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https://www.readbyqxmd.com/read/27920850/choledochoduodenal-fistula-in-the-setting-of-crohn-s-disease
#1
Shane Knipping, Ravi Rajpoot, Roozbeh Houshyar
Of all the spontaneous fistulas that occur between the extrahepatic biliary system and the intestine, a choledochoduodenal fistula is rarely seen. When it does occur, it is most often secondary to a perforated duodenal ulcer, choledocholithiasis, or cholelithiasis. It may also be seen following complications related to iatrogenic injury or tuberculosis. Generally, choledochoduodenal fistulas are asymptomatic, but may present with vague abdominal pain, fever, and other symptoms related to cholangitis. As a result, they can be difficult to diagnose clinically before imaging is obtained...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27904625/an-intriguing-case-of-gallstone-ileus-after-hepaticojejunostomy-caused-by-a-stone-on-a-suture
#2
Mahir Gachabayov, Petr Mityushin
Gallstone ileus (GI) is a mechanical obstruction of small or large bowel caused by gallstone passed to the intestinal lumen through spontaneous or postoperative biliodigestive fistula. A 42-year-old female patient was admitted with the clinical presentation of small bowel obstruction. She underwent hepaticojejunostomy 4 years prior to admission for primary sclerosing cholangitis. Barium meal follows through revealed Rigler's triad. The patient underwent laparotomy which revealed GI. A "stone on a suture" was removed through enterotomy...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27895400/esophagogastric-anastomosis-in-rats-improved-healing-by-bpc-157-and-l-arginine-aggravated-by-l-name
#3
Zeljko Djakovic, Ivka Djakovic, Vedran Cesarec, Goran Madzarac, Tomislav Becejac, Goran Zukanovic, Domagoj Drmic, Lovorka Batelja, Anita Zenko Sever, Danijela Kolenc, Alen Pajtak, Nikica Knez, Mladen Japjec, Kresimir Luetic, Dinko Stancic-Rokotov, Sven Seiwerth, Predrag Sikiric
AIM: To cure typically life-threatening esophagogastric anastomosis in rats, lacking anastomosis healing and sphincter function rescue, in particular. METHODS: Because we assume esophagogastric fistulas represent a particular NO-system disability, we attempt to identify the benefits of anti-ulcer stable gastric pentadecapeptide BPC 157, which was in trials for ulcerative colitis and currently for multiple sclerosis, in rats with esophagocutaneous fistulas. Previously, BPC 157 therapies have promoted the healing of intestinal anastomosis and fistulas, and esophagitis and gastric lesions, along with rescued sphincter function...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27884320/prediction-of-procalcitonin-for-postoperative-intraabdominal-infections-after-definitive-operation-of-intestinal-fistulae
#4
Huajian Ren, Jianan Ren, Qiongyuan Hu, Gefei Wang, Guosheng Gu, Guanwei Li, Xiuwen Wu, Zhiwu Hong, Jieshou Li
BACKGROUND: Inflammatory biomarkers usually start to rise earlier before the infection becomes clinically evident. This study was designed to evaluate the predictive performance of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) counts in postoperative intraabdominal infections (IAIs) after definitive operation of intestinal fistulae. MATERIAL AND METHODS: We prospectively enrolled a total of 356 consecutive patients who underwent elective digestive tract reconstruction for gastrointestinal fistulae without existing clinical infection...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27878827/review-article-mesenchymal-stromal-cell-therapy-for-inflammatory-bowel-diseases
#5
REVIEW
C Grégoire, C Lechanteur, A Briquet, É Baudoux, F Baron, E Louis, Y Beguin
BACKGROUND: Inflammatory bowel diseases (IBD) are chronic relapsing diseases in which pro-inflammatory immune cells and cytokines induce intestinal tissue damage and disability. Mesenchymal stromal cells (MSCs) exert powerful immunomodulatory effects and stimulate tissue repair. AIM: To review the current data on mesenchymal stromal cell therapy in IBD. METHOD: We searched PubMed and 'ClinicalTrials.gov' databases using the terms 'mesenchymal stromal cells', 'mesenchymal stem cell transplantation', 'inflammatory bowel diseases', 'Crohn disease' and 'colitis, ulcerative'...
