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https://www.readbyqxmd.com/read/29331086/current-management-of-small-bowel-obstruction-in-the-uk-results-from-the-national-audit-of-small-bowel-obstruction-clinical-practice-survey
#1
Matthew J Lee, Adele E Sayers, Timothy R Wilson, Austin G Acheson, Iain D Anderson, Nicola S Fearnhead
AIM: Small bowel obstruction (SBO) is associated with high rates of morbidity and mortality. The National Audit of Small Bowel Obstruction (NASBO) is a collaboration between trainees and specialty associations to improve the care of patients with SBO through national clinical audit. The aim of this study was to define current Consultant practice preferences in the management of small bowel obstruction in the UK. METHOD: A survey was designed to assess practice preferences of consultant surgeons...
January 13, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29325513/use-of-methylene-blue-in-the-prevention-of-recurrent-intra-abdominal-postoperative-adhesions
#2
Octavian C Neagoe, Mihaela Ionica, Octavian Mazilu
Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoperative adhesions. Methods Patients with a history of >2 surgeries for intra-abdominal adhesion-related complications were selected for this study. Adhesiolysis surgery was subsequently performed using administration of 1% methylene blue. The follow-up period was 28.5 ± 11.1 months. Results Data were available from 20 patients (seven men and 13 women) whose mean ± SD age was 51.2 ± 11.4 years. Adhesions took longer to become symptomatic after the first abdominal surgery when the initial pathology was malignant compared with benign...
January 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29317267/spiral-enteroscopy-assisted-ercp-in-bariatric-length-roux-en-y-anatomy-a-large-single-center-series-and-review-of-the-literature-with-video
#3
Mohammad F Ali, Rani Modayil, Krishna C Gurram, Collin Brathwaite, David Friedel, Stavros Stavropoulos
BACKGROUND: Deep enteroscopy-assisted ERCP (DEA-ERCP) in post-bariatric Roux-en-Y (RY) anatomy is challenging. Laparoscopy-assisted ERCP (LA-ERCP) or EUS-directed transgastric ERCP (EDGE) are technically easier and faster, but are more invasive and morbid procedures. Therefore, we have used DEA-ERCP as our first-line approach, reserving EDGE and LA-ERCP for cases in which adjunctive techniques that cannot be performed through an enteroscope are required (eg, EUS-FNA, SO manometry), or DEA-ERCP failures...
January 6, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29289627/management-prevention-and-sequelae-of-adhesions-in-women-undergoing-laparoscopic-gynecologic-surgery-a-systematic-review
#4
REVIEW
Sara Farag, Pamela Frazzini Padilla, Katherine A Smith, Michael L Sprague, Stephen E Zimberg
Surgical adhesions can lead to significant consequences including abdomino-pelvic pain, bowel obstruction, subfertility, and subsequent surgery. Although laparoscopic surgery is associated with decreased risk of adhesion formation, methods to further decrease adhesions are warranted. We systematically reviewed literature addressing the management, prevention, and sequelae of adhesions in women undergoing laparoscopic gynecologic surgery. We searched PubMed, EMBASE, EBSCOhost, and CENTRAL and found 6566 records...
December 28, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29279662/ct-scan-reliability-in-detecting-internal-hernia-after-gastric-bypass
#5
Mohammad A Farukhi, Michael S Mattingly, Benjamin Clapp, Alan H Tyroch
Background and Objectives: Internal hernia (IH) after gastric bypass can be a life-threatening complication. Obstruction presents acutely or as chronic relapses, with symptoms of abdominal pain, nausea, and vomiting. Early detection and exploration of IH as the cause of small bowel obstruction (SBO) is critical in this surgical emergency and can reduce morbidity and mortality. We conducted a retrospective review of laparoscopic Roux-en-Y bypass (LRYGB) records to determine the specificity and sensitivity of computed tomography (CT) in identifying postoperative IH...
October 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/29275447/old-and-new-lymphocyte-players-in-inflammatory-bowel-disease
#6
REVIEW
Paolo Giuffrida, Gino Roberto Corazza, Antonio Di Sabatino
Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, is a chronic intestinal inflammatory disorder characterized by diffuse accumulation of lymphocytes in the gut mucosa as a consequence of over-expression of endothelial adhesion molecules. The infiltrating lymphocytes have been identified as subsets of T cells, including T helper (Th)1 cells, Th17 cells, and regulatory T cells. The function of these lymphocyte subpopulations in the development of IBD is well-known, since they produce a number of pro-inflammatory cytokines, such as interferon-γ and interleukin-17A, which in turn activate mucosal proteases, thus leading to the development of intestinal lesions, i...
