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Enterocutaneous fistulas

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https://www.readbyqxmd.com/read/29455876/laser-ablation-facilitates-closure-of-chronic-enterocutaneous-fistulae
#1
Ravi N Srinivasa, Rajiv N Srinivasa, Joseph J Gemmete, Anthony N Hage, William Sherk, Jeffrey Forris Beecham Chick
This report describes the use of laser ablation for treatment of chronic enterocutaneous fistulae (ECFs) after failure of conservative therapy. Three patients underwent laser ablation for treatment of 8 ECFs. Mean duration of fistula patency was 28 months with mean fistula output of 134 mL/day. The initial technical success was 100% with no major or minor complications. Three ECFs required repeat treatment. At mean follow-up of 53 days, 7 of the fistulae were occluded. One fistula showed a markedly reduced output of 10 mL/day...
March 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29448989/redefining-bowel-regimen-pharmacologic-strategies-and-nutritional-considerations-in-the-management-of-small-bowel-fistulas
#2
REVIEW
Sara E Parli, Carolyn Pfeifer, Douglas R Oyler, Barbara Magnuson, Levi D Procter
Enterocutaneous fistulae (ECF) and enteroatmospheric fistulae (EAF) are difficult complications that primarily arise after abdominal surgical procedures. Development of an ECF or EAF carries significant mortality and morbidity. Effective management of patients with these disease states requires a multidisciplinary approach, which includes surgical, pharmacotherapeutic, and nutritional interventions. This review focuses on the medical and nutritional management of ECF/EAF, providing background on drug agents and nutritional strategies that may be helpful in reducing effluent volume, optimizing fistula healing, and maintaining nutritional health...
February 12, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29428021/results-after-definitive-surgical-treatment-in-patients-with-enteroatmospheric-fistula
#3
Jose L Martinez, Enrique Luque-de-León, Luis Manuel Souza-Gallardo, Maricela Jiménez-López, Eduardo Ferat-Osorio
As enteroatmospheric fistulas (EAF) lack healthy overlying tissue, spontaneous healing is very unlikely. Our aim was to identify risk factors for recurrence and mortality after definitive surgical treatment for EAF. Sixty-two consecutive patients with a diagnosis of EAF were submitted to definitive surgical repair (fistula resection and primary anastomosis) during a 6-year period. Several patient, disease, and operative variables were assessed as risk factors associated to our endpoints: recurrence and mortality...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29427748/the-non-thyroidal-illness-syndrome-is-associated-with-postoperative-surgical-site-infections-in-enterocutaneous-fistulae
#4
Huajian Ren, Jianan Ren, Gefei Wang, Zhiwu Hong, Guosheng Gu, Jun Chen, Xiuwen Wu, Qiongyuan Hu, Guanwei Li
BACKGROUND: Non-thyroidal illness syndrome (NTIS) is common in critically ill patients and associated with adverse outcomes. Many enterocutaneous fistula (ECF) patients still suffer NTIS prior to definitive surgery. This study was designed to explore the association between preoperative NTIS and postoperative outcomes in ECF patients. METHODS: A total of 264 ECF patients who underwent definitive surgery from April 2014 to November 2016 were studied. Thyroid hormones were tested for each patient before surgery, and the patients were divided into two groups (NTIS group and euthyroid group) according to the presence of NTIS...
February 7, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29388080/what-is-the-evidence-for-the-use-of-biologic-or-biosynthetic-meshes-in-abdominal-wall-reconstruction
#5
REVIEW
F Köckerling, N N Alam, S A Antoniou, I R Daniels, F Famiglietti, R H Fortelny, M M Heiss, F Kallinowski, I Kyle-Leinhase, F Mayer, M Miserez, A Montgomery, S Morales-Conde, F Muysoms, S K Narang, A Petter-Puchner, W Reinpold, H Scheuerlein, M Smietanski, B Stechemesser, C Strey, G Woeste, N J Smart
INTRODUCTION: Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations...
January 31, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29383245/spontaneous-closure-of-multiple-enterocutaneous-fistula-due-to-abdominal-tuberculosis-using-negative-pressure-wound-therapy-a-case-report
#6
Yuliardy Limengka, Wifanto S Jeo
Enterocutaneous fistula (ECF) is one of the most challenging abdominal complications, for surgeons and other healthcare members, which involves significant morbidity and potentially mortality. Despite advancements in both operative and non-operative therapy, fistula-related complications are still unavoidable. Negative pressure wound therapy (NPWT) had been used years to treat chronic wound, to decrease tissue edema, improve circulation, promote healthy granulation tissue and inhibit bacterial growth. We report a 29-year-old male with complicated ECF due to abdominal tuberculosis, that was healed after treated using NPWT...
