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https://www.readbyqxmd.com/read/29340917/biliary-bypass-with-laparoscopic-choledochoduodenostomy
#1
Joshua K Kays, Leonidas G Koniaris, Daniel P Milgrom, Attila Nakeeb
Laparoscopic choledochoduodenostomy (LCDD) is employed to treat many benign biliary diseases when endoscopic or percutaneous techniques are not feasible. We describe our technique for LCDD, which utilizes common bile duct transection and an end-to-side biliary-enteric anastomosis. This procedure includes the following elements: isolation and transection of the common bile duct, mobilization of the duodenum (Kocher maneuver), inspection of the common bile duct, and end-to-side biliary-enteric anastomosis. Key details and pitfalls are discussed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29334903/a-rare-case-of-pericarditis-and-pleural-empyema-secondary-to-transdiaphragmatic-extension-of-pyogenic-liver-abscess
#2
Eunae Cho, Sang Woo Park, Chung Hwan Jun, Sang Soo Shin, Eun Kyu Park, Kyo Seon Lee, Seon Young Park, Chang Hwan Park, Hyun Soo Kim, Sung Kyu Choi, Jong Sun Rew
BACKGROUND: Transdiaphragmatic extension of pyogenic liver abscess is the rarest cause of pericarditis and pleural empyema. It is a rapidly progressive and highly lethal infection with mortality rates reaching 100% if left untreated. However, the transmission route, treatment methods and prognosis have not been well studied. CASE PRESENTATION: A 65-year-old male patient presented with a fever, dyspnea, and right upper quadrant abdominal pain. Computed tomography of the chest and abdomen showed huge liver abscess without full liquefaction in the left lobe, large amount of left pleural effusion, and mild pericardial effusion, and the patient was treated with parenteral antibiotics and pigtail insertion at the left pleura...
January 15, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29327310/c-reactive-protein-on-postoperative-day-1-is-a-reliable-predictor-of-pancreas-specific-complications-after-pancreaticoduodenectomy
#3
Théophile Guilbaud, David Jérémie Birnbaum, Coralie Lemoine, Mircea Chirica, Olivier Risse, Stéphane Berdah, Edouard Girard, Vincent Moutardier
BACKGROUND: Postoperative pancreatic fistula and pancreas-specific complications have a significant influence on patient management and outcomes after pancreatoduodenectomy. The aim of the study was to assess the value of serum C-reactive protein on the postoperative day 1 as early predictor of pancreatic fistula and pancreas-specific complications. METHODS: Between 2013 and 2016, 110 patients underwent pancreaticoduodenectomy. Clinical, biological, intraoperative, and pathological characteristics were prospectively recorded...
January 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29324374/ileal-gist-presenting-with-bacteremia-and-liver-abscess-a-case-report-and-review-of-literature
#4
Marina Gorelik, Braulio Sabates, Adel Elkbuli, Tony Dunne
INTRODUCTION: Small intestine gastrointestinal stromal tumors can infrequently present with intra-abdominal abscess, perforation, obstruction or fistula. Tumor-small intestine fistula is a rare phenomenon and occurs as a result of GISTs' propensity to cause mucosal ulceration. This allows bacteria from the gut to gain access to the systemic circulation and predisposes the patient to bacteremia and pyogenic liver abscess. PRESENTATION OF CASE: We present a case of a 63-year-old female whose initial symptoms included fever, nausea, vomiting and right upper quadrant pain...
December 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29322641/case-of-laparoscopic-right-hemicolectomy-for-ascending-colon-cancer-after-aortic-graft-replacement-and-revascularization-of-the-superior-mesenteric-artery
#5
Kiyotaka Hagihara, Hidekazu Takahashi, Norikatsu Miyoshi, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori
A 67-year-old man who presented with a bloody stool was diagnosed with ascending colon cancer. He had previously experienced thoracic and abdominal aortic dissections, which were treated with thoracic and abdominal aortic grafts and superior mesenteric artery revascularization. We performed a laparoscopic right hemicolectomy with a D3 lymph node dissection. During the laparotomy, we identified the superior mesenteric artery and an enlarged anterior superior pancreaticoduodenal artery. Injury to the latter artery could lead to severe ischemia in multiple organs; therefore, it was crucial to identify the primary feeding artery and vascular anatomy before and during surgery...
