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Abdominal Radiology (New York) Apr 2023Abdominal wall and spinal soft tissue findings are frequently encountered on CT or MR imaging of the abdomen and pelvis. Many of these entities have specific imaging... (Review)
Review
Abdominal wall and spinal soft tissue findings are frequently encountered on CT or MR imaging of the abdomen and pelvis. Many of these entities have specific imaging findings, for which a definitive diagnosis can be made without the need for further work up. These abdominal wall and spinal findings may be diagnostically challenging for sub-specialized abdominal radiologists who are unfamiliar with their appearance and appropriate management. This review article describes and illustrates pathognomonic or characteristic abdominal wall and spinal pathologies, which reside outside the abdominopelvic cavity. The cases selected all have findings that allow a confident diagnosis without further imaging or intervention. The cases presented include myonecrosis, intramuscular abscess, myositis, iliopsoas bursitis, Morel-Lavallée lesion, hydrocele of canal of Nuck, Klippel Trenaunay Weber syndrome, neurofibroma with target sign, perineural cysts, filum terminale lipoma, calvarial bone flap, transverse rectus abdominis muscle (TRAM) flap, liposuction, and hidradenitis suppurativa, among others. Although not all-encompassing, this paper will help abdominal radiologists to accurately diagnose a variety of abdominal and pelvic extra-cavitary soft tissue pathologies by identifying key radiologic findings.
Topics: Male; Humans; Abdominal Wall; Pelvis; Surgical Flaps; Magnetic Resonance Imaging
PubMed: 36790455
DOI: 10.1007/s00261-023-03830-3 -
Ugeskrift For Laeger Aug 2022
Topics: Abdominal Wall; Abdominoplasty; Hernia; Herniorrhaphy; Humans; Plastic Surgery Procedures
PubMed: 35959829
DOI: No ID Found -
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 -
Journal of Reconstructive Microsurgery Jul 2022Abdominal wall vascularized composite allotransplantation (AW-VCA) is a novel reconstructive technique used for large abdominal wall defects in combination with... (Review)
Review
BACKGROUND
Abdominal wall vascularized composite allotransplantation (AW-VCA) is a novel reconstructive technique used for large abdominal wall defects in combination with intestinal transplantation (ITx) or multivisceral abdominal transplantation (MVTx). Since the introduction of this procedure, several studies have been published reporting their experience. This study aims to present a scoping review looking at all available evidence-based medicine information to understand the most current surgical techniques and clinical outcomes.
METHODS
This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) extension for scoping reviews checklist. A comprehensive research strategy of several databases was conducted.
RESULTS
A total of 31 studies were included in this review, which comprised animal, cadaveric, and human studies. In human studies, four surgical techniques with high flap survival rates and low complication rates were found. In cadaveric studies, it was shown that the use of iliofemoral cuff-based flaps provided adequate tissue perfusion to the abdominal wall graft. Also, the use of thoracolumbar nerves have been described to provide functionality to the AW-VCA and prevent long-term muscle atrophy.
CONCLUSION
AW-VCA is a safe and efficient alternative for patients with large and complex abdominal wall defects. The future holds a promising evolution of a functional AW-VCA, though surgeons must face and overcome the challenge of distorted anatomy frequently present in this population. Forthcoming studies with a better level of evidence are required to evaluate functionality and differences between surgical techniques.
