Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 574
Filter
1.
Rev. colomb. cir ; 37(3): 505-510, junio 14, 2022. fig
Article in Spanish | LILACS | ID: biblio-1378847

ABSTRACT

Introducción. La úlcera duodenal perforada es una entidad de etiología no clara que rara vez ocurre en la población pediátrica. Generalmente se diagnostica de manera intraoperatoria y el tratamiento ideal incluye el uso del parche de epiplón o de ser necesario, la resección quirúrgica. Caso clínico. Se presenta un paciente de 12 años con abdomen agudo y diagnóstico tomográfico prequirúrgico de úlcera duodenal perforada, tratado por vía laparoscópica con drenaje de peritonitis y parche de Graham. La evolución y el seguimiento posterior fueron adecuados. Discusión. La úlcera duodenal perforada es una entidad multifactorial, en la que se ha implicado el Helicobacter pylori. El diagnóstico preoperatorio es un reto y el tratamiento debe ser quirúrgico. Conclusiones. Cuando se logra establecer el diagnóstico preoperatorio, se puede realizar un abordaje laparoscópico y el uso del parche de Graham cuando las úlceras son menores de dos centímetros.


Introduction. Perforated duodenal ulcer is an entity of unclear etiology that rarely occurs in the pediatric population. It is usually diagnosed intraoperatively and the ideal treatment includes the use of the omentum patch or, if necessary, surgical resection. Clinical case. A 12-year-old patient with acute abdomen and preoperative tomographic diagnosis of perforated duodenal ulcer, treated laparoscopically with peritonitis drainage and Graham patch is presented. The evolution and subsequent follow-up were adequate. Discussion. Perforated duodenal ulcer is a multifactorial entity, in which Helicobacter pylori has been implicated. Preoperative diagnosis is challenging and treatment must be surgical. Conclusions. When the preoperative diagnosis is established, a laparoscopic approach and the use of the Graham patch can be performed when the ulcers are less than two centimeters.


Subject(s)
Humans , Duodenal Ulcer , Intestinal Perforation , Omentum , Helicobacter pylori , Laparoscopy
2.
Einstein (Säo Paulo) ; 20: eRC5584, 2022. graf
Article in English | LILACS | ID: biblio-1360405

ABSTRACT

ABSTRACT A 2-year-old female patient, admitted in the emergency room, presented diarrhea for 5 days and bloody stools in the last 24 hours. Physical examination revealed no significant findings. Ultrasound was initially performed, showing an elongated, well delimited and solid mass occupying since right hypocondrium until left iliac fossa, displacing adjacent structures. In sequence, magnetic resonance imaging was performed for confirmation of findings suggestive of omentum lipoma. After 1 week, the surgical resection was performed by videolaparoscopic acess. During 2-year follow-up, there was no sign of recurrence.


Subject(s)
Humans , Female , Child, Preschool , Child , Omentum/surgery , Omentum/diagnostic imaging , Lipoma/surgery , Lipoma/diagnostic imaging , Magnetic Resonance Imaging , Ultrasonography
3.
Arq. bras. med. vet. zootec. (Online) ; 73(2): 423-430, Mar.-Apr. 2021. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1248942

ABSTRACT

Non-strangulated acquired hernias in stallions are rare, especially when the herniated content is not intestinal loops. Thus, the aim of the current study is to describe a case of acquired non-strangulated inguinoscrotal hernia in a stallion, whose herniated content was the omentum. The patient was a Criollo stallion with history of rhabdomyolysis, laminitis and bilateral scrotal volume increase observed in the left scrotal region. The animal presented pain in both thoracic limbs, abnormal blood test, especially hypoproteinemia, and mild pain during palpation in the left inguinal ring region. Hydrocele secondary to hypoproteinemia was suspected. After admission, the animal showed signs of acute abdomen, which were clinically reversed. With this, the animal was subjected to ultrasound examination of the scrotal region, whose findings suggested non-strangulated inguinal hernia, although the content could not be identified. Surgical treatment was chosen in order to identify the herniated content and remove the left testicle. Access to the affected scrotum was performed, in which the presence of fluid and a portion of the omentum was observed surrounding the testis and adhering to it. The animal was discharged after he recovered from the surgery and from laminitis. During the breeding season, the stallion remained with a herd of mares for natural mating. After 15 months of surgery, the animal was reassessed and showed no active signs of inflammatory and degenerative processes in the remaining testis. On this occasion, a pregnancy diagnosis was also performed, and all the mares were pregnant. It is concluded that the presence of omentum as a herniated content does not represent a surgical emergency but can make the reproductive prognosis reserved. In addition, removal of the affected testicle can benefit the spermatogenesis of the remaining testicle.(AU)