December 23, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29273999/distal-duodenogastrostomy-or-proximal-jejunogastrostomy-in-the-management-of-ultra-short-bowel
#7
Tjipke Olivier Hofker, Mirjam Anna Kaijser, Vincent B Nieuwenhuijs, Johan Frederick Michel Lange, Hendrik Sijbrand Hofker
Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records...
December 22, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29273378/safety-and-efficacy-of-preoperative-abdominal-aortic-balloon-occlusion-in-placenta-increta-and-or-percreta
#8
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/29251701/lower-emergency-general-surgery-egs-mortality-among-hospitals-with-higher-quality-trauma-care
#9
John W Scott, Thomas C Tsai, Pooja U Neiman, Gregory J Jurkovich, Garth H Utter, Adil H Haider, Ali Salim, Joaquim M Havens
BACKGROUND: Patients undergoing emergency general surgery (EGS) procedures are up to eight times more likely to die than patients undergoing the same procedures electively. This excess mortality is often attributed to non-modifiable patient factors including comorbidities and physiologic derangements at presentation, leaving few targets for quality improvement. Though the hospital-level traits that contribute to EGS outcomes are not well understood, we hypothesized that facilities with lower trauma mortality would have lower EGS mortality...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29246778/computed-tomography-whirl-sign-an-image-based-indication-for-surgery
#10
C Hobeika, I Anzoua Kouakou, C Eveno
Adhesive closed-loop small bowel obstruction can lead to volvulus and ischemia with risk of necrosis. The vital prognosis and bowel viability are highly dependent on rapid management. The physical examination is often insufficient to establish the diagnosis and computed tomography is ordered. The whirl sign provides the best imaging evidence of volvulus and can be sufficient to establish the indication for surgery.
December 12, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29223139/novel-treatments-for-inflammatory-bowel-disease
#11
Hyo Sun Lee, Soo-Kyung Park, Dong Il Park
Increased understanding of the immunopathology of inflammatory bowel disease (IBD) has led to the development of targeted therapies and has unlocked a new era in IBD treatment. The development of treatment options aimed at a variety of pathological mechanisms offers new hope for customized therapies. Beyond anti-tumor necrosis factor agents, selective lymphocyte trafficking inhibitors have been proposed as potent drugs for IBD. Among these, vedolizumab has recently been approved for both Crohn's disease and ulcerative colitis...
December 11, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29218668/early-laparoscopic-adhesiolysis-for-small-bowel-obstruction-retrospective-study-of-main-advantages
#12
Claudia Hannele Mazzetti, Francesco Serinaldi, Eric Lebrun, Jean Lemaitre
BACKGROUND: The problem of managing adhesional small bowel obstruction (ASBO) is still unsolved. A conservative medical attitude is privileged even if it is associated to a high rate of recurrences, while surgery is applied to cases showing no improvement after 48-72 h. Adhesiolysis via laparotomy has been the standard surgical management, but it causes other adhesions in a vicious circle. The aim of the study is to evaluate the advantages of early laparoscopic adhesiolysis as an alternative approach...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29204117/protective-effect-of-pogostone-on-2-4-6-trinitrobenzenesulfonic-acid-induced-experimental-colitis-via-inhibition-of-t-helper-cell
#13
Jiyan Su, Cailan Li, Xiuting Yu, Guanghua Yang, Jianhua Deng, Ziren Su, Huifang Zeng, Jiannan Chen, Xiaojun Zhang, Xiaoping Lai
Inflammatory bowel disease (IBD) is a chronic immune-related disease mainly caused by the disequilibrium of T helper (Th) cell paradigm? Pogostone (PO) is one of the major chemical constituents of Pogostemon cablin (Blanco) Benth. The present study aims to investigate the potential benefit of PO against IBD in a 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced experimental colitis model. PO treatment by enema significantly brought down the disease activity index (DAI) of the TNBS-challenged rats, which was manifested by the ameliorated inflammatory features including ulceration, adhesion, and edema...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29198548/embolization-of-arterial-gastrointestinal-hemorrhage-with-fuaile-medical%C3%A2-adhesive
#14
Min Xu, Xiaoli Zhu, Yizhi Liu, Zhi Li, Tianzhi An, Tianpeng Jiang, Jie Song, Lizhou Wang, Shi Zhou, Caifang Ni
BACKGROUND: To investigate the safety and effectiveness of Fuaile medical adhesive (FAL) with superselective catheterization in endovascular embolotherapy for the treatment of gastrointestinal hemorrhage (GIH) that was unresponsive to internal medicine treatment and gastroscopy management. METHODS: A total of 25 patients with GIH, confirmed using angiography but with failed results after internal medicine treatment or gastroscopy were retrospectively analyzed. A mixture of lipiodol and FAL (1:1) was used to embolize the bleeding vessels...
