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https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#1
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28613003/systematic-review-pharmacotherapy-for-high-output-enterostomies-or-enteral-fistulas
#2
REVIEW
F E E de Vries, L F Reeskamp, O van Ruler, I van Arum, W Kuin, G Dijksta, J W Haveman, M A Boermeester, M J Serlie
BACKGROUND: High-output enterocutaneous fistula or enterostomies can cause intestinal failure. There is a wide variety of options in medical management of patients with high output. AIM: To systematically review the literature on available pharmacotherapy to reduce output and to propose an algorithm for standard of care. METHODS: Relevant databases were systematically reviewed to identify studies on pharmacotherapy for reduction in (high-) output enterostomies or fistula...
June 14, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28611568/two-anomalies-in-one-a-rare-case-of-an-intrahepatic-gallbladder-with-a-cholecystogastric-fistula
#3
Mohammad F Ali, David Friedel, Galina Levin
The gallbladder can be situated in a variety of anomalous positions. An intrahepatic gallbladder - the second most common ectopic location of the gallbladder - is one that is completely embedded within the liver parenchyma. Described in the literature as early as 1935, intrahepatic gallbladders predominantly result from a developmental anomaly but in some instances have been reported to be secondary to chronic inflammation. The significance of an intrahepatic gallbladder lies in the fact that 60% of the cases are associated with gallstones and may present a challenge for the general surgeon during cholecystectomy and other biliary operations in addition to causing misdiagnosis on imaging...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28598298/efficacy-of-exclusive-enteral-nutrition-in-complicated-crohn-s-disease
#4
Qingfan Yang, Xiang Gao, Huiping Chen, Miao Li, Xiaojian Wu, Min Zhi, Ping Lan, Pinjin Hu
AIM: To investigate the efficacy of exclusive enteral nutrition (EEN) in induction of remission in adult active Crohn's disease (CD) complicated with intestinal fistula/abdominal abscess or inflammatory intestinal stricture. METHOD: Patients diagnosed with active CD with complications were recruited between July 2013 and July 2015. Patients were offered EEN for 12 weeks. Patients with abscess received antibiotic treatment with or without percutaneous drainage. Clinical variables were recorded (ClinicalTrials...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597827/inflammatory-bowel-disease-in-childhood-and-adolescence
#5
Jan Däbritz, Patrick Gerner, Axel Enninger, Martin Claßen, Michael Radke
BACKGROUND: The incidence of inflammatory bowel disease (IBD) in childhood and adolescence is 5-11 cases per 100 000 persons per year, corresponding to a new diagnosis of IBD in 800-1470 patients in Germany each year. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, including guidelines from Germany and abroad. RESULTS: Children and adolescents with IBD often have extensive involvement and an aggressive course of disease...
May 12, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28567115/factors-associated-with-the-achievement-of-mucosal-healing-in-crohn-s-disease-the-benefit-of-endoscopic-monitoring-in-treating-to-target
#6
Ren Mao, Yun Qiu, Bai-Li Chen, Sheng-Hong Zhang, Rui Feng, Yao He, Zhi-Rong Zeng, Shomron Ben-Horin, Min-Hu Chen
BACKGROUND: Mucosal healing (MH), the proposed treat to target in Crohn's disease (CD), is associated with improved disease outcomes. There are still scant data on factors associated with achieving MH in clinical practice. We evaluated the probability of achieving MH and identified factors predictive of subsequent MH in patients with CD. METHODS: This was a retrospective, observational cohort study. A total of 272 patients with CD with serial endoscopy assessment and subsequent therapeutic management were reviewed...
June 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28540837/enterovesical-fistula-after-enteric-conversion-of-a-bladder-drained-pancreatic-allograft-a-case-report
#7
Clifford Akateh, Amer Rajab, Mitchell Henry, Ashraf El-Hinnawi
Since the inception of pancreas transplant as a treatment for type 1 diabetes mellitus, there has been considerable debate about the best way to manage exocrine secretions and monitor patients for graft rejection. For patients who undergo bladder exocrine drainage of a pancreatic allograft, a bladder-to-enteric drainage conversion can serve as a rescue procedure in case of anastomotic leaks or other complications. However, this procedure is associated with its own complications, including a rarely described enterovesical fistula...