As hérnias adquiridas não estranguladas em garanhões são raras, principalmente quando o conteúdo herniado não é de alças intestinais. Assim, o objetivo deste trabalho foi descrever um caso de hérnia inguino escrotal adquirida e não estrangulada em garanhão, cujo conteúdo herniado era composto pelo omento. Foi atendido um garanhão da raça Crioula com histórico de rabdomiólise, laminite e aumento de volume escrotal bilateral, evidenciado na região escrotal esquerda. O animal apresentava dor nos membros torácicos, alterações na avaliação sanguínea, destacando-se a hipoproteinemia, e demonstrava dor leve à palpação na região do anel inguinal esquerdo. Suspeitou-se de hidrocele secundária a hipoproteinemia. Após a internação, o animal apresentou sinais de abdômen agudo, revertidos clinicamente. Com isso, realizou-se ultrassonografia da região escrotal, cujos achados sugeriram hérnia inguinal não estrangulada, sem que o conteúdo pudesse ser identificado. Optou-se pelo tratamento cirúrgico, com o intuito de identificação do conteúdo herniado e remoção do testículo esquerdo. Foi realizado acesso à bolsa escrotal afetada, na qual se observou presença de líquido e de uma porção do omento envolvendo o testículo e aderido a ele. O animal recebeu alta após restabelecimento da cirurgia e da laminite. Na propriedade, durante temporada reprodutiva, o garanhão permaneceu com uma manada de éguas para realização de monta natural. Passados 15 meses da cirurgia, o animal foi reavaliado e não demonstrou sinais ativos de processo inflamatório e degenerativos no testículo remanescente. Nessa ocasião, também foi realizado diagnóstico de gestação e todas as éguas encontravam-se prenhes. Conclui-se que a presença de omento como conteúdo herniado não representa uma emergência cirúrgica, mas pode tornar o prognóstico reprodutivo reservado. Ainda, a remoção do testículo afetado pode trazer benefícios à espermatogênese do remanescente.(AU)


Subject(s)
Animals , Male , Scrotum/surgery , Testis/surgery , Hernia, Inguinal/veterinary , Horses , Omentum
4.
Rev. bras. ciênc. vet ; 28(1): 20-22, jan./mar. 2021. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1368347

ABSTRACT

Hérnia é uma protrusão de vísceras através de um orifício adquirido, tendo como constituintes o anel, conteúdo e saco herniário. As hérnias escrotais ocorrem quando, por algum defeito no anel inguinal, alguma víscera se desloca por ele, chegando até a bolsa escrotal. Sua etiologia não é completamenteelucidada, sendo a elevação da pressão intra-abdominal um dos prováveis desencadeadores. Em caninos, essa é uma condição rara e os poucos relatos citam em animais jovens. Objetivou-se descrever a ocorrência de uma hérnia escrotal unilateral esquerda com protrusão de omento maior em um cão da raça Dachshund com 14 anos de idade e com 12,1 kg de peso corporal. Para a redução do conteúdo à cavidade abdominal, foi necessária a realização de incisão na região inguinal cranial, abertura do saco herniário e a orquiectomia. Destaca-se a importância do tratamento cirúrgico da hérnia escrotal, bem como a inclusão dessa afecção no diagnóstico diferencial para afecções testiculares de cães adultos ou idosos.


Hernia is a protrusion of viscera through an acquired orifice, having as constituents the ring, contents and hernial sac. Scrotal hernias occur when, due to a defect in the inguinal ring, some viscera travel through it, reaching the scrotum. Its etiology is not completely elucidated, and the increase in intra-abdominal pressure is one of the probable triggers. In canines, this is a rare condition and the few reports mention it in young animals. The objective was to describe the occurrence of a left unilateral scrotal hernia with protrusion of the greater omentum in a 14-year-old Dachshund dog weighing 12.1 kg of body weight. To reduce the content of the abdominal cavity, it was necessary to make an incision in the cranial inguinal region, open the hernial sac and orchiectomy. The importance of surgical treatment of scrotal hernia is highlighted, as well as the inclusion of this condition in the differential diagnosis for testicular disorders of adult or elderly dogs.


