Articles: rectus-abdominis.
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Case Reports
Rectus sheath nerve block for analgesia & incarcerated hernia reduction in the emergency department.
Patients who present to the emergency department (ED) with incarcerated or strangulated ventral hernias are often in significant pain. Furthermore, even with procedural sedation, reduction itself also causes substantial pain. Hernias that cannot be reduced at the bedside with intravenous opioids or procedural sedation will require emergent surgery, which contributes to morbidity and mortality, especially in high-risk populations. ⋯ Ultrasound can visualize and diagnose an incarcerated hernia, and a bilateral rectus sheath block can be performed in the ED to anesthetize the peritoneal wall, paralyze abdominal musculature, and achieve nearly painless hernia reduction.
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Case Reports
Spontaneous rectus sheath hematoma complicated by deep venous thrombosis: A case report.
Rectus sheath hematoma (RSH) is an unusual cause of acute abdominal pain. It is more common in elderly patients on anticoagulation. The diagnosis is often challenging, as it mimics other more common causes of acute abdomen. No standard treatment guidelines exist, presenting therapeutic dilemmas. Herein, we describe a case of spontaneous RSH complicated by deep venous thrombosis (DVT). ⋯ Although rare, RSH is a potential cause of acute abdomen, particularly among patients on anticoagulation, and can be life-threatening. A high index of suspicion is therefore important for early diagnosis. Clinicians should also appreciate the heightened risk of DVT in the immediate postoperative period despite mechanical anticoagulation.
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Review Meta Analysis
Primary closure versus vertical rectus abdominis myocutaneous (VRAM) flap closure of perineal wound following abdominoperineal resection-a systematic review and meta-analysis.
Perianal wound healing and/or complications are common following abdominoperineal resection (APR). Although primary closure is commonly undertaken, myocutaneous flap closure such as vertical rectus abdominis myocutaneous flap (VRAM) is thought to improve wound healing process and outcome. A comprehensive meta-analysis was performed to compare outcomes of primary closure versus VRAM flap closure of perineal wound following APR. ⋯ We highlight the advantage of VRAM flap closure over primary closure for perineal wounds following APR. However, tailoring operative strategy based on patient and disease factors remains important in optimising outcomes.
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Review Case Reports
Desmoid tumors of rectus abdominis: A case report and literature review.
Desmoid tumor (DT) is a rare soft tissue tumor that can occur anywhere in the body. Abdominal wall DT presents unique clinical challenges due to its distinctive manifestations, treatment modalities, and the lack of biomarkers for diagnosis and recurrence prediction, making clinical decisions exceedingly complex. ⋯ Abdominal wall DT treatment requires personalized plans from multidisciplinary team discussions. Genetic testing plays a crucial role in identifying novel biomarkers for abdominal wall DT. We have once again demonstrated the significant clinical significance of CTNNB1 mutations in the diagnosis and progression of abdominal wall DT. Additionally, genes such as CCND1, CYP3A4, SLIT1, RRM1, STIM1, ESR2, UGT1A1, among others, may also be closely associated with the progression of abdominal wall DT. Future research should delve deeper into and systematically evaluate the precise impact of these genetic mutations on treatment selection and prognosis for abdominal wall DT, in order to better guide patient management and treatment decisions.