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pancreatic trauma

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https://www.readbyqxmd.com/read/28780610/pancreatic-leaks-and-fistulae-an-endoscopy-oriented-classification
#1
REVIEW
Massimiliano Mutignani, Stefanos Dokas, Alberto Tringali, Edoardo Forti, Francesco Pugliese, Marcello Cintolo, Raffaele Manta, Lorenzo Dioscoridi
BACKGROUND: Pancreatic leaks occur as a complication of upper gastrointestinal surgery, acute pancreatitis, or abdominal trauma. Pancreatic fistulas and leaks are primarily managed conservatively. Overall, conservative measures are successful in more than half of cases. Whenever conservative treatment is not efficient, surgery is usually considered the treatment of choice. Nowadays however, endoscopic treatment is being increasingly considered and employed in many cases, as a surgery sparing intervention...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28780503/late-mortality-after-acute-hypoxic-respiratory-failure
#2
Hallie C Prescott, Michael W Sjoding, Kenneth M Langa, Theodore J Iwashyna, Daniel F McAuley
BACKGROUND: Acute hypoxic respiratory failure (AHRF) is associated with significant acute mortality. It is unclear whether later mortality is predominantly driven by pre-existing comorbid disease, the acute inciting event or is the result of AHRF itself. METHODS: Observational cohort study of elderly US Health and Retirement Study (HRS) participants in fee-for-service Medicare (1998-2012). Patients hospitalised with AHRF were matched 1:1 to otherwise similar adults who were not currently hospitalised and separately to patients hospitalised with acute inciting events (pneumonia, non-pulmonary infection, aspiration, trauma, pancreatitis) that may result in AHRF, here termed at-risk hospitalisations...
August 5, 2017: Thorax
https://www.readbyqxmd.com/read/28757865/emergency-backwards-whipple-for-bleeding-formidable-and-definitive-surgery
#3
Cristian Lupascu, Ana Trofin, Mihai Zabara, Alexandra Vornicu, Ramona Cadar, Nutu Vlad, Oana Apopei, Valentin Grigorean, Corina Lupascu-Ursulescu
INTRODUCTION: During the past decades, the safety of pancreatoduodenectomy has improved, with low mortality and reduced morbidity, particularly in centers with extensive experience. Emergency pancreatoduodenectomy is an uncommon event, for treatment of pancreaticoduodenal trauma, bleeding, or perforation. We herein present a single center experience concerning nontrauma emergency pancreatoduodenectomy for pancreaticoduodenal bleeding. METHODS: From January 2007 to December 2015, from a population of 134 PD (70 males and 64 females, mean age 62...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28733741/tips-and-tricks-of-splenic-vessel-preservation-during-laparoscopic-distal-pancreatectomy
#4
Claire Goumard, Satoshi Ogiso, Masayuki Okuno, Jason B Fleming, Michael Kim, Ching-Wei D Tzeng, Jean-Nicolas Vauthey, Jeffrey E Lee, Claudius Conrad
BACKGROUND: While a laparoscopic approach can minimize postoperative morbidity in splenic vessel preserving (SVP) distal pancreatectomy (DP), this procedure can be technically challenging. A systematic approach to SVP minimizes the chances of vascular injury and maximizes the chances of successful splenic preservation. This video demonstrates a laparoscopic DP with SVP, highlighting technical tips and tricks that optimize the chances for SVP. PATIENT: The patient is a 14-year-old male with an incidentally discovered pancreatic tail mass...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28732002/-gastrointestinal-stromal-tumor-in-young-pregnant-woman-case-report
#5
Walker Del Cid Jove Oblitas, Miguel Joseph Abril Barreda
Female patient, 28 years old, with a gestation of 14 weeks, natural and from Ilo-Moquegua. Came with a time of disease 4 days with hematemesis, melena, epigastric pain and syncope. Background of colonic resection for peritonitis due to trauma 20 years ago; upper gastrointestinal bleeding three years ago; paternal grandparents died of gastric cancer; chronic gastritis diagnosed from 19 year old. In laboratory studies hemoglobin of 9.2. In the upper gastrointestinal endoscopy was found absence of active upper gastrointestinal bleeding, a large tumor in proximal body toward greater curvature and posterior wall, 8 cm in diameter approximately, lobed appearance, with most of the mucosal surface unscathed is evidence, areas of ulceration of 2-3 mm covered with fibrin (biopsies taken), hard consistency, tent sign (positive) and cushionsign (negative)...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28653162/completely-intracorporeal-handsewn-laparoscopic-anastomoses-during-whipple-procedure
#6
Giovanni Dapri, Nigel Antonio Bascombe, Leonardo Gerard, Carla Samaniego Ballart, Carlos Gimenez Viñas, Sven Saussez
BACKGROUND: Whipple procedure has been described since 1935,1 using classic open surgery. With the advent of minimally invasive surgery (MIS), it has been described to be feasible using the latest technology.2 (,) 3 In this video the authors report a full laparoscopic Whipple procedure, realizing the three anastomoses by intracorporeal handsewn method. VIDEO: A 70-year-old man who presented with adenocarcinoma of the ampulla of Vater, infiltrating the pancreatic parenchyma underwent to a laparoscopic Whipple...
