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Pneumoperitoneum

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https://www.readbyqxmd.com/read/28736096/pneumoperitoneum-by-inguinal-laceration-after-traffic-accident
#1
Daesung Lim, Soo Hoon Lee, Sang Bong Lee, TaeJin Park
BACKGROUND: The leading cause of surgical pneumoperitoneum is hollow viscus perforation, which accounts for approximately 90% of cases. A nonsurgical etiology may account for up to about 10% of the causes of pneumoperitoneum. However, a pneumoperitoneum often poses significant management dilemmas for surgeons, especially when signs of peritonitis are absent or when the cause is unknown prior to laparotomy. We present the first case of pneumoperitoneum due to inguinal laceration without viscus perforation after a traffic accident...
July 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28734974/the-effects-of-pneumoperitoneum-and-the-steep-trendelenburg-position-on-heart-rate-variability-and-cerebral-oxygenation-during-robotic-sacrocolpopexy
#2
Emad Matanes, Amir Weissman, Aleksandr Rivlin, Roy Lauterbach, Amnon Amit, Zeev Wiener, Lior Lowenstein
STUDY OBJECTIVE: The aim of the current study was to investigate how steep Trendelenburg positioning with pneumoperitoneum modifies brain oxygenation and autonomic nervous system modulation of heart rate variability during robotic sacrocolpopexy. DESIGN: A 5-minute computerized ECG, cerebral O2 saturation (cSO2), systemic O2 saturation (sSO2), heart rate (HR), diastolic blood pressure (BP), systolic BP and end tidal CO2 tension were recorded immediately after anesthesia induction (baseline phase) and after alterations in positioning and in intra-abdominal pressure...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28733748/preoperative-botulinum-toxin-a-enabling-defect-closure-and-laparoscopic-repair-of-complex-ventral-hernia
#3
Omar Rodriguez-Acevedo, Kristen E Elstner, Anita S W Jacombs, John W Read, Rodrigo Tomazini Martins, Fernando Arduini, Michael Wehrhahm, Colette Craft, Peter H Cosman, Anthony N Dardano, Nabeel Ibrahim
INTRODUCTION: Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair. METHODS: This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28730774/laparoscopic-colectomy-for-serosa-positive-colon-cancer-pt4a-in-patients-with-preoperative-diagnosis-of-cancer-without-serosal-invasion
#4
Shenglong Guo, Detao Tang, Xiaojun Chen, Ming Chen, Yaqian Xiang
PURPOSE: Although general surgeons normally perform laparoscopic colectomies in patients with colon cancer, the procedure is also indicated for serosa-negative tumors (≤ cT3). Serosal invasion (T4a) is regarded as a potential risk factor for peritoneal dissemination due to pneumoperitoneum effects and tumor manipulation during laparoscopic colectomy. We compared short- and long-term outcomes of patients who underwent laparoscopic and open colectomies for serosa-involving colon cancer (pT4a) and had a preoperative diagnosis of cancer without serosal invasion (≤cT3)...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28721190/a-case-of-fatal-internal-jugular-vein-perforation-during-nasogastric-tube-insertion
#5
Katherine A Smith, Jeffrey P Fleming, Robert D Bennett, Andrew A Taitano
Nasogastric tube (NGT) insertion is a routine procedure in the management of surgical patients. We report the second case of internal jugular vein perforation during NGT insertion. A 79-year-old man presented with diffuse abdominal pain secondary to a perforated viscus. Abdominal CT revealed pneumoperitoneum, necessitating emergent exploratory laparotomy. On post-operative Day 7, the patient developed mild abdominal distension and subjective nausea for which NGT placement was ordered for decompression. Tube placement was confirmed by insufflation of air without aspiration of gastric contents...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28716779/localised-pneumoperitoneum-following-liver-mass-biopsy-in-the-setting-of-post-ercp-pneumobilia
#6
Fredy Nehme, Imad Nassif
No abstract text is available yet for this article.
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28708771/effect-of-clonidine-on-hemodynamic-responses-during-laparoscopic-cholecystectomy-a-systematic-review-and-meta-analysis
#7
Yi Zhang, Xi Zhang, Yu Wang, Jiefeng Zhang
BACKGROUND: Clonidine might be beneficial to the patients undergoing laparoscopic cholecystectomy. This meta-analysis focused on the influence of clonidine on hemodynamic responses in patients undergoing laparoscopic cholecystectomy. METHODS: We searched several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. This meta-analysis included randomized controlled trials regarding the influence of clonidine versus placebo on laparoscopic cholecystectomy...
