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small bowel resection adhesions

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https://www.readbyqxmd.com/read/29273999/distal-duodenogastrostomy-or-proximal-jejunogastrostomy-in-the-management-of-ultra-short-bowel
#1
Tjipke Olivier Hofker, Mirjam Anna Kaijser, Vincent B Nieuwenhuijs, Johan Frederick Michel Lange, Hendrik Sijbrand Hofker
Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records...
December 22, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29251701/lower-emergency-general-surgery-egs-mortality-among-hospitals-with-higher-quality-trauma-care
#2
John W Scott, Thomas C Tsai, Pooja U Neiman, Gregory J Jurkovich, Garth H Utter, Adil H Haider, Ali Salim, Joaquim M Havens
BACKGROUND: Patients undergoing emergency general surgery (EGS) procedures are up to eight times more likely to die than patients undergoing the same procedures electively. This excess mortality is often attributed to non-modifiable patient factors including comorbidities and physiologic derangements at presentation, leaving few targets for quality improvement. Though the hospital-level traits that contribute to EGS outcomes are not well understood, we hypothesized that facilities with lower trauma mortality would have lower EGS mortality...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29170020/impact-of-race-on-the-surgical-management-of-adhesive-small-bowel-obstruction
#3
Alexander S Chiu, Raymond A Jean, Kimberly A Davis, Kevin Y Pei
BACKGROUND: Small bowel obstruction (SBO) represents roughly 15% of admissions by general surgeons. Management of SBO relies heavily on provider judgement, including decisions on how long to trial non-surgical management and whether to use a laparoscopic or open approach when surgery is needed. Given the subjective nature of these decisions, it is unknown if patient race influences management of SBO. STUDY DESIGN: The National Surgical Quality Improvement Program was used to identify patients who underwent adhesiolysis or small bowel resection for adhesive SBO between 2010-2015 (n=13,896)...
November 20, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29161796/-small-bowel-perforation-caused-by-press-through-package
#4
Jung Seok Kim, Jae Myung Cha, Min Seob Kwak, Jin Young Yoon, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Hye Young Kim
With an increased use of the press-through package (PTP) tablet, there has also been an increase in mis-swallowing cases, especially in elderly patients. We report a rare case of PTP-induced small bowel perforation and fistula formation with adjacent small bowel in a healthy elderly patient, who experienced persistent abdominal pain of unknown cause. A 62-year-old healthy man was admitted to our hospital with left abdominal pain that started one month ago. Neither abdominal tenderness nor rebound tenderness was present on physical examination...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29117026/the-american-association-for-the-surgery-of-trauma-severity-grade-is-valid-and-generalizable-in-adhesive-small-bowel-obstruction
#5
Martin D Zielinski, Nadeem N Haddad, Asad Choudhry, Matthew C Hernandez, Daniel C Cullinane, David Turay, Ji-Ming Yune, Salina Wydo, Kenji Inaba, D Dante Yeh, Therese M Duane, Andrea Pakula, Ruby Skinner, Jill Watras, Carlos J Rodriguez, Kenneth A Widom, John Cull, Julie Dunn, Eric A Toschlog, Valerie G Sams, John C Graybill
INTRODUCTION: The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) was validated at a single institution. We aimed to externally validate the AAST ASBO grading system using the Eastern Association for the Surgery of Trauma (EAST) multi-institutional SBO prospective observational study. METHODS: Adults (age≥18) with (ASBO) were included. Baseline demographics, physiologic parameters (heart rate, blood pressure, respiratory rate), labs (lactate, hemoglobin, creatinine, leukocytosis), imaging findings, operative details, length of stay, and Clavien-Dindo complications were collected...
November 7, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29030779/recurrence-after-operative-treatment-of-adhesive-small-bowel-obstruction
#6
Lea Lorentzen, Mari N Øines, Erling Oma, Kristian K Jensen, Lars N Jorgensen
BACKGROUND: Postoperative adhesions are a common cause of small-bowel obstruction, and up to 53% of patients operated on for adhesive small-bowel obstruction (ASBO) experience recurrence. The primary aim of this study was to identify predictors for recurrence of ASBO. METHODS: We reviewed medical records including operation descriptions from patients who underwent emergency surgery due to ASBO at our institution between 2004 and 2013. Information on the peri- and postoperative periods, including conservatively and surgically treated recurrent ASBO, were obtained from medical records...
October 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28963604/understanding-the-weekend-effect-for-emergency-general-surgery
#7
Richard S Hoehn, Derek E Go, Vikrom K Dhar, Young Kim, Dennis J Hanseman, Koffi Wima, Shimul A Shah
BACKGROUND: Several studies have identified a "weekend effect" for surgical outcomes, but definitions vary and the cause is unclear. Our aim was to better characterize the weekend effect for emergency general surgery using mortality as a primary endpoint. METHODS: Using data from the University HealthSystem Consortium from 2009 to 2013, we identified urgent/emergent hospital admissions for seven procedures representing 80% of the national burden of emergency general surgery...
