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Pediatric Radiology Apr 2018Abdominal wall defects range from the mild umbilical cord hernia to the highly complex limb-body wall syndrome. The most common defects are gastroschisis and... (Review)
Review
Abdominal wall defects range from the mild umbilical cord hernia to the highly complex limb-body wall syndrome. The most common defects are gastroschisis and omphalocele, and the rarer ones include the exstrophy complex, pentalogy of Cantrell and limb-body wall syndrome. Although all have a common feature of viscera herniation through a defect in the anterior body wall, their imaging features and, more important, postnatal management, differ widely. Correct diagnosis of each entity is imperative in order to achieve appropriate and accurate prenatal counseling and postnatal management. In this paper, we discuss fetal abdominal wall defects and present diagnostic pearls to aid with diagnosis.
Topics: Abdominal Wall; Diagnosis, Differential; Digestive System Abnormalities; Female; Gastroschisis; Humans; Magnetic Resonance Imaging; Pregnancy; Prenatal Diagnosis; Urogenital Abnormalities
PubMed: 29550866
DOI: 10.1007/s00247-017-3914-x -
Abdominal Radiology (New York) Jun 2020Abdominal wall endometriosis (AWE) is a rare form of endometriosis that often results in substantial pain and debility. The current treatment algorithm for AWE is not... (Review)
Review
Abdominal wall endometriosis (AWE) is a rare form of endometriosis that often results in substantial pain and debility. The current treatment algorithm for AWE is not well established. The purpose of this review is to describe the Mayo Clinic experience with thermal ablation of symptomatic AWE as well as to review current imaging and interventional literature regarding the diagnosis and treatment of AWE.
Topics: Abdominal Wall; Cryosurgery; Endometriosis; Female; Humans
PubMed: 31894380
DOI: 10.1007/s00261-019-02379-4 -
Surgical and Radiologic Anatomy : SRA Aug 2022With the increased use of simulation-based training using animal models for the education of surgical and anaesthetic techniques, an increased understanding of the... (Review)
Review
PURPOSE
With the increased use of simulation-based training using animal models for the education of surgical and anaesthetic techniques, an increased understanding of the anatomy of such models and how they compare to humans is required. The transversus abdominis plane block is a regional anaesthetic technique that requires an understanding of the abdominal wall anatomy along with proficient ultrasound use. The current review aims to compare the anatomy of the abdominal wall across species, particularly focussing on the pertinent differences within the class of mammals, and secondarily, it aims to address the implications of these differences for the use of simulation-based training of the transversus abdominis plane block.
METHODS
To achieve this, the PubMed, Web of Science and Google Scholar databases were searched for relevant literature. Studies pertaining to the musculature, vasculature or innervation of the anterolateral abdominal wall across species were included.
RESULTS
The mammalian abdominal wall differs in its musculature, vasculature or innervation from that of amphibians, birds or reptiles; however, among species of mammals, the structure of the abdominal wall follows a similar framework. Particular differences among mammals include the additional muscular layer of the panniculus carnosus found in most mammals other than humans, the variable arterial origins and dominant vascular supply of the abdominal wall and the number of thoracolumbar nerves innervating the abdominal wall.
CONCLUSION
When using animal models for simulation-based training, the pig is recommended for the transversus abdominis plane block given its closely homologous abdominal wall structure, availability and larger comparative size.
Topics: Abdominal Muscles; Abdominal Wall; Animals; Humans; Mammals; Nerve Block; Swine; Ultrasonography
PubMed: 35864247
DOI: 10.1007/s00276-022-02991-y -
Prague Medical Report 2023Detailed knowledge of the human anatomy is an integral part of every surgical procedure. The majority of surgery related complications are due to a failure to possess... (Review)
Review
Detailed knowledge of the human anatomy is an integral part of every surgical procedure. The majority of surgery related complications are due to a failure to possess appropriate knowledge of human anatomy. However, surgeons pay less attention of the anatomy of the anterior abdominal wall. It is composed of nine abdominal layers, which are composed of fascias, muscles, nerves, and vessels. Many superficial and deep vessels and their anastomoses supply the anterior abdominal wall. Moreover, anatomical variations of these vessels are often presented. Intraoperative and postoperative complications associated with entry and closure of the anterior abdominal wall could compromise the best surgical procedure. Therefore, sound knowledge of the vascular anatomy of the anterior abdominal wall is fundamental and a prerequisite to having a favourable quality of patient care. The purpose of the present article is to describe and delineate the vascular anatomy and variations of the anterior abdominal wall and its application in abdominal surgery. Consequently, the most types of abdominal incisions and laparoscopic accesses will be discussed. Furthermore, the possibility of vessels injury related to different types of incisions and accesses will be outlined in detail. Morphological characteristics and distribution pattern of the vascular system of the anterior abdominal wall is illustrated by using figures either from open surgery, different types of imaging modalities or embalmed cadaveric dissections. Oblique skin incisions in the upper or lower abdomen such as McBurney, Chevron and Kocher are not the topic of the present article.
