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https://www.readbyqxmd.com/read/28197671/-rectal-perforation-a%C3%A2-rare-complication-following-radiotherapy
#1
M Binnebösel, A Lambertz, C D Klink, U P Neumann
BACKGROUND: Radiotherapy in the treatment of prostate cancer is well established. Intestinal complications following radiotherapy are divided into acute and chronic toxicity. Chronic complications like perforation and fistula formation to the rectum are rare and difficult to treat. MATERIALS AND METHODS: In case of chronic radiotherapy complications and particularly chronic fistula formation to the rectum, evidence is low. Therefore, an overview of the available literature of surgical therapy strategies is given...
February 14, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28194589/clinical-outcome-of-transarterial-embolization-for-postgastrectomy-arterial-bleeding
#2
Kichang Han, Bestun Mustafa Ahmed, Man-Deuk Kim, Jong Yun Won, Do Yun Lee, Gyoung Min Kim, Joon Ho Kwon, Sung Il Park, Sung Hoon Noh, Woo Jin Hyung
BACKGROUND: The aim of this study was to retrospectively investigate the feasibility and safety of transcatheter arterial embolization in the management of postgastrectomy arterial bleeding. METHODS: Between January 2004 and July 2015, 13,246 patients underwent total or subtotal gastrectomy at our institution, and 24 patients (18 men; mean age 66.8 years; range 42-80 years) underwent transcatheter arterial embolization for postoperative arterial bleeding identified on angiography...
February 13, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28194352/application-of-a-silicone-sheet-in-negative-pressure-wound-therapy-to-treat-an-abdominal-wall-defect-after-necrotizing-fasciitis
#3
Jin Su Shin, Hwan Jun Choi
Necrotizing fasciitis (NF) is an aggressive soft-tissue infection involving the deep fascia and is characterized by extensive deterioration of the surrounding tissue. Immediate diagnosis and intensive treatment, including debridement and systemic antibiotics, represent the most important factors influencing the survival of NF patients. In this report, we present a case of NF in the abdomen due to an infection caused by a perforated small bowel after abdominal liposuction. It was successfully treated using negative-pressure wound therapy, in which a silicone sheet functioned as a barrier between the sponge and internal organs to protect the small bowel...
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28193645/not-your-usual-constipation-stercoral-perforation
#4
Matthew Marget, Hussam Ammar
Stercoral perforation is a rare cause of bowel perforation. It is caused by faecal impaction, which generates pressure against the colon wall, leading to ischaemic necrosis and subsequent perforation. Since diagnosis is often delayed, stercoral perforation is usually mistreated as constipation or faecal impaction, leading to high mortality. This report presents a case of stercoral perforation in a woman aged 34 years who was promptly diagnosed and successfully treated.
February 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28192597/a-phase-2-and-biomarker-study-of-cabozantinib-in-patients-with-advanced-cholangiocarcinoma
#5
Lipika Goyal, Hui Zheng, Matthew B Yurgelun, Thomas A Abrams, Jill N Allen, James M Cleary, Michelle Knowles, Eileen Regan, Amanda Reardon, Anna Khachatryan, Rakesh K Jain, Valentina Nardi, Darrell R Borger, Dan G Duda, Andrew X Zhu
BACKGROUND: Advanced cholangiocarcinoma carries a poor prognosis, and no standard treatment exists beyond first-line gemcitabine/platinum-based chemotherapy. A single-arm, phase 2 and biomarker study of cabozantinib, a multikinase inhibitor with potent activity against vascular endothelial growth factor receptor 2 (VEGFR2) and MET, was performed for patients with advanced refractory cholangiocarcinoma. METHODS: Previously treated patients with unresectable or metastatic cholangiocarcinoma received cabozantinib (60 mg orally and daily on a continuous schedule)...
February 13, 2017: Cancer
https://www.readbyqxmd.com/read/28188037/determinants-of-outcomes-in-patients-with-simple-gastroschisis
#6
Fouad Youssef, Jean-Martin Laberge, Pramod Puligandla, Sherif Emil
PURPOSE: We analyzed the determinants of outcomes in simple gastroschisis (GS) not complicated by intestinal atresia, perforation, or necrosis. METHODS: All simple GS patients enrolled in a national prospective registry from 2005 to 2013 were studied. Patients below the median for total parenteral nutrition (TPN) duration (26days) and hospital stay (34days) were compared to those above. Univariate and multivariate logistic and linear regression analyses were employed using maternal, patient, postnatal, and treatment variables...
January 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28185616/tuberculous-peritonitis
#7
Urvashi Vaid, Gregory C Kane
Tuberculous peritonitis is rare in the United States but continues to be reported to occur in certain high-risk populations, which include patients with AIDS or cirrhosis, patients on continuous ambulatory peritoneal dialysis, recent immigrants from areas of high endemicity, and those who are immunosuppressed. The diagnosis of this disease requires a high clinical index of suspicion and should be considered in the differential of ascites with a lymphocyte predominance and serum-ascitic albumin gradient of <1...
