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Enteric fistula

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https://www.readbyqxmd.com/read/28091846/risk-factors-of-surgical-site-infections-in-patients-with-crohn-s-disease-complicated-with-gastrointestinal-fistula
#1
Kun Guo, Jianan Ren, Guanwei Li, Qiongyuan Hu, Xiuwen Wu, Zhiwei Wang, Gefei Wang, Guosheng Gu, Huajian Ren, Zhiwu Hong, Jieshou Li
PURPOSE: Surgical site infection (SSI) is the most common complication following surgical procedures. This study aimed to determine risk factors associated with SSI in patients with Crohn's disease (CD) complicated with gastrointestinal fistula. METHODS: This was a retrospective review of patients who underwent surgical resection in gastrointestinal fistula patients with CD between January 2013 and January 2015, identified from a prospectively maintained gastrointestinal fistula database...
January 16, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28077159/concurrent-chemoradiotherapy-combined-with-enteral-nutrition-support-a-radical-treatment-strategy-for-esophageal-squamous-cell-carcinoma-patients-with-malignant-fistulae
#2
Li Ma, Guang-Yu Luo, Yu-Feng Ren, Bo Qiu, Hong Yang, Chun-Xia Xie, Song-Ran Liu, Shi-Liang Liu, Zhao-Lin Chen, Qun Li, Jian-Hua Fu, Meng-Zhong Liu, Yong-Hong Hu, Wen-Feng Ye, Hui Liu
BACKGROUND: Concurrent chemoradiotherapy (CCRT) significantly increases the survival rate of esophageal squamous cell carcinoma (ESCC) patients with malignant fistulae. Recent clinical evidence has shown the benefits of enteral nutrition for malnourished cancer patients. In this study, we aimed to validate that, with the support of enteral nutrition, ESCC patients who develop malignant fistulae might be able to complete CCRT and achieve long-term survival. METHODS: We reviewed the medical records of 652 patients with ESCC who received definitive CCRT at Sun Yat-sen University Cancer Center between January 2010 and December 2012...
January 11, 2017: Chinese Journal of Cancer
https://www.readbyqxmd.com/read/28061521/quality-of-life-after-surgical-treatment-for-esophageal-atresia-long-term-outcome-of-154-patients
#3
Alice Catherine Hölscher, Michael Laschat, Vera Choinitzki, Nadine Zwink, Ekkehart Jenetzky, Oliver Münsterer, Ralf Kurz, Marcus Pauly, Ulrike Brokmeier, Andreas Leutner, Benno Ure, Martin Lacher, Johannes Schumacher, Heiko Reutter, Thomas Michael Boemers
Background The short- and long-term surgical results in patients with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) have been described in depth from a physician's perspective. Contrarily, the perception and coping strategies of affected patients and their parents have rarely been reported. The aim of this study was to generate data on this matter. Patients and Methods A total of 154 patients who had operative reconstruction for EA between 1971 and 2012 were evaluated for demographic data, surgical technique, affection of daily life, and coping strategies...
January 6, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28058018/factors-associated-with-surgery-in-patients-with-intra-abdominal-fistulizing-crohn-s-disease
#4
Shaul Yaari, Ariel Benson, Eyal Aviran, Naama Lev Cohain, Ran Oren, Jacob Sosna, Eran Israeli
AIM: To characterize radiological and clinical factors associated with subsequent surgical intervention in Crohn's disease (CD) patients with intra-abdominal fistulae. METHODS: From a cohort of 1244 CD patients seen over an eight year period (2006 to 2014), 126 patients were identified as having intra-abdominal fistulae, and included in the study. Baseline patient information was collected from the medical records. Imaging studies were assessed for: anatomic type and number of fistulae; diameter of the inflammatory conglomerate; length of diseased bowel; presence of a stricture with pre-stenotic dilatation; presence of an abscess; lymphadenopathy; and the degree of bowel enhancement...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28054751/the-prevention-of-pancreatic-fistula-using-polyethylene-glycolic-acid-mesh-reinforcement-around-pancreatojejunostomy-the-propensity-score-matched-analysis
#5
Jae Seung Kang, Youngmin Han, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim, Jin-Young Jang
BACKGROUND/PURPOSE: Several small-scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperative pancreatic fistula (POPF) and evaluated other risk factors for POPF. METHODS: This study enrolled 464 consecutive patients who underwent PD performed by one surgeon between 2006 and 2015, including a PGA group of 281 patients (60...
