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Abdominal cocoon syndrome is rare cause of intestinal obstruction characterized by small bowel encapsulation by a fibro-collagenous membrane or "cocoon".A 30 yearman presented in emergency department with abdominal pain. Preoperatively contrast enhanced computed tomography of abdomen revealed encapsulated cluster of mildly dilated and edematous small bowel loops with multiple air fluid levels with thin membrane and crowding of mesenteric vessels in left upper quadrant.Intra-operatively, the entire small bowel was found to be encapsulated in a dense fibrous sac. The peritoneal sac was excised, followed by lysis of the inter-loop adhesionswith smooth postoperative recovery.High index of suspicion is required in patient presenting with features of recurrent acute or chronic small bowel obstruction for diagnosis of abdominal cocoon syndrome. Contrast enhanced Computed Tomography of abdomen is a useful radiological to aid in preoperative diagnosis of syndrome.Keywords: Abdomen; abdominal cocoon; CECT; encapsulated cluster.

BACKGROUND : Advances in intra-abdominal pressure (IAP) measurement have enabled better monitoring and physiological manipulation of patients with intra-abdominal hypertension or abdominal compartment syndrome. This study aimed to determine the correlation between transvesical (TV), transgastric (TG) and direct transperitoneal (TP) IAP monitoring at different IAPs in porcine models. OBJECTIVES : To assess the statistical agreement between TV, TG and TP pressure monitoring in a pneumoperitoneum and an intestinal obstruction intra-abdominal hypertension model at different IAPs. METHODS : Fifty-nine pigs were divided into six groups: a control group (Cr; n=5), three pneumoperitoneum groups at pressures of 20 mmHg, 30 mmHg, and 40 mmHg (Pn20, Pn30, Pn40; n=40), and two intestinal-occlusion groups at pressures of 20 mmHg and 30 mmHg (Oc20, Oc30; n=14). IAP was simultaneously measured in each pig using the three methods at different times. The control group did not have any intervention to increase the IAP. Intra-class correlation was used to assess agreement between the methods. RESULTS : At pressures >20 mmHg, all three methods showed good correlation with each other (Pn20=0.87; Pn30=0.96; Pn40=0.88; Oc20=0.69; Oc30=0.86). Correlation between TP and TG (Cr=0.0; Pn20=0.85; Pn30=0.94; Pn40=0.90; Oc20=0.78; Oc30=0.78); TP and TV (Cr=0.0; Pn20=0.83; Pn30=0.95; Pn40=0.86; Oc20=0.59; Oc30=0.88); and importantly between TV and TG (Cr=0.0; Pn20=0.95; Pn30=0.98; Pn40=0.88; Oc20=0.69; Oc30=0.91) was good. CONCLUSION : All three measurement methods showed good correlation at pressures >20 mmHg and were unaffected by the type of IAP model. These results suggest that either transvesical or transgastric pressure measurements can be used for IAP measurement when TP pressures are >20 mmHg. ; Grant from Extremadura Regional Government through the Plan Regional de Investigación de Extremadura (PRI09A161 to Minimally Invasive Surgery Center Jesús Usón). ; http://www.sajcc.org.za ; am2018 ; Statistics

STUDY DESIGN: Single subject design with five subjects. OBJECTIVES: The objetive of this study is to compare the effectiveness and usability of alternative commercial abdominal compression garments with participants' usual medical binders. SETTING: Private residences in Pierce and King Counties, WA, USA. METHODS: Participants wore each garment for 5 days followed by a 2-day washout in personal binder. Week 1: Personal binder. Weeks 2 and 3: Randomly ordered test garments (tank, bodysuit). Physiologic measurements: blood pressure (SBP, DBP), blood oxygen saturation (SaO(2)), forced expiratory volume in one second (FEV(1)), and heart rate (HR). Participants completed logs twice daily for 5 days per garment regarding ease of use, comfort, respiration, and appearance. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. RESULTS: The use of a personal binder results in significant increases in SBP and FEV(1). Personal binders support FEV(1) significantly better than test garments. There is no difference in SBP between test garments and personal binders. There are no significant differences between DBP, SaO(2), or HR between participants' personal binders and no binder. Participants reported that neither tank nor bodysuit felt adequately supportive or easy to use. CONCLUSIONS: Abdominal compression improves respiratory function and supports SBP in individuals with chronic SCI. Further research is needed to guide the development of an easy-to-use and physiologically supportive abdominal compression garment.

