Read by QxMD icon Read

Walled off necrosis

Sameen Khalid, Aamer Abbass, Eric Nellis, Shashin Shah, Hiral Shah
Pancreatic pseudocysts and walled-off pancreatic necrosis arise as a complication of pancreatitis. Multiple fluid collections are seen in 5-20% of the patients who have walled-off peripancreatic fluid collections. There is a paucity of data regarding the role of endoscopic transmural drainage in the management of multiple pancreatic fluid collections. In this case report, we present the case of a 72-year-old male with three walled-off pancreatic fluid collections in the setting of acute necrotizing pancreatitis...
January 9, 2018: Curēus
Marc Giovannini
Ultrasound-guided drainage is the first-line modality for drainage of symptomatic of pancreatic fluid collections. In the context of pancreatic cancer, use of multiple double-pigtail plastic stents suffice, with high treatment efficacy. This approach provides similar success rates with low complications and better quality of life compared with surgery. Lumen apposing metallic stents (LAMSs) permit more effective drainage with larger diameter; because of their higher costs than plastic stents, their main role is probably in the context of walled-off necrosis, but the place and the use of LAMS should be studied to avoid and reduce the risks of complications...
April 2018: Gastrointestinal Endoscopy Clinics of North America
Andrea Tringali, Salvatore F Vadalà di Prampero, Vincenzo Bove, Vincenzo Perri, Antonio La Greca, Gilda Pepe, Valerio Cozza, Guido Costamagna
Background and study aims  Endoscopic drainage of walled-off pancreatic necrosis (WOPN) is feasible when contact with the gastric or duodenal wall is present; when WOPN cannot be accessed endoscopically, a percutaneous approach can be considered. Percutaneous use of esophageal self-expandable metal stents (SEMS) to establish access to a WOPN cavity was evaluated.
March 2018: Endoscopy International Open
Suresh Vasan Venkatachalapathy, Noor Bekkali, Stephen Pereira, Gavin Johnson, Kofi Oppong, Manu Nayar, John Leeds, Bharat Paranandi, Ian Penman, Nicholas Carroll, Edmund Godfrey, Martin James, Guruprasad Aithal, Colin McKay, John Devlin, Terry Wong, Alistair Makin, Barbara Ryan, Matthew Huggett
Background and study aims:  Pancreatic fluid collection (PFC) is a common complication of pancreatitis for which endoscopic ultrasound-guided drainage is first-line treatment. A new single-device, lumen-apposing, covered self-expanding metal stent (LAMS) has been licensed for PFC drainage. We therefore present our multicenter experience with the LAMS for PFC drainage in a multicenter prospective case series to assess success and complication rates. Patients and methods:  All adult patients from 11 tertiary centers who had LAMS placement for PFC from July 2015 to July 2016 were included...
March 2018: Endoscopy International Open
Anupama Ramachandran, Sanchit Sharma, Shalimar, Raju Sharma, Kumble Seetharama Madhusudhan
Walled-off necrosis (WON) is a well-known delayed local complication of acute necrotizing pancreatitis. Occasionally, WON may spontaneously rupture into the gastrointestinal tract or peritoneal cavity. However, erosion of a WON to a systemic vein has not been reported in literature so far. We report an unusual case of a 63-year-old male with acute necrotizing pancreatitis in whom WON was eroding into the inferior vena cava resulting in its thrombosis. Our patient also had a bunch of other well-described complications of pancreatitis including splanchnic venous thrombosis...
February 2, 2018: Current Problems in Diagnostic Radiology
Bryan Brimhall, Samuel Han, Philip D Tatman, Toshimasa J Clark, Sachin Wani, Brian Brauer, Steven Edmundowicz, Mihir S Wagh, Augustin Attwell, Hazem Hammad, Raj J Shah
BACKGROUND & AIMS: There have been few studies that compared the effects of lumen-apposing metal stents (LAMS) and double pigtail plastic stents (DPS) in patients with peri-pancreatic fluid collections from pancreatitis. We aimed to compare technical and clinical success and adverse events in patients who received LAMS vs DPS for pancreatic pseudocysts and walled-off necrosis. METHODS: We performed a retrospective study of endoscopic ultrasound-mediated drainage in 149 patients (65% male; mean age, 47 years) with pancreatic pseudocysts or walled-off necrosis (97 received LAMS and 152 received DPS), from January 2011 through September 2016 at a single center...