Subject(s)
Animals , Dogs , Testis/surgery , Dogs/surgery , Hernia/veterinary , Omentum/surgery , Herniorrhaphy/veterinary , Inguinal Canal/surgery
5.
Acta Physiologica Sinica ; (6): 175-180, 2021.
Article in English | WPRIM | ID: wpr-878246

ABSTRACT

The great omentum is an intraperitoneal organ and plays an important role in protecting the environment of the peritoneal cavity. Several specialized innate immune cells including B1 cells and resident macrophages are found in the omentum, which may be attributed to the unique niche and its special stromal cells. However, it is not clear how these omental innate immune cells contribute to the peritoneal immunity. This review attempts to summarize the latest research on the omental innate immunity and discuss its involvement in the immune response of the peritoneal cavity.


Subject(s)
Immunity, Innate , Macrophages , Omentum , Peritoneal Cavity , Stromal Cells
6.
Arq. bras. med. vet. zootec. (Online) ; 72(6): 2259-2265, Nov.-Dec. 2020. ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1142302

ABSTRACT

A osteomielite é um desafio terapêutico em ortopedia, capaz de retardar ou mesmo impedir a consolidação óssea. O omento, há anos, tem sido empregado como alternativa em diferentes procedimentos cirúrgicos, por sua capacidade, entre outras, de angiogênese, sendo aplicado na ortopedia veterinária quando há o risco de não união óssea. Neste caso, um cão Fila Brasileiro foi submetido à realização de enxerto com retalho pediculado de omento maior, após osteomielite resistente presente em osteossíntese de fratura múltipla de tíbia aberta grau II. Durante 16 dias, manteve-se a comunicação do retalho, mas, diante do risco de peritonite, o pedículo foi seccionado. Numa sequência de intervenções cirúrgicas, após 89 dias, houve cicatrização óssea e remissão da osteomielite, mesmo na presença de bactérias multirresistentes. Neste relato, o omento foi efetivo como terapia adjuvante no tratamento da osteomielite e garantiu o retorno da função do membro.(AU)


Osteomyelitis is a therapeutic challenge in orthopedics, capable of delaying or even preventing bone healing. The omentum has been used in different surgical procedures as an alternative for its capacity, among others, of angiogenesis, being applied in veterinary orthopedics, when there is a risk of non-union of bone. In this case, a Brazilian row dog was submitted to grafting with pedicle flap of greater omentum, after resistant osteomyelitis present in open fracture osteosynthesis of open tibia grade II. For 16 days the communication of the flap was maintained, but at the risk of peritonitis, the pedicle was sectioned. In a sequence of surgical interventions, after 89 days, there was bone healing and remission of osteomyelitis, even in the presence of multi-resistant bacteria. In this report, the omentum was effective as adjuvant therapy in the treatment of osteomyelitis and guaranteed the return of limb function.(AU)


Subject(s)
Animals , Dogs , Omentum/transplantation , Osteomyelitis/therapy , Osteomyelitis/veterinary , Tibia/pathology , Pedicle Screws/veterinary
8.
Arq. bras. med. vet. zootec. (Online) ; 72(1): 87-92, Jan.-Feb. 2020. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1088928

ABSTRACT

Chronic septic bone nonunion requires a well-designed therapeutic planning, demanding a multimodal treatment to achieve bone consolidation and elimination of infection. A successful case of an association of the major omentum flap with surgical stabilization with an interlocking nail for treatment of a femoral septic nonunion in dog is reported. The patient had partial functional return of the limb 30 days after surgery, negative bacterial culture with radiographic signs of bone healing and total functional return of the limb at 90th days after the surgical procedure.(AU)


