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İntraabdominal infections

Clement D Marshall, Michael S Hu, Tripp Leavitt, Leandra A Barnes, Alexander T M Cheung, Samir Malhotra, H Peter Lorenz, Michael T Longaker
Abdominal adhesions consist of fibrotic tissue that forms in the peritoneal space in response to an inflammatory insult, typically surgery or intraabdominal infection. The precise mechanisms underlying adhesion formation are poorly understood. Many compounds and physical barriers have been tested for their ability to prevent adhesions after surgery with varying levels of success. The mouse and rat are important models for the study of abdominal adhesions. Several different techniques for the creation of adhesions in the mouse and rat exist in the literature...
2016: Journal of Visualized Experiments: JoVE
H Drinhaus, T Annecke, J Hinkelbein
Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space (Monaldi-position) or in the anterior to mid-axillary line of the 4th/5th intercostal space (Bülau-position)...
October 2016: Der Anaesthesist
Philipp Horvath, Stefan Beckert, Florian Struller, Alfred Königsrainer, Ingmar Königsrainer
AIM: To investigate the clinical impact of post-hyperthermic intraperitoneal chemotherapy (HIPEC) leukopenia, intraperitoneal and combined intravenous/intraperitoneal drug administrations were compared. METHODS: Two patient cohorts were retrospectively analyzed regarding the incidence of postoperative leukopenia. The first cohort (n = 32) received Mitomycin C (MMC)-based HIPEC intraperitoneally (35 mg/m² for 90 min) and the second cohort (n = 10) received a bi-directional therapy consisting of oxaliplatin (OX) (300 mg/m(2) for 30 min) intraperitoneally and 5-fluorouracil (5-FU) 400 mg/m² plus folinic acid 20 mg/m² intravenously...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
Norma Carolina Manassero, Mercedes Navarro, Marta Rocchi, Horacio di Bella, Ana M Gasparotto, A Valeria Ocaña Carrizo, Federico Novillo, Daniela Furiasse, Aída Monterisi
Enterococcal bacteremia has acquired considerable importance in recent years, mainly due to an increased number of cases that occur during hospital admission. We describe the episodes of enterococcal bacteremia in adult patients recorded at our hospital. Between January 2000 and December 2013, 117 episodes were analyzed. Sixty one percent (61%) of the patients were male and 39% female. The mean age was 68. Predisposing factors were present in 91% of patients. The primary source of infection was intraabdominal...
August 24, 2016: Revista Argentina de Microbiología
Jana Enderes, Julia van der Linde, Jan Müller, Bich-Thu Tran, Wolfram von Bernstorff, Claus-Dieter Heidecke, Tobias Schulze
BACKGROUND: FTY720 is an immunosuppressive molecule licensed for the treatment of chronic relapsing multiple sclerosis (MS). It attenuates the adaptive immune response by sequestering T cells within secondary lymphoid organs via its action as functional antagonist of sphingosine-1-phasphate. To date it is unknown whether FTY-induced lymphopenia puts MS patients at increased risk for severe forms of postoperative infectious complications such as abdominal sepsis. OBJECTIVES: To determine the effect of FTY720-induced lymphopenia on survival to sepsis secondary to postoperative intraabdominal infections in a murine model of polymicrobial sepsis...
August 24, 2016: Shock
Stephen B Vickery, David McClain, Kurt A Wargo
Ceftolozane-tazobactam, a novel β-lactam/β-lactamase inhibitor, was recently approved for the treatment of complicated urinary tract and intraabdominal infections, as monotherapy and in combination with metronidazole, respectively. Ceftolozane-tazobactam exhibits a wide spectrum of activity against both gram-positive bacteria, gram-negative bacteria including multidrug-resistant (MDR) Pseudomonas aeruginosa, and some anaerobic bacteria. Although not currently approved for any pulmonary indication, studies have demonstrated excellent distribution to epithelial lining fluid, indicating that it may be an alternative agent to use in the treatment of respiratory tract infections caused by MDRP...
October 2016: Pharmacotherapy
Ilker Kahramanoglu, Veysel Sal, Tugan Bese
INTRODUCTION: Vaginal cuff dehiscence after hysterectomy can be life-threating condition. Vaginal evisceration of bowel may lead to intestinal ischemia and intraabdominal infection. Immediate recognition and surgical repair are crucial for succesful management. CASE REPORT: Herein, we report a case of vaginal cuff dehiscence with small bowel evisceration in a 32-year old woman who underwent laparoscopic type II hysterectomy for stage IA2 cervical cancer. CONCLUSION: Patients who have undergone hysterectomy should be advised about when to restart coitus...
