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Luca Ferrario, Pietro Zerbi, Maria Rachele Angiolini, Alberto Agarossi, Eliana Riggio, Andrea Bondurri, Piergiorgio Danelli
INTRODUCTION: Leiomyomatosis peritonealis disseminata (LPD) is an uncommon disease featured by the presence of multiple nodules of smooth muscle cells scattered in the abdominal cavity. To date only about 150 cases have been reported in literature. We report a case of recurrent LPD after laparotomy. CASE PRESENTATION: In March 2016 a 36-year-old female, with a history of multiple previous laparoscopic myomectomies, consulted her gynaecologist complaining abdominal pain; a MRI was performed and reported multiple pelvic masses, subsequently excised during laparotomy...
June 18, 2018: International Journal of Surgery Case Reports
Yizhuo Yang, Zhongyu Liu, Lei Song, Hui Liu, Lian Li, Yuanguang Meng
INTRODUCTION: Retroperitoneal ectopic pregnancy (REP) is a rare type of gestation that is difficult to diagnose and treat. To date, only several published cases are available and no specific guideline has been developed to manage this disease. As the lesions are located closely to the large retroperitoneal blood vessels, surgical resection of the gestational tissue might incur risks such as associated hemorrhage, injury of blood vessels or nerves. On the other hand, the therapeutic effect of conservative treatment using methotrexate is not satisfactory...
June 9, 2018: International Journal of Surgery Case Reports
S Wang, Y Zhang, Y Y Zhao, S Lu
Cornual pregnancy is one of the diseases caused by embryo embedment at abnormal site. Since few women with cornual pregnancy continue to a middle or late gestation are at a relatively increased risk of uterus rupture,placenta accrete,postpartum hemorrhage and some other severe obstetric complications. We reported two cases of cornual pregnancy at the third trimester, including their clinical symptoms, diagnoses, treatments and obstetric outcomes. Patient 1 had regular prenatal examination. The ultrasound scan at the second trimester showed that the placenta was located at the right fundus of uterus and the myometrium was thin...
June 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Margaret Mary Mansbridge, Edward Ramez Latif, Lobsang Tenzin Lamdark, Martin Wullschleger
Presented here is the case of an 86-year-old man who was found to have right-sided pelvicalyceal rupture and anuric renal failure, secondary to obstructive uropathy caused by life-saving extraperitoneal pelvic packing (EPP) in the settling of severe trauma. In efforts to control haemorrhage in this haemodynamically unstable patient, EPP placement deviated from the recognised method of three extraperitoneal packs bilaterally with seven surgical packs placed. Progress postoperative imaging revealed right-sided hydroureteronephrosis with obstruction evident at the level of the extraperitoneal pelvic packs, identified by delayed contrast excretion from the preceding CT angiography imaging...
June 20, 2018: BMJ Case Reports
Erica J Weinstein, Jacob L Levene, Marc S Cohen, Doerthe A Andreae, Jerry Y Chao, Matthew Johnson, Charles B Hall, Michael H Andreae
BACKGROUND: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017. OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing elective surgery. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to December 2016 without any language restriction...
June 20, 2018: Cochrane Database of Systematic Reviews
D Zhu, S Chen, S K Yao, Y M Li, S X Chen
Objective: To establish a canine model of slow transit constipation (STC), and to test the changes in defecation, gastrointestinal transit time and pathology sections. Methods: Baseline information was measured in 8 beagle dogs, and these dogs were randomly divided into the control group and the model group. The dogs in model group were given a diet of canned meat, as well as a combination of compound diphenoxylate and alosetron hydrochloride for 5 weeks. Dogs in control group were given normal diet with no special intervention...
June 12, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Adauto Tsutomu Ikejiri, Frederico Somaio Neto, Paulo Roberto Bertoletto, José Carlos Chaves, Alexandre Key WakateTeruya, Cândida Aparecida Leite Kassuya, Murched Omar Taha, Djalma José Fagundes
PURPOSE: To evaluate the effect of hyperbaric oxygenation (HBO) on the expression of the genes antioxidant glutathione peroxidase 4 (Gpx4) and lactoperoxidase (Lpo) in the lung of mice subjected to intestinal ischemia and reperfusion (IIR). METHODS: Control group (CG) in which were subjected to anesthesia, laparotomy and observation for 120 minutes; an ischemia and reperfusion group (IRG) subjected to anesthesia, laparotomy, small bowel ischemia for 60 minutes and reperfusion for 60 minutes; and three groups treated with HBO during ischemia (HBOG + I), during reperfusion (HBOG + R) and during ischemia and reperfusion (HBOG + IR)...
