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1.
Biomed Eng Online ; 20(1): 23, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33632226

RESUMO

BACKGROUND: Precise visualization of meshes and their position would greatly aid in mesh shrinkage evaluation, hernia recurrence risk assessment, and the preoperative planning of salvage repair. Lightweight (LW) meshes are able to preserve abdominal wall compliance by generating less post-implantation fibrosis and rigidity. However, conventional 3D imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) cannot visualize the LW meshes. Patients sometimes have to undergo a second-look operation for visualizing the mesh implants. The goal of this work is to investigate the potential advantages of Automated 3D breast ultrasound (ABUS) pore texture analysis for implanted LW hernia mesh identification. METHODS: In vitro, the appearances of four different flat meshes in both ABUS and 2D hand-held ultrasound (HHUS) images were evaluated and compared. In vivo, pore texture patterns of 87 hernia regions were analyzed both in ABUS images and their corresponding HHUS images. RESULTS: In vitro studies, the imaging results of ABUS for implanted LW meshes are much more visualized and effective in comparison to HHUS. In vivo, the inter-class distance of 40 texture features was calculated. The texture features of 2D sectional plans (axial and sagittal plane) have no significant contribution to implanted LW mesh identification. Significant contribution was observed in coronal plane. However, since the mesh may have spatial variation such as shrinkage after implantation surgery, the inter-class distance of 3D coronal plane pore texture features are bigger than 2D coronal plane, so the contribution of 3D coronal plane pore texture features are more valuable than 2D coronal plane for implanted LW mesh identification. The use of 3D pore texture features significantly improved the robustness of the identification method in distinguishing between LW mesh and fascia. CONCLUSIONS: An innovative new ABUS provides additional pore texture visualization, by separating the LW mesh from the fascia tissues. Therefore, ABUS has the potential to provides more accurate features to characterize pore texture patterns, and ultimately provide more accurate measures for implanted LW mesh identification.


Assuntos
Parede Abdominal/diagnóstico por imagem , Hérnia/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Reconhecimento Automatizado de Padrão , Telas Cirúrgicas , Adulto , Idoso , Feminino , Análise de Fourier , Hérnia/terapia , Humanos , Imageamento Tridimensional , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Próteses e Implantes , Ultrassonografia
2.
BMJ Case Rep ; 14(1)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504519

RESUMO

Actinomycotic mycetoma is a disease of the tropical region and usually presents as a chronic, suppurative and deforming granulomatous infection. We present an unusual case of actinomycotic mycetoma of the abdominal wall that was found to infiltrate into the bowel. A 51 year-old man presented with pain and swelling in the left flank of 2-year duration. Even after comprehensive preoperative evaluation with advanced radiological imaging, biochemistry and pathology, the diagnosis could not be arrived at. Histopathological examination of the excised specimen after the surgery guided to the diagnosis of actinomycotic mycetoma, which entirely changed the management in the postoperative period. We propose that mycetoma should be kept as a possible differential diagnosis for anterior abdominal wall swelling in the indicated clinical setting and the investigations be done keeping the same in mind. Otherwise, a lot of valuable time may be lost allowing the disease to progress further.


Assuntos
Parede Abdominal/diagnóstico por imagem , Actinomicose/diagnóstico , Colo Descendente/diagnóstico por imagem , Doenças do Colo/diagnóstico , Micetoma/diagnóstico , Parede Abdominal/patologia , Parede Abdominal/cirurgia , Actinomicose/patologia , Actinomicose/terapia , Antibacterianos/uso terapêutico , Biópsia por Agulha Fina , Colo Descendente/patologia , Colo Descendente/cirurgia , Doenças do Colo/patologia , Doenças do Colo/terapia , Cisticercose/diagnóstico , Diagnóstico Diferencial , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Micetoma/patologia , Micetoma/terapia , Sarcoma/diagnóstico , Tomografia Computadorizada por Raios X , Ultrassonografia
3.
Clinics (Sao Paulo) ; 76: e2170, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33503184

RESUMO

The practice of regional anesthesia is in a state of progressive evolution, mainly due to the advent of ultrasound as an anesthesiologist's instrument. Alternative techniques for postoperative analgesia of abdominal surgeries, such as transversus abdominis plane block, oblique subcostal transversus abdominis plane block, rectus abdominis muscle sheath block, ilioinguinal and iliohypogastric nerve block, and quadratus lumborum plane block, have proven useful, with good analgesic efficacy, especially when neuroaxial techniques (spinal anesthesia or epidural anesthesia) are not possible. This review discusses such blockades in detail, including the anatomical principles, indications, techniques, and potential complications.


