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https://www.readbyqxmd.com/read/28979892/the-adjunctive-role-of-nutritional-therapy-in-the-management-of-phlegmon-in-two-children-with-crohn-s-disease
#1
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-davf
#2
Angelique Sao-Mai Do, Joseph Kapurch, Ravi Kumar, John Port, Jeffrey W Miller, Jamie J Van Gompel
Spinal DAVFs have diverse presentations. MRIs reveal spinal cord swelling in only 45-74%. We present an unusual case of a 57 yo male with a craniocervical junction DAVFs in which the edema appeared in the thoracolumbar region skipping the cervical spinal cord. A case report and literature review from a tertiary referral center. In our patient, symptoms progressed over 3 months from low back and radicular pain to weakness, saddle anesthesia, and urinary retention. MRI showed T2 hyperintensity from T3-4 to the conus medullaris (Fig 1 a,b)...
September 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28963700/enterocutaneous-fistulas-a-primer-for-radiologists-with-emphasis-on-ct-and-mri
#3
REVIEW
Massimo Tonolini, Paolo Magistrelli
Enterocutaneous fistulas (ECFs) represent abnormal communications between the gastrointestinal tract and the skin. Nowadays, the majority (~80%) of ECFs develops secondary to abdominal surgeries; alternative, less common causes include chronic inflammatory bowel diseases (IBD) such as Crohn's disease, tumours, and radiation enteritis in descending order of frequency. These rare disorders require thorough patient assessment and multidisciplinary management to limit the associated morbidity and mortality. This pictorial review includes an overview of causes, clinical manifestations, complications and management of ECFs...
September 29, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28924879/a-systematic-review-and-meta-analysis-of-timing-and-outcome-of-intestinal-failure-surgery-in-patients-with-enteric-fistula
#4
Fleur E E de Vries, Jasper J Atema, Oddeke van Ruler, Carolynne J Vaizey, Mireille J Serlie, Marja A Boermeester
BACKGROUND: The timing of intestinal failure (IF) surgery has changed. Most specialized centers now recommend postponing reconstructive surgery for enteric fistula and emphasize that abdominal sepsis has to be resolved and the patient's condition improved. Our aim was to study the outcome of postponed surgery, to identify risk factors for recurrence and mortality, and to define more precisely the optimal timing of reconstructive surgery. METHODS: PubMed, Embase, and the Cochrane Library were systematically reviewed on the outcomes of reconstructive IF surgery (fistula recurrence, mortality, morbidity, hernia recurrence, total closure, enteral autonomy)...
September 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28923655/coloduodenovesical-fistula-after-simultaneous-pancreas-kidney-transplant-case-report-and-review-of-the-literature
#5
A A Rahnemai-Azar, M Penna, S D Morrison, S C Rayhill, L Sibulesky, K A Muczynski, R Bakthavatsalam
BACKGROUND: Complicated diverticulitis after transplantation occurs in as many as 3.5% of cases and carries a 25% mortality rate. Diagnosis of complicated diverticulitis in this population can be challenging because of abnormal presentations caused by immunosuppression. Only 4 cases of fistulization after kidney transplantation are described in the literature; none occurred after simultaneous pancreas-kidney transplant. METHODS: We present a first case of a coloduodenovesical fistula in a patient 9 years after simultaneous pancreas-kidney transplant...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28918964/intersphincteric-fistula-without-external-opening-and-to-re-enter-the-rectum
#6
Jesús Catalá, Zutoia Balciscueta, María Carmen Martín, Natalia Uribe
No abstract text is available yet for this article.
September 14, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28904581/split-notochord-syndrome-a-rare-variant
#7
Vidhu Dhawan, Kanchan Kapoor, Balbir Singh, Suman Kochhar, Alka Sehgal, Rima Dada
Split notochord syndrome represents an extremely rare and pleomorphic form of spinal dysraphism characterized by a persistent communication between the endoderm and the ectoderm, resulting in splitting or deviation of the notochord. It manifests as a cleft in the dorsal midline of the body through which intestinal loops are exteriorized and even myelomeningoceles or teratomas may occur at the site. A rare variant was diagnosed on autopsy of a 23(+4)-week-old fetus showing a similar dorsal enteric fistula and midline protruding intestinal loops in thoracolumbar region...
