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https://www.readbyqxmd.com/read/29755780/appendiceal-diverticulosis-a-harbinger-of-underlying-primary-appendiceal-adenocarcinoma
#1
Jia Lin Ng, Shing Lih Wong, Ronnie Mathew
Diagnosis of primary appendiceal adenocarcinoma (PAA) is hindered by its rarity and largely asymptomatic nature. Appendiceal diverticulosis (AD) is equally rare. We report an unusual case of PAA presenting with perforated appendiceal diverticulitis, and discuss a review of the literature about its association, and its surgical and pathological implications. A middle-aged man was admitted with right iliac fossa (RIF) pain and a corresponding tender abdominal mass for 5 days. Computerised tomography (CT) scan demonstrated a thickened appendix with 3 cm abscess at its base...
April 2018: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29742985/laparoscopic-redo-ileocolic-resection-for-crohn-s-disease-in-patients-with-previous-multiple-laparotomies
#2
V Celentano, F Sagias, K G Flashman, J Conti, J Khan
PURPOSES: Over 80% of patients with primary ileocolic Crohn's disease have a surgical resection within 10 years of diagnosis, and 40%-50% of them need further surgery within 15 years. Laparoscopic surgery can be challenging due to a thickened mesentery and the potential for fistulas, abscesses, and phlegmons. Aim of this study is to analyze the short-term outcomes of laparoscopic redo ileocolic resections for Crohn's disease in patients with previous multiple laparotomies. METHODS: All patients undergoing laparoscopic surgery for ileocolic Crohn's disease from March 2006 to February 2017 were prospectively evaluated...
May 1, 2018: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29730811/phlegmonous-gastritis-associated-with-advanced-esophageal-cancer
#3
Nobutoshi Hagiwara, Takeshi Matsutani, Hiroki Umezawa, Munenaga Nakamizo, Kazuhiko Yokoshima, Eriko Shinozuka, Tsutomu Nomura, Eiji Uchida
Phlegmonous gastritis is a rapidly progressive bacterial infection of the stomach wall. It has a high mortality rate and aggressive treatment, either with antibiotics or surgical resection, is required. Here, we report an extremely rare case of phlegmonous gastritis associated with advanced esophageal cancer. A 65-year-old Japanese man was urgently admitted to the hospital due to pyrexia and gastrointestinal symptoms. Abdominal computed tomography revealed widespread diffuse thickening of the gastric wall. On endoscopic examination, an ulcerative mass was detected at the lower thoracic esophagus, and a markedly elevated submucosal lesion was present in the middle of the stomach body...
May 5, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29718874/diagnosis-and-treatment-of-acute-phlegmonous-gastritis-a-case-report
#4
Hongxin Yang, Zhiqiang Yan, Jiaju Chen, Haitao Xie, Haibin Wang, Qian Wang
RATIONALE: Acute phlegmonous gastritis (PG) is a rare and often fatal condition mainly characterized by severe bacterial infection of the gastric wall. Case reports of PG over the past century average about 1 per year. Early diagnosis and immediate treatment are crucial to achieve positive outcomes. PATIENT CONCERNS: A 47-year-old man was referred to our hospital because of abdominal pain, high fever, and vomiting for 4 days, with aggravation for 24 hours. Physical examination revealed epigastric abdominal pain, rebound pain, and abdominal wall tightness...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29718450/real-time-interobserver-agreement-in-bowel-ultrasonography-for-diagnostic-assessment-in-patients-with-crohn-s-disease-an-international-multicenter-study
#5
Emma Calabrese, Torsten Kucharzik, Christian Maaser, Giovanni Maconi, Deike Strobel, Stephanie R Wilson, Francesca Zorzi, Kerri L Novak, David H Bruining, Marietta Iacucci, Mamoru Watanabe, Elisabetta Lolli, Carlo Chiaramonte, Stephen B Hanauer, Remo Panaccione, Francesco Pallone, Subrata Ghosh, Giovanni Monteleone
Background: The unavailability of standardized parameters in bowel ultrasonography (US) commonly used in Crohn's disease (CD) and the shortage of skilled ultrasonographers are 2 limiting factors in the use of this imaging modality around the world. The aim of this study is to evaluate interobserver agreement among experienced sonographers in the evaluation of bowel US parameters in order to improve standardization in imaging reporting and interpretation. Methods: Fifteen patients with an established diagnosis of CD underwent blinded bowel US performed by 6 experienced sonographers...
