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International Urogynecology Journal May 2013Many surgeons recommend rest and restricting activities to their patients after surgery. The aim of this review is to summarize the literature regarding types of... (Review)
Review
Many surgeons recommend rest and restricting activities to their patients after surgery. The aim of this review is to summarize the literature regarding types of activities gynecologic surgeons restrict and intra-abdominal pressure during specific activities and to provide an overview of negative effects of sedentary behavior (rest). We searched PubMed and Scopus for years 1970 until present and excluded studies that described recovery of activities of daily living after surgery as well as those that assessed intra-abdominal pressure for other reasons such as abdominal compartment syndrome and hypertension. For our review of intra-abdominal pressure, we excluded studies that did not include a generally healthy population, or did not report maximal intra-abdominal pressures. We identified no randomized trial or prospective cohort study that studied the association between postoperative activity and surgical success after pelvic floor repair. The ranges of intra-abdominal pressures during specific activities are large and such pressures during activities commonly restricted and not restricted after surgery overlap considerably. There is little concordance in mean peak intra-abdominal pressures across studies. Intra-abdominal pressure depends on many factors, but not least the manner in which it is measured and reported. Given trends towards shorter hospital stays and off work intervals, which both predispose women to higher levels of physical activity, we urge research efforts towards understanding the role of physical activity on recurrence of pelvic organ prolapse and urinary incontinence after surgery.
Topics: Abdominal Cavity; Evidence-Based Medicine; Exercise; Female; Gynecologic Surgical Procedures; Humans; Pressure; Sedentary Behavior
PubMed: 23340879
DOI: 10.1007/s00192-012-2026-2 -
Tumour Biology : the Journal of the... May 2016As the most common metastatic disease of abdomen pelvic cavity cancer, peritoneal carcinomatosis (PC) renders significant negative impact on patient survival and quality... (Review)
Review
As the most common metastatic disease of abdomen pelvic cavity cancer, peritoneal carcinomatosis (PC) renders significant negative impact on patient survival and quality of life. Invasive peritoneal exfoliated cancer cells (PECCs) preferentially select the omentum as a predominant target site for cancer cell colonization and proliferation compared with other tissues in the abdominal cavity. The precise pathogenic mechanism remains to be determined. As omental milky spots (MSs) are the major implantation site for malignant cells in peritoneal dissemination, researches on mechanisms of PC have been mainly focused on MS, primitive lymphoid tissues with unique structural features, and functional characteristics. To date, extensive biophysical and biochemical methods have been manipulated to investigate the MS exact function in the peritoneal cavity. This review summarized MS as hotbeds for PECC. The anatomical distribution was briefly described first. Then, MS histology was systematically reviewed, including morphological features, cellular constituents, and histological staining methods. At last, the roles of MS in PC pathological process were summarized with special emphasis on the distinct roles of macrophages.
Topics: Animals; Carcinoma; Cell Movement; Humans; Lymphocytes; Lymphoid Tissue; Macrophages, Peritoneal; Omentum; Organ Specificity; Peritoneal Neoplasms; Pleura; Staining and Labeling
PubMed: 26831659
DOI: 10.1007/s13277-016-4887-3 -
International Wound Journal Sep 2016Traditionally, the surgical approach to managing abdominal injuries was to assess the extent of trauma, repair any damage and close the abdomen in one definitive... (Review)
Review
Traditionally, the surgical approach to managing abdominal injuries was to assess the extent of trauma, repair any damage and close the abdomen in one definitive procedure rather than leave the abdomen open. With advances in medicine, damage control surgery using temporary abdominal closure methods is being used to manage the open abdomen (OA) when closure is not possible. Although OA management is often observed in traumatic injuries, the extension of damage control surgery concepts, in conjunction with OA, for the management of the septic patient requires that the general surgeon who is faced with these challenges has a comprehensive knowledge of this complex subject. The purpose of this article is to provide guidance to the acute care and general surgeon on the use of OA negative pressure therapy (OA-NPT; ABTHERA™ Open Abdomen Negative Pressure Therapy System, KCI, an ACELITY Company, San Antonio, TX) for OA management. A literature review of published evidence, clinical recommendations on managing the OA and a case study demonstrating OA management using OA-NPT have been included.
