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Subtotal colectomy

Behdod Poushanchi, Hiren Vallabh, Gorman Joel Reynolds
Ipilimumab is a monoclonal antibody that works as an immunotherapeutic agent through selective targeting of T cells to strengthen the response to metastatic melanoma. It is well known that this pharmaceutical agent can cause the adverse effect of colitis. We report a rare presentation of ileocolitis refractory to both glucocorticosteroids and infliximab with a resultant pneumatosis and perforation requiring subtotal colectomy and end ileostomy.
2018: Case Reports in Gastrointestinal Medicine
Kristy L Rialon, Eileen Crowley, Natashia M Seemann, Aleixo Muise, Jacob C Langer
PURPOSE: The timing of J-pouch surgery following colectomy for children with very early-onset colitis is controversial, with some advocating early reconstruction and others delaying reconstruction because of fear that the colitis may be owing to Crohn's disease (CD). We sought to determine the long-term incidence of CD in this population and whether there may be clinical features that predict the risk of CD. METHODS: Children with noninfectious colitis diagnosed prior to age 10, who underwent subtotal colectomy and ileostomy from 2000 to 2015, were reviewed...
February 8, 2018: Journal of Pediatric Surgery
Nicholas P McKenna, Amy E Glasgow, Robert R Cima, Elizabeth B Habermann
BACKGROUND: Organ space infection (OSI) after ileal pouch anal anastomosis (IPAA) is a devastating complication. The aim of this was study was to determine separately risk factors for OSI after total proctocolectomy (TPC) with IPAA and completion proctectomy (CP) with IPAA. METHODS: 4049 patients with a diagnosis of chronic ulcerative colitis undergoing TPC with IPAA or CP with IPAA between 2005 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
March 6, 2018: American Journal of Surgery
Yukihiro Kaneko, Ken-Ichi Oinuma, Tsuneko Terachi, Yasuaki Arimura, Mamiko Niki, Koichi Yamada, Hiroshi Kakeya, Tetsu Mizutani
A 53-year-old woman was hospitalized due to septic shock after developing pneumococcal pneumonia after undergoing esophageal cancer surgery. Her transverse colon became perforated after receiving antimicrobial chemotherapy; therefore, emergency subtotal colectomy was performed. Fungi detected in both her colon tissue and a drainage sample indicated intestinal mucormycosis. Early intensive treatment with high-dose liposomal amphotericin B was successful, and she was subsequently discharged from the hospital...
March 9, 2018: Internal Medicine
Amy L Lightner
Crohn's disease (CD) may affect any part of the gastrointestinal tract. When isolated to the colon, and patients become medically refractory, there are several surgical options - segmental resection, subtotal colectomy with ileorectal anastomosis, or a total proctocolectomy and end ileostomy. Unfortunately, surgery does not cure CD, and, regardless of the extent of bowel removed, recurrence may be seen in the small bowel. This may lead to need for further immunosuppression or surgery. Therefore, when appropriate, a segmental colectomy or subtotal colectomy may prevent a permanent ostomy required with a total proctocolectomy...
February 15, 2018: Inflammatory Bowel Diseases
Toshihiro Tajirika, Nobuhisa Matsuhashi, Takao Takahashi, Kazuhiro Yoshida
Ulcerative colitis(UC)is a chronic inflammatorydisease. Since it is known to be a risk factor for colorectal cancer, severe cases, refractorycases, or cases with cancer are often treated with surgery. We report a case of anal canal squamous cell carcinoma(SCC)found 9 years after subtotal colectomy for UC. A 32-year-old man underwent subtotal colectomyand ileorectum anastomosis 9 years ago for fulminant UC. Anemia was detected during treatment with infliximab, which was initiated 2 years ago. Endoscopic findings revealed a type 3 tumor at the anal canal in the anastomotic region, and he presented to our department...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yosuke Yamada, Ken Sugimoto, Yashiro Yoshizawa, Yoshifumi Arai, Yoshiro Otsuki, Tomio Arai, Yasuyuki Kobayashi, Yoshihiko Sato, Yoshisuke Hosoda
BACKGROUND: Mesenteric inflammatory veno-occlusive disease (MIVOD) is difficult to diagnose because of its rarity, nonspecific clinical findings, and frequent confusion with other diseases including inflammatory bowel disease. This report presents a very rare case of MIVOD that occurred during the course of ulcerative colitis (UC). CASE PRESENTATION: A 32-year-old man, who had been diagnosed with UC at the age of 29 and was in remission maintained by oral administration of 5-aminosalicylic acid (5-ASA), showed exacerbation of diarrhea and was admitted to the hospital...