January 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28169459/long-term-effectiveness-and-complication-rates-of-bladder-augmentation-in-patients-with-neurogenic-bladder-dysfunction-a-systematic-review
#8
Lisette 't Hoen, Hazel Ecclestone, Bertil F M Blok, Gilles Karsenty, Véronique Phé, Romain Bossier, Jan Groen, David Castro-Diaz, Bárbara Padilla Fernández, Giulio Del Popolo, Stefania Musco, Jürgen Pannek, Thomas M Kessler, Tobias Gross, Marc P Schneider, Rizwan Hamid
AIMS: To systematically evaluate effectiveness and safety of bladder augmentation for adult neuro-urological patients. METHODS: The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement was followed for review of publications. The Medline, Embase, and Cochrane controlled trial databases and clinicaltrial.gov were searched until January 2015. No limitations were placed on date or language. Non-original articles, conference abstracts, and publications involving children and animals were excluded...
February 7, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28168885/methylnaltrexone-versus-naloxone-for-opioid-induced-constipation-in-the-medical-intensive-care-unit
#9
Cristian Merchan, Diana Altshuler, John Papadopoulos
BACKGROUND: Opioid-induced constipation (OIC) is common in critically ill patients; it leads to complications that can increase hospital stay and, rarely, bowel perforation. Opioid antagonists are considered a logical approach to treat OIC; however, the agent of choice has yet to be determined. OBJECTIVE: To assess the effectiveness and safety of enteral naloxone (NTX) versus subcutaneous methylnaltrexone (MNTX) for the treatment of OIC in the medical intensive care unit...
March 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28162864/use-of-computed-tomography-to-determine-perforation-in-patients-with-acute-appendicitis
#10
Cameron E Gaskill, Vlad V Simianu, Jonathan Carnell, Daniel S Hippe, Puneet Bhargava, David R Flum, Giana H Davidson
PURPOSE: Urgent appendectomy has long been the standard of care for acute appendicitis. Six randomized trials have demonstrated that antibiotics can safely treat appendicitis, but approximately 1 in 4 of these patients eventually requires appendectomy. Overall treatment success may be limited by complex disease including perforation. Patients׳ success on antibiotic therapy may depend on preoperative identification of complex disease on imaging. However, the effectiveness of computed tomography (CT) in differentiating complex disease including perforated from nonperforated appendicitis remains to be determined...
December 7, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28161256/cecal-perforation-associated-with-clostridium-difficile-infection-a%C3%A2-case-report
#11
Sarah Kyuragi Luthe, Ryota Sato
BACKGROUND: Various complications are reported with Clostridium difficile infection (CDI), including fulminant CDI. Fulminant CDI is an underappreciated life-threatening condition associated with complications such as toxic megacolon and bowel perforation. CASE REPORT: A 79-year-old woman presented to the Emergency Department with altered mental status. She was admitted and conservatively treated for a left thalamic hemorrhage. While hospitalized, she developed watery diarrhea due to Clostridium difficile...
February 2, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28149153/subcutaneous-facial-and-neck-emphysema-as-first-sign-of-intestinal-perforation-in-a-female-patient-after-a-routine-colonoscopy
#12
Dimitrios Anyfantakis, Miltiades Kastanakis, Paraskevi Karona, Alexandros Papadomichelakis, Emmanouil Bobolakis
Colonoscopy is a safe procedure for the diagnosis and management of colorectal diseases. Colonic perforation due to colonoscopy represents an uncommon complication. Here we present an unusual case of iatrogenic bowel perforation resulting in subcutaneous facial and neck emphysema, pneumomediastinum and pneumoretroperitoneum. Taking a detailed recent medical history information is always required when encountering patients with subcutaneous emphysema after invasive examination procedures. Alertness on iatrogenic complication eventualities may improve prognosis and avoid life-threatening conditions...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28145214/-faecolithiasis-straightforward-to-detect-but-often-missed
#13
B Katerberg, F Ter Borg
Faecal impaction is a problem which is becoming more prevalent now that the number of elderly patients is increasing. When not detected and treated inadequately, it can lead to symptoms such as diarrhoea, faecal incontinence and other serious problems like anorexia, vomiting and rectal ulcers with bleeding or even a bowel perforation. We describe two patients with serious and less common complications of faecolithiasis. Patient A, a 79-year-old woman with signs of dementia, presented with faecal incontinence and unexplained worsening of her cognitive symptoms leading to a situation where she could no longer live in her own home...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28138365/triple-tube-drainage-for-difficult-gastroduodenal-perforations-a-prospective-study
#14
Nitin Agarwal, Nishant Kumar Malviya, Nikhil Gupta, Iqbal Singh, Sanjay Gupta
AIM: To prospectively study the outcome of difficult gastroduodenal perforations (GDPs) treated by triple tube drainage (TTD) in order to standardize the procedure. METHODS: Patients presenting to a single surgical unit of a tertiary hospital with difficult GDPs (large, unfavourable local and systemic factors) were treated with TTD (gastrostomy, duodenostomy and feeding jejunostomy). Postoperative parameters were observed like time to return of bowel sounds, time to start enteral feeds, time to start oral feeds, daily output of all drains, time to clamping/removal of all drains, time for skin to heal, complications, hospital stay, and, mortality...
