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Female Pelvic Medicine & Reconstructive... 2019High intra-abdominal pressure (IAP) may influence the development of pelvic floor disorders. We and others have used intravaginal pressure transducers to measure IAP in...
OBJECTIVES
High intra-abdominal pressure (IAP) may influence the development of pelvic floor disorders. We and others have used intravaginal pressure transducers to measure IAP in women during exercise and daily activities, but utilizing the transducer for long-term measurements creates compliance issues. Waist-worn accelerometers are prominent in research and may be a reliable alternative for approximating IAP. We hypothesized that there are pair-wise positive correlations between the mean maximal accelerometer vector magnitude and 2 IAP measurements: mean maximal IAP and area under the curve (AUC).
METHODS
Twenty-five women who regularly participated in exercise performed 13 activities. Intra-abdominal pressure was measured with an intravaginal transducer and acceleration with a waist-worn accelerometer. We determined the mean maximal IAP, AUC for IAP, and mean maximal accelerometer vector magnitude for each activity and participant. The relationship between IAP and acceleration was determined by computing the Pearson correlation coefficient (R) and the 95% confidence interval for mean maximal accelerometer vector magnitude versus mean maximal IAP and mean maximal accelerometer vector magnitude versus AUC for IAP.
RESULTS
The R values were 0.7353 for mean maximal accelerometer vector magnitude versus mean maximal IAP (including walking) and 0.5059 for mean maximal accelerometer vector magnitude versus AUC for IAP (excluding walking). Walking at 3 speeds, analyzed separately, presented R values of 0.72208 for mean maximal IAP and 0.21678 for AUC.
CONCLUSION
Waist-worn accelerometers may provide a viable method for approximating mean maximal IAP in a population of women during most activities.
Topics: Abdominal Cavity; Acceleration; Accelerometry; Adolescent; Adult; Exercise; Female; Humans; Middle Aged; Monitoring, Ambulatory; Pressure; Walking; Young Adult
PubMed: 29135811
DOI: 10.1097/SPV.0000000000000523 -
Romanian Journal of Morphology and... 2020Abdominal elastotic deposits are uncommon lesions that often presents as polyps. They show three histological patterns: fibroelastosis, angioelastosis, and... (Review)
Review
Abdominal elastotic deposits are uncommon lesions that often presents as polyps. They show three histological patterns: fibroelastosis, angioelastosis, and elastofibroma. We describe 23 cases including rare locations, such as mesentery, greater omentum, hernia sac, spleen, peripancreatic fat, and hypodermal fat. The age of the patients ranged from 49 to 93 years (mean, 76.8 years). Most lesions were discovered incidentally in the microscopic study. The most frequent locations were peritoneal subserosa (43.5%) and mesentery∕mesocolon∕greater omentum (39.1%). The most common pattern was fibroelastosis (69.6%) followed by angioelastosis (26.1%). We observed one case of omental elastofibroma. A review of the 14 abdominal elastofibromas described including our case revealed that the age of the patients ranged from 45 to 88 years (mean, 68.5 years). Female predominance is striking (M:F, 1:12). The most common site was the stomach (50%). The greater omentum (14.3%), small intestine (7.1%), and pancreas (7.1%) are very rare sites for this lesion. Only one case before ours has been published in the greater omentum. The size of the lesions ranged from 0.7 cm to 8 cm (mean 3.2 cm). In 36.4% of the cases located in the digestive tract, the mucosa did not show alterations. Ulcerations (36.4%) or polypoid excrescences (18.2%) were mostly observed. Six (42.9%) cases were asymptomatic and six (42.9%) cases simulated a neoplasm. Two cases were associated with elastofibromas in other locations. Differential diagnosis includes amyloidoma, elastofibrolipoma, mesenteric elastic vascular sclerosis in neuroendocrine tumors, diverticular disease elastosis, pseudoxanthoma elasticum, pulse granuloma, and digestive lesions in patients treated with D-Penicillamine.
