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Bowel obstruction

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https://www.readbyqxmd.com/read/28550641/a-fascia-lata-free-flap-in-pelvic-exenteration-for-fournier-gangrene-due-to-advanced-rectal-cancer-a-case-report
#1
Hiroshi Sawayama, Nobutomo Miyanari, Hidetaka Sugihara, Shiro Iwagami, Takao Mizumoto, Tatsuo Kubota, Yoshio Haga, Hideo Baba
BACKGROUND: Fournier gangrene due to advanced rectal cancer is a rapidly progressive gangrene of the perineum and buttocks. Emergency surgical debridement of necrotic tissue is crucial, and secondary surgery to resect tumors is necessary for wound healing. However, pelvic exenteration damages the pelvic floor, increasing the likelihood of herniation of internal organs into the infectious wound. The management of pelvic exenteration for rectal cancer with Fournier gangrene has not yet been established...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28550422/prospective-evaluation-of-transanal-irrigation-for-fecal-incontinence-and-constipation
#2
T Juul, P Christensen
BACKGROUND: The aim of the present study was to evaluate the effect of transanal irrigation on bowel function and quality of life in a prospective cohort of Danish patients with fecal incontinence or constipation. METHODS: Patients with fecal incontinence or constipation of heterogeneous origin were treated by a specialist nurse at the Anal Physiology Clinic/Department of Surgery at Aarhus University Hospital, Aarhus, Denmark. If satisfactory results were not obtained after conservative bowel management, patients were instructed in the use the transanal irrigation procedure and were consecutively recruited for this observational cohort study in the period from March 2010 to September 2013...
May 26, 2017: Techniques in Coloproctology
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
#3
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...
May 26, 2017: Oncologist
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#4
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28548199/-acute-small-bowel-diverticulitis-in-a-patient-with-crohn%C3%A2-s-disease
#5
Macarena Hevia, Rodrigo Quera, Leonardo Soto, Tomás Regueira, Andrés O'Brien, Andrés Larach, Udo Kronberg
Diverticular disease of the small intestine is rare, especially when it is located in the jejunum. It is generally asymptomatic, but in some patients it may have complications such as acute diverticulitis with peritonitis, gastrointestinal bleeding or obstruction. In such cases, the recommended treatment is surgery. We report a 77-year-old patient with ileal Crohn’s disease with a long-standing inflammatory phenotype, who developed acute diverticulitis of the jejunum presenting a severe septic shock and secondary multiple-organ failure...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28547930/orbit-technique-in-malrotation-with-non-obstructive-volvulus-a-novel-technique-of-devolvulation
#6
Sundeep Kisku
INTRODUCTION: Volvulus may be noted in up to two-thirds of cases involving malrotation beyond infancy. Laparoscopic devolvulation has been described as a frustrating procedure because of restricted visualization. Here, a setup and technique that address these concerns are proposed. MATERIALS AND SURGICAL TECHNIQUE: Three boys (median age: 7 years) who had been diagnosed preoperatively with malrotation underwent laparoscopic exploration and devolvulation for volvulus found intraoperatively...
May 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28546717/intussusception-a-rare-complication-after-feeding-jejunostomy-a-case-report
#7
Shreyas Dholaria, Kamal Kishor Lakhera, Sanjeev Patni
Feeding jejunostomy (FJ) is a commonly done surgical procedure for enteral nutrition. Intussusception is one of the rare complications of FJ. Clinical presentation may be similar to other causes of small bowel obstruction. Intussusception should be suspected if a patient with jejunostomy tube develops upper gastrointestinal obstructive symptoms, which are relieved by nasogastric tube drainage. CT or ultrasonography (USG) can help to confirm the diagnosis. It can be relieved spontaneously or sometimes requires laparotomy...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28546100/does-the-timing-of-loop-ileostomy-closure-affect-outcome-a-case-matched-study
#8
Wanglin Li, Gokhan Ozuner
INTRODUCTION: The optimal timing for the closure of loop ileostomies remains controversial. The aim of this study is to determine whether ileostomy closure (<3 months post formation) affects stoma-related morbidity compared to late closure (≥3 months post formation). METHODS: All patients who had loop ileostomy and ileostomy closure between 2012 and 2015 were identified from an IRB-approved, prospectively maintained institutional database.The patients who underwent ileostomy closure (<3 months) were compared against matched patients undergoing ileostomy closure (≥3 months)...