April 28, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29663311/interobserver-variability-in-the-classification-of-appendicitis-during-laparoscopy
#6
A L van den Boom, E M L de Wijkerslooth, K A L Mauff, I Dawson, C C van Rossem, B R Toorenvliet, B P L Wijnhoven
BACKGROUND: The intraoperative classification of appendicitis dictates the patient's postoperative management. Prolonged antibiotic prophylaxis is recommended for complex appendicitis (gangrenous, perforated, abscess), whereas preoperative prophylaxis suffices for simple appendicitis. Distinguishing these two conditions can be challenging. The aim of this study was to assess interobserver variability in the classification of appendicitis during laparoscopy. METHODS: Short video recordings taken during laparoscopy for suspected appendicitis were shown to surgeons and surgical residents...
April 16, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29656303/spondylodiscitis-following-endovascular-abdominal-aortic-aneurysm-repair-imaging-perspectives-from-a-single-centre-s-experience
#7
Ramin Mandegaran, Christopher S W Tang, Erlick A C Pereira, Ali Zavareh
OBJECTIVE: Very few reports have previously described spondylodiscitis as a potential complication of endovascular aortic aneurysm repair (EVAR). We present to our knowledge the first case series of spondylodiscitis following EVAR based on our institution's experience over an 11-year period. Particular attention is paid to the key imaging features and challenges encountered when performing spinal imaging in this complex patient group. MATERIALS AND METHODS: Of 1,847 patients who underwent EVAR at our institution between January 2006 and January 2017, a total of 9 patients were identified with imaging features of spondylodiscitis (0...
April 14, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29644292/serious-phlegmonous-lesion-of-the-hand-following-an-injury-by-vegetal-thorn-never-forget-pasteurella-multocida
#8
A Maleb, J Elmalki, O Bouayadi, Y Ben Lahlou, M Frikh, N Abdeljaouad, A Lemnouer, H Yacoubi, M Elouennass
Pasteurella multocida can cause serious infections after dog or cat bite. We report here a rare case of hand infection caused by P. multocida consecutive to an injury by a thorn of the prickly pear. It caused an amputation of the distal phalanx of the thumb in a trisomic patient. It is about a 27-year-old man who was admitted to the hospital with swelling and intense pain of the left hand. He reported a sting by a thorn of prickly pear 15 days before. The patient was admitted to proceed with operative irrigation and debridement...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29607969/phlegmonous-gastritis-a-report-of-three-cases-with-clinical-and-imaging-features
#9
Mitsuaki Ishioka, Noboru Watanabe, Masayuki Sawaguchi, Sho Fukuda, Hisashi Shiga, Tamotsu Matsuhashi, Mario Jin, Katsunori Iijima
Phlegmonous gastritis is a rare but often fatal acute pyogenic infection of the stomach. We herein report three cases of phlegmonous gastritis with different causes: the long-term placement of a nasogastric feeding tube, bacteremia associated with cellulitis in a diabetic patient, and an adverse reaction to paclitaxel/carboplatin chemotherapy for cancer of unknown primary cause, which were classified as primary, secondary, and idiopathic types, respectively. Coping with the increasing morbidity rate associated with the diverse background of such patients requires a thorough understanding of the clinical features and image findings associated with this entity...