In recent years, there has been a steady increase in injuries all over the world. Man-made and natural disasters, local military conflicts, transport and industrial accidents in 50-60% of cases of all injuries lead to combined and multiple injuries to organs and systems of the human body, and, as a result, to high sanitary losses in the first hours and days [1,2,5,13,19,21]. This article discusses intestinal injuries in combined abdominal trauma.

Infrarot (IR) -Rezeptoren sind innerhalb der Insekten offensichtlich mehrfach unabhängig voneinander entstanden. Bei den Vertretern der Gattung Melanophila, einigen Rindenwanzen der Gattung Aradus und bei dem australischen Käfer Acanthocnemus nigricans sind diese aus unterschiedlichen Vorläuferstrukturen in verschiedenen Bereichen des Thorax entstanden. Abdominale IR-Rezeptoren hingegen sind bisher nur beim australischen Feuerkäfer Merimna atrata und der Wanze Leptoglossus occidentalis beschrieben worden und sind Gegenstand der vorliegenden Arbeit. Der australische Feuerkäfer Merimna atrata (Buprestidae, Coleoptera) zeigt ein ausgeprägtes pyrophiles ("Feuer liebendes") Verhalten. Käfer dieser Spezies suchen gezielt frische Brandflächen auf, die durch offenes Feuer, heiße Asche und Rauch gekennzeichnet sind. Grund für dieses ungewöhnliche Verhalten ist die Abhängigkeit ihres Reproduktionszyklus von Waldbränden. Die IR-Organe von Merimna atrata befinden sich paarig angeordnet auf den abdominalen Sterniten. Sie bestehen aus einem spezialisierten Cuticula-Bereich, der rundlichen absorbierenden Fläche, und einem sensorischen Komplex, der diesen Bereich innerviert. Der sensorische Komplex beinhaltet ein thermosensitives, multipolares Neuron mit einer spezialisierten dendritischen Region, der sog. terminalen dendritischen Masse (TDM). In direkter Nähe zu diesem multipolaren Neuron befinden sich zusätzlich mechanorezeptive Strukturen (Skolopidien), deren genaue Morphologie und Funktion im IR-Organ jedoch zu Beginn der Arbeit weitgehend unbekannt waren. Leptoglossus occidentalis (Coreidae, Hemiptera) ist die einzige Insektenspezies ohne pyrophile Lebensweise, für die ebenfalls extra-antennale IR-Rezeptoren beschrieben wurden. Es handelt sich um eine, ursprünglich in Nordamerika beheimatete, mittlerweile kosmopolitisch verbreitete Spezies, die sich phytophag von sich entwickelnden Samen verschiedener Koniferen ernährt. Basierend auf Verhaltensexperimenten und elektro-physiologischen Untersuchungen wurde beschrieben, dass L. occidentalis ebenfalls über abdominale IR-Rezeptoren verfügt. Der IR-Sinn soll dazu dienen, die Samen tragenden Zapfen aufzuspüren. Morphologische Daten über die dafür notwendigen Rezeptorstrukturen fehlten bisher jedoch. Im Rahmen der vorliegenden Arbeit sollten auch die vermeintlichen IR-rezeptiven Strukturen von L. occidentalis morphologisch charakterisiert werden. Die gewonnenen Ergebnisse widerlegen aufgrund mangelnder Innervation eine mögliche Funktion der in der Literatur beschriebenen abdominalen Strukturen als IR-Rezeptoren. Es konnten jedoch unterschied-liche Typen epidermaler Drüsenzellen in hoher Zahl identifiziert werden, die eine sekretorische Funktion der besagten Bereiche nahelegen. Das Vorkommen von IR-Rezeptoren bei Insekten ist somit nach aktuellem Kenntnisstand beschränkt auf Spezies mit pyrophiler Lebensweise. Abdominale IR-Rezeptoren existieren bisher nur bei Merimna atrata. Im Vordergrund der Arbeiten lag die funktionsmorphologische Charakterisierung der im IR-Organ von Merimna identifizierten Skolopidien im Hinblick auf eine mögliche Beteiligung bei der IR-Rezeption. Die gewonnenen Ergebnisse belegen eine zusätzliche Innervation des IR-Organs durch ein einzelnes Chordotonalorgan. Dieses befindet sich in direkter Nachbarschaft zu dem bereits beschriebenen thermosensitiven multipolaren Neuron. Das Chordotonalorgan besteht aus zwei einzelnen nebeneinander liegenden mononematischen, monodynalen Skolopidien. Ihre Dendriten erstrecken sich in anteriorer Richtung und sind über