November 30, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29195141/il-17-is-a-protection-effector-against-the-adherent-invasive-escherichia-coli-in-murine-colitis
#15
Hai-Jia Zhang, Bin Xu, Hu Wang, Bing Xu, Guo-Dong Wang, Ming-Zuo Jiang, Chao Lei, Mei-Ling Ding, Peng-Fei Yu, Yong-Zhan Nie, Kai-Chun Wu, Su-Mei Sha, Meng-Bin Li
Inflammatory bowel disease (IBD) is caused by aberrant immune responses to the gut microbiota. Among the gut microbiota, adherent-invasive Escherichia Coli (AIEC) is thought to be the pathogen through invading the intestinal epithelial cells and causing inflammation. IL-17 secretion increase, induced by enhanced bacterial adhesion to the intestine epithelium, could on one hand protect the mucosa, but on the other hand, over amount of IL-17 initializes inflammation reactions that in turn damages the mucosa. The relationship between IL-17 and AIEC is still unclear...
November 28, 2017: Molecular Immunology
https://www.readbyqxmd.com/read/29184883/small-bowel-obstruction-caused-by-cryptorchidism-in-an-adult
#16
Chang Woo Kim, Gyeong Eun Min, Suk-Hwan Lee
Small bowel obstruction (SBO) is a common complication after abdominal surgery, and can occur due to many reasons. However, cryptorchidism can cause SBO in patients with no history of abdominal surgery. We report the case of a 67-year-old man with SBO caused by adhesions between an undescended testis and the terminal ileum.
November 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29183332/a-novel-ruminococcus-gnavus-clade-enriched-in-inflammatory-bowel-disease-patients
#17
Andrew Brantley Hall, Moran Yassour, Jenny Sauk, Ashley Garner, Xiaofang Jiang, Timothy Arthur, Georgia K Lagoudas, Tommi Vatanen, Nadine Fornelos, Robin Wilson, Madeline Bertha, Melissa Cohen, John Garber, Hamed Khalili, Dirk Gevers, Ashwin N Ananthakrishnan, Subra Kugathasan, Eric S Lander, Paul Blainey, Hera Vlamakis, Ramnik J Xavier, Curtis Huttenhower
BACKGROUND: Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract that is associated with changes in the gut microbiome. Here, we sought to identify strain-specific functional correlates with IBD outcomes. METHODS: We performed metagenomic sequencing of monthly stool samples from 20 IBD patients and 12 controls (266 total samples). These were taxonomically profiled with MetaPhlAn2 and functionally profiled using HUMAnN2...
November 28, 2017: Genome Medicine
https://www.readbyqxmd.com/read/29181216/endovascular-repair-with-a-stent-graft-in-a-patient-with-aortoduodenal-fistula-after-radiation-therapy
#18
Kazuhiko Morikawa, Hirokazu Ashida, Yosuke Nozawa, Kenji Motohashi, Takao Igarashi, Hiroya Ojiri, Yuji Kanaoka, Takao Ohki
Primary aortoduodenal fistula (ADF) is a direct communication between the abdominal aorta and the gastrointestinal tract without any previous vascular intervention and represents a rare but critical cause of repeated and massive gastrointestinal bleeding. Primary ADF often occurs as a result of atherosclerotic aneurysm and infection, but ADF involving a normal-size aorta is rare; furthermore, ADF related to radiation therapy is extremely rare. We present the case of a 56-year-old man with a history of bowel obstruction due to radiation enteritis who was admitted with severe hematemesis and hemorrhagic shock...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/29170020/impact-of-race-on-the-surgical-management-of-adhesive-small-bowel-obstruction
#19
Alexander S Chiu, Raymond A Jean, Kimberly A Davis, Kevin Y Pei
BACKGROUND: Small bowel obstruction (SBO) represents roughly 15% of admissions by general surgeons. Management of SBO relies heavily on provider judgement, including decisions on how long to trial non-surgical management and whether to use a laparoscopic or open approach when surgery is needed. Given the subjective nature of these decisions, it is unknown if patient race influences management of SBO. STUDY DESIGN: The National Surgical Quality Improvement Program was used to identify patients who underwent adhesiolysis or small bowel resection for adhesive SBO between 2010-2015 (n=13,896)...
November 20, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29161796/-small-bowel-perforation-caused-by-press-through-package
#20
Jung Seok Kim, Jae Myung Cha, Min Seob Kwak, Jin Young Yoon, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Hye Young Kim
With an increased use of the press-through package (PTP) tablet, there has also been an increase in mis-swallowing cases, especially in elderly patients. We report a rare case of PTP-induced small bowel perforation and fistula formation with adjacent small bowel in a healthy elderly patient, who experienced persistent abdominal pain of unknown cause. A 62-year-old healthy man was admitted to our hospital with left abdominal pain that started one month ago. Neither abdominal tenderness nor rebound tenderness was present on physical examination...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
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