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https://www.readbyqxmd.com/read/28328258/value-of-mdct-and-clinical-and-laboratory-data-for-predicting-the-need-for-surgical-intervention-in-suspected-small-bowel-obstruction
#1
Andrew Scrima, Meghan G Lubner, Scott King, Joshua Pankratz, Gregory Kennedy, Perry J Pickhardt
OBJECTIVE: The purpose of this article is to assess the value of a large panel of clinical and MDCT variables in patients with suspected small-bowel obstruction (SBO) for predicting urgent surgical intervention (< 72 hours), bowel ischemia, and bowel resection. MATERIALS AND METHODS: MDCT studies performed at admission for 179 nonconsecutive adults (mean age, 55.8 years; 86 men and 93 women) with suspected SBO were retrospectively reviewed by three board-certified radiologists...
April 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28327195/does-rating-the-operation-videos-with-a-checklist-score-improve-the-effect-of-e-learning-for-bariatric-surgical-training-study-protocol-for-a-randomized-controlled-trial
#2
Javier Rodrigo De La Garza, Karl-Friedrich Kowalewski, Mirco Friedrich, Mona Wanda Schmidt, Thomas Bruckner, Hannes Götz Kenngott, Lars Fischer, Beat-Peter Müller-Stich, Felix Nickel
BACKGROUND: Laparoscopic training has become an important part of surgical education. Laparoscopic Roux-en-Y gastric bypass (RYGB) is the most common bariatric procedure performed. Surgeons must be well trained prior to operating on a patient. Multimodality training is vital for bariatric surgery. E-learning with videos is a standard approach for training. The present study investigates whether scoring the operation videos with performance checklists improves learning effects and transfer to a simulated operation...
March 21, 2017: Trials
https://www.readbyqxmd.com/read/28327177/intestinal-t-lymphocyte-homing-is-associated-with-gastric-emptying-and-epithelial-barrier-function-in-critically-ill-a-prospective-observational-study
#3
Christian Greis, Zohal Rasuly, Rolf A Janosi, Lambros Kordelas, Dietrich W Beelen, Tobias Liebregts
BACKGROUND: Impaired gastric emptying is common in critically ill patients. Intestinal dysmotility, a major cause of feed intolerance, may foster infectious complications due to mucosal barrier disruption. However, little is known about gut-directed immune activation, intestinal barrier function and its association with impaired gastric emptying in critically ill patients at ICU admission. METHODS: We conducted a prospective observational study at two tertiary care medical ICUs...
March 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28325075/acquired-transdiaphragmatic-hernia-an-unusual-cause-of-cardiac-tamponade
#4
Virginie D'Orio, Pierre Demondion, Guillaume Lebreton, Guillaume Coutance, Sheida Varnous, Pascal Leprince
Transdiaphragmatic peritoneopericardial hernia is a rare complication after peritoneopericardial window formation, coronary artery bypass grafting using the gastroepiploic artery, or subxiphoid epicardial pacemaker insertion. We describe two different clinical presentations of transdiaphragmatic peritoneopericardial hernia in patients who had undergone recent heart transplantation. One was an exceptional case of cardiac tamponade caused by small bowel strangulation through a diaphragmatic defect.
March 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28325056/-internal-hernia-as-a-cause-of-small-bowel-obstruction
#5
D Dvořák, Z Adamová, T Bár, R Slováček
Internal hernia is a rare cause of acute small bowel obstruction and may be difficult to diagnose. We would like to use two case reports to demonstrate that laparoscopy is a feasible treatment method for incarcerated internal hernias.Key words: intestinal obstruction - internal hernia - laparoscopy.
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28321329/utility-of-the-wireless-motility-capsule-and-lactulose-breath-testing-in-the-evaluation-of-patients-with-parkinson-s-disease-who-present-with-functional-gastrointestinal-symptoms
#6
Andrew Su, Rita Gandhy, Carrolee Barlow, George Triadafilopoulos
BACKGROUND: The aetiology and origin of gastrointestinal symptoms in Parkinson's disease (PD) remains poorly understood. Gastroparesis, small bowel transit delay and bacterial overgrowth may, individually or collectively, play a role. AIMS: In patients with PD and functional gastrointestinal symptoms, we aimed to determine the utility of the wireless motility capsule and lactulose breath tests in further defining their symptoms' aetiology. METHODS: In this retrospective cohort study, consecutive patients with PD and functional gastrointestinal symptoms underwent clinical assessment, as well as wireless motility capsule and lactulose breath testing using standard protocols...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28321065/small-bowel-obstruction-caused-by-the-ingestion-of-a-wooden-toothpick-the-ct-findings-and-a-literature-review
#7
Junichi Izumi, Kimihiko Satoh, Wataru Iwasaki, Takaya Miura, Shusei Fujimori
We present a case in which the accidental ingestion of a toothpick caused duodenal perforation and small intestinal obstruction. A 58-year-old man visited our emergency room with acute abdominal pain. Computed tomography (CT) showed obstructive ileus as well as a foreign body penetrating the duodenum, which was identified as a toothpick and removed endoscopically. Unenhanced CT was superior in detecting the object. The patient has been doing well since the operation.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28319601/effectiveness-of-double-balloon-enteroscopy-facilitated-polypectomy-in-paediatric-patients-with-peutz-jeghers-syndrome
#8
Dalia Belsha, Arun Urs, Thomas Attard, Mike Thomson
BACKGROUND: Sizable small-bowel (SB) polyps in Peutz-Jeghers syndrome (PJS) pose a high risk for intussusception, often necessitating laparotomy and intraoperative-enteroscopy (IOE). This series examines the effectiveness of double-balloon enteroscopy (DBE) facilitated polypectomy for pediatric patients with PJS. METHODS: Prospective analysis of collected data (6 years) on all patients with PJS referred for DBE-facilitated SB polypectomy at a pediatric tertiary-referral center...