Kappenzellen unterhalb der Cuticula im Zentrum der absorbierenden Fläche befestigt. Die relative Position und Lagebeziehung der sensorischen Komponenten im Verhältnis zur absorbierenden Fläche konnte über die Kombination neuroanatomischer Färbetechniken und dreidimensionale Rekonstruktion eindeutig bestimmt werden. Vergleichende Untersuchungen an abdominaler Cuticula offenbarten weitere strukturelle Spezialisierungen der absor-bierenden Fläche, insbesondere im Bereich des sensorischen Komplexes und der Anheftungsstellen der Skolopidien. So ist die Dicke der Cuticula im Zentrum der absor-bierenden Fläche im Vergleich zu gewöhnlicher abdominaler Cuticula um durchschnittlich 47% reduziert. Auch der relative Anteil der unterschiedlichen Cuticula-Schichten sowie ihre Materialeigenschaften (Elastizitätsmodul und Härte) weisen signifikante Unterschiede auf. Basierend auf den gewonnen Daten zur dreidimensionalen Morphologie der absorbierenden Fläche und ihrer Materialeigenschaften wurden mit Hilfe von Finite Element Simulationen ihre thermomechanischen Eigenschaften analysiert. Die Ergebnisse weisen darauf hin, dass bei Erwärmung deutliche thermische Deformationen der absorbierenden Fläche auftreten. Eine potentielle Funktion der Skolopidien als thermo-, bzw. photomechanische IR-Rezeptoren ist daher denkbar. Des Weiteren deuten die Ergebnisse darauf hin, dass die Skolopidien als potentielle IR-Rezeptoren möglicherweise keine höhere Sensitivität aufweisen als das multipolare Neuron. Eine potentielle Funktion der zusätzlichen Innervation des IR-Organs durch ein Chordotonalorgan ist somit eher in der Erweiterung des generellen Funktionsumfangs, z.B. durch die Vergrößerung des Dynamikbereichs, einer Verringerung der Ansprechzeiten, einer höheren Ausfallsicherheit oder verbesserten Filtereigenschaften zu erwarten. ; Functional morphology of abdominal infrared receptors of insects In insects, infrared (IR) -receptors have evolved several times independently. IR-receptors can be found in buprestid beetles of the genus Melanophila, in several flat bug species belonging to the genus Aradus, and in the Australian beetle Acanthocnemus nigricans on different regions of the thoracic segments, respectively. Abdominal IR-receptors, so far have been described only in the Australian 'fire-beetle', Merimna atrata, and in the western conifer seed bug, Leptoglossus occidentalis. The abdominal IR-receptors in the two mentioned species are the subject of the present thesis. As the name already indicates, the 'fire-beetle' Merimna atrata (Buprestidae, Coleoptera) shows a pronounced pyrophilous ("fire-loving") behavior. Beetles of this species approach freshly burnt areas that are characterized by open flames, hot ash and smoke. A reason for this unusual behavior is the dependency of the reproductive cycle of Merimna atrata on the occurrence of forest fires. IR-organs are located in pairs on the abdominal sternites. They consist of a specialized cuticular portion, the roundish absorbing area, and a sensory complex innervating this area. The sensory complex comprises a thermosensitive, multipolar neuron with a specialized dendritic region, the so-called terminal dendritic mass (TDM). In direct vicinity to the multipolar neuron additional mechanoreceptive units (scolopidia) have been identified, but their specific morphology and function within the IR-organ, so far were unknown. Leptoglossus occidentalis (Coreidae, Hemiptera) is the only non-pyrophilous insect species, for which extra-antennal IR-receptors have been described. Originally native to North-America, L. occidentalis became a cosmopolitan in the recent years. The species feeds on developing seeds of different conifers. Based on behavioral and electrophysiological experiments it has been proposed that L. occidentalis is equipped with abdominal IR-receptors used for the localization of cones. Morphological data on the underlying IR-receptors, however, are missing. In the present thesis an attempt was made to characterize the