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Intestinal perforation

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https://www.readbyqxmd.com/read/28650684/intentional-ingestion-of-elemental-mercury-requiring-multi-step-decontamination-and-prophylactic-appendectomy-a-case-report-and-treatment-proposal
#1
Andrea Michielan, Azzurra Schicchi, Roberto Cappuccio, Davide Lonati, Francesca Lamboglia, Alessandra Vitalba, Alessandro Caroli, Marta Crevani, Carlo A Locatelli, Giorgio Betetto
BACKGROUND: Ingestion of elemental mercury (Hg0) is considered non-toxic. After massive ingestion, local intestinal complications may develop: retention within appendix is quite frequent but treatment is debated. We describe a case of intentional ingestion of Hg0 requiring multi-step decontamination and prophylactic appendectomy. Case detail: A 19-year-old woman was admitted to ED for abdominal pain. History revealed ingestion of large amount of Hg0 as suicide attempt. To prevent absorption, facilitate elimination, and avoid complications a conservative approach was started...
June 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28646882/magnetic-foreign-body-ingestion-in-pediatric-patients-report-of-three-cases
#2
Jinbeom Cho, Kiyoung Sung, Dosang Lee
BACKGROUND: Although foreign bodies (FBs) typically pass spontaneously and uneventfully through the digestive tract, a subset of such bodies may become trapped, eventually leading to significant injury. In particular, the ingestion of magnetic materials can cause serious morbidity due to proximate attraction through the intestinal wall. CASE PRESENTATION: We recently treated three pediatric patients who had ingested several magnetic foreign materials. None of these patients exhibited any clinical symptoms or signs suggestive of surgical abdomen...
June 24, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28633098/high-prevalence-of-cytomegalovirus-infection-in-surgical-intestinal-specimens-from-infants-with-necrotizing-enterocolitis-and-spontaneous-intestinal-perforation-a-retrospective-observational-study
#3
Soley Omarsdottir, Margret Agnarsdottir, Charlotte Casper, Abiel Orrego, Mireille Vanpée, Afsar Rahbar, Cecilia Söderberg-Nauclér
BACKGROUND: Necrotizing enterocolitis (NEC) is a severe, often fatal gastrointestinal emergency that predominantly affects preterm infants, and there is evidence that neonatal cytomegalovirus (CMV) infection may in some cases contribute to its pathogenesis. OBJECTIVES: This study aimed to evaluate the prevalence of CMV in infants with NEC. STUDY DESIGN: Seventy intestinal specimens from 61 infants with NEC, spontaneous intestinal perforation (SIP), or related surgical complications were collected at Karolinska University Hospital and Uppsala University Hospital, Sweden...
June 3, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28616605/splenic-laceration-after-routine-colonoscopy-a-case-report-of-a-rare-iatrogenic-complication
#4
Shuo Li, Nishant Gupta, Yogesh Kumar, Frank Mele
Colonoscopy is a common and routine procedure performed in the United States, most commonly performed for screening of colorectal cancer. Although colonoscopy is considered a safe procedure, it is associated with complications including intestinal hemorrhage and perforation. Splenic trauma, such as laceration or even complete rupture is a rarely reported, but potentially fatal complication if undetected. We present a case of splenic laceration with subcapsular hematoma status post routine colonoscopy. Fortunately, patient was able to be managed medically, without further operative intervention...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28615946/treatment-and-outcome-of-intestinal-perforation-after-liver-transplant-surgery-in-adults-a-single-center-experience
#5
Jianyu Lin, Jing Wang, Peng Yue, Xingmao Zhang, Ren Lang, Yuan Wang, Chen Cui, Qiang He
OBJECTIVE: Intestinal perforation is a rare complication after liver transplantation. This study was designed to calculate the incidence and investigate the outcomes of intestinal perforation in adult liver transplant patients. MATERIALS AND METHODS: The clinical records of liver transplant recipients between January 2014 and June 2016 were obtained. The incidence of intestinal perforation was calculated, and high risk factors were analyzed. RESULTS: The mean operative time was 8...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28609811/successful-management-of-unresectable-small-bowel-lymphoma-with-laparoscopy-assisted-surgical-exclusion-of-the-affected-intestine
#6
Tetsuya Kagawa, Tatsunori Kobayashi, Satoshi Ueyama, Hiroki Okabayashi, Tetsuya Ogino, Toshiyoshi Fujiwara
The incidence of small bowel lymphoma (SBL) is increasing worldwide. In contrast to resectable SBL, the treatment of unresectable SBL is still contentious. Here, we report a case of unresectable SBL that was treated by laparoscopic exclusion of the affected intestine before systemic chemotherapy was administered. An 84-year-old man was diagnosed with primary SBL involving extranodal dissemination. The patient received prophylactic surgery, namely exclusion of the affected intestine. This therapy diminishes well-known and life-threatening complications, such as perforation, bleeding, and obstruction, which may still occur after chemotherapy, and it makes the administration of chemotherapy safer...
