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Venkata S R Dukkipati, Anne L Ridler, Keith G Thompson, Bryce M Buddle, Barry A Hedgespeth, Marian Price-Carter, Douglas J Begg, Richard J Whittington, Brigitte Gicquel, Alan Murray
A long-term study was undertaken to monitor immune responses, faecal cultures and clinical disease in sheep experimentally infected with Mycobacterium avium subspecies paratuberculosis (Map) strain Telford. New Zealand Merino lambs (N=56) were challenged with three oral doses of Map suspension. The lambs were weighed and faecal and blood samples obtained at different time-points. At 63 weeks post-challenge, surviving sheep were euthanised and samples of liver, ileo-caecal valve and mesenteric lymph node were collected for histopathology and Map culture...
November 15, 2016: Veterinary Microbiology
Charbel Karam, Sally Lord, Rohan Gett, Alan P Meagher
BACKGROUND: Leak rates of over 5% following anastomoses between the ileum and colon continue to be reported in large series and are associated with substantial morbidity and with mortality rates of 10-20%. In 1994, we began performing circumferentially oversewn inverted stapled anastomoses in patients undergoing ileo-colic anastomoses or ileostomy closure. It has become increasingly apparent that this method is associated with a low risk of leakage, which we should report. METHODS: The anastomotic technique described was used in all patients undergoing ileo-colic anastomosis or closure of ileostomy by surgeon 1 (1994-2015) and in all ileo-colic anastomoses by surgeon 2 (2007-2015)...
October 20, 2016: ANZ Journal of Surgery
Muhammad A Jawad, Lars Nelson, Rena C Moon, Andre F Teixeira
BACKGROUND: Although effective, duodenal switch can be a complicated and time-consuming operation for surgeons. PURPOSE: The purpose of this article is to present our technique of biliopancreatic diversion and vertical sleeve gastrectomy, creating a 150-cm common channel and a 100-cm alimentary limb. MATERIAL AND METHODS: A robot-assisted technique was utilized in creating a biliopancreatic diversion and vertical sleeve gastrectomy. RESULTS: Laparoscopy was used for marking stitches and then the robot was docked...
October 19, 2016: Obesity Surgery
Gentilini Lorenzo, Coscia Maurizio, Lombardi Pietro Maria, Marta Tanzanu, Laureti Silvio, Podda Mariangela, Poggioli Gilberto
PURPOSE: Short-term results after ileo-pouch anal anastomosis (IPAA) are well established; data are conflicting in long-standing patients. We retrospectively evaluated long-term complications and functional results after follow-up longer than 20 years. METHODS: Two hundred five patients with follow-up longer than 20 years have been identified out of 1112 IPAA performed in our institution; of these, 20 cases were lost at follow-up or decline to take part at the study...
September 28, 2016: International Journal of Colorectal Disease
V S Kappikeri, Akshay Mahesh Kriplani
INTRODUCTION: Enteroliths are an uncommon entity in humans and form a rare cause of subacute intestinal obstruction. They occur proximal to stricture or in a diverticulum or a blind loop due to stasis. CASE DESCRIPTION: 40 years male presenting with intermittent right lower abdominal pain since 1 year. Barium meal follow-through and CT abdomen diagnosed as a case of subacute intestinal obstruction with an enterolith in the distal ileal segment. On exploratory laparotomy multiple ileal strictures with mesenteric adhesions were noted...
2016: SpringerPlus
Mike Thomson, Andrea Tringali, Rosario Landi, Jean-Marc Dumonceau, Marta Tavares, Jorge Amil-Dias, Marc Benninga, Merit M Tabbers, Raoul Furlano, Manon Spaander, Cesare Hassan, Christos Tzvinikos, Hanneke Ijsselstijn, Jérôme Viala, Luigi Dall'Oglio, Rok Orel, Yvan Vandenplas, Radan Keil, Štěpán Hlava, Claudio Romano, Eva Brownstone, Patrick Gerner, Werner Dolak, Wolf Dietrich Huber, Simon Everett, Andreas Vecsei, Lars Aabakken, Alessandro Zambelli
This Guideline refers to infants, children and adolescents aged 0-18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileo-colonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangio-pancreatography and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) has been dealt with in other Guidelines [1-3] and are therefore not mentioned in this Guideline...
September 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
Bogdan Stancu, Alexandra Chira, Romeo Ioan Chira, Ioana Grigorescu, Claudia Diana Gherman, Dan Lucian Dumitraşcu
We present a rare cause of intestinal obstruction in an adult, due to ileo-colic intussusception by a lipoma of the ileo-cecal valve and its ultrasonographic presentation. The case presented in emergency for spontaneously appearing and disappearing palpable elastic mass in the right iliac fossa. The ultrasonographic examination raised the suspicion of an ileo-colic intussusception due to a polypoid tumor. The contrast-enhanced computed tomography confirmed the finding and suggested that the polypoid tumor was more likely a lipoma...
