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https://www.readbyqxmd.com/read/29776790/-modern-treatment-of-mesenteric-ischemia
#1
Alexandre Nuzzo, Audrey Huguet, Olivier Corcos
Acute mesenteric ischemia is a highly morbid affliction which requires urgent care. Acute mesenteric ischemia consists in an ischemia injury of the small bowel, secondary to vascular insufficiency, either occlusive (thrombosis, embolism, arterial, venous) or non-occlusive (low flow or vasospasm). Given that the superior mesenteric artery supplies the small bowel as well as the right part of the colon, any ischemic process involving the right colon should be considered an acute mesenteric ischemia until proven otherwise...
May 15, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29693938/point-of-care-abdominal-ultrasound
#2
Jiro Hata
Point-of-care ultrasound (POCUS) in the diagnoses of postoperative complications is discussed. POCUS is useful in many situations such as abdominal distension, elevated liver enzymes, abdominal pain, and fever, which are the common complications encountered after surgical operations. In the patients with abdominal distention, bowel distention or ascites can be easily detected by POCUS. Occasionally, congestive liver and milk of calcium bile caused by the administration of antibiotics cause elevated liver enzymes, and both of these can also be detected by POCUS...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29601825/identification-of-endpoints-for-development-of-anti-fibrosis-drugs-for-treatment-of-crohn-s-disease
#3
Silvio Danese, Stefanos Bonovas, Anthony Lopez, Gionata Fiorino, William J Sandborn, David T Rubin, Michael A Kamm, Jean-Frederic Colombel, Bruce E Sands, Severine Vermeire, Julian Panes, Gerhard Rogler, Geert D'Haens, Laurent Peyrin-Biroulet
BACKGROUND & AIMS: Intestinal fibrosis is a challenge to management of patients with Crohn's disease (CD); there is an urgent need to expedite development of anti-fibrosis drugs for this disease. The International Organization for the Study of Inflammatory Bowel Disease (IOIBD) aimed to identify a set of endpoints that can be used to determine efficacy of anti-fibrosis agents tested in clinical trials of patients with CD. METHODS: We conducted a systematic review to identify clinical, radiologic, biochemical, endoscopic, and composite endpoints used in assessing activity of fibrostenosing CD and response to treatment, and determined their operational properties...
March 27, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29526137/bowel-ischaemia-after-endovascular-aneurysm-repair
#4
Christopher Lowe, Oussama El Bakbachi, Damian Kelleher, Imran Asghar, Francesco Torella, George A. Antoniou
The aim of this review was to investigate presentation, aetiology, management, and outcomes of bowel ischaemia following EVAR. We present a case report and searched electronic bibliographic databases to identify published reports of bowel ischaemia following elective infra-renal EVAR not involving hypogastric artery coverage or iliac branch devices. We conducted our review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. In total, five cohort studies and three case reports were included...
March 12, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29433829/acute-mesenteric-ischemia-a-critical-role-for-the-radiologist
#5
P Copin, M Zins, A Nuzzo, Y Purcell, S Beranger-Gibert, L Maggiori, O Corcos, V Vilgrain, M Ronot
Acute mesenteric ischemia is defined as an inadequate blood supply to the gastrointestinal tract resulting in ischemic and inflammatory injury that may progress to necrosis of the bowel wall. Prognosis is poor with a mortality rate greater than 95% without treatment, dropping to around 70% when surgical treatment is performed. Contrast-enhanced computed tomography (CT) has become the cornerstone of the diagnosis by showing features of vascular disorders (occlusion and/or insufficient blood supply) and features of intestinal ischemic injury...
March 2018: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29431849/medical-treatment-in-the-management-of-deep-endometriosis-infiltrating-the-proximal-rectum-and-sigmoid-colon-a-comprehensive-literature-review
#6
REVIEW
Paolo Vercellini, Laura Buggio, Alessandra Borghi, Ermelinda Monti, Umberto Gattei, Maria P Frattaruolo
A comprehensive literature review was performed to evaluate the effect of various hormonal therapies, in terms of variations of intestinal and pain complaints and of patient satisfaction with treatment, in women with symptomatic, non-severely sub-occlusive endometriosis infiltrating the proximal rectum and sigmoid colon. A MEDLINE search through PubMed from 2000 to 2018 was conducted to identify all original English language articles published on medical treatment for colorectal endometriosis. Additional reports were identified by systematically reviewing reference lists and using the "similar articles" function in PubMed...
February 12, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29399329/intestinal-failure-a-review
#7
REVIEW
Philip Allan, Simon Lal
Intestinal failure (IF) is the inability of the gut to absorb necessary water, macronutrients (carbohydrate, protein, and fat), micronutrients, and electrolytes sufficient to sustain life and requiring intravenous supplementation or replacement. Acute IF (types 1 and 2) is the initial phase of the illness and may last for weeks to a few months, and chronic IF (type 3) from months to years. The challenge of caring for patients with IF is not merely the management of the underlying condition leading to IF or the correct provision of appropriate nutrition or both but also the prevention of complications, whether thromboembolic phenomenon (for example, venous occlusion), central venous catheter-related bloodstream infection, IF-associated liver disease, or metabolic bone disease...
