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Abdominal sepsis

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https://www.readbyqxmd.com/read/28637565/is-percutaneous-cholecystostomy-a-good-alternative-treatment-for-acute-cholecystitis-in-high-risk-patients
#1
Davide Papis, Eiman Khalifa, Ricky Bhogal, Amit Nair, Saboor Khan, Zaed Hamady, Jawad Ahmed, Gabriele Marangoni
Cholecystectomy is the treatment of choice for acute cholecystitis but the management of high-risk surgical patients is a difficult dilemma. Percutaneous cholecystostomy (PC) could represent a safer and less invasive option. The aim of the study was to assess the outcomes of PC in high-risk patients. This is a retrospective single-center study; data were collected from our hospital electronic record system. From February 2009 to March 2014, there were 753 patients admitted with acute cholecystitis. Of these 39 were considered high risk for surgery and underwent PC during their hospital stay...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28635683/blastic-plasmacytoid-dendritic-cell-neoplasm-with-pulmonary-involvement-and-atypical-skin-lesion
#2
Cyndi Myrelle da Silva Barros Romão, Cláudio José Dos Santos Júnior, Luiz Arthur Calheiros Leite, Maria Jordana Rocha Gomes Alves, Nathalia Silva Araújo, Anderson F L Castro, Muriel Silva Moura, Vitória Mikaelly da Silva Gomes, Arthur Moacir Costa Sampaio Batinga, João Antonio S Queiroz, Natanael Barbosa Dos Santos
BACKGROUND Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematodermic malignancy neoplasm with highly aggressive course and poor prognosis. This disease typically presents with cutaneous involvement as the first manifestation, with subsequent or simultaneous spread to bone marrow and peripheral blood.  CASE REPORT Here, we report the case of a 51-year-old woman who presented a violaceus skin lesion on the lateral region of the right thigh, weight loss, fever, and lymphadenopathies. Computed tomography (CT) displayed thoracic and abdominal lymph node and alveolar bleeding...
June 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#3
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/28620552/refractory-lactic-acidosis-in-small-cell-carcinoma-of-the-lung
#4
Daniel J Oh, Ellen Dinerman, Andrew H Matthews, Abraham W Aron, Katherine M Berg
BACKGROUND: Elevated lactate levels in critically ill patients are most often thought to be indicative of relative tissue hypoxia or type A lactic acidosis. Shock, severe anemia, and thromboembolic events can all cause elevated lactate due to tissue hypoperfusion, as well as the mitochondrial dysfunction thought to occur in sepsis and other critically ill states. Malignancy can also lead to elevation in lactate, a phenomenon described as type B lactic acidosis, which is much less commonly encountered in the critically ill...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28612150/single-versus-multiple-solid-organ-injuries-following-blunt-abdominal-trauma
#5
Ayman El-Menyar, Husham Abdelrahman, Ammar Al-Hassani, Ruben Peralta, Hiba AbdelAziz, Rifat Latifi, Hassan Al-Thani
BACKGROUND: We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS: A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014. Data were analyzed and compared for patients with single versus multiple SOIs. RESULTS: A total of 504 patients with SOIs were identified with a mean age of 28 ± 13 years...
June 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28608164/impact-of-multidetector-computed-tomography-on-the-diagnosis-and-treatment-of-patients-with-systemic-inflammatory-response-syndrome-or-sepsis
#6
S Schleder, L Luerken, L M Dendl, A Redel, M Selgrad, P Renner, C Stroszczynski, A G Schreyer
OBJECTIVES: To evaluate the impact of CT scans on diagnosis or change of therapy in patients with systemic inflammatory response syndrome (SIRS) or sepsis and obscure clinical infection. METHODS: CT records of patients with obscure clinical infection and SIRS or sepsis were retrospectively evaluated. Both confirmation of and changes in the diagnosis or therapy based on CT findings were analysed by means of the hospital information system and radiological information system...