January 5, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28044953/a-rare-case-of-upper-digestive-hemorrhage-due-to-bleeding-duodenal-tumor
#6
Claudiu Turculeţ, Dragoş Ene, Teodor Florin Georgescu, E Ciucă, A Vlădăşcău, Florin Iordache, Mircea Beuran
We present the case of a 48-year-old patient with no medical history, who presents himself to the emergency room with melena, asthenia and dizziness. The blood tests revealed a severe anemia (Hb = 4,8 g/dL). He is admitted in the Gastroenterology ward, where a first superior digestive endoscopy is performed which shows a duodenal bleeding tumor (second duodenum) of 7 cm in length. After the administration of red blood cell mass, plasma and haemostatic agents the level of the hemoglobin increases. The abdominal CT scan reveals a 3/5 tumor localized in the second and third duodenum...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28030494/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#7
Leah Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura B Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multi-center retrospective cohort study was performed across three Level I Trauma Centers encompassing traumatic colon injuries from January 2006 through June 2014...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28027816/pancreatic-anastomosis-after-pancreatoduodenectomy-a-position-statement-by-the-international-study-group-of-pancreatic-surgery-isgps
#8
REVIEW
Shailesh V Shrikhande, Masillamany Sivasanker, Charles M Vollmer, Helmut Friess, Marc G Besselink, Abe Fingerhut, Charles J Yeo, Carlos Fernandez-delCastillo, Christos Dervenis, Christoper Halloran, Dirk J Gouma, Dejan Radenkovic, Horacio J Asbun, John P Neoptolemos, Jakob R Izbicki, Keith D Lillemoe, Kevin C Conlon, Laureano Fernandez-Cruz, Marco Montorsi, Max Bockhorn, Mustapha Adham, Richard Charnley, Ross Carter, Thilo Hackert, Werner Hartwig, Yi Miao, Michael Sarr, Claudio Bassi, Markus W Büchler
BACKGROUND: Clinically relevant postoperative pancreatic fistula (grades B and C of the ISGPS definition) remains the most troublesome complication after pancreatoduodenectomy. The approach to management of the pancreatic remnant via some form of pancreatico-enteric anastomosis determines the incidence and severity of clinically relevant postoperative pancreatic fistula. Despite numerous trials comparing diverse pancreatico-enteric anastomosis techniques and other adjunctive strategies (pancreatic duct stenting, somatostatin analogues, etc), currently, there is no clear consensus regarding the ideal method of pancreatico-enteric anastomosis...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28000195/-risk-factors-of-early-surgical-intervention-in-crohn-s-disease-patients-with-spontaneous-intra-abdominal-abscess
#9
Xiaosheng He, Xiaobin Zheng, Lei Lian, Chi Zhou, Xiaowen He, Xiaojian Wu, Ping Lan
OBJECTIVE: To investigate the risk factors of early surgical intervention in Crohn's disease (CD) patients with spontaneous intra-abdominal abscess. METHODS: Clinical data of 94 CD patients with spontaneous intra-abdominal abscess admitted to The Sixth Affiliated Hospital of Sun Yat-sen University between May 2008 and Dec 2015 were analyzed retrospectively. Univariate and multivariate analysis were applied to evaluate the early surgery risk of CD patients with spontaneous intra-abdominal abscess using logistic regression model...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27936419/unexplained-gastrointestinal-bleed-due-to-arteriobiliary-fistula-after-percutaneous-liver-biopsy
#10
John Smirniotopoulos, Paul Barone, Marc Schiffman
We represent a case of a 54-year-old male who presented to the emergency department with right upper quadrant abdominal pain and melena three weeks after percutaneous liver biopsy. He was found to have anemia secondary to an upper gastrointestinal hemorrhage, unresponsive to multiple blood transfusions. Angiography later revealed an arteriobiliary fistula with contrast extravasation entering the duodenum. The fistula was successfully embolized and the patient was discharged without complication. This report demonstrates the importance in considering a vascular intrahepatic fistula in patients with right upper quadrant abdominal pain after remote liver biopsy...
