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Malignant bowel obstruction

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https://www.readbyqxmd.com/read/28643316/-endoscopic-metallic-stent-followed-by-elective-laparoscopic-surgery-for-malignant-colorectal-obstruction
#1
Qingping Lu, Qilong Lan, Long Chen, Dongbo Xu, Jun Li, Shuangmin Lin, Changrong Que, Jianxun Chen
OBJECTIVE: To investigate the feasibility of endoscopic metallic stent as a bridge to elective laparoscopic surgery in patients with malignant colorectal obstruction. METHODS: Clinical data of 63 patients with obstructive colorectal cancer who underwent endoscopic metallic stent insertion under radiologic monitoring at the Longyan First Hospital between June 2012 and August 2016 were analyzed retrospectively. After complete remission of the obstruction, all the patients received multi-disciplinary team (MDT) evaluation to make the further treatment strategy...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28643306/-laparoscopy-and-endoscopy-cooperative-surgery-for-colorectal-tumors
#2
Pinghong Zhou, Yunshi Zhong, Tao Chen
Laparoscopy and endoscopy cooperative surgery (LECS) for colorectal tumors is not only a minimally invasive treatment, but also a safer therapy. It mainly includes laparoscopy-assisted colonoscopic resection and colonoscopy-assisted laparoscopic surgery. Laparoscopy-assisted colonoscopic procedure can make endoscopic resection more "aggressive". Performers can directly observe to ensure normal intestinal wall, and the intestinal defect can be directly repaired. If suspected malignant tumor can not be removed by colonoscopy, the laparoscopic surgery can be performed...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28624050/impact-of-hospital-volume-on-outcomes-for-laparoscopic-adhesiolysis-for-small-bowel-obstruction
#3
Raymond A Jean, Kathleen M O'Neill, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Volume-to-outcome data have been studied in several complex surgical procedures, demonstrating improved outcomes at higher volume centers. Laparoscopic lysis of adhesions (LLOA) for small bowel obstruction (SBO) may result in better outcomes, but there is no information on the learning curve for this potentially complex case. This study evaluates the effect of institutional procedural volume on length of stay (LOS), outcomes, and costs in LLOA for SBOs. MATERIALS AND METHODS: The Nationwide Inpatient Sample data set between 2000 and 2013 was queried for discharges for a diagnosis of SBO involving LLOA in adult patients...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28595432/challenges-and-successes-in-non-operative-management-of-high-grade-malignant-bowel-obstruction
#4
Sandhya K Mudumbi, Erica V Leonard, Keith M Swetz
Malignant bowel obstruction (MBO) occurs in between 3% and 15% of patients with cancer, and portends a poor mean survival of four weeks for patients who are not able to undergo operative intervention. Surgical interventions may be fraught with complications since these patients typically have compromised nutritional status and progressive metastatic disease burden, with tumor type and degree of aggressiveness affecting outcomes. MBO is a dynamic and difficult process to treat, with adequate pain control being limited by unpredictable enteral absorption and need for prolonged parenteral analgesia (given limited enteral access) with its inherent risks...
March 14, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28580564/-using-the-focus-family-intervention-in-caring-for-a-patient-spouse-dyad-with-advanced-colorectal-cancer
#5
Hsuan-Ju Kuo, Sin-Yuan Jhang, Shiow-Ching Shun
The care-related burdens of the spouses of advanced cancer patients often impact negatively on their physical health, emotional well-being, social functioning, and quality of life. Thus, dyad interventions have been created to meet the demands of advanced cancer patients and their spouses. However, the application of dyadic care in clinical settings is currently rather limited in Taiwan. The present case study involved a patient with advanced colorectal cancer and malignant bowel obstruction whose disease-related demands had eroded the patient's physical, psychological, and spiritual health...
June 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28570883/terminal-ileostomy-and-on-table-enteroscopy-a-case-report-describing-a-novel-approach-for-retrieval-of-foreign-bodies-in-the-difficult-abdomen
#6
Shadi Al-Bahri, Esther Cha, Gregory Burgoyne
INTRODUCTION: With any abdominal surgery in a difficult abdomen, the procedure is filled with potential hazards. In addition to a prolonged operative time, there is a risk of enterotomy or damage to blood vessels and ureters. An irradiated pelvis increases this risk and may cause additional morbidity such as delayed healing. An impacted foreign body can also be a challenging problem to deal with alone but when combined with a difficult abdomen can make the problem impossible. PRESENTATION OF CASE: A 67 year-old male presented with a small bowel obstruction secondary to a foreign body impacted in the distal...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28569279/safety-and-efficacy-of-self-expandable-metal-stents-for-obstructive-proximal-and-distal-large-bowel-cancer
#7
V Mitra, M Hu, D Majumdar, V Krishnan, B Chaudhury, J Hancock, D Dwarakanath
Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction)...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28560024/neuroendocrine-carcinoma-as-a-rare-cause-of-jejunal-intussusception-in-an-adult-management-and-literature-review
#8
Georgios Sahsamanis, Georgios Mitsopoulos, Titos Deverakis, Alexandra Terzoglou, Paschalis Evangelidis, Georgios Dimitrakopoulos
Intussusception of the small bowel is an uncommon condition, with the majority of cases being observed during infancy. A number of points are responsible, with benign and malignant lesions of the small intestine being the most common. Herein, we present the case of a 75-year-old male patient with vague abdominal pain and black stool during defecation, who underwent surgery due to jejunal intussusception. Pathology report demonstrated a neuroendocrine carcinoma as the underlying cause for his condition, with no additional metastases during the initial diagnosis...
