The Abdominal Cocoon. A Case Report

The abdominal cocoon, or idiopathic sclerosing encapsulating peritonitis, is a rare cause of intestinal obstruction. This rare condition, in which the small intestine is encased in a thick fibrous membrane, has been reported predominantly in females. Despite some reports of a preoperative diagnosis, in the majority of cases diagnosis is only made at laparotomy for acute or subacute intestinal obstruction. Treatment consists of resection of the membrane with lysis of adhesions. We present a case of abdominal cocoon in a man where early preoperative diagnosis by radiological evaluation was overlooked. A better awareness of this condition may result in early diagnosis and proper management, thus avoiding unnecessary bowel resections and bad outcomes.     

Abdominal Aortic Aneurysms: Endovascular Options and Outcomes — Proliferating Therapy,But Effective?

Abdominal aortic aneurysm (AAA) has a reported prevalence rate of 1.4% in the US. AAA rupture accounts for an estimated 15,000 deaths per year, rendering it the 10th leading cause of death in men over the age of 55. Endovascular repair (EVR) has proliferated in the last two decades as an increasingly popular alternative to traditional open surgery, and is now the default treatment in the majority of centres worldwide. This review article outlines the evidence supporting this stance. The development of EVR is reviewed, alongside trends in utilisation of this therapy over time. The evidence for the relative short-term and long-term outcomes of EVR and open AAA repair is discussed, and ongoing controversies surrounding the use of EVR are considered.     

Anterior abdominal wall ‘peritoneal recess’: cause for pseudoherniation of small bowel resulting in chronic abdominal pain

A middle-aged patient presented with intermittent chronic abdominal pain without any obvious cause. Computed tomography detected a hernia (presumed to be the cause of the patient’s symptoms) without any obvious lump on examination. A laparoscopy was performed to repair the hernia. This revealed a left-sided unilateral ‘peritoneal recess’ at the level of the arcuate line extending medial to the linea semilunaris. No extraperitoneal sac or defect was noted in the rectus sheath or in the muscle, nor were any contents present in the recess at the time of the laparoscopy. We believe the bowel was being trapped intermittently in this space, causing the abdominal symptoms.     

耳内镜下自体腹壁脂肪修复中央性鼓膜穿孔的临床探讨

目的探讨耳内镜下腹壁脂肪修补中央性鼓膜穿孑L的临床效果。方法回顾性分析64例（68耳）中央性鼓膜穿孔的病例资料，均于耳内镜下行腹壁脂肪修补术，术后随访3—6个月，术后6个月复查纯音测听，观察术后疗效。结果鼓膜一次性愈合63耳；鼓膜部分愈合4耳，予新鲜鸡蛋膜外贴修补后愈合；1耳未愈；一次性治愈率为92．6％（63／68）。结论耳内镜视野清晰，使用简单方便；耳内镜下腹壁脂肪修补中央性鼓膜穿孔临床效果显著，值得在基层医院推广应用。     

Longitudinal variations of characteristic frequencies of skeletal muscle fibre potentials detected by a bipolar electrode or multi-electrode

We aimed to reveal reasons for longitudinal variations of characteristic frequencies of electromyographic signals detected by surface longitudinal multi-electrodes. Since the terminal phases were reduced in bipolar recordings, wetested whether the frequency variations reflected the effects of the excitation origin and extinction as in monopolar recordings. A precise and fast convolution method to calculate the signals detected by a multielectrode was suggested. The contribution of different electrode poles was introduced in the impulse response. When a longitudinal multi-electrode with an even number of poles was positioned above the end-plate of asymmetrical fibres, the signal mainly reflected the processes of the excitation extinction. This increased the signal mean and median frequencies. Although the effects of origin and extinction of the excitation were significantly reduced in the spatially filtered signals, the frequency variations along the fibre reflected these intrinsic features of any skeletal muscle fibre of finite length.     

腹部热敷配合按摩促进早产儿胎粪排出的效果观察

目的探讨腹部热敷配合按摩对促进新生儿胎粪排出的效果。方法以80例早产儿为研究对象,随机分成对照组和实验组,每组40例,对照组给予新生儿常规护理,实验组在常规护理基础上实施腹部热敷配合按摩。观察并记录两组新生儿首次胎粪排出的时间、首次排出胎粪的重量及出生24 h内胎粪排出次数。结果实验组患儿首次排便时间明显早于对照组(p<0.05),首次排出胎粪的量多于对照组(p<0.05),出生24 h内胎粪排出的次数多于对照组(p<0.01)。结论对早产儿早期进行腹部热敷配合按摩能促进早产儿胎粪排泄及胃肠道功能的成熟,防止胎粪排泄延迟发生相关的并发症。     

剖宫产术后腹壁切口愈合不良的原因

随着我国科技的快速发展以及社会因素、剖宫产手术技术的提高,广大的孕妇对于剖宫产分娩出来胎儿的方法已普遍接受。随着剖宫产率的增高,人们关注的重点反而不是剖宫产,而是在剖宫产后相关并发症,这其中主要是剖宫产术后腹壁切口愈合不良,主要的症状有切口脂肪液化、切口裂开、切口感染等,这些并发症的产生对孕妇及其家属的精神上、身体上、工作上以及经济上都造成了不同程度的损害。如果并发症发生严重情况,甚至会对产妇的生命造成威胁。与此同时,产科的医生所受到的压力也增加起来,而且病床周转率也随之降低。笔者根据本院一些临床实例对剖宫产术后腹壁切口愈合不良的原因进行分析,以此为临床提供能够有效预防与控制剖宫产术后腹壁切口愈合不良以及对愈合不良切口的处理方法。     

Prevalence of Thoracic Aortic Aneurysms in Patients with Degenerative Abdominal Aortic Aneurysms: Results from the Prospective ACTA Study

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Retroperitoneal Spinal Extradural Arachnoid Cyst Combined with Congenital Hemivertebrae

Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged ''thecal sac-side'' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.