Assuntos
Parede Abdominal , Bloqueio Nervoso , Músculos Abdominais/diagnóstico por imagem , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Humanos , Dor Pós-Operatória , Ultrassonografia de Intervenção
4.
AJR Am J Roentgenol ; 216(3): 812-823, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33439049

RESUMO

OBJECTIVE. The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. CONCLUSION. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement.


Assuntos
Enfisema/diagnóstico por imagem , Gases , Tomografia Computadorizada por Raios X , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/microbiologia , Abscesso/diagnóstico por imagem , Abscesso/microbiologia , Aortite/diagnóstico por imagem , Aortite/microbiologia , Cistite/diagnóstico por imagem , Cistite/microbiologia , Enfisema/microbiologia , Colecistite Enfisematosa/diagnóstico por imagem , Colecistite Enfisematosa/microbiologia , Feminino , Gangrena de Fournier/diagnóstico por imagem , Gangrena de Fournier/microbiologia , Gangrena Gasosa/diagnóstico por imagem , Gangrena Gasosa/microbiologia , Gastrite/diagnóstico por imagem , Gastrite/microbiologia , Hepatite/diagnóstico por imagem , Hepatite/microbiologia , Humanos , Masculino , Pancreatite/diagnóstico por imagem , Pancreatite/microbiologia , Doenças Prostáticas/diagnóstico por imagem , Doenças Prostáticas/microbiologia , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/microbiologia , Pielite/diagnóstico por imagem , Pielite/microbiologia , Pielonefrite/diagnóstico por imagem , Pielonefrite/microbiologia , Doenças Uterinas/diagnóstico por imagem , Doenças Uterinas/microbiologia
5.
J Plast Reconstr Aesthet Surg ; 73(9): 1665-1674, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32522519

RESUMO

BACKGROUND: No preoperative risk assessment tool is available to predict postoperative bulge formation after abdomen-based breast reconstruction. The authors evaluated the association between clinical variables and morphometric measurements on preoperative computed tomographic (CT) angiography and postoperative abdominal wall morbidity. METHODS: The authors evaluated all cases of postoperative bulge/hernia and normal controls in patients who underwent preoperative CT angiography and abdomen-based microsurgical breast reconstruction between July 2009 and January 2018. CT-based abdominal wall profiles, including abdominal wall protrusion, abdominopelvic cavity cross-sectional area (CSA), and abdominopelvic cavity-to-total body CSA ratio, were obtained and analyzed. A novel risk stratification scoring system to stratify the risk of bulge/hernia was developed. RESULTS: Among 463 patients who underwent abdomen-based breast reconstruction, 23 were diagnosed as having a bulge/hernia. Age (OR 2.912; 95% CI 1.157-7.333), lateral row perforator (OR 5.065; 95% CI 1.834-13.986), and abdominal wall protrusion (OR 3.687; 95% CI 1.494-9.100) were significant risk factors associated with postoperative bulge/hernia in the multivariate analysis. Using the risk stratification scoring system, the incidence rates of postoperative bulge/hernia were 1.7%, 4.8%, and 19.0% for low-, intermediate-, and high-risk patients, respectively (p<0.001). CONCLUSIONS: Age, lateral row perforator, and abdominal wall protrusion were significantly associated with postoperative bulge/hernia formation after abdomen-based microsurgical breast reconstruction. The authors' risk score based on the three variables may help predict and minimize donor-site morbidity.