January 11, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29317845/pyomyositis-in-the-setting-of-complicated-diverticulitis-case-report
#6
James Sun, David Leor Kashan, Jolita Marie Auguste, Akella Chendrasekhar
Pyomyositis is typically thought of as a disease of the tropics. However, it is becoming more prevalent in temperate regions, and may be underdiagnosed. Here, pyomyositis is encountered as a complication of perforated diverticulitis, which has not been previously reported. A 61-year-old Caucasian man initially presented in respiratory distress and was diagnosed with respiratory failure due to COPD exacerbation. The patient was taking high-dose prednisone, 60 mg daily for the past 2 years. Initially, he was afebrile, normotensive, tachycardic to 178 beats/minute and tachypneic to 28 breaths/minute, requiring noninvasive ventilation to maintain oxygenation...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29316041/bilateral-tubo-ovarian-abscesses-presenting-with-huge-pelvic-mass-after-repeated-intrauterine-inseminations-in-a-woman-with-severe-endometriosis
#7
Patsama Vichinsartvichai
A 32-year-old woman consulted for an evaluation of pelvic pain following intrauterine insemination (IUI). Vaginal and abdominal sonography, septic workup were performed and laparoscopic surgery was scheduled after failure to respond to a course of antibiotics. During laparoscopic surgery, bilateral tubo-ovarian abscesses arising on the endometriotic cysts of both ovaries were identified with a vast amount of brownish peritoneal fluid under the adhesion of the greater omentum. Bilateral ovarian cystectomy, right salpingectomy and lysis adhesion were performed...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29313584/an-interesting-case-of-recurrent-pyelonephritis
#8
Achintya Dinesh Singh, Siddharth Jain, Agrima Mian, Surabhi Vyas, Neeraj Nischal, Pankaj Jorwal
A 35-year-old male presented with repeated episodes of fever and abdominal pain of 3-month duration. He had been hospitalized twice with similar complaints in the past 3-month. He was diagnosed as pyelonephritis and managed with intravenous antibiotics. However, fever recurred after ten days of discharge from the hospital. With these complaints, he was referred to the Department of Medicine, AIIMS, New Delhi. After evaluation, he was diagnosed as pyelonephritis with right sided consolidation and was started on broad spectrum antibiotics...
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29298133/epidemiology-and-risk-factors-for-isolation-of-multi-drug-resistant-organisms-in-patients-with-complicated-intra-abdominal-infections
#9
Francesco M Labricciosa, Massimo Sartelli, Lilian M Abbo, Pamela Barbadoro, Luca Ansaloni, Federico Coccolini, Fausto Catena
BACKGROUND: Patients with complicated intra-abdominal infections (cIAIs) caused by multi-drug-resistant organisms (MDROs) have been identified as being at increased risk for adverse outcomes. Prompt identification and stratification of these patients is essential in the clinical management, allowing the physician timely optimization of empiric antimicrobial therapy while awaiting results of intra-operative cultures to streamline antibiotic treatment. METHODS: The study is a secondary analysis from two prospective multi-center color surveillance studies...
January 3, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29290506/thigh-emphysema-as-the-initial-presentation-of-colon-ischemia
#10
Chin-Chuan Hsu, Ping-Yuan Chen, Chih-Cheng Lai
The incidence of colon ischemia has increased in recent years, and is associated with high morbidity and mortality. The typical presentations of colon ischemia include abdominal pain, bloody diarrhea, and in severe case, ileus, fever and peritonitis. Here, we document a rare case of colon ischemia presenting with subcutaneous and intramuscular emphysema of the thigh. A 76-year-old woman presented to the emergency department for left thigh pain for three days. Physical examination revealed tenderness without obvious crepitus, erythema or swelling over the left groin area and a soft abdomen without tenderness...
