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https://www.readbyqxmd.com/read/29227855/a-case-report-of-successful-management-of-clostridium-difficile-colitis-with-antegrade-fidaxomicin-through-a-mucous-fistula-obviating-the-need-for-subtotal-colectomy
#1
Suzanne Arnott, Matthew Skancke, Sheena Chen, Bruce Abell
INTRODUCTION: Clostridium difficile is the most common cause of healthcare-associated infections and can have devastating morbidity and mortality. Traditional treatment algorithms involve intravenous metronidazole and enteric metronidazole or vancomycin. Fidaxomicin (DificidR) targets "switch regions" within RNA polymerases and effectively kills clostridium difficile bacteria and is typically administered orally primarily or through a naso/oro-gastric conduit. PRESENTATION OF CASE: 55-year-old with a recent elective surgical procedure was hospitalized with multifocal pneumonia and subsequently developed clostridium difficile colitis...
November 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29215479/major-abdominal-and-perianal-surgery-in-crohn-s-disease-long-term-follow-up-of-australian-patients-with-crohn-s-disease
#2
James W T Toh, Nelson Wang, Christopher J Young, Matthew J F X Rickard, Anil Keshava, Peter Stewart, Viraj Kariyawasam, Rupert Leong
BACKGROUND: Most patients with Crohn's disease still require surgery despite significant advances in medical therapy, surveillance, and management strategies. OBJECTIVE: The purpose of this study was to assess surgical strategies and outcomes in Crohn's disease, including surgical recurrence and emergency surgery. DESIGN: This was a multicenter, retrospective review of a prospectively collected database. SETTINGS: A specialist-referred cohort of patients with Crohn's disease between 1970 and 2009 was studied...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29207370/a-bleeding-heart-coronary-cameral-fistula-after-septal-myomectomy
#3
Daniel Walters, Ryan Reeves, Lawrence Ang, Ali Pourdjabbar, Ehtisham Mahmud
Coronary-cameral fistulas are relatively rare communications arising within the coronary vasculature entering into one of the four cardiac chambers. This case highlights a striking angiographic example of coronary-cameral fistula occurring after septal myomectomy, a complication occurring somewhat frequently with typical spontaneous resolution.
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29205793/duodenal-graft-complications-requiring-duodenectomy-after-pancreas-and-pancreas-kidney-transplantation
#4
Erica Pieroni, Niccolò Napoli, Carlo Lombardo, Piero Marchetti, Margherita Occhipinti, Carla Cappelli, Davide Caramella, Giovanni Consani, Gabriella Amorese, Maurizio De Maria, Fabio Vistoli, Ugo Boggi
Duodenal graft complications are poorly reported complications of pancreas transplantation that can result in graft loss. Excluding patients with early graft failure, after a median follow-up period of 126 months (range 23-198) duodenectomy was required in 14 of 312 pancreas transplants (4.5%). All patients were insulin-independent at the time of diagnosis. Reasons for duodenectomy included delayed duodenal graft perforation (n=10, 71.5%) and refractory duodenal graft bleeding (n=4, 28.5%). In patients with duodenal graft bleeding, a total duodenectomy was performed...
December 4, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29192722/cephalic-vein-transposition-is-a-durable-approach-to-managing-cephalic-arch-stenosis
#5
Jon C Henry, Ulka Sachdev, Eric Hager, Ellen Dillavou, Theodore Yuo, Michel Makaroun, Steven A Leers
INTRODUCTION: The proximal cephalic vein that enters the axillary vein (cephalic arch) is a common site of stenosis in patients with upper extremity arteriovenous fistulas for hemodialysis (HD). In this study, we present the outcomes of a series of cephalic vein transposition, to determine its utility in the setting of refractory arch stenosis. METHODS: We conducted a retrospective review of patients undergoing cephalic vein transposition to manage refractory cephalic arch stenosis from January 1, 2008 to August 31, 2015...
