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Ultrasound images of fetal ascites. (a) case 4, 22 weeks of gestation, (b) case 6, 26 weeks of gestation, (c) case 7, 28 weeks of gestation, (d) case 9, 31 weeks of gestation, (e) case 10, 39 weeks of gestation. (f) case 11, 28 weeks of gestation. Asterisk (*): ascites, arrow: greater omentum, s: stomach, b: bladder.
Source publication
The greater omentum is an apron-like peritoneal mesothelial sheet that was described by ultrasound as a floating fluid-filled viscus in ascites during the fetal period. To examine the association between the etiology of fetal ascites and ultrasound findings of the greater omentum, a retrospective study was conducted. Ultrasound findings of fetal om...
Contexts in source publication
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... case 2, the lymphocytedominated ascites was identified from the stillborn baby. In case 3 and case 4, the cause of fetal hydrops was compression of the inferior vena cava associated with an intrathoracic lesion and hyperinflated lungs by laryngeal atresia, respectively ( Figure 1a) and congenital pulmonary airway malformation, respectively. In both cases, the ascites was improved and the greater omentum was not observed at 30 weeks. ...
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... were four cases of isolated ascites with a floating greater omentum (cases 4-8). Cases 5 and 6 ( Figure 1b) were diagnosed with congenital cytomegalovirus infection. Maternal Cytomegalovirus(CMV)-IgM antibody was positive in case 6 but negative in case 5. CMV-DNA was detected in the urine of both newborns. ...
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... case 6, the fetal ascites resolved spontaneously, and the greater omentum was not observed at 30 weeks of gestation. Case 7 (Figure 1c) resulted in intrauterine fetal death of unknown cause at 32 weeks. The greater omentum was observed by ultrasound until just before the fetal death. ...
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... fetal greater omentum was not observed in all three cases of meconium peritonitis (cases 9-11, Figure 1d-f). None of the three cases showed fetal hydrops. ...
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... of the three cases showed fetal hydrops. Polyhydramnios was observed in cases 9 (Figure 1d) and 11 ( Figure 1f). In case 10, the fetal dilated small intestine was observed, and intestinal atresia was suspected. ...
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... of the three cases showed fetal hydrops. Polyhydramnios was observed in cases 9 (Figure 1d) and 11 ( Figure 1f). In case 10, the fetal dilated small intestine was observed, and intestinal atresia was suspected. ...
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... case 10, the fetal dilated small intestine was observed, and intestinal atresia was suspected. At 39 weeks of gestation, fetal ascites suddenly appeared (Figure 1e), and an emergency cesarean section was performed due to a non-reassuring fetal status. After birth, the neonate underwent emergency surgery and was diagnosed with meconium peritonitis by midgut volvulus with intestinal malrotation and atresia. ...
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... birth, the neonate underwent emergency surgery and was diagnosed with meconium peritonitis by midgut volvulus with intestinal malrotation and atresia. In case 11, fetal ascites resolved spontaneously, and intra-abdominal calcification was observed during the third trimester of pregnancy (Figure 1f). ...
Citations
... Великий чепець натепер визнаний важливим органом у боротьбі з інтраабдомінальними інфекціями, тому його часто називають «поліцейським очеревинної порожнини» [1]. Раніше його вважали інертною жировою тканиною, призначеною лише для ізоляції черевної порожнини, натепер він визнаний активним імунологічним органом зі складною структурою, унікально придатною для захисту від патогенів і травм [2][3][4][5][6][7]. Незважаючи на ці важливі особливості, участь великого чепця в імунологічних механізмах, залишається не до кінця зрозумілою. ...
... Протягом кількох днів фібрин починає формуватися з розвитком нових кровоносних судин та фібробластів. У довготривалій перспективі, якщо господар виживе, ушкоджена ділянка буде оточена щільним колагеновим шаром, що призведе до утворення злукового процесу [3,51]. ...
The greater omentum is now recognized as an important organ in the fight against intra-abdominal infections, so it is often called the “policeman of the peritoneal cavity”. The greater omentum plays the most important role in the implementation of immune supervision of the antigenic condition of the peritoneal fluid and rapid response of damage to the gastrointestinal tract, which is often complicated by inflammation of the peritoneum – peritonitis. The purpose of the work was to study the peculiarities of the structure of the greater omentum of white rats and its role in peritonitis by means of a bibliographic analysis of the literature. Materials and methods. This bibliographic analysis is based on published articles, books, textbooks, monographs and dissertation abstracts. For the purposes of this systematic review, a literature search was carried out in the worldwide Internet, domestic sources of literature, scientific and electronic library of Poltava State Medical University using the following key words: “morphology”, “comparative anatomy”, “greater omentum”, “greater omentum of the rats”, “immune system”, “white rats”, “laboratory animals”, “rat anatomy”, “peritonitis”. Results and discussion. The greater omentum of white rats and humans are represented by two different structures: translucent membranous regions and regions rich in adipose tissue. According to the literature, the greater omentum of white rats is the main morphological characteristic (in miniature), homologous to the human one. The main function of the greater omentum, according to the opinion of many authors and ours too, is immunity. Immune structures of the greater omentum of white rats are represented by lymphoid nodules, known in the literature as milky spots, most of which are located near arteries and veins. In pathological conditions, the greater omentum acquires absolutely special properties, such as plasticity, the ability to fuse with a traumatic and inflamed surface, the ability to hemostasis and phagocytosis, the ability to germinate and revascularize, to absorb fluids and microparticles from the peritoneal cavity, and the ability to the immunological response. Conclusion. According to the literature, the greater omentum of white rats is a miniature likeness of the greater omentum of a person. However, unlike the latter, it consists of only one duplication of the visceral peritoneum, between the leaves of which there are blood vessels with deposits of adipose tissue and milk spots. Thus, the greater omentum of white rats is a perfectly acceptable object of experimental research with the subsequent legitimate extrapolation of their results to humans. The greater omentum occupies a central place in the peritoneal defense mechanisms due to its innate immune function, high absorbing capacity, and ability to attach to neighboring structures to close defects of abdominal organs and promote their healing, due to its expressive angiogenic activity
Experimental studies devoted to the study of the mechanisms of the pathogenesis of acute peritonitis and the development of new methods of medical and surgical treatment are becoming increasingly relevant. Today, experimental medicine knows many different ways to modeling septic peritonitis and eliminate it, but the role of the local immune system is underestimated, whereas it takes a direct part in inflammation. The objective of our work to study morphological features of results of experimental modeling of septic peritonitis in white rats. The study included 15 sexually mature white male rats weighing 276.75±6.56 grams. A simulation of septic peritonitis was performed by perforating the upper part of the cecum with four punctures with a G16 injection needle. As a result of the experiment, after examination of the peritoneal cavity, all 15 animals were diagnosed with omentum tamponade of perforated damage to the caecum. In 11 cases, the perforated wall of the caecum was covered by the greater omentum (73.34 %), and in the other 4 animals, tamponade was performed by one of the epididymal omentum (26.66 %). The initial stage of tamponade with the greater or epididymal omentums of a perforated caecum begins on the first day of the experiment and consists of tight interstitial consolidation between them, as well as in the invasion of blood vessels from the omentum side to the focus of infection, which ensure the delivery of the appropriate immunocompetent cells. As a result of this process, intensive lymphoid infiltrates are formed in this area, as well as the growth of adipose tissue, which isolates the inflammatory focus from the peritoneal cavity with a thick layer.