Não uniões ósseas associadas à osteomielite crônica necessitam de um planejamento terapêutico muito bem realizado, demandando tratamento multimodal para conseguir atingir a consolidação óssea e eliminar a infecção. Relatou-se um caso de sucesso do uso da associação de retalho do omento maior com estabilização cirúrgica com haste intramedular bloqueada para tratamento de uma não união séptica de fêmur em cão. O paciente apresentou retorno funcional parcial do membro com 30 dias após a cirurgia, cultura bacteriana estéril com sinais radiográficos de consolidação óssea e retorno funcional total do membro aos 90 dias de pós-operatório.(AU)


Subject(s)
Animals , Dogs , Omentum/transplantation , Osteomyelitis/veterinary , Transplantation, Autologous/veterinary , Fracture Fixation, Intramedullary
9.
Rev. colomb. cir ; 35(4): 689-694, 2020. fig
Article in Spanish | LILACS | ID: biblio-1147986

ABSTRACT

Introducción. Los teratomas son masas de células totipotenciales, frecuentes en los ovarios o testículos. Su localización extragonadal es rara, siendo el epiplón aún más infrecuente. Hasta la actualidad se conocen aproximadamente 34 casos similares en la literatura. Presentación del caso. Se presenta una paciente de 61 años, con dolor en hemiabdomen inferior asociado a sensación de masa, con marcadores tumorales negativos e imágenes diagnósticas que muestran una masa encapsulada y calcificación anular interna sugestiva de necrosis grasa antigua versus tumor desmoide. Por la presentación clínica y los hallazgos imagenológicos se decide llevar a laparotomía exploratoria donde se encuentra masa quística dependiente de epiplón, con material sebáceo en su interior entremezclado con pelo y fragmentos óseos, que se reseca en bloque sin complicaciones. El informe del estudio histopatológico finalmente concluyó la presencia de un teratoma quístico maduro con cambios degenerativos. Por evolución satisfactoria se da egreso hospitalario. Discusión. El teratoma quístico extragonadal del epiplón es exótico en la literatura mundial, con escasos reportes de casos. En este caso, la resección mediante laparotomía resultó exitosa y sin complicaciones. Por su baja incidencia, la laparotomía ha sido una opción válida y segura para el manejo, no obstante conocer el caso permite plantear un abordaje con técnicas mínimamente invasivas


Introduction. Teratomas are totipotential cell masses, commonly located in the ovaries or testes. Its extragonadal location is rare, in the omentum being even rarer. To date, approximately 34 similar cases are known in the literature.Case presentation. A 61-year-old female patient is presented, with pain in the lower abdomen associated with a sensation of mass, with negative tumor markers and diagnostic images that show an encapsulated mass and internal annular calcification suggestive of old fat necrosis versus desmoid tumor. Due to the clinical presentation and the imaging findings, it was decided to carry out exploratory laparotomy where a cystic mass dependent on the omentum was found, with sebaceous material intermixed with hair and bone fragments, which was resected in bloc without complications. The histopathological study report finally concluded the presence of a mature cystic teratoma with degenerative changes. Due to satisfactory evolution, he was dis-charged from hospital.Discusion. Extragonadal cystic teratoma of the omentum is exotic in the world literature, with few case reports. In this case, the laparotomy resection was successful and uncomplicated. Due to its low incidence, laparotomy has been a valid and safe option for management, although knowing the case allows us to propose an approach with minimally invasive techniques


Subject(s)
Humans , Teratoma , Omentum , Dermoid Cyst , Abdominal Neoplasms
10.
Rev. méd. Urug ; 36(3): 322-324, 2020. graf
Article in Spanish | LILACS, BNUY | ID: biblio-1127111

ABSTRACT

Resumen: Introducción: el infarto segmentario idiopático de epiplón mayor es una excepcional causa de cuadro agudo de abdomen en el adulto. Caso clínico: se presenta el caso de un adulto joven que se operó de urgencia con diagnóstico de apendicitis aguda y el abordo por vía laparoscópica, comprobándose en la exploración un infarto segmentario de epiplón mayor que se resolvió mediante la omentectomía parcial con buena evolución y alta precoz. Discusión: si bien el diagnóstico imagenológico de infarto de epiplón mayor es posible dada su baja incidencia y las características de presentación clínica, su diagnóstico habitualmente es intraoperatorio. Su tratamiento es la omentectomía laparoscópica del sector afectado. Con diagnóstico preoperatorio, puede admitirse una conducta expectante, aunque la persistencia de la sintomatología es causa de reingreso y prolongación del tratamiento definitivo.