May 2018: Acta Cirúrgica Brasileira
Betty Leclerc, Lucie Salomon Du Mont, Anne-Laure Parmentier, Guillaume Besch, Simon Rinckenbach
BACKGROUND: The abdominal compartment syndrome (ACS) has been clearly identified as being one of the main causes of mortality after ruptured abdominal aortic aneurysm (rAAA). The ACS is defined as a sustained intra-abdominal pressure > 20 mm Hg associated with a new organ dysfunction or failure. A pilot study was conducted and found that the threshold of 3 among 8 selected criteria, we would predict an ACS occurrence with a 54% positive predictive value and a 92% negative predictive value...
June 2018: Medicine (Baltimore)
Xiaodong Sun, Zhongqi Fan, Wei Qiu, Yuguo Chen, Chao Jiang, Guoyue Lv
RATIONALE: Median arcuate ligament (MAL) may compress the coeliac trunk inducing median arcuate ligament syndrome (MALS). MALS is a risk factor for hepatic artery thrombosis (HAT) in liver transplant recipients. PATIENT CONCERNS: A thin female complained about upper abdominal pain for two months. DIAGNOSES: The patient was diagnosed as primary biliary cirrhosis. INTERVENTIONS: The patient received two liver transplantations...
June 2018: Medicine (Baltimore)
A Tornambè, P S L Aiello, G Tornambè
Gallbladder cancer is the most frequent neoplasm originating from the extrahepatic biliary tract, with characteristics of late presentation and rapid progression. We report the case of a 58 years old female patient with concomitant small cell carcinoma and adenocarcinoma of the gallbladder, incidentally reported after a cholecystectomy performed for cholelithiasis. According to the stage of the disease, we performed a second surgical procedure with laparotomy, resection of the liver parenchyma IVb and V and regional lymphadenectomy...
May 2018: Il Giornale di Chirurgia
Barbaros Sahin Karagun, Tugana Akbas, Taner Arpaci, Bulent Antmen
GI perforation after stem cell transplantation is extremely rare and is associated with poor prognosis. In addition, the clinical limitations of MMF are associated with GI intolerance and hematologic suppression. However, the exact mechanism whereby MMF induces changes in GI mucosa is unknown. Currently, there is no definite method to distinguish between GI toxicity associated with MMF and GVHD. It is important to recognize association between MMF and the histologic changes mimicking GVHD, given that GVHD is a significant differential diagnosis in stem cell transplant patients...
June 19, 2018: Pediatric Transplantation
Evangelos Blevrakis, Maria Raissaki, Sofia Xenaki, Elissavet Astyrakaki, Nelli Kholcheva, Emmanuel Chrysos
Ingested foreign bodies occur in children younger than 3 years and pass uneventfully through the gastrointestinal tract. However, multiple magnet ingestion are associated with serious complications. A 9-year old male with abdominal pain and vomiting 3 days prior to admission, underwent abdominal radiographs showing radiopaque foreign bodies. Ultrasonography (US) independently discovered one magnet floating in the jejunum. Preoperative Computed Tomography (CT) confirmed the presence of two neighbouring magnets causing obstruction and beaking of an adjacent jejunal loop...
July 2018: Annals of Medicine and Surgery
Veerabhadra Radhakrishna, Ashok Rijhwani, Bhushanrao Jadhav
Introduction: Cecal duplication is a rare congenital anomaly and to the best of our knowledge, only 43 cases have been reported in the literature till date. Most of them present within the first year of life. They can mimic intussusception, and the delay in diagnosis can lead to high morbidity. Case report: A five-year boy presented with pain abdomen for a week. He was found to have ileocolic intussusception. The intussusception could only be partially reduced by the hydrostatic method...
July 2018: Annals of Medicine and Surgery
Sarah E Wills, Hugues H Beaufrère, Brigitte A Brisson, Russell S Fraser, Dale A Smith
A 1-y-old spayed female ferret (Mustela putorius furo) was referred for additional diagnostic evaluation after physical examination by the referring veterinarian revealed a cranial abdominal mass. The ferret had a 2-wk history of inappetence, weight loss, and lethargy. On presentation, the ferret was thin, and an approximately 3-cm mass was palpable in the cranial abdomen. No other abnormalities were noted. Abdominal ultrasonography confirmed the presence of a soft-tissue structure, with a moderate blood supply and mesenteric lymphadenopathy...