Topics: Abdominal Wall; Animals; Cadaver; Graft Rejection; Humans; Plastic Surgery Procedures; Surgical Flaps; Vascularized Composite Allotransplantation
PubMed: 34905782
DOI: 10.1055/s-0041-1740121 -
Medical Ultrasonography Nov 2017Abdominal wall endometriosis (AWE) is a rare condition defined by the presence of endometrial tissue in the subcutaneous fatty layer and the muscles of the abdominal... (Review)
Review
Abdominal wall endometriosis (AWE) is a rare condition defined by the presence of endometrial tissue in the subcutaneous fatty layer and the muscles of the abdominal wall. It is usually caused by the dissemination of endometrial tissue in the wound at the time of obstetrical and gynecological surgeries. AWE is rare and difficult to diagnose. The most frequent clinical presentation is that of a palpable subcutaneous mass near surgical scars associated with cyclic pain and swelling during menses. AWE may be an underreported pathology partly because it has scarcely received attention in the radiologic literature. Its frequency is expected to rise along with the increasing rate of cesarean deliveries; thus, it is important that physicians or sonographers are familiar with this pathology. The purpose of our review is to present the latest data regarding risk factors, clinical and imagisticfindings, and management of AWE.
Topics: Abdominal Wall; Endometriosis; Female; Humans; Magnetic Resonance Imaging; Ultrasonography
PubMed: 29197920
DOI: 10.11152/mu-1248 -
Canadian Association of Radiologists... Feb 2014This article focuses on the cross-sectional imaging spectrum of abnormalities that affect the abdominal wall, with emphasis on magnetic resonance imaging (MRI).... (Review)
Review
This article focuses on the cross-sectional imaging spectrum of abnormalities that affect the abdominal wall, with emphasis on magnetic resonance imaging (MRI). Cross-sectional imaging is valuable for diagnosing and evaluating the extent of abdominal-wall masses. With the increasing use of MRI, it is often possible to reach a diagnosis or narrow the differential diagnosis, thereby guiding effective management. Neoplastic and non-neoplastic pathologies will be illustrated, and the distinctive imaging characteristics of these entities will be highlighted.
Topics: Abdominal Abscess; Abdominal Neoplasms; Abdominal Wall; Contrast Media; Cysticercosis; Diagnosis, Differential; Endometriosis; Fasciitis, Necrotizing; Female; Foreign Bodies; Hematoma; Humans; Image Enhancement; Magnetic Resonance Imaging; Vascular Malformations
PubMed: 22884230
DOI: 10.1016/j.carj.2012.02.001 -
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 -
Ugeskrift For Laeger Mar 2018
Topics: Abdominal Wall; Abdominal Wound Closure Techniques; Humans; Laparotomy; Postoperative Complications; Suture Techniques
PubMed: 29559073
DOI: No ID Found -
Annals of Transplantation Mar 2022Short bowel syndrome is the most common etiology of intestinal failure, resulting from either resections of different intestinal segments or a congenital condition. Due...
Short bowel syndrome is the most common etiology of intestinal failure, resulting from either resections of different intestinal segments or a congenital condition. Due to the absence or considerable reduction of intestinal loops in the abdominal cavity, patients with short bowel syndrome present with atrophy and muscle retraction of the abdominal wall, which leads to loss of abdominal domain and elasticity. This complication is an aggravating factor of intestinal transplantation since it can prevent the primary closure of the abdominal wall. A vast array of surgical techniques to overcome the challenges of the complexity of the abdominal wall have been described in the literature. The aim of our study was to review the modalities of abdominal wall closure in intestinal/multivisceral transplantation. Our study consisted of a systematic review following the methodological instructions described in the PRISMA guidelines. Duplicate studies and studies that did not meet the criteria for the systematic review were excluded, especially those without relevance and an explicit relationship with the investigated theme. After this step, 63 articles were included in our study. The results obtained with these techniques have been encouraging, but a high incidence of wound complications in some reports has raised concerns. There is no consensus among transplantation centers regarding which technique would be ideal and with higher success rates and lower rates of complications.
Topics: Humans; Abdominal Wall; Incidence; Intestines; Organ Transplantation; Wound Closure Techniques
PubMed: 35228508
DOI: 10.12659/AOT.934595 -
Canadian Association of Radiologists... Nov 2013
Review
Topics: Abdominal Injuries; Abdominal Wall; Female; Groin; Humans; Male; Musculoskeletal Diseases; Ultrasonography
PubMed: 23103240
DOI: 10.1016/j.carj.2012.07.001