November 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29181216/endovascular-repair-with-a-stent-graft-in-a-patient-with-aortoduodenal-fistula-after-radiation-therapy
#6
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/29178091/-surgical-treatment-of-chronic-radiation-enteropathy
#7
Lei Wang, Qiyuan Qin, Binjie Huang
Chronic radiation enteropathy(CRE) represents a latent intestinal injury resulting from abdominal-pelvic radiotherapy. Severe complications like refractory bleeding, intestinal obstruction, perforation and fistula may occur during CRE progression. Surgical treatment is the most effective way to handle these complications. Since radiotherapy has become an important and common way to relieve or even cure many malignant tumors, the incidence of severe complications of CRE is likely to rise. Thus the value of surgical treatment in managing severe complications of CRE should gain more attention...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29154411/effect-of-graft-size-matching-on-pediatric-living-donor-liver-transplantation-at-a-single-center
#8
Jun-Jie Li, Cai-Hua Zu, Shi-Peng Li, Wei Gao, Zhong-Yang Shen, Jin-Zhen Cai
We retrospectively analyzed 252 patients with end-stage liver disease who had undergone LDLT from January 2009 to September 2015. Of these, 25 had a GRWR of <2.0% (Group A), 204 had a GRWR of ≥2.0% or <4.0% (Group B), and 23 had a GRWR ≥4.0% (Group C). The three GRWR groups demonstrated similar characteristics, except for recipient age and recipient BMI. The overall one, two, and three-year graft survival rates were 95.1%, 93.5%, and 93.5%, respectively. However, among the three groups, graft survival rates at one year, two years and three years were significantly different (P=0...
November 20, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29151703/3d-printed-fistula-stent-designed-for-management-of-enterocutaneous-fistula-an-advanced-strategy
#9
Jin-Jian Huang, Jian-An Ren, Ge-Fei Wang, Zong-An Li, Xiu-Wen Wu, Hua-Jian Ren, Song Liu
Enterocutaneous fistulas (ECFs) are great challenges during the open abdomen. The loss of digestive juice, water-electrolyte imbalance and malnutrition are intractable issues during management of ECF. Techniques such as "fistula patch" and vacuum-assisted closure therapy have been applied to prevent contamination of open abdominal wounds by intestinal fistula drainage. However, failures are encountered due to high-output fistula and anatomical complexity. Here, we report 3D-printed patient-personalized fistula stent for ECF treatment based on 3D reconstruction of the fistula image...
November 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29150418/immune-enhancing-formulas-for-patients-with-cancer-undergoing-esophagectomy-systematic-review-protocol
#10
Astrid Naranjo, Elizabeth Isenring, Laisa Teleni
BACKGROUND: Adult patients with an esophageal cancer can potentially be compromised with postoperative leaks or fistulae if patients' nutritional status is in a vulnerable stage. Currently in Australia, there is a growing need for clinicians to know whether use of immune-enhancing formulas (IEFs) containing Arg, omega-3, and RNA are a cost-effective approach compared with isonitrogenous-isocaloric formulas to reduce postoperative infectious complications in esophagectomy patients. Since IEFs may carry higher costs, this has led to inconsistencies in practice among clinicians and hospitals...
November 17, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29137063/gallstone-ileus-displaying-the-typical-rigler-triad-and-an-occult-second-ectopic-stone-a-case-report
#11
Li Wang, Ping Dong, Yi Zhang, Bole Tian
RATIONALE: Gallstone ileus is a rare complication of cholecystolithiasis. It has a female predominance and can result in high mortality rates. PATIENT CONCERNS: A 71-year-old woman complaining of recurrent vomiting and vague epigastralgia for > 2 weeks presented to our department. DIAGNOSIS: Based on her physical examination, laboratory test results and radiographic findings (the typical Rigler's triad), she was diagnosed with gallstone ileus caused by multiple ectopic stones...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29133232/embryological-and-comparative-description-of-the-cephalic-vein-joining-the-external-jugular-vein-a-case-report
#12
R C Araújo, L A S Pires, M L Andrade, M C Perez, C S L Filho, M A Babinski
The cephalic vein arises from the radial end of the dorsal venous arch. It turns around the radial border of the forearm and passes proximally along the arm to the shoulder, where it enters the axillary vein by penetrating the clavipectoral triangle. The cephalic vein is prone to vary at the antecubital fossa, where it forms numerous anastomoses. A male cadaver fixated with a 10% formalin solution was dissected during regular anatomy lessons. It was found that the cephalic vein crossed the upper third of the arm between two fasciculi of the deltoid muscle and reached the shoulder, where it passed above the acromion and crossed the posterior border of the clavicle in order to join the external jugular vein...
November 10, 2017: Morphologie: Bulletin de L'Association des Anatomistes
https://www.readbyqxmd.com/read/29126412/obstetric-fistulae-in-southern-mozambique-incidence-obstetric-characteristics-and-treatment
#13
Sibone Mocumbi, Claudia Hanson, Ulf Högberg, Helena Boene, Peter von Dadelszen, Anna Bergström, Khátia Munguambe, Esperança Sevene
BACKGROUND: Obstetric fistula is one of the most devastating consequences of unmet needs in obstetric services. Systematic reviews suggest that the pooled incidence of fistulae in community-based studies is 0.09 per 1000 recently pregnant women; however, as facility delivery is increasing, for the most part, in Africa, incidence of fistula should decrease. Few population-based studies on fistulae have been undertaken in Sub-Saharan Africa, including Mozambique. This study aimed to estimate the incidence of obstetric fistulae in recently delivered mothers, and to describe the clinical characteristics and care, as well as the outcome, after surgical repair...
