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Gastrointestinal Trauma

Milena Armacki, Anna Katharina Trugenberger, Ann K Ellwanger, Tim Eiseler, Christiane Schwerdt, Lucas Bettac, Dominik Langgartner, Ninel Azoitei, Rebecca Halbgebauer, Rüdiger Groß, Tabea Barth, André Lechel, Benjamin M Walter, Johann M Kraus, Christoph Wiegreffe, Johannes Grimm, Annika Scheffold, Marlon R Schneider, Kenneth Peuker, Sebastian Zeißig, Stefan Britsch, Stefan Rose-John, Sabine Vettorazzi, Eckhart Wolf, Andrea Tannapfel, Konrad Steinestel, Stefan O Reber, Paul Walther, Hans A Kestler, Peter Radermacher, Thomas Fe Barth, Markus Huber-Lang, Alexander Kleger, Thomas Seufferlein
Dysregulated intestinal epithelial apoptosis initiates gut injury, alters the intestinal barrier, and can facilitate bacterial translocation leading to a systemic inflammatory response syndrome (SIRS) and/or multi-organ dysfunction syndrome (MODS). A variety of gastrointestinal disorders, including inflammatory bowel disease, have been linked to intestinal apoptosis. Similarly, intestinal hyperpermeability and gut failure occur in critically ill patients, putting the gut at the center of SIRS pathology. Regulation of apoptosis and immune-modulatory functions have been ascribed to Thirty-eight-negative kinase 1 (TNK1), whose activity is regulated merely by expression...
October 15, 2018: Journal of Clinical Investigation
Camila Brandão Polakowski, Massakazu Kato, Vinicius Basso Preti, Maria Eliana Madalozzo Schieferdecker, Antonio Carlos Ligocki Campos
OBJECTIVES: Gastrointestinal microflora is involved in the development and regulation of the immune response. Non-pathogenic bacteria are important to prevent the development and subsequent invasion of enteropathogenic bacteria. Surgical trauma and intestinal preparation can disrupt the intestinal microbiota balance. Modulating the microbiota in the preoperative period in patients with colorectal cancer may have an effect on the occurrence of postoperative complications. The aim of this study was to assess the effect of preoperative synbiotic administration in patients with colorectal cancer subjected to colorectal resection...
July 11, 2018: Nutrition
Aaron Richman, Clay Cothren Burlew
No abstract text is available yet for this article.
October 1, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Teresa A Allison, Pei Jen Lin, Jennifer A Gass, Kenneth Chong, Samuel J Prater, Miguel A Escobar, Heather D Hartman
OBJECTIVE: This study investigated the percentage of patients who achieved hemostasis with 4-factor prothrombin complex concentrate (4-factor PCC) 35 U/kg. The primary end point was to determine the effect of 4-factor PCC 35 U/kg on bleeding progression, assessed using computed tomography. METHODS: This was a retrospective, observational, single-center study conducted in patients with a major bleed admitted to a level 1 trauma center from May 1, 2013, to June 15, 2015, who received 4-factor PCC 35 U/kg for reversal of a direct factor Xa inhibitor taken prior to admission...
September 24, 2018: Journal of Intensive Care Medicine
Brandt D Whitehurst
Lower gastrointestinal bleeding entails a range of severity and a multitude of options for localization and control of bleeding. With experience in trauma, critical care, endoscopy, and definitive surgical interventions, general surgeons are equipped to manage this condition in various clinical settings. This article examines traditional and emerging options for bleeding localization and control available to general surgeons.
October 2018: Surgical Clinics of North America
David W Nelms, Carlos A Pelaez
Upper gastrointestinal bleeding (UGIB), defined as intraluminal hemorrhage proximal to the ligament of Treitz, can range from mild and asymptomatic to massive life-threatening hemorrhage. For the purposes of this article, the authors define an acute UGIB to be one that results in new acute symptoms and is, therefore, potentially life-threatening. UGIB requires a systematic approach to evaluation and treatment, similar to the management of a trauma patient. Surgeon involvement in UGIBs remains integral despite the rare need for operative management...
October 2018: Surgical Clinics of North America
Anil Agarwal
The extremity foreign body in a child has propensity of getting missed or mistaken diagnosis. We report our experience of extremity foreign body trauma in order to increase awareness of this disease entity. The retrospective series of 24 retained foreign bodies was based on a 10-year chart review of emergency data (ICD code Z18). Patients with both upper and lower limb affections were included. Patients with ocular, otolaryngeal, tracheobronchial, gastrointestinal, and axial foreign bodies were excluded from the study...
