RESUMO
The inguinal canal is an anatomically complex region. Although much has been written about the gubernaculum and the descent of the testis, little is known about the development of the abdominal wall itself. We dissected this inguinal canal in 75 fetuses between 10 and 25 weeks of gestation, 42 males and 33 females. We identified the anterior body-wall muscular layers, located the gonads and uterus, and observed the formation of the scrotum. The gubernaculum was dissected, from the deep to the superficial ends and its distal attachments were determined. We proved that the muscular-fibrous layers of the wall were well-differentiated and observed how the inguinal canal enlarged with embryological development. In only one of the cases, an abnormal testis was found located in the scrotum. The upper end of the gubernaculum inserted into the inferior pole of the testis or the lateral angle of the uterus, according to gender. The lower end was attached by one or multiple tails, mainly on the pubic bone. This fact explained the clinical findings of ectopic testis. Observations of the abdominal wall and its relationship with the gubernaculum assisted us in explaining the development of the inguinal region, the formation of the inguinal canal, and the presence of the gubernaculum, in both genders. We intend to explain how the deep inguinal ring moves upwards, bringing the gubernaculum along with it, and thus determines the final form of the inguinal canal.
Assuntos
Canal Inguinal/embriologia , Músculos Abdominais/embriologia , Parede Abdominal/embriologia , Feminino , Humanos , Masculino , Testículo/anormalidadesRESUMO
Se muestra el origen embriológico y anatómico de la pared abdominal. Se presentan las características clínicas, diagnóstico y tratamiento de las hernias externas, hernia inguinal, hernia crural o femoral, hernia umbilical, incisional, epigástrica, obturatoria de spiegel, inginal con apendicitis, de Littré o hernia diverticular, crural con apendicitis y divertículo de Meckel en una hernia femoral
Assuntos
Humanos , Músculos Abdominais/anatomia & histologia , Divertículo Ileal , Hérnia Femoral , Hérnia/diagnóstico , Músculos Abdominais/embriologia , Hérnia/terapiaRESUMO
Omphalocele, umbilical cord hernia, and gastroschisis are surgically correctable defects of the abdominal wall. Each of these defects has a distinct embryologic basis that results in a characteristic clinical picture. Twenty-five infants with congenital defects of the abdominal wall were treated at the University of New Mexico Hospital in the past four years. Six infants had omphalocele, one had umbilical cord hernia, and 18 had gastroschisis. Survival among infants who underwent a corrective operation was as follows: omphalocele, 50%; umbilical cord hernia, 100%; and gastroschisis, 82%. Long-term survival for the entire group was 72% (18/25). Gastroschisis, which had a lower incidence of major associated anomalies, had a better prognosis than omphalocele. The mortality of congenital abdominal wall defects was related to presence of severe associated anomalies and to poor clinical condition on admission. Prompt and informed initial care may increase the chance of survival.