March 17, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28318600/strangulated-small-bowel-obstruction-in-children
#9
Yi-Jung Chang, Dah-Chin Yan, Jin-Yao Lai, Hsun-Chin Chao, Chyi-Liang Chen, Shih-Yen Chen, Ming-Han Tsai
BACKGROUND: Diagnosing intestinal strangulation as a complication of small bowel obstruction (SBO) remains a considerable challenge in children. We evaluated the clinicoradiological parameters for predicting the presence of a strangulated intestine. METHODS: We reviewed the medical records of 69 pediatric patients who underwent operation for acute SBO. Regression analysis was used to identify the parameters for predicting strangulated SBO. RESULTS: Of the 69 patients with SBO, 27 patients had intestinal strangulation and were awarded one point each towards the overall clinical score: intractable continuous abdominal pain, tachycardia, white blood cell count >13,600/mm(3), and abdominal distention...
March 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28318326/optimal-use-of-polyethylene-glycol-for-preparation-of-small-bowel-video-capsule-endoscopy-a-network-meta-analysis
#10
Shan Wu, Yun-Jie Gao, Zhi-Zheng Ge
OBJECTIVE: Standardized strategy of bowel preparation before video capsule endoscopy (VCE) remains controversial. We aimed to assess the ideal dose of PEG based on small bowel visualization quality (SBVQ), diagnostic yield (DY) and complete rate (CR) of VCE using a network meta-analysis (NMA) of randomized controlled trials (RCTs). METHODS: This NMA included RCTs comparing any of the following bowel preparation interventions for VCE: fasting overnight ('Fast'), 1 liter PEG ('PEG 1L'), 2-liter PEG ('PEG 2L'), or 4-liter PEG ('PEG 4L')...
March 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28316782/a-retrospective-study-of-laparoscopic-surgery-for-small-bowel-obstruction
#11
Kensuke Otani, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Keisuke Hata, Tomomichi Kiyomatsu, Toshiaki Tanaka, Takeshi Nishikawa, Koji Yasuda, Kazuhito Sasaki, Koji Murono, Toshiaki Watanabe
BACKGROUND: Open laparotomy is widely accepted as the standard surgical treatment for small bowel obstruction (SBO). However, laparoscopic surgery has recently become a treatment option. There is no consensus on the appropriate settings for the laparoscopic treatment of SBO. The purpose of this study is to evaluate the outcomes of laparoscopic surgery for SBO. PATIENTS AND METHODS: From January 2012 to May 2016, 48 consecutive patients underwent surgical treatment for SBO in our department...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28316066/long-term-results-and-tolerability-of-tandem-peptide-receptor-radionuclide-therapy-with-90-y-177-lu-dotatate-in-neuroendocrine-tumors-with-respect-to-the-primary-location-a-10-year-study
#12
Jolanta Kunikowska, Dariusz Pawlak, Marianna I Bąk, Beata Kos-Kudła, Renata Mikołajczak, Leszek Królicki
INTRODUCTION: The peptide receptor radionuclide therapy (PRRT) with (90)Y and (177)Lu is a form of molecular targeted therapy for inoperable or disseminated neuroendocrine tumors (NET). AIM: The aim of the study was to evaluate clinical results and long-term side effects of tandem (90)Y /(177)Lu-DOTATATE therapy in patients with NET. Additionally, we evaluated clinical results with reference to the primary site. MATERIALS AND METHODS: 59 patients with disseminated NET were included in the study prospectively...
March 18, 2017: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/28315152/bilateral-robotic-transabdominal-adrenalectomy-in-a-patient-with-intestinal-malrotation
#13
Zuliang Feng, Carmen C Solórzano
Bilateral adrenalectomy is the preferred surgical approach for patients with failed treatments for pituitary-based Cushing's syndrome. Intestinal malrotation (IM) is a rare congenital anatomic variant that rarely affects adults. The abnormal abdominal anatomy is concerning to surgeons planning elective procedures in such patients. Here, we describe a bilateral robotic transabdominal adrenalectomy (RTA) in a patient with IM. A 29-year-old female presented with refractory pituitary-based Cushing's syndrome and was found to have IM on preoperative CT scan...
