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Perforated ulcer

Sara Ebrahimi, Gholamreza Khademi, Seyed Ali Jafari, Nona Zaboli Nejad, Abdolreza Norouzy, Bahareh Imani
Very-early-onset inflammatory bowel disease (VEO-IBD) has a distinct phenotype and should be considered a specific entity. VEO-IBD presents with very severe clinical pictures and is frequently known by an indeterminate colitis whose clinical remission is unmanageable. This study examines the case of a neonate with VEO-IBD, not responding to medical and surgical treatment. A 7-day-old Iranian female neonate presented with severe bloody diarrhea, poor feeding, abdominal distention, and dehydration suggesting severe proctocolitis due to an allergy to the protein in cow's milk...
May 2018: Iranian Journal of Medical Sciences
Ryohei Ono, Hidemitsu Ogino, Jun Kawachi, Rai Shimoyama, Hiroyuki Kashiwagi, Naoko Isogai, Katsunori Miyake, Ryuta Fukai, Takaaki Murata, Yuto Igarashi, Nobuaki Shinozaki
INTRODUCTION: Small intestinal metastasis from oesophageal carcinoma is rare. We report a case of small intestinal metastases from oesophageal carcinoma presenting as a perforation and discuss the aetiology with other cases of small intestinal metastasis from oesophageal carcinoma reported in previous literature. PRESENTATION: An 86-year-old man presented with fever and coughing. He had choked while eating and had history of weight loss. He was diagnosed with aspiration pneumonia...
June 5, 2018: International Journal of Surgery Case Reports
Predrag Sikiric, Rudolf Rucman, Branko Turkovic, Marko Sever, Robert Klicek, Bozo Radic, Domagoj Drmic, Mirjana Stupnisek, Marija Misic, Lovorka Batelja Vuletic, Katarina Horvat Pavlov, Ivan Barisic, Antonio Kokot, Marina Peklic, Sanja Strbe, Alenka Boban Blagaic, Ante Tvrdeic, Dinko Stancic Rokotov, Hrvoje Vrcic, Mario Staresinic, Sven Seiwerth
Years ago, we revealed a novel cytoprotective mediator, stable gastric pentadecapeptide BPC 157, particular anti-ulcer peptide that heals different organs lesions when given as a therapy, native in human gastric juice while maintaining GI- tract mucosal integrity, already tested in trials (ulcerative colitis and now multiple sclerosis). The stomach cytoprotection is the most fundamental concept, stomach cell protection and endothelium protection are largely elaborated, but so far cell, protection and endothelium protection outside of the stomach were not implemented in the therapy...
June 7, 2018: Current Pharmaceutical Design
Yuki Sakamoto, Masaaki Iwatsuki, Kazuya Sakata, Eiichiro Toyama, Noboru Takata, Ichiro Yoshinaka, Kazunori Harada, Hideo Baba
As a surgical treatment for a perforated duodenal ulcer, duodenal omental filling is effective. However, filling the perforation site with a sufficient amount of omentum is difficult in some situations. We herein report that we successfully filled a perforated duodenal ulcer with a sufficient amount of omentum using intraoperative endoscopy. The operation was performed with three ports, the operation time was 110 min, and the estimated blood loss was small. The postoperative course was good. No stenosis of deformity of the duodenum was observed on follow-up endoscopy...
June 4, 2018: Surgery Today
Jason D Struthers, Nick Robl, Valerie M Wong, Matti Kiupel
Gastrinoma, an infrequent diagnosis in middle-aged dogs, occurs with nonspecific gastrointestinal morbidity. Laboratory tests can yield a presumptive diagnosis, but definitive diagnosis depends on histopathology and immunohistochemistry. We describe a malignant pancreatic gastrinoma with lymph node metastases and corresponding Zollinger-Ellison syndrome in a Mexican gray wolf ( Canis lupus baileyi) and review this endocrine neoplasm in domestic dogs. A 12-y-old, captive, male Mexican gray wolf developed inappetence and weight loss...
June 1, 2018: Journal of Veterinary Diagnostic Investigation
Dandan Huang, Qiang Zhan, Shudong Yang, Qi Sun, Zhiyi Zhou
INTRODUCTION: Synchronous double superficial gastric cancer with gastritis cystica profunda (GCP) and submucosal lipoma is a rare disease and is difficult to diagnose and treat. CASE PRESENTATION: A 61-year-old man was referred to our hospital with upper abdominal discomfort for the past 10 days. One year ago, the patient underwent surgery for duodenal ulcer and perforation. The diseases were diagnosed by magnifying endoscopy with narrowband imaging and pathological methods...
