineations. The aims of this work were to evaluate possible embryological relationships among AWD cases, review the related nomenclature, identify patterns involving AWDs, and stress the importance of complete clinical descriptions. METHODS Cases diagnosed as AWD complexes were selected from live- and stillborn infants of the Hospital Materno Infantil Sardá, Buenos Aires, and from the Laboratory of Perinatal Pathology, Buenos Aires, Argentina. They were sorted by the location of the AWD, the umbilical cord length, and the presence or absence of a persistent cloaca. The findings in 26 cases were described, according to proposed definitions. RESULTS: Three patterns could be identified: 1) the AWD involving the umbilical ring, a persistent or exstrophic cloaca, and a spinal cord anomaly; 2) the AWD extending laterally to the umbilical ring, severe unilateral limb defects, and same-sided agenesis of abdominal organs; and 3) the AWD not involving the umbilical ring, clefts, exencephaly, and amputations. Furthermore, overlapping among these patterns was observed, and possible involved mechanisms are discussed. CONCLUSIONS: The observed overlapping among patterns suggested that malformation complexes involving AWDs might not be independent conditions but rather belong to a common and broader spectrum of anomalies. Complete clinical descriptions, the avoidance of synonyms and generalizations, and strictly defined inclusion criteria are proposed for a better understanding of pathogenetic pathways in, and relationships among, AWD complexes. Birth Defects Research (Part A), 2007. © 2006 Wiley-Liss, Inc. [source] Healing process induced by three composite prostheses in the repair of abdominal wall defectsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2002Juan M. Bellón Abstract The present study compared the performance of three composite prostheses used to repair abdominal wall defects in rabbits. Two of them [Parietex Composite® (PC) and Composix® (CS)] are commonly used in clinical practice and one was designed by the present team (PL-PU99). At 14 and 90 days postimplant, specimens were obtained for morphological, macrophage response (RAM-11) and morphometric and biomechanical analysis. The prosthetic area covered by adhesions was significantly greater (p < 0.05) in the CS group (6.83 ± 2.31 cm2) than in PC (0.11 ± 0.02 cm2) or PL-PU99 (0.10 ± 0.07 cm2). At 14 days, it was observed a homogeneous, organized, well-vascularized neoperitoneum that was significantly thicker (p < 0.05) in PL-PU99. Except in the CS implants, this layer was covered by a continuous mesothelium. All three composites achieved good recipient tissue integration. Highest macrophage levels were recorded at 14 days with significantly higher values in the PL-PU99 prosthesis. Biomechanical strength was significantly greater (p < 0.05) in CS at two weeks postimplant, but it was similar at 90 days. These findings suggest that the three composites show ideal integration with host tissue, along with similar biomechanical strength at 90 days, and significantly higher adhesion formation is induced by the CS prosthesis, possibly due to incomplete mesothelialization of the lower prosthetic surface. © 2002 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Biomater) 63: 182,190, 2002; DOI 10.002/jbm.10123 [source] Anterior abdominal wall defects and biliary obstructionJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2005L Teoh Abstract:, Three infants with anterior abdominal wall defects (gastroschisis and exomphalos) who presented with obstructive jaundice secondary to biliary obstruction, are described. All three infants had abnormal biliary systems, with mechanical distortion of the biliary tree. Biliary obstruction secondary to structural biliary anomalies should be considered in patients with abdominal wall defects and cholestasis, as prolonged unrelieved biliary obstruction may lead to biliary cirrhosis and portal hypertension. [source] Biomechanical findings in rats undergoing fascial reconstruction with graft materials suggested as an alternative to polypropylene ,,NEUROUROLOGY AND URODYNAMICS, Issue 3 2010M.L. Konstantinovic Abstract Aims Graft materials used for pelvic floor reinforcement should still be considered as investigational and, therefore, evaluated experimentally and within clinical trials. The present report describes our biomechanical findings in rats implanted with selected novel implant materials, which in recent years have been suggested as alternatives to plain polypropylene (PP) meshes. Methods Full thickness abdominal wall defects were primarily repaired by the implant of interest. Experiments involved eight different implant materials: two partly degradable synthetic implants, that is, a hybrid of polyglactin 910 with PP (Vypro II) and