January 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29280707/successful-conservative-treatment-of-enterocutaneous-fistula-with-cyanoacrylate-surgical-sealant-case-report
#7
N Musa, F Aquilino, P Panzera, G Martines
AIM: Enterocutaneous (EC) fistula is an abnormal communication between the gastrointestinal tract and the skin. The majority of EC fistulas result from surgery. Only 15-25% of EC fistulas are spontaneous and they often result from underlying diseases such as Crohn's disease, radiation and chemotherapy. CASE REPORT: A 62-year old woman who, in 2012, underwent Pylorus-preserving cephalic pancreaticoduodenectomy (PPPD sec. Traverso-Longmire), due to an advanced pancreatic ductal adenocarcinoma (pT3N1M1)...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29276586/postoperative-enterocutaneous-fistula-principles-in-non-operative-approach
#8
E A Sule, M A Nzegwu, J C Okolo, R U Onyemekheia
Introduction: Postoperative enterocutaneous fistulae could constitute a challenge when they occur following an abdominal surgery. Astute application of correct principles in its management is essential for good outcomes. Methods: A retrospective review of records of patients with enterocutaneous fistulas managed non-operatively was done. Clinical assessment, anatomic and physiologic classification of fistula, fluid resuscitation, electrolyte correction, parenteral/enteral nutrition, antibiotic use and fistula effluent monitoring, formed the basis of management...
December 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29260128/emergency-cases-following-elective-colonoscopy-iatrogenic-colonic-perforation
#9
Ebubekir Gündeş, Hüseyin Çiyiltepe, Ulaş Aday, Durmuş Ali Çetin, Aziz Serkan Senger, Orhan Uzun, Kamuran Cumhur Değer, Mustafa Duman, Erdal Polat
Objective: Our aim in this study was to present the cases of our patients who contracted colonic perforation during elective colonoscopy and became emergency cases; we also discuss treatment modalities along with literature reports on the subject. Material and Methods: Cases of patients who contracted iatrogenic colonic perforation following endoscopy of the colorectal system between January 2009 and December 2015 at Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital's Endoscopy Unit were reviewed retrospectively...
2017: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29247365/full-thickness-skin-graft-vs-synthetic-mesh-in-the-repair-of-giant-incisional-hernia-a-randomized-controlled-multicenter-study
#10
L Clay, B Stark, U Gunnarsson, K Strigård
PURPOSE: Repair of large incisional hernias includes the implantation of a synthetic mesh, but this may lead to pain, stiffness, infection and enterocutaneous fistulae. Autologous full-thickness skin graft as on-lay reinforcement has been tested in eight high-risk patients in a proof-of-concept study, with satisfactory results. In this multicenter randomized study, the use of skin graft was compared to synthetic mesh in giant ventral hernia repair. METHODS: Non-smoking patients with a ventral hernia > 10 cm wide were randomized to repair using an on-lay autologous full-thickness skin graft or a synthetic mesh...
December 15, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29215475/an-effective-bundled-approach-reduces-surgical-site-infections-in-a-high-outlier-colorectal-unit
#11
Emre Gorgun, Ahmet Rencuzogullari, Volkan Ozben, Luca Stocchi, Thomas Fraser, Cigdem Benlice, Tracy Hull
BACKGROUND: Surgical site infections are the most common hospital-acquired infection after colorectal surgery, increasing morbidity, mortality, and hospital costs. OBJECTIVE: The purpose of this study was to investigate the impact of preventive measures on colorectal surgical site infection rates in a high-volume institution that performs inherent high-risk procedures. DESIGN: This was a prospective cohort study. SETTINGS: The study was conducted at a high-volume, specialized colorectal surgery department...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29187086/nutrition-management-of-home-parenteral-nutrition-among-patients-with-enterocutaneous-fistula-in-the-sustain-registry
#12
Charlene Compher, Marion F Winkler, Peggi Guenter, Ezra Steiger
BACKGROUND: Home parenteral nutrition (HPN) is a vital therapy for patients who have the diagnosis of enterocutaneous fistula (ECF), yet little is known about how these patients are managed. This research compares nutrition management of adults with ECF as the indication for HPN therapy to those with other indications. METHODS: This is an analysis of data from adult HPN patients in the Sustain registry enrolled between August 2011 and February 2014 who have the diagnosis of ECF or other indication for HPN who served as the control group...
February 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29151703/3d-printed-fistula-stent-designed-for-management-of-enterocutaneous-fistula-an-advanced-strategy
#13
Jin-Jian Huang, Jian-An Ren, Ge-Fei Wang, Zong-An Li, Xiu-Wen Wu, Hua-Jian Ren, Song Liu
Enterocutaneous fistulas (ECFs) are great challenges during the open abdomen. The loss of digestive juice, water-electrolyte imbalance and malnutrition are intractable issues during management of ECF. Techniques such as "fistula patch" and vacuum-assisted closure therapy have been applied to prevent contamination of open abdominal wounds by intestinal fistula drainage. However, failures are encountered due to high-output fistula and anatomical complexity. Here, we report 3D-printed patient-personalized fistula stent for ECF treatment based on 3D reconstruction of the fistula image...