June 12, 2017: European Radiology
https://www.readbyqxmd.com/read/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#7
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28598064/emphysematous-gastritis-with-air-in-portal-venous-system
#8
Omesh Goyal, Ajesh Bansal, Prerna Goyal
Emphysematous gastritis is a rare but severe form of phlegmonous gastritis caused by gastric mucosal disruption and infection of stomach wall by gas-forming bacteria. Ingestion of corrosive substances is the most common predisposing factor, followed by alcohol abuse, abdominal surgery, diabetes and immunosuppression. Patients usually present with abdominal pain, vomiting, diarrhea, constipation and/or gastro-intestinal hemorrhage. Characteristic radiological findings include presence of gas in the gastric wall...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28593006/ultrasound-detection-of-aortoenteric-fistula-in-a-patient-with-sepsis
#9
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/28576683/management-of-acute-intra-abdominal-sepsis-caused-by-leakage-after-one-anastomosis-gastric-bypass
#10
Nathan Beaupel, Matthieu Bruzzi, Thibault Voron, Haydar A Nasser, Richard Douard, Jean-Marc Chevallier
BACKGROUND: Leakage after one-anastomosis gastric bypass (OAGB) is fortunately rare (<1%), but it remains the most severe complication. Few published data exist on this specific issue. OBJECTIVES: To analyze the results from patients who presented with acute intra-abdominal sepsis (AIAS) caused by leakage after OAGB. SETTING: A university public hospital in France. METHODS: Between October 2006 and February 2016, 17 consecutive patients with a diagnosis of AIAS caused by leakage after OAGB were included...
April 8, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28564621/the-characteristics-and-impact-of-source-of-infection-on-sepsis-related-icu-outcomes
#11
Niranjan Jeganathan, Stephen Yau, Neha Ahuja, Dara Otu, Brian Stein, Louis Fogg, Robert Balk
BACKGROUND: Source of infection is an independent predictor of sepsis-related mortality. To date, studies have failed to evaluate differences in septic patients based on the source of infection. METHODS: Retrospective study of all patients with sepsis admitted to the ICU of a university hospital within a 12month time period. RESULTS: Sepsis due to intravascular device and multiple sources had the highest number of positive blood cultures and microbiology whereas lung and abdominal sepsis had the least...
May 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28554937/untargeted-antifungal-therapy-in-adult-patients-with-complicated-intra-abdominal-infection-protocol-for-a-systematic-review-with-meta-analysis
#12
Marie Warrer Petersen, Anders Perner, Fredrik Sjövall, Morten Hylander Møller
INTRODUCTION: Intra-abdominal infections are the second most frequent cause of sepsis. In a recent cohort, fungal specimens were found in 51.9% of all patients with sepsis and peritonitis. Current systematic reviews comparing untargeted antifungal treatment with placebo or no treatment in patients who are critically ill have provided conflicting results, and clinical equipoise exists. Accordingly, we aim to assess patient-important benefits and harms of untargeted antifungal therapy versus placebo or no treatment in adult patients with complicated intra-abdominal infection...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28554875/cd39-limits-p2x7-receptor-inflammatory-signaling-and-attenuates-sepsis-induced-liver-injury
#13
Luiz Eduardo Baggio Savio, Paola de Andrade Mello, Vanessa R Figliuolo, Thiago F de Avelar Almeida, Patrícia T Santana, Suellen D S Oliveira, Claudia L M Silva, Linda Feldbrügge, Eva Csizmadia, Richard D Minshall, Maria Serena Longhi, Yan Wu, Simon C Robson, Robson Coutinho-Silva
BACKGROUND & AIMS: The severity of sepsis can be linked to excessive inflammatory responses resulting in hepatic injury with progressive cholestasis. Monocyte/macrophages have been linked to the pathogenesis of cholestasis, cellular injury, and liver failure. P2X7 receptor activation by extracellular ATP (eATP) exacerbates inflammation by augmenting cytokine production; while CD39 scavenges eATP to generate adenosine, thereby limiting P2X7 activation and resulting in A2A receptor stimulation...
