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https://www.readbyqxmd.com/read/28814969/the-role-of-open-abdomen-in-non-trauma-patient-wses-consensus-paper
#1
REVIEW
Federico Coccolini, Giulia Montori, Marco Ceresoli, Fausto Catena, Ernest E Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M Abu-Zidan, Massimo Sartelli, Marc De Moya, George Velmahos, Gustavo Pereira Fraga, Bruno M Pereira, Ari Leppaniemi, Marja A Boermeester, Andrew W Kirkpatrick, Ron Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Ignacio Martin-Loeches, Michael Sugrue, Salomone Di Saverio, Ewen Griffiths, Kjetil Soreide, John E Mazuski, Addison K May, Philippe Montravers, Rita Maria Melotti, Michele Pisano, Francesco Salvetti, Gianmariano Marchesi, Tino M Valetti, Thomas Scalea, Osvaldo Chiara, Jeffry L Kashuk, Luca Ansaloni
The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28814938/superior-mesenteric-artery-syndrome-in-association-with-abdominal-tuberculosis-an-eye-opener
#2
Shuchi Bhatt, Biswajit Mishra, Anupama Tandon, Smita Manchanda, G Parthsarathy
Superior Mesenteric Artery Syndrome (SMAS) is a rare clinical entity presenting as acute or chronic upper gastrointestinal obstruction. It occurs due to compression of third part of duodenum between abdominal aorta and overlying superior mesenteric artery caused by a decrease in angle between the two vessels. Rapid loss of retroperitoneal fat, in conditions leading to severe weight loss is the main factor responsible for this disorder. Superior mesenteric artery syndrome in association with abdominal tuberculosis has not been reported earlier to the best of our knowledge...
May 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28806285/peritoneal-cavity-lavage-reduces-the-presence-of-mitochondrial-damage-associated-molecular-patterns-in-open-abdomen-patients
#3
Patricia Angellice Martinez-Quinones, Cameron Grant McCarthy, Caleb J Mentzer, Camilla Ferreira Wenceslau, Steven Barry Holsten, R Clinton Webb, Keith O'Malley
BACKGROUND: Mitochondrial damage-associated molecular patterns (mtDAMPs), such as mitochondrial DNA and N-formylated peptides, are endogenous molecules released from tissue after traumatic injury. mtDAMPs are potent activators of the innate immune system. They have similarities with bacteria, which allow mtDAMPs to interact with the same pattern recognition receptors and mediate the development of Systemic Inflammatory Response Syndrome (SIRS). Current recommendations for management of an open abdomen include returning to the operating room every 48 hours for peritoneal cavity lavage until definitive procedure...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28802164/agenesis-of-gall-bladder-in-laparoscopic-cholecystectomy-a-case-report
#4
Samer Makki Mohamed Al-Hakkak
INTRODUCTION: Agenesis of gallbladder is a rare congenital anomaly of biliary tree that may be associated with other biliary and extra biliary congenital anomalies. CASE PRESENTATION: A 43- year- old female presented with a 4 months history of upper abdominal pain associated with nausea and vomiting. It was associated with dyspeptic symptoms and become worse following ingestion of high-fat meal contents. Clinically, a differential of gall stone disease was considered...
August 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28799635/utility-of-anteroposterior-diameter-ratio-of-tumor-and-abdomen-for-laparoscopic-approach-for-radical-nephrectomy-in-large-renal-masses
#5
Priyank Yadav, Devarshi Srivastava, Sachin Arakere, Shashikant Gupta, Pallavi Aga, Anil Mandhani
INTRODUCTION: Laparoscopic radical nephrectomy (LRN) is now increasingly done for tumors larger than 10 cm. Despite selection of favorable cases, LRN may not be successful due to lack of adequate working space with large tumors. We describe a new feature on Contrast Enhanced Computed Tomography (CECT) abdomen to predict feasibility of LRN for large renal masses between 10 and 15 cm. METHODS: From January 2005 to December 2015, renal tumors between 10 and 15 cm were selected retrospectively for LRN...
August 7, 2017: Urologia
https://www.readbyqxmd.com/read/28782748/ileostomy-site-approach-for-adhesiolysis-and-laparoscopic-cholecystectomy-in-a-hostile-abdomen-a-novel-technique
#6
Deeplaxmi Purushottam Borle, Nikhil Agrawal, Asit Arora, Senthil Kumar, Tushar Kanti Chattopadhyay
INTRODUCTION: Gallstones are an etiological factor in 23%-54% of patients with acute pancreatitis. A small proportion of these patients will also have intestinal complications requiring necrosectomy with diverting loop ileostomy. Later, these patients require cholecystectomy and ileostomy reversal. Laparoscopic cholecystectomy is fraught with difficulty in these patients due to dense intra-abdominal adhesions, and many surgeons resort to an open approach. We describe a technique which takes advantage of the ileostomy site for initial access...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28780148/intra-abdominal-hypertension-abdominal-compartment-syndrome-and-the-open-abdomen
#7
REVIEW
William Kirke Rogers, Luis Garcia
Abdominal Compartment Syndrome (ACS) is the endpoint of a process whereby massive interstitial swelling in the abdomen or rapid development of a space-filling lesion within the abdomen (such as ascites or a hematoma) leads to a pathologically increased pressure. This results in so-called Intra-Abdominal Hypertension (IAH), causing decreased perfusion of the kidneys and abdominal viscera and possible difficulties with ventilation and maintenance of cardiac output. These effects contribute to a cascade of ischemia and multiple organ dysfunction with high mortality...
