UMBLICAL DEFECTS 3

UMBILICAL DEFECTS

During  the  embryonic period at about the tenth  week  of  fetal

life; the viscera normally return to the abdominal cavity and the

abdominal wall closes slowly during subsequent fetal development.

At birth, many infants will show a small umbilical hernia because

this  process has not been completed (Fig. 24.8b).  In most  cases

spontaneous closure occurs within the first three years of life.

Rarely,  the  process  of  abdominal  wall  closure  is   totally

incomplete  at birth and omphalocele is present.  The  defect  at

the umbilicus is covered only by a peritoneal sac.

In a few cases, the embyrologic duct from small bowel to the yolk

sac (vitillo-intestinal duct) remains patent and attached to  the

umbilical cord at birth.

This  duct  is  likely  to be included  in  the  tie.   When  the

umbilical remanent sloughs later; a fistula into the small gut is

created.

In  other cases; the tract from the bladder; the  urachus  enters

the  umbilical arteries.  The remnant of the cephalic portion  of

the  embryonic  urinary  bladder is  usually  obliterated  before

birth;  if  it  remains patent, it may  become  involved  in  the

umbilical  cord  ligature  and a  draining  umbilical  sinus  may

present.

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ABDOMINAL WALL HERNIAS 2 ventral hernias

 ETIOLOGY

Hernias  may result from congenital weakness of the wall  or  the

weakness may develop secondarily during later life. The Secondary

hernia are usually considered to be traumatic or acquired due  to

sudden lifting of weights.

The development of a hernia in the groin, during middle life  may

also  be  because  of increased intra  abdominal  pressure.  Thus

chronic  cough,  symptoms of  genitourinary  or  gastrointestinal

tract obstruction may preceed herniation.

Some  young  male adults first discover a hernia  after  vigorous

physical exercise.

3. VENTRAL HERNIAS

Ventral  hernias are situated on the anterior abdominal wall  and

same are in the midline  and include

UMBILICAL DEFECTS

During  the  embryonic period at about the tenth  week  of  fetal

life; the viscera normally return to the abdominal cavity and the

abdominal wall closes slowly during subsequent fetal development.

At birth, many infants will show a small umbilical hernia because

this  process has not been completed (Fig. 24.8b).  In most  cases

spontaneous closure occurs within the first three years of life.

Rarely,  the  process  of  abdominal  wall  closure  is   totally

incomplete  at birth and omphalocele is present.  The  defect  at

the umbilicus is covered only by a peritoneal sac.

In a few cases, the embyrologic duct from small bowel to the yolk

sac (vitillo-intestinal duct) remains patent and attached to  the

umbilical cord at birth.

This  duct  is  likely  to be included  in  the  tie.   When  the

umbilical remanent sloughs later; a fistula into the small gut is

created.

In  other cases; the tract from the bladder; the  urachus  enters

the  umbilical arteries.  The remnant of the cephalic portion  of

the  embryonic  urinary  bladder is  usually  obliterated  before

birth;  if  it  remains patent, it may  become  involved  in  the

umbilical  cord  ligature  and a  draining  umbilical  sinus  may

present.

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archives for access & review.

Visitors that follow may post contributions to the site,please write to address above.

To creat consumer/provider engagement visit www.otmanage.blogspot.com

www.surginstruatlas.blogspot.com           www.drmmkapur.blogspot.com

ABDOMINAL WALL HERNIAS definitions

ABDOMINAL WALL HERNIAS

1. DEFINITION

1.1  A hernia is the protursion of an organ through the  wall  of

the cavity in which it is normally present.  The different  parts

of a hernia are shown in Fig. 24.1.

The  common  cause  for  abdominal hernias  is  a  congenital  or

acquired  weakness  in  the abdominal wall.   Thus  the  contents

(viscera)  cannot be retained in the abdominal cavity because  of

this weakness of the wall.

1.2  The  largest  number of hernias occur  in  the  Inguinal  or

Femoral  regions  and  are usually classified  as  groin  hernias

1.3 If the contents of the hernia can be returned to their normal

intra abdominal position, the hernia is defined as reducible.

1.4 In an irreducible hernia, the contents cannot be pushed  back

into the abdominal cavity probably because of adhesions but there

are no symptoms.

    

1.5  An  obstructed  hernia is irreducible  and  shows  signs  of

intestinal obstruction, however, the blood supply to the contents

has as yet not been compromised.3

1.6  If  compromise of the blood supply of  the  contained  organ

occurs, it is an incarcerated (stragulated) 

1.7  When a portion of the wall of the hernial sac is made up  by

an  organ such as the cecum or the sigmoid colon, it is  referred

to as a "sliding hernia". 

1.8 A hernia containing a loop of bowel is an enterocele and that

containing omentum is an omentocele. 

1.9  When  a  part of the circumference of the bowel  is  in  the

hernial sac, it is called Richter's hernia. 

1.10 A hernia containing the Meckel's diverticulum is a  Littre's

hernia.

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Visitors follow may post contributions to the site,please write to address above.

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LYMPHOMA 2 Investigation Treatment NHL

Investigation are required to stage the disease  accurately

and include.

-  blood count

-  bone marrow

-  chest x-ray

-  lymphangiography

-  CT scan

-  Radioisotope scan

-  Magnetic resonace Imaging

-  Staging lapratomy and splenectomy (to eliminate

   involment)

8.1.3 TREATMENT

With radiotherapy chemotherapy after staging

8.2 Non Hodgkin's Lymphoma

In usually not so localised clinical presentation  with pain less

lymph gland enlargement and an ann arbor staging is required  for

which a node biopsy is followed by tests identified for Hodgkin's

lymphoma, are undertaken.

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All older posts are stored in archives for access and review

Visitors that follow may post contributions to the site,please write to address above.

To create consumer provider engagement visit www.otmanage.blogspot.com

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