November 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29090018/incidence-root-cause-and-outcomes-of-unintentionally-retained-intraabdominal-surgical-sponges-a-retrospective-case-series-from-two-hospitals-in-togo
#14
Boyodi Tchangai, Mazamaesso Tchaou, Iroukora Kassegne, Kpatekana Simlawo
BACKGROUND: The term gossypiboma refers to a sponge that has been forgotten in the surgical field. It is the most common retained surgical item, and constitutes a continuing problem for surgical safety. We performed a hospital-based study to examine their incidence, root cause, and outcomes, as an effort toward improving prevention. METHODS: This retrospective study covered 10 years (2006-2015) and included surgically confirmed cases of abdominal gossypibomas occurring after 45,011 abdominal and gynaecological operations in 2 public hospitals in Lome (Togo)...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/29062452/enterocutaneous-fistula-a-novel-video-assisted-approach
#15
Hugo Palma Rios, André Goulart, Carla Rolanda, Pedro Leão
Video-assisted anal fistula treatment (VAAFT) is a novel minimally invasive and sphincter-saving technique to treat complex anal fistulas described by Meinero in 2006. An enterocutaneous fistula is an abnormal communication between the bowel and the skin. Most cases are secondary to surgical complications, and managing this condition is a true challenge for surgeons. Postoperative fistulas account for 75-85% of all enterocutaneous fistulas. The aim of paper was to devise a minimally invasive technique to treat enterocutaneous fistulas...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/28974999/malignant-posterior-reversible-encephalopathy-syndrome-an-exacting-challenge-for-neurocritical-care-physicians
#16
Shahvaiz Magsi, Atif Zafar
We report a case of malignant posterior reversible encephalopathy syndrome (PRES) in a 62-year-old Caucasian female with a complex medical history and comorbidities admitted for bowel resection and lysis of iatrogenic bowel adhesions and enterocutaneous fistulas. Postoperatively, the patient developed sudden bilateral visual loss with no other neurologic deficits. Computed tomography scan showed very severe PRES-like changes, confirmed on magnetic resonance imaging (MRI). Systolic blood pressure remained around 170 mm HG...
October 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28969198/spontaneous-enterocutaneous-fistula-resulting-from-richter-s-hernia
#17
Ranendra Hajong, Donkupar Khongwar, Ojing Komut, Narang Naku, Kappa Baru
Richter's hernia is due to the entrapment of a part of circumference of the bowel wall. As the bowel continuity is maintained, the patients usually do not have intestinal obstruction. Some patients with Richter's hernia may present with enterocutaneous fistula either spontaneous or due to surgical intervention mistaking the obstructed hernia to be inguinal abscess. This is more so in developing countries due to lack of awareness among the masses or due to the delay in seeking medical attention. Presenting here is a case of a 53-year-old male patient with enterocutaneous fistula which occurred spontaneously and sought medical attention only after about three years of repeated discharge of yellowish fluid from the left inguinal region...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28963700/enterocutaneous-fistulas-a-primer-for-radiologists-with-emphasis-on-ct-and-mri
#18
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...
December 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28953519/the-use-of-bilayered-fascia-lata-with-an-interpositional-omental-flap-for-autologous-repair-of-contaminated-abdominal-fascial-defects
#19
Hui Chai Fong, Bien-Keem Tan, Pierce Kh Chow, Hock Soo Ong
INTRODUCTION: Contaminated abdominal fascial defects, such as those seen in enterocutaneous fistula, or wound dehiscence with mesh exposure, are a significant source of morbidity and present unique reconstructive challenges. We present our technique of using the fascia lata, augmented with an interpositional omental flap, for complete autologous reconstruction of contaminated fascial defects, and the postoperative results of 3 cases. METHODS: Three patients with contaminated abdominal defects underwent wound debridement/fistula resection and immediate reconstruction with fascia lata and omentum flap...
November 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28892969/fistulating-richter-s-hernia-of-groin-with-necrotizing-soft-tissue-infection-a-lethal-combination
#20
Shibojit Talukder, Ashish Gupta, Basant Narayan Singh, Lileswar Kaman, P Abhinaya Reddy
Strangulation of groin hernia can result in significant morbidity and mortality. Spontaneous external fistulation following strangulation is rare and typically occurs with Richter's hernia. Spreading Necrotizing Soft Tissue Infection (NSTI) secondary to Enterocutaneous Fistula (ECF) is an ominous sign, further worsening its prognosis. Early diagnosis and prompt surgical treatment is crucial to improve outcome. Herewith the authors are presenting a case of neglected inguinal hernia. It was complicated with ECF formation and rapidly spreading NSTI of flank...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
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