March 17, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28314324/a-single-institutional-analysis-of-systemic-therapy-for-unresectable-or-recurrent-small-bowel-adenocarcinoma
#14
Shunichiro Makino, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Masakazu Ikenaga, Kohei Murata, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori, Tsunekazu Mizushima
BACKGROUND: Small bowel adenocarcinoma (SBA) is rare. For unresectable or recurrent SBA, systemic treatment is the only potentially promising option. PATIENTS AND METHODS: This retrospective study included 13 patients with SBA treated at our Institute. All patients received fluorouracil- or fluoropyrimidine-based regimens. We analyzed associations between the progression-free interval (PFI) and therapeutic regimen (n=17) and patient characteristics. RESULTS: The 5-year overall survival of patients with SBA was 23...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28314199/unusual-ultrasound-appearance-of-small-bowel-intussusception-and-secondary-bowel-obstruction-in-a-child-with-peutz-jeghers-syndrome
#15
Lei Wu, Ramesh S Iyer, George T Drugas, A Luana Stanescu
Small bowel intussusception (SBI) in pediatric patients resolves spontaneously in the majority of cases. Pathologic small bowel intussusception with a lead point is rare in children. Ultrasound (US) is the preferred initial imaging study for the diagnosis of intussusception. We report a case of long-segment SBI and secondary bowel obstruction caused by a large hamartomatous polyp. This case emphasizes unique, atypical ultrasound findings that may be encountered in small bowel intussusception, with correlative radiographic, CT (computed tomography) and intra-operative findings...
March 9, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28303507/laparoscopic-conversion-of-one-anastomosis-gastric-bypass-to-a-standard-roux-en-y-gastric-bypass
#16
Imed Ben Amor, Niccolo Petrucciani, Radwan Kassir, Abdullah Al Munifi, Thierry Piche, Tarek Debs, Jean Gugenheim
INTRODUCTION: One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. METHODS: We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014...
March 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28303455/duodenal-cancer-in-a-young-patient-with-peuts-jeghers-syndrome-harboring-an-entire-deletion-of-the-stk11-gene
#17
Satoshi Teramae, Koichi Okamoto, Kumiko Tanaka, Reika Matsumoto, Shinji Kitamura, Tetsuo Kimura, Masahiro Sogabe, Hiroshi Miyamoto, Naoki Muguruma, Yoshimi Bando, Mitsuo Shimada, Tetsuji Takayama
A 21-year-old woman with Peuts-Jeghers syndrome (PJS) was referred to our hospital for gastrointestinal surveillance. She had been diagnosed as having PJS from a young age based on her family history and the presence of mucocutaneous pigmentation on her lips and oral mucosa. Her mother and brother had PJS harboring an entire deletion of the STK11 gene. She had tetralogy of Fallot, atrial tachycardia, sick sinus syndrome, and mental retardation in her past history. Esophagogastroduodenoscopy identified a protruded lesion with a depressed area that occupied the lumen half-circumferentially in the duodenal second portion and also showed a 10-mm protruded lesion on the anterior wall of the lower gastric body...
March 16, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28303430/management-of-neuroendocrine-tumor-liver-metastases-long-term-outcomes-and-prognostic-factors-from-a-large-prospective-database
#18
Mark Fairweather, Richard Swanson, Jiping Wang, Lauren K Brais, Trevor Dutton, Matthew H Kulke, Thomas E Clancy
BACKGROUND: Liver-directed therapies have been used to treat neuroendocrine liver metastases (NELM) for both symptomatic improvement and tumor growth control. We reviewed our experience with NELM to investigate the outcomes of available treatment modalities and to identify prognostic factors for survival. METHODS: We identified all patients with NELM, who were managed at our institution, from a prospectively collected institutional database. Overall survival (OS) was determined for each treatment modality...
March 16, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28303069/ileo-ileal-knot-a-rare-case-of-acute-strangulated-intestinal-obstruction
#19
Kohei Taniguchi, Ryo Iida, Tomohiko Watanabe, Masahiko Nitta, Masao Tomioka, Kazuhisa Uchiyama, Akira Takasu
Strangulated intestinal obstruction is one of the most common types of acute abdomen and requires urgent surgical treatment. Herein, we report a very rare case of strangulated intestinal obstruction caused by an ileo-ileal knot. An 80-year-old woman was admitted to our hospital with suspicion of strangulation ileus and underwent emergency laparotomy after investigation by exploratory single-port laparoscopy. During surgery, a small bowel gangrene caused by an ileo-ileal knot was found. The gangrenous segment was resected, and primary anastomosis was performed...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28302520/complex-hernias-with-loss-of-domain-in-morbidly-obese-patients-role-of-laparoscopic-sleeve-gastrectomy-in-a-multi-step-approach
#20
Yves Borbély, Jens Zerkowski, Julia Altmeier, Anna Eschenburg, Dino Kröll, Philipp Nett
BACKGROUND: Morbid obesity and its associated co-morbidities are risk factors for the development of abdominal hernias, add complexity to their repair, and increase perioperative risk. Repair of hernias with loss of domain (LoD) is further complicated by risk of abdominal compartment syndrome. A staged concept with an initial weight loss procedure might enable a reposition of the herniated viscera, improve co-morbidities for, and prohibit abdominal compartment syndrome in the subsequent repair...
January 27, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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