putative IR-receptors of L. occidentalis morphologically. Due to missing innervation the results clearly disprove the existence of abdominal IR-receptors in L. occidentalis. Instead, the identification of different types of epidermal glandular cells, occurring in high numbers, indicates a secretory function of the proposed regions. According to these results, the existence of IR-receptors in insects is still restricted to pyrophilous beetles. Abdominal IR-receptors can be found, so far, only in Merimna atrata. Investigations on the IR-organ of Merimna atrata confirmed a bimodal innervation by an additional mechanosensory unit, represented by a single chordotonal organ situated in close proximity to the thermosensitive multipolar neuron. The chordotonal organ houses two single mononematic, monodynal scolopidia. They are located approximately in the center of the absorbing area. Their dendrites extend in anterior direction and are attached to the cuticle apically via a cap cell. The relative position and orientation of the sensory cells in relation to the absorbing area was determined by combining neuroanatomical staining techniques with three-dimensional reconstructions. Comparative studies on the abdominal cuticle revealed further structural specializations of the absorbing area, especially at the region of the sensory complex and the attachment sites of the scolopidia. Accordingly, cuticular thickness at the center of the absorbing area is reduced on average by 47% in comparison to normal abdominal cuticle. Furthermore, the relative proportion of the different cuticular layers and their respective material properties exhibit significant differences at both regions. Based on these findings, the thermomechanical properties of the absorbing area were analyzed by using finite element simulations. The results indicate that a distinct thermal deformation of the absorbing area takes place in response to heating of the exterior cuticle. Therefore, a function of the scolopidia as putative thermo- or photomechanical IR-receptors seems possible. The findings further indicate that the scolopidia, if acting as IR-receptors, probably do not exhibit higher sensitivities as the multipolar neuron. Other probable benefits provided by the additional mechanoreceptive innervation of the IR-organ could include e.g. faster response times, a larger dynamic range, higher reliability or improved filter properties. In summary, this could increase the overall performance of the whole IR-organ.

49 year-old man presented to our clinic for pain in the right hypochondrium, diarrhea, and fever. The clinical examination highlights a tumoral formation in the right side of the abdomen, with firm consistency, poorly defined margins, and present mobility in the deep structures. On biological exams, leukocytosis with neutrophilia, inflammatory syndrome, and hypoalbuminaemia were identified. The first computed tomography exam described parietal thickening of the ascending colon, with infiltrative aspect, and multiple local adenopathies, lomboaortic and interaortocave. Moreover, four nodular liver tumors, with hypodense image in native examination, were identified. The lab tests for infectious diseases were all inconclusives: three hemocultures, three stool samples, and three coproparasitological exams were all negatives. Interdisciplinary examinations, internal medicine and infectious diseases, sustained the diagnosis of colonic neoplasm with peritumoral abscess and liver pseudo-tumoral masses. The colonoscopy did not revealed any bowel lesions relevant for neoplasia. This result as well as the bio-clinical context imposed abstention from surgical intervention. Wide spectrum antibiotics and symptomatic treatment were initiated. But, ten days after hospitalization, the second computed tomography exam showed reduction of the ascending colon wall thickness associated with significant increases of the liver tumors is so revealed. The investigations for other possible etiologies were so continued.

