RESUMO
A contained open abdomen is commonly used during damage control laparotomy and consists of the temporary coverage of the abdomen for protection of the viscera and reduction of intra-abdominal pressure. Definitive closure of a contained open abdomen is technically difficult due to the inability to obtain primary fascial suture. The insertion of a prosthetic mesh can be complicated with enterocutaneous fistula, and other definitive closure techniques need several surgical procedures. We describe a low cost technique that allows definitive closure of large abdominal wall defects avoiding the risk of intestinal fistula.
Assuntos
Traumatismos Abdominais/cirurgia , Fístula Intestinal/prevenção & controle , Laparotomia/métodos , Reto do Abdome/transplante , Retalhos Cirúrgicos/irrigação sanguínea , Traumatismos Abdominais/diagnóstico , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Seguimentos , Humanos , Cuidados Intraoperatórios/métodos , Laparotomia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Reto do Abdome/cirurgia , Medição de Risco , Telas Cirúrgicas , Deiscência da Ferida Operatória/prevenção & controle , Técnicas de Sutura , Fatores de Tempo , Resultado do Tratamento , Cicatrização/fisiologia , Adulto JovemRESUMO
A 38-year-old woman with neurofibromatosis type 1 was referred for massive swelling of the left thigh, pain, and anemia. Angiography demonstrated three saccular aneurysms of the femoropopliteal artery. The largest measured 3 cm in diameter. Resection of the aneurysms and femoropopliteal interposition grafting using reversed saphenous vein was performed through a medial surgical approach. Arterial involvement in neurofibromatosis is a well known but infrequent occurrence. Stenotic lesions predominate. Aneurysmal defects are less common, and rupture of peripheral arteries is exceptional. Neurofibromatous invasion and dysplasia of the tunica media of the femoropopliteal vessel were confirmed by means of pathologic study. We think this is the second reported case of a femoropopliteal artery aneurysm and rupture associated with neurofibromatosis.