March 30, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29605040/outcomes-of-interval-appendectomy-in-comparison-with-appendectomy-for-acute-appendicitis
#10
Abbas Al-Kurd, Ido Mizrahi, Baha Siam, Amram Kupietzky, Nurith Hiller, Nahum Beglaibter, Ahmed Eid, Haggi Mazeh
BACKGROUND: Traditionally, patients treated conservatively for periappendiceal abscess or phlegmon would subsequently undergo interval appendectomy (IA); however, recent evidence has shed doubt on the necessity of this procedure. This study aimed to assess the outcomes of patients who underwent IA, in comparison with those operated acutely for appendicitis. MATERIALS AND METHODS: A retrospective analysis identified patients who underwent IA between 2000 and 2016...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29595747/postoperative-infection-in-patients-undergoing-posterior-lumbosacral-spinal-surgery-a-pictorial-guide-for-diagnosis-and-early-treatment
#11
Shih-Hao Chen, Wen-Jer Chen, Meng-Huang Wu, Jen-Chung Liao, Chen-Ju Fu
Surgical site infections after posterior spinal surgery may lead to spondylodiscitis, pseudarthrosis, correction loss, adverse neurological sequelae, sepsis, and poor outcomes if not treated immediately. Infection rates vary depending on the type and extent of operative procedures, use of instrumentation, and patients' risk factors. Image evaluation is crucial for early diagnosis and should be complementary to clinical routes, laboratory survey, and treatment timing. Magnetic resonance imaging detects early inflammatory infiltration into the vertebrae and soft tissues, including hyperemic changes of edematous marrow, vertebral endplate, and abscess or phlegmon accumulation around the intervertebral disk, epidural, and paravertebral spaces...
March 27, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29589454/-open-versus-laparoscopic-appendectomy-for-acute-appendicitis-in-children
#12
R Štichhauer, J Koudelka
INTRODUCTION: Acute appendicitis is a common disease affecting both adults and children. The basic therapeutic procedure is an appendectomy. Open appendectomy has been gradually supplemented and sometimes replaced by a laparoscopic approach in numerous departments. The aim of our work was to compare laparoscopic and open surgery objectively. METHOD: Retrospective analysis of data from patients operated on at the Department of Pediatric Surgery and Traumatology, Teaching Hospital in Hradec Králové in 20092016...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29559489/prostate-cancer-with-an-unusual-metastatic-affinity-for-the-appendix-inducing-acute-appendicitis
#13
Erasmia Christou
Acute appendicitis induced by metastatic disease is uncommon. We present the case of an 82-year-old man with known bony metastases secondary to prostatic cancer who presents with a short history of acute abdominal pain. A CT scan was indicative of acute appendicitis and the patient underwent a laparoscopic appendicectomy; a phlegmonous mass seen intraoperatively was suspicious for malignancy, and histopathology confirmed acute appendicitis as well as metastases of prostate cancer. Metastatic disease should be considered as an important differential in all patients with a known history of malignancy, as this may in turn complicate their presenting surgical complaint...
March 20, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29535884/free-intraperitoneal-gallstone-an-unusual-case-of-small-bowel-obstruction-from-extrinsic-compression
#14
Kor Woi Tiang, Hang Fai So, Yang Hwang, Manjunath Siddaiah-Subramanya
Laparoscopic cholecystectomy (LC) is preferred in the treatment of symptomatic cholecystolithiasis. Gallstone spillage is not uncommon, and there have been reports of associated complications. We report a case of a free intraperitoneal gallstone, left inadvertently during LC, which developed an inflammatory phlegmon with abscess containing gallstone, causing extraluminal compression on the distal ileum, resulting in small bowel obstruction. This complication in particular is almost unheard of. The patient underwent laparoscopic drainage of abscess and retrieval of gallstone, which relieved the obstruction...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29528400/the-management-of-intestinal-penetrating-crohn-s-disease
#15
Robert P Hirten, Shailja Shah, David B Sachar, Jean-Frederic Colombel
Crohn's disease (CD) leads to the development of complications through progressive uncontrolled inflammation and the transmural involvement of the bowel wall. Most of the available literature on penetrating CD focuses on the perianal phenotype. The management of nonperianal penetrating complications poses its own set of challenges and can result in significant morbidity and an increased risk of mortality. Few controlled trials have been published evaluating this subgroup of patients for clinicians to use for guidance...
