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Gastric aspiration

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https://www.readbyqxmd.com/read/29234894/amputation-neuroma-mimicking-lymph-node-metastasis-of-remnant-gastric-cancer-a-case-report
#1
Kenichiro Furukawa, Yutaka Tanizawa, Kimihide Kusafuka, Noriyuki Nishiwaki, Keiichi Fujiya, Hayato Omori, Sanae Kaji, Makoto Hikage, Rie Makuuchi, Tomoyuki Irino, Masanori Tokunaga, Etsuro Bando, Taiichi Kawamura, Masanori Terashima
BACKGROUND: Amputation neuromas (ANs) are reactive hyperplasia of nerve tissues that occur after a trauma or surgery involving the peripheral nerves. Only two previous reports of ANs occurring around the stomach and post gastrectomy have been reported. We report the case of a patient with AN near the remnant stomach who underwent distal gastrectomy for gastric cancer. CASE PRESENTATION: A 76-year-old man underwent distal gastrectomy, D1+ lymphadenectomy, and Billroth-I reconstruction for early gastric cancer in another hospital at 63 years of age...
December 12, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29230709/point-of-care-gastric-ultrasound-and-aspiration-risk-assessment-a-narrative-review
#2
Anahi Perlas, Cristian Arzola, Peter Van de Putte
This narrative review summarizes the current knowledge on point-of-care ultrasound (POCUS) of gastric contents in order to inform an assessment of aspiration risk and guide anesthetic management at the bedside. An I-AIM framework (Indication, Acquisition, Interpretation, and Medical decision-making) is used to summarize and organize the content areas. This narrative review spans the breadth of the literature on pediatric and adult subjects as well as on special patient populations such as obstetric and severely obese individuals...
December 11, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29224771/revision-repair-of-type-iv-laryngotracheoesophageal-cleft-using-multiple-long-tapered-engaging-grafts
#3
Evan J Propst
An 8 year-old female with esophageal atresia and a type IV laryngotracheoesophageal cleft underwent tracheostomy, gastric pull-up and fundoplication with G-tube insertion at birth. She remained nil per os due to aspiration. The trachealis was separated from the esophagus that was reapproximated and clavicular periosteum was placed. A long posterior costal cartilage graft that engaged behind the cricoid plate and tapered inferiorly was inserted. A second thin cartilage graft was sutured to it distally to extend the length of the repair...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29212476/the-role-of-endoscopic-ultrasound-in-children-with-pancreatobiliary-and-gastrointestinal-disorders-a-single-center-series-and-review-of-the-literature
#4
Alessandro Fugazza, Barbara Bizzarri, Federica Gaiani, Marco Manfredi, Alessia Ghiselli, Pellegrino Crafa, Maria Clotilde Carra, Nicola de'Angelis, Gian Luigi de'Angelis
BACKGROUND: The role of endoscopic ultrasound (EUS) in the management of pancreatobiliary and digestive diseases is well established in adults, but it remains limited in children. The aim of this study was to evaluate the feasibility, safety, and clinical impact of EUS use in children. METHODS: This is a retrospective analysis of a prospectively acquired database of consecutive pediatric (< 18 years) patients presenting an indication for EUS for pancreatobiliary and gastrointestinal disorders...
December 6, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29194055/hinged-lids-and-fatal-head-entrapment-in-early-childhood
#5
Roger W Byard, Allan D Cala
Young children are at risk of head entrapment because they often do not understand potentially dangerous situations or have the intellectual or physical capabilities to self-extricate. Two cases of head entrapment due to hinged lids are presented to demonstrate another rare lethal situation specific to the very young. Case 1 was a 14-month-old boy found suspended by his neck in a semikneeling position under a toilet seat. A horizontal linear bruise measuring 0.6 × 20 mm was present on the right side of the neck with petechial hemorrhages of the forehead...
December 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29160244/pulmonary-aspiration-in-adjustable-gastric-banding-carriers-undergoing-a-second-surgical-procedure-considerations-on-personal-experience-and-review-of-the-literature
#6
Contardo Vergani, Marco Venturi, Sara Badiali, Barbara Chella, Enrico Mozzi
BACKGROUND: The observation of a relatively high number of pulmonary aspirations (PA) among gastric band (GB) carriers undergoing a second surgery, prompted us to modify our strategy for GB patients candidate to further operation under general anesthesia. MATERIAL OF STUDY AND RESULTS: In January 2013, following the occurrence of PA at the induction of general anesthesia in 1 GB carrier undergoing a further operation, we reviewed our Data Base between January 2005 and 2013, to explore the rate of pulmonary aspiration in patients GB carriers undergoing a second surgery...
November 7, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29155354/incidence-of-gastric-to-pulmonary-aspiration-in-patients-undergoing-elective-upper-gastrointestinal-endoscopy
#7
J Kyle Bohman, Adam K Jacob, Kelsey A Nelsen, Daniel A Diedrich, Nathan Smischney, Oludare Olatoye, Rochelle Molitor, Nicholas R Oblizajek, Andrew C Hanson, Navtej S Buttar
No abstract text is available yet for this article.