September 2016: Medical Ultrasonography
Tsunetaka Arai, Ken Takeuchi, Miyuki Miyamura, Rumiko Ishikawa, Akihiro Yamada, Masao Katsumata, Yoshinori Igarashi, Yasuo Suzuki
BACKGROUND & AIMS: Previous studies have not found a correlation between fecal level of calprotectin and small bowel Crohn's disease (CD). However, these studies evaluated patients mainly by ileocolonoscopy, which views up to only the terminal ileum rather than entire small intestine. We investigated whether level of fecal calprotectin (FC) is a marker of active CD of the small bowel, identified by balloon-assisted enteroscopy and computed tomography enterography (CTE). METHODS: We performed a prospective study of 123 patients with CD (35 with ileitis, 72 with ileocolitis, and 16 with colitis) evaluated by balloon-assisted enteroscopy from May 2012 through July 2015 at Toho University Sakura Medical Centre in Japan...
August 23, 2016: Clinical Gastroenterology and Hepatology
E Iaculli, M Agostini, L Biancone, C Fiorani, A Di Vizia, F Montagnese, S Sibio, A Manzelli, M Tesauro, A Rufini, G S Sica
The aim of this study was to determine the perioperative behavior of C-reactive protein (CRP) in Crohn's disease (CD) patients undergoing elective ileo-cecal (IC) resection and to identify association between perioperative CRP levels and endoscopic recurrence at 1 year. Study hypothesis was that perioperative CRP changes are disease specific and could detect subset of patients with more aggressive pathopysiology. Seventy-five patients undergoing IC resection for CD were prospectively enrolled. Serial CRP levels were assessed: preoperative, postoperative day 1 (POD1) and day 5 (POD5)...
2016: Cell Death Discovery
Louise Nicol, Hazel Wilkie, Anton Gossner, Craig Watkins, Robert Dalziel, John Hopkins
Two different forms of clinical paratuberculosis in sheep are recognised, related to the level of bacterial colonization. Paucibacillary lesions are largely composed of lymphocytes with few bacteria, and multibacillary pathology is characterized by heavily-infected macrophages. Analysis of cytokine transcripts has shown that inflammatory Th1/Th17 T cells are associated with development of paucibacillary pathology and Th2 cytokines are correlated with multibacillary disease. The master regulator T cell transcription factors TBX21, GATA3, RORC2 and RORA are critical for the development of these T cell subsets...
2016: Veterinary Research
Alexander T Hawkins, Sekhar Dharmarajan, Katerina K Wells, Devi Mukkai Krishnamurty, Matthew G Mutch, Sean C Glasgow
BACKGROUND: Anastomotic leak is one of the most feared complications of gastrointestinal surgery. Surgeons routinely perform a diverting loop ileostomy (DLI) to protect high-risk colo-rectal anastomoses. STUDY DESIGN: The NSQIP database was queried from 2012 to 2013 for patients undergoing open ileo-colic resection with and without a DLI. The primary outcome was the development of any anastomotic leak-including those managed operatively and non-operatively. Secondary outcomes included overall complication rate, return to the OR, readmission, and 30-day mortality...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Rodolfo J Oviedo, Bruce M Dixon, Chase W Sofiak
INTRODUCTION: Rectal bleeding is the most common symptom of Familial Adenomatous Polyposis (FAP). This case investigates the efficacy of emergency surgery for FAP with total proctocolectomy end ileostomy for recurrent lower gastrointestinal (GI) hemorrhage in an uninsured patient in a 266-bed community hospital. The optimal treatment for FAP with acute lower GI hemorrhage and hemodynamic compromise unresponsive to conservative management is unclear. PRESENTATION OF CASE: A 41-year-old uninsured African American man with no past medical or family history presented to the emergency department with hematochezia lasting three days...
2016: International Journal of Surgery Case Reports
Emmanuel Innocent, Kwaghe B Vandhi, Ajetunmobi Olanrewaju, Akpa Philip Ojile, M A Misauno, Ezra NabasuLemech, DikkolNendangtokDakup
Lipoma is the commonest soft tissue tumour and ubiquitous in distribution. The gastrointestinal tract is a rare site for this neoplasm. This 38 years old patient presented to the surgical emergency unit of the Jos University Teaching Hospital with features of intestinal obstruction which was confirmed by plain abdominal X-ray. Patient was resuscitated and had exploratory laparotomy. At surgery, a dilated, oedematous, and pale segment of ileum was seen measuring 56 cm in length and 10 cm short of the ileo-caecal junction, where an obstruction had occurred...
