1/11. Strangulated umbilical hernia in a child: report of a case.Most umbilical hernias in children close spontaneously. Complications associated with umbilical hernias are rarely observed during follow-up. We report herein a 5-month-old girl with a strangulated umbilical hernia. Her umbilicus was hard, reddish, and irreducible. Plain radiography of the abdomen showed signs of mechanical ileus. The patient was thus diagnosed to have a strangulated umbilical hernia. A 5-cm section of the ascending colon and a 5-cm section of the terminal ileum, as well as the cecum and appendix, were congested, edematous, and erythematous, and together were enclosed by a firm hernial ring. A closure of the fascial defect and umbilicoplasty were performed. The postoperative course was uneventful. In patients with infantile umbilical hernias, strangulation may occur as the fascial defect decreases in size.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
2/11. Omental herniation through a 3-mm umbilical trocar site: unmasking a hidden umbilical hernia.BACKGROUND: The incidence of umbilical hernia following laparoscopic surgery varies from 0.02-3.6%. The incidence of pre-existing fascial defects, however, may be as high as 18% in patients undergoing abdominal laparoscopic surgery. Previous recommendations have been made to close any fascial defect greater than or equal to 10 mm. Reported here is a case of herniation through a 3-mm trocar site incision and the discovery of a pre-existing fascial defect. CASE REPORT: A 32-year-old female underwent an uncomplicated laparoscopic tubal ligation using a 3-mm umbilical port. Prior to umbilical trocar removal at the completion of the case, the carbon dioxide was evacuated from the abdomen and the sleeve was withdrawn under direct vision. Neither the fascial nor skin incisions were sutured. On postoperative day two, the patient returned with omentum herniating from the 3-mm site. At surgery, a 1.5-cm pre-existing fascial defect was discovered adjacent to the trocar site. The hernia sac tracked laterally to the base of the umbilicus, and the omentum had slid into the sac and out the skin opening. CONCLUSION: As this report illustrates, herniation associated with laparoscopic trocar sites can occur with incisions as small as 3 mm. The presence of pre-existing fascial defects can cause increased morbidity in any laparoscopic surgery, and as illustrated in this report, may predispose the patient to site herniation. The detection and management of these defects is crucial in preventing postlaparoscopic complications.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
3/11. Congenital defect in the abdominal wall in an adult: a case report.We describe a rare case of a woman aged 38 who presented with an untreated omphalocele in association with a duplication of the vena cava and malposition of the right kidney. An aesthetic and functional reconstruction of the abdomen was achieved with local flaps and the creation of a neoumbilicus.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
4/11. Management of neglected giant omphalocele with Gore-tex in a child aged 8 years.Omphalocele is a disease of neonatal age and its present management is successful in almost all specialized centers of Pediatric Surgery. A case of an 8-year-old girl who was managed with conservative treatment during her neonatal period with mercurochrome (Grob method) is presented. Due to very serious congenital cardiopathy, a corrective operative procedure of the omphalocele was not feasible during neonatal age. However, following successful heart surgery the child grew up with her initial disorder. The child was first seen in our clinic at the age of 5 years, presenting with a very large omphalocele. Following a staged pressure of the abdomen with a special belt an attempt was made to close the ventral hernia successfully using a Gore-tex sheet.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
5/11. Strangulated umbilical hernia including a mesenteric cyst: a rare cause of acute abdomen.Mesenteric cysts are rare intra-abdominal lesions. They are usually diagnosed as an incidental laparotomy finding in adults but in childhood, they may present with acute abdomen. In this report, a 72-year old female was referred to our hospital, suffering from acute abdominal pain, several episodes of nausea and vomiting. Clinical abdominal examination revealed an irreducible recurrent umbilical hernia. The patient had both muscular defense and abdominal tenderness. Plain abdominal radiography showed multiple air-fluid levels. With these findings, a diagnosis of acute abdominal pathology was accepted and an urgent laparotomy was performed. A 5-cm-diameter mesenteric cyst was excised from the mesentery of the proximal jejunum and a prosthetic mesh was placed for incisional hernia. This is the first report of a strangulated umbilical hernia complicated with a mesenteric cyst.- - - - - - - - - - ranking = 5keywords = abdomen (Clic here for more details about this article) |