Topics: Humans; Abdominal Wall; Laparoscopy; Abdominal Muscles; Postoperative Complications; Dissection
PubMed: 37212131
DOI: 10.14712/23362936.2023.9 -
Journal of the Mechanical Behavior of... Oct 2017Abdominal wall hernias are one of the most common and long-standing surgical applications for biomaterials engineering. Yet, despite over 50 years of standard use of... (Review)
Review
Abdominal wall hernias are one of the most common and long-standing surgical applications for biomaterials engineering. Yet, despite over 50 years of standard use of hernia repair materials, revision surgery is still required in nearly one third of patients due to hernia recurrence. To date, hernia mesh designs have focused on maximizing tensile strength to prevent structural failure of the implant. However, most recurrences occur at the biomaterial-tissue interface. There is a fundamental gap in understanding the degree to which a mechanical mismatch between hernia repair materials and host tissue contributes to failure at this interface. This review summarizes the current literature related to the anatomy and mechanics of both human and animal abdominal wall tissues, as well as the mechanical properties of many commonly-utilized hernia repair materials. The studies reviewed here reported greater compliance of the linea alba, larger strains for the intact abdominal wall, and greater stiffness for the rectus sheath and umbilical fascia when the tissues were loaded in the longitudinal direction compared to transverse. Additionally, greater stresses were observed in the linea alba when loaded in the transverse direction compared to longitudinal. Given these trends, a few recommendations can be made regarding orientation of mesh. The most compliant axis of the biomaterial should be oriented in the cranio-caudal (longitudinal) direction, and the strongest axis of the biomaterial should be oriented in the medial-lateral (transverse) direction. The human abdominal wall is also anisotropic, with anisotropy ratios as high as 8-9 reported for the human linea alba. Current biomaterial designs exhibit anisotropy ratios in the range of 1-3, and it is unclear whether an ideal ratio exists for optimal match between mesh and tissue. This is likely dependent on implantation location as the linea alba, rectus sheath, and other tissues of the abdominal wall exhibit different characteristics. Given the number of unknowns yet to be addressed by studies of the human abdominal wall, it is unlikely that any single biomaterial design currently encompasses all of the ideal features identified. More data on the mechanical properties of the abdominal wall will be needed to establish a full set of guidelines for ideal mesh mechanics including strength, compliance, anisotropy, nonlinearity and hysteresis.
Topics: Abdominal Wall; Animals; Biocompatible Materials; Biomechanical Phenomena; Hernia, Abdominal; Hernia, Ventral; Herniorrhaphy; Humans; Surgical Mesh; Tensile Strength
PubMed: 28692907
DOI: 10.1016/j.jmbbm.2017.05.008 -
AJR. American Journal of Roentgenology Jan 2020The purpose of this article is to describe the imaging findings associated with complex fetal abdominal wall defects and provide an algorithmic method for arriving at a... (Review)
Review
The purpose of this article is to describe the imaging findings associated with complex fetal abdominal wall defects and provide an algorithmic method for arriving at a final diagnosis. Fetal ventral abdominal wall defects are a complex group of conditions with a broad spectrum of associated multisystem anomalies and manifestations. Correct characterization and classification of these defects require not only familiarity with imaging findings but also a systematic approach to avoid diagnostic confusion.