May 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28543087/death-due-to-complications-of-bowel-obstruction-following-raw-poppy-seed-ingestion
#9
Leah M Schuppener, Robert F Corliss
Eating poppy seeds can cause a positive urine drug screen, but it is unknown whether ingesting large quantities can result in opiate intoxication or toxicity. A 54-year-old woman with intractable vomiting was found unresponsive at home and later pronounced dead. At autopsy, a cast-like large bowel obstruction composed of poppy seeds was identified. Postmortem blood morphine level was < 10 ng/mL. Cause of death was determined to be complications of a bowel obstruction secondary to poppy seed ingestion. Deaths related to eating poppy seeds have not been described in the literature...
May 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28540052/a-unique-case-of-massive-gastrointestinal-bleeding
#10
Akihiko Kida, Koichiro Matsuda, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
OBJECTIVES: Lipomas are the second most common benign tumors of the small bowel, and most lipomas are asymptomatic. However, lipomas with diameters of >20 mm tend to be symptomatic, for example, to cause bleeding, obstructive jaundice, abdominal pain, intestinal obstruction, intussusception, and/or perforation. METHODS/RESULTS: We report a case of massive gastrointestinal bleeding from a jejunal lipoma combined with intussusception. A preoperative diagnosis of gastrointestinal bleeding derived from a jejunal lipoma combined with intussusception was made based on double-balloon enteroscopy and contrast-enhanced computed tomography, and partial resection of the small intestine was performed...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28539037/small-bowel-obstruction-caused-by-aloe-vera-bezoars-a-case-report
#11
In Taik Hong, Jae Myung Cha, Hye Jin Ki, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Jung Won Jeoun, Sung Il Choi
Small bowel obstruction is a clinical condition commonly caused by postoperative adhesion, volvulus, intussusceptions, and hernia. Small bowel obstruction due to bezoars is clinically uncommon, accounting for approximately 2-4% of all obstructions. Computed tomography (CT) is a useful method in diagnosing the cause of small bowel obstruction. However, small bowel obstruction caused by bezoars may not be detected by an abdominal CT examination. Herein, we report a rare case of small bowel obstruction by Aloe vera bezoars, which were undetected by an abdominal CT...
May 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28539036/a-case-of-tuberculous-peritonitis-presenting-as-small-bowel-obstruction
#12
Hae Koo Kim, Sung Eun Kim, Moo In Park, Seun Ja Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Yong Jin Nam
The peritoneum is one of the common extrapulmonary sites of tuberculosis infection. Patients with underlying end-stage renal or liver disease are frequently complicated by tuberculous peritonitis; however, the diagnosis of the tuberculous peritonitis is difficult due to its insidious nature, well as its variability in presentation and limitation of available diagnostic tests. Once diagnosed, the preferred treatment is usually antituberculous therapy in uncomplicated cases. However, surgical treatment may also be required for complicated cases, such as small bowel obstruction or perforation...
May 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28537083/an-unusual-variant-of-adenocarcinoma-of-the-left-colon-associated-with-microsatellite-instability-a-case-report
#13
Abrar A Attiya, Hatim Q Almaghraby, Mohamed B Satti
We report a case of colonic adenosquamous carcinoma with MSI-H (microsatellite instability-high) in a 43-year-old male who presented with bowel obstruction due to a circumferential mass involving the descending colon and splenic flexure. Microscopically, it showed poorly differentiated adenocarcinoma with squamous differentiation, tumor infiltrating lymphocytes >3/high-power field, and mild peritumoral lymphocytic response. Immunohistochemistry was equivocal for MLH-1, PMS-2, and MSH-2, with retention of MSH-6 expression...
April 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28536898/impact-of-tissue-adhesives-on-the-prevention-of-anastomotic-leakage-of-colonic-anastomoses-an-in-vivo-study
#14
Konstantinos A Vakalopoulos, Joanna W A M Bosmans, Kevin W Y van Barneveld, Ruben R M Vogels, Geesien S A Boersema, Zhouqiao Wu, Marion J J Gijbels, Johannes Jeekel, Gert-Jan Kleinrensink, Nicole D Bouvy, Johan F Lange
BACKGROUND: Tissue adhesives (TA) may be useful to strengthen colorectal anastomoses, thereby preventing anastomotic leakage (AL). Previous studies have identified cyanoacrylate (CA) TAs as the most promising colonic anastomotic sealants. This study investigates the protective effects of sealing colonic anastomoses with various CAs. MATERIALS AND METHODS: Fifty-five Wistar rats underwent laparotomy and transection of the proximal colon. An anastomosis was created with 4 interrupted sutures followed by either application of Histoacryl Flexible, Omnex, Glubran 2, or no TA seal...