Topics: Abdominal Cavity; Abdominal Injuries; Abdominal Wound Closure Techniques; Critical Care; Humans; Negative-Pressure Wound Therapy; Wound Healing
PubMed: 27547961
DOI: 10.1111/iwj.12655 -
BMJ Case Reports Sep 2023A man presented with nausea, vomiting, abdominal pain and diarrhoea. Cross-sectional imaging of the abdomen and pelvis showed gastric pneumatosis. He was treated...
A man presented with nausea, vomiting, abdominal pain and diarrhoea. Cross-sectional imaging of the abdomen and pelvis showed gastric pneumatosis. He was treated conservatively with broad-spectrum antibiotics, bowel rest, nasogastric tube placement for gastric decompression and intravenous proton pump inhibitor therapy. He developed an upper gastrointestinal bleed during hospitalisation and underwent an esophagogastroduodenoscopy (EGD) which revealed a large >50 mm cratered gastric ulcer. Initial biopsy was inconclusive for malignancy thus a repeat EGD was scheduled however prior to that procedure he returned to the emergency department with severe abdominal pain. CT of the abdomen and pelvis showed recurrence of gastric pneumatosis. Repeat EGD showed a 4 mm linear gastric ulcer and repeat biopsies showed gastric mucosa with moderate chronic inactive gastritis without any metaplasia, dysplasia, carcinoma or amyloid. He was once again treated successfully with conservative measures and discharged after short hospitalisation.
Topics: Male; Humans; Stomach Ulcer; Gastric Mucosa; Abdominal Cavity; Abdominal Pain
PubMed: 37723089
DOI: 10.1136/bcr-2023-256724 -
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 -
Radiographics : a Review Publication of... 2021Cystic lesions found in and around the peritoneal cavity can often be challenging to diagnose owing to significant overlap in imaging appearance between the different...
Cystic lesions found in and around the peritoneal cavity can often be challenging to diagnose owing to significant overlap in imaging appearance between the different entities. When the cystic lesion can be recognized to arise from one of the solid abdominal organs, the differential considerations can be more straightforward; however, many cystic lesions, particularly when large, cannot be clearly associated with one of the solid organs. Cystic lesions arising from the mesentery and peritoneum are less commonly encountered and can be caused by relatively rare entities or by a variant appearance of less-rare entities. The authors provide an overview of the classification of cystic and cystic-appearing lesions and the basic imaging principles in evaluating them, followed by a summary of the clinical, radiologic, and pathologic features of various cystic and cystic-appearing lesions found in and around the peritoneal cavity, organized by site of origin. Emphasis is given to lesions arising from the mesentery, peritoneum, or gastrointestinal tract. Cystic lesions arising from the liver, spleen, gallbladder, pancreas, urachus, adnexa, or soft tissue are briefly discussed and illustrated with cases to demonstrate the overlap in imaging appearance with mesenteric and peritoneal cystic lesions. When approaching a cystic lesion, the key imaging features to assess include cyst content, locularity, wall thickness, and presence of internal septa, solid components, calcifications, or any associated enhancement. While definitive diagnosis is not always possible with imaging, careful assessment of the imaging appearance, location, and relationship to adjacent structures can help narrow the differential diagnosis. RSNA, 2021.
Topics: Abdominal Cavity; Cysts; Diagnosis, Differential; Humans; Mesentery; Pelvis; Peritoneum
PubMed: 34469214
DOI: 10.1148/rg.2021200207 -
International Journal of Surgery... Jun 2009Natural orifice translumenal endoscopic surgery (N.O.T.E.S) is a technique that allows access to the peritoneal cavity through natural orifices (oral, rectal, vaginal,... (Review)
Review
Natural orifice translumenal endoscopic surgery (N.O.T.E.S) is a technique that allows access to the peritoneal cavity through natural orifices (oral, rectal, vaginal, vesical) without passing through the anterior abdominal wall. Rapid strides have been made in developing this technique, especially in animal models. Majority of research work in this field is originating from USA, while human clinical trials are being reported from India and Southern America. Morbidly obese patients and ITU patients are two target groups where N.O.T.E.S if implemented, will have the highest potential and bearing. With increasing evidence of safe practice in human models, questions on indications and feasibility of practice need to be addressed by rigorous research, strong evidence and collaboration between surgical centers worldwide.