2018: F1000Research
https://www.readbyqxmd.com/read/29313164/treatment-of-nonocclusive-mesenteric-ischemia-with-type-b-aortic-dissection-using-intra-arterial-catheterization-after-trauma-surgery-case-report
#8
Sho Fujiwara, Yuki Sekine, Ryuichi Nishimura, Kazuya Tadasa, Shukichi Miyazaki
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) is a mesenteric arterial spasm and intestinal ischemia. This disease is a highly lethal disease because diagnosis and decision of appropriate treatments are often difficult. Operations cannot resolve the spasms and may worsen the situation. However, the safety and effectiveness of catheterization for NOMI with aortic dissection (AD) have not yet been elucidated. Here, we report a successful case of early diagnosis and treatment of NOMI with type B AD involving the superior mesenteric artery (SMA) using the intra-arterial infusion of a vasodilator via the SMA...
January 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29273378/safety-and-efficacy-of-preoperative-abdominal-aortic-balloon-occlusion-in-placenta-increta-and-or-percreta
#9
Wenjuan Sun, Shuhong Duan, Gang Xin, Juan Xiao, Fanzhen Hong, Haijie Hong, Yuange Wu, Yongping Xu
BACKGROUND: With the increase of cesarean deliveries globally, the incidence of placenta adhesive disorder has been on the rise greatly which is associated closely with maternal and infant morbidity and mortality. We sought to investigate the safety and efficacy of preoperative transfemoral balloon occlusion of abdominal aorta in cesarean section of women with placenta increta or percreta. METHODS: We conducted a retrospective study of 31 patients with placenta increta or percreta diagnosed by ultrasound and/or magnetic resonance imaging...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29129414/-surgical-management-of-deep-infiltrating-endometriosis-with-bowel-involvement-and-urinary-tract-involvement
#10
Sofiane Bendifallah, Marcos Ballester, Emile Darai
Endometriosis is a benign pathology that affects 3% of the general population and about 10% of women of reproductive age. Three anatomoclinical entities are described: peritoneal, ovarian (endometrioma) and deep endometriosis characterized by the infiltration of anatomical structures or organs beyond the peritoneum. Laparoscopic surgery should be performed, as this is associated with a reduction in postoperative complications, length of hospitalization and convalescence. Several surgical techniques allow the removal of deep endometriosis with colorectal involvement: rectal shaving, anterior discoid resection, segmental resection...
December 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#11
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28956274/successful-treatment-of-non-occlusive-mesenteric-ischemia-with-indocyanine-green-fluorescence-and-open-abdomen-management
#12
Toshiyuki Irie, Takeshi Matsutani, Nobutoshi Hagiwara, Tsutomu Nomura, Itsuo Fujita, Yoshikazu Kanazawa, Daisuke Kakinuma, Eiji Uchida
Non-occlusive mesenteric ischemia (NOMI), which can lead to multifocal and segmental intestinal necrosis without demonstrable occlusion in the main mesenteric artery, is associated with extremely high mortality. Because these intestinal ischemic changes can progress, it is difficult to make a definitive determination intraoperatively as to whether resection of damaged intestine is required. A 62-year-old man who underwent esophagectomy for advanced cervicothoracic esophageal cancer complained of severe abdominal pain on postoperative day 4...
December 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28876642/outcome-of-liver-resection-for-carcinoid-neuroendocrine-metastases
#13
M D Polkinghorne, J E J Krige, E Jonas, U K Kotze, M M Bernon
BACKGROUND: Gastrointestinal carcinoid tumours, despite their low malignant potential, frequently metastasize to the liver. While liver resection improves survival and provides symptomatic relief, multifocal bilobar disease complicates surgical management. METHOD: All patients with carcinoid liver secondaries managed by resection from 1990-2015 were identified from a prospective departmental database. Demographic data, operative management, morbidity using the Accordion classification and mortality were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28819577/the-role-of-laparoscopy-in-the-management-of-a-diagnostic-dilemma-jejunal-ectopic-pancreas-developing-into-jejunojejunal-intussusception
#14
Alessio Giordano, Giovanni Alemanno, Carlo Bergamini, Paolo Prosperi, Alessandro Bruscino, Andrea Valeri
Ectopic pancreas (EP) is a rare congenital anomaly defined as the presence of pancreatic tissue in topographic anomaly. It is usually silent but it may become clinically evident when complicated by acute conditions. The development of laparoscopic surgery has changed the way to manage such conditions, especially in the setting of emergency surgery, thanks to its diagnostic and therapeutic role with excellent results. We decided to perform an emergency diagnostic exploratory laparoscopy in a 29-year-old man with an acute abdomen and nonspecific radiological images for intestinal occlusion...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28752257/what-is-the-best-revascularization-strategy-for-acute-occlusive-arterial-mesenteric-ischemia-systematic-review-and-meta-analysis
#15
Giancarlo Salsano, Antonio Salsano, Elena Sportelli, Francesco Petrocelli, M'ahmed Dahmane, Giovanni Spinella, Bianca Pane, Simone Mambrini, Domenico Palombo, Francesco Santini
PURPOSE: Acute mesenteric ischemia (AMI) is a life-threatening disease that leads to bowel infarction and death. The optimal management of AMI remains controversial. The present meta-analysis aimed to estimate the prognostic impact of surgical (SG) versus endovascular or hybrid intervention (EV) as the first-line treatment for acute arterial occlusive mesenteric ischemia and to assess whether endovascular strategy was actually effective in reducing bowel resection. METHODS: MEDLINE, Scopus and the Cochrane Library databases were searched...
