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Gastric aspiration

Eun Jeong Gong, Do Hoon Kim
Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis...
September 2016: Clinical Endoscopy
Yoshiaki Maeda, Toshiki Shinohara, Tomonari Katayama, Akihisa Nagatsu, Noriaki Futakawa, Tomonori Hamada
Gastrointestinal stromal tumors (GISTs) of the stomach presenting as an intra-abdominal abscess are extremely rare. We herein report a case that underwent successful laparoscopic resection of gastric GIST presenting with an intra-abdominal abscess. A 70-year-old man presented with a 3-day history of acute upper abdominal pain with a fever. Laboratory data showed an elevated white blood cell count and C-reactive protein level. A CT scan revealed a mass of mixed solid and fluid components, measuring 5.5 cm, in the adjacent lesser curvature of the stomach...
May 2016: Case Reports in Gastroenterology
Anahita Rouzé, Julien De Jonckheere, Farid Zerimech, Julien Labreuche, Erika Parmentier-Decrucq, Benoit Voisin, Emmanuelle Jaillette, Patrice Maboudou, Malika Balduyck, Saad Nseir
BACKGROUND: Despite intermittent control of tracheal cuff pressure (P cuff) using a manual manometer, cuff underinflation (<20 cmH2O) and overinflation (>30 cmH2O) frequently occur in intubated critically ill patients, resulting in increased risk of microaspiration and tracheal ischemic lesions. The primary objective of our study was to determine the efficiency of an electronic device in continuously controlling P cuff. The secondary objective was to determine the impact of this device on the occurrence of microaspiration of gastric or oropharyngeal secretions...
December 2016: Annals of Intensive Care
Koji Morita, Takahiko Sakamoto, Shuji Ota, Hideo Masugi, Ikumi Chikuta, Yamato Mashimo, Naoki Edo, Takuo Tokairin, Nobuhiko Seki, Toshio Ishikawa
It has been shown that metastases to the thyroid from extrathyroidal malignancies occur as solitary or multiple nodules, or may involve the whole thyroid gland diffusely. However, diffuse metastasis of gastric cancer to the thyroid is extremely rare. Here, we report a case of a 74-year-old woman with diffuse infiltration of gastric adenocarcinoma (signet-ring-cell carcinoma/poorly differentiated adenocarcinoma) cells in the thyroid. The pathological diagnosis was made based on upper gastrointestinal endoscopy with biopsy and fine-needle aspiration cytology of the thyroid...
October 1, 2016: Journal of Medical Ultrasonics
Chen Tian, Yizhuo Zhang
INTRODUCTION: Most primary stomach lymphomas are now recognized to originate from B-cell. Primary gastric anaplastic lymphoma kinase (ALK)-negative anaplastic large-cell lymphoma (ALCL) as shown in this case is very rare. CASE REPORT: A 59-year-old man presented with a 1-month history of epigastric pain. Computed tomography showed a tumor in the stomach with perigastric lymphadenopathy. Biopsy of the tumor with gastroendoscopy showed ALCL. Bone marrow aspiration and trephine biopsy showed no infiltration...
2016: OncoTargets and Therapy
Jari Rubbens, Joachim Brouwers, Jan Tack, Patrick Augustijns
This study investigated the impact of relevant gastrointestinal conditions on the intraluminal dissolution, supersaturation and precipitation behavior of the weakly basic drug indinavir. The influence of (i) concomitant PPI intake and (ii) the nutritional state on the gastrointestinal behavior of indinavir was assessed in order to identify the underlying mechanisms responsible for previously reported interactions. Five healthy volunteers were recruited into a cross-over study containing the following arms: fasted state, fed state and fasted state with concomitant proton pump inhibitor (PPI) use...
September 28, 2016: European Journal of Pharmaceutics and Biopharmaceutics
Lionel Bouvet, Caroline Augris, Clémence Aubergy, Dominique Chassard
We report two cases of patients presenting for elective surgery, in whom significant gastric contents were identified by performing fortuitous ultrasound examination of their antral area. The first patient presented for a day-case surgery scheduled under regional anesthesia. With his consent, ultrasound examination of the antral area was by chance performed within the context of training for this technique, showing significant solid contents in the stomach. The patient admitted that he had not respected preoperative fasting...
