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Fistula first

Guomin Li, Qian Shen, Li Sun, Haimei Liu, Yu An, Hong Xu
Branchio-oto-renal (BOR) syndrome is a rare autosomal dominant disorder characterized by branchial cleft fistulae or cysts, preauricular pits, ear malformations, hearing loss, and renal anomalies. Mutations in the human homologue of the Drosophila eyes absent gene ( EYA1 ) are the most common cause of BOR syndrome. PCR and direct sequencing were used to investigate all of the exons and exon-intron boundaries in the EYA1 gene in a patient with BOR syndrome from China. The patient was a child who displayed clinical features of BOR syndrome...
February 2018: Intractable & Rare Diseases Research
Dian He, Yuan Li, Yunli Yu, Gang Cai, Fu Ouyang, Yuchan Lin, Hongjuan Lu, Lan Chu
Neurofibromatosis type 1 (NF1) is a rare autosomal dominant disorder that primarily affects the skin and the nervous system. This condition is called segmental NF1 (also called neurofibromatosis type V) when clinical features are limited to one area of the body. Segmental NF1 is generally thought to result from somatic mosaicism due to a postzygotic mutation in the NF1 gene, thus a test for NF1 gene abnormalities in peripheral blood is usually negative. Here we report a 31-year-old male presenting with epileptic seizures, who had a history of neurofibromas confirmed by biopsy, but lacked a family history of neurofibromatosis...
March 1, 2018: Clinical Neurology and Neurosurgery
Matthew C Hernandez, Brandon R Bruns, Nadeem Haddad, Margaret Lauerman, David S Morris, Kristen Arnold, Herb A Phelan, David Turay, Jason Murry, John S Oh, Toby Enniss, Matthew M Carrick, Thomas M Scalea, Martin Zielinski
INTRODUCTION: Threatened, perforated, and infarcted bowel is managed with conventional resection and anastomosis (hand sewn (HS) or stapled (ST)). The SHAPES analysis demonstrated equivalence between HS and ST techniques, yet surgeons appeared to prefer (HS) for the critically ill. We hypothesized that HS is more frequent in patients with higher disease severity as measured by the AAST EGS grading system. METHODS: We performed a post hoc analysis of the SHAPES database...
March 12, 2018: Journal of Trauma and Acute Care Surgery
A Phillips, E R Kulendra, R Lam, N J Kulendra, D J Brockman
A 9-month-old domestic short-haired cat presented with stunted growth and chronic gastrointestinal signs. Tachypnoea, a heart murmur and cranial abdominal bruit were detected on physical examination. Echocardiography revealed volume overload in all heart chambers. CT angiography identified an abnormal communication between the hepatic arterial circulation and the portal vein, along with multiple acquired shunts. The abnormal vascular communication was surgically ligated. Echocardiography documented improvement in cardiac parameters following surgery and the cat continues to have no clinical signs 39 months after surgery...
March 14, 2018: Journal of Small Animal Practice
John J Sim, Hui Zhou, Jiaxiao Shi, Sally F Shaw, Shayna L Henry, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Steven J Jacobsen
PURPOSE: The early period after chronic kidney disease (CKD) patients transition to end-stage renal disease (ESRD) represents the highest mortality risk but is variable among different patient populations and clinical circumstances. We compared early mortality outcomes among a diverse CKD population that transitioned to ESRD. METHODS: A retrospective cohort study (1/1/2002 through 12/31/2013) of CKD patients (age ≥ 18 years) who transitioned to peritoneal dialysis (PD), hemodialysis (HD) with arteriovenous fistula/grafts, and HD with catheters was performed...
March 12, 2018: International Urology and Nephrology
Yuki Horita
The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy...
March 1, 2018: Journal of Vascular Access
Leah Leibovitch, Iris Zohar, Ayala Maayan-Mazger, Ram Mazkereth, Tzipora Strauss, Ron Bilik
BACKGROUND: The estimated incidence of esophageal atresia (EA) with or without tracheo-esophageal fistula (TEF) is 1:3500 live births. During childhood these patients have various co-morbidities, but the overall quality of life among adults is similar to that of the general population. OBJECTIVES: To evaluate short- and long-term co-morbidities and quality of life among infants born with EA ± TEF at a large single medical center. METHODS: Medical records of 65 children born over a 21 year period were reviewed for short- and long-term medical data...