August 2, 2017: Chest
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#8
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28764244/a-rare-case-of-intestinal-malrotation-and-volvulus-of-jejunum-with-coexisting-carcinoid-tumour-of-appendix
#9
Priyanka Tiwari, Darshan Patel, Vimal Dhaduk, Prasanna Kumar Reddy, Jainudeen Khalander Abdul Jameel
Malrotation of the midgut is generally regarded as a paediatric pathology. It is rare in adults. Patients may present with symptoms of acute bowel obstruction or chronic abdominal pain. Barium study, Contrast Enhanced Computed Tomography (CECT), Magnetic Resonance Imaging (MRI), diagnostic laparoscopy and sometimes explorative laparotomy are used for diagnosis. Ladd's procedure through the open approach has been the treatment of choice for complete malrotation of midgut, however there are reports on successful outcome for both complete and incomplete malrotation after laparoscopic approach as well...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28758036/successful-endoscopic-treatment-of-bouveret-syndrome-in-a-patient-with-choledochoduodenal-fistula-complicating-duodenal-ulcer
#10
Syed Hasan, Zubair Khan, Umar Darr, Toseef Javaid, Nauman Siddiqui, Jamal Saleh, Abdallah Kobeissy, Ali Nawras
INTRODUCTION: Cholecystoduodenal fistulas represent the most common type of bilioenteric fistulas while choledochoduodenal fistulas account for only 1-25% of cases. Bilioenteric fistula cases are associated with cholelithiasis and are rarely associated with duodenal peptic ulcers. Here we present the first case of Bouveret syndrome secondary to choledochoduodenal fistula complicating peptic duodenal ulcer managed successfully via endoscopic mechanical lithotripsy. CASE: 86-year-old male with a medical history significant for coronary artery disease and stage 3 colorectal cancer status after resection and chemoradiation presented with intractable sharp abdominal pain worse postprandially for one week in duration, associated with early satiety, anorexia, and 5 lbs weight loss in one week...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28756358/jejunal-diverticula-with-perforation-in-non-steroidal-anti-inflammatory-drug-user-a-case-report
#11
Shobhit Gupta, Naveen Kumar
INTRODUCTION: Multiple diverticulosis of the jejunum constitutes an uncommon pathology of the small bowel. The disease is often asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain and discomfort. CASE PRESENTAION: We are thereby reporting a 50yr patient on chronic NSAID ingestion presenting to us with acute abdomen. On exploration, there were multiple (14) jejunal diverticuli on both mesenteric and antimesentric border from 10cm to 90cm distal to duedenojejunal junction with a perforation in one of the diverticulum, 80cm distal to the ligament of Treitz...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28746591/the-therapeutic-challenge-of-giant-splenic-artery-aneurysm-a-case-repport
#12
Paulo Kauffman, Antonio Luiz de Vasconcellos Macedo, Roberto Sacilotto, Adriano Tachibana, Sergio Kuzniec, Lucas Lembrança Pinheiro, Nelson Wolosker
Giant splenic artery aneurysm is a rare condition that represents an eminent life threatening for the patient, requiring, therefore, urgent surgical correction. A 61-year-old woman, former smoker, hypertensive, hypercholesterolemic and multipara sought our service because of a large tumor in the mesogastrium, which was an abdominal ultrasound finding. Despite the size of the tumor, the patient was asymptomatic. The angiotomography and the magnetic resonance image of the abdomen were suggestive of giant splenic artery aneurysm with more than 10cm in diameter that was confirmed by an angiography...
July 24, 2017: Einstein
https://www.readbyqxmd.com/read/28745787/short-term-and-long-term-effects-of-covered-stent-endovascular-graft-exclusion-for-the-treatment-of-abdominal-aortic-aneurysm-rupture
#13
L Li, Y-Q Li, B Liu, H Wang, D-M Zhang
OBJECTIVE: We studied short-term and long-term effects of covered stent endovascular graft exclusion for the treatment of abdominal aortic aneurysm rupture. PATIENTS AND METHODS: From January 2013 to January 2016, 88 patients with fractured abdominal aortic aneurysm were enrolled in this study. Patients were divided into the control group or the open abdomen group (n=52) and the observation group or the isolated group (n=36). Patients in the control group were treated with open abdominal aneurysm resection and artificial blood vessel transplant technique, while patients in the observation group were treated with percutaneous stent graft endovascular graft exclusion...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28733748/preoperative-botulinum-toxin-a-enabling-defect-closure-and-laparoscopic-repair-of-complex-ventral-hernia
#14
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/28732537/negative-pressure-wound-therapy-versus-modified-barker-vacuum-pack-as-temporary-abdominal-closure-technique-for-open-abdomen-management-a-four-year-experience
#15
Giulia Montori, Niccolò Allievi, Federico Coccolini, Leonardo Solaini, Luca Campanati, Marco Ceresoli, Paola Fugazzola, Roberto Manfredi, Stefano Magnone, Matteo Tomasoni, Luca Ansaloni
BACKGROUND: We reviewed our experience with patients presenting with trauma and peritonitis who underwent an open abdomen (OA) procedure, and compared outcomes between Negative Pressure Wound Therapy (NPWT) and a modified Barker Vacuum Pack (mBVP) technique. METHODS: In this descriptive study, we retrospectively analyzed data regarding all patients who underwent OA for intra-abdominal sepsis or abdominal trauma at our Centre from January 2012 to December 2015. Demographic data, co-morbidities, indications to surgery, intra-operative details and Björck classification grade were considered...