June 2018: Medicine (Baltimore)
Alon Kaplan, Dan Schwarzfuchs, Vladimir Zeldetz, Jing Liu
Acute myocardial infarction and perforated peptic ulcer disease with associated peritonitis are both medical emergencies requiring urgent intervention. This patient presented with both emergencies simultaneously. Current literature is devoid of guidance as to which should be addressed initially. A multidisciplinary discussion was conducted leading to a unanimous decision for initiating percutaneous coronary intervention (PCI). After successful PCI, the patient was immediately taken to the operating room for laparoscopic repair of the perforated viscous...
August 2017: Clinical practice and cases in emergency medicine
Zahraa Abdul Sater, Smita Jha, Raven McGlotten, Iris Hartley, Mustapha El Lakis, Katherine Araque Triana, Lynnette K Nieman
Context: Patients taking exogenous glucocorticoids are at risk of gastrointestinal (GI) complications including peptic ulcer disease with perforation, and gastric bleeding. However, little is known about the GI co-morbidity in patients with endogenous hypercortisolemia. Case descriptions: We describe six patients with endogenous Cushing's Syndrome (CS) who developed sudden perforation of colonic diverticula requiring urgent exploratory laparotomy. Most of these patients shared the following features of Cushing's syndrome: significant skin thinning, severe hypercortisolemia (24-hour urine free cortisol ≥10X the upper limit of normal), ectopic secretion of ACTH, and severe hypokalemia...
May 28, 2018: Journal of Clinical Endocrinology and Metabolism
Deepali Singhal, Pranita Sahay, Prafulla Kumar Maharana, Sreelakshmi P Amar, Jeewan S Titiyal, Namrata Sharma
PURPOSE: To describe the clinical features and management of corneal fistula in patients of healed keratitis. METHODS: Medical records of all patients of healed keratitis presenting to the cornea clinic from November 2016 to September 2017 were reviewed. Eightcases of corneal fistula (six true fistulas, two closed fistulas) were identified. Six patients were managed with autologous tenon patch graft while two patients were managed medically. Various risk factors and treatment outcomes of corneal fistulisation were evaluated...
May 29, 2018: British Journal of Ophthalmology
Raffaele Serra, Nicola Ielapi, Egidio Bevacqua, Antonia Rizzuto, Giovanni De Caridi, Mafalda Massara, Filomena Casella, Giulio Di Mizio, Stefano de Franciscis
Varicose veins (VVs) and varicose ulceration (VU) are usually considered non-life-threatening conditions, but in some cases they can lead to major complications such as fatal bleeding. The aim of this systematic review is to evidence the most updated information on bleeding from VV and VU. As evidence acquisition, we planned to include all the studies dealing with "Haemorrhage/Bleeding" and "VVs/VU". We excluded all the studies, which did not properly fit our research question, and with insufficient data...
May 28, 2018: International Wound Journal
Dajiang Song, Zan Li, Xiao Zhou, Songlin Xie
Objective: To explore the feasibility of harvesting free thinned innervated anterolateral thigh (ALT) perforator flap for repairing the donor defect after wrap-around flap transfer. Methods: Between May 2011 and December 2013, free thinned innervated ALT perforator flap was used to repair the donor defects after wrap-around flap transfer in 9 patients. There were 8 males and 1 female, with a mean age of 31.2 years (range, 19-42 years). The interval time between injury and admission was 3-12 hours (mean, 6...
August 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Rohan Stuart Smith, Senthilkumar Rajavel Sundaramurthy, Daniel Croagh
INTRODUCTION: Perforated peptic ulcer disease (PPU) is a condition subject to wide geographical variations in incidence. It remains a significant cause of morbidity and mortality, even in the era of Helicobacter pylori eradication and proton-pump inhibitor therapy. There is no clear consensus on whether laparoscopic or open approaches are superior, and with most studies in this area originating from Europe and Asia, Australian data addressing this issue are lacking. METHODS: This retrospective cohort study included all patients who underwent surgery for PPU within a hospital network in Australia...
May 27, 2018: Asian Journal of Endoscopic Surgery
Martin Grohmann, Stefan Benedikt, Anna Vasilyeva, Heinz Bürger, Abigail Forbes, Michael Valentin Schintler
Despite various therapy options, the prophylactic and symptomatic treatment of recurrent ulcerations in the diabetic foot are still challenging. We report the application of a free vascularized medial femoral condyle flap to prevent the recurrence of pressure ulcer in a patient with diabetic foot syndrome. Our patient had type 2 diabetes and presented with pressure ulcers and osteomyelitis of metatarsal heads 2 and 3 after a great toe amputation. We chose to use a medial femoral condyle flap as a damper in the area of the metatarsal heads because of the relatively young age and good vascularity of our patient...