April 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28903762/mesh-penetrating-the-cecum-and-bladder-following-inguinal-hernia-surgery-a-case-report
#8
Hiroshi Asano, Saori Yajima, Yoshie Hosoi, Makoto Takagi, Hiroyuki Fukano, Yasuhiro Ohara, Nozomi Shinozuka, Takaya Ichimura
BACKGROUND: Tension-free repair using mesh is a common inguinal hernia surgical procedure. However, various complications such as mesh-related infection and recurrence may develop as a result. Moreover, although rare, there are also reports of intestinal obstruction caused by adhesion of the mesh to the intestinal wall and cases of mesh migration into various organs. Here, we report our experience with a patient in whom mesh extraction was performed due to migration of mesh into the intestinal tract following inguinal hernia surgery and formation of a fistula with the bladder...
September 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28884052/colovesical-fistula-an-unusual-complication-of-cytomegalovirus-colitis
#9
Talal Asif, Badar Hasan, Alisa Likhitsup, David Bamberger
Cytomegalovirus (CMV) is a double-stranded DNA virus that is associated with clinically significant disease in patients with advanced immunosuppression, particularly those with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). End-organ disease with CMV is classically associated with a CD4 cell count less than 50 cells/microliter. CMV colitis is the second most common manifestation of end-organ disease in this patient population. CMV-associated enteric fistula is a rare complication that has been described in only a few case reports in the literature...
July 5, 2017: Curēus
https://www.readbyqxmd.com/read/28876594/salmonella-typhimurium-infected-abdominal-aortic-aneurysm-endovascular-repair-with-secondary-aortoenteric-fistula-formation
#10
M Dickfos, K Garnham, J Jenkins
Endovascular aneurysm repair (EVAR) is a widely accepted and used technique for the treatment of abdominal aortic aneurysms (AAA). However, it comes with a unique set of complications, two of the rarer being infection and aorto-enteric fistula formation. Due to the infrequency of the situation, there are currently no guidelines for their management. A 75-year-old male presented with vague abdominal pain and fevers. He was diagnosed with an infected abdominal aortic EVAR stent graft on computer tomography imaging...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28859370/management-of-recurrent-tracheoesophageal-fistula-after-esophageal-atresia-and-follow-up
#11
J Wang, M Zhang, W Pan, W Wu, W Yan, W Cai
Recurrent tracheoesophageal fistula (rTEF) is a complex complication after the repair of esophageal atresia (EA) and remains a challenge because of difficulties in preoperative management and the substantial rates of mortality and morbidity after reoperation. By reviewing a single institution's experience in the management of rTEF and assessing the outcome, we aimed to provide an optimal approach for managing rTEF and to evaluate growth and feeding problems after reoperations. The medical records of 35 patients with rTEF treated at a single institution from June 2012 to December 2015 were reviewed, and follow-up data were collected from all survivors...
September 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28843859/aortic-pseudoaneurysm-after-endarterectomy-for-small-aorta-syndrome
#12
M Domanin, D Bissacco, S Romagnoli, A Buora
INTRODUCTION: Small Aorta Syndrome (SAS) or hypoplastic aorto-iliac syndrome is a rare pathology of the aorta that affects almost exclusively young or middle-aged women and is characterized by smaller dimension of the aorta and iliac axes. Etiopathogenesis is unclear and many factors have been invoked. The smaller caliber of the aorta and iliac arteries may predispose to aorto-iliac occlusive disease development. In the past aorto-iliac endarterectomy (AE) with patch closure was utilized as an alternative to surgical bypass in order to correct steno-obstructive syndromes affecting carriers of SAS...
August 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28841540/laparoscopically-assisted-treatment-of-entero-atmospheric-fistula-following-abdominal-wall-repair-of-complex-incisional-hernia-case-report
#13
Francesca Ceci, Linda D'Amore, Maria Romana Grimaldi, Elena Annesi, Domenico Tuscano, Francesco Gossetti, Paolo Negro
INTRODUCTION: Entero-atmospheric fistula (EAF) is an uncommon complication. Its timing and surgical management could be extremely challenging because extensive adhesions may heavily affect the approach to the abdominal cavity. PRESENTATION OF CASE: We hereby report a case of EAF in a 70 year-old man. In order to control the fistula output and the surrounding tissue damage from enteric content, the patient was managed conservatively using different technical solutions...
August 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28822367/internal-iliac-enteric-fistula-a-rare-cause-of-hemorrhagic-shock
#14
Nina Cohen, Robert Lyons, Leonard Weireter
No abstract text is available yet for this article.