March 2018: Israel Medical Association Journal: IMAJ
Ga Jin Han, Suk Kim, Nam Kyung Lee, Chang Won Kim, Hyeong Il Seo, Hyun Sung Kim, Tae Un Kim
Objective: Postpancreatectomy hemorrhage (PPH) is an uncommon but serious complication of Whipple surgery. To evaluate the radiologic features associated with late PPH at the first postoperative follow up CT, before bleeding. Materials and Methods: To evaluate the radiological features associated with late PPH at the first follow-up CT, two radiologists retrospectively reviewed the initial postoperative follow-up CT images of 151 patients, who had undergone Whipple surgery...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
A Srivastava, S K Sureka, S Prabhakaran, H Lal, M S Ansari, R Kapoor
Radiocephalic arteriovenous fistula (RCAVF) is the first choice for native arteriovenous fistula (AVF). Preoperative vessel assessment with ultrasonography (USG) has been reported to enhance the outcome of native AVF, but data regarding its predictive value for functional maturation of RCAVF are scanty. We aimed to determine the role of preoperative duplex USG (DUS) for prediction of functional maturity of radiocephalic fistula in the wrist. The data from 173 patients were analyzed prospectively. The estimated duplex variable included size, patency, and continuity of cephalic vein and size, peak systolic velocity, and wall calcifications in radial artery at the wrist...
January 2018: Indian Journal of Nephrology
Marco Vito Marino, Galyna Shabat, Oleksii Potapov, Gaspare Gulotta, Andrzej L Komorowski
BACKGROUND: Described for the first time in 2003, the robotic pancreatic surgery shows interesting results. The evaluation of post-operative outcomes is necessary once we describe an innovative surgical approach. METHODS: We have performed a retrospective analysis of a prospectively maintained database on robotic pancreatic surgery including malignant and benign indications for surgery. RESULTS: A total of 50 consecutive patients underwent robotic pancreatic surgery (26 pancreatico duodenectomy and 24 distal pancreatectomy) between January 2012 and July 2015 in a single centre...
March 8, 2018: Acta Chirurgica Belgica
Enio Campos Amico, Ítalo Medeiros de Azevedo, Marcos Vinicius de Lira Fernandes, Mariane Albuquerque Reis, Samir Assi João
BACKGROUND: The value of drain amylase on the first postoperative day after pancreatic resections has been described as an efficient predictor of pancreatic fistula. In spite of this, the cut-off point below which the drains can be removed early remains controversial. AIM: Validate the use of the amylase on the 1st postoperative day in the correlation with pancreatic fistula and define the value at which early drain removal is safe. METHOD: Were included patients undergoing Whipple surgery in the period of 2007 to 2016...
March 1, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Arnaud Pasquer, Elise Pelascini, Gilles Poncet, Maud Robert
PURPOSE: Postoperative abdominal pain after Roux en Y gastric bypass associated with gastro esophageal reflux is difficult to manage. A gastro-gastric fistula can be the etiology and besides pain and weight regain, it can also be revealed by a dilatation of the excluded stomach and duodenum. METHODS: We present the case of a 45-year-old woman who had a medical history of revisional RYGB after failure of gastric band. She recently complained of recurrent epigastric abdominal pain and biliary GERD...
March 5, 2018: Obesity Surgery
Alexandros Mallios, Benoit Boura, Alessandro Costanzo, Myriam Combes
BACKGROUND: To present a case of banding failure with vessel wall erosion and pseudo-aneurysm creation caused by the suture. CASE REPORT: A 75-year-old male patient was operated for a high-flow fistula (>2 L/min). This was overall the third time that the patient was operated for the same indication since he started dialysis 5 years ago. Standard banding technique with perioperative flow measurements was used, and three separate Prolene sutures tied over 5 and 4...