Summary: Introduction: idiopathic segmental infarction of the greater omentum constitutes an exceptional cause of an acute condition in adults. Clinical case: study presents the clinical case of a young adult who underwent an emergency laparoscopic appendectomy for the treamtent of acute apenditicis. The exploration revealed a segmental infarction of the greater omentum that was resolved by partial omentectomy. Evolution was good and the patient was allowed an early discharge. Discussion: despite the fact an image diagnosis of infarction of the greater omentum is possible, its low incidence and the characteristics of its clinical presentation result in it usually being diagnosed during surgery. Treatment consists in laparoscopic omentenctomy of the affected area. Preoperative diagnosis may allow for watchful waiting, although persistence of symptoms requires readmission to hospital and extension of the definitive treatment.


Resumo: Introdução: o infarto segmentar idiopático do grande omento é uma causa excepcional de quadro agudo de abdômen no adulto. Caso clínico: apresenta-se um caso clínico de um adulto jovem operado de urgência por via laparoscópica com diagnóstico de apendicite aguda comprovando-se na exploração um infarto segmentar de grande omento solucionado por uma omentectomia parcial com boa evolução e alta precoce. Discussão: embora o diagnóstico por técnicas de imagem de infarto do grande omento seja possível, seu diagnóstico habitualmente es intraoperatório devido à sua baja incidência e as características da apresentação clínica. O tratamento é a omentectomia laparoscópica do segmento afetado. Com diagnóstico pré-operatório, pode-se admitir uma conduta expectante, embora a persistência de sintomatologia é causa de re-internação e prolongamento do tratamento definitivo.


Subject(s)
Male , Adult , Omentum/surgery , Infarction , Laparoscopy , Abdomen, Acute
11.
ABCD arq. bras. cir. dig ; 32(1): e1425, 2019. tab, graf
Article in English | LILACS | ID: biblio-983674

ABSTRACT

ABSTRACT Background: Traditionally, total omentectomy is performed along with gastric resection and extended lymphadenectomy in gastric cancer (GC) surgery. However, solid evidences regarding its oncologic benefit is still scarce. Aim: To evaluate the incidence of metastatic omental lymph nodes (LN) in patients undergoing curative gastrectomy for GC, as well as its risk factors and patients' outcomes. Methods: All consecutive patients submitted to D2/modified D2 gastrectomy due to gastric adenocarcinoma from March 2009 to April 2016 were retrospectively reviewed from a prospective collected database. Results: Of 284 patients included, five (1.8%) patients had metastatic omental LN (one: pT3N3bM0; two: pT4aN3bM0; one: pT4aN2M0 and one pT4bN3bM0). Four of them deceased and one was under palliative chemotherapy due relapse. LN metastases in the greater omentum significantly correlated with tumor's size (p=0.018), N stage (p<0.001), clinical stage (p=0.022), venous invasion growth (p=0.003), recurrence (p=0.006), site of recurrence (peritoneum: p=0.008; liver: p=0.023; ovary: p=0.035) and death (p=0.008). Conclusion: The incidence of metastatic omental LN of patients undergoing radical gastrectomy due to GC is extremely low. Total omentectomy may be avoided in tumors smaller than 5.25 cm and T1/T2 tumors. However, the presence of lymph node metastases in the greater omentum is associated with recurrence in the peritoneum, liver, ovary and death.