June 26, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28645741/chylous-ascites-due-to-idiopathic-chronic-pancreatitis-managed-with-endoscopic-stenting
#7
Amit Kumar, Harshal S Mandavdhare, Surinder S Rana, Rajesh Gupta, Vishal Sharma
Chylous ascites is an uncommon clinical entity, which usually results from congenital or acquired abnormality in proper lymphatic flow. While the common causes are related to trauma, malignancy or tuberculosis, pancreatic disorders can occasionally result in chylous ascites. Sporadic cases of chylous ascites due to acute or chronic pancreatitis or surgery for pancreatitis have been reported. The usual management is with medium chain triglycerides (MCT), total parenteral nutrition and octreotide. We report a case of a young male with idiopathic chronic pancreatitis who presented with chylous ascites which did not respond to MCT based diet and octreotide...
June 20, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28640662/using-probiotics-in-clinical-practice-where-are-we-now-a-review-of-existing-meta-analyses
#8
Mariangela Rondanelli, Milena Anna Faliva, Simone Perna, Attilio Giacosa, Gabriella Peroni, Anna Maria Castellazzi
The scientific literature has demonstrated that probiotics have a broad spectrum of activity, although often the results are contradictory. This study provides a critical overview of the current meta-analyses that have evaluated the efficacy of probiotics in physiologic and pathological conditions, such as metabolic disease, antibiotic-associated and Clostridium difficile-associated diarrhea, IBS, constipation, IBD, chemotherapy-associated diarrhea, respiratory tract infection, ventilator-associated pneumonia, NAFLD, liver encephalopathy, periodontitis, depression, vaginosis, urinary tract infections, pancreatitis, incidence of ventilator-associated pneumonia, hospital infection and stay in ICU, mortality of post-trauma patients, necrotising enterocolitis in premature infants...
June 22, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28633652/spontaneous-rupture-of-the-common-hepatic-duct-associated-with-acute-pancreatitis-a-case-report
#9
Makram Moussa, Wissem Triki, Omar Karray, Ines Marzouk, Bouchoucha Sami
BACKGROUND: Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity. CASE PRESENTATION: We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed...
June 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28631007/how-schwann-cells-facilitate-cancer-progression-in-nerves
#10
REVIEW
Sylvie Deborde, Richard J Wong
Recent studies have demonstrated a critical role for nerves in enabling tumor progression. The association of nerves with cancer cells is well established for a variety of malignant tumors, including pancreatic, prostate and the head and neck cancers. This association is often correlated with poor prognosis. A strong partnership between cancer cells and nerve cells leads to both cancer progression and expansion of the nerve network. This relationship is supported by molecular pathways related to nerve growth and repair...
June 19, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28612150/single-versus-multiple-solid-organ-injuries-following-blunt-abdominal-trauma
#11
Ayman El-Menyar, Husham Abdelrahman, Ammar Al-Hassani, Ruben Peralta, Hiba AbdelAziz, Rifat Latifi, Hassan Al-Thani
BACKGROUND: We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS: A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014. Data were analyzed and compared for patients with single versus multiple SOIs. RESULTS: A total of 504 patients with SOIs were identified with a mean age of 28 ± 13 years...
June 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28611566/periorbital-ecchymosis-raccoon-eye-and-orbital-hematoma-following-endoscopic-retrograde-cholangiopancreatography
#12
Jafar Nasiri, Farhad Zamani
Endoscopic retrograde cholangiopancreatography (ERCP) is a conventional technique for diagnosis and treatment of pancratobiliary diseases, which is associated with various complications, including pancreatitis, hemorrhage, cholangitis, perforation, and mortality. In our case, a 69-year-old woman with positive hepatobiliary symptoms underwent ERCP, at the end of which a rare complication (raccoon eye) occurred, which was hypothesized to be due to amyloidosis, but the patient refused to complete the diagnostic procedure and became symptom free after 3 weeks...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#13
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28596059/development-and-validation-of-a-pancreatic-injury-mortality-score-pims-based-on-473-consecutive-patients-treated-at-a-level-1-trauma-center
#14
Jake E Krige, Richard T Spence, Pradeep H Navsaria, Andrew J Nicol
BACKGROUND: This study sought to develop a pancreatic injury mortality score (PIMS) to identify patients at greatest risk of in-hospital mortality after a major pancreatic injury. METHODS: The study used data from a prospective database of 473 patients treated for pancreatic injuries between January 1990 and December 2015. Two thirds of the patients were assigned to the derivation cohort and one third to the validation cohort. Clinical correlates of in-hospital death were identified and considered in stepwise logistic regression analyses that identified the factors included in the risk index...
