[Giant loss of domain hernia: Preoperative treatment with botulinum toxin of the abdominal oblique muscles].

Autor:	Cruz Guisado V; Servicio de Medicina Física y Rehabilitación, Hospital Jerez de la Frontera, Jerez de la Frontera, Cádiz, España. Electronic address: vik88m@hotmail.com., Méndez García C; Servicio de Cirugía General, Hospital Jerez de la Frontera, Jerez de la Frontera, Cádiz, España., Gómez Benítez G; Unidad del Dolor, Servicio de Neurocirugía, Hospital Universitario Puerta del Mar, Cádiz, España., Ramos Domínguez V; Servicio de Medicina Física y Rehabilitación, Hospital Jerez de la Frontera, Jerez de la Frontera, Cádiz, España.
Jazyk:	Spanish; Castilian
Zdroj:	Rehabilitacion [Rehabilitacion (Madr)] 2019 Oct - Dec; Vol. 53 (4), pp. 284-287. Date of Electronic Publication: 2019 Feb 22.
DOI:	10.1016/j.rh.2018.12.003
Abstrakt:	In giant loss of domain hernia there is a high risk of abdominal compartment syndrome and restrictive lung disease after complete surgical repair of the fascial defect. We report the case of a 54-year-old man with a late-stage right giant mesogastric loss of domain hernia who began preoperative treatment with progressive pneumoperitoneum. After evaluation of the muscles and skin, ultrasound and electromyographic-guided infiltration of botulinum toxin type A was performed in the abdominal oblique muscles. It caused a flaccid paralysis of the wall and allowed advancement of the lateral flaps without weakening them. The patient underwent surgery one month later with complete closure of the defect and with no signs of respiratory failure or compartment syndrome. The use of botulinum toxin in the preoperative treatment of patients with loss of domain hernias seems a safe and effective therapeutic option. (Copyright © 2019 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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