May 23, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28534070/total-abdominal-colectomy-vs-restorative-total-proctocolectomy-as-the-initial-approach-to-medically-refractory-ulcerative-colitis
#15
Jinyu Gu, Luca Stocchi, Jeanie Ashburn, Feza H Remzi
PURPOSE: There is scant data assessing the consequences of staging restorative proctocolectomy for ulcerative colitis. The aim of the study is to compare outcomes of initial vs. staged restorative proctocolectomy. METHODS: Patients completing restorative proctocolectomy, including ileostomy reversal, during 2006-2012 were identified from an IRB-approved database. Demographics, treatment variables, and perioperative outcomes were assessed. RESULTS: Out of 521 patients, 322 (62%) underwent initial total abdominal colectomy before restorative proctectomy...
May 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28530107/leptomeningeal-carcinomatosis-in-a-young-patient-with-obstructive-colorectal-signet-ring-cell-adenocarcinoma
#16
Alejandro Lusilla, Jorge de Tomás
We present the case report of a twenty-five-year-old Moroccan male patient who suffered from leptomeningeal carcinomatosis related to a signet-ring cell carcinoma of the rectum. He presented to the emergency department with abdominal pain, constipation, weight loss and rectal bleeding. The rectal examination showed a rectal tumor and a CT scan revealed a large bowel obstruction due to rectal diffuse thickening. An emergency transverse colostomy was performed, with a rectal biopsy and a cytological sample collection...
May 22, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28527586/gastrointestinal-bowel-obstruction-in-acute-ischemic-stroke-incidence-risk-factors-and-outcomes-in-a-u-s-nationwide-analysis-of-3-998-667-hospitalizations
#17
Kavelin Rumalla, Ashwath S Kumar, Manoj K Mittal
OBJECTIVE: The prognosis from acute ischemic stroke (AIS) is worsened by poststroke medical complications. The incidence, risk factors, and outcomes of gastrointestinal bowel obstruction (GIBO) in AIS are not known. METHODS: We queried the Nationwide Inpatient Sample (2002-2011) to identify all patients with a primary diagnosis of AIS and subsets with and without a secondary diagnosis of GIBO without hernia. Multivariable analysis was utilized to identify risk factors for GIBO in AIS patients and the association between GIBO, in-hospital complications, and outcomes...
May 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28525251/-gallstone-ileus-a-rare-cause-of-acute-bowel-obstruction
#18
T Dossouvi, B N'Timon, K Adabra, E Sorsy, P Meignie
Gallstone ileus is a rare cause of bowel obstruction observed in older persons. The diagnosis is based on computed tomography. Enterolithotomy with or without cholecystectomy and the repair of the fistula is the treatment of choice. The aim of our study is to report two cases of gallstone ileus and to describe the epidemiology, diagnosis and therapy of gallstone ileus.
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28523487/unplanned-reoperation-following-colorectal-surgery-indications-and-operations
#19
Alex D Michaels, Matthew G Mullen, Christopher A Guidry, Elizabeth D Krebs, Florence E Turrentine, Traci L Hedrick, Charles M Friel
AIM: Prior studies have demonstrated a reoperation rate ranging from 5.8 to 7.6% following colorectal surgery. However, the indications for reoperation have not been extensively evaluated. We aimed to describe the indications for reoperation and associated procedures following colorectal resection. METHODS: This is a retrospective cohort study of all patients undergoing colorectal resection at a single institution from 2003 to 2013. For patients who returned to the operating room, the primary indication was categorized into mutually exclusive categories and all procedures performed within 30 days of the initial operation were indexed...
May 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28523367/-a-67-year-old-man-with-epigastric-pain
#20
A Greger, W Hamelmann, M Konermann
A 67-year-old man suffering from epigastric pain showed a phytobezoar in the endoscopy. Therapy with Coca Cola® and enzymes was initiated. The (partial) lysis led to a migration of the bezoar into the ileum, resulting in a small bowel obstruction. After removal of the remaining bezoar via ileotomy a secondary pneumatosis intestinalis occurred. As a rare finding the (phyto-)bezoar should be considered as a differential diagnosis of abdominal pain - especially considering the rising numbers of bariatric surgery, which is a potential risk factor...
May 18, 2017: Der Internist
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