October 2015: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
Yifan Wang, Stephen Gowing, Goffredo Arena
INTRODUCTION: Intussusception refers to the telescoping of a segment of bowel into the lumen of an adjacent segment. While pediatric intussusception is common and generally idiopathic, adult intussusception is exceedingly rare and is usually attributable to a pathologic lead point. PRESENTATION OF CASE: 37-year-old man who presented with abdominal pain, and was preoperatively diagnosed with a colo-colonic intussusception. Intraoperatively, the lead point was found to be congenital bands, and there was no evidence of underlying malignancy...
2016: International Journal of Surgery Case Reports
Emanuela de Cillis, Annamaria Dachille, Francesco Giardinelli, Tommaso Acquaviva, Alessandro Santo Bortone
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) technique represents a real revolution in the field of interventional cardiology and medicine, in particular for the treatment of severe aortic valve stenosis in elderly patients or in patients when the periprocedural risk for the traditional surgical option is considered too high, as an alternative to the traditional aortic valve replacement. Although experience on the valves of the last generation is still limited in terms of time, the data currently available are definitely moving in the direction of a minimum hospital mortality (1%) as well as a drastic reduction in the incidence of complications when compared to the devices of the previous generation...
July 29, 2016: Surgical Technology International
G N Andrei, B I Diaconescu, B V Martian, M Beuran
We present a rare case of a 74 year old man admitted by ambulance to our department following a blunt minor abdominal trauma (veal attack). He complained of pain in the left abdominal flank and in the lower abdomen. The lower abdomen was tender, moderate distended but not rigid. He also had a left inguinal uncomplicated hernia. Because he was hemodynamic stable we performed a CT - scan who revealed several pockets of free air anteriorly in the midline. One hour and a half after admission the pacient underwent exploratory laparotomy, revealing a antimesostenic perforation of the ileum about 120 cm from the ileo-cecal valve...
May 2016: Chirurgia
Dan Bratu, Radu Chicea, Tanasescu Ciprian, Laurentiu Beli, Sabau Dan, Alin Mihetiu, Boicean Adrian
INTRODUCTION: We report our experience involving a rare case of ileum endometriosis complicated with small bowel obstruction. PRESENTATION OF CASE: 33 years old female patient, admitted to emergency service with abdominal pain, abdominal distension, and vomiting. Abdominal X-ray showed dilated small bowel loops. Computerized tomography scan showed dilated small intestine segments excepting last ileum loop, gastric distension, enlarged ovaries. Emergency laparotomy was performed, showing acute bowel obstruction due to a stenotic tumor placed on the terminal ileum, cecum tumors, multiple tumors in Douglas pouch, multiple mesenteric enlarged lymph nodes...
2016: International Journal of Surgery Case Reports
A Lecoindre, P Lecoindre, J L Cadoré, M Chevallier, S Guerret, G Derré, S P Mcdonough, K W Simpson
OBJECTIVES: To describe the clinical and pathological features of canine focal lipogranulomatous lymphangitis, to evaluate its underlying infectious cause and to compare it with human Crohn's disease. METHODS: Retrospective review of case records with a histopathological diagnosis of focal lipogranulomatous lymphangitis. Bacterial and fungal colonisation was evaluated using fluorescence in situ hybridisation and histochemical staining, respectively. A comparison with Crohn's disease was performed by a human pathologist...
September 2016: Journal of Small Animal Practice
Philip Blasto Ooko, Seno Saruni, Mark Oloo, Hillary Mariko Topazian, Russell White
INTRODUCTION: Ileo-sigmoid knotting (ISK) is a rare cause of bowel obstruction in which the ileum twists around the sigmoid colon. It is associated with rapid bowel gangrene and a high mortality rate. Little has been published about this condition in Kenya. The objective was to determine the presentation, management, and outcome of patients with ISK. METHODS: A seven year (January 2008-December 2014) retrospective chart review of patients managed for ISK at Tenwek Hospital in Bomet, Kenya...
2016: Pan African Medical Journal
Young Wan Kim
BACKGROUND: Intussusception refers to a condition in which a segment of the intestine invaginates into the lumen of an adjacent segment of the intestine. Postoperative intussusception after gastrointestinal surgery is an uncommon clinical condition, and there is only one case report of small bowel intussusception after rectal cancer surgery. Here, we report a case of spontaneous small bowel intussusception following laparoscopic total mesorectal excision for rectal cancer. CASE PRESENTATION: A 56-year-old female military officer was referred to the Colorectal Surgical Department for mid-rectal cancer, 8 cm from the anal verge...
2016: Military Medical Research
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