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Intestinal perforation

Motohiro Tamiya, Hidekazu Suzuki, Takayuki Shiroyama, Ayako Tanaka, Naoko Morishita, Norio Okamoto, Kenichi Sakai, Hironori Shigeoka, Kunimitsu Kawahara, Tomonori Hirashima
Background Bevacizumab (Bev) is generally well-tolerated, and Bev-associated intestinal perforation (BAP) is a rare albeit serious side effect in cases of non-small cell lung cancer (NSCLC). Therefore, the present study aimed to identify clinical predictors of BAP to help predict and manage the development of life-threatening intestinal complications among patients receiving Bev. Methods This retrospective study evaluated demographic, clinical, and treatment factors for patients with NSCLC who were treated with Bev between February 2010 and August 2015 at our center...
March 14, 2018: Investigational New Drugs
Bryan R Anderson, Jaron Marriott, Chinthaka Bulathsinghala, Humayun Anjum, Salim Surani
Introduction: Gastrointestinal histoplasmosis (GH) is a well-described albeit uncommon disease. It is found almost exclusively in the immunocompromised host, especially those with untreated HIV and low CD4 counts. Presentation with intestinal perforation is seen mostly commonly in the colon. We present a patient with jejunal perforation, and there have been only 3 previous cases reported in the literature. Case: A 39-year-old male with known, untreated HIV presented to the ED with an acute abdomen after experiencing worsening intermittent abdominal pain for 2 months before that was associated with nausea, vomiting, diarrhea, and weight loss...
2018: Case Reports in Medicine
Sophie Ovesen, Michala Herskind Sejr, Peter Andersen
A 15-year-old girl was admitted to the paediatric ward due to abdominal pain, vomiting and diarrhoea. Her symptoms could not be explained by the clinical examinations, blood samples or ultrasound, but she had a history of tricho-phagia. A CT-scan showed gastric retention, and an endoscopy revealed a trichobezoar, which was removed by a laparotomy. Furthermore, a smaller bezoar and three perforations were found in the proximal part of the small intestine. The treatment of trichobezoars should include surgery as well as multidisciplinary involvement to prevent future trichophagia...
March 12, 2018: Ugeskrift for Laeger
Yukihiro Kaneko, Ken-Ichi Oinuma, Tsuneko Terachi, Yasuaki Arimura, Mamiko Niki, Koichi Yamada, Hiroshi Kakeya, Tetsu Mizutani
A 53-year-old woman was hospitalized due to septic shock after developing pneumococcal pneumonia after undergoing esophageal cancer surgery. Her transverse colon became perforated after receiving antimicrobial chemotherapy; therefore, emergency subtotal colectomy was performed. Fungi detected in both her colon tissue and a drainage sample indicated intestinal mucormycosis. Early intensive treatment with high-dose liposomal amphotericin B was successful, and she was subsequently discharged from the hospital...
March 9, 2018: Internal Medicine
Yasmine Yousef, Fouad Youssef, Michael Homsy, Trish Dinh, Hayden Stagg, Robin Petroze, Robert Baird, Jean-Martin Larberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
BACKGROUND: Total parenteral nutrition (TPN) is often used in children with perforated appendicitis, despite the absence of clear indications. We assessed the validity of specific clinical indications for initiation of TPN in this patient cohort. METHODS: Data were gathered prospectively on duration of nil per os (NPO) status and TPN use in a cohort of children treated under a perforated appendicitis protocol during a 19-month period. TPN was started in the immediate postoperative period in patients who had generalized peritonitis and severe intestinal dilatation at operation, or later per the discretion of the attending surgeon...
February 9, 2018: Journal of Pediatric Surgery
Pan Hu, Zhi Mao, Chao Liu, Xin Hu, Hongjun Kang, Feihu Zhou
Malignant atrophic papulosis (MAP) is a rare type of obliterating vasculopathy that can present as pure cutaneous lesions or a systemic entity affecting multiple organs. Systemic disease, such as gastrointestinal or central nervous system involvement, may predispose the patients to poorer or even fatal outcomes. We present a 30-year-old female patient with systemic manifestation of MAP 10 days after delivery of a full-term pregnancy who subsequently developed motor aphasia and intestinal perforation. The patient was administrated empirical treatment with an antiplatelet, anticoagulant, methylprednisolone sodium succinate and alprostadil...
March 8, 2018: Journal of Dermatology
Ding Wu, Shen Yuehong, Li Qiang, Jiang Shouyin, Shen Huahao
AIMS: Therapeutic hypothermia has shown beneficial effects in sepsis. This study focused on its mechanism. MAIN METHODS: Sixteen male Sprague-Dawley rats underwent cecal ligation and perforation and subsequently were treated with either hypothermia (HT; body temperature cooled and maintained at 34 °C by ice pad for 10 h; n = 8) or normothermia (NT; n = 8). Three additional rats underwent sham surgery. The body temperatures of the sham-operated and NT groups were maintained at 38 °C with a thermal pad...
