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The Pan African Medical Journal 2022Abdominal wall endometriosis is the development of endometrial tissue in the anterior abdomen usually due to an operation in which the uterus is manipulated. We herein...
Abdominal wall endometriosis is the development of endometrial tissue in the anterior abdomen usually due to an operation in which the uterus is manipulated. We herein delineate the presentation, clinical investigation, and surgical treatment of an abdominal wall endometriosis case. A 42-year-old female presented with acute abdominal pain in the lower quadrants in the margins of an old cesarean scar. Two masses in the abdominal wall highly suspected of consisting of endometrial tissue were found during the investigation of the patient. These ones were removed in surgery and endometrial tissue secondary to previous cesarean section was confirmed after histological analysis. Consequently, although rare, if a painful mass in a surgical scar, such as a Pfannenstiel incision, is found in women of reproductive age with a history of obstetric surgery, the differential diagnosis shall include endometriosis. There is a portion of cases in which endometriosis recurs within five years following conservative surgery.
Topics: Abdominal Wall; Adult; Cesarean Section; Cicatrix; Endometriosis; Female; Humans; Neoplasm Recurrence, Local; Pregnancy
PubMed: 35685105
DOI: 10.11604/pamj.2022.41.193.33536 -
Chinese Medical Journal Nov 2015Intraperitoneal lymphangioma (IL) used to be thought of as a benign lymphatic malformation with a low rate of preoperative diagnosis. This retrospective study aimed to...
BACKGROUND
Intraperitoneal lymphangioma (IL) used to be thought of as a benign lymphatic malformation with a low rate of preoperative diagnosis. This retrospective study aimed to explore the connection between the cysts and clinical manifestation and imaging characteristics, and to study diagnostic confusion, therapeutic principles and potential recurrent reasons, to further enhance the comprehension of this rare disease.
METHODS
Here, we retrospectively reviewed 21 patients diagnosed with IL. Age, sex, complaints, physical findings, and imaging features of each patient were documented. The therapies, postoperative complications and treatments were discussed.
RESULTS
Symptomatology included eight patients (38%) with intermittent dull pain in the abdomen, and three patients (14%) complained of abdominal persistent pain. The physical examination revealed an abdominal mass in 16 patients (76%), and eight (38%) were reported no discomfort. IL was correctly established preoperatively in 19 patients (90%). Patients were treated using laparotomy, except one who was treated with laparoscopy. Two recurrences were noted during follow-up.
CONCLUSIONS
IL should be suspected in any patient with a mobile abdominal mass and surgery is required immediately after discovery of the tumor.
Topics: Abdomen; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Laparoscopy; Lymphangioma; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Young Adult
PubMed: 26608984
DOI: 10.4103/0366-6999.169061 -
Radiology Oct 2020Background Angiotensin-converting enzyme 2, a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrates its highest surface expression in the...
Background Angiotensin-converting enzyme 2, a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrates its highest surface expression in the lung, small bowel, and vasculature, suggesting abdominal viscera may be susceptible to injury. Purpose To report abdominal imaging findings in patients with coronavirus disease 2019. Materials and Methods In this retrospective cross-sectional study, patients consecutively admitted to a single quaternary care center from March 27 to April 10, 2020, who tested positive for SARS-CoV-2 were included. Abdominal imaging studies performed in these patients were reviewed, and salient findings were recorded. Medical records were reviewed for clinical data. Univariable analysis and logistic regression were performed. Results A total of 412 patients (average age, 57 years; range, 18 to >90 years; 241 men, 171 women) were evaluated. A total of 224 abdominal imaging studies were performed (radiography, = 137; US, = 44; CT, = 42; MRI, = 1) in 134 patients (33%). Abdominal imaging was associated with age (odds ratio [OR], 1.03 per year of increase; = .001) and intensive care unit (ICU) admission (OR, 17.3; < .001). Bowel-wall abnormalities were seen on 31% of CT images (13 of 42) and were associated with ICU admission (OR, 15.5; = .01). Bowel findings included pneumatosis or portal venous gas, seen on 20% of CT images obtained in patients in the ICU (four of 20). Surgical correlation ( = 4) revealed unusual yellow discoloration of the bowel ( = 3) and bowel infarction ( = 2). Pathologic findings revealed ischemic enteritis with patchy necrosis and fibrin thrombi in arterioles ( = 2). Right upper quadrant US examinations were mostly performed because of liver laboratory findings (87%, 32 of 37), and 54% (20 of 37) revealed a dilated sludge-filled gallbladder, suggestive of bile stasis. Patients with a cholecystostomy tube placed ( = 4) had negative bacterial cultures. Conclusion Bowel abnormalities and gallbladder bile stasis were common findings on abdominal images of patients with coronavirus disease 2019. Patients who underwent laparotomy often had ischemia, possibly due to small-vessel thrombosis. © RSNA, 2020.