June 13, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28606229/-early-postnatal-application-of-glucocorticoids-for-preventing-bronchopulmonary-dysplasia-in-preterm-infants-a-meta-analysis
#7
Feng-Juan Ji, Yong Yin, Juan Xu, Li-Xia Zhao, Ya-Juan Zhou, Lei Zhu
OBJECTIVE: To study the clinical effect and safety of early postnatal application of glucocorticoids in the prevention of bronchopulmonary dysplasia (BPD) in preterm infants. METHODS: The databases including PubMed, Cochrane Library, Embase, CNKI, Wanfang Data, and VIP were comprehensively searched for articles on early postnatal application of glucocorticoids in the prevention of BPD in preterm infants published up to June 2016. Review Manager 5.3 was used for the Meta analysis of 16 randomized controlled trials (RCTs) that met the inclusion criteria...
June 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28598830/tetrahydrobiopterin-improves-microcirculation-in-experimental-sepsis
#8
Tristan Dumbarton
BACKGROUND: Tetrahydrobiopterin (BH4), an endogenous nucleic acid derivative, acts as an important cofactor for several enzymes found within the vascular endothelium, which is deranged in sepsis. OBJECTIVE: We hypothesized that BH4 would improve capillary density and decrease inflammation within the intestinal microcirculation of septic rats. METHODS: We conducted a randomized, controlled trial using two previously validated models of sepsis in rats: 1) A fecal peritonitis model using a stent perforating the ascending colon, and 2) An endotoxemia model using lipopolysaccharide (LPS) toxin from E...
June 8, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28598564/withdrawn-celecoxib-for-rheumatoid-arthritis
#9
REVIEW
Sarah E Garner, Dogan Fidan, Ruth R Frankish, Maria Judd, Beverley Shea, Tanveer Towheed, Peter Tugwell, George A Wells
BACKGROUND: Rheumatoid arthritis (RA) is a systemic auto-immune disorder, involving persistent joint inflammation. NSAIDs are used to control the symptoms of RA, but are associated with significant gastro-intestinal toxicity, including a risk of potentially life threatening gastroduodenal perforations, ulcers and bleeds. The NSAIDs known as the selective Cox II inhibitors, of which celecoxib is a member, were developed in order to reduce the GI toxicity, but are more expensive. OBJECTIVES: To establish the efficacy and safety of celecoxib in the management of RA by systematic review of available evidence...
June 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28597677/endoscopic-management-of-afferent-loop-syndrome-caused-by-enteroliths-and-anastomotic-stricture-a-case-report
#10
Ana Rita Alves, Nuno Almeida, Margarida Ferreira, Luís Tomé
Afferent loop syndrome (ALS) is a rare complication of Billroth-II gastrojejunostomy. Causes of afferent loop obstruction include adhesions, internal hernias, intestinal strictures or malignancy. Obstruction caused by enteroliths is rare and usually requires surgery. We present the case of a 90-year-old man with a Billroth-II performed 50 years earlier and three acute pancreatitis. He presented with acute abdominal pain, without signs of pancreatitis. Upper digestive endoscopy revealed a punctiform anastomotic stricture of the afferent loop...
