RESUMO
PURPOSE: Abdominal wall injuries (AWI) is a clinical and radiological diagnosis of fasciomuscular and at times cutaneous defects after abdominal trauma. Their severity encompasses a spectrum of parietal defects, with the most severe being a burst abdomen with eviscerated organs. With the wide use of CT scans in trauma settings, their incidence is being more recognized. Especially in severe AWI, where associated intrabdominal lesions are highly prevalent, many questions about parietal reconstruction arise concerning the timing and type of surgery, and their final hernia recurrence rate. METHOD: A list of severe AWI injuries have been retrieved, all of which were treated in our center. Type of trauma, clinical presentation, surgical technique and follow-up have been included. RESULTS: Eight cases were found with severe abdominal injuries, with an age range of 11-85 years. Road traffic accidents, crush injuries, fall from height, stab and gunshot wounds are included. Seven out of the 8 cases had associated intrabdominal traumatic lesions. Mesh augmentation due to tissue loss was used in three cases. Recurrence rate was estimated around 25%. CONCLUSION: Prompt surgical exploration is required as associated intrabdominal traumatic lesions are highly associated with severe AWI. Even when intrabdominal lesions are ruled out, fasciomuscular defects should be managed during the same hospitalization, to prevent intestinal strangulation and occlusion. Mesh augmentation should only be used when parietal defects include extensive tissue loss preventing tension-free parietal reconstruction.
Assuntos
Traumatismos Abdominais , Parede Abdominal , Ferimentos por Arma de Fogo , Ferimentos não Penetrantes , Traumatismos Abdominais/complicações , Traumatismos Abdominais/cirurgia , Parede Abdominal/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Herniorrafia , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/cirurgia , Ferimentos não Penetrantes/complicações , Adulto JovemRESUMO
Desmoplastic small round cell tumors (DSRCT) are rare malignancies that typically arise in the abdominopelvic cavities. They are very uncommon in the head and neck region. We present a case of an 11-year-old Caucasian male with a primary cervical lymph node tumor in the neck. Fine-needle aspiration cytology, histopathologic examination, immunohistochemical staining, and molecular genetic testing led to the diagnosis of DSRCT. Due to the very limited number of cases reported and the lack of staging criteria, the preferred management approach remains uncertain.
