Vaginal reconstruction with rectus abdominis myocutaneous flap: CT findings.
The distally based rectus abdominis myocutaneous flap is used in a new technique for vaginal reconstruction after pelvic exenteration for malignant disease. We identified 27 patients who underwent this procedure, of whom eight had a total of 14 postoperative CT scans and two CT-directed biopsies. The myocutaneous flap appeared as a unilateral arcuate band of soft tissue extending from the linea alba to the rectal fascia or sacrum. Additional CT findings included asymmetric thinning of the ventral abdominal wall (7/8), fluid collections (2/8), vaginal breakdown (1/8), presacral soft-tissue thickening (6/8), and tumor recurrence (3/8). The postoperative CT scan reflects the altered anatomy produced by the surgery. Complications and recurrent disease can be recognized as deviations from the normal postoperative appearance.
Willing
S J
SJ
Department of Diagnostic Radiology, University of Louisville, KY 40202.
Pursell
S H
SH
Koch
S R
SR
Tobin
G R
GR
D000009:Abdominal Muscles / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D010385:Pelvic Exenteration; D013518:Surgery, Plastic / Q000379:methods*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D014621:Vagina / Q000000981:diagnostic imaging / Q000601:surgery*