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Disease-a-month : DM Jan 2019
Review
Topics: Abdominal Cavity; Acute Kidney Injury; Critical Illness; Decompression, Surgical; Humans; Hypertension; Intra-Abdominal Hypertension; Multiple Organ Failure; Oliguria; Practice Guidelines as Topic; Pressure; Prevalence; Risk Factors; Transducers, Pressure
PubMed: 30454823
DOI: 10.1016/j.disamonth.2018.04.003 -
Rozhledy V Chirurgii : Mesicnik... 2021Open abdomen is known as a serious consequence of various intra-abdominal pathologies. Initially, patients often have a life-threatening condition, sepsis or septic...
Open abdomen is known as a serious consequence of various intra-abdominal pathologies. Initially, patients often have a life-threatening condition, sepsis or septic shock. Severe stress related malnutrition, mineral and fluid imbalance develop as metabolic consequences. Intestinal fistulas also occur as a frequent complication in patients with open abdomen. In such patients, a comprehensive approach is needed, including rehabilitation, nutritional support using optimal formulas, and local care for the open abdomen. Our case report presents a patient with open abdomen and enterocutaneous fistulation. A complex nutritional approach in the course of the disease is described and its importance is discussed. Finally, a summary of nutritional care for open abdomen patients is provided based on current recommendations.
Topics: Abdomen; Abdominal Cavity; Humans; Intestinal Fistula; Sepsis; Shock, Septic
PubMed: 33910341
DOI: No ID Found -
AORN Journal May 2021
Topics: Abdomen; Abdomen, Acute; Abdominal Cavity; Humans
PubMed: 33929744
DOI: 10.1002/aorn.13407 -
BMJ Case Reports Feb 2019Testicular tuberculosis (TB) is rare, and, because of this, the lack of pathognomonic clinical features and its tendency to mimic other commoner conditions, the...
Testicular tuberculosis (TB) is rare, and, because of this, the lack of pathognomonic clinical features and its tendency to mimic other commoner conditions, the diagnosis is frequently delayed or may be missed. In this case, the initial clinical presentation was typical for bacterial epididymo-orchitis in a 38-year-old man. When the patient failed to improve with standard treatment including broadening of antibiotics, the diagnosis was re-considered because some unusual signs suggested testicular malignancy or lymphoma. Further, history-taking and subsequent cross-sectional imaging with CT/MRI identified co-existent pulmonary nodularity, thoracic and abdominal lymphadenopathy and bony changes that, together, raised the suspicion of TB. was confirmed on DNA-based testing of the hydrocele fluid, although standard acid-fast bacilli culture was negative. This case prompted a review of the literature to explore the optimal steps in the investigation and diagnosis of this rare disease.
Topics: Abdominal Cavity; Adult; Antitubercular Agents; Diagnosis, Differential; Epididymitis; Humans; Lymphadenopathy; Magnetic Resonance Imaging; Male; Mycobacterium tuberculosis; Orchitis; Pain; Testicular Diseases; Testicular Hydrocele; Testis; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Urogenital
PubMed: 30787023
DOI: 10.1136/bcr-2018-226697 -
Communications Biology Aug 2021The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of...
The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of abdominal anatomy, there are multiple mesenteries. Recent findings point to an alternative model in which digestive organs are connected to a single mesentery. Given that direct evidence of this is currently lacking, we investigated the development and shape of the entire mesentery. Here we confirm that, within the abdomen, there is one mesentery in which all abdominal digestive organs develop and remain connected to. We show that all abdominopelvic organs are organised into two, discrete anatomical domains, the mesenteric and non-mesenteric domain. A similar organisation occurs across a range of animal species. The findings clarify the anatomical foundation of the abdomen; at the foundation level, the abdomen comprises a visceral (i.e. mesenteric) and somatic (i.e. musculoskeletal) frame. The organisation at that level is a fundamental order that explains the positional anatomy of all abdominopelvic organs, vasculature and peritoneum. Collectively, the findings provide a novel start point from which to systemically characterise the abdomen and its contents.
Topics: Humans; Mesentery; Peritoneum
PubMed: 34408242
DOI: 10.1038/s42003-021-02496-1 -
Clinical Obstetrics and Gynecology Jun 2020This chapter reviews issues which complicate surgery in obese pregnant patients. Maternal obesity is prevalent in the United States and is associated with numerous... (Review)
Review
This chapter reviews issues which complicate surgery in obese pregnant patients. Maternal obesity is prevalent in the United States and is associated with numerous adverse health outcomes. When surgery is indicated during pregnancy, the presence of maternal obesity increases surgical risks for both the fetus and mother. Specific risks are identified and strategies to avoid them are evaluated. The prognosis and management of pregnant women who have undergone bariatric surgery is also discussed, and practical guidelines for obstetric management of these patients are presented.