July 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28705101/abdominal-wall-expanding-system-obviates-the-need-for-lateral-release-in-giant-incisional-hernia-and-laparostoma
#8
Dietmar Eucker, Andreas Zerz, Daniel C Steinemann
BACKGROUND: In large incisional hernias and after laparostoma midline closure may be impossible. A novel abdominal wall expander system (AWEX) is proposed and evaluated. METHODS: In patients with large incisional hernias and laparostoma where primary midline closure was impossible, AWEX was used. Patients undergoing abdominal wall reconstruction using AWEX between May 2012 and December 2015 were included. Intraoperative the abdominal wall was stretched by attaching the midline fascia borders to a retraction system under tension for 30 minutes...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28702167/clostridium-perfringens-s-necrotizing-acute-pancreatitis-a-case-of-success
#9
Rita Castro, Joana Mendes, Luís Amaral, Rui Quintanilha, Tiago Rama, António Melo
The authors report a case of a 62-year-old man with upper abdominal pain with few hours of onset and vomits. The initial serum amylase was 2306 U/L. The first CT showed signs of a non-complicated acute pancreatitis. He suffered clinical deterioration and for this reason he was admitted on the intensive care unit where he progressed to multiple organ failure in <24 h. A new CT scan was performed that showed pneumoperitoneum and pneumoretroperitoneum. He underwent an exploratory laparotomy and pancreatic necrosectomy and vacuum pack laparostomy were performed...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28697891/delayed-tension-pneumoperitoneum-after-colonoscopy
#10
M Serrano-Dueñas, M J Rodriguez-Muñoz, M Portilla-Botelho
No abstract text is available yet for this article.
July 8, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28697016/a-spontaneous-pneumoperitoneum-following-klebsiella-induced-chronic-granulomatous-cholecystitis-is-the-surgery-warranted
#11
Irada Ibrahim-Zada, Megan A Adams, Trevor Nydam
No abstract text is available yet for this article.
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28685017/traumatic-diaphragmatic-rupture-with-underlying-lung-laceration-and-tension-pneumoperitoneum
#12
Zexi Allan, Calvin Peng, Raaj Chandra
Tension pneumoperitoneum is commonly caused by gastrointestinal perforation and pulmonary causes are extremely rare. We present a case of a 47-year-old male post motor vehicle accident with a suspected left-sided haemopneumothorax on initial chest x-ray. CT of the chest post chest tube insertion showed a left-sided diaphragmatic rupture and an extensive diaphragmatic hernia. While en-route to the operating theatre, the intubated patient developed tension pneumoperitoneum with positive pressure ventilation and required immediate surgical intervention and repair...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28679201/physiological-effects-of-the-open-lung-approach-during-laparoscopic-cholecystectomy-focus-on-driving-pressure
#13
Davide D'Antini, Michela Rauseo, Salvatore Grasso, Lucia Mirabella, Luigi Camporota, Antonella Cotoia, Savino Spadaro, Alberto Fersini, Rocco Petta, Rosaria Menga, Alberto Sciusco, Michele Dambrosio, Gilda Cinnella
BACKGROUND: During laparoscopy, respiratory mechanics and gas exchange are impaired because of pneumoperitoneum and atelectasis formation. We applied an open lung approach (OLA) consisting in lung recruitment followed by a decremental positive-end expiratory pressure (PEEP) trial to identify the level of PEEP corresponding to the highest compliance of the respiratory system (best PEEP). Our hypothesis was that this approach would improve both lung mechanics and oxygenation without hemodynamic impairment...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28677420/a-prospective-observational-trial-assessing-the-efficacy-of-abdominal-compression-in-reducing-laparoscopic-induced-shoulder-pain
#14
Mark A Rettenmaier, John P Micha, Katrina L Lopez, Amber M Wilcox, Bram H Goldstein
INTRODUCTION: Postoperative shoulder pain is a condition associated with laparoscopic surgery and presumably attributed to residual carbon dioxide (CO2) in the abdomen. The intent of the current prospective, observational study was to assess the efficacy of abdominal compression in mitigating this painful complication. METHODS: We recruited 30 patients who were treated with laparoscopic surgery for the management of gynecologic disease. All study participants underwent abdominal compression to evacuate the CO2 associated with their pneumoperitoneum...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28674919/creating-diagnostic-criteria-for-perforated-appendicitis-using-cross-sectional-imaging
#15
Joseph T Church, Megan A Coughlin, Alexis G Antunez, Ethan A Smith, Steven W Bruch
INTRODUCTION: Preoperative determination of perforated versus acute appendicitis can be difficult. We compared CT and MRI performance in diagnosing perforated appendicitis, and created diagnostic criteria. METHODS: We retrospectively reviewed all pediatric patients who underwent appendectomy within one day of CT or MRI between 1/1/2013 and 1/16/2016. True diagnosis was determined by pathology report. Findings on CT/MRI were grouped into "hard" findings (abscess, pneumoperitoneum, extruded fecalith, appendiceal wall with visible hole) and "soft" findings (extensive/diffuse inflammation/free fluid, phlegmon)...
