Aspectos ultrassonográficos e anatomia da aponeurose do músculo transverso do abdome

Abstract

-Background: Ultrasound, computed tomography, and magnetic resonance imaging of abdominal wall has increasingly been used for hernia diagnosis when clinical examination is uncertain. Anatomical study of abdominal wall along with the ultrasound of transversus abdominis muscle aponeurosis can help identify a Spigelian hernia in this region, a disease of difficult diagnosis. Aim: To compare the ultrasound findings of anterolateral wall of the abdomen, focusing on Spigelian aponeurosis, to the anatomy of abdominal wall studied in cadavers. Methods: The evaluation of the transversus abdominis aponeurosis was performed during routine ultrasound exams of the anterolateral wall of the abdomen in 90 individuals of both genders, over 25 years, and data were correlated with 60 dissections of the abdominal wall, held on cadavers.Results: Ultrasound showed no significant defects in the aponeurosis of transversus abdominis muscle in the 90 subjects studied and the width of the Spigelian aponeurosis ranged from 0.83 to 2.93 cm (mean 1.72 cm). During dissections of the transversus abdominis, some defects were found in 14 out of 60 muscles and aponeurosis studied (23.3%) and the width of the Spigelian aponeurosis ranged from 1.5 to 3.5 cm (mean 2.26 cm). Comparisons between age groups and genders evaluated by ultrasound with cadaver dissections performed were not statistically significant. Conclusion: Sonographic examinations found no defects in the aponeurosis of transversus abdominis muscle compatible with hernias, and anatomical variations and defects found during dissections were not as well accompanied by Spigelian hernias in the studied corpse. RESUMO -Racional:A avaliação da parede abdominal pela ultrassonografia, tomografia computadorizada e ressonância magnética tem sido cada vez mais indicada para auxiliar no diagnóstico das hérnias quando o exame clínico deixa dúvidas. A correlação de estudos da anatomia da parede abdominal com o exame ultrassonográfico da aponeurose do músculo transverso do abdome pode auxiliar no diagnóstico de uma hérnia desta localização, a hérnia de Spiegel, que se apresenta como doença de diagnóstico clínico difícil. Objetivo: Comparar os achados ultrassonográficos da parede anterolateral do abdome, com foco na aponeurose de Spiegel, e a anatomia da parede abdominal estudada em cadáveres não fixados. Método: A avaliação da aponeurose do músculo transverso do abdome foi realizada durante exames ultrassonográficos de rotina da parede anterolateral do abdome em 90 indivíduos de ambos os gêneros, maiores de 25 anos e estes dados foram relacionados com 60 dissecções da parede abdominal realizadas em cadáveres não fixados. Resultados: Os exames ultrassonográficos não evidenciaram falhas significativas na aponeurose do músculo transverso do abdome nos 90 indivíduos estudados e a largura das aponeuroses de Spiegel variou de 0,83 a 2,93 cm (média de 1,72 cm). Durante as dissecções do transverso do abdome foram encontradas alterações anatômicas em 14 de 60 músculos e aponeuroses estudadas (23,3%)...

Ultrasonography as a Tool to Improve Preoperative Marking in Body Contour Surgery

“…Taking advantage of these findings can lead to safe and possibly more satisfactory outcomes. [19][20][21][22][23] Our study aimed to evaluate the agreement between presurgical markings made by five plastic surgeons using the conventional palpation technique. Later, it validated these markings with US, giving results that were consistent only in one evaluated structure (midline).…”

Volume calculation of rats' organs and its application in the validation of the volume relation between the abdominal cavity and the hernial sac in incisional hernias with "loss of abdominal domain"

“…In Brazil, the pioneering studies by Kather-Neto and Lázaro da Silva 12 advocated the calculation of the volume of the hernia sac with tape and pelvimeter, allowing to find the values ​​for calculating the volume of an ellipse. Imaging methods for evaluating the abdominal wall and the abdominal contents in obese have been increasingly used 8 , 9 , 27 . Tanaka used in his studies the volume ratio of the sac and cavity, calculated with the aid of CT slices of the abdomen and pelvis, and the mathematical formula of the ellipsoid method which allows you to defining when the hernia is considered giant or when there is loss of domain which asks for the preoperative pneumoperitoneum or even colon resections to achieve the closure of the abdominal cavity, avoiding the abdominal compartment syndrome, a condition of extreme morbidity that may be accompanied by renal and respiratory failure 13 , 14 , 16 , 26 .…”

Carta ao Editor

“…I consider it necessary to congratulate the Editor for the option to publish the articles also in English, greatly increasing the reach and impact of the publication, as well as the speed, the less bureaucratic and friendly way to contact the journal and even the Editor. To illustrate the quality of the journal reviewers, I emphasize a recent publication of ABCD: "Ultrasound aspects and anatomy of the aponeurosis of the transversus abdominis muscle" (Arq Bras Cir Dig 2013; 26 (3): 184-189) 2 , that received the ward of Best Poster of 29th International Congress of the Medical Women's International Association, held in Seoul, Korea, between July 31 and August 3, 2013.…”