Ultrasonographic findings in primary umbilical endometriosis

Abstract: Primary cutaneous endometriosis is a rare condition. It appears without a prior history of surgical procedure and the umbilicus is the most frequently involved area. Primary umbilical endometriosis, or Villar's nodule, usually presents as a painful nodule. Its differential diagnosis may be challenging. Although histopathological assessment represents the gold standard for diagnosis, cutaneous ultrasonography may be useful in guiding the surgical treatment. Ultrasonographic features of cutaneous endometriosis have not yet been fully explored in the literature. Hence, we report peculiar ultrasonographic findings of primary umbilical endometriosis

Avaliação ultrassonográfica de componentes umbilicais inflamados em bezerros da raça Holandesa com até 30 dias de vida / Ultrassonographic avaliation of the inflamed umbilical structures in Holstein calves during their first 30 days of life

As afecções umbilicais merecem destaque entre as enfermidades que acometem bezerros no primeiro mês de vida, pela alta incidência durante essa fase da vida dos neonatos e pelas relevantes perdas econômicas, decorrentes da mortalidade, custos de tratamento e atendimento veterinário, além de sequelas que poderão determinar menores ganho de peso e produção leiteira. O diagnóstico dessas enfermidades muitas vezes é prejudicado pela dificuldade em se detectar os acometimentos das estruturas intra-abdominais do umbigo, o que afetará negativamente a escolha do tratamento mais adequado e o estabelecimento do real prognóstico para cada animal. No presente estudo, realizou-se a análise ultrassonográfica dos animais com inflamação/infecção dos componentes umbilicais sendo possível observar algumas características em relação a mensurações e ecogenicidade, presentes nos componentes umbilicais acometidos. A partir dessas avaliações concluiu-se que a medida mais adequada para identificar animais com possíveis processos inflamatórios nos componentes umbilicais é a espessura da parede dos vasos umbilicais quando comparada ao diâmetro dos mesmos. Ainda, o estudo possibilitou verificar algumas particularidades do comportamento dos componentes do cordão umbilical em bezerros sadios da raça Holandesa, bem como determinar que os vasos umbilicais intra-abdominais iniciam uma involução em porção mais interna e progridem para as extremidades próximas ao anel umbilical com o evoluir da idade. Destaca-se que o confronto desses resultados com aqueles poucos descritos na literatura disponível mostrou-se com notáveis diferenças.(AU)

Umbilical disorders deserve mention among the illnesses affecting calves in the first month of life. The high incidence during this phase of life of newborns and relevant economic losses arising from mortality, cost of treatment and veterinary care, beyond sequelae may determine lower weight gain and milk production. The diagnosis of these diseases is often hampered by the difficulty to detect the involvement of intra-abdominal umbilical structures, which negatively affect the choice of the most appropriate treatment and the actual outcome for each calf. In the present study, we performed ultrasound examinations of calves with inflammation/infection in the umbilical components and observed some characteristics related with measurements and echogenicity present in umbilical affected components. From these evaluation it was concluded that the wall thickness of the umbilical vessels is the more reliable standard to determine changes in these components, as compared with that of the diameter of the umbilical vessels. Furthermore, from this study we observed some peculiarities of involution of the intra-abdominal umbilical cord components in healthy Holstein calves used for the control group to characterize the behavior of the umbilical structures during the progress of the age in the newborns. It is noteworthy that the comparison of these results with those found in the rare literature available showed notable differences.(AU)

A computed tomographic study of umbilical anatomy: the relationship between umbilical thickness and diameter / Un estudio de tomografía computadorizada de la anatomía umbilical: la relación entre grosor y diámetro umbilical

Laparoscopic surgeries were first introduced in the 1980s. More recently, similar techniques such as natural orifice transluminal endoscopic surgery and other advanced transumbilical surgeries have been developed. With all of these surgical advances, basic information about the umbilicus is lacking. This study evaluated the relationship between umbilical diameter and thickness, as well as the underlying vessels, in order to develop a simple means of assessing umbilical anatomy. We retroactively reviewed 842 computed tomography images that included the umbilicus. Umbilical thickness, diameter, type of vessel located beneath the umbilicus, depth to the vessel, and other parameters were measured. Age and sex were noted, and their relationship was analyzed as it pertains to the umbilical anatomy. Average umbilical thickness and diameter were 8.2 mm and 3.5 mm, respectively. Vessels directly under the umbilicus were located on average 60.0 mm from the umbilicus. The most common vessels detected were the aorta and the right common iliac artery. A wider umbilical diameter was correlated with a thinner umbilicus. As natural orifice transluminal endoscopic surgery is relatively new, further studies regarding umbilical anatomy and clinical correlation are warranted. However, this report brings to light the importance of basic umbilical anatomy, and that these characteristics should be taken into account during the laparoscopic entry procedure.

Las cirugías laparoscópicas se introdujeron en la década de 1980. Recientemente, se han desarrollado técnicas similares, tales como cirugía endoscópica transluminal por orificios naturales y otras cirugías transumbilicales avanzadas. Con todos estos avances quirúrgicos, es insuficiente la información básica sobre el ombligo. Este estudio evaluó la relación entre el diámetro y el espesor umbilical, así como los vasos subyacentes, a fin de desarrollar un medio simple de evaluar la anatomía umbilical. Se revisaron retroactivamente 842 imágenes de tomografía computarizada que incluían el ombligo. Se midió espesor umbilical, diámetro, el tipo de vaso situado bajo del ombligo, y la profundidad junto a otros parámetros. Se observaron edad y sexo, y se analizó su relación en lo que respecta a la anatomía umbilical. Espesor umbilical medio y el diámetro eran de 8,2 mm y 3,5 mm, respectivamente. Vasos directamente bajo el ombligo se localizaron en promedio 60,0 mm del ombligo. Los vasos más comunes detectados fueron la aorta y la arteria ilíaca común derecha. Un diámetro más amplio umbilical se correlacionó con un ombligo más delgado. Como en los orificios naturales la cirugía endoscópica transluminal es relativamente nueva, se justifican más estudios en relación con la anatomía umbilical y su correlación clínica. Sin embargo, este informe pone de manifiesto la importancia de la anatomía básica umbilical, y que estas características se deben tener en cuenta durante el procedimiento de entrada laparoscópica.