December 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29286017/a-case-of-invasive-infection-caused-by-a-highly-virulent-strain-of-klebsiella-pneumoniae-displaying-hypermucoviscosity-in-a-patient-with-hepatic-involvement-without-liver-abscess
#11
Margherita Scapaticci, Marta Biscaro, Francesco Burelli, Lucio Cadamuro, Renzo Biscaro, Andrea Bartolini
Klebsiella pneumoniae is an opportunistic nosocomial pathogen belonging to the Enterobacteriaceae family that is associated with a wide range of infections. In the 1980s a new hypervirulent (hypermucoviscous) variant of Klebsiella pneumoniae (hvKP) emerged in southeast Asia and is now increasingly spreading to Western countries due to an invasive syndrome. hvKP isolates can cause serious, life-threatening community-acquired infections in younger healthy hosts, including liver abscess, pneumonia, meningitis and endophthalmitis...
December 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/29285682/efficacy-of-autologous-fat-graft-injection-in-the-treatment-of-anovaginal-fistulas
#12
S Norderval, L Lundby, H Hougaard, S Buntzen, S Weum, L de Weerd
BACKGROUND: Injection of autologous fat is an established method within plastic surgery for soft tissue augmentation. The aim of the present study was to determine whether transperineal fat graft injection could promote healing of anovaginal fistulas. METHODS: The procedures were performed at the University Hospital of North Norway, Tromsø, Norway, and at Aarhus University Hospital, Aarhus, Denmark, between May 2009 and September 2016. After abdominal liposuction, fat was injected around the fistula tract that was finally transected percutaneously with a sharp cannula and fat injected between the cut parts...
December 28, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29280125/-pediatric-colonoscopy-in-south-china-a-single-center-experience-from-229-cases
#13
Jinhua Chen, Huichuan Yu, Weijie Zhong, Honglei Chen, Xianhe Kong, Jiachen Sun, Xiaolin Wang, Chujun Li
OBJECTIVE: To investigate the safety, feasibility, clinical value, indication, and distribution of diagnostic diseases in different age groups of colonoscopy in pediatric patients. METHODS: A retrospective analysis was performed on the data of pediatric patients receiving colonoscopy from April 2013 to June 2016 at The Sixth Affiliated Hospital of Sun Yat-sen University. Pediatric patients were divided into 0-6 years group (n=57) and 7-14 years group (n=172). Indication for colonoscopy, detective events and diagnostic diseases distribution were compared between two groups...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29278611/utility-of-point-of-care-ultrasound-in-children-with-pulmonary-tuberculosis
#14
Sabine Bélard, Charlotte C Heuvelings, Ebrahim Banderker, Lindy Bateman, Tom Heller, Savvas Andronikou, Lesley Workman, Martin P Grobusch, Heather J Zar
BACKGROUND: Point-of-care ultrasound (POCUS) detects extra-pulmonary tuberculosis (EPTB) in HIV-infected adults but has not been evaluated in children despite their higher risk of EPTB. This study's aims were to investigate feasibility of POCUS for EPTB in children, frequency of POCUS findings suggestive of EPTB, and time to sonographic resolution of findings with treatment. METHODS: This prospective South African cohort study enrolled children with suspected PTB...
December 22, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29260135/laparoscopic-surgery-in-distal-pancreatic-tumors
#15
Fatma Ümit Malya, Hüseyin Kazım Bektaşoğlu, Mustafa Hasbahçeci, Yunus Taşçı, Enver Kunduz, Oğuzhan Karatepe, Kemal Dolay
Objective: Laparoscopic distal pancreatectomy is increasingly being used in the surgical treatment of corpus and distal pancreatic tumors. In this study, patients who underwent laparoscopic or open distal pancreatectomy for benign or malignant causes were evaluated in terms of tumor characteristics and perioperative outcomes. Material and Methods: We retrospectively reviewed data from a total of 27 distal pancreatectomy cases performed for benign or malignant causes in the General Surgery Department between January 2013 and December 2015...
