Extensive Circumferential Heterotopic Ossification Discovered at the Base of a Loop Ileostomy

Bosaily, Ahmad; Edminister, John; Magal, Samarchitha; Jamil, Muhammad; Lynn, Amy; Hall, Glenn C.

doi:10.1155/2019/4036716

Cited by 4 publications

(6 citation statements)

References 26 publications

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“…El diagnóstico de la OHI se basa en los hallazgos característicos por estudios de imágenes (lesiones de aspecto lineal y ramificado de alta densidad localizadas principalmente en el mesenterio), dentro del contexto clínico sugerente (varón de mediana edad con antecedentes quirúrgicos múltiples o traumáticos abdominales). Además, se ha demostrado que la elevación de la fosfatasa alcalina puede sugerir el diagnóstico junto con los factores antes descritos, debido a la actividad osteoblástica presente en esta patología 2 .…”

Section: Discussionunclassified

“…La osificación heterotópica intraabdominal (OHI) es un proceso benigno que consiste en la formación de tejido óseo en sitios no habituales dentro del abdomen. Ocurre sobre todo en el mesenterio, la pared abdominal y el omento, pero se han reportado casos en cicatriz quirúrgica 1 , asa de ileostomía 2 , reparaciones con malla de hernias 3 y apófisis xifoide 4 .…”

Section: Introductionunclassified

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Osificación heterotópica intraabdominal: reporte de caso

Navarro-Briceño¹,

Villalba-Meneses²

2023

RCHRAD

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La formación de tejido óseo (osificación) en sitios no habituales (heterotópica) ocurre con escasa frecuencia dentro del abdomen. Las intervenciones quirúrgicas múltiples y los traumatismos abdominales son los principales factores asociados, pero su etiología aún es desconocida. Se presenta el caso de un varón de 56 años que por un accidente de tránsito en motocicleta presentó traumatismo múltiple con trauma cerrado de abdomen y lesiones de vísceras sólidas y huecas. Fue intervenido quirúrgicamente en varias ocasiones, primero para las reparaciones de sus lesiones traumáticas y posteriormente por complicaciones sobreañadidas. La tomografía computarizada realizada 13 meses después del trauma mostró formaciones óseas intraabdominales localizadas en el mesenterio, el epiplón mayor y la pared abdominal con extensión a la apófisis xifoides, concordantes con osificación heterotópica intraabdominal.

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Section: Discussionunclassified

Section: Introductionunclassified

Osificación heterotópica intraabdominal: reporte de caso

Navarro-Briceño¹,

Villalba-Meneses²

2023

RCHRAD

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“…The main clinical significance for recognizing HMO is its complications, such as small bowel obstruction, ileus, abortion of surgical procedure due to extensive involvement of mesenteric vasculature [ 5 , 8 , 17 , 25 ], and its differential diagnosis from malignancies such as peritoneal carcinomatosis which is important due to relevance in clinical management. Other differential diagnoses include dystrophic calcification (no osteoblasts), leakage of contrast, and foreign materials [ 12 , 13 , 17 , 22 , 24 ]. Clinical management of HMO depends on the presence of symptoms and complications.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical procedure to remove the HMO might be necessary for symptomatic patients or for those with severe complications such as ileus or obstruction. Invasive treatment is considered unnecessary for asymptomatic patients [ 17 ]. Noninvasive treatments, such as non-steroidal anti-inflammatory drugs (e.g., ibuprofen, indomethacin), diphosphonates (etidronate), or radiation therapy have been reported in early studies [ 2 , 7 , 10 ], but are rarely seen in recent literature [ 13 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Heterotopic Mesenteric Ossification With Trilineage Hematopoiesis

Martinbianco¹,

Lilley²,

Grech³

et al. 2022

Cureus

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Heterotopic ossification (HO) histologically refers to extraskeletal bone formation in non-ossifying tissues, most commonly noted in the extremities, buttocks, abdominal wall, and hip joints. HO developing in the mesentery (heterotopic mesenteric ossification, HMO) is very rare, with fewer than 100 cases reported in the literature. It usually occurs in adult male patients with a history of repeated abdominal trauma. So far, only two cases of HMO have been reported with the development of hematopoietic bone marrow. Here, we report the third case of HMO with true trilineage hematopoiesis in a 66-year-old female with suspicious mesenteric-retained foreign material from prior surgical procedures, including hysterectomy for endometrial adenocarcinoma and multiple repairs for incisional hernia.

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“…In a large proportion of case reports, heterotopic mesenteric ossification is described as a sequela of abdominal surgery, commonly presenting with obstructive symptoms (Table 1). 14–42 Some have suggested that small regions of ossification may not be a rare complication of surgery 3 . Other risk factors for developing heterotopic mesenteric ossification include trauma, such as fractures, blunt injury, burns, and spinal cord or brain injuries 10 .…”

Section: Discussionmentioning

confidence: 99%

Heterotopic Ossification of the Mesentery: A Rare Postoperative Complication

Sura¹,

Jackson²,

Yodzis³

et al. 2021

AJSP: Reviews and Reports

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Heterotopic ossification is a rare, reactive condition, sometimes classified as a “pseudotumor,” involving the formation of bone within the soft tissues (Int J Surg Case Rep 2014;5:476–479), This process can occur as an undesirable pathologic sequela of trauma and surgery (J Am Acad Orthop Surg 2004;12:116–125). The few cases reported in the literature are almost exclusively in men with a predominance in people of African ancestry (J Am Acad Orthop Surg 2004;12:116–125; Bone Joint J 2016;98-B:761–766; Case Rep Surg 2019;2019:4036716). Reports of heterotopic ossification have been described in medical literature since 1692 as myositis ossificans progressiva (JBJS 1938;20:661–674). It was not until 1999 that the term “heterotopic mesenteric ossification” was formally used by Wilson et al to describe a complication found in post–abdominal surgical patients (Am J Surg Pathol 1999;23:1464–1470). Although the exact pathologic mechanism of heterotopic mesenteric ossification has not been elucidated, some hypotheses include differentiation of mesenchymal progenitor cells toward an osteogenic lineage, as well as proliferation of dislocated fragments of bone from other regions of the body (J Gastrointest Surg 2015;19:579–580). Since the late 1900s, fewer than 40 cases of mesenteric ossification have been reported. Limited gross and histologic description is available for pathologists and surgeons to identify this phenomenon; however, further data can be acquired at autopsy. Awareness of this condition on the part of clinicians, and early review and recognition by pathologists, may alter surgical management decisions and improve upon morbidity and mortality in these patients. We present gross and histologic examination of an advanced case of heterotopic ossification at autopsy, with a review of current management recommendations.

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Extensive Circumferential Heterotopic Ossification Discovered at the Base of a Loop Ileostomy

Cited by 4 publications

References 26 publications

Osificación heterotópica intraabdominal: reporte de caso

Osificación heterotópica intraabdominal: reporte de caso

Heterotopic Mesenteric Ossification With Trilineage Hematopoiesis

Heterotopic Ossification of the Mesentery: A Rare Postoperative Complication

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