RESUMO Racional: Tradicionalmente a omentectomia total é realizada juntamente com a ressecção gástrica associada à linfadenectomia na cirurgia do câncer gástrico. No entanto, evidências sólidas em relação ao seu benefício oncológico são escassas . Objetivo: Avaliar a incidência de metástases em linfonodos do omento maior em pacientes submetidos à gastrectomia potencialmente curativa por câncer gástrico, assim como, avaliar os fatores de risco para a ocorrência e a evolução dos pacientes. Métodos: Pacientes consecutivos submetidos à gastrectomia D2/D2 modificada devido ao adenocarcinoma gástrico foram analisados retrospectivamente a partir de um banco de dados. Resultados: Dos 284 pacientes, cinco (1,8%) tinham linfonodos metastáticos no omento maior (um pT3N3bM0; dois pT4aN3bM0; um pT4aN2M0 e um pT4bN3bM0). Quatro faleceram e um estava em tratamento paliativo com quimioterapia devido à recidiva da doença. Os linfonodos metastáticos no omento maior tiveram correlação significativa com o tamanho do tumor (p=0,018), estádio N (p<0,001), estádio clínico (p=0,022), invasão venosa (p=0,003), recorrência (p=0,006), local de recorrência (peritônio p=0,008; fígado p=0,023; ovário p=0,035) e óbito (p=0,008). Conclusão: A incidência de linfonodos metastático no omento maior de pacientes submetidos à gastrectomia radical por câncer gástrico é baixa. A omentectomia total pode ser evitada em tumores menores que 5,25 cm e estádios T1/T2. Entretanto, a presença de metástases linfonodais no omento maior está associada à recidiva no peritônio, fígado, ovário e óbito.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Omentum/pathology , Stomach Neoplasms/surgery , Lymphatic Metastasis/pathology , Stomach Neoplasms/pathology , Retrospective Studies , Risk Factors , Gastrectomy , Neoplasm Staging
12.
Clinical Endoscopy ; : 283-287, 2019.
Article in English | WPRIM | ID: wpr-763428

ABSTRACT

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, primarily arising from the stomach. With the widespread utilization of and technical advancements in endoscopy, gastric GISTs are being increasingly detected at an early stage, enabling complete endoscopic resection. Endoscopic full-thickness resection (EFTR) is an advanced technique that has been recognized as a treatment tool for neoplasms in the digestive tract in selected patients. Although a number of methods are available, closing large iatrogenic defects after EFTR can be a concern in clinical practice. If this potential problem is appropriately solved, patients with gastric GISTs would be suitable candidates for resection utilizing this technique. To our knowledge, this is the first study to propose omental patching and purse-string endosuture closure following EFTR as a feasible endoscopic option in patients with gastric GISTs.


Subject(s)
Endoscopy , Gastrointestinal Stromal Tumors , Gastrointestinal Tract , Humans , Omentum , Stomach
14.
Kosin Medical Journal ; : 146-151, 2019.
Article in English | WPRIM | ID: wpr-786387

ABSTRACT

Sarcomatoid mesothelioma is not very common, mesothelioma is directly attributable to occupational asbestos exposure, with 90% of cases showing a history of exposure. A 66-year-old male was admitted with an abdominal pain that persisted for 3 weeks. He had no abdominal mass. Computed tomography showed soft tissue thickening in perihepatic space and nodularities in omentum and peritoneum with ascites. There was no absolute diagnosis evidence in ascites analysis. Although the pathology of ascites was free for malignancy, the patient underwent omentum biopsy for definitive diagnosis. In laproscopic exploration, there was omental cake, peritoneal nodular seeding. It was suspected cancer carcinomatosis. Immunohistochemical findings suggested that it was sarcomatoid masothelioma. This is the rare case of a peritoneal sarcomatoid mesothelioma, without any exposure to asbestos.


Subject(s)
Abdominal Pain , Aged , Asbestos , Ascites , Biopsy , Carcinoma , Diagnosis , Humans , Male , Mesothelioma , Omentum , Pathology , Peritoneum , Sarcoma
15.
Article in English | WPRIM | ID: wpr-785879

ABSTRACT

Desmoplastic small round cell tumor (DSRCT) is a rare and aggressive malignancy common in young male patient. Typical imaging features of DSRCT include multiple soft tissue masses in the peritoneal cavity, omentum, or mesentery without an organ of origin. This report presents a rare manifestation of DSRCT revealing a solitary large retroperitoneal mass with hepatic metastasis and malignant portal vein thrombosis in 70-year-old women together with the review of literature. The tumor showed a hemorrhagic and necrotic mass with peripheral portion of T2 hypo-intensity and delayed enhancement that indicated desmoplastic stroma with dense cellularity.