2016: International Journal of Surgery Case Reports
Marina Pieri, Marcus Müller, Anna Mara Scandroglio, Panagiotis Pergantis, Alexandra Kretzschmar, Friedrich Kaufmann, Volkmar Falk, Thomas Krabatsch, Georg Arlt, Marian Kukucka, Evgenij Potapov
Mediastinitis is more frequent in patients with implantable ventricular assist devices (VAD) than in other cardiac surgery patients and carries significant mortality. We report our experience with a stepwise approach including aggressive debridement, jet lavage, vacuum assisted closure (VAC) dressing and finally coverage with well-vascularized and immune active omental flaps in VAD patients with infective mediastinitis.We retrospectively collected and analyzed data of patients with continuous flow VAD who underwent plasty with the omental flap due to mediastinitis at Deutsches Herzzentrum Berlin beween 1 January 2008 and 30 October 2015 ...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Claire Goumard, David Fuks, François Cauchy, Jacques Belghiti, Catherine Paugam-Burtz, Yves Castier, Olivier Soubrane
BACKGROUND: Postoperative pleural empyema following liver resection has not been thoroughly described in the literature yet. Hence, we aimed to describe characteristics of patients experiencing this complication. METHODS: Characteristics and outcomes of 21 patients who developed pleural empyema after hepatectomy, defined as a bacteriologically proven pleural infection with clinical and biological inflammatory signs requiring antibiotherapy and thoracic drainage, from 2001 to 2014, were retrospectively analyzed...
July 27, 2016: World Journal of Surgery
Julio C U Coelho, Christiano M P Claus, Antonio C L Campos, Marco A R Costa, Caroline Blum
Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites...
July 27, 2016: World Journal of Gastrointestinal Surgery
Nobuhisa Matsuhashi, Kazuya Yamaguchi, Naoki Okumura, Toshiyuki Tanahashi, Satoshi Matsui, Hisashi Imai, Yoshihiro Tanaka, Takao Takahashi, Shinji Osada, Kazuhiro Yoshida
BACKGROUND: The indications for laparoscopic gastrectomy for early stomach cancer have spread worldwide, and the short-term outcomes have been favorable. Intraabdominal delta-shaped gastroduodenostomy using endoscopic linear staplers, a technique which was developed by Kanaya et al. is one of the feasible reconstructive procedures. Pure laparoscopic surgery is reported to be associated with several intraoperative and postoperative advantages in comparison with laparoscopy-assisted surgery...
July 21, 2016: Surgical Endoscopy
Taku Omura, Eizo Watanabe, Yasufumi Otsuka, Yoko Yoshida, Hideki Kato, Masaomi Nangaku, Toshiyuki Miyata, Shigeto Oda
UNLABELLED: To describe a case of complete remission of thrombotic microangiopathy after treatment with eculizumab in a patient with non-Shiga toxin-associated bacterial enteritis. CASE REPORT: Medical/surgical intensive care unit (ICU) of a university teaching hospital.A 62-year-old man presented to a local hospital with mucous and bloody stool persisting for 1 month and worsening abdominal pain for 2 weeks. He had thrombocytopenia and renal dysfunction and was admitted with a diagnosis of sepsis due to intraabdominal infection...
July 2016: Medicine (Baltimore)
Ana Berlin, Jason Michael Johanning
Intraabdominal infections represent a diagnostic and therapeutic challenge in the elderly population. Atypical presentations, diagnostic delays, additional comorbidities, and decreased physiologic reserve contribute to high morbidity and mortality, particularly among frail patients undergoing emergency abdominal surgery. While many infections are the result of age-related inflammatory, mechanical, or obstructive processes, infectious complications of feeding tubes are also common. The pillars of treatment are source control of the infection and judicious use of antibiotics...
August 2016: Clinics in Geriatric Medicine
Shoji Kubo, Shigekazu Takemura, Shogo Tanaka, Hiroji Shinkawa, Masahiko Kinoshita, Genya Hamano, Tokuji Ito, Masaki Koda, Takanori Aota, Takatsugu Yamamoto, Hiroaki Terajima, Gorou Tachiyama, Terumasa Yamada, Shoji Nakamori, Akira Arimoto, Masahiro Fujikawa, Yoshito Tomimaru, Yasuhiko Sugawara, Kei Nakagawa, Michiaki Unno, Toru Mizuguchi, Kenji Takenaka, Koichi Kimura, Ken Shirabe, Akio Saiura, Katsuhiko Uesaka, Hiroki Taniguchi, Akira Fukuda, Ja-Mun Chong, Yuko Kuwae, Masahiko Ohsawa, Yasunori Sato, Yasuni Nakanuma
BACKGROUND: Cholangiocarcinoma caused by exposure to 1,2-dichloropropane and/or dichloromethane is recognized as occupational cholangiocarcinoma. The aim of this study was to investigate the outcomes after resection of occupational cholangiocarcinoma to establish a treatment strategy for this disease. METHODS: Clinicopathological findings and outcomes after surgical intervention in 20 patients with occupational cholangiocarcinoma were investigated. RESULTS: Of 20 the patients, curative resection was performed in 16 patients...