Topics: Aged; Aged, 80 and over; Female; Gastrointestinal Tract; Humans; Intestine, Small; Mesentery; Middle Aged; Omentum; Soft Tissue Neoplasms
PubMed: 33817725
DOI: 10.47162/RJME.61.3.22 -
Revista Espanola de Enfermedades... Jun 2024A 63-year-old man presented with left abdominal pain, abdominal distention, and black stool following emotional stress and strenuous exercise. CT examination revealed a...
A 63-year-old man presented with left abdominal pain, abdominal distention, and black stool following emotional stress and strenuous exercise. CT examination revealed a large cystic mass in the left abdominal cavity, as well as the presence of a teratoma in the hepatogastric space and a descending duodenal diverticulum. Subsequently, he underwent surgical resection, and the pathological findings indicated that the cyst wall consisted of mucinous glandular epithelium and smooth muscle, displaying a structure similar to normal intestinal wall tissue. Furthermore, the cyst was lined with ciliated columnar epithelium, confirming the diagnosis of an isolated enterogenous cyst (EC). Due to the potential trauma associated with excising the EC, the patient did not undergo resection of the teratoma, especially given its proximity to a branch of the trunk abdominal artery.
Topics: Humans; Male; Teratoma; Middle Aged; Cysts; Tomography, X-Ray Computed; Retroperitoneal Space
PubMed: 37539533
DOI: 10.17235/reed.2023.9799/2023 -
The American Journal of Case Reports Feb 2023BACKGROUND Primary hepatic angioleiomyoma is a rare mesenchymal tumor that is characterized by blood vessels and smooth muscle. Herein, we report an extremely rare case...
BACKGROUND Primary hepatic angioleiomyoma is a rare mesenchymal tumor that is characterized by blood vessels and smooth muscle. Herein, we report an extremely rare case of primary hepatic angioleiomyoma and discuss the clinicopathological features. CASE REPORT A 60-year-old Mongolian man was diagnosed with a hepatic tumor in the second and third segments of screening in 2012. It had been under control by a physician for 10 years. The patient had discomfort and vague pain in the right side of the abdomen since April 2022. Hepatitis virus markers (hepatitis B and hepatitis C) were negative. Plain computed tomography revealed an 80-mm solitary liver lesion in the left lobe with well-defined margins and heterogeneous enhancement. A left hepatectomy was performed in May 2022. The cut surface of the tumor showed a grayish-white, elastic, hard mass with a diameter of 50×80 mm. Histological findings of the tumor revealed that it was clearly demarcated from the surrounding liver tissues with relatively clear boundaries showing thick, muscle-coated blood vessels with perivascular smooth muscle bundles. Immunohistochemical staining showed that the smooth muscle cells were strongly diffuse and positive for smooth muscle actin. CONCLUSIONS Clinically, primary hepatic angioleiomyoma should be distinguished from other types of liver tumors, especially liver cancer. In combination with our long-term observation and other case reports, we recommend general follow-up if the preoperative pathological diagnosis can be confirmed and the patient has no other symptoms.
Topics: Male; Humans; Middle Aged; Angiomyoma; Liver Neoplasms; Hepatectomy; Abdominal Cavity
PubMed: 36805667
DOI: 10.12659/AJCR.938645 -
Medicine Sep 2022Multicystic Mesothelioma (MM) is very rare and preoperative diagnosis is difficult.
RATIONALE
Multicystic Mesothelioma (MM) is very rare and preoperative diagnosis is difficult.
PATIENT CONCERNS
We report a case of a 34-year-old man with solid abdominal cystic echo mass. Physical examination showed that the patient had a flat and soft abdomen without tenderness or rebound pain, no fluid wave tremor, and no obvious abdominal mass was touched. The patient complained of repeated abdominal distention with nausea for 5 days. Sonographic examination suspected pseudomyxoma peritoneum.
DIAGNOSIS
Conventional ultrasound examination showed a cystic solid echo mass in the right abdominal cavity of the patient, with uneven internal echo and honeycomb change, and clear boundary with surrounding organs. Color Doppler suggested that the blood flow in the mass was not obvious. Contrast-enhanced computed tomography of the abdomen revealed hypodensity foci in hepatic and renal crypts and right paracolic sulcus.
