Entero mesh vaginal fistula secondary to abdominal sacral colpopexy.
*Surgical Mesh; Abdomen; Female; Gynecologic Surgical Procedures; Humans; Intestinal Fistula/*etiology; Intestine; Middle Aged; Postoperative Complications/*etiology; Sacrum; Small; Uterine Prolapse/surgery; Vaginal Fistula/*etiology
BACKGROUND: Abdominal sacral colpopexy is a popular method for resupporting the vaginal apex. Bleeding and infection are the most common complications. We report a complication resulting in a small bowel fistula. CASE: A 48-year-old woman developed a chronic vaginal discharge 4-6 months after routine abdominal sacral colpopexy in which a velour mesh remained exposed in the pelvis. Conservative measures failed to control the intermittent copious discharge from the upper vaginal vault where the mesh was visualized. At laparotomy, an entero mesh vaginal fistula was discovered. Excellent long-term results were obtained by removal of the mesh along with resection of the involved small intestine. CONCLUSION: At the time of abdominal sacral colpopexy, we recommend that mesh not remain exposed in the pelvis.
Hopkins Michael P; Rooney Christopher
Obstetrics and gynecology
2004
2004-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/01.AOG.0000127940.45774.b4" target="_blank" rel="noreferrer noopener">10.1097/01.AOG.0000127940.45774.b4</a>
Distribution and origin of corticotropin-releasing factor-immunoreactive axons in the female rat lumbosacral spinal cord.
Animals; Axons/*metabolism/ultrastructure; Brain/cytology/*metabolism; Corticotropin-Releasing Hormone/*metabolism; Efferent Pathways/cytology/*metabolism; Female; Fluorescent Dyes; Herpesvirus 1; Immunohistochemistry; Lumbar Vertebrae; NADPH Dehydrogenase/metabolism; Nitrergic Neurons/cytology/metabolism; Parasympathetic Nervous System/cytology/*metabolism; Paraventricular Hypothalamic Nucleus/cytology/metabolism; Pons/cytology/metabolism; Pregnancy; Presynaptic Terminals/metabolism/ultrastructure; Rats; Reproduction/physiology; Sacrum; Spinal Cord/cytology/*metabolism; Sprague-Dawley; Suid; Uterus/*innervation
Corticotropin-releasing factor (CRF) is a neuropeptide traditionally known for its hormonal role in the hypothalamic/pituitary/adrenal stress axis. However, CRF has been reported in axons in sites that may be considered outside of the direct stress axis, e.g., in axons in the lumbosacral spinal cord associated with the micturition response. Whether any of these CRF-immunoreactive axons interacts with uterine-related preganglionic autonomic neurons or projection neurons in the lumbosacral spinal cord is unknown. Thus, immunohistochemistry and retrograde tracing were employed to determine the presence, distribution, and origin of
Puder B A; Papka R E
Journal of neuroscience research
2001
2001-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/jnr.10033" target="_blank" rel="noreferrer noopener">10.1002/jnr.10033</a>
Reevaluation of the lumbosacral region of Oreopithecus bambolii
Anthropology; ape oreopithecus; australopithecus-afarensis; Bipedalism; body size; Evolutionary Biology; functional-morphology; grip capability; locomotor skeleton; Lumbar vertebrae; Lumbar vertebrae; morphometric-analysis; Oreopithecus; positional behavior; Sacrum; sexual-dimorphism
Functional interpretations of the postcranium of the late Miocene ape Oreopithecus bambolii are controversial. The claim that Oreopithecus practiced habitual terrestrial bipedalism is partly based on restored postcranial remains originally recovered from Baccinello, Tuscany (Kohler and Moya-Sola, 1997). The lower lumbar vertebrae of BA#72 were cited as evidence that Oreopithecus exhibits features indicative of a lordotic lumbar spine, including dorsal wedging of the vertebral bodies and a caudally progressive increase in postzygapophyseal interfacet distance. Here, we demonstrate why the dorsal wedging index value obtained by Miller and Moya-Sola (1997) for the BA#72 last lumbar vertebra is questionable due to distortion in that region, present a more reliable way to measure postzygapophyseal interfacet distance, and include an additional metric (laminar width) with which to examine changes in the transverse dimensions of the neural arches. We also quantify the external morphology of the BA#72 proximal sacrum, which, despite well-documented links between sacral morphology and bipedal locomotion, and excellent preservation of the sacral prezygapophyses, first sacral vertebral body, and right ala, was not evaluated by Kohler and Moya-Sola (1997). Measures of postzygapophyseal interfacet distance and laminar width on the penultimate and last lumbar vertebrae of BA#72 reveal a pattern encompassed within the range of living nonhuman hominoids and unlike that of modern humans, suggesting that Oreopithecus did not possess a lordotic lumbar spine. Results further show that the BA#72 sacrum exhibits relatively small prezygapophyseal articular facet surface areas and mediolaterally narrow alae compared with modern humans, indicating that the morphology of the Oreopithecus sacrum is incompatible with the functional demands of habitual bipedal stance and locomotion. The Oreopithecus lumbosacral region does not exhibit adaptations for habitual bipedal locomotion. (C) 2013 Elsevier Ltd. All rights reserved.
Russo G A; Shapiro L J
Journal of Human Evolution
2013
2013-09
Journal Article
<a href="http://doi.org/10.1016/j.jhevol.2013.05.004" target="_blank" rel="noreferrer noopener">10.1016/j.jhevol.2013.05.004</a>