Learning objectives
Reviewing the current classification of wall hernias and repair indications with preaponeurotic meshes
Describing the RM protocol that we use in our Center for the valuation of the meshes
Getting acquainted with the different sequences of MRI and the radiological appearance of the visible meshes
Assessing the usefulness of MRI for the study of the integrity and disposition of the mesh,
as well as its complications.
Fig. 1
Background
Until a few years ago,
the abdominal wall repair meshes were "invisible" to our radiological eyes.
None of the imaging techniques available allowed an appropriate assessment of the mesh or the possible complications.
The use of prosthetic materials is not exempt from short and medium-term complications (contraction,
folding,
displacement,
rupture,
adhesions to adjacent viscera),
hence the importance of achieving better post-operative control.
The use of new preaponeurotic meshes with iron filaments allows to carry out a study with MRI to assess its integrity,
its folding,...
Findings and procedure details
TYPES OF WALL HERNIAS
The diagnosis of abdominal hernia is clinically established,
however Multislice computed tomography (MSCT) is very useful for identifying and classifying them.
Types of Wall hernias
Direct inguinal
Indirect inguinal
Femoral
Obturator
Ventral
Umbilical
Paraumbilical
Epigastric
Hypogastric
Lateral or paramedian.
Spigelian
Lumbar
Incisional
TYPES OF WALL HERNIAS
Direct inguinal hernias:
They appear through the Hesselbach hole,
above the inguinal and medial ligament to the inferior epigastric vessels.
They are acquired secondarily to a weakness of the transverse fascia in the triangle of...
Conclusion
The appearance of new visible meshes,
which allow both the repair of hernias and eventrations of the abdominal wall and prophylactic repair in high-risk patients,
make it necessary for the radiologist to be familiar with their appearance in MRI.
Thus,
the MRI becomes a useful tool in the post-surgical assessment of complications of abdominal wall repair in patients with preaponeurotic meshes,
allowing us to assess their integrity and the appearance of complications,
in addition to the study of the state of the musculature.