May 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28553568/colorectal-cancer-presenting-with-constipation-during-pregnancy
#9
Adriana Jones, Michael R Povlow
Colorectal cancer is a rare occurrence during pregnancy and can present with symptoms that are common during pregnancy such as constipation.This can make the diagnosis of colorectal cancer during pregnancy difficult. Management of colorectal cancer during pregnancy is similar to the treatment of non-pregnant patients, but with fetal safety in mind. This case report describes a 33-year-old female gravida two para one (G2P1) at 29 weeks gestation who presented with a complete bowel obstruction. Colonoscopy, magnetic resonance imaging (MRI) and later resection showed an obstructing malignancy which was then resected through an exploratory laparotomy with left hemicolectomy...
April 25, 2017: Curēus
https://www.readbyqxmd.com/read/28550027/exceptional-response-to-nivolumab-and-stereotactic-body-radiation-therapy-sbrt-in-neuroendocrine-cervical-carcinoma-with-high-tumor-mutational-burden-management-considerations-from-the-center-for-personalized-cancer-therapy-at-uc-san-diego-moores-cancer-center
#10
Andrew Sharabi, Sangwoo Shawn Kim, Shumei Kato, Philip D Sanders, Sandip Pravin Patel, Parag Sanghvi, Elizabeth Weihe, Razelle Kurzrock
Neuroendocrine carcinoma of the cervix is an ultra-rare malignancy with a poor prognosis and limited treatment options. Checkpoint blockade immunotherapy has rapidly developed into an emerging standard of care for several common disease types. Interestingly, in preclinical and retrospective clinical data, radiation therapy has been demonstrated to synergize with checkpoint inhibitors. Here we report a patient with metastatic, chemotherapy-refractory neuroendocrine carcinoma who presented with partial bowel obstruction due to a large tumor burden...
June 2017: Oncologist
https://www.readbyqxmd.com/read/28488730/octreotide-associated-neutropenia
#11
Stacy S Tse, Troy Kish
Drug-induced neutropenia and agranulocytosis are rare adverse events but can be fatal. Neutropenia can be induced by a myriad of drugs from almost every pharmacologic class. Octreotide is a somatostatin analogue that has been used to treat variceal bleeding, acromegaly, and severe diarrhea associated with metastatic tumors, and to reduce symptoms in the setting of malignant bowel obstruction and pseudo-obstruction. The most common adverse effects associated with octreotide include pain at the injection site and gastrointestinal effects such as loose stools, cramping, and nausea; neutropenia is not currently listed as an adverse effect of the drug...
May 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28483604/selective-approach-for-patients-with-advanced-malignancy-and-gastrointestinal-obstruction
#12
Deep Pujara, Yi-Ju Chiang, Janice N Cormier, Eduardo Bruera, Brian Badgwell
BACKGROUND: The purpose of this study was to determine the frequency of tumor-related gastrointestinal obstruction and identify variables associated with functional outcome and survival in patients with advanced malignancy and gastrointestinal obstruction. STUDY DESIGN: We reviewed the medical records of 490 patients with advanced cancer who underwent surgical consultation for gastrointestinal obstruction between January 2000 and May 2014. We used chi-square and logistic regression analyses to identify variables associated with survival and eating at discharge...
May 5, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28458844/long-tract-ileocolic-intussusception-due-to-mucinous-adenocarcinoma-of-the-ileocecal-valve-a-case-report-and-literature-review
#13
E H Gruenberger, M Hassan, I Kratzke
Intussusception in adults lacks specific symptoms and is often diagnosed emergently when they present with obstruction. Though intussusception certainly varies in size and location, the increased likelihood of ischemia or obstruction make large intussusceptions very rare in the literature. A patient admitted to our facility for small bowel obstruction was found to have extensive intussusception from the right lower quadrant to the splenic flexure, where a lead point was identified. Histopathology revealed multiple satellite lesions surrounding the lead point tumor, which was found to be invasive mucinous adenocarcinoma of the ileocecal valve...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28458829/distant-melanoma-causing-small-bowel-obstruction
#14
Justin M Hintze, Donal B O'Connor, Peter Molony, Paul C Neary
Small bowel obstructions (SBOs) are common. Adhesions make up the majority of cases at 84.9%, followed by abdominal herniae and malignancies. A 71-year-old female presented with total constipation, abdominal distension, on a background of resected cutaneous melanoma nine years prior. A CT-scan showed small bowel intussusception and disseminated mucosal-enhancing lesions consistent with metastases. She was brought to the operating theatre where six areas of intussusception were identified and manually reduced...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28456709/a-laparoscopic-approach-is-associated-with-a-decreased-incidence-of-ssi-in-patients-undergoing-palliative-surgery-for-malignant-bowel-obstruction
#15
Yoshiaki Maeda, Toshiki Shinohara, Tomonari Katayama, Nozomi Minagawa, Masao Sunahara, Akihisa Nagatsu, Noriaki Futakawa, Tomonori Hamada
BACKGROUND: Several authors have reported on the utility of a laparoscopic approach for the palliation of malignant bowel obstruction (MBO); however, the advantages of laparoscopic surgery for MBO have not yet been confirmed. METHODS: We retrospectively reviewed the medical records of patients who underwent palliative surgery for MBO between 2007 and 2015. Laparoscopic procedures have been performed when technically possible since 2014. Successful palliation was defined as the ability to tolerate solid food (TSF) for at least 2 weeks...