July 3, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28674585/-a-rare-case-of-spontaneous-massive-pneumoperitoneum
#16
Mohamed Essarghini, Mohamed Tarchouli, Mohamed Elfahssi, Abdelmounim Aitali, Ahmed Bounaim
Spontaneous pneumoperitoneum is a rare disorder characterized by the presence of free air in the peritoneal cavity, in the absence of any obvious cause. We here report the case of a patient with massive pneumoperitoneum, detected by scan, in whom clinical, biological, radiological and laparoscopic examinations showed no detectable etiology. This case study describes a clinical entity rarely seen in our practice constituting a real diagnostic trap; accurate knowledge about the disease would avoid unnecessary and especially aggressive laparotomies revealing no signs of perforation...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28669704/low-pressure-robot-assisted-radical-prostatectomy-with-the-airseal-system-at-olv-hospital-results-from-a-prospective-study
#17
Sabrina La Falce, Giacomo Novara, Giorgio Gandaglia, Paolo Umari, Geert De Naeyer, Frederiek D'Hondt, Jean Beresian, Rik Carette, Martin Penicka, Yujiing Mo, Geert Vandenbroucke, Alexandre Mottrie
BACKGROUND: Limited studies examined effects of pneumoperiotneum during robot-assisted radical prostatectomy (RARP) and with AirSeal. The aim of this study was to assess the effect on hemodynamics of a lower pressure pneumoperitoneum (8 mmHg) with AirSeal, during RARP in steep Trendelenburg 45° (ST). MATERIALS AND METHODS: This is an institutional review board-approved, prospective, interventional, single-center study including patients treated with RARP at OLV Hospital by one extremely experienced surgeon (July 2015-February 2016)...
June 2, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28669373/on-scene-rescue-breathing-resulting-in-gastric-perforation-and-massive-pneumoperitoneum
#18
Mike Butterfield, Tamas Peredy
Rescue breathing performed too vigorously or by untrained individuals may cause gastric distension and perforation. A 26-year-old woman is presented who developed acute abdominal pain and distension after receiving rescue breathing following a heroin overdose. Massive pneumoperitoneum was seen on chest x-ray, and on subsequent laparotomy, a 4cm laceration was found in the lesser curvature of the stomach. Review of the literature suggests that the lesser curvature is particularly susceptible to perforation following over-distension...
July 3, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28665139/intraoperative-retrograde-perfusion-sphinterometry-to-evaluate-efficacy-of-autologous-6-branch-suburethral-sling-to-properly-restore-sphincteric-apparatus-during-robotic-assisted-radical-prostatectomy
#19
Andrea Cestari, Davide Soranna, Giuseppe Zanni, Antonella Zambon, Matteo Zanoni, Mattia Sangalli, Massimo Ghezzi, Fabio Fabbri, Francesco Sozzi, Vincenzo Dell'Acqua, Patrizio Rigatti
OBJECTIVES: To describe urodynamically the effect of the use of 6-branch autologous suburethral sling, made with absorbable sutures and vas deferens, to support bladder neck and urethra during Robotic Assisted Radical Prostatectomy (RALP), to improve early urinary continence recovery. Materials &Methods: Retrograde leak point pressure (RLPP) was intraoperatively evaluated, by means of retrograde perfusion sphinterometry (RPS), in 77 patients (mean age ± SD: 65.64±7.23 years, mean BMI ± SD 26...
June 30, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28664347/antibiotic-treatment-for-uncomplicated-and-mild-complicated-diverticulitis-outpatient-treatment-for-everyone
#20
Gaëtan-Romain Joliat, Jonathan Emery, Nicolas Demartines, Martin Hübner, Bertrand Yersin, Dieter Hahnloser
PURPOSE: Antibiotic treatment is the treatment of choice for uncomplicated diverticulitis (uD) and can be performed for mild complicated diverticulitis (mcD). In several cases, outpatient treatment (OT) can be undertaken. This study assessed the 1-month failure rate of OT for uD/mcD compared to inpatient treatment (IT), and identified predictive factors for treatment failure. METHODS: All consecutive patients (2006-2012) diagnosed with uD/mcD by CT scan were retrospectively analyzed...
June 29, 2017: International Journal of Colorectal Disease
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