Topics: Abdomen; Adolescent; Adult; Aged; Aged, 80 and over; Betacoronavirus; COVID-19; Coronavirus Infections; Female; Gastrointestinal Diseases; Humans; Laparotomy; Male; Middle Aged; Pandemics; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2; Young Adult
PubMed: 32391742
DOI: 10.1148/radiol.2020201908 -
Abdominal volume index: a predictive measure in relationship between depression/anxiety and obesity.African Health Sciences Mar 2020Obesity is a risk factor for mood disorder (such as depression and anxiety). We aimed to assess application of A Body Shape Index (ABSI) and abdominal volume index...
BACKGROUND
Obesity is a risk factor for mood disorder (such as depression and anxiety). We aimed to assess application of A Body Shape Index (ABSI) and abdominal volume index (AVI), as new indices of obesity to evaluate the relationship between obesity and depression/anxiety.
METHODS
This cross sectional study was conducted on 307 overweight and obese women (249 females, 58 males) 20-60 years in Iran in 2017-2018. The anthropometric measures including weight, waist circumference, hip circumference, body fat and derived values of body mass index, waist-hip ratio, AVI and ABSI were evaluated. HADS questionnaire for depression and anxiety completed.
RESULTS
Prevalence of depression was 36.1% in women; men 24.1%; overweight 28.1%; obese 36.5 % and central obesity 33.7%. Anxiety was apparent in 27.1% of overweight 30.3 % obese and 29.6% central obesity. People with depression and anxiety had higher WC, BF and AVI. ABSI had no significant correlation with depression/anxiety. The odds of depression (1.06; 95% CI, 1.02-1.12) and anxiety (1.06; 95% CI, 1.01-1.11) were elevated with increase AVI.
CONCLUSION
Our results suggested that AVI as an indirect measure of abdominal obesity along with WC and BF could be useful in predicting the relationship between obesity and depression/anxiety.
Topics: Abdomen; Adult; Anthropometry; Anxiety; Body Mass Index; Cross-Sectional Studies; Depression; Female; Humans; Iran; Male; Middle Aged; Obesity; Waist Circumference; Waist-Hip Ratio; Young Adult
PubMed: 33402914
DOI: 10.4314/ahs.v20i1.31 -
ACS Nano Feb 2023Postoperative abdominal adhesions are a common problem after surgery and can produce serious complications. Current antiadhesive strategies focus mostly on physical...
Postoperative abdominal adhesions are a common problem after surgery and can produce serious complications. Current antiadhesive strategies focus mostly on physical barriers and are unsatisfactory and inefficient. In this study, we designed and synthesized advanced injectable cream-like hydrogels with multiple functionalities, including rapid gelation, self-healing, antioxidation, anti-inflammation, and anti-cell adhesion. The multifunctional hydrogels were facilely formed by the conjugation reaction of epigallocatechin-3-gallate (EGCG) and hyaluronic acid (HA)-based microgels and poly(vinyl alcohol) (PVA) based on the dynamic boronic ester bond. The physicochemical properties of the hydrogels including antioxidative and anti-inflammatory activities were systematically characterized. A mouse cecum-abdominal wall adhesion model was implemented to investigate the efficacy of our microgel-based hydrogels in preventing postoperative abdominal adhesions. The hydrogels, with a high molecular weight HA, significantly decreased the inflammation, oxidative stress, and fibrosis and reduced the abdominal adhesion formation, compared to the commercial Seprafilm group or Injury-only group. Label-free quantitative proteomics analysis demonstrated that S100A8 and S100A9 expressions were associated with adhesion formation; the microgel-containing hydrogels inhibited these expressions. The microgel-containing hydrogels with multifunctionality decreased the formation of postoperative intra-abdominal adhesions in a murine model, demonstrating promise for clinical applications.
Topics: Mice; Animals; Hydrogels; Microgels; Abdominal Wall; Tissue Adhesions; Inflammation
PubMed: 36779870
DOI: 10.1021/acsnano.2c12104 -
Medicine Jun 2022Neuroendocrine tumours (NETs) are rare tumors. 55% of NETs originate in the gastrointestinal tract and the liver is the most common site of distant metastases. Serum...
INTRODUCTION
Neuroendocrine tumours (NETs) are rare tumors. 55% of NETs originate in the gastrointestinal tract and the liver is the most common site of distant metastases. Serum chromogranin A is the most common biomarker for assessing the extent of disease and monitoring treatment; carcinoid syndrome occurs in 19% of NETs and is characterized by chronic diarrhea or flushing. Primary mesenteric NETs are rare and have been described only in case reports in literature; our case is an apparent primary mesenteric NETs with a surgical program to remove the mesenteric mass and subrenal interaortocaval and retrocaval lymphadenectomies.