June 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28451475/an-unusual-cause-of-small-bowel-obstruction-a-case-report
#16
Sundaramurthi Sudharsanan, T P Elamurugan, Chellappa Vijayakumar, Kumar Rajnish, Sadasivan Jagdish
Small bowel obstruction is a common surgical emergency. The common causes are adhesions, malignancies, and hernias. We present a rare case of small intestinal obstruction caused by an enterolith in the distal ileum in a patient with an apparently normal gut.  A 59-year-old male who underwent gastrojejunostomy 15 years back presented with features of intestinal obstruction of five days' duration. After initial conservative management, the patient was taken up for laparotomy. An enterolith causing obstruction was found in the distal ileum, and it was crushed and milked into the colon...
March 26, 2017: Curēus
https://www.readbyqxmd.com/read/28437204/drainage-percutaneous-endoscopic-gastrostomy-for-malignant-bowel-obstruction-in-gastrointestinal-cancers-prognosis-and-implications-for-timing-of-palliative-intervention
#17
Kerry-Ann Pinard, Tabitha N Goring, Barbara C Egan, Douglas J Koo
BACKGROUND: Malignant bowel obstruction (MBO) is a frequent complication in patients with advanced solid tumors. Palliative relief may be achieved by the use of a drainage percutaneous endoscopic gastrostomy (dPEG) tube, although optimal timing of placement remains unknown. OBJECTIVES: To determine median survival after diagnosis of MBO and dPEG placement, factors associated with worse survival in MBO, factors associated with receipt of dPEG, and association of timing of dPEG placement on survival...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28424736/a-case-of-xanthogranulomatous-pyelonephritis-associated-with-renoduodenal-fistula
#18
R Conor Holton-Burke, Mini Varughese
Xanthogranulomatous pyelonephritis (XGP) is a rare form of pyelonephritis associated with repeated infection, chronic inflammation, and obstruction. Various fistulas, including those to the intestine, are a known association with XGP. Here, a 55-year-old woman with a history of multiple previous renal calculi presented with dysuria and back pain. Contrast-enhanced computed tomography (CT) revealed a soft tissue density in her renal pelvis and perirenal space consistent with XGP along with a tract connecting the upper pole of her right kidney to the second portion of the duodenum...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28422909/multi-institutional-prospective-observational-study-comparing-the-gastrografin-challenge-versus-standard-treatment-in-adhesive-small-bowel-obstruction
#19
Martin D Zielinski, Nadeem N Haddad, Daniel C Cullinane, Kenji Inaba, Dante D Yeh, Salina Wydo, David Turay, Andrea Pakula, Therese M Duane, Jill Watras, Kenneth A Widom, John Cull, Carlos J Rodriguez, Eric A Toschlog, Valerie G Sams, Joshua P Hazelton, John Christopher Graybill, Ruby Skinner, Ji-Ming Yune
INTRODUCTION: Existing trials studying the use of Gastrografin for management of adhesive small bowel obstruction (SBO) are limited by methodological flaws and small sample sizes. We compared institutional protocols with and without Gastrografin (GG), hypothesizing that a SBO management protocol utilizing GG is associated with lesser rates of exploration, shorter length of stay, and fewer complications. METHODS: A multi-institutional, prospective, observational study was performed on patients appropriate for GG with adhesive SBO...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28393434/multivisceral-transplantation-for-abdominal-tumors-in-children-a-single-center-experience-and-review-of-the-literature
#20
Eliza Lee, Nicole Hodgkinson, Rima Fawaz, Khashayar Vakili, Heung Bae Kim
Standard management of intra-abdominal pediatric solid tumors requires complete resection. However, tumors with multiple organ and vascular involvement present a unique surgical challenge. We conducted a retrospective chart review of four patients, aged 2-14 years, undergoing MVT for intra-abdominal tumors with significant involvement of the visceral arteries and/or portomesenteric venous system at our institution. Indications for MVT included hepatocellular carcinoma, inflammatory myofibroblastic tumor, and two cases of hepatoblastoma...
April 9, 2017: Pediatric Transplantation
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