Subject(s)
Aged , Desmoplastic Small Round Cell Tumor , Female , Humans , Magnetic Resonance Imaging , Male , Mesentery , Neoplasm Metastasis , Omentum , Peritoneal Cavity , Portal Vein , Venous Thrombosis
16.
Asian Spine Journal ; : 976-983, 2019.
Article in English | WPRIM | ID: wpr-785488

ABSTRACT

STUDY DESIGN: Retrospective case analyses.PURPOSE: To investigate the causes, diagnosis, and management of esophageal perforation, depending on the time of diagnosis.OVERVIEW OF LITERATURE: To date, few studies have addressed these issues.METHODS: A total of seven patients were included in this study. The patients were classified into three groups based on esophageal perforation diagnosis time: intraoperative (diagnosed during surgery), perioperative (diagnosed within 30 days postoperatively), and delayed (diagnosed >30 days postoperatively) groups.RESULTS: In the intraoperative group (N=2), infectious spondylitis was the main cause of esophageal perforation. Anterior plate and screw removal, followed by posterior instrumentation, was performed. The injured esophagus was managed by omentum flap repair in one patient and primary repair in one patient. In the perioperative group (N=2), revision surgery for infection and metal failure were the main causes of esophageal perforation. In both cases, food residue was drained on the third postoperative day. The injured esophagus was managed conservatively. In the delayed group (N=3), chronic irritation caused by metal failure was the main cause of esophageal perforation. In all patients, there was no associated infection. The anterior instrumentation was removed, and the two patients were treated by primary repair, and one patient was treated using sternocleidomastoid muscle flap. One patient in intraoperative group died of sepsis.CONCLUSIONS: The main cause of intraoperative esophageal perforation was esophageal adhesions because of infectious spondylitis. However, perioperative and delayed esophageal perforations were caused by chronic irritation because of metal failure. Anterior plate and screw removal was necessary, and posterior instrumentation and fusion may be considered, depending on the fusion status.


Subject(s)
Diagnosis , Esophageal Perforation , Esophagus , Humans , Omentum , Retrospective Studies , Sepsis , Spine , Spondylitis
17.
Annals of Coloproctology ; : 285-288, 2019.
Article in English | WPRIM | ID: wpr-762325

ABSTRACT

An inflammatory myofibroblastic tumor (IMT) is a solid tumor of unknown etiology frequently affecting children and young adults and commonly affecting the lung or orbital region. We present a case involving a 41-year-old man who had an IMT combined with Mycobacterium tuberculosis infection in the retroperitoneum. He presented with only pain in the right lower abdomen without accompanying symptoms; a retroperitoneal mass was found on computed tomography. The tumor had invaded the end of the ileum and was attached to the omentum, so mass excision could not be performed. The tumor was completely excised surgically and had histological features diagnostic of an IMT. Histologic findings of the omentum were positive for Ziehl-Nielsen staining for acid-fast bacilli and for a positive polymerase chain reaction for M. tuberculosis. The patient had no apparent immune disorder. These findings made this case exceptional because IMTs, which are mostly due to atypical mycobacteria, have been found mainly in immunocompromised patients.


Subject(s)
Abdomen , Adult , Child , Humans , Ileum , Immune System Diseases , Immunocompromised Host , Inflammation , Lung , Mycobacterium tuberculosis , Myofibroblasts , Nontuberculous Mycobacteria , Omentum , Orbit , Polymerase Chain Reaction , Tuberculosis , Young Adult
18.
Rev. bras. cir. plást ; 33(2): 262-266, abr.-jun. 2018. ilus
Article in English, Portuguese | LILACS | ID: biblio-909431

ABSTRACT

Apresentamos o caso de um paciente de 70 anos de idade que evoluiu com extenso defeito cutâneo em parede torácica anterior após ter sido submetido a revascularização do miocárdio e mediastinite pós-operatória. Pela impossibilidade de utilização de retalhos cutâneos e musculares da região, fizemos a reconstrução com a rotação de retalho de omento baseado na artéria gastroepiploica esquerda e enxerto de pele em malha.


We report the case of a 70-year-old patient who developed an extensive skin defect in the anterior chest wall after undergoing myocardial revascularization and postoperative mediastinitis. Owing to the impossibility of using cutaneous and muscular flaps on the region, we performed the reconstruction with an omentum flap based on the left gastroepiploic artery and meshed skin graft.