May 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28537654/effect-of-ecological-immune-enhanced-enteral-nutrition-on-patients-with-gastrointestinal-fistulas
#8
Q-H Wang
OBJECTIVE: The aim of this study was to determine the effects of early ecological immune-enhanced enteral nutrition on the nutritional status, immune function and intestinal mucosal barrier in patients with gastrointestinal fistulas. PATIENTS AND METHODS: 54 patients with gastrointestinal fistulas were randomized to either the ecological immune-enhanced enteral nutrition group (EIEN group, 28) or the parenteral nutrition group (PN group, 26). The changes in the immunity, nutrition index and intestinal mucosal barrier indexes before the ecological immune-enhanced enteral nutrition support and at 7 days and 14 days after the ecological immune-enhanced enteral nutrition support were determined...
May 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28532242/antioxidant-supplementation-a-linchpin-in-radiation-induced-enteritis
#9
Mumtaz Anwar, Shabeer Ahmad, Reyhan Akhtar, Akhtar Mahmood, Safrun Mahmood
Radiation enteritis is one of the most feared complications of abdominal and pelvic regions. Thus, radiation to abdominal or pelvic malignancies unavoidably injures the intestine. Because of rapid cell turnover, the intestine is highly sensitive to radiation injury, which is the limiting factor in the permissible dosage of irradiation. Bowel injuries such as fistulas, strictures, and chronic malabsorption are potentially life-threatening complications and have an impact on patient quality of life. The incidence of radiation enteritis is increasing because of the current trend of combined chemotherapy and radiation...
January 1, 2017: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/28503544/update-on-foregut-molecular-embryology-and-role-of-regenerative-medicine-therapies
#10
REVIEW
Silvia Perin, Conor J McCann, Osvaldo Borrelli, Paolo De Coppi, Nikhil Thapar
Esophageal atresia (OA) represents one of the commonest and most severe developmental disorders of the foregut, the most proximal segment of the gastrointestinal (GI) tract (esophagus and stomach) in embryological terms. Of intrigue is the common origin from this foregut of two very diverse functional entities, the digestive and respiratory systems. OA appears to result from incomplete separation of the ventral and dorsal parts of the foregut during development, resulting in disruption of esophageal anatomy and frequent association with tracheo-oesophageal fistula...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28497448/healing-of-spongiosus-cutaneous-fistula-with-hyperbaric-oxygen-therapy-hbot-a-case-report
#11
Pier A Della Camera, Gianmartin Cito, Simone Morselli, Francesco Sessa, Davide Facchiano, Andrea Cocci, Mauro Gacci, Sergio Serni, Marco Carini, Alessandro Natali
INTRODUCTION: We present a case of a spongiosus-cutaneous fistula in a 39-year-old man with recurrent episodes of cutaneous abscess in dorsal middle third penis (5 × 3 cm) treated with Hyperbaric Oxygen Therapy (HBOT). CASE REPORT: After emptying nodular abscess, the patient was noncompliant for further surgery. Therefore, it was suggested the association between HBOT and antibiotic therapy. HBOT is carried out in a hyperbaric room, where the internal pressure is increased (compression phase) by entering compressed air up to 283...
May 10, 2017: Urologia
https://www.readbyqxmd.com/read/28489647/obesity-bariatric-surgery-and-crohn-s-disease
#12
Burton I Korelitz, Niket Sonpal, Judy Schneider, Arun Swaminath, Joseph Felder, Mitchell Roslin, Jeffrey Aronoff
BACKGROUND: Crohn's disease (CD) following bariatric surgery has been previously described. It is not clear whether the clinical entity is due to rapid metabolism of fat, change in the bacterial milieu of the bowel, the loss of defense mechanisms of the stomach, or even a coincidence. OBJECTIVES: To present observations which might serve to sort out these various etiologies. DESIGN: We present 5 cases of colitis, ileocolitis or enteritis, some with fistula formation, with clinical onset following bariatric surgery and add these to the 7 cases previously identified as CD reported elsewhere...
May 9, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28461184/failed-minimally-invasive-staged-treatment-of-a-giant-symptomatic-aortic-perigraft-hygroma-after-open-aortic-repair
#13
Andrés Reyes Valdivia, Africa Duque Santos, Francisco Alvarez Marcos, Alvaro Osorio Ruiz, Julia Ocaña Guaita, Claudio Gandarias Zúñiga
BACKGROUND: Perigraft hygromas or seromas are an unusual finding and/or complication after open aortic repair. CASE REPORT: We present a case of an 82 year-old man with a previous urgent aortic bifurcated graft for abdominal aortic aneurysm (AAA) rupture. He received several treatments due to abdominal compartment syndrome (ACS), requiring a Bogota Bag and colostomy derivation. He was finally discharged home and lost on follow-up. Eight years after this procedure he presented to the urgency department with an abdominal mass and pain...