PATIENT CONCERNS
A 73-year old man came to us because he had been experiencing abdominal pain for a year and he had recently developed diabetes mellitus. He was an active smoker with arterial hypertension.
DIAGNOSIS
After a computed tomography scan and 68 Gallium-positron emission tomography, a diagnosis of what appeared to be a primary mesenteric NET with retrocaval and interaortocaval lymph nodes was made. Laparoscopic biopsy showed NET G2 positive for serotonin, chromogranin A, synaptophysin.
INTERVENTIONS
The intraoperative finding of a primitive ileum-NET changed the surgical program. We removed the mesenteric mass with the lymph nodes of the superior mesenteric vessel and the middle distal ileum along with the cecum.
OUTCOMES
The postoperative course was normal, and the patient was discharged on the seventh postoperative day without signs of short bowel syndrome. Follow-up at 6 months revealed no evidence of short bowel syndrome or disease progression.
CONCLUSION
68 Gallium-positron emission tomography does not show NETs smaller than 0.5 mm. Accurate palpation of the intestine is essential during surgery for NETs for two reasons: to find the primitive, and because of the risk of multiple intestinal primitives.
Topics: Aged; Chromogranin A; Humans; Male; Malignant Carcinoid Syndrome; Mesentery; Neuroendocrine Tumors; Short Bowel Syndrome
PubMed: 35713456
DOI: 10.1097/MD.0000000000029464 -
World Journal of Gastroenterology Jun 2008Neurenteric cysts are extremely rare congenital anomalies, often presenting in the first 5 years of life, and are caused by an incomplete separation of the notochord...
Neurenteric cysts are extremely rare congenital anomalies, often presenting in the first 5 years of life, and are caused by an incomplete separation of the notochord from the foregut during the third week of embryogenesis. They are frequently accompanied with spinal or gastrointestinal abnormalities, but the latter may be absent in adults. Although usually located in the thorax, neurenteric cysts may be found along the entire spine. We present a 24-year-old woman admitted for epigastric pain, nausea, vomiting, low grade fever and leucocytosis. She underwent cystgastrostomy for a loculated cyst of the distal pancreas at the age of 4 years, which recurred when she was at the age of 11 years. Ultrasound and computer tomograghy (CT) scan revealed a 16 cm multiply 15 cm cystic mass in the body and tail of pancreas, with a 6-7 mm thickened wall. Laboratory data and chest X-ray were normal and spinal radiographs did not show any structural abnormalities. The patient underwent a complete cyst excision, and after an uneventful recovery, remained symptom-free without recurrence during the 5-year follow-up. The cyst was found to contain 1200 mL of pale viscous fluid. It was covered by a primitive single-layered cuboidal epithelium, along with specialized antral glandular parenchyma and hypoplastic primitive gastric mucosa. Focal glandular groups resembling those of the body of the stomach were also seen. In addition, ciliary respiratory epithelium, foci of squamous metaplasia and mucinous glands were present. The wall of the cyst contained a muscular layer, neuroglial tissue with plexogenic nerve fascicles, Paccini corpuscle-like structures, hyperplastic neuroganglionar elements and occasional psammomatous bodies, as well as fibroblast-like areas of surrounding stroma. Cartilagenous tissue was not found in any part of the cyst. Immunohistochemistry confirmed the presence of neurogenic elements marked by S-100, GFAP, NF and NSE. The gastric epithelium showed mostly CK7 and EMA immunoexpression, and the respiratory epithelium revealed a CK8 and CK18 immunoprofile without CK 10/13 positive elements, though neither CEA or AFP positive cells were found. To our knowledge, this is the first reported case of an abdominally located neurenteric cyst with no associated spinal anomalies.
Topics: Abdomen; Adult; Female; Humans; Immunohistochemistry; Neural Tube Defects; Pancreatic Cyst; Recurrence; Tomography, X-Ray Computed
PubMed: 18595146
DOI: 10.3748/wjg.14.3759 -
Frontiers in Endocrinology 2021There are few studies on non-obese fatty liver disease, the aims of this study was to analyze its prevalence, popular trends, and associated and predictive factors, so...
BACKGROUND AND AIMS
There are few studies on non-obese fatty liver disease, the aims of this study was to analyze its prevalence, popular trends, and associated and predictive factors, so as to provide reference for its prevention and treatment.
METHODS
Individuals with complete data of body mass index, sex, age, and abdominal ultrasound in Karamay Central Hospital from 2009 to 2016 were selected to analyze the prevalence and popular trends of non-obese fatty liver disease (body mass index <24 kg/m), and associated and predictive factors.
