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https://www.readbyqxmd.com/read/28108634/rectal-colonic-mural-hematoma-following-enema-for-constipation-while-on-therapeutic-anticoagulation
#1
Rebecca M Rentea, Charles H Fehring
Causes of colonic and recto-sigmoid hematomas are multifactorial. Patients can present with a combination of dropping hemoglobin, bowel obstruction and perforation. Computed tomography imaging can provide clues to a diagnosis of intramural hematoma. We present a case of rectal hematoma and a review of current management literature. A 72-year-old male on therapeutic anticoagulation for a pulmonary embolism, was administered an enema resulting in severe abdominal pain unresponsive to blood transfusion. A sigmoid colectomy with end colostomy was performed...
January 19, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28106653/outcomes-of-rectovaginal-fistula-repair
#2
Jenifer N Byrnes, Jennifer J Schmitt, Benjamin M Faustich, Kristin C Mara, Amy L Weaver, Heidi K Chua, John A Occhino
OBJECTIVES: Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical approach. METHODS: This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28100994/reocclusion-after-self-expandable-metallic-stent-placement-for-relieving-malignant-colorectal-obstruction-as-a-palliative-treatment
#3
Toshikatsu Nitta, Kensuke Fujii, Yoshimasa Hirata, Tomo Tominaga, Yoshihiro Inoue, Hiroshi Kawasaki, Ken Kawakami, Takashi Ishibashi
Self-expandable metallic stent (SEMS) placement has been practiced in several hospitals in Japan, including ours, since January 2012. Here, we report the case of an 82-year-old Japanese man who presented to the hospital with a 1-week history of right hypochondrial pain. Computed tomography (CT) findings indicated colorectal cancer. The laboratory findings on admission indicated severe anemia (red blood cell count, 426 × 104/μL; hemoglobin, 7.9 g/dL). We performed SEMS placement because the patient refused to undergo surgery...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100944/ostomy-in-nontraumatic-conditions-our-experience-and-review-of-the-literature
#4
Kenan Büyükaşık, Bünyamin Gürbulak, Emre Özoran, Yiğit Düzköylü, Esin Kabul Gürbulak, Aziz Arı, Hasan Bektaş
A number of nontraumatic acute abdomen can result in peritonitis leading to sepsis. In emergent conditions, various procedures like segmentary colectomy and/or subtotal colectomy with anastomosis, Hartmann's procedure, transverse colectomy, and/or expandable metallic stent (SEMS) placement can be performed, considering the status of the patient and the facilitaties of the institution. In our study, we examined the cases diagnosed as acute abdomen without the history of trauma, which had lead to a procedure requiring colostomy...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100941/outcomes-of-laparoscopy-combined-with-enhanced-recovery-pathway-for-reversal-of-hartmann-s-procedure
#5
Liang Zhang, Yong Zhong, Hao Lin, Lv Xiao-Peng
The objective of this study is to discuss the security and feasibility of the laparoscopic reversal of Hartmann's procedure (LRHP) on the concept of enhanced recovery after surgery (ERAS). The clinical data of 42 patients who underwent laparoscopic reversal of Hartmann's procedure was retrospectively analyzed, and the operative time, blood loss, intraoperative and postoperative complications, conversion to open surgery, postoperative hospital stay, and so on were observed. Twenty-nine patients (69.00 % of the study pool) received complete postoperative recovery courses as prescribed by enhanced recovery program (ERP)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28099377/what-is-the-current-role-of-laparoscopic-lavage-in-perforated-diverticulitis
#6
Walter L Biffl, Frederick A Moore, Ernest E Moore
Patients with perforated diverticulitis suffer high morbidity and mortality. For decades, sigmoid colectomy with colostomy (Hartman's procedure) has been considered the standard surgical management. Over the past several years, less-morbid alternatives have been advocated. Laparoscopic lavage showed promise in retrospective studies. However, recent prospective randomized clinical trials have suggested that outcomes may not be better compared with the Hartman's procedure. A critical analysis of the literature leads the authors to the conclusion that there is still a role for laparoscopic lavage in selected patients, as a bridge to elective colectomy or, in some cases, as definitive management...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28087137/nos-interacting-protein-nosip-is-increased-in-the-colon-of-patients-with-hirschsprung-s-disease
#7
Anne-Marie O'Donnell, David Coyle, Prem Puri
PURPOSE: Voltage-dependent K(+) channels (Kv channels) participate in electrical rhythmicity and smooth muscle responses and are regulated by excitatory and inhibitory neurotransmitters. Kv channels also participate in the interstitial cell of Cajal (ICC) and smooth muscle cell (SMC) responses to neural inputs. The Kv family consists of 12 subfamilies, Kv1-Kv12, with five members of the Kv7 family identified to date: Kv7.1-Kv7.5. A recent study identified the potassium channel Kv7.5 as having a role in the excitability of ICC-IM in the mouse colon...