April 28, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28442849/operative-management-of-enteroatmospheric-fistula-in-bj%C3%A3-rck-4-open-abdomen-patients-by-the-help-of-laparoscopic-lateral-approach
#14
Fahri Yetişir, A Ebru Sarer
As the open abdomen (OA) management increases, the number of fistula formation has also been increasing during the last two decades. These fistulas in OA have been defined as enteroatmospheric fistula (EAF). EAF occurring in a frozen OA is classified as Björck 4 OA. Management of Björck 4 OA patient is not easy and mortality of these patients is very high in spite of the presence of modern treatment modalities. There are a few surgical approaches for treatment of Björck 4 OA patients. One of them is excising the hostile segment by lateral abdominal approach from the healthy side or entering from lateral border of OA wound after enough time intervals for subsiding of the edematous intestine in acute inflammatory reaction in the hostile environment...
April 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#15
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28372449/enteral-stent-for-the-treatment-of-a-urinary-fistula-associated-with-a-biological-mesh-following-a-bricker-type-procedure
#16
Raquel Díaz Ruiz, Marta Castillo Pradillo, Óscar Nogales Rincón, Cecilia González Asanza
Postoperative fistula results in increased morbidity and a longer hospital stay. While surgery is the most common treatment, the endoscopic approach is an increasingly used alternative. A 57-year-old woman underwent surgery for colonic adenocarcinoma, which relapsed as peritoneal carcinomatosis and was managed with chemotherapy and surgery, a biological Permacol™ mesh was used for abdominal wall closure.
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28358595/treatment-of-enterocutaneous-fistulas-then-and-now
#17
Luis Alfonso Ortiz, Bin Zhang, Maureen Walsh McCarthy, Haytham M A Kaafarani, Peter Fagenholz, David R King, Marc De Moya, George Velmahos, Daniel Dante Yeh
BACKGROUND: An enterocutaneous fistula (ECF) is an aberrant connection between the gastrointestinal tract and the skin or atmosphere (enteroatmospheric fistula [EAF]). Multimodal treatment includes surgical procedures, nutrition support, and wound care. We evaluated our practice and compared our outcomes with previous results published from our institution. MATERIALS AND METHODS: We performed a retrospective analysis of hospitalized ECF/EAF patients admitted between January 2011 and November 2015...
March 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28338158/-diagnosis-and-treatment-of-duodenal-injury-and-fistula
#18
Kunmei Gong, Shikui Guo, Kunhua Wang
Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28338154/-experience-of-the-three-stage-strategy-for-intestinal-fistula-complicated-with-complex-abdominal-infection
#19
Qingchuan Zhao, Xuzhao Li, Xiaohua Li, Juan Wang
Intestinal fistula, as a serious complication after abdominal surgery, not only leads to a series of pathophysiological changes such as fluid loss, malnutrition and organ dysfunction, but also causes the severe abdominal infection, which often threatens the life of patients. How to make the diagnosis and give the treatment of intestinal fistula is the key to save the lives of high-risk patients. In our hospital, during the past course of diagnosis and treatment for intestinal fistula complicated with severe abdominal infection, based on the combination of literatures at home and abroad with our clinical experiences for many years, an effective three-stage prevention and treatment strategy was formed gradually, which included early diagnosis, effective treatment of infection source, open drainage of abdominal infection and early enteral nutrition support...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#20
REVIEW
Luca Sorrentino, Osvaldo Chiara, Massimiliano Mutignani, Fabrizio Sammartano, Paolo Brioschi, Stefania Cimbanassi
BACKGROUND: Currently, both the step-up approach, combining percutaneous drainage (PD) and video-assisted retroperitoneal debridement (VARD), and endoscopic transgastric necrosectomy (ETN) are mini-invasive techniques for infected necrosis in severe acute pancreatitis. A combination of these approaches could maximize the management of necrotizing pancreatitis, conjugating the benefits from both the experiences. However, reporting of this combined strategy is anecdotal. This is the first reported case of severe necrotizing pancreatitis complicated by biliary fistula treated by a combination of ETN, PD, VARD, and endoscopic biliary stenting...
2017: World Journal of Emergency Surgery: WJES
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