September 2016: Journal of Hepato-biliary-pancreatic Sciences
P Horvath, J Lange, R Bachmann, F Struller, A Königsrainer, M Zdichavsky
BACKGROUND: Laparoscopic appendectomy is now the treatment of choice in uncomplicated appendicitis. To date its importance in the treatment of complicated appendicitis is not clearly defined. METHODS: From January 2005 to June 2013 a total of 1762 patients underwent appendectomy for the suspected diagnosis of appendicitis at our institution. Of these patients 1516 suffered from complicated appendicitis and were enrolled. In total 926 (61 %) underwent open appendectomy (OA) and 590 (39 %) underwent laparoscopic appendectomy (LA)...
May 18, 2016: Surgical Endoscopy
Karl Dichtl, Johannes Wagener, Johannes Tschöp, Ludwig Ney
Here, we report a patient developing a postoperative peritoneal infection by Aspergillus fumigatus. While galactomannan serum levels were negative throughout the time course, galactomannan levels in peritoneal fluids yielded high results. Serological testing of peritoneal fluids for fungal antigens might be a useful and easily applicable tool to support diagnosis of intraabdominal aspergillosis, which represents a rare type of invasive fungal infection.
October 2016: Infection
Bradford J Kim, Thomas A Aloia
Despite the creation of several programs to decrease the incidence of surgical site infection, it remains a common complication that has a significant impact on patient recovery and medical costs. The following is a description and brief outcome report of a modified primary closure technique used for dirty (Class IV) wounds. There were 14 consecutive patients who had a laparotomy with Class IV wounds treated by a single surgeon (TAA) from 2011 to 2015. All patients had a history of cancer and either showed signs suggestive for an acute abdomen and required an emergent exploratory laparotomy or were found to have purulent intraabdominal infection at the time of elective surgery...
May 3, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
O Toumi, F Noomen, R Salem, H Rabeh, S B Jabra, I Korbi, S Bannani, M Nasr, K Zouari, G Mondher, A Hamdi
PURPOSE: Hydatid cyst rupture into abdominal cavity is a rare but a serious complication. The rupture can occur after a trauma, or spontaneously as a result of increased intracystic pressure. It is a surgical emergency with high morbidity and mortality rates. Early diagnosis and appropriate surgical management of this complication can be life saving. The objective of the current paper is to evaluate the clinical, and radiographic findings and surgical treatment of this complication. METHODS: A retrospective study on 12 patients operated in our department for intraperitoneal rupture of hydatid cyst between January 1990 and May 2015...
March 23, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Doğan Alhan, İsmail Şahin, Serbülent Güzey, Andaç Aykan, Fatih Zor, Serdar Öztürk, Mustafa Nışancı, İsmail Hakkı Özerhan
BACKGROUND: Open abdomen is a salvage procedure that prevents catastrophes after severe intraabdominal traumas. However, following this life saving attempt, it is mostly not feasible to close the abdomen immediately after the recovery of intraabdominal injuries. Consequently, a staged reconstruction is required, and the first stage is usually a temporary closing approach. At the end of this stage, resulting giant "ventral hernia" is a burden for both the patient and the surgeon. Therefore a permanent repair is subsequently needed...
December 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Orhan Gozeneli, Yusuf Yucel, Ali Akal, Alpaslan Terzi, Abdullah Ozgonul, Faik Tatli, Resit Ciftci, Mehmet Gumer, Ali Uzunkoy
UNLABELLED: The aim of this study is to evaluate the thyroid function tests in order to examine whether 10 % of Povidone-Iodine(PI), the medication we applied in 1/5 ratio diluted with 0.9 %NaCl, joins the systemic circulation during clean contaminated, contaminated and dirty operations for solid organ hydatid cysts in abdominal area to avoid abscess formation and spreading. 7 men and 6 women were included to the present study, prospectively. The mean age was 33.69(± 13.49). TSH, free T3 (fT3) and free T4 (fT4) hormone levels were measured before the operation and at the third day of postoperative period...
2016: Annali Italiani di Chirurgia
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