INTERVENTIONS
Laparoscopic resection of the mass was performed, and the postoperative pathological findings were polycystic mesothelioma (greater omentum).
OUTCOMES
After mass resection, all laboratory tests and abdominal ultrasound were normal, and abdominal distension and nausea disappeared.
LESSONS
Improved ultrasound diagnosis of MM is useful for clinical decision-making.
Topics: Adenomatoid Tumor; Adult; Diagnostic Errors; Humans; Male; Mesothelioma; Nausea; Omentum
PubMed: 36086679
DOI: 10.1097/MD.0000000000030441 -
Acta Cirurgica Brasileira Sep 2018To evaluate the effects of hyperbaric oxygenation on prevention of adhesions in the abdominal cavity after laparotomy.
PURPOSE
To evaluate the effects of hyperbaric oxygenation on prevention of adhesions in the abdominal cavity after laparotomy.
METHODS
Fifty four rats underwent laparotomy; stitches were made in the four quadrant parietal peritoneum and abdominal cavity closure. Animals were divided into three groups: 1 - control; 2 - subjected to high pressures and oxygenation; 3 - subjected to 100% hyperbaric oxygenation. The animals in groups 2 and 3 were daily submitted to oxygenation hyperbaric chamber after surgery. On the seventh day another laparotomy, registration of procedure, assessment of adhesions and biopsies of the peritoneum were held. Professionals analyzed the videos and the biopsies.
RESULTS
Peritoneal cavity adhesions occurred in animals of three groups with no difference between them. In Group 3, the adhesions presented more fragile and vascular proliferation more pronounced, and there was no difference in comparison with the first and second groups. However, there was no significant difference in the evaluation of these parameters between the animals in groups 1 and 2.
CONCLUSIONS
Postoperative hyperbaric oxygenation in rats submitted to laparotomy did not alter the frequency, but reduced the density of adhesions in the peritoneal cavity and promoted vascular proliferation. The change in atmospheric pressure alone had no influence on the results.
Topics: Animals; Disease Models, Animal; Hyperbaric Oxygenation; Laparotomy; Peritoneal Cavity; Postoperative Complications; Rats; Rats, Wistar; Tissue Adhesions
PubMed: 30328915
DOI: 10.1590/s0102-865020180090000011 -
Frontiers in Endocrinology 2022The interest on partial adrenalectomy has steadily increased over the past twenty years. Adrenal pathologies are mostly benign, making an organ-preserving procedure... (Review)
Review
The interest on partial adrenalectomy has steadily increased over the past twenty years. Adrenal pathologies are mostly benign, making an organ-preserving procedure attractive for many patients. The introduction of minimally invasive techniques played probably an important role in this process because they transformed a complex surgical procedure, related to the difficult access to the retroperitoneal space, into a simple operation improving the accessibility to this organ. In this review we summarize the role of partial retroperitoneoscopic adrenalectomy over the years and the current indications and technique.
Topics: Adrenal Gland Neoplasms; Adrenalectomy; Humans; Retroperitoneal Space
PubMed: 35418944
DOI: 10.3389/fendo.2022.855326 -
Asian Journal of Surgery Jan 2020Etiology of ascites of unknown origin varies with geographic area and ethnic origin. Tuberculous peritonitis and peritoneal carcinomatosis constitute a considerable... (Review)
Review
Etiology of ascites of unknown origin varies with geographic area and ethnic origin. Tuberculous peritonitis and peritoneal carcinomatosis constitute a considerable proportion of patients. Differentiation between both is a major challenge. The role of omental thickness (OT) by ultrasonography to predict risk of malignancy in unexplained ascites. This prospective study was done at Kasr Alainy School of Medicine, Cairo University and included 100 adults with unexplained ascites and thickened omentum (>15 mm) on ultrasonography. An expert performed ultrasonography to assess peritoneum and peritoneal cavity and measure OT. Ascites was assessed regarding volume, echogenicity, and loculation. The ascitic fluid was analyzed to measure lactate dehydrogenase, adenosine deaminase, and total leukocytic count. Laparoscopic exploration with biopsy was done for final diagnosis that divided the patients into; TB Group (n = 44) and peritoneal carcinomatosis group (n = 56). Main Outcome Measures were to determine degree of omental thickness as a predictor of malignancy risk in unexplained ascites and other ultrasonographic features to predict malignancy risk including omental echogenicity and results of diagnostic ascitic tapping. We found that OT was greater in the PC group compared to the TB group (24.6 ± 4.6 mm vs. 17.9 ± 3.0 mm, respectively, p < 0.001). Higher frequency of hypoechogenicity, irregular peritoneal surface, omental cakes, and lymph nodes was seen in PC Group. ADA, TLC, and relative lymphocyte count were higher in TB group. Omental thickness ≥19.5 mm has a sensitivity of 89.3%, specificity of 84.1% to diagnose PC. We can conclude that omental thickness >19 mm is a sensitive and specific predictor of malignancy in patients with unexplained ascites.