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28803644/surgical-experience-and-the-practice-of-pancreatoduodenectomy
#15
Gregory T Kennedy, Matthew T McMillan, Laura Maggino, Michael H Sprys, Charles M Vollmer
BACKGROUND: Experienced surgeons demonstrate improved pancreatoduodenectomy outcomes, but little is known about what distinguishes their practice. Furthermore, the concept of experience has been variably interpreted in the surgical literature. We investigated how 4 interpretations of experience influence pancreatoduodenectomy management decisions. METHODS: A survey assessing pancreatoduodenectomy practice patterns was distributed by 6 surgical societies. Regression analysis identified behaviors associated with 4 forms of experience: years in practice, surpassing the learning curve (≥50 pancreatoduodenectomies), high annual volume (≥25 pancreatoduodenectomy/year), and high career volume (>200 pancreatoduodenectomy)...
October 2017: Surgery
https://www.readbyqxmd.com/read/28740350/cryptogenic-multifocal-ulcerous-stenosing-enteritis-radiologic-features-and-clinical-behavior
#16
Jiyoung Hwang, Jin Sil Kim, Ah Young Kim, Joon Seok Lim, Se Hyung Kim, Min Ju Kim, Mi Sung Kim, Kyoung Doo Song, Ji Young Woo
AIM: To investigate the characteristic radiologic findings of cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) which can be differentiated from other similar bowel disease and to assess their clinical behavior. METHODS: Twenty pathologically and clinically confirmed CMUSE patients (males:females = 8:12; mean age: 40.4 years) between March 2002 and August 2015 from seven academic centers in South Korea were retrospectively reviewed. We evaluated small bowel series (SBS; n = 25), computed tomography (CT) enterography (n = 21), magnetic resonance (MR) enterography (n = 2), and abdominopelvic CT (n = 18) images, focusing on enteric and perienteric manifestations...
July 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28732000/biliary-ileus-case-report
#17
Fernanda Kreve, Jonas Takada, Janaina Gatto, Francisco S Loss, Everson L A Artifon
Biliary ileusis a uncommon cause of mechanical bowel obstruction, affecting older adult patients who often have other significant medical conditions. It is caused by intestinal impaction of a gallstone that enters the bowel via a cholecysto-enteric fistula. The mortality rate is considerable, ranging between 12 and 27%. Treatment in most cases is surgical, aimed at the resolution of the intestinal obstruction. We report the case of a 55 year old patient diagnosed with biliary ileus, wich evolved without complications after a enterolithotomy...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28714539/safety-and-efficacy-of-functional-laryngectomy-for-end-stage-dysphagia
#18
Michael C Topf, Linda C Magaña, Kelly Salmon, James Hamilton, William M Keane, Adam Luginbuhl, Joseph M Curry, David M Cognetti, Maurits Boon, Joseph R Spiegel
OBJECTIVES/HYPOTHESIS: To evaluate functional outcomes and complication rate after total laryngectomy (TL) for dysfunctional larynx with end-stage dysphagia. STUDY DESIGN: Retrospective chart review. METHODS: Chart review was performed on all patients who underwent TL from January 2008 to July 2016 at a single tertiary academic medical center. Patients who underwent TL for dysfunctional larynx without preoperative evidence of malignancy were included...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28706924/abdominal-aortic-aneurysm-pictorial-review-of-common-appearances-and-complications
#19
REVIEW
Yogesh Kumar, Kusum Hooda, Shuo Li, Pradeep Goyal, Nishant Gupta, Melkamu Adeb
Abdominal aortic aneurysms (AAAs) are defined as focal dilatations of the abdominal aorta that are 50% greater than the proximal normal segment or when it is more than 3 cm in maximum diameter. The early diagnosis and treatment is very important to prevent catastrophic complications. Due to its ability to assess the peri-aortic soft tissue and the exact extension of aneurysm, as well as its excellent vascular opacification and multiplanar reconstruction capabilities, computed tomography angiography (CTA) has become an integral part of the evaluation of AAA and has virtually replaced conventional angiography for the evaluation of AAA...
June 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28701605/role-of-transesophageal-echocardiography-in-surgical-retrieval-of-embolized-amplatzer-device-and-closure-of-coronary-cameral-fistula
#20
Bhupesh Kumar, Alok Kumar, Ganesh Kumar, Harkant Singh
Congenital coronary artery fistula is an uncommon anomaly. Transcatheter coil embolization or Amplatzer vascular plug device closure of fistula is often done in symptomatic patients with safe accessibility to the feeding coronary artery. Embolization of Amplatzer vascular plug device is rare. We report an 11-year-old male child who presented to us with increasing shortness of breath for 7 years. He had a history of Amplatzer vascular plug device closure of right coronary-cameral fistula 8 years back. Echocardiography demonstrated a dilated aneurysmal right coronary artery with turbulent jet entering into the right ventricle (RV) and device embolized into the left pulmonary artery (LPA)...
July 2017: Annals of Cardiac Anaesthesia
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