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Treating abdominal fistulas

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https://www.readbyqxmd.com/read/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#1
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
April 24, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28416240/efficacy-of-tumour-necrosis-factor-antagonists-in-stricturing-crohn-s-disease-a-tertiary-center-real-life-experience
#2
Mariangela Allocca, Cristiana Bonifacio, Gionata Fiorino, Antonino Spinelli, Federica Furfaro, Luca Balzarini, Stefanos Bonovas, Silvio Danese
BACKGROUND: Stenosis is the most common complication of Crohn's disease (CD). Long-term outcome of patients receiving tumour necrosis factor (TNF) antagonists for such disease complication is poorly understood. METHODS: 51 CD patients (from July 2006 to November 2015) who had a diagnosis of small bowel or colonic stenosis, diagnosed by colonoscopy and/or MRI enterography, and were treated with TNF antagonists (adalimumab or infliximab) were enrolled. The primary outcome was to assess the rate of success of TNF antagonists on avoiding abdominal surgery for stricturing CD patients...
March 30, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28413300/anorectal-agenesis-with-rectovaginal-fistula-a-rare-regional-variant
#3
Subhasis Roy Choudhury, Niyaz Ahmed Khan, Pinaki Ranjan Debnath, Partap Singh Yadav, Shalu Shah, Rajiv Chadha
AIMS AND OBJECTIVES: The anatomical types of female anorectal malformation (ARM) are complex and include several rare and regional variants. The aim of this report is to highlight the diagnosis and management of cases of anorectal agenesis with rectovaginal fistula (RVF). MATERIALS AND METHODS: This is a retrospective chart review of cases of RVF who underwent definitive surgery between November 2000 and September 2016 in a single institution. RESULTS: Of the 244 female patients with anorectal anomalies treated in our institution over a 16-year period, there were 15 cases of RVF with anorectal agenesis giving it an incidence of 6%...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28401880/gallstone-ileus-a-case-treated-with-minilaparotomy-and-a-review-of-the-literature
#4
Francesco Zappia, Giovanni Petracca, Carlo Alessandro Talarico
Gallstone ileus is a rare complication of cholelithiasis which occurs in less than 1% of patients and is the cause of 1- 4% of cases of small bowel obstruction. The pathogenesis involves the formation of a bilioenteric fistula. We report the case of gallstone ileus in an 81-year old woman with typical abdominal pain, arterial hypertension and coronary artery disease. An abdominal computed tomography (CT) scan showed pneumobilia, dilated loops of small bowel and an ectopic gallstone obstructing the intestinal lumen...
March 29, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28372450/a-bronchobiliary-fistula-treated-with-cyanoacrylate-glue-in-a-patient-with-liver-cirrhosis
#5
Raúl Honrubia López, Ana Barbado Cano, Gloria Ruiz Fernández, Katherine Yelenia Bustamante Robles
A 60-year-old male was operated upon in 2002 for liver hydatidosis, which included partial right hepatectomy with cholecystectomy and bilioduodenal anastomosis. He then developed liver cirrhosis secondary to left hepatic duct stricture. He presents at the emergency room with dry cough, which he had for a month and then became associated with yellowish, bitter-tasting "fluid" expectoration. A chest-abdominal CT scan revealed a 6 x 5-cm collection roughly located somewhere between the middle pulmonary lobe and subphrenic area ...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28349296/roux-en-y-fistulojejunostomy-a-new-therapeutic-option-for-complicated-post-sleeve-gastric-fistulas-video-report
#6
Theodoros Thomopoulos, Maximilien Thoma, Benoit Navez
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become during the last few years the most frequent procedure in bariatric surgery. However, complications related to the gastric staple line can be even more serious. The incidence of gastric fistula after LSG varies from 1 to 7%. Its management can be very challenging and long. In case of chronic fistula and failure of the previous treatment, total gastrectomy or Roux-en-Y fistulo-jejunostomy (RYFJ) might be considered. RYFJ has been described very rarely as a salvage procedure of gastric leaks after LSG...