Topics: Abdominal Cavity; Animals; Endoscopes; Endoscopy; Humans; Minimally Invasive Surgical Procedures; Models, Animal
PubMed: 19371796
DOI: 10.1016/j.ijsu.2009.04.001 -
Anaesthesiology Intensive Therapy 2021Abdominal compartment syndrome (ACS) is defined as sustained intra-abdominal pressure (IAP) exceeding 20 mm Hg, which causes end-organ damage due to impaired tissue...
Abdominal compartment syndrome (ACS) is defined as sustained intra-abdominal pressure (IAP) exceeding 20 mm Hg, which causes end-organ damage due to impaired tissue perfusion, as with other compartment syndromes [1, 2]. This dysfunction can extend beyond the abdomen to other organs like the heart and lungs. ACS is most commonly caused by trauma or surgery to the abdomen. It is characterised by interstitial oedema, which can be exacerbated by large fluid shifts during massive transfusion of blood products and other fluid resuscitation [3]. Normally, IAP is nearly equal to or slightly above ambient pressure. Intra-abdominal hypertension is typically defined as abdominal pressure greater than or equal to 12 mm Hg [4]. Initially, the abdomen is able to distend to accommodate the increase in pressure caused by oedema; however, IAP becomes highly sensitive to any additional volume once maximum distension is reached. This is a function of abdominal compliance, which plays a key role in the development and progression of intra-abdominal hypertension [5]. Surgical decompression is required in severe cases of organ dysfunction - usually when IAPs are refractory to other treatment options [6]. Excessive abdominal pressure leads to systemic pathophysiological consequences that may warrant admission to a critical care unit. These include hypoventilation secondary to restriction of the deflection of the diaphragm, which results in reduced chest wall compliance. This is accompanied by hypoxaemia, which is exacerbated by a decrease in venous return. Combined, these consequences lead to decreased cardiac output, a V/Q mismatch, and compromised perfusion to intra-abdominal organs, most notably the kidneys [7]. Kidney damage can be prerenal due to renal vein or artery compression, or intrarenal due to glomerular compression [8] - both share decreased urine output as a manifestation. Elevated bladder pressure is also seen from compression due to increased abdominal pressure, and its measurement, via a Foley catheter, is a diagnostic hallmark. Sustained intra-bladder pressures beyond 20 mm Hg with organ dysfunction are indicative of ACS requiring inter-vention [2, 8]. ACS is an important aetiology to consider in the differential diagnosis for signs of organ dysfunction - especially in the perioperative setting - as highlighted in the case below.
Topics: Abdomen; Abdominal Cavity; Compartment Syndromes; Fluid Therapy; Humans; Intensive Care Units; Intra-Abdominal Hypertension
PubMed: 33586415
DOI: 10.5114/ait.2021.103513 -
Revista Do Colegio Brasileiro de... 2021
Topics: Abdominal Cavity; Humans; Intensive Care Units; Intra-Abdominal Hypertension
PubMed: 33605393
DOI: 10.1590/0100-6991e-20202838 -
California Medicine Nov 1957Bile peritonitis may occur after open operations on the biliary tract or following needle biopsy of the liver. Usually it is secondary to rupture of the common duct...
Bile peritonitis may occur after open operations on the biliary tract or following needle biopsy of the liver. Usually it is secondary to rupture of the common duct caused by overlooked common duct stone.Sterile intraperitoneal bile collections may be tolerated fairly well for long periods. Placing drains in the abdomen after biliary tract operations helps prevent dangerous accumulations of bile. Patients with extensive bile peritonitis should be operated upon as soon as possible. Ideally, the operation should include drainage of the abdomen and repair of any underlying pathological cause, but the condition of the patient may be so poor that only drainage can be carried out at the moment.
Topics: Abdominal Cavity; Bile; Biliary Tract Surgical Procedures; Drainage; Female; Gallstones; Humans; Liver; Male; Peritonitis; Postoperative Complications; Postoperative Period
PubMed: 13472469
DOI: No ID Found