January 3, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28071947/presacral-abscess-as-a-rare-complication-of-sacral-nerve-stimulator-implantation
#8
A Gumber, S Ayyar, H Varia, S Pettit
A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28067986/prospective-randomised-controlled-trial-comparing-early-post-operative-complications-in-patients-undergoing-loop-colostomy-with-and-without-a-stoma-rod
#9
Joshua Franklyn, Gigi Varghese, Rohin Mittal, Grace Rebekah, Mark Ranjan Jesudason, Benjamin Perakath
AIM: A stoma rod or bridge has been traditionally placed under the bowel loop while constructing loop colostomies. This is believed to prevent stomal retraction and provide better faecal diversion. However, the rod can cause complications such as mucosal congestion, oedema and necrosis. This single centre prospective randomized controlled trial compared outcomes after loop colostomy creation with and without a supporting stoma rod. The primary outcome studied was stoma retraction rate, and other stoma related complications were studied as secondary outcomes...
January 9, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28064245/conservative-management-of-migrated-percutaneous-endoscopic-colostomy-tube
#10
Thomas J G Chase, Joshua Luck, Lauren S Harris, Gareth Bashir
A 68-year-old male nursing home resident presented following dislodgement of a percutaneous endoscopic colostomy (PEC) tube originally sited to prevent recurrent sigmoid volvulus. Computed tomography demonstrated tube migration into the lumen of the recto-sigmoid junction, where it remained for 12 days before passing spontaneously. During this period, the patient remained asymptomatic; the residual colocutaneous fistula functioned as a decompressive valve. Originally, the patient was due to be discharged with early flexible sigmoidoscopy follow-up...
January 6, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28054168/minimally-invasive-surgery-for-complicated-diverticulitis
#11
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
January 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28051242/a-pilot-study-about-the-oncologic-safety-of-colonic-self-expandable-metal-stents-sems-in-obstructive-colon-cancer-is-occlusion-always-better-than-silent-perforation
#12
A Zanghì, G Piccolo, A Cavallaro, E Pulvirenti, E Lo Menzo, F Cardì, M Di Vita, A Cappellani
OBJECTIVE: To evaluate the oncologic safety of colonic self-expandable metal stents (SEMS) in obstructive colon cancer. PATIENTS AND METHODS: We retrospectively reviewed all the patients who were treated with endoscopic placement of a self-expandable metallic stent (SEMS) at our institution. RESULTS: A total of 26 patients were identified during the study period, of which 24 patients (92.30%) were treated with SEMS as a bridge-to-surgery and 2 (7...
December 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28044957/right-hemihepatectomy-for-colon-cancer-metachronous-liver-metastasis-in-a-patient-with-crohn-s-disease-case-report-and-review-of-the-literature
#13
Ionuţ Negoi, Alexandru Runcanu, Sorin Paun, Mircea Beuran
: Introduction: Twenty percent of patients with colorectal cancer present stage IV disease at the time of diagnosis. The Crohn's disease increases 20 times the risk of colorectal cancer and worsens the patients' prognosis. The objective of this case report is to illustrate the surgical resection of a liver metachronous metastasis of colon cancer origin in a patient with Crohn's disease. CASE REPORT: A 53-year old female patient was admitted to our hospital for a colon cancer metachronous liver metastasis...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28044949/sphincter-sparing-surgery-in-patients-with-mid-and-low-rectal-cancer-risk-factors-for-local-recurrence-and-anastomotic-leakage
#14
Denis Aslan, Florin Grama, Daniel Cristian, Adrian Bordea, Traean Burcoş
: Background: Rectal cancer is a major health problem. The current treatment of distal rectal cancer involves a multimodality approach aimed at achieving an optimal oncologic control and an increased quality of life. PURPOSE: The purpose of this article is to identify the risk factors for local recurrence and anastomotic leakage after sphincter-sparing surgery for low and mid rectal cancer. Material and Methods: We prospectively analyzed a group of 38 patients with low and middle rectal cancer who underwent sphincter-sparing surgery...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28044239/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-effects-on-patient-reported-quality-of-life-and-functional-outcome
#15
T W A Koedam, G H van Ramshorst, C L Deijen, A K E Elfrink, W J H J Meijerink, H J Bonjer, C Sietses, J B Tuynman
BACKGROUND: Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. METHODS: Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated...