March 2, 2018: Life Sciences
Paul M Jeziorczak, Brad W Warner
Enteric duplications have been described throughout the entire gastrointestinal tract. The usual perinatal presentation is an abdominal mass. Duplications associated with the foregut have associated respiratory symptoms, whereas duplications in the midgut and hindgut can present with obstructive symptoms, perforation, nausea, emesis, hemorrhage, or be asymptomatic, and identified as an incidental finding. These are differentiated from other cystic lesions by the presence of a normal gastrointestinal mucosal epithelium...
March 2018: Clinics in Colon and Rectal Surgery
Teppei Kono, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Masaya Satake, Yasufumi Yamada, Arika Ida, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Kazuhiko Yoshimatsu, Takeshi Shimakawa, Takao Katsube, Hiroyuki Kato, Yoshihiko Naritaka
The patient was 55-year-old woman, undergoing Hartmann operation by the sigmoid colon diverticulum perforation, 2 years later visited our hospital with abdominal pain. Although lower endoscopy and histological examination could not be performed due to stoma stenosis, we diagnosed cecal carcinoma, liver metastasis, distant lymph node metastasis from CT and PET-CT, CapeOX plus Bmabtherapy and IRIS plus Bmabtherapy were performed. After that, repeated intestinal obstruction due to exacerbated stoma stenosis, metastatic lesion increased in CT examination, furthermore the patient had hope of stoma closure, we decided to resect the primacy tumor, performed subtotal colonectomy and stoma closure...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Megumi Sano, Kazuhiko Yoshimatsu, Shinichi Asaka, Yoshitomo Ito, Rie Imaizumi, Shota Mitsuboshi, Takako Matsumoto, Taro Koike, Yoshihiko Naritaka
INTRODUCTION: we examined the cases in which surgery was performed for the lower intestinal perforation due to peritoneal dissemination in our hospital. SUBJECTS: Four cases of lower intestinal perforation of patients with peritoneal dissemination who underwent emergency operation in our hospital were enrolled. RESULTS: Two males and 2 females patients with median age of 65.5 year old(63-71)were included. The perforated sites were 3 cases of small intestine and 1 case of ascending colon, and the APACHE II score at the visit was 14...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Germán Reyes-Botero, Stéphanie Cartalat-Carel, Olivier L Chinot, Maryline Barrie, Luc Taillandier, Patrick Beauchesne, Isabelle Catry-Thomas, Jérôme Barrière, Jean-Sebastien Guillamo, Michel Fabbro, Didier Frappaz, Alexandra Benouaich-Amiel, Emilie Le Rhun, Chantal Campello, Isabelle Tennevet, François Ghiringhelli, Marie-Laure Tanguy, Karima Mokhtari, Jérôme Honnorat, Jean-Yves Delattre
LESSONS LEARNED: Results suggest that the combination of bevacizumab plus temozolomide is active in terms of response rate, survival, performance, quality of life, and cognition in elderly patients with glioblastoma multiforme with poor performance status.Whether this combination is superior to temozolomide alone remains to be demonstrated by a randomized study. BACKGROUND: The optimal treatment of glioblastoma multiforme (GBM) in patients aged ≥70 years with a Karnofsky performance status (KPS) <70 is not established...
February 22, 2018: Oncologist
Jamie E Anderson, Ian E Brown, Kristin A Olson, Katherine Iverson, Christine S Cocanour, Joseph M Galante
BACKGROUND: Data suggest that methamphetamine may increase the risk of non-occlusive mesenteric ischemia (NOMI). We describe patterns of presentation and outcomes of patients with methamphetamine use who present with NOMI to a single institution. METHODS: This is an observational study of patients from January 2015 to September 2017 with methamphetamine use who presented with NOMI at an academic medical center in Northern California. We summarize patient co-morbidities, clinical presentation, operative findings, pathologic findings, hospital course, and survival...
February 17, 2018: Journal of Trauma and Acute Care Surgery
Bruno Freitas, Yvonne Bausback, Johannes Schuster, Matthias Ulrich, Sven Bräunlich, Andrej Schmidt, Dierk Scheinert
INTRODUCTION: To report our preliminary experience with endovascular revascularization of patients with acute mesenteric ischemia (AMI), using thrombectomy devices. MATERIAL AND METHODS: A retrospective analysis of patients admitted to our hospital due to AMI and who were subjected to concomitant or exclusive endovascular treatment, from January 2011 to January 2016. Patients were admitted at the emergency department, underwent imaging investigation and were referred to the endovascular specialist...
