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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
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
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
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
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
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...
February 16, 2018: European Journal of Gastroenterology & Hepatology
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
S A Sovtsov, A G Kriger, O V Pribytkova, A V Smirnov
AIM: To study the possibility of antibacterial therapy for acute appendicitis as an alternative to surgical treatment. MATERIAL AND METHODS: For the period 1985-2010 diagnostic laparoscopy was performed in 5548 patients with suspected acute appendicitis. Acute phlegmonous or gangrenous appendicitis was observed in 2275 (41.0%) patients who underwent laparoscopic appendectomy. Other acute diseases occurred in 2458 (44.3%) patients. Acute catarrhal appendicitis or secondary inflammation of the appendix were diagnosed in 815 (14...
2018: Khirurgiia
Belén Aneiros Castro, Indalecio Cano Novillo, Araceli García Vázquez, Pedro Yuste García, Eduardo Ferrero Herrero, Andrés Gómez Fraile
INTRODUCTION: Subhepatic appendicitis in children is an unusual condition that can be challenging for the pediatric surgeons to treat. The aim of our study was to compare the outcomes of laparoscopic appendectomies based on the position of the appendix. METHODS: The data of 1736 patients who had undergone laparoscopic appendectomy in our tertiary center were retrospectively reviewed. We compared two groups: subhepatic location (n = 56) and non-subhepatic location (n = 1680)...
February 19, 2018: Asian Journal of Endoscopic Surgery
Meera Raghavan, Elena Lazzeri, Christopher J Palestro
Spondylodiscitis is an infection of the vertebral body or disc and may also involve the epidural space, posterior elements, and paraspinal soft tissues. It is a cause of morbidity and mortality, and warrants early diagnosis and prompt treatment. Diagnosis can be difficult because of nonspecific signs and symptoms. Magnetic resonance imaging is sensitive and specific and is the imaging modality of choice for spondylodiscitis. Gadolinium contrast can show the extent of soft tissue and bone phlegmon and abscess...
March 2018: Seminars in Nuclear Medicine
Harun Arslan, Zülküf Akdemir, Alpaslan Yavuz, Fahri Gökçal, Cemal Parlakgümüş, Necat İslamoglu, Hüseyin Akdeniz
BACKGROUND In the present study, the role and efficiency of strain elastography (SE) were evaluated in diagnosis and staging of acute appendicitis in pediatric patients. MATERIAL AND METHODS We enrolled 225 pediatric patients with suspected clinical and laboratory findings of acute appendicitis. Gray-scale sonographic findings were recorded and staging was made by the colorization method of SE imaging. Appendectomy was performed in all patients and the results of the surgical pathology were compared with the imaging findings...
February 11, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Martina Brandlhuber, Christian Genzinger, Bernhard Brandlhuber, Wieland H Sommer, Mario H Müller, Martin E Kreis
PURPOSE: It is controversial whether patients fare better with conservative or surgical treatment in certain stages of acute diverticulitis (AD), in particular when phlegmonous inflammation or covered micro- or macro-perforation are present. The aim of this study was to determine long-term quality of life (QoL) for AD patients who received either surgery or conservative treatment in different stages. METHODS: We included patients treated for AD at the University Hospital Grosshadern, Munich, Germany, between January 1, 2000, and December 31, 2010...
March 2018: International Journal of Colorectal Disease
Sara Schülin, Nadine Schlichting, Carlotta Blod, Sabine Opitz, Anne Suttkus, Catalina Suzana Stingu, Kathryn Barry, Martin Lacher, Ulf Bühligen, Steffi Mayer
Intestinal microbiota is involved in metabolic processes and the pathophysiology of various gastrointestinal disorders. We aimed to characterize the microbiome of the appendix in acute pediatric appendicitis comparing extraluminal and intraluminal samples.Between January and June 2015, 29 children (3-17 years, mean age 10.7 ± 3.4 years, sex M:F = 2.6:1) undergoing laparoscopic appendectomy for acute appendicitis were prospectively included in the study. Samples for bacterial cultures (n = 29) and 16S ribosomal desoxyribonucleic acid (rDNA) sequencing (randomly chosen n = 16/29) were taken intracorporeally from the appendiceal surface before preparation ("extraluminal") and from the appendiceal lumen after removal ("intraluminal")...