2017: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29259630/abdominopelvic-tuberculosis-secondary-to-a-nontuberculous-mycobacterium-in-an-immunocompetent-patient
#16
Beng Kwang Ng, Kembang Aziah Yakob, Wendy Yin Ling Ng, Pei Shan Lim, Rahana Abd Rahman, Abdul Kadir Abdul Karim, Ani Amelia Zainuddin, Zaleha Abdullah Mahdy
Tuberculosis (TB) remained as one of the top 10 causes of death worldwide despite an overall decline in its incidence rate globally. Extrapulmonary TB is uncommon and only accounts for 10-20% of overall TB disease burden. Abdominopelvic TB is the sixth most common location of extrapulmonary TB. The symptoms and signs are often insidious and nonspecific. Diagnosing abdominopelvic TB can be very challenging at times and poses great difficulties to the clinician. Infection with nontuberculous Mycobacterium (NTM) is even rarer especially in an immunocompetent patient...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29249641/a-case-of-liver-abscess-co-infected-with-desulfovibrio-desulfuricans-and-escherichia-coli-and-review-of-the-literature
#17
Tomoo Yamazaki, Satoru Joshita, Eriko Kasuga, Kazuki Horiuchi, Ayumi Sugiura, Naoyuki Fujimori, Michiharu Komatsu, Takeji Umemura, Akihiro Matsumoto, Eiji Tanaka
A 73-year-old woman was admitted with consciousness disturbance following a fever. Abdominal computed tomography revealed a large liver abscess with which the presence of Desulfovibrio desulfuricans and Escherichia coli was confirmed by thorough blood and abscess content culture. Empiric meropenem treatment was switched to cefoperazone/sulbactam, followed by ampicillin/sulbactam based on susceptibility testing. Desulfovibrio desulfuricans is a common bacterium that rarely causes liver abscess and may be overlooked during co-infection due to overgrowth of the accompanying bacteria...
December 14, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29248126/management-of-the-infected-aortic-endograft
#18
REVIEW
Kamphol Laohapensang, Supapong Arworn, Saranat Orrapin, Termpong Reanpang, Saritphat Orrapin
Although the incidence of abdominal and thoracic aortic endograft infection is infrequent, ranging between 0.2% and 5%, stent-graft infection carries significant morbidity and mortality and exemplifies a formidable therapeutic challenge. The treatment goal is to eradicate the infectious process by endograft explantation, regional tissue debridement, and arterial reconstruction by either an extra-anatomic or in situ grafting procedure using autologous vein, cryopreserved allograft, or antibiotic-soaked prosthetic grafts...
June 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29247068/randomised-trial-and-open-label-extension-study-of-an-anti-interleukin-6-antibody-in-crohn-s-disease-andante-i-and-ii
#19
Silvio Danese, Séverine Vermeire, Paul Hellstern, Remo Panaccione, Gerhard Rogler, Gerald Fraser, Anna Kohn, Pierre Desreumaux, Rupert W Leong, Gail M Comer, Fabio Cataldi, Anindita Banerjee, Mary K Maguire, Cheryl Li, Natalie Rath, Jean Beebe, Stefan Schreiber
OBJECTIVE: Neutralising pro-inflammatory interleukin-6 (IL-6) may effectively treat Crohn's disease (CD). Effects of PF-04236921, an anti-IL-6 antibody, in adults with CD are reported. DESIGN: Parallel-group, dose-ranging, double-blind trial with 4-week screening and 12-week treatment periods. After induction, patients entered 28-week follow-up or 48-week open-label extension (OLE) with 28-week follow-up. Adults with confirmed CD and inadequate response to anti-tumour necrosis factor (TNF) therapy were included...
December 15, 2017: Gut
https://www.readbyqxmd.com/read/29233628/xanthogranulomatous-pyelonephritis-in-a-paediatric-cohort-1963-2016-outcomes-from-a-large-single-center-series
#20
I Stoica, F O'Kelly, M B McDermott, F M J Quinn
BACKGROUND: Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic destructive granulomatous inflammation of the kidney. It was first described in 1916, and is thought to affect 6/1000 cases of pyelonephritis. Its manifestations are varied, and with a limited number of cases in the literature, the optimal diagnosis and management of XGP in the paediatric cohort is still unknown. MATERIAL AND METHODS: The medical records of children who were diagnosed and treated for XGP at the current unit during the period 1963-2016, inclusive, were retrospectively reviewed...
November 24, 2017: Journal of Pediatric Urology
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