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https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#1
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28628271/surgical-treatment-of-trans-sphincteric-anal-fistulas-with-the-fat-graft-technique-a-minimally-invasive-procedure
#2
N Stroumza, G Fuzco, J Laporte, R Nail Barthelemy, S Houry, M Atlan
AIM: Anal fistulas are common pathologies with a significant social impact; however their treatment is often complex and the recurrence rate can be significant. Some surgical treatments for fistula are also associated with the risk of sphincter injury. In this technical note, we aim to evaluate the feasibility and efficacy of the Fat GRAFT technique (Fat Grafting in Anal Fistula Treatment) in the treatment of recurrent anal fistulas. METHOD: All patients presenting with recurrent trans-sphincteric anal fistulas over an 18-month period were included...
June 19, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28611568/two-anomalies-in-one-a-rare-case-of-an-intrahepatic-gallbladder-with-a-cholecystogastric-fistula
#3
Mohammad F Ali, David Friedel, Galina Levin
The gallbladder can be situated in a variety of anomalous positions. An intrahepatic gallbladder - the second most common ectopic location of the gallbladder - is one that is completely embedded within the liver parenchyma. Described in the literature as early as 1935, intrahepatic gallbladders predominantly result from a developmental anomaly but in some instances have been reported to be secondary to chronic inflammation. The significance of an intrahepatic gallbladder lies in the fact that 60% of the cases are associated with gallstones and may present a challenge for the general surgeon during cholecystectomy and other biliary operations in addition to causing misdiagnosis on imaging...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28603565/current-concepts-congenital-scoliosis
#4
Agnivesh Tikoo, Manish K Kothari, Kunal Shah, Abhay Nene
BACKGROUND: Congenital scoliosis is one of the 'difficult to treat' scenarios which a spine surgeon has to face. Multiple factors including the age of child at presentation, no definite pattern of deformity and associated anomalies hinder the execution of the ideal treatment plan. All patients of congenital scoliosis need to be investigated in detail. X rays and MRI of spine is usually ordered first. Screening investigations to rule out VACTERL (Visceral, Anorectal, Cardiac, Tracheo-esophageal fistula, Renal and Lung) abnormalities are required...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28603100/total-closure-of-pancreatic-section-for-end-to-side-pancreaticojejunostomy-decreases-incidence-of-pancreatic-fistula-in-pancreaticoduodenectomy
#5
Yu-Ling Sun, Ya-Lei Zhao, Wen-Qi Li, Rong-Tao Zhu, Wei-Jie Wang, Jian Li, Shuai Huang, Xiu-Xian Ma
BACKGROUND: Postoperative pancreatic fistula (POPF) is a serious complication and results in prolonged hospitalization and high mortality. The present study aimed to evaluate the safety and effectiveness of total closure of pancreatic section for end-to-side pancreaticojejunostomy in pancreaticoduodenectomy (PD). METHODS: This was a prospective randomized clinical trial comparing the outcomes of PD between patients who underwent total closure of pancreatic section for end-to-side pancreaticojejunostomy (Group A) vs those who underwent conventional pancreaticojejunostomy (Group B)...
June 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28598298/efficacy-of-exclusive-enteral-nutrition-in-complicated-crohn-s-disease
#6
Qingfan Yang, Xiang Gao, Huiping Chen, Miao Li, Xiaojian Wu, Min Zhi, Ping Lan, Pinjin Hu
AIM: To investigate the efficacy of exclusive enteral nutrition (EEN) in induction of remission in adult active Crohn's disease (CD) complicated with intestinal fistula/abdominal abscess or inflammatory intestinal stricture. METHOD: Patients diagnosed with active CD with complications were recruited between July 2013 and July 2015. Patients were offered EEN for 12 weeks. Patients with abscess received antibiotic treatment with or without percutaneous drainage. Clinical variables were recorded (ClinicalTrials...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597677/endoscopic-management-of-afferent-loop-syndrome-caused-by-enteroliths-and-anastomotic-stricture-a-case-report
#7
Ana Rita Alves, Nuno Almeida, Margarida Ferreira, Luís Tomé
Afferent loop syndrome (ALS) is a rare complication of Billroth-II gastrojejunostomy. Causes of afferent loop obstruction include adhesions, internal hernias, intestinal strictures or malignancy. Obstruction caused by enteroliths is rare and usually requires surgery. We present the case of a 90-year-old man with a Billroth-II performed 50 years earlier and three acute pancreatitis. He presented with acute abdominal pain, without signs of pancreatitis. Upper digestive endoscopy revealed a punctiform anastomotic stricture of the afferent loop...