December 2017: Medicine (Baltimore)
Carlotta Blod, Nadine Schlichting, Sara Schülin, Anne Suttkus, Nicole Peukert, Catalina Suzana Stingu, Christian Hirsch, Wieland Elger, Martin Lacher, Ulf Bühligen, Steffi Mayer
PURPOSE: The oral microbiome has been related to numerous extra oral diseases. Recent studies detected a high abundance of oral bacteria in inflamed appendices in pediatric patients. To elucidate the role of oral bacteria in acute pediatric appendicitis, we studied the oral and appendiceal microbiome of affected children compared to healthy controls. METHODS: Between January and June 2015, 21 children undergoing appendectomy for acute appendicitis and 28 healthy controls were prospectively enrolled in the study...
December 22, 2017: International Journal of Colorectal Disease
Won Gi Woo, Young Woo Do, Geun Dong Lee, Sung Soo Lee
We report the case of a 67-year-old woman presenting with epigastric pain. Computed tomography identified diffuse phlegmonous esophagitis. Esophagogastroduodenoscopy revealed multiple perforations in the mucosal layer of the esophagus. A large amount of pus was drained internally through the gut. The patient was treated with antibiotics and early jejunostomy feeding. Although phlegmonous esophagitis is a potentially fatal disease, the patient was successfully treated medically with only a minor complication (esophageal stricture)...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
Iván Karaffa, Zoltán Barra, Tamás Balog, Zita Farkas, János Bezsilla
INTRODUCTION: Several indications of cecal wedge resection can be found in the literature, but the most common ones are acute appendicitis, appendiceal mucocele and selected cecal polyps. PURPOSE: We summarize the indications, review the results of laparoscopic cecal wedge resections carried out in our department from 01.01.2010 till 31.12.2016. A case report is presented when cecal resection was carried out for a cecal polyp. PATIENTS: Between 01...
December 2017: Magyar Sebészet
Alise Adoviča, Linda Veidere, Marks Ronis, Gunta Sumeraga
OBJECTIVES: In patients hospitalized due to deep neck infections (DNIs), to investigate the association between demographic parameters, etiology, and localization of abscesses and/or phlegmons, complications, comorbidities, treatment, and bacterial cultures. METHODS: We analyzed data of 263 patients that were hospitalized from January 1, 2012, to December 31, 2015, due to deep neck space phlegmons and/or abscesses. We performed statistical analysis with the SPSS 22...
October 30, 2017: Otolaryngologia Polska
Katelyn A Young, Nina M Neuhaus, Marcus Fluck, Joseph A Blansfield, Marie A Hunsinger, Mohsen M Shabahang, Denise M Torres, Kenneth A Widom, Jeffrey L Wild
BACKGROUND: This study characterized the failure rate of non-operative management (NOM) for complicated appendicitis (CA; perforation, abscess, phlegmon), and compared outcomes among patients undergoing acute appendectomy (AA), elective interval appendectomy (EIA), and unplanned appendectomy after failing to improve with NOM. METHODS: Adults treated at one facility between 2007 and 2014 were retrospectively studied. RESULTS: Ninety-five patients presented with CA...
October 31, 2017: American Journal of Surgery
Z Beriashvili, M Gurgenidze
A 28-year-old male patient came to Surgical Department 15.07.2003 after a gunshot wound. An emergency operation was performed. Among the other damages of different part of intestinum damage of the anterior wall of the second anatomical part of the duodenum was diagnosed intraoperatively. The size of the damaged area was 3×1 sm. The doudenal wound was sutured with two layers after updating the edges. On the fifth postoperative day the wound leakage was detected. Later the giant sizes of duodenal fistula was formed...
October 2017: Georgian Medical News
Bo Young Kim, Hyun-Sook Kim
[This corrects the article on p. 945 in vol. 32, PMID: 28814069.].
November 2017: Korean Journal of Internal Medicine
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