November 16, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29152936/gastric-ultrasound-to-guide-anesthetic-management-in-elective-surgical-patients-non-compliant-with-fasting-instructions-a-retrospective-cohort-study
#8
Peter van de Putte, Jonathan van Hoonacker, Anahi Perlas
BACKGROUND: Perioperative aspiration leads to significant morbidity and mortality. Standard fasting periods are used to ensure an empty stomach in patients. Anesthesiologists are frequently confronted with cases of dubious adherence to these guidelines. Point-of-care gastric ultrasound is a diagnostic tool that offers information on the type and volume of gastric contents. METHODS: We performed a retrospective analysis of a departmental database containing clinical and sonographic information on elective surgical patients who had been non- compliant to the fasting guidelines...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29148123/donohue-syndrome-a-review-of-literature-case-series-and-anesthetic-considerations
#9
REVIEW
Alana Kirkwood, Grant Stuart, Louise Harding
BACKGROUND: Donohue syndrome is a rare autosomal recessive disorder of insulin resistance, causing a functional defect in insulin receptor function, and affecting the ability of the insulin to bind the receptor. Features include severe hyperinsulinism and fasting hypoglycemia, along with severe failure to thrive despite feeding. An accelerated fasting state results in muscle wasting, decreased subcutaneous fat, and an excess of thick skin. A reduced thoracic diameter is accentuated by increased abdominal distension, which impacts on respiratory reserve...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29102525/clinical-impact-of-endoscopic-ultrasonography-on-the-management-of-neuroendocrine-tumors-lights-and-shadows
#10
REVIEW
Alessandra Zilli, Paolo Giorgio Arcidiacono, Dario Conte, Sara Massironi
The incidence of gastroenteropancreatic neuroendocrine neoplasms has increased in the recent decades. An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature (retrospective and prospective studies, systematic reviews, case series) published mostly between year 1997 and June 2017, using both medical subject heading (MeSH) terms and free-language keywords about the accuracy and diagnostic and therapeutic role of endoscopic ultrasound in the context of gastro-entero-pancreatic neuroendocrine neoplasms...
October 19, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29093627/oval-mucosal-opening-bloc-biopsy-after-incision-and-widening-by-ring-thread-traction-for-submucosal-tumor
#11
Hirohito Mori, Hideki Kobara, Yu Guan, Yasuhiro Goda, Nobuya Kobayashi, Noriko Nishiyama, Tsutomu Masaki
Gastric submucosal tumors (SMTs) less than 2 cm are generally considered benign neoplasms, and endoscopic observation is recommended, but SMTs over 2 cm, 40% of which are gastrointestinal stromal tumors (GISTs), have malignant potential. Although the Japanese Guidelines for GIST recommend partial surgical resection for GIST over 2 cm with malignant potential as well as en bloc large tissue sample to obtain appropriate and large specimens of SMTs, several reports have been published on tissue sampling of SMTs, such as with endoscopic ultrasound sound fine needle aspiration, submucosal tunneling bloc biopsy, and the combination of bite biopsy and endoscopic mucosal resection...
October 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29092869/testing-placement-of-gastric-feeding-tubes-in-infants
#12
Norma A Metheny, Ann Pawluszka, Melanie Lulic, Leslie J Hinyard, Kathleen L Meert
BACKGROUND: Inadvertent positioning of a nasogastric tube in the lung can cause serious complications, so identifying methods to detect improperly inserted tubes is imperative. OBJECTIVES: To compare the sensitivity, specificity, and negative and positive predictive values of 4 pH cut points (< 4.0, < 4.5, < 5.0, and < 5.5) in differentiating gastric and tracheal aspirates under various treatment conditions and to explore the utility of a pepsin assay for distinguishing between gastric and tracheal aspirates...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29076905/aspiration-incidentally-detected-by-a-meckel-scintigraphy
#13
Xia Bai, Johannes C Fostitsch, Hongming Zhuang
Meckel scintigraphy with Tc-pertechnetate was performed in a 5-year-old boy to determine whether a Meckel diverticulum containing ectopic gastric mucosa caused bleeding. The images did not reveal focal activity characteristic of a Meckel diverticulum. Unexpectedly, activity in the tracheobronchial tree was visualized, consistent with aspiration of the radioactive saliva.