March 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28281481/a-novel-method-of-minimally-invasive-rectus-abdominis-muscle-flap-harvest-laparoscopic-surgeons-take-note
#7
Tabish Aijaz, Dhruv Singhal, Sanda A Tan, Atif Iqbal
The rectus abdominis muscle (RAM) is a workhorse flap to fill or repair abdominal defects. A drawback of an open RAM harvest is donor site morbidity, and minimally invasive techniques for flap harvesting have been previously proposed but involve vertical division of the rectus fascia. We present a case of a 52-year-old woman with a recurrent rectovaginal fistula in a radiated field treated with a laparoscopic low anterior resection with simultaneous RAM flap harvest utilising a single Pfannenstiel incision...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28278560/hepatogastric-fistula-as-a-rare-complication-of-pyogenic-liver-abscess
#8
Kyu Won Lee, Hee Yeon Kim, Chang Wook Kim, Young Ki Kim, Ohbeom Kwon, Min Ah Kim, Youngyun Cho, Keungmo Yang
Hepatogastric fistula following a pyogenic liver abscess is extremely rare, and only a handful of cases have been reported. An 88-year-old female presented with generalized weakness, fever and chills. An abdominal computed tomography scan revealed a 5cm-sized hypodense lesion with internal septa in the left lateral section of the liver. Due to initial suspicion of early liver abscess, she was treated with empirical intravenous antibiotics. Initially, aspiration or drainage of the liver abscess was not performed due to immature lesion characteristics...
March 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28271435/adalimumab-therapy-in-a-patient-with-crohn-s-disease-with-a-giant-pelvic-paraganglioma-after-chemotherapy
#9
Tsutomu Mizoshita, Masashi Ando, Hiroyuki Sagawa, Yoshinori Mori, Takahito Katano, Keiji Ozeki, Satoshi Tanida, Yasuyuki Okamoto, Takaya Shimura, Eiji Kubota, Hiromi Kataoka, Takeshi Kamiya, Takashi Joh
A 23-year-old man was diagnosed with a giant pelvic paraganglioma in September 2013, and a 6-month chemotherapy course was performed. The chemotherapy resulted in stable disease of the tumor for about 1 year. However, in April 2015, the patient complained of fever and diarrhea of more than ten times a day. Endoscopy showed serpiginous (snake-like) ulcers in the cecum, ascending, descending, and sigmoid colons, with granulomas without caseation histologically. The patient was diagnosed with the active stage of Crohn's disease (CD) in June 2015...
March 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28261702/pseudoaneurysm-of-the-splenic-artery-an-uncommon-cause-of-delayed-hemorrhage-after-pancreaticoduodenectomy
#10
Radu Dumitru, Ana Carbunaru, Mugur Grasu, Mihai Toma, Mihnea Ionescu, Traian Dumitrascu
Delayed post-pancreatectomy hemorrhage (PPH) is a relatively uncommon, but feared, complication after pancreaticoduodenectomy (PD). A splenic artery pseudoaneurysm is a rare cause of delayed PPH after a PD. This paper describes the case of a patient with PD used to treat a distal bile duct cholangiocarcinoma complicated with a clinically significant pancreatic fistula and secondary intraabdominal abscess. Computed tomography-guided drainage of the abscess was performed with an apparently favourable outcome; the patient was discharged on postoperative day (POD) 35 and the abdominal drains were removed on POD 50...
November 2016: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28255551/multiple-perforations-and-fistula-formation-following-corticosteroid-administration-a-case-report
#11
Jing-Ni He, Zhong Tian, Xu Yao, Hang-Yu Li, Yun Yu, Yuan Liu, Jin-Gang Liu
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic small- and medium-sized-vessel vasculitis. The literature contains only a few reports of gastrointestinal perforation with this condition. We report a patient with EPGA treated with high-dose steroid who underwent emergency surgery for intestinal perforations. We performed a simple repair of the 11 perforations. Intestinal fistulas developed 8 d postoperatively; they healed well after 60 d of continuous washing and negative pressure suction...