Topics: Abdominal Cavity; Bariatric Surgery; Comorbidity; Female; Humans; Obesity, Maternal; Postoperative Complications; Pregnancy; Pregnancy Complications; Risk Adjustment; Risk Assessment; Surgical Procedures, Operative
PubMed: 32224705
DOI: 10.1097/GRF.0000000000000530 -
Anaesthesiology Intensive Therapy 2015Appropriate open abdomen treatment is one of the key elements in the management of patients who require decompressive laparotomy or in whom the abdomen is left open... (Review)
Review
Appropriate open abdomen treatment is one of the key elements in the management of patients who require decompressive laparotomy or in whom the abdomen is left open prophylactically. Apart from fluid control and protection from external injury, fluid evacuation and facilitation of early closure are now the goals of open abdomen treatment. Abdominal negative pressure therapy has emerged as the most appropriate method to reach these goals. Especially when combined with strategies that allow progressive approximation of the fascial edges, high closure rates can be obtained. Intra-abdominal pressure measurement can be used to guide the surgical strategy and continued attention to intra-abdominal hypertension is necessary. This paper reviews recent advances as well as identifying the remaining challenges in patients requiring open abdomen treatment. The new classification system of the open abdomen is an important tool to use when comparing the efficacy of different strategies, as well as different systems of temporary abdominal closure.
Topics: Abdomen; Abdominal Cavity; Humans; Intra-Abdominal Hypertension; Laparotomy; Lower Body Negative Pressure
PubMed: 25973658
DOI: 10.5603/AIT.a2015.0023 -
Journal of Minimally Invasive Gynecology Mar 2021Entry into the abdomen during operative laparoscopy is a source of some controversy regarding the safest and most useful method. The objective of this review is to... (Review)
Review
OBJECTIVE
Entry into the abdomen during operative laparoscopy is a source of some controversy regarding the safest and most useful method. The objective of this review is to describe, compare, and contrast the most popular entry techniques.
DATA SOURCES
Data were collected from the historical starting point until present day from English language journal articles and book chapters.
METHODS OF STUDY SELECTION
Descriptive accounts dating back to the start of laparoscopy in the 1970s and spanning to present day well-designed randomized controlled trials and Cochrane reviews were compiled to evaluate the evidence for the effectiveness and safety of abdominal entry techniques.
TABULATION, INTEGRATION, AND RESULTS
The most common sites of entry are the umbilicus and the left upper quadrant. Between the Veress needle, direct trocar insertion, and open entry there is no high-quality evidence to suggest that any of these offers a universal safety advantage. The Veress needle is still the most used among gynecologists and facilitates primary trocar placement. Direct trocar entry under laparoscopic visualization may be underused, is faster, and may result in fewer failed entries. Open (Hasson) entry can be more technically challenging, but may be best for patients with suspected intra-abdominal adhesions.
CONCLUSION
Surgeon comfort is critical in choosing the entry site, method, and equipment. Surgeon familiarity with entry-failure troubleshooting, possible complications, and management is essential because major entry complications are rare in modern laparoscopy but critical because the essential steps of recognition and management can be lifesaving.
Topics: Abdomen; Abdominal Cavity; Female; Gynecologic Surgical Procedures; History, 20th Century; History, 21st Century; Humans; Laparoscopy; Needles; Postoperative Complications; Surgical Instruments; Umbilicus
PubMed: 32712324
DOI: 10.1016/j.jmig.2020.07.010 -
Biomolecules May 2021Post-surgical adhesions are internal scar tissue and a major health and economic burden. Adhesions affect and involve the peritoneal lining of the abdominal cavity,... (Review)
Review
Post-surgical adhesions are internal scar tissue and a major health and economic burden. Adhesions affect and involve the peritoneal lining of the abdominal cavity, which consists of a continuous mesothelial covering of the cavity wall and majority of internal organs. Our understanding of the full pathophysiology of adhesion formation is limited by the fact that the mechanisms regulating normal serosal repair and regeneration of the mesothelial layer are still being elucidated. Emerging evidence suggests that mesothelial cells do not simply form a passive barrier but perform a wide range of important regulatory functions including maintaining a healthy peritoneal homeostasis as well as orchestrating events leading to normal repair or pathological outcomes following injury. Here, we summarise recent advances in our understanding of serosal repair and adhesion formation with an emphasis on molecular mechanisms and novel gene expression signatures associated with these processes. We discuss changes in mesothelial biomolecular marker expression during peritoneal development, which may help, in part, to explain findings in adults from lineage tracing studies using experimental adhesion models. Lastly, we highlight examples of where local tissue specialisation may determine a particular response of peritoneal cells to injury.
Topics: Gene Expression Regulation, Developmental; Gene Regulatory Networks; Genetic Markers; Humans; Peritoneum; Tissue Adhesions
PubMed: 34063089
DOI: 10.3390/biom11050692 -
Clinical Radiology Oct 2016The lymphatic system of the abdomen comprises of the cisterna chyli, its major and minor lymphatic tributaries, and lymph nodes. Disorders of the lymphatic system of the... (Review)
Review
The lymphatic system of the abdomen comprises of the cisterna chyli, its major and minor lymphatic tributaries, and lymph nodes. Disorders of the lymphatic system of the abdomen are rarely encountered and consist of primary and secondary types. Abdominal lymphangiomas constitute the majority and have characteristic imaging features. Complicated lymphangiomas may pose a diagnostic dilemma. Generalised systemic lymphangiomatosis is a rare condition and affects major organs with a poor prognosis. Retroperitoneal lymphangiectasia in the appropriate setting might predict underlying infection, such as filariasis. Other acquired conditions include iatrogenic or treatment-induced chylocoele. Chylous ascites can be secondary to multiple causes and can be confirmed by biochemical testing and lymphangiogram in appropriate settings.
Topics: Abdominal Cavity; Diagnostic Imaging; Humans; Lymphatic System
PubMed: 27450410
DOI: 10.1016/j.crad.2016.06.116