January 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28138363/perforated-peptic-ulcer-an-update
#15
REVIEW
Kin Tong Chung, Vishalkumar G Shelat
Peptic ulcer disease (PUD) affects 4 million people worldwide annually. The incidence of PUD has been estimated at around 1.5% to 3%. Perforated peptic ulcer (PPU) is a serious complication of PUD and patients with PPU often present with acute abdomen that carries high risk for morbidity and mortality. The lifetime prevalence of perforation in patients with PUD is about 5%. PPU carries a mortality ranging from 1.3% to 20%. Thirty-day mortality rate reaching 20% and 90-d mortality rate of up to 30% have been reported...
January 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28135790/-second-korean-guidelines-for-the-management-of-crohn-s-disease
#16
REVIEW
Jae Jun Park, Suk Kyun Yang, Byong Duk Ye, Jong Wook Kim, Dong Il Park, Hyuk Yoon, Jong Pil Im, Kang Moon Lee, Sang Nam Yoon, Heeyoung Lee
Crohn's disease (CD) is a chronic, progressive, and disabling inflammatory bowel disease (IBD) with an uncertain etiopathogenesis. CD can involve any site of the gastrointestinal tract from the mouth to the anus, and is associated with serious complications, such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower compared with those in Western countries, but they have been rapidly increasing during the recent decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies have been applied for the treatment of this disease...
January 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28133111/-unresectable-stage-iv-sigmoid-colon-cancer-with-extended-resection-for-primary-tumor-a-case-report
#17
Yuta Kimura, Nobuaki Suzuki, Shinobu Tomochika, Yuka Inoue, Hironori Tanaka, Yoshihiro Tokuhisa, Michihisa Iida, Kazuhiko Sakamoto, Shigeru Takeda, Tomio Ueno, Shigeru Yamamoto, Shigefumi Yoshino, Shoichi Hazama, Hiroaki Nagano
A 65-year-old woman who was diagnosed with unresectable Stage IV sigmoid colon cancer underwent transverse colostomy with double orifices. Although KRAS gene mutation was observed, we could not administer bevacizumab because of the risk of bleeding from the primary tumor and peritumoral abscess. We started bi-weekly XELOX therapy but bloody bowel discharge continued. We planned extended resection of the primary tumor in order to control the bleeding and perforation. Sigmoidectomy, partial resection of the left ureter and small intestine, partial hysterectomy, bilateral salpingo-oophorectomy, and umbilical tumor resection were performed and the patient was discharged on the 10th day after surgery...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28131064/gastric-duplication-cyst-gdc-associated-with-ectopic-pancreas-case-report-and-review-of-the-literature
#18
I D Passos, G Chatzoulis, K Milias, E Tzoi, C Christoforakis, P Spyridopoulos
INTRODUCTION: Duplication of the alimentary tract is a relatively rare congenital anomaly. It can affect any part of the gastrointestinal tract, with ileum being the most common site. These malformations are believed to be congenital, formed before the differentiation of epithelial lining, and therefore named for the organ with which they are associated. Duplication cysts of the stomach represent four percent of all alimentary tract duplications. CASE REPORT: Here, we report a rare case of symptomatic duplication cyst of stomach associated with ectopic pancreas presenting in adult...
January 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28121679/effects-of-prostaglandin-e1-on-patients-undergoing-major-gastrointestinal-surgery
#19
Fabao Hao, Hongjie Guo, Jia Zhong, Qiankun Geng, Yang Yang, Bailin Chen, Chunbao Guo
OBJECTIVE: The aim of this study was to investigate the clinical effects of prostaglandin E1 (PGE1) in patients who underwent surgery for gastrointestinal (GI) trauma, perforation, or obstruction. BACKGROUND: PGE1 is thought to enhance intestinal blood supply and reduce GI complications during the postoperative period. METHODS: The medical records of 889 patients undergoing major GI surgery were reviewed retrospectively. Propensity score matching was performed to adjust for any baseline differences...
January 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28116474/prenatal-magnetic-resonance-and-ultrasonographic-findings-in-small-bowel-obstruction-imaging-clues-and-postnatal-outcomes
#20
Eva I Rubio, Anna R Blask, Andrea T Badillo, Dorothy I Bulas
BACKGROUND: Prenatal small-bowel obstruction can result from single or multiple atresias, and it can be an isolated abnormality or part of a syndrome. It is sometimes the first manifestation of cystic fibrosis. Accurate prediction of the level of obstruction and length of bowel affected can be difficult, presenting a challenge for counseling families and planning perinatal management. OBJECTIVE: To review the prenatal US and MRI findings of small-bowel obstruction and to assess whether fetal MRI adds information that could improve prenatal counseling and perinatal management...
January 23, 2017: Pediatric Radiology
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