December 5, 2016: Clinical Imaging
https://www.readbyqxmd.com/read/27931638/complications-of-diagnostic-and-therapeutic-endoscopic-ultrasound
#11
REVIEW
Sundeep Lakhtakia
Endoscopic Ultrasound (EUS) provides the unique opportunity to visualize, interrogate and intervene gastrointestinal (GI) luminal, mural or peri-luminal structures and pathology with negligible adverse effects. Diagnostic, upper GI and rectal EUS is feasible, extremely safe, and efficacious. Most EUS guided interventions are safe, effective and minimally invasive, compared to peers in the percutaneous radiological or surgical procedures. As with any endoscopic procedure, EUS and its guided interventions may be accompanied by adverse events...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27918375/treatments-and-other-prognostic-factors-in-the-management-of-the-open-abdomen-a-systematic-review
#12
Adam T Cristaudo, Scott B Jennings, Kerry Hitos, Ronny Gunnarsson, Alan DeCosta
BACKGROUND: The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Despite this, challenges remain with it associated with a high incidence of complications and poor outcomes. The objective of this article is to perform a systematic review in accordance with PRISMA guidelines to identify prognostic factors in OA patients in regards to definitive fascial closure (DFC), mortality and intra-abdominal complications...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27916444/influence-of-weight-at-enterostomy-reversal-on-surgical-outcomes-in-infants-after-emergent-neonatal-stoma-creation
#13
Lindsay J Talbot, Robert D Sinyard, Kristy L Rialon, Brian R Englum, Elizabeth T Tracy, Henry E Rice, Obinna O Adibe
PURPOSE: Neonates after emergent enterostomy creation frequently require reversal at low weight because of complications including cholestasis, dehydration, dumping, failure to thrive, and failure to achieve enteral independence. We investigated whether stoma reversal at low weight (< 2.5kg) is associated with poor surgical outcomes. METHODS: Patients who underwent enterostomy reversal from 2005 to 2013 at less than 6months old were identified in our institutional database...
October 25, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27913762/aspen-felanpe-clinical-guidelines
#14
Vanessa J Kumpf, Jose Eduardo de Aguilar-Nascimento, Jose Ignacio Diaz-Pizarro Graf, Amber M Hall, Liam McKeever, Ezra Steiger, Marion F Winkler, Charlene W Compher
BACKGROUND: The management of patients with enterocutaneous fistula (ECF) requires an interdisciplinary approach and poses a significant challenge to physicians, wound/stoma care specialists, dietitians, pharmacists, and other nutrition clinicians. Guidelines for optimizing nutrition status in these patients are often vague, based on limited and dated clinical studies, and typically rely on individual institutional or clinician experience. Specific nutrient requirements, appropriate route of feeding, role of immune-enhancing formulas, and use of somatostatin analogues in the management of patients with ECF are not well defined...
January 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27903471/bovine-pericardium-as-new-technical-option-for-in-situ-reconstruction-of-aortic-graft-infection
#15
Brigitta Lutz, Christian Reeps, Gabor Biro, Christoph Knappich, Alexander Zimmermann, Hans-Henning Eckstein
BACKGROUND: Alloplastic aortic graft infection is a devastating complication following aortic surgery. It is associated with excessively high mortality and morbidity caused by anastomotic rupture or septicemia. Many authors consider in situ replacement after complete surgical graft removal as the method of choice. However, there is an ongoing debate about the most suitable material for reconstruction. We present our first experiences with replacing the descending and infrarenal aorta using custom-made bovine pericardium grafts...