September 29, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28958281/an-innovative-way-to-separate-gastrointestinal-and-abdominal-wall-reconstruction-after-complex-abdominal-trauma
#8
David H Livingston, David V Feliciano
Despite advances in trauma care, a subset of patients surviving damage control cannot achieve fascial closure and require split-thickness skin grafting (STSG) of their open abdomen. Controversy exists as to whether reconstruction of the gastrointestine (GI) should be staged or performed at the time of abdominal wall reconstruction (AWR). Many surgeons do not believe that operations through the STSG can be completed safely or without loss of graft. This series reviews the outcomes of operations for GI reconstruction performed through the elevated healed STSG...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28759326/assessment-of-strangulation-in-adhesive-small-bowel-obstruction-on-the-basis-of-combined-ct-findings-implications-for-clinical-care
#9
Ingrid Millet, Delphine Boutot, Claire Faget, Emmanuelle Pages-Bouic, Nicolas Molinari, Marc Zins, Patrice Taourel
Purpose To determine which computed tomography (CT) findings or combinations of findings can help to accurately identify strangulation in adhesive small bowel obstruction (SBO). Materials and Methods Contrast agent-enhanced CT findings in a cohort of 256 patients consecutively admitted for adhesive SBO, with a delay of less than 24 hours between CT and surgery for the operated patients, were reviewed independently by two radiologists, with consensus by a third, to assess CT findings commonly associated with strangulation...
December 2017: Radiology
https://www.readbyqxmd.com/read/28720378/a-novel-technique-carbon-dioxide-gas-assisted-total-peritonectomy-diaphragm-and-intestinal-meso-stripping-in-open-surgery-for-advanced-ovarian-cancer-%C3%A3-ukurova-technique
#10
Ghanim Khatib, Ahmet Baris Guzel, Umran Kucukgoz Gulec, Mehmet Ali Vardar
OBJECTIVE: Most of the ovarian cancers are diagnosed at advanced stages. As peritoneal carcinomatosis increases, especially when it extends to the diaphragm and intestinal mesos, probability of obtaining complete cytoreduction is reduced. Complete cytoreduction (residue zero: R0) is one of the main factors affecting survival [1-3]. Here we present a novel technique of stripping the peritoneal surfaces as a part of cytoreductive surgery in such cases. METHODS: A 55year-old woman diagnosed with peritoneal carcinomatosis was considered appropriate for primary cytoreduction after assessment of her thorax-abdominopelvic tomography, which revealed resectable intra-abdominal disease...
September 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28657949/laparoscopic-surgery-for-adhesive-small-bowel-obstruction-is-associated-with-a-higher-risk-of-bowel-injury-a-population-based-analysis-of-8584-patients
#11
COMPARATIVE STUDY
Ramy Behman, Avery B Nathens, James P Byrne, Stephanie Mason, Nicole Look Hong, Paul J Karanicolas
OBJECTIVE: We set out to compare the incidence of bowel repair and/or resection in a large cohort of patients with adhesive small bowel obstruction (SBO) managed operatively. BACKGROUND: Laparoscopic lysis of adhesions for adhesive SBO (aSBO) is becoming more common, yet might increase the risk of bowel injury given the distended and/or potentially compromised small bowel. METHODS: We used administrative discharge data derived from a large geographic region, identifying patients who underwent surgery for their first episode of aSBO during 2005 to 2014...
September 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28624050/impact-of-hospital-volume-on-outcomes-for-laparoscopic-adhesiolysis-for-small-bowel-obstruction
#12
Raymond A Jean, Kathleen M O'Neill, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Volume-to-outcome data have been studied in several complex surgical procedures, demonstrating improved outcomes at higher volume centers. Laparoscopic lysis of adhesions (LLOA) for small bowel obstruction (SBO) may result in better outcomes, but there is no information on the learning curve for this potentially complex case. This study evaluates the effect of institutional procedural volume on length of stay (LOS), outcomes, and costs in LLOA for SBOs. MATERIALS AND METHODS: The Nationwide Inpatient Sample data set between 2000 and 2013 was queried for discharges for a diagnosis of SBO involving LLOA in adult patients...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28547932/from-intraperitoneal-onlay-mesh-repair-to-preperitoneal-onlay-mesh-repair
#13
REVIEW
George Pei Cheung Yang
Laparoscopic repair for ventral and incisional hernias was first reported in the early 1990s. It uses intraperitoneal only mesh placement to achieve a tension-free repair of the hernia. However, in recent years, there has been greater concern about long-term complication involving intraperitoneal mesh placement. Many case reports and case series have found evidence of mesh adhesion, mesh fistulation, and mesh migration into hollow organs including the esophagus, small bowel, and large bowel, resulting in various major acute abdominal events...
