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Enterocutaneous fistulas

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https://www.readbyqxmd.com/read/29215475/an-effective-bundled-approach-reduces-surgical-site-infections-in-a-high-outlier-colorectal-unit
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
September 29, 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
#9
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
#10
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
https://www.readbyqxmd.com/read/28884052/colovesical-fistula-an-unusual-complication-of-cytomegalovirus-colitis
#11
Talal Asif, Badar Hasan, Alisa Likhitsup, David Bamberger
Cytomegalovirus (CMV) is a double-stranded DNA virus that is associated with clinically significant disease in patients with advanced immunosuppression, particularly those with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). End-organ disease with CMV is classically associated with a CD4 cell count less than 50 cells/microliter. CMV colitis is the second most common manifestation of end-organ disease in this patient population. CMV-associated enteric fistula is a rare complication that has been described in only a few case reports in the literature...
July 5, 2017: Curēus
https://www.readbyqxmd.com/read/28876571/duodenectomy-managing-the-fistula
#12
M Govender, O Matsevych, F Ghoor, N Singh, C Molenaar
BACKGROUND: Duodenectomy is rarely indicated, however, in certain circumstances may have be performed. Enterocutaneous fistula (ECF) is the main cause of serious adverse outcomes. Its management remains challenging. METHOD: Two cases of emergency duodenectomy are presented. The management of ECF is described and discussed. RESULTS: Case 1: A 22-year-old male presented in septic shock with perforated duodenal ulcer, suffered two cardiac arrests before index surgery...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28739123/effects-of-modifiable-non-modifiable-and-clinical-process-factors-in-ventral-hernia-repair-surgical-site-infections-a-retrospective-study
#13
John Chipko, Anthony DeSantis, Erik Quinn, Vic Velanovich
BACKGROUND: The hypothesis of this study is that non-modifiable factors are more important in ventral hernia repair (VHR) surgical site infection (SSI) than care process factors. METHODS: All VHR's which were reviewed retrospectively for both NSQIP-recorded data, and also: preoperative hospitalization, existing mesh, enterocutaneous fistula, open wound, case month, case day, case length, prophylactic antibiotics, skin preparation, other procedure performed, re-do operation, estimate blood loss, hernia size, repair approach, repair type, mesh used, skin closure, suture type, use of drains, and dressing...
November 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28721569/management-of-enterocutaneous-fistula-outcomes-in-276-patients
#14
Martha Quinn, Stuart Falconer, Ruth F McKee
OBJECTIVE: To assess the outcomes of patients with type II intestinal failure due to enterocutaneous fistulae in a tertiary referral centre over a 15 year period. Intestinal failure secondary to enterocutaneous fistula (ECF) requires multidisciplinary management at significant cost. Mortality and morbidity are high. METHODS: Patients were identified from a prospectively collected database of patients requiring inpatient parenteral nutrition (1998-2013). Data collected included: demographics, mode of admission, pathological grouping and outcome...
October 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28711168/surgical-treatment-of-intestinal-complications-of-graft-versus-host-disease-in-the-pediatric-population-case-series-and-review-of-literature
#15
REVIEW
Camille A Gutierrez, Mehul V Raval, Hannah R Vester, Sonali Chaudhury, Daniel von Allmen, David H Rothstein
BACKGROUND/PURPOSE: Intestinal complications of acute graft-versus-host disease (aGVHD) include hemorrhage and perforation in the short-term, and stricture with bowel obstruction in the long-term. As medical management of severe aGVHD has improved, more patients are surviving even advanced stages of intestinal aGVHD. This review summarizes the available pediatric literature on surgical treatment of complications of intestinal GVHD. METHODS: A systematic review was performed using PubMed, Cochrane, Embase, and Scopus databases...
November 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28693839/outcome-of-incisional-hernia-repair-in-patients-with-inflammatory-bowel-disease
#16
Tomas M Heimann, Santosh Swaminathan, Adrian J Greenstein, Alexander J Greenstein, Randolph M Steinhagen
BACKGROUND: Incisional Hernia (IH) repair in patients with Inflammatory Bowel Disease (IBD) has not been well studied. METHODS: Outcomes of 170 patients with IBD who underwent IH repair were included in the study. RESULTS: The incidence of recurrence after IH repair in IBD is 27%. Patients with Crohn's disease (CD) had larger defects at the time of repair, higher proportion of bowel resection and a longer postoperative stay when compared to Ulcerative colitis (UC)...
September 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28684940/management-of-intestinal-failure-the-high-output-enterostomy-and-enterocutaneous-fistula
#17
REVIEW
Franklin Adaba, Carolynne J Vaizey, Janindra Warusavitarne
This article provides an overview of the pathophysiology, causes, investigations, and management of high-output enterostomy and enterocutaneous fistula. High-output stoma and enterocutaneous fistula can result in intestinal failure and this is often fatal if not managed properly. The management involves reducing fluid losses, providing nutrients with fluids, and treating the underlying cause and sepsis. A multidisciplinary approach is required for successful management of patients with high-output enterostomy and enterocutaneous fistula...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28684934/considerations-in-stoma-reversal
#18
REVIEW
Karen L Sherman, Steven D Wexner
Temporary stomas are frequently used in the management of diverticulitis, colorectal cancer, and inflammatory bowel disease. These temporary stomas are used to try to mitigate septic complications from anastomotic leaks and to avoid the need for reoperation. Once acute medical conditions have improved and after the anastomosis has been proven to be healed, stomas can be reversed. Contrast enemas, digital rectal examination, and endoscopic evaluation are used to evaluate the anastomosis prior to reversal. Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28668733/challenging-abdominal-incisional-hernia-repaired-with-platelet-rich-plasma-and-bone-marrow-derived-mesenchymal-stromal-cells-a-case-report
#19
Gian Marco Palini, Lucia Morganti, Filippo Paratore, Federico Coccolini, Giacomo Crescentini, Matteo Nardi, Luigi Veneroni
INTRODUCTION: The necessity to develop new treatment options for challenging procedures in hernia surgery is becoming even more evident and tissue engineering and biological technologies offer even newer strategies to improve fascial healing. The present case reports a patient-tailored surgical technique performed to repair a grade IV abdominal incisional hernia, with a combined use of platelet-rich plasma and bone marrow-derived mesenchymal stromal cells, implanted on a biological mesh...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28637559/complex-abdominal-wall-hernia-repair-in-contaminated-surgical-fields-factors-affecting-the-choice-of-prosthesis
#20
COMPARATIVE STUDY
Manuel López-Cano, María Teresa Quiles, José Antonio Pereira, Manuel Armengol-Carrasco, María Antonia Arbós Vía
To compare patients with complex abdominal wall hernias undergoing surgical repair using synthetic nonabsorbable or biologic meshes in contaminated fields. Retrospective review of 62 patients with complex abdominal wall hernia with surgical repair in an elective setting and in the context of a clean-contaminated or contaminated fields (January 2009-April 2015). Two groups according to the prosthesis (synthetic nonabsorbable, n = 48 or biologic, n = 14). Mean follow-up was 24.6 (15.8) months. Clean-contaminated wounds were significantly more frequent in the synthetic group...
June 1, 2017: American Surgeon
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