January 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27878619/an-open-prospective-study-evaluating-efficacy-and-safety-of-a-new-medical-device-for-rectal-application-of-activated-carbon-in-the-treatment-of-chronic-uncomplicated-perianal-fistulas
#6
Antoni Zawadzki, Louis Banka Johnson, Måns Bohe, Claes Johansson, Mats Ekelund, Ole Haagen Nielsen
PURPOSE: It has been proposed that biological/chemical substances in the intestine might play a role in the occurrence and deterioration of perianal fistulas. Elimination of such unidentified factors from the lower gastrointestinal tract might offer a new strategy for the management of anal fistulas. The aim of this study was to evaluate the clinical effects on non-Crohn's disease perianal fistula healing, and the safety and tolerability of a new medical device that applies high-purity, high-activity granular activated carbon locally into the rectum twice daily of patients with perianal fistulas without any concomitant medication...
November 23, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27878550/diverticulitis-a-comprehensive-review-with-usual-and-unusual-complications
#7
REVIEW
Mehmet Ruhi Onur, Erhan Akpinar, Ali Devrim Karaosmanoglu, Cavid Isayev, Musturay Karcaaltincaba
: Diverticulitis is characterized by inflammation of the outpouchings of the bowel wall. Imaging findings of diverticulitis include edematous thickening of the bowel wall with inflammatory changes within the adjacent mesenteric fat. Uncomplicated diverticulitis can be treated conservatively; however, complicated diverticulitis may not be responsive to medical treatment and life-threatening conditions may occur. In this review, we aimed to illustrate the ultrasonography (US) and computed tomography (CT) features of diverticulitis and its complications including perforation, phlegmon, abscess, ascending septic thrombophlebitis (phylephlebitis), bleeding, intestinal obstruction, and fistula...
November 22, 2016: Insights Into Imaging
https://www.readbyqxmd.com/read/27855530/the-role-of-a-defunctioning-stoma-for-colonic-and-perianal-crohn-s-disease-in-the-biological-era
#8
M Martí-Gallostra, P Myrelid, N Mortensen, S Keshav, S P L Travis, B George
OBJECTIVE: A defunctioning stoma is a therapeutic option for colonic or perianal Crohn's disease. In the pre-biologic era the response rate to defunctioning in our unit was high (86%), but intestinal continuity was only restored in 11-20%. Few data exist on the outcome of defunctioning since the widespread introduction of biologicals. MATERIAL AND METHODS: All patients undergoing a defunctioning stoma for colonic/perianal Crohn's disease since 2003-2011 were identified from a prospective database...
November 18, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27853338/primary-enterolith-in-a-patient-with-intestinal-tuberculosis-a-case-report
#9
Mohd Habib Raza, RafiulImad Finan, Sadik Akhtar, Manzoor Ahmad
Primary enterolithiasis is a rare surgical ailment. The underlying cause is intestinal stasis. Numerous anatomical and micro environmental factors such as enteritis, incarcerated hernia, malignancy, diverticula, blind loops, and enteroenterostomy predispose to clinically significant concretions. Enterolithiasis in tuberculosis can be due to the presence of strictures, intestinal bands, or interbowel/parietal adhesions, leading to intestinal stasis. Secondary enterolithiasis is generally caused by gallstones or renal stones migrating to the gastrointestinal tract due to fistula formation...
November 2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27833380/indications-and-surgical-options-for-small-bowel-large-bowel-and-perianal-crohn-s-disease
#10
REVIEW
James Wt Toh, Peter Stewart, Matthew Jfx Rickard, Rupert Leong, Nelson Wang, Christopher J Young
Despite advancements in medical therapy of Crohn's disease (CD), majority of patients with CD will eventually require surgical intervention, with at least a third of patients requiring multiple surgeries. It is important to understand the role and timing of surgery, with the goals of therapy to reduce the need for surgery without increasing the odds of emergency surgery and its associated morbidity, as well as to limit surgical recurrence and avoid intestinal failure. The profile of CD patients requiring surgical intervention has changed over the decades with improvements in medical therapy with immunomodulators and biological agents...