June 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28593006/ultrasound-detection-of-aortoenteric-fistula-in-a-patient-with-sepsis
#8
Tiziano Perrone, Chiara Pagani, Elisa Eleonora Mossolani
We report a case of an 81-year-old man, hospitalized for sepsis unresponsive to targeted antibiotic therapy, who underwent abdominal aortic aneurysmectomy with stent placement before 12 years. Point-of-care ultrasound examination showed the presence of a voluminous and inhomogeneous lesion adjacent to the anterior wall of aortic bifurcation with pulsatile flow from the aorta into the lesion, highlighted by Color-Doppler, and peripheral (closely with intestinal loops) floating hyperechoic spots marked by posterior comet tail artifact, suggestive for the presence of air bubbles...
June 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28589186/extremely-rare-presentation-of-an-omphalomesenteric-cyst-in-a-61-year-old-patient
#9
Recep Aktimur, Uğur Yaşar, Elif Çolak, Nuraydın Özlem
The umbilicus is remaining scar tissue from the umbilical cord in the fetus. If the omphalomesenteric duct in the umbilicus is not properly closed, an ileal-umbilical fistula, sinus formation, cysts, or, most commonly, Meckel's diverticulum can develop. The others are very rare and mostly occur in the pediatric population. We describe herein a 61-year-old female with a giant omphalomesenteric cyst presented as an asymptomatic infraumbilical mass. To our knowledge, this is the oldest patient reported and the largest cyst described in the literature...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28587747/flexible-endoscopic-diagnosis-and-treatment-of-esophageal-stenosis-in-children-with-noninvasive-ventilation-support
#10
Kao-Hsian Hsieh, Wen-Jue Soong, Mei-Jy Jeng, Yu-Sheng Lee, Pei-Chen Tsao, Ya-Ling Chou
BACKGROUND: Esophageal stenosis (ES) is characterized by dysphagia, failure to thrive, and long-term disability. It requires repeated management because it is refractory. Traditionally, these procedures are performed under general anesthesia with airway intubation. PURPOSE: This study investigated the safety and efficacy of the management of interventional flexible endoscopy (IFE) performed with a novel noninvasive ventilation (NIV) support. METHODS: Use of a short-length flexible endoscope with NIV of pharyngeal oxygen, nose closure, and abdominal compression during IFE was investigated...
May 10, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28585429/laparoscopic-versus-open-distal-pancreatectomy-for-pancreatic-ductal-adenocarcinoma-a-single-center-experience
#11
Ai-Bin Zhang, Ye Wang, Chen Hu, Yan Shen, Shu-Sen Zheng
OBJECTIVE: The aim of this study was to compare complications and oncologic outcomes of patients undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) at a single center. METHODS: Distal pancreatectomies performed for pancreatic ductal adenocarcinoma during a 4-year period were included in this study. A retrospective analysis of a database of this cohort was conducted. RESULTS: Twenty-two patients underwent LDP for pancreatic ductal adenocarcinoma, in comparison to seventy-six patients with comparable tumor characteristics treated by ODP...
June 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28579585/a-case-of-liver-abscess-caused-by-appendicitis-which-was-considered-to-be-drained-from-hepatobronchial-fistula
#12
Shigeo Manabe, Takayuki Yasuoka, Yuki Endo, Fumitaka Usui, Taku Yamaguchi, Tatsuzo Matsuyama, Ikuhiro Hirata, Shuji Takahashi
A 52-year-old man was referred to our hospital complaining of right lower abdominal pain. He was diagnosed with appendicitis complicated with a liver abscess and underwent an appendectomy. After antibiotic treatment following surgery, the liver abscess penetrated the right lung, which was considered to be drained from a hepatobronchial fistula. Due to the effect of drainage, the liver abscess immediately improved and the patient was subsequently discharged.
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28578386/injectable-in-situ-cross-linking-chitosan-hyaluronic-acid-based-hydrogels-for-abdominal-tissue-regeneration
#13
Youming Deng, Jianan Ren, Guopu Chen, Guanwei Li, Xiuwen Wu, Gefei Wang, Guosheng Gu, Jieshou Li
Abdominal wall defect caused by open abdomen (OA) or abdominal trauma is a serious issue since it induces several clinical problems. Although a variety of prosthetic materials are commonly employed, complications occur including host soft tissue response, fistula formation and chronic patient discomfort. Recently, abundant natural polymers have been used for injectable hydrogel synthesis in tissue regeneration. In this study, we produced the chitosan - hyaluronic acid (CS/HA) hydrogel and investigated its effects on abdominal tissue regeneration...
June 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28576692/utero-abdominal-wall-fistula-after-cesarean-section-in-patient-with-prior-colorectal-resection-for-endometriosis-case-report-and-systematic-review
#14
Chloé Chattot, Patrick Aristizabal, Sofiane Bendifallah, Emile Daraï
Utero-Abdominal Wall Fistula (UAWF) is a very rare complication of cesarean section. We report an unusual case of a UAWF occurring in a 37-year-old woman, 4 years after a cesarean section and previously radical surgery for deep infiltrating endometriosis (DIE) with bowel resection. The patient presented with persistent purulent discharge of the Pfannenstiel scar and had noted that the discharge was blood-stained during menstruation. Magnetic resonance imaging confirmed the diagnosis of UAWF. Surgery was performed by laparotomy and was complicated by a postoperative rectovaginal fistula (RVF) which was successfully treated by the placement of a biological mesh via the vagina route...