RESULTS
Between 2009 and 2016, a total of 191,555 medical check-ups were included. The prevalence of non-obese fatty liver disease increased from 1.9% to 5.1% among general medical examinants (<0.001), increased from 4.6% to 11.7% in non-obese individuals (<0.001). Compared with the non-obese control group, the levels of age, body mass index, blood pressure, fasting blood glucose, triglycerides, total cholesterol and uric acid in the non-obese fatty liver group were higher (<0. 05). Even among non-obese subjects, elevated body mass index was associated with a 0.63-fold increased risk for non-obese fatty liver disease (<0.001, odds ratio=1.63, 95% confidence interval 1.54-1.72) for every one-unit increase in body mass index. The most common abnormal indicator of non-obese fatty liver disease was elevated triglycerides (44.2%), which was also the best predictor of non-obese fatty liver disease (area under the curve =0.795) in non-obese physical examinators.
CONCLUSIONS
The prevalence of non-obese fatty liver disease was high and increasing rapidly in Karamay. Triglycerides is the best predictor of non-obese fatty liver in non-obese physical examinators.
Topics: Abdomen; Adult; Age Factors; Aged; Blood Glucose; Blood Pressure; Body Mass Index; Female; Humans; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Predictive Value of Tests; Prevalence; Sex Factors; Triglycerides; Ultrasonography
PubMed: 34603215
DOI: 10.3389/fendo.2021.744710 -
Journal of Internal Medicine Jan 1997To determine relationship of intra-abdominal pressure to central obesity and the comorbidity of obesity.
OBJECTIVES
To determine relationship of intra-abdominal pressure to central obesity and the comorbidity of obesity.
DESIGN
Non-randomized, prospective.
SETTING
University hospital, operating room.
SUBJECTS
Eighty-four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non-obese patients before colectomy for ulcerative colitis.
MAIN OUTCOME MEASURES
Weight, body mass index (BMI), co-morbid history, sagittal abdominal diameter, waist:hip (W:H) ratio and urinary bladder pressure, as an estimate of intra-abdominal pressure.
RESULTS
Urinary bladder pressure was greater in the obese than the non-obese (18 +/- 0.7 vs. 7 +/- 1.6 cm H2O, P < 0.001), correlated with sagittal abdominal diameter (r = +0.67, P < 0.001) and was greater (P < 0.05) in patients with, than those without, morbidity probably (hypoventilation, gastroesophageal reflux, venous stasis, stress incontinence, incisional hernia) or possibly (hypertension, diabetes) due to increased abdominal pressure. W:H ratio correlated with urinary bladder pressure in men (r = +0.6, P < 0.05) but not women (r = -0.3).
CONCLUSIONS
Increased sagittal abdominal diameter was associated with increased intraabdominal pressure which contributed to obesity-related comorbidity. W:H ratio was not a reliable indicator of intra-abdominal pressure for women who often have both peripheral and central obesity. Further studies are needed to evaluate the relationship between intra-abdominal pressure and Type II diabetes and hypertension.
Topics: Abdomen; Adult; Female; Humans; Male; Obesity, Morbid; Prospective Studies; Urinary Bladder
PubMed: 9042096
DOI: 10.1046/j.1365-2796.1997.89104000.x -
Malawi Medical Journal : the Journal of... Mar 2021Gossypiboma refers to foreign bodies left inside the body during surgery, such as sponges and gauze. These foreign bodies represent a significant cause of morbidity and...
Gossypiboma refers to foreign bodies left inside the body during surgery, such as sponges and gauze. These foreign bodies represent a significant cause of morbidity and mortality. A 57-year-old female presented to us with right upper abdominal pain. Her past history was non-contributory except for an open cholecystectomy 20 years previously. A physical examination revealed tenderness to palpation on the right of the abdomen, while the remaining examination was normal. An abdominal computed tomography (CT) and magnetic resonance imaging (MRI) scan revealed a well-defined calcified mass of 5 cm that was compatible with a mesenteric cyst. During surgery, the mass was found to be adherent to the mesocolon and to have invaded the colon wall. A right hemicolectomy and ileotransverse anastomosis was performed. The pathological mass was considered to be a gossypiboma that had been left behind during the earlier cholecystectomy. The body's reaction to the foreign body was seen to extend beyond the lamina propria and muscularis propria. Gossypiboma is an undesired and life-threatening but preventable surgical complication. This condition may present with non-specific findings and a clinical scenario that mimics various disorders, even after many years. A diagnosis of gossypiboma should be kept in mind for patients with a history of previous operations and undergoing surgery due to the suspicion of a mesenteric cyst.
Topics: Abdomen; Abdominal Pain; Anastomosis, Surgical; Cholecystectomy; Colectomy; Female; Foreign Bodies; Humans; Magnetic Resonance Imaging; Middle Aged; Postoperative Complications; Surgical Sponges; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 34422237
DOI: 10.4314/mmj.v33i1.11