July 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28735118/giant-meckel-s-diverticulum-compressing-root-of-mesentery-a-rare-cause-of-ileal-gangrene-case-report-and-review-of-literature
#16
Mohammed Farooq, Aashish Rajesh
INTRODUCTION: Meckel's diverticulum (MD) commonly presents as gastrointestinal bleeding in the pediatric population and intestinal obstruction in adults. There is no consensus for surgical excision of an incidentally diagnosed MD. We present a hitherto unreported vascular cause of intestinal gangrene due to MD. CASE PRESENTATION: A 16year old boy was referred as an acute abdomen for tertiary hospital management. Clinical examination and CT suggested small bowel obstruction and emergency laparotomy was performed...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28704322/malignant-bowel-obstruction-in-relapsed-ovarian-cancer-with-peritoneal-carcinomatosis-an-occlusive-state
#17
Pedro Martinez Castro, Lara Vargas, Antonio Mancheño, Salvador Martín Utrilla, Francisco Pascual, Ignacio Romero, Cristina Zorrero, José Manuel Bosch, Andrés Poveda, Lucas Minig
OBJECTIVE: The aim of this study was to describe the clinical and oncological outcomes of women with malignant bowel obstruction (MBO) for relapsed ovarian cancer and peritoneal carcinomatosis. METHODS: A retrospective cohort study was performed in all consecutive patients admitted at Instituto Valenciano de Oncología, Valencia, Spain, between July 2013 and July 2016 with MBO for relapsed ovarian cancer and peritoneal carcinomatosis. All patients underwent the same protocol of conservative management...
September 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28259577/outcomes-of-fenestrated-and-branched-endovascular-repair-of-complex-abdominal-and-thoracoabdominal-aortic-aneurysms
#18
Andres Schanzer, Jessica P Simons, Julie Flahive, Jonathan Durgin, Francesco A Aiello, Danielle Doucet, Robert Steppacher, Louis M Messina
BACKGROUND: More than 80% of infrarenal aortic aneurysms are treated by endovascular repair. However, adoption of fenestrated and branched endovascular repair for complex aortic aneurysms has been limited, despite high morbidity and mortality associated with open repair. There are few published reports of consecutive outcomes, inclusive of all fenestrated and branched endovascular repairs, starting from the inception of a complex aortic aneurysm program. Therefore, we examined a single center's consecutive experience of fenestrated and branched endovascular repair of complex aortic aneurysms...
September 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259479/-management-of-mesenteric-ischemia-in-the-era-of-intestinal-stroke-centers-the-gut-and-lifesaving-strategy
#19
REVIEW
A Nuzzo, O Corcos
Mesenteric ischemia is a gut and life-threatening, medical and surgical, digestive and vascular emergency. Mesenteric ischemia is the result of an arterial or venous occlusion, a vasospasm secondary to low-flow states in intensive care patients, aortic clamping during vascular surgery or intestinal transplantation. Progression towards mesenteric infarction and its complications is unpredictable and correlates with high rates of mortality or a high risk of short bowel syndrome in case of survival. Thus, mesenteric ischemia should be diagnosed and treated at an early stage, when gut injury is still reversible...
September 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28133158/-clinical-experience-with-nutrition-and-anticoagulation-therapy-for-a-patient-with-a-30-cm-residual-jejunum
#20
Arisa Muratsu, Shingo Noura, Tae Matsumura, Masaki Hirota, Yuta Yoshida, Takashi Shuto, Akinobu Yasuyama, Chikato Koga, Masahiro Murakami, Chizu Kameda, Ryohei Kawabata, Junzou Shimizu, Junichi Hasegawa
Patients with short bowel syndrome experience malabsorption and digestive disorders. They are unable to maintain adequate nutrition by the oral or enteral route alone, and their requirements for liquids, electrolytes, nutrients, microelements, vitamins, etc., are not completely met. Managing the nutritional needs of these patients is important. Another concern is these patients' inability to absorb medication, because the small intestine that is shortened in short bowel syndrome is the principal site of drug absorption...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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