EURORAD ESR

Case 15283

Giant ventral incisional hernias with loss of domain: what the radiologist needs to know

Author(s)
Tonolini Massimo, MD.

"Luigi Sacco" University Hospital, Radiology Department; Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
female, 75 year(s)
 
 
  • Figure 1
    Unenhanced CT and measurements
     

    Axial (a) and coronal (b) CT images allowed easy measurement of maximal transverse section (calipers in a) and craniocaudal diameter (caliper in b) of large ventral hernia sac, containing fat, colon and small bowel...

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Axial (a) and coronal (b) CT images allowed easy measurement of maximal transverse section (calipers in a) and craniocaudal diameter (caliper in b) of large ventral hernia sac, containing fat, colon and small bowel...

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Table explaining assessment of hernia sac volume (HSV) (see Figs.1a-b)

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Axial (c) and coronal (d) images showing measurement of maximal transverse section (calipers in a) and craniocaudal diameter (caliper in d) of intra-abdominal compartment. Note symmetrically thin, atrophied rectus...

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Axial (c) and coronal (d) images showing measurement of maximal transverse section (calipers in a) and craniocaudal diameter (caliper in d) of intra-abdominal compartment.

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Table explaining assessment of abdominal cavity volume (ACV) (see Figs.1d-e)

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;
     
     
  • Figure 2
    Unenhanced CT
     

    Sagittal (a) and axial (b) images allowed rapid measurement of longitudinal (caliper in a) and transverse (caliper in b) diameter of abdominal wall defect, respectively.

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Sagittal (a) and axial (b) images allowed rapid measurement of longitudinal (caliper in a) and transverse (caliper in b) diameter of abdominal wall defect, respectively.

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Additionally, on the axial plane the defect angle (calipers) relative to a fixed point at the ventral aspect of lumbosacral vertebrae may be calculated.

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;
     
     
Axial (a) and coronal (b) CT images allowed easy measurement of maximal transverse section (calipers in a) and craniocaudal diameter (caliper in b) of large ventral hernia sac, containing fat, colon and small bowel loops.
 
Axial (a) and coronal (b) CT images allowed easy measurement of maximal transverse section (calipers in a) and craniocaudal diameter (caliper in b) of large ventral hernia sac, containing fat, colon and small bowel loops.
 
Table explaining assessment of hernia sac volume (HSV) (see Figs.1a-b)
 
Axial (c) and coronal (d) images showing measurement of maximal transverse section (calipers in a) and craniocaudal diameter (caliper in d) of intra-abdominal compartment. Note symmetrically thin, atrophied rectus muscles.
 
Axial (c) and coronal (d) images showing measurement of maximal transverse section (calipers in a) and craniocaudal diameter (caliper in d) of intra-abdominal compartment.
 
Table explaining assessment of abdominal cavity volume (ACV) (see Figs.1d-e)
 
Sagittal (a) and axial (b) images allowed rapid measurement of longitudinal (caliper in a) and transverse (caliper in b) diameter of abdominal wall defect, respectively.
 
Sagittal (a) and axial (b) images allowed rapid measurement of longitudinal (caliper in a) and transverse (caliper in b) diameter of abdominal wall defect, respectively.
 
Additionally, on the axial plane the defect angle (calipers) relative to a fixed point at the ventral aspect of lumbosacral vertebrae may be calculated.
 
 
 
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