Assuntos
Parede Abdominal/diagnóstico por imagem , Hérnia Abdominal/etiologia , Mamoplastia/efeitos adversos , Mamoplastia/métodos , Medição de Risco , Músculos Abdominais/diagnóstico por imagem , Fatores Etários , Estudos de Casos e Controles , Estudos de Coortes , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Microcirurgia , Pessoa de Meia-Idade , Retalho Perfurante , Cuidados Pré-Operatórios , Estudos Retrospectivos , Fatores de Risco
6.
Surgery ; 168(3): 543-549, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32576404

RESUMO

BACKGROUND: The goal of our study was to compare results in patients with large midline incisional hernia using modified anterior component separation versus preoperative botulinum toxin and following Rives repair, with a focus on surgical site occurrences, possibility of fascial closure, duration of hospital stay, and hernia recurrence rate. METHODS: From to March 2016 to June 2019, a prospective comparative study was performed in 80 consecutive patients with large midline incisional hernias and hernia transverse diameters between 11 and 17 cm under elective hernia repair at our tertiary center. Two groups were analyzed prospectively: 40 patients with preoperative botulinum toxin administration and following open Rives repair (botulinum toxin group) were compared with 40 patients who underwent open component separation during that period (component separation group). RESULTS: All large midline incisional hernias were classified W3, with mean transverse and longitudinal defect diameters of 14.9 cm (11.8-16.5) and 24 cm (11-28), respectively. Complete fascial closure was possible in all patients in the preoperative botulinum toxin group. No complications occurred during the administration of preoperative botulinum toxin, but surgical site complications were most frequent in the component separation group, especially skin necrosis (12.5%, P = .020). At a median of 19.6 months (range, 11-35) of postoperative follow-up, 2 cases of hernia recurrence (8.9%) were reported, all of them in the component separation group. CONCLUSION: Botulinum toxin allows getting a successful downstaging from surgical repair to Rives technique in patients with large midline incisional hernia, especially with hernia transverse diameters between 11 and 17 cm. These results contribute to minimize disadvantages associated to the anterior component separation.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Hérnia Ventral/terapia , Herniorrafia/métodos , Hérnia Incisional/terapia , Cuidados Pré-Operatórios/métodos , Músculos Abdominais/diagnóstico por imagem , Músculos Abdominais/cirurgia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Adulto , Idoso , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Hérnia Ventral/diagnóstico , Humanos , Hérnia Incisional/diagnóstico , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tomografia Computadorizada por Raios X
7.
J Surg Res ; 253: 121-126, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32353637

RESUMO

BACKGROUND: With the widespread use of advanced imaging there is a need to quantify the prevalence and impact of hernias. We aimed to determine the prevalence of abdominal wall hernias among patients undergoing computed tomography (CT) scans and their impact on abdominal wall quality of life (AW-QOL). METHODS: Patients undergoing elective CT abdomen/pelvis scans were enrolled. Standardized physical examinations were performed by surgeons blinded to the CT scan results. AW-QOL was measured through the modified Activities Assessment Scale. On this scale, 1 is poor AW-QOL, 100 is perfect, and a change of 7 is the minimum clinically important difference. Three surgeons reviewed the CT scans for the presence of ventral or groin hernias. The number of patients and the median AW-QOL scores were determined for three groups: no hernia, hernias only seen on imaging (occult hernias), and clinically apparent hernias. RESULTS: A total of 246 patients were enrolled. Physical examination detected 62 (25.2%) patients with a hernia while CT scan revealed 107 (43.5%) with occult hernias. The median (interquartile range) AW-QOL of patients per group was no hernia = 84 (46), occult hernia = 77 (57), and clinically apparent hernia = 62 (55). CONCLUSIONS: One-fourth of individuals undergoing CT abdomen/pelvis scans have a clinical hernia, whereas nearly half have an occult hernia. Compared with individuals with no hernias, patients with clinically apparent or occult hernias have a lower AW-QOL (by 22 and seven points, respectively). Further studies are needed to determine natural history of AW-QOL and best treatment strategies for patients with occult hernias.


