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small bowel resection adhesions

Gavish K Awotar, Fuwen Luo, Zhengdong Zhao, Guoxin Guan, Shili Ning, Jinshuai Ren, Yaqing Liu, Guangzhi Wang, Pixu Liu
BACKGROUND: The cancer of the splenic flexure of the colon is a rare medical entity with severe morbidity because of its insidious onset. METHODS: We present the case of a 59-year-old male patient with dull left upper quadrant pain, leukocytosis, and anemia. A splenic abscess described as an air-fluid level with splenocolic fistula was found on CT scan imaging. Surgery was done for splenic pus drainage. He was again admitted 2 months later for intestinal obstruction...
September 2016: Medicine (Baltimore)
Zanazir E Alexander, Bruce Su'a, Caleb T G Hill, Mataroria P Lyndon, Primal P Singh, Andrew G Hill
BACKGROUND: Studies conducted in animal models have shown that statins (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors) reduce adhesion formation by upregulating fibrinolysis. The aim of this study was to determine the effect of orally administered statins on the promoters and inhibitors of the fibrinolytic pathway. METHODS: In a previously described double-blinded clinical trial, 144 patients undergoing elective colorectal resection, or reversal of Hartmann's procedure were randomized to receive 40 mg once daily oral simvastatin 3-7 d before surgery or placebo...
September 2016: Journal of Surgical Research
Kazuhide Matsushima, Kenji Inaba, Ryan Dollbaum, Vincent Cheng, Moazzam Khan, Keith Herr, Aaron Strumwasser, Sabrina Asturias, Evren Dilektasli, Demetrios Demetriades
BACKGROUND: Patients with adhesive small bowel obstruction (ASBO) often develop intraabdominal free fluid (IFF). While IFF is a finding on abdominopelvic computed tomography (CT) associated with the need for surgical intervention, many patients with IFF can be still managed non-operatively. A previous study suggested that a higher red blood cell count of IFF is highly predictive of strangulated ASBO. We hypothesized that radiodensity in IFF (Hounsfield unit (HU)) on CT would predict the need for surgical intervention...
September 9, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Daniel Sumner, Jagjit Sahota, John Schofield
A 74-year-old woman was referred to the surgical team from clinic, reporting of a 1-week history of vomiting and abdominal distension on a background of previous large bowel resection for a flare up of diverticulitis with a suspicion of diaphragm disease of the small intestine diagnosed at the same time. She was initially managed conservatively owing to the likely diagnosis of adhesion(s) leading to small bowel obstruction, but a CT of the abdomen a day later revealed a recurrence of diaphragmatic disease of the small bowel causing an obstruction, most likely due to chronic non-steroidal anti-inflammatory drug use...
2016: BMJ Case Reports
John W Scott, Olubode A Olufajo, Gabriel A Brat, John A Rose, Cheryl K Zogg, Adil H Haider, Ali Salim, Joaquim M Havens
IMPORTANCE: Emergency general surgery (EGS) represents 11% of surgical admissions and 50% of surgical mortality in the United States. However, there is currently no established definition of the EGS procedures. OBJECTIVE: To define a set of procedures accounting for at least 80% of the national burden of operative EGS. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review was conducted using data from the 2008-2011 National Inpatient Sample...
June 15, 2016: JAMA Surgery
Jian Wang, Qi Mao, Danhua Yao, Yousheng Li, Jieshou Li
OBJECTIVE: To determine the feasibility and possible superiority of laparoscopic surgery for chronic adhesive small bowel obstruction(CASBO). METHODS: Clinical data of 36 CASBO patients who underwent laparoscopic surgery in Jinling Hospital from March 2011 to August 2014 were retrospectively reviewed. In addition, 36 cases, matched by age, gender, previous abdominal surgery history, body mass index(BMI) and abdominal adhesion grade, who underwent open surgery from April 2007 to February 2011 were used as controls...
April 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Nicolò Pecorelli, Salvatore Amodeo, Matteo Frasson, Andrea Vignali, Walter Zuliani, Marco Braga
PURPOSE: To evaluate the impact of laparoscopy compared to open surgery on long-term outcomes in a large series of patients who participated in a randomized controlled trial comparing short-term results of laparoscopic (LPS) versus open colorectal resection. METHODS: This is a retrospective review of a prospective database including 662 patients with colorectal disease (526, 79 % cancer patients) who were randomly assigned to LPS or open colorectal resection and followed every 6 months by office visits...