July 21, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28732300/complete-torsion-of-gallbladder-following-laparoscopic-cholecystectomy-a-case-study
#16
Tomoaki Bekki, Tomoyuki Abe, Hironobu Amano, Nobuaki Fujikuni, Hiroshi Okuda, Tatsunari Sasada, Minoru Yamaki, Tsuyoshi Kobayashi, Toshio Noriyuki, Masahiro Nakahara
INTRODUCTION: Gallbladder torsion is mainly associated with a floating gallbladder. From an anatomical perspective, laparoscopic cholecystectomy is a more optimal treatment than open cholecystectomy. PRESENTATION OF CASE: An 84-year-old woman visited the Onomichi General Hospital because of progressive pain in the right upper quadrant of her abdomen. Physical examination revealed a positive Murphy sign and peritoneal irritation. Laboratory data demonstrated that inflammatory marker levels were increased...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28717912/management-of-the-open-abdomen-after-liver-transplantation
#17
Christian Hobeika, Marc-Antoine Allard, Petru-Octav Bucur, Salima Naili, Antonio Sa Cunha, Daniel Cherqui, Denis Castaing, René Adam, Eric Vibert
INTRODUCTION: The optimal management of the open abdomen (OA) after liver transplantation (LT) is unclear. The negative pressure wound therapy (NPWT) has been shown to be safe and can increase the chance for early fascial closure in trauma or septic patients. However, little data are available on the specific setting of LT. We aimed to report our experience of OA after LT, marked by the recent use of NPWT. METHODS: All patients with postponed wall closure after LT, from 2002 to 2014, in a single institution were included and retrospectively analyzed...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28715250/the-development-of-technology-for-effective-respiratory-gated-irradiation-using-an-image-guided-small-animal-irradiator
#18
M A Hill, J Thompson, A Kavanagh, I D C Tullis, R G Newman, J Prentice, J Beech, S Gilchrist, S Smart, E Fokas, B Vojnovic
The development of image-guided small animal irradiators represents a significant improvement over standard irradiators by enabling preclinical studies to mimic radiotherapy in humans. The ability to deliver tightly collimated targeted beams, in conjunction with gantry or animal couch rotation, has the potential to maximize tumor dose while sparing normal tissues. However, the current commercial platforms do not incorporate respiratory gating, which is required for accurate and precise targeting in organs subject to respiration related motions that may be up to the order of 5 mm in mice...
July 17, 2017: Radiation Research
https://www.readbyqxmd.com/read/28693050/long-term-results-of-fixation-free-incisional-hernia-repair-using-a-tentacle-shaped-implant
#19
Giuseppe Amato, Giorgio Romano, Thorsten Goetze, Luca Gordini, Enrico Erdas, Fabio Medas, Piergiorgio Calò
INTRODUCTION: The fixation and the overlap of the mesh represent an open issue in incisional hernia repair. An exclusively designed prosthesis has been developed to assure a suture-free repair and a broader coverage of the abdominal wall. This study describes the long-term results of incisional hernia procedures carried out positioning a tentacle-shaped implant through a specifically developed surgical technique. MATERIALS AND METHODS: A proprietary symmetrically-shaped flat mesh constituted by a large central body with integrated radiating arms was used to repair incisional hernias in 68 patients...
July 25, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28688313/laparoscopic-management-of-a-complicated-case-of-wilkie-s-syndrome-a-case-report
#20
Yehya Khodear, Wisam Al-Ramli, Zsolt Bodnar
INTRODUCTION: Superior mesenteric artery (SMA) syndrome also known as Wilkie's syndrome is a rare condition caused by the entrapment of the third part of the duodenum between the aorta and the SMA. The incidence of Wilkie's syndrome range between 0.013% and 0.3%. The normal angle between the aorta and SMA has been described to range between 38° and 65°, whereas in Wilkie's syndrome this angle is reduced to less than 20° causing gastric outlet obstruction. CASE PRESENTATION: We report a case of a previously diagnosed 43 year-old male with SMA syndrome, whom had been conservatively managed for 5-years for recurrent admissions with symptoms of gastric outlet obstruction...
2017: International Journal of Surgery Case Reports
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