February 20, 2018: Clinical Gastroenterology and Hepatology
Surinder Singh Rana, Rajesh Gupta, Mandeep Kang, Vishal Sharma, Ravi Sharma, Ujjwal Gorsi, Deepak K Bhasin
Background and Objectives: Infected pancreatic necrosis (IPN) in the early phase is treated with "step up approach" involving initial percutaneous catheter drainage (PCD) followed by necrosectomy. There is a paucity of data on a combined approach of initial PCD followed by endoscopic drainage and necrosectomy. A retrospectively study on safety and efficacy of initial PCD followed by endoscopic transluminal drainage and necrosectomy in IPN. Methods: Retrospective analysis of data of 23 patients with IPN who were treated with a combined approach...
January 2018: Endoscopic Ultrasound
Surinder Singh Rana, Ravi Sharma, Rajesh Gupta
No abstract text is available yet for this article.
January 11, 2018: Digestive and Liver Disease
Nadav Sahar, Richard A Kozarek, Zaheer S Kanji, Shingo Chihara, S Ian Gan, Michael Gluck, Michael Larsen, Andrew S Ross, Shayan Irani
BACKGROUND AND AIMS: Although society guidelines recommend a short course of antibiotics after drainage of walled-off necrosis (WON), the exact duration is unclear. METHODS: This is a retrospective review of patients with no prior antibiotic exposure who underwent dual modality drainage (DMD) for sterile WON from 2008 to 2017. Patients were grouped into- short duration (SD, ≤5 days) vs. long duration (LD, >5 days). The main outcome was the frequency of recurrent infections...
February 2, 2018: Journal of Gastroenterology and Hepatology
Tajana Pavic, Davor Hrabar, Dominik Kralj, Ivan Lerotic, Doris Ogresta
Necrotizing pancreatitis remains a challenging and unpredictable condition accompanied by various complications. Endoscopic ultrasound-guided transmural drainage and necrosectomy have become the standard treatment for patients with walled-off necrosis (WON). Endoscopic therapy via lumen-apposing metal stents (LAMS) with large diameters has shown success in the management of pancreatic fluid collections, but there are few data on specific complications of that therapy. We report a case of infected WON and concomitant fungemia following LAMS placement and necrosectomy...
January 30, 2018: Clinical Journal of Gastroenterology
Mateusz Jagielski, Marian Smoczyński, Krystian Adrych
BACKGROUND: Pancreaticocolonic fistulas (PCFs) are serious complication of acute pancreatitis related with high mortality. The aim of this study was to evaluate the efficiency and safety of endoscopic treatment in patients with walled-off pancreatic necrosis (WOPN) complicated with PCF. METHODS: This is a retrospective analysis of results and complications in the group of 226 patients, who underwent endoscopic treatment of symptomatic WOPN between years 2001 and 2016 in the Department of Gastroenterology and Hepatology of Medical University of Gdańsk...
January 17, 2018: Surgical Endoscopy
Mahesh Kumar Goenka, Usha Goenka, Md Yasin Mujoo, Indrajit Kumar Tiwary, Sanjay Mahawar, Vijay Kumar Rai
Background/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walled-off necrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. We evaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON. Methods: Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WON requiring intervention...
January 4, 2018: Clinical Endoscopy
Tariq Hammad, Muhammad Ali Khan, Yaseen Alastal, Wade Lee, Ali Nawras, Mohammad Kashif Ismail, Michel Kahaleh
BACKGROUND AND AIMS: Endoscopic ultrasound (EUS)-guided transmural drainage has been increasingly utilized as a first-line therapeutic modality for drainage of pancreatic fluid collections (PFC). Recently, lumen-apposing metal stents (LAMS) have been utilized for management of PFCs. We conducted a systematic review and meta-analysis to evaluate the cumulative efficacy and safety of LAMS in the management of PFC (primary outcome). We also compared the efficacy and safety of LAMS with multiple plastic stents (MPS) in the management of PFC (secondary outcome)...
December 27, 2017: Digestive Diseases and Sciences
Douglas G Adler, Linda Jo Taylor, Raza Hasan, Ali A Siddiqui
OBJECTIVES: To report the safety and clinical efficacy with the novel lumen-apposing metal stent (LAMS) with an electrocautery enhanced delivery system for the drainage of pancreatic fluid collections (PFCs). METHODS: This was a retrospective analysis of all consecutive patients with PFCs who underwent endoscopic ultrasound (EUS)-guided drainage using the LAMS with an electrocautery enhanced delivery system in 2 US centers. RESULTS: Thirteen patients with PFCs (69% with walled-off necrosis [WON]) underwent drainage using the study device...