October 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27803836/primarily-proximal-jejunal-stone-causing-enterolith-ileus-in-a-patient-without-evidence-of-cholecystoenteric-fistula-or-jejunal-diverticulosis
#11
Houssam Khodor Abtar, Mostapha Mneimneh, Mazen M Hammoud, Ahmed Zaaroura, Yasmina S Papas
Stone formation within the intestinal lumen is called enterolith. This stone can encroach into the lumen causing obstruction and surgical emergency. Jejunal obstruction by an enterolith is a very rare entity and often missed preoperatively. To our knowledge, most cases of jejunal obstruction, secondary to stone, were associated with biliary disease (cholecystoenteric fistula), bezoar, jejunal diverticulosis, or foreign body. Hereby we present a rare case report of small bowel obstruction in an elderly man who was diagnosed lately to have primary proximal jejunal obstruction by an enterolith without evidence of a cholecystoenteric fistula or jejunal diverticulosis...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27799269/prevalence-of-bowel-damage-assessed-by-cross-sectional-imaging-in-early-crohn-s-disease-and-its-impact-on-disease-outcome
#12
Gionata Fiorino, Mathilde Morin, Stefanos Bonovas, Cristiana Bonifacio, Antonino Spinelli, Adeline Germain, Valérie Laurent, Camille Zallot, Laurent Peyrin-Biroulet, Silvio Danese
BACKGROUND AND AIMS: Bowel damage in Crohn's disease [CD] is defined as the presence of intestinal strictures, fistulas or abscesses. Early disease may represent a window of opportunity for timely intervention. We evaluated disease activity and severity by the Lémann Index [LI] and the Magnetic Resonance Index of Activity [MaRIA] score, and their prognostic value in early CD. METHODS: All consecutive patients diagnosed with CD in two referral centres, assessed by magnetic resonance imaging or computerized tomography, were prospectively included...
October 31, 2016: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/27790873/preperitoneal-onlay-mesh-repair-for-ventral-abdominal-wall-and-incisional-hernia-a-novel-technique
#13
Pc George Yang, Lm Karen Tung
INTRODUCTION: Intraperitoneal onlay mesh repair is a current technique for laparoscopic repair of ventral and incisional hernias. However, the placement of synthetic mesh intraperitoneally may potentially lead to mesh-induced complications such as adhesive intestinal obstruction, enterocutaneous fistula, or even mesh erosion into organs. Inspired by the concept of laparoscopic inguinal hernia repair, we developed a novel technique: preperitoneal onlay mesh repair (PPOM). This involves placing the mesh in the preperitoneal plane to help eliminate mesh-induced complications...
November 2016: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/27780886/development-of-an-index-to-define-overall-disease-severity-in-ibd
#14
Corey A Siegel, Cynthia B Whitman, Brennan M R Spiegel, Brian Feagan, Bruce Sands, Edward V Loftus, Remo Panaccione, Geert D'Haens, Charles N Bernstein, Richard Gearry, Siew C Ng, Gerassimos J Mantzaris, Balfour Sartor, Mark S Silverberg, Robert Riddell, Ioannis E Koutroubakis, Colm O'Morain, Peter L Lakatos, Dermot P B McGovern, Jonas Halfvarson, Walter Reinisch, Gerhard Rogler, Wolfgang Kruis, Curt Tysk, Stefan Schreiber, Silvio Danese, William Sandborn, Anne Griffiths, Bjorn Moum, Christoph Gasche, Francesco Pallone, Simon Travis, Julian Panes, Jean-Frederic Colombel, Stephen Hanauer, Laurent Peyrin-Biroulet
BACKGROUND AND AIM: Disease activity for Crohn's disease (CD) and UC is typically defined based on symptoms at a moment in time, and ignores the long-term burden of disease. The aims of this study were to select the attributes determining overall disease severity, to rank the importance of and to score these individual attributes for both CD and UC. METHODS: Using a modified Delphi panel, 14 members of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) selected the most important attributes related to IBD...
October 25, 2016: Gut
https://www.readbyqxmd.com/read/27778058/-closure-of-pancreas-stump-after-distal-and-segmental-resection-suture-stapler-coverage-or-anastomosis
#15
C W Michalski, P Tramelli, M W Büchler, T Hackert
Postoperative pancreatic fistulas represent the most frequent complication after distal and segmental pancreatectomy and occur with a frequency of up to 50 %. There are many technical variations of pancreatic stump treatment for reduction of fistula rates after distal resection. Most of these techniques have only been analyzed in retrospective studies and the evidence for or against a specific technique is low. Several retrospective trials have been conducted with good results to compare suturing with stapled closure of the remnant and to assess the effect of a vascularized falciform ligament patch in reducing postoperative pancreatic fistula; however, in a recently published randomized trial, which analyzed closure of the remnant with a pancreaticojejunostomy compared to standard closure, these results could not be confirmed...