February 15, 2018: Annals of Vascular Surgery
Sara J Kuik, Michelle E van der Laan, Margot T Brouwer-Bergsma, Jan B F Hulscher, Anthony R Absalom, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Preterm infants requiring surgery are at risk of impaired neurocognitive development caused, possibly, by cerebral ischemia associated with impaired cerebrovascular autoregulation (CAR). We evaluated CAR before, during, and after laparotomy. STUDY DESIGN: This was a hypothesis generating prospective observational cohort study. SUBJECTS: We included preterm infants requiring surgery for necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP)...
February 14, 2018: Early Human Development
Takeshi Yamashina, Yoshikazu Hayashi, Hirotsugu Sakamoto, Tomonori Yano, Yoshimasa Miura, Satoshi Shinozaki, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
BACKGROUND:  Colorectal endoscopic submucosal dissection (ESD) can be technically difficult in some situations, such as paradoxical movement of the proximal colon. The double-balloon endoscope provides stable endoscopic maneuvering, even in the small intestine. The aim of this study was to assess the outcomes of balloon-assisted endoscopic submucosal dissection (BAESD) of colonoscopically difficult superficial proximal colon tumors. METHODS:  We retrospectively reviewed the records of patients who underwent BAESD of superficial proximal colon tumors where colonoscopic difficulties were encountered, from January 2011 to September 2016...
February 12, 2018: Endoscopy
Andrea Pakula, Ruby Skinner
INTRODUCTION: Acute care surgeons care for the entire breadth of the American adult population, including obese patients. As the population gets heavier, more patients will present to acute case surgeons with nonbariatric surgical emergencies. Do these surgeons need bariatric training to properly care for obese population? OBJECTIVES: To evaluate our experience in obese population requiring acute surgery and compare outcomes based on surgeon expertise in bariatric surgery...
December 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Julian A Marin-Acevedo, Dana M Harris, M Caroline Burton
Since their introduction for melanoma treatment, the use of immune checkpoint inhibitors (ICIs) has rapidly expanded. Though their impact on survival is irrefutable, these medications have been associated with autoimmune-like adverse events related to their ability to induce the immune system. One of the most commonly affected organ systems is the gastrointestinal (GI) tract, in which manifestations range from mild diarrhea to severe colitis with intestinal perforation. Because of the increased use of ICIs, hospitalists are caring for an increasing number of patients experiencing their adverse events...
February 6, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Per Eriksson, Mårten Segelmark, Olof Hallböök
OBJECTIVE: Involvement of the gastrointestinal (GI) tract is a rare complication of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). The aim was to describe frequency, diagnosis, treatment, and outcome of GI disease in a large series of patients in a single center. METHODS: A database that includes all patients with GPA and MPA diagnosed since 1997 in a defined area of southeastern Sweden as well as prevalent older cases and tertiary referral patients was screened for patients with GI disease...
February 1, 2018: Journal of Rheumatology
Nozomu Uematsu, Masahiko Sumi, Hiroko Kaiume, Wataru Takeda, Takehiko Kirihara, Toshimitsu Ueki, Yuki Hiroshima, Mayumi Ueno, Naoaki Ichikawa, Masahide Watanabe, Hikaru Kobayashi
A 59-year-old man who complained of abdominal pain was referred to our hospital. Computed tomography (CT) revealed mesenteric lymph node swelling and intestinal perforation. Histopathological study of the resected ileum and lymph node demonstrated diffuse proliferation of medium-sized atypical lymphocytes. Immunohistochemistry results were positive for cluster of differentiation (CD) 3, CD8, and CD56 cells, negative for CD5 and CD4 cells, and negative for Epstein-Barr virus-encoded RNA-fluorescent in situ hybridization (EBER-FISH)...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Shogo Miura, Hiroyuki Kuroda, Ken Sato, Michiko Yamada, Ryo Itou, Michihiro Ono, Tomoyuki Abe, Shigeyuki Fujii, Masahiro Maeda, Masahiro Yoshida, Wataru Jomen, Masayoshi Kobune, Junji Kato, Miri Fujita
The gastrointestinal tract is a common site for the occurrence of non-Hodgkin's lymphoma (NHL). NHL with gastrointestinal lesions may lead to clinically relevant intestinal complications such as obstruction, perforation, and exsanguination during the course of the disease. Consequently, patients with NHL are often examined by means of upper and lower gastrointestinal endoscopy at the initial visit. There are no clear guidelines regarding which patients should undergo capsule endoscopy (CE) and balloon enteroscopy for detecting small intestinal lesions...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
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