May 24, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Koichiro Ishikawa, Junichiro Ishikawa
OBJECTIVE: To elucidate the clinical and radiographic outcomes for rheumatoid arthritis (RA) patients treated with a synthetic disease-modifying antirheumatic drug, iguratimod (IGU). METHODS: Clinical outcomes for 213 RA patients treated with 25 mg/day oral IGU or 50 mg/day after 4 weeks of 25 mg/day treatment for one day to 104 weeks were assessed. RESULTS: 142 active RA patients (DAS28-ESR≥3.2) treated for more than 12 weeks showed a significant reduction in both DAS and simplified disease activity index (SDAI) scores at week 4 (p < 0...
May 25, 2018: Modern Rheumatology
Anne-Sophie Florczak, Benoit Chaput, Christian Herlin, Pascal Rousseau, Eric Watier, Nicolas Bertheuil
BACKGROUND: In recent years, pedicled perforator flaps have revolutionized plastic surgery by reducing donor site morbidity and ensuring larger and deeper reconstructions with local pedicled cutaneous flaps. The aim of the study was to make a systematic review of perforator pedicled propeller flaps (PPPFs) in chest reconstruction. METHODS: Pubmed and Cochrane databases were searched from 1989 to October 2016 for articles describing the use of PPPFs in chest reconstruction...
May 17, 2018: Annals of Plastic Surgery
Constantin E Uhlig, Viktoria C Müller
Purpose: To present a modified technique for secure tightening and fixing of multilayer amniotic membranes in deep or perforating corneal ulcers. Observations: The modified procedure for application and fixation of multilayer amniotic membranes is retrospectively described step by step, and the results of three patients treated with this technique were retrospectively analysed and presented.The modification consists basically in fixing the inlays with one mini-overlay that is sutured intracorneally with resorbable and running Vicryl 10...
June 2018: American Journal of Ophthalmology Case Reports
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
Yasuhiro Goda, Hirohito Mori, Hideki Kobara, Tsutomu Masaki
BACKGROUND: Duodenal ESD is considered especially difficult with perforation and bleeding. This study assessed safer duodenal ESD procedures, especially with regard to obtaining a good operation view using a ring-thread method and closure of a post-ESD artificial ulcer. METHODS: From 2013 to 2015, 17 patients who were diagnosed with duodenal adenoma or early duodenal cancer >20 mm in diameter underwent conventional ESD (C group). From 2016 to 2017, 12 patients underwent ring-shaped thread counter traction ESD with hemoclips and/or Over-The-Scope Clip (OTSC) (Ovesco Endoscopy GmbH, Tuebingen, Germany) closure of post ESD artificial ulcer (ring group)...
May 15, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Julie Cho, N Venkatesh Prajna, Prajna Lalitha, Revathi Rajaraman, Tiruvengada Krishnan, Yijie Brittany Lin, Kathryn J Ray, Thomas M Lietman, Jennifer Rose-Nussbaumer
OBJECTIVE: To compare oral voriconazole versus placebo in addition to topical antifungals in the treatment of filamentous fungal keratitis. DESIGN: Non-prespecified, secondary case-control analysis from a multicenter, double-masked, randomized placebo-controlled clinical trial STUDY PARTICIPANTS: Patients with smear-positive filamentous fungal ulcers and visual acuity of 20/400 or worse who eventuated to therapeutic penetrating keratoplasty (TPK). INTERVENTION: Study participants were randomized to oral voriconazole versus oral placebo; all received topical antifungal drops...
May 11, 2018: American Journal of Ophthalmology
Takuya Tomioka, Keiko Soma, Yoichiro Sato, Koshiro Miura, Ayako Endo
Pyoderma gangrenosum is a rare ulcerative condition associated with various systemic diseases. Lesions on the lower extremities and the trunk are common, but lesions on the nose are rare. Here we report a case of pyoderma gangrenosum on the nose. A 33-year-old woman presented with fever, nasal obstruction, and painful swelling on the nasal bridge. Physical examination revealed swellings on the nasal septal mucosa bilaterally. Computed tomography showed a septal abscess and a subcutaneous abscess on the nasal bridge...
May 9, 2018: Auris, Nasus, Larynx
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