March 1, 2018: Journal of Vascular Access
Sushil Mehandru, Attiya Haroon, Avais Masud, Mayurkumar Patel, Elmer Sadiang-Abay, Eric J Costanzo, Tushar J Vachharajani
While an arteriovenous fistula is the best available access, many patients continue to rely on a tunneled hemodialysis catheter for dialysis therapy. Despite the highest risk of catheter-related bacteremia and associated morbidity and mortality, patients often prefer tunneled hemodialysis catheter to avoid pain associated with cannulation of an arteriovenous access. We report three tunneled hemodialysis catheter-dependent end-stage renal disease patients (age: 38, 35, 33 years), who became pregnant. Pregnancy was discovered at 10, 12 and 10 weeks of gestation...
March 1, 2018: Journal of Vascular Access
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
This study reports the clinical complication and infection rates of an active pediatric IT program that has never utilized bowel decontamination in either the donor or the recipient. All patients undergoing IT from 2003 to 2015 at a single pediatric IT center were reviewed. Post-transplant surgical, infectious, and immunosuppressive complications are reported. There were 52 patients who underwent IT during the study period. Among these patients, 4% developed a postoperative abscess, one developed an enteric fistula (2%), and one had an enteric or anastomotic leak (2%)...
March 2, 2018: Pediatric Transplantation
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
Hankun Hao, Jun Hong, Yaping Wang, Jian Wang, Yibing Bei, Luchun Hua
OBJECTIVE: To evaluate the feasibility and the short-term safety of self-pulling and latter transected esophagojejunostomy(SPLT) in totally laparoscopic total gastrectomy (TLTG). METHODS: One hundred patients with gastric cancer received TLTG-SPLT at General Surgery Department of Huashan Hospital (Fudan University) from June 2014 to January 2017(SPLT group). The clinicopathologic characteristics, surgical and postoperative outcomes were collected retrospectively and compared with the conventional group undergoing TLTG plus overlap or functional end-to-end anastomosis from October 2013 to December 2015...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Nan Zhang, Xiangqian Su, Kai Xu
OBJECTIVE: To compare the safety and effectiveness of circular stapler and linear stapler in Billroth II( anastomosis following distal gastrectomy for gastric cancer patients. METHODS: Clinical data of gastric adenocarcinoma patients who received distal gastrectomy with Billroth II( anastomosis at Ward IIII( of Gastrointestinal Cancer Center of Peking University Cancer Hospital from January 2013 to April 2017 were collected retrospectively. EXCLUSION CRITERIA: (1) patients identified as stage IIII( gastric cancer by preoperative clinical and postoperative pathological staging...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Sinan Khadhouri, Dupinderjit Singh Rye, Manish Powari, Ian R Daniels, John S McGrath
Squamous cell carcinoma (SCC) arising from a suprapubic cystostomy tract is a rare complication of long-term suprapubic catheterization (SPC). A 53-year-old man with paraplegia secondary to spina bifida presented with a painful granulomatous lesion around his SPC site that was being treated with silver nitrate cauterization in the community. Consequently, he developed a sacral pressure sore due to reduced mobility from the pain. He also had increasing difficulties with defaecation secondary to his spina bifida...
February 2018: Journal of Surgical Case Reports
Ryo Shirotsuki, Hiroo Uchida, Yujiro Tanaka, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Akinari Hinoki, Kazuo Oshima, Kosuke Chiba, Wataru Sumida, Masahiro Hayakawa, Takahisa Tainaka
BACKGROUND: Postoperative chylothorax after surgery for esophageal atresia/tracheoesophageal fistula (TEF) is a rare but serious complication, especially in neonates. This study aimed to identify the thoracic duct and ligate chylous leakage sites, using thoracoscopic navigation of an indocyanine-green (ICG)-based near-infrared (NIR) fluorescence imaging system. METHODS: From November 2014 to April 2017, thoracoscopic intraoperative ICG-NIR imaging was performed in 10 newborns (11 surgeries) with first TEF operation or with persistent postoperative chylothorax after TEF operation...
February 1, 2018: Journal of Pediatric Surgery
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