May 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28509142/erosion-of-a-tenckhoff-catheter-to-the-sigmoid-colon-an-uncommon-delayed-complication
#14
Jorge Quinto Ruiz, Carlos Eduardo Durón Gutiérrez, Antonio Hiram Romero Moreno, Stephanie González Rosas, Alfonsina Daniela Castañeda Gutiérrez
Continuous ambulatory peritoneal dialysis is one of the most commonly used therapies for patients with impaired renal function. Most frequent complications directly related to the catheter usually present within the first weeks, and range from catheter dysfunction to dialysis-associated peritonitis; bowel perforation while placing the catheter is uncommon, and it is usually assessed in the same surgical event. There are, however, delayed complications, and one of the least frequently described is erosion of the catheter into the bowel...
November 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28458829/distant-melanoma-causing-small-bowel-obstruction
#15
Justin M Hintze, Donal B O'Connor, Peter Molony, Paul C Neary
Small bowel obstructions (SBOs) are common. Adhesions make up the majority of cases at 84.9%, followed by abdominal herniae and malignancies. A 71-year-old female presented with total constipation, abdominal distension, on a background of resected cutaneous melanoma nine years prior. A CT-scan showed small bowel intussusception and disseminated mucosal-enhancing lesions consistent with metastases. She was brought to the operating theatre where six areas of intussusception were identified and manually reduced...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28451475/an-unusual-cause-of-small-bowel-obstruction-a-case-report
#16
Sundaramurthi Sudharsanan, T P Elamurugan, Chellappa Vijayakumar, Kumar Rajnish, Sadasivan Jagdish
Small bowel obstruction is a common surgical emergency. The common causes are adhesions, malignancies, and hernias. We present a rare case of small intestinal obstruction caused by an enterolith in the distal ileum in a patient with an apparently normal gut.  A 59-year-old male who underwent gastrojejunostomy 15 years back presented with features of intestinal obstruction of five days' duration. After initial conservative management, the patient was taken up for laparotomy. An enterolith causing obstruction was found in the distal ileum, and it was crushed and milked into the colon...
March 26, 2017: Curēus
https://www.readbyqxmd.com/read/28426721/diagnosis-treatment-and-prognosis-of-small-bowel-volvulus-in-adults-a-monocentric-summary-of-a-rare-small-intestinal-obstruction
#17
Xiaohang Li, Jialin Zhang, Baifeng Li, Dehui Yi, Chengshuo Zhang, Ning Sun, Wu Lv, Ao Jiao
OBJECTIVES: Small bowel volvulus is a rare disease, which is also challenging to diagnose. The aims of this study were to characterize the clinical and radiological features associated with small bowel volvulus and treatment and to identify risk factors for associated small bowel necrosis. METHODS: Patients with small bowel volvulus who underwent operations from January 2001 to December 2015 at the First Affiliated Hospital of China Medical University (Shenyang, China) were reviewed...
2017: PloS One
https://www.readbyqxmd.com/read/28422909/multi-institutional-prospective-observational-study-comparing-the-gastrografin-challenge-versus-standard-treatment-in-adhesive-small-bowel-obstruction
#18
MULTICENTER STUDY
Martin D Zielinski, Nadeem N Haddad, Daniel C Cullinane, Kenji Inaba, Dante D Yeh, Salina Wydo, David Turay, Andrea Pakula, Therese M Duane, Jill Watras, Kenneth A Widom, John Cull, Carlos J Rodriguez, Eric A Toschlog, Valerie G Sams, Joshua P Hazelton, John Christopher Graybill, Ruby Skinner, Ji-Ming Yune
INTRODUCTION: Existing trials studying the use of Gastrografin for management of adhesive small bowel obstruction (SBO) are limited by methodological flaws and small sample sizes. We compared institutional protocols with and without Gastrografin (GG), hypothesizing that a SBO management protocol utilizing GG is associated with lesser rates of exploration, shorter length of stay, and fewer complications. METHODS: A multi-institutional, prospective, observational study was performed on patients appropriate for GG with adhesive SBO...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28381939/laparoscopy-for-benign-diseases-of-the-colon
#19
REVIEW
Radhika Smith, David J Maron
Laparoscopic surgery has revolutionized the delivery of care to the surgical patient undergoing colorectal resection. Since the first laparoscopic-assisted colectomy in 1991, significant advances have been made in minimally invasive colorectal surgery. For many benign conditions, laparoscopic colectomy has been proven to be safe and effective, and in some instances superior when compared with open surgery. Complex laparoscopic resections such as those for diverticulitis and inflammatory bowel disease have also been shown to have equivalent outcomes when compared with open surgery...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28280961/failure-of-conservative-treatment-with-gastrografin%C3%A2-for-adhesive-small-bowel-obstruction-after-colorectal-surgery
#20
Jordi Miquel, Sebastiano Biondo, Esther Kreisler, Catalina Uribe, Loris Trenti
PURPOSE: The aim of this study was to identify risk factors related with failure of conservative management of adhesive small bowel obstruction (ASBO) in patients with previous colorectal surgery. METHODS: Patients admitted with the diagnosis of ASBO after previous colorectal resection, were included. All patients underwent administration of Gastrografin®. Abdominal radiography was done after 24 h, to confirm the presence of contrast in colon (incomplete obstruction) or not (complete obstruction)...
July 2017: International Journal of Colorectal Disease
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