January 11, 2018: BMC Gastroenterology
Jinke Sui, Wei Zhang
Surgery, as one of the methods for the treatment of chronic constipation, is the final choice after the failure of non-surgical treatment with its specific particularity. The history of surgical treatment of chronic constipation is complex and tortuous. How to select operation among many kinds of surgery, and control risk is difficult for clinician. The choice of surgical procedure depends mainly on the patient's conditions, the objective examination basis and the experience of physician teams. Based on the previous reports and the team's experience, this paper discusses the choice of surgical treatment for the following types of chronic constipation: (1) Slow transit constipation: subtotal colorectal resection plus ileorectal anastomosis or ascending colon rectum anastomosis is widely used at present in the domestic, and its efficacy is quite good...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Alexander T Hawkins, Jun W Um, Amosy E M'Koma
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). Emergency colectomies are performed for fulminant colitis (ie, toxic megacolon, profuse bleeding, perforation, or sepsis). The RPC and IPAA involve manipulation of the proximal ileum, which may influence the essential physiological function of gut-associated lymphoid tissues. Circulating plasma immunoglobulin G (p-IgG) deficiency is observed in patients with fulminant UC...
2017: Clinical Medicine Insights. Gastroenterology
Suzanne Arnott, Matthew Skancke, Sheena Chen, Bruce Abell
INTRODUCTION: Clostridium difficile is the most common cause of healthcare-associated infections and can have devastating morbidity and mortality. Traditional treatment algorithms involve intravenous metronidazole and enteric metronidazole or vancomycin. Fidaxomicin (DificidR ) targets "switch regions" within RNA polymerases and effectively kills clostridium difficile bacteria and is typically administered orally primarily or through a naso/oro-gastric conduit. PRESENTATION OF CASE: 55-year-old with a recent elective surgical procedure was hospitalized with multifocal pneumonia and subsequently developed clostridium difficile colitis...
2018: International Journal of Surgery Case Reports
E Schloericke, M Zimmermann, C Benecke, T Laubert, R Meyer, H-P Bruch, R Bouchard, T Keck, M Hoffmann
BACKGROUND: Patients with rectovaginal fistulas have a significantly reduced quality of life. Therefore, surgical therapy is often needed even in palliative cases. The aim of the present study was to perform an analysis of the results of the different treatment options available today. METHODS: We performed a retrospective analysis of patients who underwent treatment for rectovaginal fistulas at the Department of Surgery, University of Schleswig-Holstein, Campus Luebeck and the Department of Surgery, WKK Heide, between January 2000 and September 2016...
December 2017: Techniques in Coloproctology
L W Leicher, M H A Lammertink, S R Offerman, H Morreau, M M de Jong, J W B de Groot, H L van Westreenen, H F A Vasen, W H de Vos Tot Nederveen Cappel
INTRODUCTION: Mismatch repair deficiency (dMMR) can be found in Lynch syndrome (LS)-associated colorectal carcinoma and in 15% of sporadic colorectal cancer (CRC). Outcome of MMR-deficiency testing is important for surgical decisions as extended colectomy is recommended in young LS-patients with CRC. Moreover, the finding of a dMMR tumour has consequences for the choices of adjuvant chemotherapy as MMR-deficient CRC is resistant to 5-fluorouracil (5-FU) monotherapy. Aims of our study are to evaluate whether MMR-deficiency testing leads to (1) identification of LS, (2) change in surgical treatment and (3) adjustment of systemic therapy in patients with dMMR CRC...
November 21, 2017: Scandinavian Journal of Gastroenterology
Molly J Hiatt, Murray Joseph Casey, Henry T Lynch, Carrie L Snyder, Mark Stacey, Ryan W Walters
BACKGROUND: This study analyzes the occurrence of colorectal cancer (CRC) in Lynch syndrome (LS) mutation carriers, interval until diagnosis of metachronous CRC, and survival after proximal colectomy (PC) compared with total (TC) and subtotal colectomy (STC) for right-sided first CRC in LS mutation carriers. METHODS: Sixty-four LS mutation carriers with right-sided first CRC treated with PC or TC + STC were confirmed by clinical records. Bivariate analyses were examined for significance and life tables were generated for risk of metachronous CRC and survival estimates following surgery...