October 26, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29075963/endoscopic-evaluation-and-management-of-gastric-stromal-tumors
#14
REVIEW
Kambiz Kadkhodayan, Ehsan Rafiq, Robert H Hawes
Purpose of Review Gastrointestinal stromal tumors (GISTs) are both relatively common. Management of these lesions has been challenging with emerging interest in the endoscopic approach for both diagnostic and therapeutic interventions. Recent Findings Although these can be visualized on CT scan, endoscopic ultrasound (EUS) represents the standard method of evaluation and characterization using fine needle aspiration cytology (FNA) when indicated. While EUS-FNA can yield diagnostic cells, full characterization requires a sufficient volume of viable cells to do molecular analysis for c-KIT and determine the mitotic index...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29072162/impact-of-homogenization-of-pasteurized-human-milk-on-gastric-digestion-in-the-preterm-infant-a-randomized-controlled-trial
#15
Samira C de Oliveira, Amandine Bellanger, Olivia Ménard, Patrick Pladys, Yann Le Gouar, Gwénaële Henry, Emelyne Dirson, Florence Rousseau, Frédéric Carrière, Didier Dupont, Claire Bourlieu, Amélie Deglaire
BACKGROUND & AIMS: It has been suggested that homogenization of Holder-pasteurized human milk (PHM) could improve fat absorption and weight gain in preterm infants, but the impact on the PHM digestive kinetics has never been studied. Our objective was to determine the impact of PHM homogenization on gastric digestion in preterm infants. METHODS: In a randomized controlled trial, eight hospitalized tube-fed preterm infants were their own control to compare the gastric digestion of PHM and of homogenized PHM (PHHM)...
August 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29064929/highly-concentrated-preterm-formula-as-an-alternative-to-powdered-human-milk-fortifier-a-randomized-controlled-trial
#16
Andrea Willeitner, Michael Anderson, Jami Lewis
OBJECTIVE: The aim of the study was to assess clinical feasibility and tolerance of concentrated preterm formula at 30 kcal/oz (CPF30) to fortify human milk to a caloric density of 24 kcal/oz, compared to conventional powdered human milk fortifier (PHMF). STUDY DESIGN: Very low birth weight neonates were stratified by birth weight and randomized to receive human milk fortification using CPF30 or PHMF. Infants were monitored from first introduction of human milk fortification, until fortified feeds were well tolerated...
November 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29053492/significance-of-mini-bronchoalveolar-lavage-fluid-amylase-level-in-ventilator-associated-pneumonia-a-prospective-observational-study
#17
Sukhen Samanta, Banani Poddar, Afzal Azim, Ratender K Singh, Mohan Gurjar, Arvind K Baronia
OBJECTIVES: Aspiration of oropharyngeal or gastric contents in intubated patients can lead to ventilator-associated pneumonia. Amylase in respiratory secretion has been reported as a possible marker of aspiration. We studied whether elevated α-amylase in mini bronchoalveolar lavage specimens can be suggestive of ventilator-associated pneumonia in intubated patients with high clinical suspicion. DESIGN: Prospective single-center observational study. SETTING: Department of Critical Care Medicine, tertiary care academic institute...
October 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29043696/-complete-and-inverted-esophagastric-duplicity
#18
J M Morán Penco, J Vázquez, E Forsheden Ahs, S Sanjuán Rodríguez, A Pairola, V García-Martínez
CASE REPORT: A 4-month old girl affected by gastric duplication discovered as a palpable abdominal mass displacing the spleen and left kidney. During laparotomy, a yellowish secretion is aspirated and the gastric duplication is excised together with the common muscular Wall of the greater curvature of the stomach. Also excised, a tubular structure starting from the inferior pole of the malformation, and communicating with it, passing superior to the head of the pancreas and the second portion of the duodenum, followed by a posterior course before inserting into the right cruz of the diaphragm...
July 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29039113/a-gastric-glomus-tumor-resected-using-non-exposed-endoscopic-wall-inversion-surgery
#19
Masahide Ebi, Tomoya Sugiyama, Kazuhiro Yamamoto, Takuya Saito, Tadahisa Inoue, Yoshiharu Yamaguchi, Yasuhiro Tamura, Shinya Izawa, Yasutaka Hijikata, Yasushi Funaki, Naotaka Ogasawara, Makoto Sasaki, Kunio Kasugai
Gastric glomus tumors are extremely rare, constituting approximately 1% of gastric mesenchymal tumors. We report the case of a 45-year-old female patient in whom upper gastrointestinal endoscopy revealed a 3-cm submucosal tumor with a bridging fold in the posterior wall of the antrum of the stomach. Contrast-enhanced computed tomography revealed the tumor to be hypervascular in the arterial phase and exhibit continuous enhancement in the post-venous phase. Dynamic contrast-enhanced magnetic resonance imaging showed that the tumor was hypervascular in the early phase and persistently enhanced in the late phase...
October 16, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29028915/point-of-care-paediatric-gastric-sonography-can-antral-cut-off-values-be-used-to-diagnose-an-empty-stomach
#20
J J Moser, A M Walker, A O Spencer
Background: Gastric sonography is emerging as a valuable clinical point-of-care tool to assess aspiration risk. A recent study proposed that a single cut-off cross-sectional area (CSA) in the supine position could diagnose an empty stomach in the parturient. This study establishes the sensitivity and specificity of a single CSA cut-off measurement in both supine and right lateral decubitus (RLD) positions in the diagnosis of an empty antrum in paediatric patients. Methods: Following induction of anaesthesia, antral sonography was performed in supine and RLD positions in 100 fasted paediatric patients prior to upper endoscopic evaluation...
November 1, 2017: British Journal of Anaesthesia
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