Topics: Aged; Ascites; Egypt; Female; Humans; Male; Middle Aged; Omentum; Predictive Value of Tests; Risk; Ultrasonography
PubMed: 30910377
DOI: 10.1016/j.asjsur.2019.03.004 -
Abdominal Radiology (New York) Nov 2019To provide an overview of complete mesocolic excision, along with a review of the relevant vascular anatomy and locoregional staging concepts, for abdominal radiologists. (Review)
Review
OBJECTIVE
To provide an overview of complete mesocolic excision, along with a review of the relevant vascular anatomy and locoregional staging concepts, for abdominal radiologists.
RESULTS
Complete mesocolic excision (CME) with central vascular ligation (CVL) for colon cancer has emerged as a technique that has growing interest in surgical oncology. Specific anatomic considerations and patterns of nodal spread have thus gained clinical significance, and should be familiar to abdominal radiologists. This review article provides an overview of CME with CVL, and discusses some of the important anatomic considerations in patients with colon cancer that are relevant to radiologists.
CONCLUSION
Knowledge of CME with CVL and the relevant anatomic and staging considerations is important for abdominal radiologists, as this surgical technique becomes increasingly utilized.
Topics: Colectomy; Colonic Neoplasms; Humans; Ligation; Mesocolon; Neoplasm Staging; Radiography, Abdominal
PubMed: 31049615
DOI: 10.1007/s00261-019-02037-9 -
Infection and Immunity Dec 2023c is a lifelong member of the mycobiome causing mucosal candidiasis and life-threatening, systemic, and intra-abdominal disease in immunocompromised and transplant...
c is a lifelong member of the mycobiome causing mucosal candidiasis and life-threatening, systemic, and intra-abdominal disease in immunocompromised and transplant patients. Despite the clinical importance of intra-abdominal candidiasis with mortality rates between 40% and 70%, the contribution of fungal virulence factors and host immune responses to disease has not been extensively studied. Secretion of the quorum-sensing molecule, farnesol, acts as a virulence factor for during systemic infection, while inducing local, protective innate immune responses in oral models of infection. Previously, we reported that farnesol recruits macrophages to the peritoneal cavity in mice, suggesting a role for farnesol in innate immune responses. Here, we expand on our initial findings, showing that farnesol profoundly alters the peritoneal cavity microenvironment promoting innate inflammation. Intra-peritoneal injection of farnesol stimulates rapid local death of resident peritoneal cells followed by recruitment of neutrophils and inflammatory macrophages into the peritoneal cavity and peritoneal mesothelium associated with an early increase in chemokines followed by proinflammatory cytokines. These rapid inflammatory responses to farnesol significantly increase morbidity and mortality of mice with intra-abdominal candidiasis associated with increased formation of peritoneal adhesions, despite similar rates of fungal clearance from the peritoneal cavity and retro-peritoneal organs. knockout and reconstituted strains recapitulate these findings. This indicates that farnesol may be detrimental to the host during intra-abdominal infections. Importantly, our results highlight a need to understand how virulence factors modulate the host immune response within the peritoneum, an exceedingly common site of infection.
Topics: Humans; Animals; Mice; Candida albicans; Farnesol; Peritoneal Cavity; Candidiasis; Intraabdominal Infections; Virulence Factors
PubMed: 37975682
DOI: 10.1128/iai.00384-23