July 2016: International Journal of Colorectal Disease
Ferid Konjic, Enes Idrizovic, Ismar Hasukic, Alen Jahic
INTRODUCTION: Adhesions are the reason for bowel obstruction in 80% of the cases. In well selected patients the adhesive ileus laparoscopic treatment has multiple advantages which include the shorter hospitalization period, earlier food taking, and less postoperative morbidity rate. CASE REPORT: Here we have a patient in the age of 35 hospitalized at the clinic due to occlusive symptoms. Two years before an opened appendectomy had been performed on him. He underwent the treatment of exploration laparoscopy and laparoscopic adhesiolysis...
February 2016: Acta Informatica Medica: AIM
Sen Hong, Miao-Miao Bi, Ping-Wei Zhao, X U Wang, Qing-Yang Kong, Yong-Tao Wang, Lei Wang
Malignant mesothelioma is a rare type of cancer, most commonly associated with exposure to asbestos. Mesothelioma of the peritoneum, the membrane lining the abdominal cavity, is extremely rare. The current study reports the case of a 60-year-old female who presented with intestinal fistula, recurrent incisional hernia and abdominal infection, with no history of asbestos exposure, and was diagnosed with clear cell MPM. Computed tomography scans of the abdomen revealed extensive small bowel adhesions and massive peritoneal effusion...
March 2016: Oncology Letters
T Sakari, R Sjödahl, L Påhlman, U Karlbom
AIM: Adhesions are the most common cause of small bowel obstruction (SBO). The costs of hospitalization and surgery for SBO are substantial for the health-care system. The adhesion-limiting potential of icodextrin has been shown in patients undergoing surgery for gynaecological diseases. A randomized, multicentre trial in colorectal cancer surgery started in 2009 with the aim of evaluating whether icodextrin could reduce the long-term risk of surgery for SBO. Because of some concerns about complications (especially anastomotic leakage) after icodextrin use, a preplanned interim analysis of morbidity and mortality was conducted...
March 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Naotake Funamizu, Tomotaka Kumamoto, Atsushi Watanabe, Tomoyoshi Okamoto, Katsuhiko Yanaga
Owing to their rare occurrence, persimmon bezoars are often overlooked as a cause of small bowel obstruction. We herein report a small bowel obstruction in a 67-year-old Japanese female who regularly consumed persimmons in autumn. The patient presented to our hospital with typical complaints of abdominal distension with pain for 2 days. Based on the patient's history of a cesarean section 34 years ago, we initially diagnosed her with small bowel obstruction resulting from adhesions and placed an ileus tube...
July 2015: International Surgery
Mehraneh D Jafari, Fariba Jafari, Jennifer E Foe-Paker, Michael J Phelan, Joseph C Carmichael, Alessio Pigazzi, Steven Mills, Michael J Stamos
Adhesions account for 74 per cent of admissions for small bowel obstruction (SBO). There is a lack of data regarding the usage and outcomes of laparoscopy (LS) for SBO. A retrospective review of urgent admissions for SBO using the Nationwide Inpatient Sample 2001 to 2011 was conducted. Among the estimated 3,948,987 SBO admissions, 36.7 per cent underwent operative management and LS was performed in 26.5 per cent with a 22.5 per cent conversion rate. Admissions increased by 3.1 per cent annually, whereas nonoperative management increased by 3...
October 2015: American Surgeon
Sanghoon Lee, Jeong-Meen Seo, Alaa Essam Younes, Chae-Youn Oh, Suk-Koo Lee
Diaphragmatic hernias (DH) occurring after pediatric liver transplantation (LT) are rare. However, such complications have been previously reported in the literature and treatment has always been surgical repair via laparotomy. We report our experience of minimally invasive thoracoscopic approach for repair of DH occurring after LT in pediatric recipients.From April 2010 to December 2014, 7 cases of DH were identified in pediatric LT recipient in Samsung Medical Center. Thoracoscopic repair was attempted in 3 patients...