With an increase in the use of laparoscopic techniques for the treatment of abdominal wall hernias, this comprehensive book provides a detailed description of the most up-to-date techniques used in the laparoscopic repair of inguinal and ventral incisional hernias. Advances in Laparoscopy of the Abdominal Wall Hernia takes the reader step-by-step through two laparoscopic techniques used in inguinal hernia correction: Extraperitoneal (TEP) and Transabdominal (TAPP), and guides the reader through the fundamentals of ventral hernia repair. The authors aim to show methods of dealing with rarer hernias and those of atypical location. This book will also inform the reader of the various kinds of meshes used and provides knowledge on how to fix them, as well as the advantages, disadvantages and indications of this type of prosthesis. Written by experts in the field, Advances in Laparoscopy of the Abdominal Wall Hernia is a valuable reference tool to surgeons and medical practitioners working in this field.

Introduction: mesenteric panniculitis is a rare disorder characterized by chronic inflammation of the adipose tissue of the intestinal mesentery, its etiology is unknown.Objective: to describe the clinical and radiological management of a patient with mesenteric panniculitis treated at Dr. Carlos J. Finlay Military Hospital in Havana, Cuba.Clinical case: a 62-year-old, male patient with apparent health history, ex-smoker. Six months ago, the patient noticed the presence of an abdominal mass located in the lower left quadrant of the abdomen. Mesenteric panniculitis is diagnosed.Conclusions: in spite of being a rare entity, mesenteric panniculitis should be considered in the differential diagnosis of patients with palpable abdominal mass, where the imaging studies are valuable for its diagnosis. ; Introducción: la paniculitis mesentérica es un trastorno poco frecuente caracterizado por inflamación crónica del tejido adiposo del mesenterio intestinal, su etiología es desconocida.Objetivo: describir la presentación clínica y radiológica de un paciente con paniculitis mesentérica atendido en el Hospital Militar Dr. Carlos J. Finlay de La Habana, Cuba.Caso clínico: paciente masculino de 62 años de edad, con antecedentes de salud aparente, ex fumador que hace seis meses, notó la presencia de una masa abdominal localizada en el cuadrante inferior izquierdo del abdomen. Se diagnostica paniculitis mesentérica.Conclusiones: a pesar de ser una entidad poco frecuente, la paniculitis mesentérica, debe ser considerada en el diagnóstico diferencial de los pacientes con masa abdominal palpable, empleando los medios imagenológicos para su estudio.

Intestinal injury is frequent after non-penetrating abdominal trauma, particularly after modern, high-energy transfer impacts. Under these circumstances, delay in the diagnosis of perforation is a major contributor to morbidity and mortality. This study establishes patterns of intestinal injury after blunt trauma by non-penetrating projectiles and examines relationships between injury distribution and abdominal wall motion. Projectile impacts of variable momentum were produced in 31 anaesthetised pigs to cause abdominal wall motion of varying magnitude and velocity. No small bowel injury was observed at initial impact velocity of less than 40 m/s despite gross abdominal compression. At higher velocity, injury to the small bowel was frequent, irrespective of the degree of abdominal compression (P = 0.00044). Large bowel injury was observed at all impact velocities and at all degrees of abdominal compression. This study confirms the potential for intestinal injury in high velocity, low momentum impacts which do not greatly compress the abdominal cavity and demonstrates apparent differences in injury mechanisms for the small bowel and colon. Familiarity with injury mechanisms may reduce delays in the diagnosis of intestinal perforation in both military and civilian situations.