May 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28559782/cholecystoparietal-fistula-revealed-by-an-epigastric-abscess
#15
Assamoi Brou Fulgence Kassi, Eric Koffi, Kacou Sébastien Yénon, Cynthia Bombet-Kouamé
Cholecystocutaneous fistula, the ultimate complication of abscessed or overlooked acute cholecystitis, is due to perforation of the gallbladder in the abdominal wall. The authors report an unusual case of cholecystoparietal fistula revealed by an epigastric abscess. Fistulography and modern imaging tools make the diagnosis easier. Surgery is the best available treatment.
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28557372/laparoscopic-sigmoidectomy-combined-with-uterus-excision-for-colouterine-fistula-caused-by-sigmoid-colon-diverticulitis-a-case-report
#16
Satoshi Arakawa, Zenichi Morise, Masashi Isetani, Hirokazu Tomishige, Norihiko Kawabe, Hidetoshi Nagata, Yukio Asano, Jin Kawase, Kenshiro Kamio, Yoshihiro Imaeda, Shunji Umemoto, Masahiro Ikeda, Akihiko Horiguchi
A case of colouterine fistula caused by colonic diverticulitis that was successfully treated laparoscopically is presented. A 74-year-old woman visited us with lower abdominal discomfort and vaginal excretion with minor fecal contamination. Mild tenderness was observed in her lower abdomen. Blood examinations revealed elevated white blood cell count and C-reactive protein. Sigmoid colon diverticulitis was revealed on CT, and her condition was diagnosed as colouterine fistula. Hinchey classification was stage I...
May 29, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28550925/use-of-a-pedicled-omental-flap-to-reduce-inflammation-and-vascularize-an-abdominal-wall-patch
#17
Takafumi Uchibori, Keisuke Takanari, Ryotaro Hashizume, Nicholas J Amoroso, Yuzuru Kamei, William R Wagner
BACKGROUND: Although a variety of synthetic materials have been used to reconstruct tissue defects, these materials are associated with complications such as seromas, fistulas, chronic patient discomfort, and surgical site infection. While alternative, degradable materials that facilitate tissue growth have been examined. These materials can still trigger a foreign body inflammatory response that can lead to complications and discomfort. MATERIALS AND METHODS: In this report, our objective was to determine the effect of placing a pedicled omental flap under a biodegradable, microfibrous polyurethane scaffold serving as a full-wall thickness replacement of the rat abdominal wall...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28545783/risk-factors-for-severe-weight-loss-at-1-month-after-gastrectomy-for-gastric-cancer
#18
Kenki Segami, Toru Aoyama, Kazuki Kano, Yukio Maezawa, Tetsushi Nakajima, Kosuke Ikeda, Tsutomu Sato, Hirohito Fujikawa, Tsutomu Hayashi, Takanobu Yamada, Takashi Oshima, Norio Yukawa, Yasushi Rino, Munetaka Masuda, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa
BACKGROUND: Body weight loss (BWL) is frequently observed in gastric cancer patients who undergo gastrectomy for gastric cancer. The risk factors for severe BWL after gastrectomy remain unclear. METHODS: The present study retrospectively examined patients who underwent curative gastrectomy for gastric cancer between January 2012 and June 2014 at Kanagawa Cancer Center. All patients received perioperative care based on the enhanced recovery after surgery protocol...
May 22, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28536687/abdominal-and-pelvic-actinomycosis-due-to-longstanding-intrauterine-device-a-slow-and-devastating-infection
#19
Evelyn Sue Nakahira, Linda Ferreira Maximiano, Fabiana Roberto Lima, Edson Yassushi Ussami
Actinomycosis is a chronic or subacute bacterial infection characterized by large abscess formation, caused mainly by the gram-positive non-acid-fast, anaerobic, or microaerophilic/capnophilic, obligate parasites bacteria from the Actinomyces genus. Although pelvic inflammatory disease is an entity associated with the longstanding use of intrauterine devices (IUDs), actinomycosis is not one of the most frequent infections associated with IUDs. We present the case of a 43-year-old female patient who was referred to the emergency facility because of a 20-day history of abdominal pain with signs of peritoneal irritation...
January 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28534335/-consistency-analysis-between-preoperative-ct-enterography-and-intraoperative-findings-in-patients-undergoing-surgery-for-crohn-s-disease
#20
Jianbo Yang, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the diagnostic value of preoperative CT enterography (CTE) on obstruction, fistula and abscess formation compared to intraoperative findings in patients undergoing surgery for Crohn's disease(CD), aiming to provide reference to clinical practice. METHODS: Preoperative CTE data of 176 CD patients confirmed by clinic, endoscopy, imaging, operation and pathology at the Department of General Surgery in Nanjing Jinling Hospital from January 2013 to December 2015 were enrolled in retrospective cohort study...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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