September 2018: Indian Journal of Orthopaedics
Sharfuddin Chowdhury, Abdullah Maher Alenazi, Yam Alwi Alharthi
BACKGROUND: Meckel's diverticulum, with an incidence of 2%, is the most common congenital anomaly in the gastrointestinal tract. Its main complications are perforation, obstruction, and bleeding. A few studies have reported that blunt abdominal trauma may result in perforation or obstruction to Meckel's diverticulum. However, reports of significant major intestinal bleeding from Meckel's diverticulum as a complication of blunt abdominal trauma is rare. This paper present what we believe to be the first reported case of significant intestinal bleeding from a Meckel's diverticulum following blunt abdominal trauma...
September 19, 2018: Journal of Medical Case Reports
Michael Ried, Laura Sommerauer, Matthias Lubnow, Thomas Müller, Alois Philipp, Dirk Lunz, Hans-Stefan Hofmann
BACKGROUND: Patients with respiratory failure are treated more frequently with veno-venous extracorporeal membrane oxygenation (vv-ECMO). These patients are at risk for bleeding due to complex multifactorial coagulation disorders resulting from the extracorporeal circulation. METHODS: Retrospective analysis of prospectively collected data on all patients requiring vv-ECMO between December 2010 and December 2016. Endpoints were the incidence, consequence and in-hospital mortality of patients with thoracic bleeding complications...
September 4, 2018: Annals of Thoracic Surgery
July Andrea Ospina-Cantillo, Ruth Helena Ramírez-Giraldo, Iris Yansa Castelblanco-Arango, Ricardo Cardona
BACKGROUND: Frey's syndrome is a group of symptoms that include unilateral sweating with malar region and external ear reddening after eating or drinking some food. It is a lesion of the auriculotemporal nerve that is secondary to surgery, parotid gland infection or facial trauma. CLINICAL CASES: Three children between 4 and two and a half years of age: two girls and one boy. They had self-limiting unilateral erythematous facial macules that reached the external ear, without rash, itching, angioedema and gastrointestinal or respiratory symptoms; its onset was associated with the consumption of acid and some sweet foods...
July 2018: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
Obada Hasan, Wajiha Khan, Muneeba Jessar, Aly Zaheer Pathan, Riaz Hussain Lakdawala
INTRODUCTION: Aeromonas are Gram-negative bacilli often causing necrotizing fasciitis or sepsis in immunocompromised patients. Aeromonas Hydrophila is most often found in immunocompromised patients or those with burns or aquatic trauma. When patients present with a discharge and infection on bone graft donor site and progressive sepsis, an Aeromonas hydrophila infection should be considered in the differential diagnosis. PRESENTATION OF CASE: We report here a rare case of Aeromonas hydrophila with surgical site sepsis/infection in an immunocompromised 69 years old female, with several comorbids...
August 25, 2018: International Journal of Surgery Case Reports
Kaitlin Harding, Tracy Simpson, David J Kearney
OBJECTIVES: Post-traumatic stress disorder (PTSD) and irritable bowel syndrome (IBS) are highly comorbid conditions associated with reduced health-related quality of life. Comorbid prevalence is especially high among veterans, ranging from 23% to 51%, but there is limited research on integrative treatments. DESIGN: To improve treatment of comorbid PTSD and IBS, this study examined the impact of mindfulness-based stress reduction (MBSR) on symptom reduction and mindfulness skill building among veterans with this comorbidity...
August 30, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Marek Hawranek, Mateusz Stolarz, Julian Dutka, Grzegorz Wrzask, Jakub Hawranek
Metallosis is a complication of hip arthroplasty. This pathological process contributes to the loosening and dislocation of the prosthesis. This article discusses the case of a 61-year-old patient who reported pressure and pain as well as a palpable subcutaneous lump in the left lower abdomen and groin area. Medical history included total arthroplasty and repeat arthroplasty of the left hip joint, hysterectomy, appendectomy and a laparoscopic fundoplasty. A CT scan and ultrasound showed an unrecognised heterogeneous fluid area raising suspicions of a rumour mass or an old haematoma...