November 8, 2017: American Journal of Surgery
J Segelman, I Matsson, B Jung, P J Nilsson, G Palmer, C Buchli
AIM: Reconstruction with an ileosigmoidal anastomosis (ISA) or ileorectal anastomosis (IRA) is a surgical option after a subtotal colectomy. Anastomotic leakage (AL) is a significant risk and high rates have been reported (AL) but here is however limited understanding of the risk factors involved. The aim of this study was to assess the established and potential predictors of AL following ISA and IRA. METHOD: This is a retrospective cohort-study including all patients who have undergone ISA or IRA at three Swedish referral centres for colorectal surgery between January 2007 and March 2015...
October 23, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
S T Ward, J Mytton, L Henderson, V Amin, J R Tanner, F Evison, S Radley
AIM: Previous studies have raised concerns that the use of anti-TNF therapy in patients with ulcerative colitis (UC) undergoing surgery may increase the risk of post-operative complications. We have taken a population-based approach to investigate whether there is an association between anti-TNF therapy and post-operative complications in UC patients undergoing subtotal colectomy. METHOD: Hospital Episode Statistics (HES) data and procedural coding was used to identify all patients in England between April 2006 and March 2015 undergoing subtotal colectomy for UC...
October 23, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Pritesh S Morar, James Hollingshead, Willem Bemelman, Nick Sevdalis, Thomas Pinkney, Graeme Wilson, Malcolm Dunlop, R Justin Davies, Richard Guy, Nicola Fearnhead, Steven Brown, Janindra Warusavitarne, Cathryn Edwards, Omar Faiz
Background and Aims: Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision. Methods: This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus...
October 27, 2017: Journal of Crohn's & Colitis
Madhavan Seshadri, Madhusudan Deepak Thalitaya, Tuno Simon, Catherine Odelola, Humphrey Enow
Antidepressants are routinely used by General Practitioners (GP) as well as Psychiatrists to treat Depression. They are tolerated well. However, in certain patient populations, they are associated with SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone Secretion) and Hyponatremia. Various research studies have shown that all antidepressants are associated with Hyponatremia. Hyponatremia as a side effect of antidepressant therapy is more commonly seen in old age, chronic Kidney disease and Hypothyroidism...
September 2017: Psychiatria Danubina
Sarah Peters, Michelle Wise, Brendan Buckley
A 35-year-old nulliparous woman underwent uterine artery embolisation (UAE) for heavy menstrual bleeding and anaemia due to fibroids, refractive to medical and surgical treatment.Bilateral UAE was performed after cephazolin prophylaxis and analgesia. Postoperatively, pain and abdominal bloating were prominent. Symptoms were initially treated as postembolisation syndrome, and analgesia was escalated. By the third day, pain was worsening and the woman developed marked tachypnoea and tachycardia, with raised inflammatory markers and lactate...
September 26, 2017: BMJ Case Reports
V N Ektov
AIM: To consider surgical tactics and to study the immediate results of primary enteroenterostomy in surgical treatment of malignant colonic obstruction. MATERIAL AND METHODS: Radical surgery was performed in 170 (63.9%) out of 266 patients with malignant obstructive colonic obstruction. Colonic resection followed by anastomosis was performed in 68 patients. Conventional hemicolectomy (9 patients) and various original techniques of Y-shaped ileotransversanastomoses (27 patients) were used for right-sided tumor process...
2017: Khirurgiia
Sharon J Song, Stuti G Shroff
Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare disease characterized by intimal smooth muscle proliferation, leading to the thickening of small to medium-sized mesenteric veins. This vascular disease mimics inflammatory bowel disease (IBD) clinically and endoscopically, while showing ischemic mucosal changes without the classic features of IBD on biopsy. Given the mixed picture, this entity is frequently misdiagnosed. Surgical resection of the diseased bowel segment reveals the true etiology of the pathology and is curative...
2017: Case Reports in Pathology
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