November 10, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29119531/the-non-operative-management-of-asymptomatic-liver-hydatids-ending-echinococcophobia
#14
Farrokh Saidi, Farrokh Habibzadeh
BACKGROUND: Cystic echinococcosis is common in many countries and involves the liver in 75% of cases. The current belief is that all incidentally discovered asymptomatic liver hydatids must be subjected to some types of interventional treatments pre-emptively for fear of some presumably impending complications. We conducted this study to assess the prognosis of patients with liver hydatids without any surgical interventions. Furthermore, we tried to predict the outcome of the cyst using two radiological signs...
November 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29113678/a-large-single-institution-review-of-tracheoesophageal-fistulae-with-evaluation-of-the-use-of-transanastomotic-feeding-tubes
#15
Joseph C Fusco, Juan L Calisto, Barbara A Gaines, Marcus M Malek
INTRODUCTION: Transanastomatic feeding tube (TAT) use in the repair of tracheoesophageal fistulas (TEF) with or without esophageal atresia (EA) and EA with or without TEF allows for earlier enteral feedings, however, may predispose to esophageal stricture. METHODS: We review our institutional experience with esophageal atresia repair over a 15-year period from 2000 to 2015 and report on our observed complication rate with emphasis on the surgical approach and use of TATs...
October 10, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29104204/-surgical-treatment-of-systemic-and-left-circumflex-coronary-pulmonary-artery-fistulas-with-aneurysm-report-of-a-case
#16
Hiroki Nakabori, Katsuyuki Miyazu, Masahiro Ikeda
Congenital coronary-pulmonary artery fistulas complicated by continuity to a systemic artery and aneurysm are extremely rare. A 78-year-old woman was admitted to our hospital with a complaint of chest discomfort. Coronary angiography showed a coronary aneurysm and coronary-pulmonary artery fistula arising from the left circumflex artery and entering into the right lower pulmonary artery. Computed tomography angiography revealed a left subclavian artery-pulmonary artery fistula communicating with the coronary-pulmonary artery fistula...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29099696/treatment-of-duodenal-injuries-and-complications-after-surgery-case-reports
#17
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
https://www.readbyqxmd.com/read/29046757/multiple-left-anterior-descending-coronary-artery-to-left-ventricular-fistula-a-case-series-and-literature-review
#18
Praneet Iyer, Rishitha Yelisetti
Coronary artery fistulas (CAFs) are found in 0.3-0.8% of patients who undergo coronary angiography. CAFs are defined as single or multiple, small or large direct communications that arise from one or more coronary arteries and enter into one of the four cardiac chambers or major vessels. We present two cases of multiple coronary artery fistulas arising from diagonal and left anterior descending (LAD) branches of left coronary artery draining into the left ventricle. In both the cases, No intervention was performed...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28979892/the-adjunctive-role-of-nutritional-therapy-in-the-management-of-phlegmon-in-two-children-with-crohn-s-disease
#19
Andrew S Day, Stephanie C Brown
Crohn's disease may be complicated by the development of penetrating (fistulizing) or structuring complications. The presentation of an intra-abdominal phlegmon or abscess with or without an associated fistula has traditionally required surgical intervention. This series of two cases illustrates a beneficial role of non-surgical management, with parenteral and then enteral nutrition playing central roles. This report further elaborates the potential adjunctive role of enteral nutrition in the management of this complication of CD...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28966151/the-long-and-winding-road-thoracic-myelopathy-associated-with-occipitocervical-dural-arteriovenous-fistula
#20
Angelique Sao-Mai Do, Joseph Kapurch, Ravi Kumar, John Port, Jeffrey W Miller, Jamie J Van Gompel
OBJECTIVES: Spinal dural arteriovenous fistulas (DAVFs) have diverse presentations. Magnetic resonance imaging (MRI) reveals spinal cord swelling in only 45% to 74% of cases. We present an unusual case of a 57-year old man with a craniocervical junction DAVF in which the edema appeared in the thoracolumbar region, skipping the cervical spinal cord. METHODS: A case report and literature review from a tertiary referral center are provided. RESULTS: In our patient, symptoms progressed over 3 months from low back and radicular pain to weakness, saddle anesthesia, and urinary retention...
September 29, 2017: World Neurosurgery
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