collagen coated PP (Pelvitex); two non-cross linked (Surgisis, InteX,n LP) and two cross-linked materials (Pelvicol, Pelvisoft) and two porous modifications of InteX,n LP and Pelvicol implants. At different time points (7, 14, 30, and 90 days), the implants and surrounding host tissue (explant) were harvested and tensiometry was performed. Tensile strength and location of breakage were recorded. Results In general resorbable non-cross linked collagen matrices and porous materials were weaker after 90 days; similar behavior was seen for implant materials alone and their construction with the surrounding native tissue. Both non-porous and porous modification of InteX,n LP appeared at 90 days as a very thin layer of collagen that was two-thirds, respectively one-third of the initial thickness. Conclusions In experimental conditions, sufficient strength was obtained only after 3 months, and PP containing constructs appeared as the strongest though reconstruction with Pelvicol showed comparable outcomes. Lower values for strength of non-cross linked and porous collagen materials are questioning their efficacy for pelvic floor reconstruction. Neurourol. Urodynam. 29:488,493, 2010. © 2009 Wiley-Liss, Inc. [source] Patterns of severe abdominal wall defects: Insights into pathogenesis, delineation, and nomenclatureBIRTH DEFECTS RESEARCH, Issue 3 2007Liliana Vauthay Abstract BACKGROUND: During the last decade, descriptions of malformation complexes involving an abdominal wall defect (AWD) have repeatedly appeared in the literature, and there has been frequent confusion regarding nomenclature, definitions, and delineations. The aims of this work were to evaluate possible embryological relationships among AWD cases, review the related nomenclature, identify patterns involving AWDs, and stress the importance of complete clinical descriptions. METHODS Cases diagnosed as AWD complexes were selected from live- and stillborn infants of the Hospital Materno Infantil Sardá, Buenos Aires, and from the Laboratory of Perinatal Pathology, Buenos Aires, Argentina. They were sorted by the location of the AWD, the umbilical cord length, and the presence or absence of a persistent cloaca. The findings in 26 cases were described, according to proposed definitions. RESULTS: Three patterns could be identified: 1) the AWD involving the umbilical ring, a persistent or exstrophic cloaca, and a spinal cord anomaly; 2) the AWD extending laterally to the umbilical ring, severe unilateral limb defects, and same-sided agenesis of abdominal organs; and 3) the AWD not involving the umbilical ring, clefts, exencephaly, and amputations. Furthermore, overlapping among these patterns was observed, and possible involved mechanisms are discussed. CONCLUSIONS: The observed overlapping among patterns suggested that malformation complexes involving AWDs might not be independent conditions but rather belong to a common and broader spectrum of anomalies. Complete clinical descriptions, the avoidance of synonyms and generalizations, and strictly defined inclusion criteria are proposed for a better understanding of pathogenetic pathways in, and relationships among, AWD complexes. Birth Defects Research (Part A), 2007. © 2006 Wiley-Liss, Inc. [source] Early high C-reactive protein in infants with open abdominal wall defects does not predict sepsis or adverse outcomeACTA PAEDIATRICA, Issue 1 2010G Ramadan Abstract Aim:, To study CRP values and relate it to outcome in infants with antenatal diagnosis of gastroschisis, exomphalos and other surgical conditions. Methods:, Over five years, infants admitted to our neonatal unit with gastroschisis, exomphalos and other surgical diagnoses were identified. Serum CRP measurements in first 5 days were studied. Group one included 33 gastroschisis patients, group two, 18 exomphalos patients, and group three, 38 patients with other surgical diagnoses. Outcome measures included TPN days, time to full feeds and duration of hospitalization. Results:, Infants with gastroschisis were more premature (36.9 vs 38.1 weeks) with lower birth weights (2515 vs 3078 g), than infants with exomphalos. CRP values on admission in gastroschisis group were significantly higher than exomphalos and other diagnoses groups (33.7 ± 6.4 vs 8.8 ± 6.0 vs 5.7 ± 2.0, respectively, p < 0.05). All blood cultures were sterile. There was no relationship between high CRP and death or adverse outcome (TPN days, time to full feeds or duration of hospitalization) in the gastroschisis group. Conclusion:, Infants with gastroschisis exhibit high early CRP, which may not indicate sepsis or adverse outcome. This increase can complicate the assessment of these infants. Clinicians should be aware of this finding as it could inform management decisions in this group. [source] | ||||||||||