November 2017: Endoscopic Ultrasound
Rafael Romero-Castro, Victoria Alejandra Jimenez-Garcia, Jaime Boceta-Osuna, Luis Castilla-Guerra, Francisco Pellicer-Bautista, Angel Caunedo-Alvarez, Juan Manuel Herrerias-Gutierrez, Manuel Romero-Gómez, Marc Giovannini
Endoscopic ultrasound (EUS)-guided drainage is now the treatment of choice in cases of pancreatic pseudocysts and walled-off necrosis, especially in the absence of luminal bulging and in patients with portal hypertension. Malignant refractory ascites usually heralds a poor prognosis and substantially impairs the quality of life of patients because of the symptoms experienced and the need for repeated paracentesis. EUS-guided placement of lumen-apposing, fully covered, self-expandable metal stents (FCSEMS) has been reported for the drainage of malignant ascites...
November 2017: Endoscopy International Open
Murad Aburajab, Zachary Smith, Abdul Khan, Kulwinder Dua
BACKGROUND AND AIMS: Lumen-apposing metal stents (LAMSs) are used to perform necrosectomy in walled-off necrosis (WON). Although necrosectomy is not required for pancreatic pseudocyst (PP), an increasing number of PPs are also being drained with LAMSs in view of their ease of deployment. The aim of the present study was to evaluate the safety and efficacy of using LAMSs to drain PPs. METHODS: At one tertiary center, from January 2014 to May 2016, all consecutive patients with PPs were drained by LAMSs, and the data were retrospectively reviewed...
December 9, 2017: Gastrointestinal Endoscopy
Noor L H Bekkali, Manu K Nayar, John S Leeds, Richard M Charnley, Matthew T Huggett, Kofi W Oppong
Background and study aims:  Bi-flanged metal stents (BFMS) have shown promise in the drainage of walled-off pancreatic necrosis (WON), but their placement requires multiple steps and the use of other devices. More recently, a novel device consisting of a combined lumen-apposing metal stent (LAMS) and electrocautery-enhanced delivery system has been introduced. The aim of this study was to compare the placement and outcomes of the two devices. Patients and methods:  This was a retrospective review of consecutive patients undergoing endoscopic ultrasound-guided placement of BFMS or LAMS for drainage of symptomatic WON...
December 2017: Endoscopy International Open
Fadi Al Daoud, Gul Sachwani Daswani, Vinu Perinjelil, Tina Nigam
INTRODUCTION: Gastric volvulus (GV) is a rare and life threatening condition if not treated promptly or wrongly diagnosed. The main complication of gastric volvulus is foregut obstruction. The extreme rotation can cut off blood supply to the stomach and even distal organs, which can lead to ischemia and necrosis of the affected area. PRESENTATION OF CASE: We report a case of a 41yo female that complained of severe abdominal pain, nausea and vomiting for approximately 3days after eating a large meal...
2017: International Journal of Surgery Case Reports
Chander Shekhar, Ben Maher, Colm Forde, Brinder Singh Mahon
BACKGROUND AND AIM: Endoscopic ultrasound-guided drainage is a minimally invasive first-line modality for the drainage of pancreatic fluid collection (PFC) resulting in a shorter hospital stay and less morbidity compared with surgical cystogastrostomy. Our aim is to evaluate potential differences in the outcomes of endoscopic ultrasound (EUS) guided transmural drainage (EUS-TD) drainage of pancreatic pseudocyst (PP) and walled-off necrosis (WON). METHOD: We retrospectively reviewed 100 consecutive EUS-guided drainages of PFC utilising EUS reports; clinical notes and imaging with follow-up (FU) to 12 months...
November 9, 2017: Scandinavian Journal of Gastroenterology
Apeksha Shah, Richard Denicola, Cynthia Edirisuriya, Ali A Siddiqui
Pancreatic fluid collections are a frequent complication of acute pancreatitis. The revised Atlanta criterion classifies chronic fluid collections into pseudocysts and walled-off pancreatic necrosis (WON). Symptomatic PFCs require drainage options that include surgical, percutaneous, or endoscopic approaches. With the advent of newer and more advanced endoscopic tools and expertise, minimally invasive endoscopic drainage has now become the preferred approach. An endoscopic ultrasonography (EUS)-guided approach for pancreatic fluid collection drainage is now the preferred endoscopic approach...
December 2017: Current Treatment Options in Gastroenterology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"