Assuntos
Parede Abdominal/diagnóstico por imagem , Doenças Assintomáticas/epidemiologia , Hérnia Abdominal/epidemiologia , Qualidade de Vida , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Parede Abdominal/fisiopatologia , Adulto , Idoso , Estudos Transversais , Feminino , Hérnia Abdominal/complicações , Hérnia Abdominal/diagnóstico , Hérnia Abdominal/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos
8.
J Surg Res ; 253: 245-251, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32387572

RESUMO

BACKGROUND: The aim of the current study was to examine different features of the rectus abdominis muscle (RA) in patients with and without a midline incisional hernia to characterize the effects of a hernia on abdominal wall skeletal muscle. MATERIAL AND METHODS: RA tissue from patients undergoing surgical repair of a large midline incisional hernia (n = 18) was compared with that from an intact abdominal wall in patients undergoing colorectal resection for benign or low-grade malignant disease (n = 18). In addition, needle biopsies were obtained from the vastus lateralis muscle (VL) of all subjects. Outcome measures were muscle fiber type and size, preoperative truncal flexion strength and leg extension power measured in strength-measure equipment, and RA cross-sectional area measured by computed tomography. RESULTS: In both the RA and VL, the fiber cross-sectional area was greater in the patients with a hernia. The RA cross-sectional area correlated significantly with the truncal flexion strength (r = 0.44, P = 0.015). Patients in the hernia group had a significantly reduced ratio between truncal flexion strength and RA cross-sectional area compared with the control group (41.3 ± 11.5 N/cm2versus 51.2 ± 16.3 N/cm2, P = 0.034). CONCLUSIONS: Anatomical displacement of the RA and lack of medial insertion in the linea alba rather than dysfunction secondary to alteration of muscle fiber structure may contribute to impairment of abdominal wall function in patients with midline incisional hernias. The study was registered at http://www.clinicaltrials.gov/(NCT02011048).


Assuntos
Parede Abdominal/fisiopatologia , Hérnia Incisional/cirurgia , Fibras Musculares Esqueléticas/patologia , Reto do Abdome/fisiopatologia , Parede Abdominal/diagnóstico por imagem , Idoso , Biópsia , Estudos de Casos e Controles , Feminino , Herniorrafia , Humanos , Hérnia Incisional/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reto do Abdome/diagnóstico por imagem , Reto do Abdome/patologia , Tomografia Computadorizada por Raios X
9.
Clin Imaging ; 64: 57-66, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32330806

RESUMO

Abdominal and pelvic wall hernias are classically defined as a weakness or opening of the muscular wall through which abdominal or pelvic tissues protrude. The aim of this manuscript is to review the imaging findings of abdominal and pelvic wall hernias and their mimics and to discuss pearls and pitfalls for accurately diagnosing and classifying these entities.


Assuntos
Parede Abdominal/diagnóstico por imagem , Hérnia Abdominal/diagnóstico por imagem , Feminino , Hérnia , Humanos , Masculino , Pelve
11.
Am Surg ; 86(3): 232-236, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32223803

RESUMO

A modern approach to incisional hernia is oriented toward midline restoration to re-establish abdominal wall physiology and to restore muscular strength. A high-protein diet has been demonstrated to improve muscle function and mass. The aim of this prospective study was to evaluate the effect of a high-protein diet on abdominal muscle remodeling in patients submitted to abdominal wall reconstruction (AWR). Forty-five patients submitted to elective AWR were prospectively divided into two groups depending on pre- and postoperative daily protein assumption: Group A patients were submitted to a standard 2300 kcal diet with 103 g of protein intake (males) and 1800 kcal diet with 80 g of protein intake (females) starting one month before surgery and lasting for three months postoperatively; Group B patients were submitted to the same dietary regimen plus 34 g of purified proteins daily. Patients underwent ultrasound scan preoperatively and three and six months after surgery, to evaluate the widest thickness of the rectus abdominis muscle on the transverse umbilical line. Three patients reporting hernia recurrence were excluded. No significant difference among the two groups in muscle thickness growth after surgery was observed at three months after surgery, even if a favorable trend in Group B was noted (10% vs 19%, P = not significant). At six months after surgery, Group B patients showed a significant difference in muscle thickening (13% vs 32%, P < 0.05 ). The study demonstrates a positive effect of a protein diet on the rectus abdominis muscle thickening after AWR. Further studies are needed.