November 27, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27895873/value-of-computerized-tomography-enterography-in-predicting-crohn-s-disease-activity-correlation-with-crohn-s-disease-activity-index-and-c-reactive-protein
#16
Eun Kyung Park, Na Yeon Han, Beom Jin Park, Deuk Jae Sung, Sung Beom Cho, Yoon Tae Jeen, Bora Keum, Min Ju Kim
BACKGROUND: The accurate evaluation of Crohn's disease activity is important for the treatment of the disease and for monitoring the response. Computerized tomography (CT) enterography is a useful imaging modality that reflects enteric inflammation, as well as extramural complications. OBJECTIVES: The aim of this study was to evaluate the correlation between CT enterographic (CTE) findings of active Crohn's disease and the Crohn's disease activity index (CDAI) and C-reactive protein (CRP)...
October 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27873747/atypical-presentation-of-appendicitis
#17
Oliver Beaumont, Robert Miller, Richard Guy
A woman aged 64 years presented as an emergency with a mass in the right iliac fossa, clinically within the abdominal wall, but an otherwise soft abdomen. Systemically, she was quite well with normal vital signs. Blood tests revealed raised inflammatory markers, and an abdominal CT scan demonstrated a perforated appendix with associated large subcutaneous abscess. This represents a rare presentation of a common condition, demonstrating how appendicitis can still be a challenging problem for the clinician...
November 10, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27853338/primary-enterolith-in-a-patient-with-intestinal-tuberculosis-a-case-report
#18
Mohd Habib Raza, RafiulImad Finan, Sadik Akhtar, Manzoor Ahmad
Primary enterolithiasis is a rare surgical ailment. The underlying cause is intestinal stasis. Numerous anatomical and micro environmental factors such as enteritis, incarcerated hernia, malignancy, diverticula, blind loops, and enteroenterostomy predispose to clinically significant concretions. Enterolithiasis in tuberculosis can be due to the presence of strictures, intestinal bands, or interbowel/parietal adhesions, leading to intestinal stasis. Secondary enterolithiasis is generally caused by gallstones or renal stones migrating to the gastrointestinal tract due to fistula formation...
2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27825332/circumcision-related-tragedies-seen-in-children-at-the-komfo-anokye-teaching-hospital-kumasi-ghana
#19
Kwaku Addai Arhin Appiah, Christian Kofi Gyasi-Sarpong, Roland Azorliade, Ken Aboah, Dennis Odai Laryea, Kwaku Otu-Boateng, Kofi Baah-Nyamekye, Patrick Opoku Manu Maison, Douglas Arthur, Isaac Opoku Antwi, Benjamin Frimpong-Twumasi, Edwin Mwintiereh Yenli, Samuel Kodzo Togbe, George Amoah
BACKGROUND: Circumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions. Despite being a minor surgical procedure, major complications may result from it. In Ghana, although commonly practiced, circumcision-related injuries have not been well documented. This study is to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana. METHODS: The study was conducted at the Urology Unit of the Komfo Anokye Teaching Hospital in Kumasi...
November 8, 2016: BMC Urology
https://www.readbyqxmd.com/read/27771601/r-gas-under-diaphragm
#20
Maddibande Ramachar Sreevathsa, Khyati Melanta
INTRODUCTION: The most common cause of gas under diaphragm is hollow viscous perforation. In 10% of cases it can be due to rare causes, both abdominal and extra-abdominal, one of them being intra abdominal infection by gas forming organisms. PRESENTATION OF THE CASE: A 51 year old male patient, a poorly controlled diabetic, presented with a second episode of severe pain abdomen and abdominal distention, with lower abdominal tenderness. Plain Xray of the abdomen in erect posture showed gas under the right dome of diaphragm and ultrasound abdomen confirmed gross pneumoperitoneum...
October 14, 2016: International Journal of Surgery Case Reports
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