Subject(s)
Humans , Male , Aged , Omentum , Postoperative Complications , Surgical Flaps , Reconstructive Surgical Procedures , Thoracic Wall , Omentum/surgery , Omentum/injuries , Postoperative Complications/diagnosis , Surgical Flaps/surgery , Reconstructive Surgical Procedures/methods , Thoracic Wall/surgery , Thoracic Wall/injuries
19.
Article in English | WPRIM | ID: wpr-714518

ABSTRACT

Bochdalek hernia (BH) is defined as herniated abdominal contents appearing throughout the posterolateral segment of the diaphragm. It is usually observed during the prenatal or newborn period. Here, we report a case of an adult patient with herniated omentum and colon due to BH that was discovered during a colonoscopy. A 41-year-old woman was referred to our hospital with severe left chest and abdominal pain that began during a colonoscopy. Her chest radiography showed colonic shadow filling in the lower half of the left thoracic cavity. A computed tomography scan revealed an approximately 6-cm-sized left posterolateral diaphragmatic defect and a herniated omentum in the colon. The patient underwent thoracoscopic surgery, during which, the diaphragmatic defect was closed and herniated omentum was repaired. The patient was discharged without further complications. To the best of our knowledge, this case is the first report of BH in an adult found during a routine colonoscopy screening.


Subject(s)
Abdominal Pain , Adult , Colon , Colonoscopy , Diaphragm , Female , Hernia , Hernia, Diaphragmatic , Humans , Infant, Newborn , Mass Screening , Omentum , Radiography , Thoracic Cavity , Thoracoscopy , Thorax
20.
Chinese Journal of Lung Cancer ; (12): 235-238, 2018.
Article in Chinese | WPRIM | ID: wpr-776313

ABSTRACT

BACKGROUND@#Bronchial pleural fistula (BPF) is a common complication after thoracic surgery for lung resection. Clinical treatment is complex and the effect is poor. The treatment of BPF after lung resection has plagued thoracic surgeons. We reviewed retrospectively the clinical and follow-up data of 6 patients in our hospital who underwent the omentum transplantation in thorax to cover bronchial stump as treatment of BPF after pulmonary resection to analyze why BPF occurs and describe this treatment method. We intend to discuss and evaluate the feasibility, safety and small sample success rate ofthis treatment method.@*METHODS@#During August 2016 to February 2018, six patients in our hospital underwent remedial open thoracotomy and omentum transplantation in pleura space to cover bronchial stump as treatment of bronchopleural fistula after pulmonary resection. Four patients had undergone a prior pneumonectomy and two patients had undergone a prior lobectomy (the residual lungs were resected with the main bronchus cut by endoscopic stapler during the reoperation). The bronchial stumps were sutured by 4-0 string with needle and covered by omentums, which were transplanted in pleura space from the cardiophrenic angle. Postoperatively, the pleura space was irrigated and drained. Summarize the clinical effect and technique learning points.@*RESULTS@#The patients were all males, aged 61 to 73 years (median age: 66). BPF occurred from postoperative day 10 to 45 (median postoperative day 25). The reoperation was finished in 80 mins-150 mins (median 110 mins). Total blood loss was 200 mL-1,000 mL (median 450 mL). These patients were discharged on postoperative day 12-17 (median 14 days), and there was no more complications associated with bronchopleural fistula. All six patients' bronchial stumps were well closed (100%) and have recovered well during the follow-up period, which lasted 1 month-18 months.@*CONCLUSIONS@#Remedial operation should be performed as soon as possible when BPF after pulmonary resection diagnosed. Excellent prognoses can be achieved by omentum which is easy to get transplanted in thorax to cover bronchial stump as treatment in patients with BPF after pulmonary resection those who can tolerate reoperation.


Subject(s)
Aged , Bronchi , General Surgery , Bronchial Fistula , General Surgery , Female , Humans , Lung , General Surgery , Lung Neoplasms , General Surgery , Male , Middle Aged , Omentum , Transplantation , Pleura , General Surgery , Pleural Diseases , General Surgery , Pneumonectomy , Postoperative Complications , General Surgery , Retrospective Studies , Thoracotomy
SELECTION OF CITATIONS
SEARCH DETAIL