Assuntos
Abdominoplastia/métodos , Proteínas na Dieta/administração & dosagem , Herniorrafia/métodos , Hérnia Incisional/cirurgia , Cicatrização/fisiologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Idoso , Estudos de Coortes , Procedimentos Cirúrgicos Eletivos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Estudos Prospectivos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler/métodos
12.
Ann R Coll Surg Engl ; 102(5): e102-e104, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32159370

RESUMO

Epigastric hernia involving the falciform ligament is exceptionally rare. Most reported cases are incisional hernia secondary to prior abdominal surgery. We report a case of primary falciform ligament herniation into the epigastric region repaired by the laparoscopic preperitoneal approach. In this case, an accompanying vessel along the herniated falciform ligament was identified. This finding provides a basis for the hypothesis of a perforating vessel piercing the linea alba and thereby creating a weak point for hernia protrusion (Moschowitz theory). The patient had an uneventful recovery and was discharged home on the postoperative day two. A laparoscopic preperitoneal approach is feasible for the repair of primary falciform ligament herniation. The magnified endoscopic view enables surgeons to achieve definite repair without missing occult defects.


Assuntos
Parede Abdominal/patologia , Hérnia Abdominal/cirurgia , Laparoscopia , Ligamentos/patologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Idoso , Feminino , Hérnia Abdominal/diagnóstico , Hérnia Abdominal/patologia , Humanos , Ligamentos/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia
13.
J Trauma Acute Care Surg ; 88(4): 572-576, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32205824

RESUMO

BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate whether computed tomography (CT) scan adds any diagnostic value in the evaluation of stab wounds of the anterior abdominal wall as compared with serial clinical examination (SCE). METHODS: PubMed, EMBASE, Cochrane Library, and MEDLINE via Ovid were systematically searched for records published from 1980 to 2018 by two independent researchers (M.G., R.L.). Quality assessment, data extraction, and analysis were performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Mantel-Haenszel method with odds ratio (OR) and 95% confidence interval (95% CI) as the measure of effect size was used for meta-analysis. RESULTS: Three studies (1 randomized controlled trial and 2 observational studies) totaling 319 patients were included in the meta-analysis. Overall laparotomy rate was 12.8% (22 of 172 patients) in SCE versus 19% (28 of 147 patients) in CT. This difference was not significant (OR [95% CI], 0.63 [0.34-1.16]; p = 0.14). Negative laparotomy rate was 3.5% (6 of 172 patients) in SCE versus 5.4% (8 of 147 patients) in CT. The difference was not significant (OR [95% CI], 0.61 [0.20-1.83]; p = 0.37). CONCLUSION: This meta-analysis compared SCE with CT scan in patients presenting with stab wounds of the anterior abdominal wall and provided level II evidence showing no additional benefit in CT scan. Further observational and experimental clinical studies are needed to confirm the findings of this meta-analysis. LEVEL OF EVIDENCE: Systematic review and meta-analysis, level II.


Assuntos
Traumatismos Abdominais/diagnóstico , Parede Abdominal/diagnóstico por imagem , Exame Físico , Tomografia Computadorizada por Raios X , Ferimentos Perfurantes/diagnóstico , Estudos de Viabilidade , Humanos , Escala de Gravidade do Ferimento
14.
Plast Reconstr Surg ; 145(4): 697e-705e, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32221198

RESUMO

BACKGROUND: In deep inferior epigastric perforator flap surgery, the amount of perfusion achievable in the contralateral side over a midline is unclear. Predicting contralateral perfusion preoperatively using computed tomographic angiography will allow efficient breast reconstruction with decreased complications. The authors used computed tomographic angiography to determine whether contralateral perfusion is related to blood vessel status across the midline. METHODS: Preoperative computed tomographic angiography scans and intraoperative perfusion in patients who underwent breast reconstruction with a deep inferior epigastric perforator flap between January of 2018 and July of 2018 were checked prospectively. A vessel scoring system was prepared according to vessel density across the flap midline on the scan (grade 0, no visible vessels; grade 1, visible vessels with disconnection or could not be judged as grade 0 or 2; grade 2, definite vessels). Intraoperative flap perfusion was confirmed with indocyanine green angiography. Postoperative fat necrosis was analyzed using ultrasonography. RESULTS: Ninety-four patients were analyzed. Mean maximal contralateral perfusion length was as follows: grade 0, 7.50 ± 1.89 cm; grade 1, 7.93 ± 2.01 cm; and grade 2, 10.14 ± 2.29 cm. Grade 2 had a statistically significantly greater contralateral perfusion length than grade 0 (p < 0.001) and grade 1 (p < 0.001). Fat necrosis occurred in 27.3 percent (grade 0), 19.1 percent (grade 1), and 8 percent (grade 2), which was statistically significant (p = 0.035). CONCLUSIONS: A definite vessel connection across the midline (as in grade 2) in preoperative computed tomographic angiography indicates that contralateral perfusion will be sufficiently achieved. This vessel scoring system would be helpful in predicting flap perfusion and planning the surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, IV.