August 2015: Medicine (Baltimore)
Amanda D Rice, Richard King, Evette D'Avy Reed, Kimberley Patterson, Belinda F Wurn, Lawrence J Wurn
BACKGROUND: Adhesion formation is a widely acknowledged risk following abdominal or pelvic surgery. Adhesions in the abdomen or pelvis can cause or contribute to partial or total small bowel obstruction (SBO). These adhesions deter or prevent the passage of nutrients through the digestive tract, and may bind the bowel to the peritoneum, or other organs. Small bowel obstructions can quickly become life-threatening, requiring immediate surgery to resect the bowel, or lyse any adhesions the surgeon can safely access...
2013: Journal of Clinical Medicine
Rohit Sharma, Subhash Reddy, David Thoman, Jonathan Grotts, Lisa Ferrigno
BACKGROUND: Small bowel obstruction (SBO) is commonly encountered by surgeons and has traditionally been handled via an open approach, especially when small bowel resection (SBR) is indicated, although recent series have shown improved outcomes with a laparoscopic approach. In this retrospective study, we sought to evaluate outcomes and identify risk factors for adverse events after emergency SBR for SBO with an emphasis on surgical approach. MATERIALS AND METHODS: In this retrospective review using American College of Surgeons National Surgical Quality Improvement Program data, 1750 patients were identified who had emergency SBR with the principal diagnosis of SBO from 2006 to 2011...
August 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
A V Pugaev, E E Achkasov, M G Negrebov, L V Aleksandrov, M P Ba, A A Andreichikov
AIM: To estimate the degree and prevalence of pathomorphological changes in the small intestine at different distances from the visible necrosis boundary depending on acute mechanical obstruction for the choice of the optimal extent of resection. MATERIALS AND METHODS: Small intestine fragments for morphological study were obtained from 52 patients aged 17-83 (mean 47 ± 17) years after emergency resection of mechanically obstructed necrotic bowel. Strangulation caused by obstructive adhesion was diagnosed in 48%, constricted hernia in 38...
2015: Klinicheskaia Meditsina
Amir Dori, Glenn Lopate, Rati Choksi, Alan Pestronk
INTRODUCTION: Different disease patterns result from loss of myelinated and unmyelinated axons, but quantitation to define their loss has been difficult. METHODS: We measured large and small endoneurial axons in axonal neuropathies by staining them with peripherin and comparing their area to that of nonmyelinating Schwann cells stained with neural cell adhesion molecule (NCAM). RESULTS: Loss of myelinated and unmyelinated axons was typically proportional, with predominant myelinated or unmyelinated axon loss in a few patients...
February 2016: Muscle & Nerve
Tyge Nordentoft
BACKGROUND: Colorectal cancer (CRC) is the most common cancer of the gastrointestinal tract. In Denmark is CRC the 3. most frequent form of cancer and the 3. leading cause of cancer-related death. Anastomoses: Surgical resection is the only curative treatment of CRC and in Denmark about 85% of patients with CRC are therefore operated. An anastomosis will be established in most cases. Colorectal anastomoses are established in the treatment of benign diseases too, i.e. as part of the surgical treatment of inflammatory bowel disease and in acute surgery...
May 2015: Danish Medical Journal
Joel Bauer, Brieze Keeley, Beth Krieger, Juan Deliz, Kojo Wallace, Danielle Kruse, Kai Dallas, Joseph Bornstein, David Chessin, Stephen Gorfine
We assessed the nonoperative and operative management of adhesive small bowel obstruction (ASBO) and compared complication rates and surgical outcomes. ASBO is a common complication of abdominopelvic surgery. Although patients may respond to nonoperative management, many require surgery. We retrospectively studied patients admitted to Mount Sinai Hospital with a diagnosis of complete ASBO to determine outcomes of nonoperative management. Patients admitted with complete ASBO from 2001 to 2011 were included. Patients with no previous abdominopelvic surgery, surgery within the six weeks preceding admission and obstruction due to other identifiable causes, such as incarcerated hernia, were excluded...
June 2015: American Surgeon
C Bălălău, N Bacalbaşa, I Motofei, Fl Popa, S Voiculescu, R V Scăunaşu
Although many people have Meckel's diverticulum, only some experience any symptoms, most under the age of 10. In adults it is usually asymptomatic but approximately 4% develop complications. Meckel's diverticulum is usually diagnosed in the first years of life and after that the risk of the complications decreases with increasing age, with no predictive factors for the development of complications. We describe the case of a 34-year-old man admitted in the emergency department with diffuse abdominal pain, nausea, flatulence and lack of transit for feces and gas...
January 2015: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
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