September 2016: Journal of Ultrasonography
Vaughn E Nossaman, William S Richardson, James B Wooldridge, Bobby D Nossaman
INTRODUCTION: A recent bariatric surgical study demonstrated an inverse relationship of intraoperative hydration with the incidence of extended hospital length of stay (ehLOS: >1 postoperative hospital day). In that study, a post hoc analysis of the preoperative duration of Nil Per Os (NPO) past midnight revealed a significant dose-response association on the incidence of ehLOS, with the lowest incidence (10-12 %) predicted within the 2-5-h NPO interval. As NPO is associated with a state of compensatory dehydration, the objectives of this study were to prospectively examine the role of decreasing preoperative NPO intervals on the incidence of ehLOS in a similar bariatric surgical population and to establish causality of this association...
September 27, 2016: Surgical Endoscopy
Nitish Fokeerah, Xinwei Liu, Yonggang Hao, Lihua Peng
Managing a patient scheduled for bronchoesophageal fistula repair is challenging for the anesthetist. If appropriate ventilation strategy is not employed, serious complications such as hypoxemia, gastric distension, and pulmonary aspiration can occur. We present the case of a 62-year-old man with a bronchoesophageal fistula in the left main stem bronchus requiring the insertion of a Y-shaped tracheobronchial stent through a rigid bronchoscope, under general anesthesia. We successfully managed this intervention and herein report this case to demonstrate the effectiveness of underwater seal gastrostomy tube drainage used in conjunction with high-frequency jet ventilation during bronchoesophageal fistula stenting...
2016: Case Reports in Anesthesiology
Ethan Charles Blocher-Smith, David A Smith
INTRODUCTION: Stomach dehiscence from the abdominal wall is a serious and potentially life-threatening complication of gastrostomy tube changes. This retrospective study evaluates gastric aspiration as an inexpensive and safe alternative to endoscopic or radiographic confirmation. METHODS: From August 1998 to June 2016, 682 patients (301 female, 381 male) underwent 1713 gastrostomy tube changes in the medical setting, with an average age of 7.59years and an average site age of 3...
September 14, 2016: Journal of Pediatric Surgery
Arthur Raymond Hubert van Zanten
Gastrointestinal feeding intolerance and critical illness-associated gastric motility dysfunction are common. Although recent guidelines recommend not interrupting gastric feeding when gastric residual volume (GRV) is lower than 500 mL or to completely abandon measurement of GRV, it may seem that the relevance of prokinetics is reduced.In patients at risk for aspiration and in multimodal strategies to enhance feeding performance, however, use of prokinetics is still advocated. Metoclopramide and erythromycin are commonly used promotility agents, although with relevant side effects...
September 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
E Bukhari, F Alaklobi, H Bakheet, A Alrabiaah, F Alotibi, F Aljobair, M Alshamrani, E Alaki, F Alnahdi, A Alodyani, F Alzamil
OBJECTIVE: The bacille Calmette Guérin (BCG) vaccine is administered worldwide to prevent tuberculosis. Although, Post BCG vaccination complications like disseminated BCG infections are rare and immunocompromised children are at high risk of developing BCG-related complications including BCG-lymphadenitis and other disseminated diseases. PATIENTS AND METHODS: This was a prospective study of children who developed disseminated BCG after vaccination who were admitted in three tertiary care hospital in Riyadh, Saudi Arabia, in the year 2015...
September 2016: European Review for Medical and Pharmacological Sciences
Alex De Leon
At present, elderly individuals represent approximately 18,5% of the European population and account for about 23% of surgical procedures performed. This patient population is at a higher riskì for perioperative complications and adverse postoperative outcome. This narrative review highlights our current knowledge about physiological changes in the aging gut and the implications for anaesthesiologists. The reduced response to stimuli in the pharynx, and reduction of the cough reflex that occurs in many older individuals, probably explains the increased incidence of aspiration pneumonia that occurs in the elderly...
September 15, 2016: Minerva Anestesiologica
Sotaro Fukuhara, Hirofumi Tazawa, Hideharu Okanobu, Michiko Kida, Miki Kido, Toshiro Takafuta, Toshihiro Nishida, Hideki Ohdan, Hideto Sakimoto
INTRODUCTION: Extramedullary plasmacytoma (EMP) is a plasma cell neoplasm that presents as a solitary tumor. EMP in the gastrointestinal organs are extremely uncommon. PRESENTATION OF CASE: A 36-year-old man was admitted to our hospital with advanced anemia. He had no specific medical history. Gastroendoscopic findings showed an 8.0-cm submucosal tumor with ulcer on the greater curvature of the gastric body. Fine-needle aspiration was performed, and the pathologic diagnosis of the submucosal tumor was a plasmacytoma...