Assuntos
Artérias Epigástricas/diagnóstico por imagem , Necrose Gordurosa/epidemiologia , Mamoplastia/efeitos adversos , Retalho Perfurante/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Parede Abdominal/irrigação sanguínea , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Adulto , Corantes/administração & dosagem , Angiografia por Tomografia Computadorizada/métodos , Artérias Epigástricas/fisiologia , Necrose Gordurosa/etiologia , Necrose Gordurosa/prevenção & controle , Feminino , Sobrevivência de Enxerto/fisiologia , Humanos , Verde de Indocianina/administração & dosagem , Mamoplastia/métodos , Pessoa de Meia-Idade , Retalho Perfurante/irrigação sanguínea , Retalho Perfurante/transplante , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Período Pré-Operatório , Fluxo Sanguíneo Regional/fisiologia , Medição de Risco/métodos , Resultado do Tratamento
15.
Indian J Pathol Microbiol ; 63(1): 116-118, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32031138

RESUMO

Bronchogenic cyst (BC) is a very rare congenital anomaly occurring due to budding of the primitive foregut, and its common location is the posterior mediastinum. BC when diagnosed prenatally can be treated if it is encroaching on the development of lungs. BC has been reported in other locations such as cervical, thoracic, abdominal sites and also as subcutaneous lesions. Omphalocele is a congenital malformation occurring due to a central defect in the abdominal wall with herniation of the viscera. The nonentity documented here was found in a female fetus with 20 weeks of gestational age. The mother was a primigravida who had antenatal ultrasound scan rendering diagnosis of a live fetus having abdominal wall defect with omphalocele. This case is exceptionally rare as the content of omphalocele was BC having a classical wall lined by pseudostratified ciliated columnar epithelium overlying band-like cartilage. The extensive search in the literature did not reveal another similar case.


Assuntos
Parede Abdominal/patologia , Feto Abortado/patologia , Cisto Broncogênico/diagnóstico por imagem , Hérnia Umbilical/diagnóstico por imagem , Parede Abdominal/diagnóstico por imagem , Feto Abortado/anormalidades , Diagnóstico Diferencial , Feminino , Idade Gestacional , Técnicas Histológicas , Humanos , Gravidez , Tomografia Computadorizada por Raios X , Ultrassonografia , Adulto Jovem
17.
Bull Cancer ; 107(3): 359-363, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32008700

RESUMO

The management of desmoid-type fibromatosis has considerably evolved these last years, toward first-line active surveillance then systemic or local symptomatic treatment in case of aggressive tumor. Magnetic resonance imaging is the modality of choice in each of these treatment settings. It needs multiparametric approach taking into account mainly the tumor size, and T2-weighted signal that is correlated with histological composition and clinical behavior. A volumetric approach should be favored for the evaluation of tumor size change. The interest of paramagnetic contrast injection and tumor enhancement requires further investigation.