January 2, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28030494/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#16
Leah Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura B Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multi-center retrospective cohort study was performed across three Level I Trauma Centers encompassing traumatic colon injuries from January 2006 through June 2014...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28028254/-palliative-surgery-for-peritoneal-metastasis-of-gastric-cancer
#17
Haruhiko Cho, Takaki Yoshikawa
Different surgical interventions can be applied for the treatment of peritoneal metastasis of gastric cancer according to the extent of metastasis. Gastrectomy is a consensus-based standard treatment for gastric cancer with minimal peritoneal metastasis, although there is a lack of established evidence. Conversely, gastrectomy for an intermediate to high extent of peritoneal metastasis is not considered a suitable treatment based on the results of the JCOG0705 study. Colostomy or bypass surgery is often performed for intestinal stenosis due to peritoneal metastasis to palliate symptoms and allow the introduction of chemotherapy...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28006721/wide-local-excision-for-anal-gist-a-case-report-and-review-of-literature
#18
Mohamed Azzaza, Houssem Ammar, Nihed Abdessayed, Rahul Gupta, Mohamed Said Nakhli, Amine Chhaider, Nafis Abdennaceur, Ali Ben Ali
INTRODUCTION: Gastrointestinal stromal tumors (GIST) are tumors of mesenchymal origin commonly detected in stomach and small bowel. GIST arising primarily from the anal canal is extremely rare. Due to the malignant potential, these tumors are treated with radical surgery like abdominoperineal resection. But with the advent of imatinib therapy and a better understanding of the tumor biology, some cases have been successfully treated with wide local excision. PRESENTATION OF CASE: We describe a case of a 70-year-old lady presenting with a 2cm mass in the anal canal...
December 2, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28000647/an-adolescent-with-prolapsed-omentum-per-rectum-spontaneous-rectal-perforation-managed-laparoscopically
#19
Ameet Kumar, Chandra K Jakhmola, Yogesh Kukreja, S S Kumar, Arjun Singh Sandhu
Spontaneous rupture of the rectum is a rare occurrence. A total laparoscopic approach to rectal perforation has only occasionally been reported. We report an unusual case of a young boy who developed a spontaneous rupture of the rectum following a trivial fall. A magnetic resonance imaging revealed a tear in the rectum at the peritoneal reflection with the omentum plugging it. He denied any history of rectal instrumentation or abnormal sexual activity. He had no history of constipation or rectal prolapse. The tear was repaired laparoscopically and a covering loop sigmoid colostomy was added...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27998313/embryonal-rhabdomyosarcoma-of-the-perineum-in-an-adult-a-case-report
#20
Sidy Ka, Freddy Gnangnon, Mamadou Moustapha Dieng, Doudou Diouf, Jaafar Thiam, Pape Macoumba Gaye, Ahmadou Dem
BACKGROUND: We report the case of an adult patient with embryonal rhabdomyosarcoma of the perineum admitted to our practice at Joliot Curie Institute in Dakar. It is a rare tumor at this age and has a bad prognosis at this localization. CASE PRESENTATION: We describe the case of a 22-year-old African man admitted for a perineal mass that had evolved over 6 months. He complained of tenesmus, obstinate constipation, and dysuria. A clinical examination revealed perineal swelling spread over his anus, scrotum, penis, testicles, and inguinal lymph nodes...
December 20, 2016: Journal of Medical Case Reports
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