June 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28585788/-intestinal-complications-in-twin-to-twin-transfusion-syndrome-ttts-treated-by-laser-coagulation-lc
#11
A Sánchez-Galán, J L Encinas, E Antolín, A Vilanova, M Dore, P Triana, J L Bartha, M López-Santamaría
AIM OF THE STUDY: The hemodynamic imbalance due to placental vascular anastomoses in TTTS but also vascular changes generated after intrauterine treatment may lead to hypoxic-ischemic complications. Different intestinal complications in TTTS are reviewed in this paper. METHODS: Retrospective review of TTTS cases treated by laser coagulation (LC) from 2012-2015. Demographic data, fetal therapy, prenatal diagnosis (US, MRI) and perinatal outcome were recorded. We describe cases with intestinal complications and their postnatal management...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28580043/delayed-small-bowel-perforation-with-findings-of-severe-ischemia-following-blunt-abdominal-trauma
#12
Sehnaz Evrimler, Irfan Okumuser, Deniz Delibas
BACKGROUND: Isolated small bowel perforation following blunt abdominal trauma (BAT) is an uncommon situation with high morbidity and mortality rates, and delayed small bowel perforation is even rarer. The pathophysiology of this condition is not clear in all cases. To the best of our knowledge, this is the first case report of delayed small bowel perforation following BAT with extensive portomesenteric vein gas. CASE REPORT: A 33-year-old male patient was admitted to the emergency department after a car accident...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28578700/a-rare-presentation-of-an-acute-abdomen-an-ileal-diverticular-perforation
#13
Basuru Uvindu Thilakawardana, Sanjay De Mel, Vasitha Abeysuriya, Janaki Hewavisenthi, Chandima De Mel, Lal Chandrasena, Visula Abeysuriya
BACKGROUND: This case report highlights the value of prompt intervention of diagnostic laparoscopy in a patient suspects of having an acute abdomen due to an intestinal perforation, where there is a limitation of performing Contrast Enhanced Computed Tomography of abdomen. A previously healthy young adult presenting with an acute abdomen due to a spontaneous ileal perforation, without any associated risk factors is a rare clinical entity in a developing country. Therefore, entertaining an early diagnosis will possibly prevent a fatal consequence...
June 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28567320/pneumoperitoneum-without-intestinal-perforation-in-a-neonate-case-report-and-literature-review
#14
Prabhavathi Gummalla, Gratias Mundakel, Maksim Agaronov, Haesoon Lee
Pneumoperitoneum in a preterm neonate usually indicates perforation of the intestine and is considered a surgical emergency. However, there are cases of pneumoperitoneum with no evidence of rupture of the intestine reported in the literature. We report a case of pneumoperitoneum with no intestinal perforation in a preterm neonate with respiratory distress syndrome who was on high frequency oscillatory ventilation (HFOV). He developed bilateral pulmonary interstitial emphysema with localized cystic lesion, likely localized pulmonary interstitial emphysema, and recurrent pneumothoraces...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28549684/primary-laparoscopic-gastrojejunostomy-tubes-as-a-feeding-modality-in-the-pediatric-population
#15
Chinwendu Onwubiko, Brent R Weil, Sigrid Bairdain, Amber M Hall, Julia M Perkins, Hariharan Thangarajah, Maireade E McSweeney, C Jason Smithers
PURPOSE: Outcomes associated with primary laparoscopic gastrojejunal (GJ) tube placement in the pediatric population were evaluated. METHODS: A single-institution, retrospective review examined patients undergoing laparoscopic GJ tube placement between June 2011 and December 2014. Outcomes included gastric feeding tolerance, subsequent fundoplication, complications, and mortality. RESULTS: Ninety laparoscopic GJ tubes were placed. Median follow-up was 342days (interquartile range [IQR]=141-561days)...