March 8, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29507603/nonoperative-management-of-appendiceal-phlegmon-or-abscess-in-children-less-than-3-years-of-age
#16
Hailan Zhang, Yuzuo Bai, Weilin Wang
Background: In children less than 3 years of age, there is little experience in the nonoperative management of appendiceal phlegmon or abscess (APA), especially in APA with an appendicolith. The purposes of this study were to evaluate the effects of an appendicolith and the success rate of nonoperative management for APA in these young children. Methods: Children younger than 3 years of age with APA who underwent attempted initial nonoperative treatment between January 2008 and December 2016 were reviewed...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29483992/acute-forefoot-phlegmon-a-complication-of-intravenous-heroin-addiction
#17
Uwe Wollina, Torello Lotti, Georgi Tchernev
Infections of the skin and soft tissues (SSTI) are clinical entities with variable presentations, causes, and levels of clinical severity. They are frequent in emergency departments. The most common pathogen in the Western World is Staphylococcus aureus . SSTI may provide a hint to underlying pathologies such as diabetes and other states of immune compromise. Here we present a 41-year-old non-diabetic male patient with pain and swelling of the left forefoot but not any recent trauma. Microbiology identified streptococci...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29464491/do-i-need-to-operate-on-that-in-the-middle-of-the-night-development-of-a-nomogram-for-the-diagnosis-of-severe-acute-cholecystitis
#18
Mattia Portinari, Michele Scagliarini, Giorgia Valpiani, Simona Bianconcini, Dario Andreotti, Rocco Stano, Paolo Carcoforo, Savino Occhionorelli
BACKGROUND: Some authors have proposed different predictive factors of severe acute cholecystitis, but generally, the results of risk analyses are expressed as odds ratios, which makes it difficult to apply in the clinical practice of the acute care surgeon. The severe form of acute cholecystitis should include both gangrenous and phlegmonous cholecystitis, due to their severe clinical course, and cholecystectomy should not be delayed. The aim of this study was to create a nomogram to obtain a graphical tool to compute the probability of having a severe acute cholecystitis...
February 20, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29462028/the-operative-risk-and-natural-history-after-the-diagnosis-of-ileal-penetrating-crohn-s-disease
#19
Peter Bossuyt, Celine Debeuckelaere, Marc Ferrante, Dirk Vanbeckevoort, Thomas Billiet, Albert Wolthuis, Gert van Assche, Andre D'Hoore, Séverine Vermeire
BACKGROUND AND PURPOSE: Crohn's disease (CD) is marked by transmural inflammation of the bowel wall leading to stricturing and/or penetrating complications in the majority of patients. The natural history and operative risk after the diagnosis of an ileal penetrating complication is understudied. The aim was to study the disease course and need for surgery in patients diagnosed with a penetrating ileal CD complication and to assess the risk factors associated with worse postoperative outcome...
May 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29461220/indexes-of-cytokine-profile-of-blood-in-patients-with-complicated-erysipelas
#20
I Ioffe, I Zelenyi, A Meleshchenko, N Meleshchenko, P Karpenko
The cytokine blood profile in patients with complicated erysipelas was investigated. It was found that in patients with complications of erysipelas (gangrene, phlegmon, abscess, thrombophlebitis of the subcutaneous veins of the shin) levels of pro-inflammatory cytokines IL-1ß, TNF-α, IL-2, IL-6 in serum significantly increase and level of anti-inflammatory cytokine IL-4 increases slightly, as well as was found a significant increase in coefficients reflecting the ratio of pro-inflammatory and anti-inflammatory cytokines, which indicates the prevalence in the blood of examined patients with complications of erysipelas an anti-inflammatory properties...
January 2018: Georgian Medical News
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