Abstract
Introduction: Parastomal hernias are a common complication of ileostomy and colostomy creation. Most are managed non-operatively, but some require surgery because of progressive symptoms and obstruction. Porcine urinary bladder matrix (UBM), utilized in many hernia applications, serves as an effective biologically-derived extracellular matrix scaffold and facilitates a favorable remodeling response with restoration of site-appropriate tissue. Case Series: Herein, eight cases are presented which describe four different techniques of parastomal hernia repair utilizing porcine UBM. In four cases, repair was performed through open laparotomy; the remaining four were performed laparoscopically. All repairs were reinforced with porcine UBM. Median duration of follow-up is 23 months. Conclusion: Surgeons may safely employ open and laparoscopic techniques for successful repair of parastomal hernias. In this series of eight cases, repairs with porcine UBM devices have proven durable at two years of follow-up and may serve as an alternative to synthetic mesh. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 7 No. 2, February 2016. ISSN – [0976-3198] Int J Case Rep Images 2016;7(2):85–91. www.ijcasereportsandimages.com Sasse et al. 85 CASE REPORT OPEN ACCESS Parastomal hernia repair with urinary bladder matrix grafts: A case series Kent C. Sasse, David L. Warner, Ellen Ackerman, Jared Brandt
Highlights
Takayasu’s arteritis is a chronic systemic vasculitis, mainly involving aorta and its major branches
Case Series: We report a series of five patients with the diagnosis of Takayasu’s arteritis
The one presenting with stroke and other presenting with limb claudication, were classified as Takayasu’s type-I; Two of the patients with heart failure were labeled as Takayasu’s typeII and III
Summary
Takayasu’s arteritis (TAK) is a rare, systemic, vasculitis of unknown aetiology. The disease has been reported worldwide, but it appears to be more prevalent in certain Asian countries, such as Japan, Korea, China, India, Thailand, Singapore, etc. ACR criteria is used to classify TAK, which include age, claudication of extremity, blood pressure difference in arms, presence of bruits in aorta or subclavian arteries and angiographic evidence of narrowing or occlusion of aorta or its major branches. There was narrowing of aorta distal to the origin of left subclavian artery This patient was labeled as Takayasu’s type-III. Computed tomography angiography showed circumferential thickening of aortic arch and descending thoracic aorta, with stenosis of both subclavian arteries. She was diagnosed as Takayasu’s type II, and was treated with azathioprine. Aortic arch, descending thoracic aorta, stenosis of both subclavian arteries
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