Assuntos
Fibromatose Agressiva/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Conduta Expectante , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/patologia , Adulto , Meios de Contraste/administração & dosagem , Fibromatose Agressiva/patologia , Fibromatose Agressiva/terapia , Humanos , Pessoa de Meia-Idade , Ombro/diagnóstico por imagem , Carga Tumoral
18.
J Med Case Rep ; 14(1): 17, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31969190

RESUMO

BACKGROUND: Necrosis of the falciform and round ligaments is extremely rare, thus making the diagnosis challenging. It is often misdiagnosed as gallbladder pathology due to the presenting symptoms. Due to the rarity of this pathology, there is limited literature available. CASE PRESENTATION: A 53-year-old white man presented to our hospital with signs and symptoms of gallbladder pain but turned out to have the rare entity of necrosis of the falciform and round ligaments. An extensive review of the world literature was performed using PubMed. Manual cross-referencing of reference lists was performed to obtain all available articles. The personal operative log of the senior author was also searched to reveal one additional case. Statistical analysis was descriptive only, given the small number of reported cases. Thirty-nine articles were found, among which forty-three case were identified, and one additional case was extracted from the operative log of the senior author. Unlike previous reports, we found that isolated inflammation and necrosis of the ligaments occurs at nearly the same frequency in both men and women, not predominantly in women as previously reported in smaller series. The mean age at presentation was 59.5 years old, and cases were typically initially diagnosed as gallbladder pathology, most commonly acute cholecystitis. Computed tomography more frequently than ultrasound revealed the falciform and round-ligament pathology. CONCLUSIONS: Isolated falciform and round-ligament inflammation and necrosis is a rare condition that is difficult to diagnose because it can present mimicking a wide variety of intra-abdominal pathologies, particularly gallbladder pathologies. It is often best treated by laparoscopic resection. Unlike prior reports, our review of the literature, which is the largest that we know of to date, shows that males and females are equally affected. Greater awareness of this entity will aid in future diagnosis.


Assuntos
Parede Abdominal/patologia , Inflamação/diagnóstico , Ligamentos/patologia , Necrose/diagnóstico , Ligamentos Redondos/patologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Diagnóstico Diferencial , Feminino , Vesícula Biliar/patologia , Humanos , Laparoscopia , Ligamentos/diagnóstico por imagem , Ligamentos/cirurgia , Masculino , Pessoa de Meia-Idade , Ligamentos Redondos/diagnóstico por imagem , Ligamentos Redondos/cirurgia , Tomografia Computadorizada por Raios X , Ultrassonografia
19.
Clin Nucl Med ; 45(3): 234-235, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31833933

RESUMO

An old woman with abdominal pain complained a palpable mass on the right anterior abdominal wall. On PET/CT images, the lesion presented as a soft tissue mass with irregular shape, invading adjacent peritoneum and showing intense FDG uptake. Based on imaging findings, a malignancy was suspected, and she underwent surgical resection. However, the abdominal wall mass was diagnosed as granulomatous inflammation with a little necrosis by pathological results. Awareness of this benign disease is helpful for an accurate diagnosis of abdominal wall mass.


Assuntos
Neoplasias Abdominais/diagnóstico por imagem , Parede Abdominal/diagnóstico por imagem , Fluordesoxiglucose F18 , Granuloma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Idoso , Diagnóstico Diferencial , Feminino , Humanos
20.
J Clin Ultrasound ; 48(3): 181-183, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31724176

RESUMO

Omphalocele is rarely complicated by umbilical cord cysts. In our case, an umbilical cord cyst and fetal ascites were detected at 26 weeks' gestation in a fetus with trisomy 13. This changed to omphalocele with subsequently absorbed fetal ascites at 35 weeks' gestation. We propose two hypotheses. The abdominal wall may have been physically pierced or an omphalocele might have preexisted, and the intestinal tract in the hernia sac was pushed by fetal ascites.


Assuntos
Cistos/complicações , Cistos/diagnóstico por imagem , Doenças Fetais/diagnóstico por imagem , Hérnia Umbilical/etiologia , Ultrassonografia Pré-Natal/métodos , Cordão Umbilical/diagnóstico por imagem , Cordão Umbilical/patologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/patologia , Adulto , Fissura Palatina/diagnóstico , Feminino , Feto/diagnóstico por imagem , Feto/patologia , Feto/cirurgia , Idade Gestacional , Hérnia Umbilical/cirurgia , Humanos , Gravidez , Resultado do Tratamento , Síndrome da Trissomia do Cromossomo 13/diagnóstico
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