July 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28590353/proposed-clinical-pathway-for-non-operative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#15
Bindi J Naik-Mathuria, Eric H Rosenfeld, Adam Vogel, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Alex Ler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for non-operative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers in order to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (AAST grade III-V) pancreatic injuries treated with NOM between 2010-15...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28584505/management-and-outcome-of-patients-with-pancreatic-trauma
#16
Ravinder Pal Singh, Anuj Mahajan, Jaspal Singh Selhi, Nikhil Garg, Honey Chahal, Manjyot Bajwa
INTRODUCTION: Pancreatic trauma is a rare entity occurring in 0.2% of patients with blunt trauma abdomen. Once the diagnosis is made, the management of patients is dependent on multiple variables. Conservative management, suture repair, drainage, and resection have been utilized with varying degree of success. This study is aimed to evaluate the management of patients with pancreatic trauma. MATERIALS AND METHODS: This was a prospective study done in the Department of Surgery in Dayanand Medical College and Hospital where forty hemodynamically stable patients diagnosed to have pancreatic trauma on contrast-enhanced computed tomography abdomen were included in the study...
January 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/28538626/the-capacity-of-icd-10-cm-pcs-to-characterize-surgical-care
#17
Garth H Utter, Kevin M Schuster, Preston R Miller, Nathan T Mowery, Suresh K Agarwal, Robert J Winchell, Marie L Crandall
The International Classification of Diseases, 10th edition, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) have been in effect since October 1, 2015 and offer much greater capacity than previous classifications to characterize the nature and treatment of surgical conditions. However, the diagnosis codes of ICD-10-CM are unevenly specific across the spectrum of surgical conditions and currently do not adequately allow description of important distinctions in disease severity for many common surgical conditions...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28516111/transhiatal-herniation-of-the-pancreas-a-rare-cause-of-acute-pancreatitis
#18
Jeremy Wang, Adarsh M Thaker, Wael Noor El-Nachef, Rabindra R Watson
Transhiatal herniation of the pancreas is rare. Acute pancreatitis secondary to this phenomenon is particularly unusual. A 102-year-old woman presented with 1 day of severe chest pain, vomiting, dyspnea, and diaphoresis. Serum lipase was elevated, and computed tomography angiogram of the chest and magnetic resonance cholangiopancreatography revealed a hiatal hernia containing the pancreas, with associated findings of pancreatitis. Pancreatitis in this setting may be due to repetitive trauma or ischemia from sliding, intermittent folding of the pancreatic duct, or pancreatic incarceration...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28514379/-closed-management-of-pancreatic-necrosis-complicated-by-diffuse-peritonitis
#19
E K Salakhov, A P Vlasov
AIM: To assess an efficiency of closed management of pancreatic necrosis complicated by widespread peritonitis by using of elective laparoscopic sanations with ultrasonic processing of an abdominal cavity and retroperitoneal space. MATERIAL AND METHODS: Treatment of 111 patients with pancreatic necrosis complicated by diffuse peritonitis was analyzed. Closed management was used in 41 patients (main group). Among them there were 12 patients who underwent laparoscopic sanation with ultrasonic cavitation of abdominal cavity, laparoscopic drainage of omental bag, US-assisted puncture drainage of retroperitoneal space and 29 patients after laparotomy followed by laparoscopic lavage and low-frequency ultrasound through retroperitoneal drains which were deployed during lumbotomy or under US control...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28452889/surgical-management-of-pancreatic-necrosis-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#20
Nathan T Mowery, Brandon R Bruns, Heather G MacNew, Suresh Agarwal, Toby M Enniss, Mansoor Khan, Weidun Alan Guo, Jeremy W Cannon, Matthew E Lissauer, Therese M Duane, Amy N Hildreth, Peter A Pappas, Lynn M Gries, Meghann Kaiser, Bryce R H Robinson
BACKGROUND: Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. METHODS: A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included...
August 2017: Journal of Trauma and Acute Care Surgery
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