Topics: Abdominal Wall; Algorithms; Female; Fetus; Humans; Pregnancy; Ultrasonography, Prenatal
PubMed: 31714849
DOI: 10.2214/AJR.19.21627 -
Expert Review of Medical Devices Sep 2006Surgeons often encounter the challenge of treating acquired abdominal wall defects following abdominal surgery. The current standard of practice is to repair most... (Review)
Review
Surgeons often encounter the challenge of treating acquired abdominal wall defects following abdominal surgery. The current standard of practice is to repair most defects using permanent synthetic mesh material. Mesh augments the strength of the weakened abdominal wall fascia and enables the hernia repair to be performed in a tension-free manner. However, there is a risk of acute and/or chronic infection, fistula formation and chronic abdominal wall pain with the use of permanent mesh materials, which can lead to more complex operations. As a means to avoid such problems, surgeons are turning increasingly to the use of xenogenic and allogenic materials for the repair of abdominal wall defects. Their rapid evolution and introduction into the clinical operating room is leading to a new era in abdominal wall reconstruction. There are promising, albeit limited, clinical data with short-term follow-up for only a few of the many biological tissue grafts that are being promoted currently for the repair of abdominal hernias. Additional clinical studies are required to better understand the long-term efficacy and limitations of these materials.
Topics: Abdominal Muscles; Abdominal Wall; Animals; Hernia, Abdominal; Humans; Neovascularization, Physiologic; Plastic Surgery Procedures; Skin, Artificial; Surgical Mesh; Tissue Expansion; Transplantation, Heterologous; Transplantation, Homologous; Wound Healing
PubMed: 17064250
DOI: 10.1586/17434440.3.5.657 -
Journal of Ultrasound in Medicine :... Oct 2021Preoperative ultrasound-guided lateral abdominal wall botulinum toxin injection is a promising method for improving patient outcomes and reducing recurrence rates after... (Review)
Review
Preoperative ultrasound-guided lateral abdominal wall botulinum toxin injection is a promising method for improving patient outcomes and reducing recurrence rates after ventral hernia repair. A review of the literature demonstrates variability in the procedural technique, without current standardization of protocols. As radiologists may be increasingly asked to perform ultrasound-guided botulinum toxin injections of the lateral abdominal wall, familiarity with the procedure and current literature is necessary.
Topics: Abdominal Wall; Botulinum Toxins, Type A; Herniorrhaphy; Humans; Neuromuscular Agents; Preoperative Care; Prospective Studies; Radiologists; Surgical Mesh; Ultrasonography, Interventional
PubMed: 33320354
DOI: 10.1002/jum.15591 -
European Journal of Obstetrics,... Jul 2020A 31-year-old female patient presented with complaints of cyclic low abdominal wall pain and palpable abdominal mass for more than 4 years. Physical examination revealed... (Review)
Review
A 31-year-old female patient presented with complaints of cyclic low abdominal wall pain and palpable abdominal mass for more than 4 years. Physical examination revealed a painful mass measuring 7 cm × 5 cm within the abdominal wall. Her surgical history included surgery for congenital lymphatic haemangioma twice and caesarean section delivery twice. Results of abdominal wall ultrasonography, magnetic resonance imaging, and enhanced computed tomography revealed a soft tissue mass within the abdominal wall, indicating abdominal wall endometriosis. Pathologic examination with fine-needle aspiration of the abdominal wall mass showed endometrial glands and stroma. A multidisciplinary treatment team was established at admission, and surgical excision of the abdominal wall endometriosis mass was recommended. Surgery was performed by our multidisciplinary treatment team. Intraoperatively, the abdominal wall muscle, symphysis pubis, and anterior bladder wall were found to be infiltrated by abdominal wall endometriosis tissue. The abdominal wall endometriosis mass was completely resected with part of the bladder wall, symphysis pubis periosteum, and abdominal wall muscle and fascia (measuring 9 cm × 8 cm × 6 cm). The abdominal wall defect could not be sutured in a routine manner; thus, autologous reconstruction of the abdominal wall defect with left anterolateral thigh musculocutaneous flap was performed. The patient recovered without complications, and follow-up was uneventful. The successful treatment in our case suggests that adequate preoperative examinations and multidisciplinary treatment team collaboration are crucial to the treatment of patients with large abdominal wall endometriosis mass. Anterolateral thigh musculocutaneous flap reconstruction may serve as an optional treatment for abdominal wall defects during surgical excision of abdominal wall endometriosis mass.
Topics: Abdominal Wall; Adult; Cesarean Section; Endometriosis; Female; Humans; Pregnancy; Plastic Surgery Procedures; Thigh
PubMed: 32361342
DOI: 10.1016/j.ejogrb.2020.04.046 -
American Journal of Obstetrics and... Dec 2017
Topics: Abdominal Wall; Endometriosis; Female; Humans; Magnetic Resonance Imaging; Middle Aged
PubMed: 28778741
DOI: 10.1016/j.ajog.2017.07.033