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https://www.readbyqxmd.com/read/29148580/ultrasound-guided-reduction-of-an-incarcerated-obturator-hernia-in-an-elderly-patient
#1
Bente M de Kok, Julien B C M Puylaert, Frank M Zijta
Obturator hernia is a rare but clinically relevant cause of intestinal obstruction, usually found in elderly, thin, multiparous women. It is difficult to diagnose, leading to diagnostic delay with a high incidence of strangulation and a high mortality rate. Surgery is the only reported treatment. We report the case of an 86-year-old woman, in whom an early diagnosis of incarcerated obturator hernia was made with subsequent reduction by compression with an ultrasound transducer. When the risk of strangulation is presumed to be low, ultrasound-guided reduction of an obturator hernia is achievable and worth considering...
November 17, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29148196/umbilicus-and-its-extensive-clinical-repertoire
#2
Spencer W Beasley
The umbilicus is involved in a wide range of abnormalities in infants and children. The most severe are evident at birth and include exomphalos (omphalocele) and gastroschisis, both of which can be life-threatening but are easy to diagnose. Exomphalos is often associated with other congenital abnormalities, whereas the associated problems in gastroschisis are largely confined to the gut. Infection of the umbilicus in the neonate presents as omphalitis. The causes of a moist umbilicus following separation of the umbilical stump are multiple, from the relatively minor umbilical granuloma or ectopic bowel mucosa to the more significant patent urachus that leaks urine...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29147878/knowledge-gaps-in-the-management-of-postoperative-crohn-s-disease-a-us-national-survey
#3
Vu Q Nguyen, Jessica L Mays, Marissa Lang, Yingxing Wu, Themistocles Dassopoulos, Miguel Regueiro, Alan Moss, Deborah D Proctor, Dario Sorrentino
BACKGROUND: Postoperative recurrence (POR) of Crohn's disease (CD) is common. Guidelines on POR management have recently been issued, but clinical practice may vary. AIMS: To examine the current clinical practice of POR management in the USA METHODS: A web-based survey was sent to all members of the American Gastroenterological Association and the American College of Gastroenterology. The survey consisted of multiple-choice questions with clinical scenarios to assess how participants manage POR...
November 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#4
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29144627/laparoscopic-nephrectomy-outside-gerota-fascia-and-en-bloc-ligation-of-the-renal-hilum-for-management-of-inflammatory-renal-diseases
#5
Liang Ma, Yanlan Yu, Guangju Ge, Gonghui Li
OBJECTIVES: This study aims to improve laparoscopic nephrectomy techniques for inflammatory renal diseases (IRD) and to reduce complications. MATERIALS AND METHODS: Thirty-three patients underwent laparoscopic nephrectomy for IRD, with a method of outside Gerota fascia dissection and en-bloc ligation and division of the renal pedicle. Operative time, blood loss, complications, analgesia requirement, post-operative recovery of intestinal function and hospital stay were recorded...
November 19, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29143090/pattern-of-lower-intestinal-ostomies-in-a-low-income-country-case-of-southeast-of-niger-republic
#6
Harissou Adamou, Oumarou Habou, Ibrahim Amadou Magagi, Ousseini Adakal, Amadou Magagi, Maazou Halidou, Rachid Sani
BACKGROUND: Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country. METHODS: This was a 4-year retrospective study (January 2013 to December 2016) at Zinder National Hospital (Niger). All patients with a digestive ostomy on an ileum or colic segment were included in the study...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142520/predictive-factors-for-malignancy-in-undiagnosed-isolated-small-bowel-strictures
#7
Ujjwal Sonika, Sujeet Saha, Saurabh Kedia, Nihar Ranjan Dash, Sujoy Pal, Prasenjit Das, Vineet Ahuja, Peush Sahni
Background/Aims: Patients with small bowel strictures have varied etiologies, including malignancy. Little data are available on the demographic profiles and etiologies of small bowel strictures in patients who undergo surgery because of intestinal obstruction but do not have a definitive pre-operative diagnosis. Methods: Retrospective data were analyzed for all patients operated between January 2000 and October 2014 for small bowel strictures without mass lesions and a definite diagnosis after imaging and endoscopic examinations...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29140941/phenotype-and-management-of-infantile-onset-inflammatory-bowel-disease-experience-from-a-tertiary-care-center-in-china
#8
Ziqing Ye, Ying Zhou, Ying Huang, Yuhuan Wang, Junping Lu, Zifei Tang, Shijian Miao, Kuiran Dong, Zhinong Jiang