6/11. Acardiac twin with externalized intestine adherent to placenta: unusual manifestation of omphalocele.TRAP (twin reversed arterial perfusion) syndrome produces an acardiac twin (acardiac monster, acardius, acardiacus, chorioangiopagus parasiticus, etc.). Acardiacs result from monozygotic multiple births in which three anatomic anomalies occur: (1) a fetus' cardiac development is disturbed; (2) artery-artery anastomosis carries blood from a normal ("pump") twin to the acardiac; (3) vein-vein anastomosis carries blood from the acardiac back to the normal twin. Whether reversal of blood flow in the acardiac results from or causes cardiac dysmorphogenesis has not been resolved. Acardiac twins demonstrate a complex constellation of malformations usually thought to result from reversed blood flow; omphalocele is particularly common. We report monochorionic monoamnionic male twins in which an acardiac twin demonstrated externalized intestines adherent to the placenta. The twins were delivered from a 30-year-old primigravida mother by cesarean section without maternal complications at 33 w. The mother has no significant past medical history. The macerated acardius had a 4-cm long attenuated umbilical cord with indeterminate number of vessels. Structures rostral to the thorax were absent save for one poorly developed hand and arm. The abdomen contained loose mesenchyme and no organs. The entire intestine (21 cm) along with two testes was located in a sac on the surface of the placenta. No histopathologic anomalies of formed structures were identified aside from spatial relationships and incomplete development. The normal twin required no intensive care and is doing well. To our knowledge, this is the first report of externalized intestine, which may represent an unusual consequence of omphalocele.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
7/11. Management of giant omphalocele with rapid creation of abdominal domain.BACKGROUND: The management of giant omphaloceles (GO) can be quite difficult when there is absence of abdominal domain. Coverage with delayed closure has been described. We present a technique to create an adequate peritoneal domain. methods: This is a retrospective review of our experience using an intraperitoneal tissue expander (IPTE) to create adequate abdominal domain in 2 patients with GO. RESULTS: In 2 children with unrepaired GO, an IPTE was placed into the pelvis and was inflated to the target volume over 3 to 4 weeks. At the definitive operation for the closure of the abdominal defect, the IPTE was removed, allowing reduction of all the viscera into the peritoneal cavity and achieving complete abdominal wall closure. The patients are now 1 year postoperative, each having a normal abdomen and enjoying normal growth and development. CONCLUSION: Intraperitoneal tissue expander placement can create the needed domain over several weeks in GO. Its use in 2 cases was associated with satisfactory complete abdominal wall closure in short order. This technique should be considered as a treatment option.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
8/11. medulloblastoma in infancy associated with omphalocele, malrotation of the intestine, and extrophy of the bladder.A successfully treated case of infantile medulloblastoma is presented that was associated with omphalocele, malrotation of the intestine, and extrophy of the bladder. A 5-month-old boy was admitted due to disturbance of consciousness and was diagnosed by computed tomography as having a medulloblastoma. Ventricular drainage, subduralperitoneal shunt, and removal of the tumor were performed, and postoperatively radiation therapy was administrated with 4,000 rad to the whole brain. He was discharged in good condition and no evidence of recurrence was observed at the 14th post-operative month. Medulloblastomas associated with congenital anomaly of the abdomen have been only rarely reported. The authors postulate that between the second and third month of gestation an intrinsic or extrinsic factor may have caused the development of the medulloblastoma, as well as anomalies of the abdomen such as omphalocele, malrotation of the intestine, and extrophy of the bladder.- - - - - - - - - - ranking = 2keywords = abdomen (Clic here for more details about this article) |
9/11. Pseudoomphalocele: pitfall in fetal sonography.Compression of the fetal abdomen between the walls of the uterus or placenta can result in an appearance that mimics that of omphalocele on sonography. This may be caused by oligohydramnios or by a transient compression of the fetal abdomen with a normal amount of amniotic fluid. Four cases of pseudoomphalocele and one case of true omphalocele are presented.- - - - - - - - - - ranking = 2keywords = abdomen (Clic here for more details about this article) |
10/11. Fetal anterior abdominal wall herniations: ultrasonographic diagnosis.gastroschisis and omphalocele are congenital abdominal wall herniations. Both are characterized by evisceratin of bowel loops, and additionally, especially in omphalocele, liver and occasionally other organs. The bowel loops present ultrasonographically as cystic masses in relation to the fetal abdomen. Sometimes the walls are thickened due to the inflammation from exposure to amniotic fluid. Ultrasonographic identification of herniated liver (omphalocele) indicates potential complex abnormalities of other organ systems, as opposed to gastroschisis, which is usually an isolated abnormality. The two entities are frequently difficult to distinguish ultrasonographically, and in fact, the surgical treatment is the same for both entities. early diagnosis will facilitate team planning, and probable cesarean section to avoid damage to exposed bowel loops. A case of gastroschisis and 2 cases omphalocele are presented.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
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