Preoperative Computed Tomographic Angiogram Measurement of Abdominal Muscles Is a Valuable Risk Assessment for Bulge Formation after Microsurgical Abdominal Free Flap Breast Reconstruction
Background: A major shortcoming associated with abdominal tissue breast reconstruction is long-term abdominal wall morbidity. Although abdominal muscle size on computed tomographic angiography has been correlated with morbidity following many abdominal operations, it has not been studied for breast reconstruction. Therefore, the authors evaluated the association between preoperative computed tomography angiography–derived measurements of abdominal core muscles and postoperative abdominal wall morbidity after abdominal tissue breast reconstruction. Methods: In this retrospective matched case-control study of women who underwent microsurgical abdominal flap breast reconstruction at one institution between January 2011 and June 2015, the authors evaluated all cases of postoperative bulge/hernia, matched by type of abdominal flap and body mass index in a ratio of 1:2 to controls without bulge/hernia. The authors obtained morphometric measurements of abdominal core muscles on preoperative computed tomographic angiographs. Using univariable and multivariable logistic regressions, the authors examined the effects of clinical risk factors and computed tomographic angiography morphometric measurements on postoperative bulge/hernia formation. Results: Of the 589 patients who underwent abdominal free flap breast reconstruction, symptomatic bulges/hernias were identified in 35 patients (5.9 percent). When compared to the 70 matched controls, multivariable analysis showed that dec...
CONCLUSIONS: Angiomyxoma is a rare, benign and locally aggressive tumor, which can infiltrate locally and present unusually as perineal hernia. Due to its rarity and lack of specific diagnostic requirements, it's difficult to diagnose preoperatively KEY WORDS: Angiomyxoma, Obturator hernia, Pelvic mass. PMID: 31723050 [PubMed - in process]
Groin hernia repair is the most common elective operation performed worldwide with over 20 million operations per year. The rate of hernia surgery varies from 10 per 10000 people in the United Kingdom to 28 per 10000 people in the United States. Around 5% –15% of hernia patients have incarceration, of which approximately 15% of cases may evolve into bowel necrosis requiring bowel resection. Patients with bowel necrosis have a significantly longer hospitalization and a higher postoperative complications, which varied from 6% to 43%[4–7], with a mortality rate of 1%–7%[4,6].
We report a series of seven patients who presented with anterior vaginal wall “mass” or bulge after cystectomy and were found on magnetic resonance defecography (MRD) to have enteroceles or sigmoidoceles in the anterior rather than posterior compartment. MRD was instrumental for diagnoses in these patients and to exclude local recurrence of bladder malignancy. We also report five additional patients that were found to have bowel herniation anterior to the vaginal apex, but without history of cystectomy.
CONCLUSIONS: Considering the severity of this condition, accurate diagnosis and timely surgical treatment is mandatory to reducing morbidity and mortality. KEY WORDS: Bochdalek hernia, Gastric volvulus. PMID: 31702578 [PubMed - in process]
Conclusion Inguinal herniation of the transplant ureter leading to ureteral obstruction is a rare, probably underreported, cause graft of dysfunction. Therefore, we advocate elective repair of inguinal or incisional hernias in renal transplant recipients. PMID: 31690216 [PubMed - as supplied by publisher]
ABSTRACT The anti-M üllerian hormone triggers the regression of uterus and fallopian tubes in male embryos; if there are problems in the synthesis or action of this protein, Müllerian structures persist in an otherwise phenotypic male. The most frequent clinical presentation of Persistent Mullerian Duct syndrome is c ryptorchidism and inguinal hernia. The few cases reported in adults are incidental findings or inguinal hernias. However, we present an adult male with history of bilateral cryptorchidism with unsuccessful orchidopexy, who presents with a large abdominal mass with the finding of a seminomatous tumor ...
CONCLUSIONS: Ovarian inguinal hernias should be considered among the differential diagnoses of a groin mass or swelling. In women of reproductive age, repair of the hernia with the intent to preserve fertility is of critical importance. PMID: 31696731 [PubMed - as supplied by publisher]
Abstract Patients with inflammatory bowel disease (IBD) will often require abdominal surgical intervention for indications not directly related to their IBD. Because these patients often have a history of multiple previous abdominal operations and/or ostomies, they are at increased risk for incisional and parastomal hernias. They may also have develop symptomatic cholelithiasis, chronic pain, or desmoid disease. All of these potentially surgical issues may require special consideration in the IBD population. PMID: 31676055 [PubMed - in process]
Conditions: Ventral Hernia; Umbilical Hernia; Epigastric Hernia Intervention: Procedure: Ventral Hernia Repair Sponsor: The Cleveland Clinic Recruiting
Conclusions: Using a novel approach, we provide details of the esophageal hiatus in patients with various kinds of hiatal hernia. Impaired LES relaxation in paraesophageal hernia may play a role in its pathophysiology and genesis of symptoms. PMID: 31677612 [PubMed - as supplied by publisher]