BACKGROUND: Infantile-onset inflammatory bowel disease (IBD) comprises rare and clinically severe disorders. We examined the phenotypes and genetic causes of patients with infantile-onset IBD from a tertiary medical center. METHODS: We enrolled 38 patients with infantile-onset IBD and applied standardized treatment with medical, surgical, and supportive care. Targeted sequencing and whole-exome sequencing were performed. Clinical data were retrieved from medical records...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29137551/environmental-manipulations-as-an-effective-alternative-treatment-to-reduce-endometriosis-progression
#9
Annelyn Torres-Reverón, Leslie L Rivera, Idhaliz Flores, Caroline B Appleyard
Treatments for endometriosis include pharmacological or surgical procedures that produce significant side effects. We aimed to determine how environmental enrichment (EE) could impact the progression of endometriosis using the autotransplantation rat model. Female rats were exposed to EE (endo-EE: toys and nesting materials, 4 rats per cage, larger area enclosure) or no enrichment (endo-NE: 2 rats per cage) starting on postnatal day 21. After 8 weeks, sham surgery or surgical endometriosis was induced by suturing uterine horn tissue next to the intestinal mesentery, then allowed to progress for 60 days during which EE or NE continued...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/29137273/programmed-death-ligand-1-and-met-co-expression-is-a-poor-prognostic-factor-in-gastric-cancers-after-resection
#10
Mi Jung Kwon, Kab-Choong Kim, Eun Sook Nam, Seong Jin Cho, Hye-Rim Park, Soo Kee Min, Jinwon Seo, Ji-Young Choe, Hye Kyung Lee, Ho Suk Kang, Kyueng-Whan Min
Programmed death-ligand 1 (PD-L1) plays an essential protein for immune evasion, contributing to tumor development and progression. Recent studies have reported MET as an upregulator for PD-L1 overexpression through an oncogenic pathway. However, an association between PD-L1 expression with MET has not been reported in gastric cancer.The prognostic significance of PD-L1 and its association with Epstein-Barr virus (EBV), microsatellite instability (MSI), and mucin phenotype remain controversial. We performed in situ hybridization for EBV-encoded RNA and immunohistochemistry in tissue microarrays for 394 gastric cancers...
October 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29136611/gut-microbiota-in-health-and-disease
#11
Yuichiro Yamashiro
Intestinal regulatory T (Treg) cells are critical to maintaining immune tolerance to dietary antigens and gut microbiota. This paper reviews several papers on this topic that were recently published by Japanese researchers. Specifically, Prof. K. Honda and his group have found that commensal microbiota capable of metabolizing butyrate induces the differentiation of colonic Treg cells. In a separate work, Prof. Y. Yokoyama and his group used a novel, culture-independent analytical method (the Yakult Intestinal Flora-Scan) for detection of bacteria in the bloodstream...
November 14, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/29135972/roux-en-y-gastric-bypass-reduces-plasma-cholesterol-in-diet-induced-obese-mice-by-affecting-trans-intestinal-cholesterol-excretion-and-intestinal-cholesterol-absorption
#12
C Blanchard, F Moreau, A Ayer, L Toque, D Garçon, L Arnaud, F Borel, A Aguesse, M Croyal, M Krempf, X Prieur, M Neunlist, B Cariou, C Le May
OBJECTIVE: Bariatric surgery appears as the most efficient therapeutic alternative in morbidly obese patients. In addition to its efficiency to decrease body weight, it also improves metabolic complications associated to morbid obesity, including dyslipidemia. Although the cholesterol-lowering effect varies with the bariatric procedures, the underlying molecular mechanisms remain poorly defined. This study aims to assess the consequence of both restrictive (sleeve gastrectomy; SG) and malabsorptive (Roux-en-Y gastric bypass; RYGB) procedures on cholesterol metabolism in mice...
September 28, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29133112/persistent-abdominal-pain-after-laparoscopic-cholecystectomy-is-associated-with-increased-healthcare-consumption-and-sick-leave
#13
Sarah Z Wennmacker, Marcel G W Dijkgraaf, Gert P Westert, Joost P H Drenth, Cornelis J H M van Laarhoven, Philip R de Reuver
BACKGROUND: Although, 33% to 40% of symptomatic gallstone patients reported persistent abdominal pain after laparoscopic cholecystectomy, there is no data on the burden of this pain to the healthcare system and society at large. This study determined healthcare consumption, sick leave, and costs in patients with persistent abdominal pain after laparoscopic cholecystectomy. Secondly, predictive factors for healthcare consumption were assessed. METHODS: This cross-sectional study included all 146 patients with persistent abdominal pain (patient-reported on Gastro-Intestinal Quality of Life Index (score 0-3) 24 weeks after laparoscopic cholecystectomy, derived from a previous prospective cohort...