May 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28540478/immune-checkpoint-inhibitor-induced-colitis-diagnosis-and-management
#16
REVIEW
Caroline Prieux-Klotz, Marie Dior, Diane Damotte, Johann Dreanic, Bertrand Brieau, Catherine Brezault, Vered Abitbol, Stanislas Chaussade, Romain Coriat
Immune checkpoint inhibitors are monoclonal antibodies indicated for an increasing number of malignant diseases. These agents can cause specific side effects, which need to be anticipated while clear patterns of management need to be established. Immune checkpoint inhibitor-mediated gastrointestinal side effects, including diarrhea and colitis, occur in up to 30% of patients. Severe colitis can lead to severe dehydration or intestinal perforation. Endoscopic lesions and histopathological features of immune checkpoint inhibitor-induced colitis are similar to an inflammatory bowel disease (IBD) flare...
May 24, 2017: Targeted Oncology
https://www.readbyqxmd.com/read/28540052/a-unique-case-of-massive-gastrointestinal-bleeding
#17
Akihiko Kida, Koichiro Matsuda, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
OBJECTIVES: Lipomas are the second most common benign tumors of the small bowel, and most lipomas are asymptomatic. However, lipomas with diameters of >20 mm tend to be symptomatic, for example, to cause bleeding, obstructive jaundice, abdominal pain, intestinal obstruction, intussusception, and/or perforation. METHODS/RESULTS: We report a case of massive gastrointestinal bleeding from a jejunal lipoma combined with intussusception. A preoperative diagnosis of gastrointestinal bleeding derived from a jejunal lipoma combined with intussusception was made based on double-balloon enteroscopy and contrast-enhanced computed tomography, and partial resection of the small intestine was performed...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28531835/postpartum-acute-colonic-pseudo-obstruction-ogilvie-s-syndrome-a-systematic-review-of-case-reports-and-case-series
#18
REVIEW
Pradeep Jayaram, Manoj Mohan, Stephen Lindow, Justin Konje
INTRODUCTION: Ogilvie's Syndrome or Acute Colonic Pseudo-Obstruction (ACPO) is a rare condition characterized by massive dilatation of the colon in the absence of mechanical obstruction. About 10% of all reported cases are related to Obstetric and Gynaecological procedures, Caesarean section being the commonest associated factor. Acute intestinal dilatation, if not treated, may lead to perforation and faecal peritonitis with consequent high morbidity and mortality. MATERIALS AND METHODS: An electronic literature searches were performed in PubMed, EMBASE, Google scholar and hand searches for relevant references were included without any language restriction...
July 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28530216/-chilaiditi-syndrome-a-case-report
#19
Sławomir Krzemiński
The abnormality being the result of a certain transposition of the large intestine winding in between diaphragm and the liver, owes it's name to a so called Chilaiditi symptom. This symptom is rarely recognized for at most 0,025-0,28% of the whole population statistics - wise. The Chilaiditi symptom can be examined without any serious (abdominal) pain indication, when conducting the gastrointestinal examination with the implication of the different disorders. When carrying out the diagnostic examination, it is strongly recommended to take notice of patients suffering from the pain in abdominal area, especially in case of the patients with the developed air - structure under the right side copula of the diaphragm...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28523070/a-curious-case-of-intestinal-diaphragm-disease-unmasked-by-perforation-of-a-duodenal-ulcer
#20
Mairéad McNally, Ion Cretu
Nonsteroidal anti-inflammatory drugs are a common cause of intestinal injury. A variety of NSAID-induced injuries may occur including ulcers, erosions, colitis, strictures, and diaphragm disease. Diaphragm disease refers to the development of multiple thin, concentric, stenosing strictures in the intestine. Strictures occur most often in the midintestine and are thought to be pathognomonic of NSAID damage. They can lead to intermittent or complete bowel obstruction. Diagnosis may be elusive as there is nothing specific about NSAID-induced injury at endoscopy and histology is also nonspecific...
2017: Case Reports in Medicine
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