October 24, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27771601/r-gas-under-diaphragm
#16
Maddibande Ramachar Sreevathsa, Khyati Melanta
INTRODUCTION: The most common cause of gas under diaphragm is hollow viscous perforation. In 10% of cases it can be due to rare causes, both abdominal and extra-abdominal, one of them being intra abdominal infection by gas forming organisms. PRESENTATION OF THE CASE: A 51 year old male patient, a poorly controlled diabetic, presented with a second episode of severe pain abdomen and abdominal distention, with lower abdominal tenderness. Plain Xray of the abdomen in erect posture showed gas under the right dome of diaphragm and ultrasound abdomen confirmed gross pneumoperitoneum...
October 14, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27757372/ovarian-mature-cystic-teratoma-with-fistula-formation-into-the-rectum-a-case-report
#17
Yuichiro Kizaki, Tomonori Nagai, Ken Ohara, Yosuke Gomi, Taichi Akahori, Yoshihisa Ono, Shigetaka Matsunaga, Yasushi Takai, Masahiro Saito, Kazunori Baba, Hiroyuki Seki
BACKGROUND: While ovarian mature cystic teratomas are benign ovarian germ-cell tumors and the most common type of all ovarian tumors, the formation of fistulas into surrounding organs such as the bladder and the intestinal tract is extremely rare. This report documents a case of ovarian mature cystic teratoma with a rectal fistula, thought to be caused by local inflammation. CASE DESCRIPTION: A pelvic mass was diagnosed as an ovarian mature cystic teratoma of approximately 10 cm in diameter on transvaginal ultrasound and magnetic resonance examinations...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27752163/-effect-of-gum-chewing-on-bowel-function-recovery-in-patients-after-radical-cystectomy-with-urinary-diversion
#18
Y Wang, Y S Meng, Y Fan, C Chen, W Yu, H Hao, W K Han, J R Hao, J Jin, L Q Zhou
OBJECTIVE: To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function in patients after radical cystectomy with ileum urinary diversion. METHODS: In the study, 60 patients who underwent radical cystectomy followed by ileum urinary diversions during Nov. 2014 and Nov. 2015 in Department of Urology of Peking University First Hospital were randomized into three groups: gum chewing group, placebo group treated with the abdomen physical therapy machine and control group treated with ordinary method...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27738458/long-term-outcomes-of-surgical-treatment-with-in-situ-graft-reconstruction-for-secondary-aorto-enteric-fistula
#19
Munetaka Hashimoto, Hitoshi Goto, Daijirou Akamatsu, Takuya Shimizu, Ken Tsuchida, Keiichiro Kawamura, Yuta Tajima, Michihisa Umetsu
Objectives: The optimal surgical management for secondary aorto-enteric fistula (sAEF) is controversial. Here, we report the long-term outcomes of a surgical treatment with in situ graft reconstruction for sAEF that was performed at our hospital. Methods: Between 2009 and 2012, 10 consecutive patients (8 males, 2 females, mean age 75.9 years) with sAEF were surgically treated with in situ graft reconstruction. Perioperative and long-term outcomes were reviewed retrospectively by medical records. Results: Clinical manifestations, including gastrointestinal bleeding, shock, sepsis, and back and abdominal pain, were observed during the treatment of the patients...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/27738427/infliximab-combined-with-enteral-nutrition-for-managing-crohn-s-disease-complicated-with-intestinal-fistulas
#20
Xiao-Li Wu, Ren-Pin Chen, Li-Ping Tao, Jian-Sheng Wu, Xiang-Rong Chen, Wei-Chang Chen
Aim. This study was performed to evaluate the additional enteral nutrition (EN) in the efficacy of infliximab (IFX) compared with the conventional therapy in managing Crohn's disease (CD) complicated with intestinal fistulas. Methods. A total of 42 CD with intestinal fistulas were randomly divided into infliximab treatment group (n = 20) and conventional therapy group (n = 22). We evaluated the laboratory indexes, Crohn's disease activity index (CDAI), Crohn's disease simplified endoscopic score (SES-CD), and healing of fistula in the two groups before treatment, at 14 weeks, and at 30 weeks, respectively...
2016: Gastroenterology Research and Practice
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