June 1, 2018: Comparative Medicine
Cheng Zhang, Yue-Feng Ma, Yu-Long Yang
BACKGROUD: Hepatic cysts are the most frequent, innocuous, space-occupying lesions of the liver. The majority of solitary liver cysts are nonsymptomatic. When liver cysts reach a large size, there are some complications, including infection, rupture, spontaneous hemorrhage, obstructive jaundice, and neoplastic degeneration. Percutaneous aspiration, fenestration, hepatic resection, and liver transplantation have been proposed for symptomatic patients. CASE PRESENTATION: In this case report, we describe a 41-year-old woman who presented with persistent liver dysfunction, indolent xanthochromia, and skin itching for 3 months...
June 19, 2018: BMC Gastroenterology
Christoph Zoeller, Emi Yoshizawa, Mohammad V Sethi, Benno M Ure, Joachim F Kuebler
INTRODUCTION:  Negative pressure wound therapy (NPWT) is a novel tool to reduce surgical site infections (SSIs). Although SSIs are a common source of morbidity in infants undergoing laparotomy, the cost of the available NPWT devices has restricted its use to adult high-risk patients. We developed a low-cost method of NPWT in infants and analyzed its impact on the incidence of SSIs in infant patients. PATIENTS AND METHODS:  A consecutive series of infants (age ≤ 12 months) who underwent a clean-contaminated, contaminated, or dirty abdominal procedure via laparotomy from 08/2015 to 12/2016 were included...
June 19, 2018: European Journal of Pediatric Surgery
Simone Guadagni, Gregorio Di Franco, Desirée Gianardi, Matteo Palmeri, Cristina Ceccarelli, Matteo Bianchini, Niccolò Furbetta, Giovanni Caprili, Cristiano D'Isidoro, Andrea Moglia, Franca Melfi, Piero Buccianti, Franco Mosca, Luca Morelli
BACKGROUND: A new robotic stapler for the da Vinci Xi® is directly controlled by the surgeon at the console and equipped with EndoWrist® technology. We evaluated operative and short-term results of the first patients who underwent anterior rectal resection for cancer with the da Vinci Xi and new staplers, and compared the results with those of a comparable group treated with traditional laparoscopic staplers. METHODS: From December 2015 to December 2017, 25 patients underwent anterior rectal resection for cancer with robotic EndoWrist staplers (EndoWrist group)...
June 19, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Rodrigo Oom, Cátia Cunha, Vítor Moura Guedes, Luís Palma Féria, Rui Maio
Peritoneal loose bodies are usually diagnosed incidentally. Only a few cases are documented in the literature. The pathophysiology of this condition is not fully known and its origin may possibly be related to the twisting and separation of epiploic appendages. The authors describe the case of a patient with a spherical solid lesion 6 cm in diameter, identified incidentally in the pelvic cavity of a 64 year old man. The patient underwent laparotomy and a free ovoid shaped white body was identified. Histological examination described a calcified and encapsulated mass with a steato-necrosis core...
May 30, 2018: Acta Médica Portuguesa
Tetsu Fukunaga, Yuji Ishibashi, Shinichi Oka, Satoshi Kanda, Yukinori Yube, Yoshinori Kohira, Yuta Matsuo, Osamu Mori, Shinya Mikami, Takeharu Enomoto, Takehito Otsubo
BACKGROUND: Billroth I reconstruction is a means of anastomosis that is widely performed after surgical resection for distal gastric cancer. Interest has grown in totally laparoscopic gastrectomy, and several methods for totally laparoscopic performance of Billroth I reconstruction have been reported. However, the methods are cumbersome, and postoperative complications such as twisting at the site of anastomosis and obstruction due to stenosis have arisen. We developed an augmented rectangle technique (ART) by which the anastomosis is created laparoscopically with the use of three automatic endoscopic linear staplers, and the resulting anastomotic opening is wide and less likely to become twisted or stenosed...
June 18, 2018: Surgical Endoscopy
Bharat Panuganti, Ea-Sle Chang, Cyril W Helm, Theresa Schwartz, Eddy C Hsueh, Jinhua Piao, Jinping Lai, Jula Veerapong
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are combined to treat peritoneal surface malignancies (PSM). The objective of cytoreduction is to eradicate macroscopic disease, while HIPEC addresses residual microscopic disease. Currently, there are no protocols guiding treatment of cirrhotic patients with PSM. We report the case of a cirrhotic patient with signet ring cell (SRC) appendiceal adenocarcinoma who underwent normothermic, as opposed to hyperthermic intraperitoneal chemotherapy (IPC)...
June 2018: Gastroenterology Research
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