February 27, 2018: Ortopedia, Traumatologia, Rehabilitacja
Qin Xiang Ng, Alex Yu Sen Soh, Wayren Loke, Nandini Venkatanarayanan, Donovan Yutong Lim, Wee-Song Yeo
BACKGROUND AND AIM: Post-traumatic stress disorder (PTSD) is a psychiatric condition characterized by symptoms of hyperarousal and hypervigilance. Increasing research on the "gut-brain" axis (bidirectional signaling between the gut and the brain) has drawn links between PTSD and irritable bowel syndrome (IBS), an exceedingly common yet incompletely understood gastrointestinal condition. This meta-analysis thus aimed to examine the body of evidence and extent of association of PTSD with IBS...
August 25, 2018: Journal of Gastroenterology and Hepatology
Eric A Russell, Richard M Braverman, Sanjeev A Vasudevan, Binita Patel
A 15-year-old girl presented with 3 days of progressive abdominal distention, pain, and bilious hematemesis. Her symptoms began after her quinceañera, during which she wore a tight corset. On examination, she was thin and had significant abdominal distention and pain. A computed tomography revealed a massively dilated stomach and proximal duodenum to the region of the superior mesenteric artery (SMA) with distal decompression. An upper gastrointestinal fluoroscopy demonstrated marked dilation of the stomach through the mid third portion of the duodenum with distal decompression and an associated linear compression on her duodenal wall...
August 20, 2018: Pediatric Emergency Care
Qian Zou, Lijuan Feng, Miao Ouyang
To explore the differences in biological characteristics for the small gastrointestinal stromal tumors and the incidence of complications and recurrence between the traditional surgical treatment and endoscopic treatment.
 Methods: We collected the relevant clinical and pathological data from patients who were diagnosed as gastrointestinal stromal tumors with the diameter less than 2 cm by the Department of Pathology of Xiangya Hospital from January 2009 to December 2015. The complications and recurrence after the surgical treatment were analyzed...
July 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Rani Berry, James Han, Mohit Girotra, James H Tabibian
Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon cause of gastrointestinal hemorrhage. Hemobilia has been documented since the 1600s, but due to its relative rarity, it has only been more critically examined in recent decades. Most cases of hemobilia are iatrogenic and caused by procedures involving the liver, pancreas, bile ducts, and/or the hepatopancreatobiliary vasculature, with trauma and malignancy representing the two other major causes. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described, but this is present in only 25-30% of patients with hemobilia...
2018: Gastroenterology Research and Practice
Shang-Li Tsai, Chi-Chun Lin, Cheng-Yu Lin, Chang Keng-Wei, Cheng-Yu Chien
Patients presenting to the emergency department with hypothermia are rare and often require prompt diagnosis and management. Myxedema coma, which may cause severe hypothermia, is a true endocrine emergency requiring early and appropriate treatment. We report on a 47-year-old woman with a history of hyperthyroidism who underwent thyroidectomy 5 years previously, with no regular medication or examinations. She presented to the emergency department with a 1-month history of progressive dyspnea associated with general weakness...
October 2018: Journal of International Medical Research
Paul M Reynolds, Robert MacLaren
STUDY OBJECTIVE: Because recent studies have challenged the efficacy of stress ulcer prophylaxis (SUP) in the critically ill patient, our objective was to evaluate the efficacy of SUP with proton pump inhibitors (PPIs) or histamine2 -receptor antagonists (H2 RAs) against placebo, control, no therapy, or enteral nutrition alone in critically ill adults. DESIGN: Meta-analysis with trial sequential analysis (TSA) of 34 randomized controlled trials. PATIENTS: A total of 3220 critically ill adults who received PPIs or H2 RAs versus placebo, control, no therapy, or enteral nutrition...
August 13, 2018: Pharmacotherapy
Kevin M Izquierdo, Ece Unal, John H Marks
Over the past 30 years, colorectal surgery has evolved to include minimally invasive surgical techniques. Minimally invasive surgery is associated with reduced postoperative pain, reduced wound complications, earlier return of bowel function, and possibly shorter length of hospital stay. These benefits have been attributed to a reduction in operative trauma compared to open surgery. The need to extract the specimen in colorectal operations through a "mini-laparotomy" can negate many of the advantages of minimally invasive surgery...
2018: Clinical and Experimental Gastroenterology
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