2016: International Journal of Surgery Case Reports
Nitin Kumar
Obesity and its comorbidities - including diabetes and obstructive sleep apnea - have taken a large and increasing toll on the United States and the rest of the world. The availability of commercial, clinical, and operative therapies for weight management have not been effective at a societal level. Endoscopic bariatric therapy is gaining acceptance as more effective than diet and lifestyle measures, and less invasive than bariatric surgery. Various endoscopic therapies are analogues of the restrictive or bypass components of bariatric surgery, utilizing gastric remodeling or intestinal anastomosis to achieve proven weight loss and metabolic benefits...
August 21, 2016: World Journal of Gastroenterology: WJG
Austin L Chiang, Marvin Ryou
PURPOSE OF REVIEW: Obesity and its comorbid illnesses affect millions worldwide and are one of the major causes of preventable death in the world. Bariatric surgery is currently offered to individuals with a BMI greater than 40 kg/m or greater than 35 kg/m with obesity-related comorbidities such as hypertension or diabetes. Endoscopic bariatric therapies, with their reduced invasiveness and potential reversibility, may complement surgical approaches for achieving weight loss. RECENT FINDINGS: At the time of this writing, two endoscopically placed intragastric balloons and an endoscopically placed aspiration tube have been approved by the Food and Drug Administration for weight loss purposes...
November 2016: Current Opinion in Gastroenterology
Norma E González, Silvia Álvarez Ponte, Mariela López, Pablo Fronti, Silvina Smith, Victor Pawluk
The secondary hemophagocytic syndrome is rare in children and even rarer associated with tuberculosis. e report the case of a patient with acquired immunodeficiency syndrome, disseminated tuberculosis and hemophagocytic syndrome. An 8-year-old girl, diagnosed with acquired immunodeficiency syndrome, was admitted due to fever, vomiting and abdominal pain. She presented abdominal distension, dehydration, tachypnea, crackles and wheezing in both lungs, anemia, thrombocytopenia and coagulopathy. She received broad-spectrum antibiotics and exploratory laparotomy was performed with appendectomy and lymph node biopsy...
October 1, 2016: Archivos Argentinos de Pediatría
Elisa Estenssoro, Arnaldo Dubin
Acute respiratory distress syndrome (ARDS) is an acute respiratory failure produced by an inflammatory edema secondary to increased lung capillary permeability. This causes alveolar flooding and subsequently deep hypoxemia, with intrapulmonary shunt as its most important underlying mechanism. Characteristically, this alteration is unresponsive to high FIO2 and only reverses with end-expiratory positive pressure (PEEP). Pulmonary infiltrates on CXR and CT are the hallmark, together with decreased lung compliance...
2016: Medicina
Stacy A Brethauer, Julietta Chang, Manoel Galvao Neto, Jan Willem Greve
BACKGROUND: Obesity and type 2 diabetes (T2D) continue to be growing epidemics worldwide. Although bariatric surgery remains the most effective and durable treatment for both of these chronic diseases, there is a need for therapies with risk and benefit profiles between medication and standard surgical procedures. Currently there are several endoscopic and minimally invasive therapies available worldwide to treat T2D. OBJECTIVE: To review the current evidence regarding the safety and efficacy of medical devices to treat T2D...
July 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
F Lee Cantrell, Phyllis Mallett, Lenore Aldridge, Kimi Verilhac, Iain M McIntyre
Tapentadol (TAP) is an analgesic agent indicated for the management of different types of pain. It has a novel mechanism of action in that it induces analgesia via both μ-opioid receptor agonism and norepinephrine reuptake inhibition. Although deaths associated with TAP use have been reported, there is a paucity of published literature regarding TAP concentrations in biological samples obtained from TAP-associated fatalities. We report a case of TAP toxicity resulting in death with postmortem peripheral and central blood concentrations, liver, vitreous, urine, and gastric contents...
September 2016: Forensic Science International
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