November 10, 2017: Surgery
https://www.readbyqxmd.com/read/29133083/jejunal-diverticulitis-review-and-treatment-algorithm
#14
Houssem Harbi, Nizar Kardoun, Sami Fendri, Nouha Dammak, Nozha Toumi, Ahmed Guirat, Rafik Mzali
Diverticulitis is much less common in the jejunum than in colonic diverticula probably because of diverticulum larger size, better intra-luminal flow and relatively sterile jejunal content. Complications of jejunal diverticulitis are acute intestinal obstruction, diverticular bleeding and mainly perforation with mesenteric abscess, localized or generalized peritonitis. The Multi-detector row computed tomography is now the best diagnostic imaging for small bowel diverticulitis as well as its complications. Magnetic resonance enterography is also quite useful but it is still impractical to resort to such an imaging in an abdominal emergency...
November 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29130230/-protective-measures-in-laparoscopic-resection-for-upper-or-mid-rectal-cancer-and-sigmoid-colon-cancer-with-transrectal-specimen-extraction-surgery
#15
Chuangang Fu, Zhuqing Zhou, Junyi Han, Bin Lu, Wei Gao, Zhe Zhu, Qixin Jiang, Fang Ji, Tao Du
OBJECTIVE: To introduce the use of a self-made specimen protective sleeve in laparoscopic resection for upper or mid rectal cancer and sigmoid colon cancer with transrectal specimen extraction surgery and the improvement of implantation method, so as to avoid and reduce bacterial contamination and tumor cell dissemination in abdominal cavity. METHODS: During June 2015 and May 2017, 48 cases of high located rectal or sigmoid colon cancer were operated laparoscopically with natural orifices specimen extraction surgery (NOSES) using a self-made specimen protecting sleeve...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29130227/-recognition-of-the-diagnosis-and-treatment-of-small-intestinal-obstruction
#16
Qiyi Chen, Jun Jiang
Small intestinal obstruction is a common and frequent disease in general surgery. Delayed diagnosis and surgical timing, and inaccurate treatment strategy will lead to life-threatening complications. Therefore, how to diagnose and treat quickly and accurately is still a difficult problem in current gastrointestinal surgery. This paper summarizes and analyzes the diagnosis and treatment strategies of small intestinal obstruction based on current laboratory technology, medical imaging technology, perioperative management and improvement of surgical concepts...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29130218/-clinical-significance-and-practice-points-of-conversion-therapy-for-gastric-cancer-with-peritoneal-metastasis
#17
Zhenggang Zhu
Gastric cancer with peritoneal dissemination is usually considered to be oncologically unresectable and is known to have a very poor prognosis. Despite recent advances in systemic chemotherapy, peritoneal dissemination due to advanced gastric cancer (AGC) still remains the most life-threatening type of metastasis and recurrence, which usually causes ascites accumulation, intestinal obstruction, or hydronephrosis, and then seriously impairs the quality of life. In general, the median survival time of these cases is reported to be just only 6-9 months...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29129414/-surgical-management-of-deep-infiltrating-endometriosis-with-bowel-involvement-and-urinary-tract-involvement
#18
Sofiane Bendifallah, Marcos Ballester, Emile Darai
Endometriosis is a benign pathology that affects 3% of the general population and about 10% of women of reproductive age. Three anatomoclinical entities are described: peritoneal, ovarian (endometrioma) and deep endometriosis characterized by the infiltration of anatomical structures or organs beyond the peritoneum. Laparoscopic surgery should be performed, as this is associated with a reduction in postoperative complications, length of hospitalization and convalescence. Several surgical techniques allow the removal of deep endometriosis with colorectal involvement: rectal shaving, anterior discoid resection, segmental resection...
November 9, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29129185/combined-use-of-high-doses-of-vasopressin-and-corticosteroids-in-a-patient-with-crohn-s-disease-with-refractory-septic-shock-after-intestinal-perforation-a-case-report
#19
Salvatore Notaro, Marcello Sorrentino, Aniello Ruocco, Annalisa Notaro, Antonio Corcione, Patrizia Murino, Eugenio Piscitelli, Marianna Tamborino
BACKGROUND: In this article, we present a clinical case of refractory septic shock resulting from intestinal perforation treated with high doses of vasopressin and hydrocortisone during emergency surgery. The use of such high doses of vasopressin for this type of shock is not described in the literature. CASE PRESENTATION: A 49-year-old white woman with grade III obesity, Crohn's disease, and an intestinal perforation presented with refractory septic shock. Initially, a low dose of vasopressin was used...
November 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29127554/is-there-any-role-for-minimally-invasive-surgery-in-net
#20
REVIEW
M Thomaschewski, H Neeff, T Keck, H P H Neumann, T Strate, E von Dobschuetz
Neuroendocrine tumors (NET) represent the variability of almost benign lesions either secreting hormones occurring as a single lesion up to malignant lesions with metastatic potential. Treatment of NET is usually performed by surgical resection. Due to the rarity of NET, surgical treatment is mainly based on the experience and recommendations of experts and less on the basis of prospective randomized studies. In addition, the development and establishment of new surgical procedures is made more difficult by their rarity...
November 11, 2017: Reviews in Endocrine & Metabolic Disorders
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