May 26, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28539036/a-case-of-tuberculous-peritonitis-presenting-as-small-bowel-obstruction
#14
Hae Koo Kim, Sung Eun Kim, Moo In Park, Seun Ja Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Yong Jin Nam
The peritoneum is one of the common extrapulmonary sites of tuberculosis infection. Patients with underlying end-stage renal or liver disease are frequently complicated by tuberculous peritonitis; however, the diagnosis of the tuberculous peritonitis is difficult due to its insidious nature, well as its variability in presentation and limitation of available diagnostic tests. Once diagnosed, the preferred treatment is usually antituberculous therapy in uncomplicated cases. However, surgical treatment may also be required for complicated cases, such as small bowel obstruction or perforation...
May 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28538438/differential-regulation-of-the-autophagy-and-proteasome-pathways-in-skeletal-muscles-in-sepsis
#15
Flavia Stana, Marija Vujovic, Dominique Mayaki, Jean-Philippe Leduc-Gaudet, Philippe Leblanc, Laurent Huck, Sabah N A Hussain
OBJECTIVES: Skeletal muscle fiber atrophy develops in response to severe sepsis, but it is unclear as to how the proteolytic pathways that are involved in its development are differentially regulated. We investigated the link between sepsis-induced fiber atrophy and activation of the proteasome and autophagy pathways and whether the degree of activation is more severe and sustained in limb muscles than it is in the diaphragm. DESIGN: Randomized controlled experiment...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28536687/abdominal-and-pelvic-actinomycosis-due-to-longstanding-intrauterine-device-a-slow-and-devastating-infection
#16
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/28536228/clostridium-difficile-extraintestinal-abscess-a-rare-complication
#17
Vamsi Krishna Kantamaneni, Krishna C Gurram, Abhijit Kulkarni
Extraintestinal Clostridium difficile is rare. A 74-year-old man with a history of ulcerative colitis presented after a fall. Trauma work-up showed liver cirrhosis. Two days later he developed abdominal pain, distension, diarrhoea and leucocytosis. Stool tested positive for C. difficile CT abdomen showed pancolitis with toxic megacolon. Total abdominal colectomy and ileostomy with a rectal stump was performed. He was discharged, but was readmitted with sepsis. CT abdomen showed a 10.4×7.2 cm fluid collection in the pelvis...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28534070/total-abdominal-colectomy-vs-restorative-total-proctocolectomy-as-the-initial-approach-to-medically-refractory-ulcerative-colitis
#18
Jinyu Gu, Luca Stocchi, Jeanie Ashburn, Feza H Remzi
PURPOSE: There is scant data assessing the consequences of staging restorative proctocolectomy for ulcerative colitis. The aim of the study is to compare outcomes of initial vs. staged restorative proctocolectomy. METHODS: Patients completing restorative proctocolectomy, including ileostomy reversal, during 2006-2012 were identified from an IRB-approved database. Demographics, treatment variables, and perioperative outcomes were assessed. RESULTS: Out of 521 patients, 322 (62%) underwent initial total abdominal colectomy before restorative proctectomy...
May 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28530620/-laparoscopic-ureteral-reimplantation
#19
Iván González Rodríguez, Rodrigo Gil Ugarteburu, Sergio Fernández-Pello Montes, Begoña Díaz Méndez, Rebeca Blanco Fernández, Javier Mosquera Madera
Although the laparoscopic ureteral reimplantation (LUR) has a history of over 20 years, its presence in the literature is relatively sparse, almost always in the form of small case series with low statistical power, which has prevented consistent results. It has proven to be a safe and effective technique, improving the safety profile and perioperative complications compared to open ureteral reimplantation (OUR). The few long-term results suggest a similar success rate between the open and laparoscopic approaches...
May 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28527248/-clinical-and-demographic-profile-and-risk-factors-for-clostridium-difficile-infection
#20
Carlos Carvajal, Carlos Pacheco, Fabián Jaimes
INTRODUCTION: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease. OBJECTIVE: To determine the clinical characteristics of hospitalized patients with C. difficile infection. MATERIALS AND METHODS: We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C...
January 24, 2017: Biomédica: Revista del Instituto Nacional de Salud
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