February 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28229301/safety-and-efficacy-of-postoperative-pharmacologic-thromboprophylaxis-with-enoxaparin-after-pancreatic-surgery
#12
Hajime Imamura, Tomohiko Adachi, Amane Kitasato, Takayuki Tanaka, Akihiko Soyama, Masaaki Hidaka, Fumihiko Fujita, Mitsuhisa Takatsuki, Tamotsu Kuroki, Susumu Eguchi
PURPOSE: Pharmacologic thromboprophylaxis is recommended for preventing pulmonary embolism according to some abdominal surgery guidelines. However, few reports have so far described pharmacologic thromboprophylaxis after pancreatic surgery. In addition, concern remains regarding postoperative bleeding due to pharmacologic thromboprophylaxis. We investigated the safety and efficacy of enoxaparin, a low-molecular-weight heparin, as postoperative pharmacologic thromboprophylaxis after pancreatic surgery...
February 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28226350/-value-of-endoscopy-application-in-the-management-of-complications-after-radical-gastrectomy-for-gastric-cancer
#13
Yiqun Zhang, Pinghong Zhou
Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28225051/low-muscle-mass-at-initiation-of-anti-tnf-therapy-for-inflammatory-bowel-disease-is-associated-with-early-treatment-failure-a-retrospective-analysis
#14
D Q Holt, P Varma, B J G Strauss, A S Rajadurai, G T Moore
BACKGROUND/OBJECTIVES: Delayed treatment failure occurs in a significant proportion of inflammatory bowel disease (IBD) patients treated with tumor necrosis factor-alpha (TNF) antagonists. Identification of predictors of loss of response (LOR) may help to optimize therapy. We sought to determine whether body composition parameters at the commencement of anti-TNF therapy were associated with earlier treatment failure. SUBJECTS/METHODS: A retrospective cohort study was performed on 68 patients who had undergone cross-sectional abdominal imaging coincident with the commencement of anti-TNF drugs...
February 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28197671/-rectal-perforation-a%C3%A2-rare-complication-following-radiotherapy
#15
M Binnebösel, A Lambertz, C D Klink, U P Neumann
BACKGROUND: Radiotherapy in the treatment of prostate cancer is well established. Intestinal complications following radiotherapy are divided into acute and chronic toxicity. Chronic complications like perforation and fistula formation to the rectum are rare and difficult to treat. MATERIALS AND METHODS: In case of chronic radiotherapy complications and particularly chronic fistula formation to the rectum, evidence is low. Therefore, an overview of the available literature of surgical therapy strategies is given...
February 14, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28163172/endovascular-management-of-para-prosthetic-aortocaval-fistula-case-report-and-systematic-review-of-the-literature
#16
Claudio Bianchini Massoni, Giulia Rossi, Tiziano Tecchio, Paolo Perini, Antonio Freyrie
The aim of this article is to report a case of asymptomatic para-anastomotic aortocaval fistula (ACF) treated by endovascular aortic repair, and to review data of the literature on arteriovenous fistulae secondary to abdominal aortic surgery. A 78-year-old male complained of worsening pain in the right lower limb since 2 months. He presented a history of right femoropopliteal bypass for peripheral arterial occlusive disease and elective surgical treatment for a non-ruptured infrarenal aortic aneurysm (Dacron tube graft)...
February 3, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28162214/-the-role-of-hong-s-single-stitch-duct-to-mucosa-pancreaticojejunostomy-in-laparoscopic-pancreaticoduodenectomy
#17
D F Hong, Y H Liu, Y H Zhang, Y C Wang, Z M Wang, W D Wu, G L Shen, J G Zhang, W Zhang, J Cheng, S Y Peng
Objective: To investigate the role of "Hong's single-stitch duct to mucosa pancreaticojejunostomy(HSDMP)" in laparoscopic pancreaticoduodenectomy (LPD). Methods: The clinical data including perioperative and short-term outcomes of 51 cases of LPD with HSDMP which performed in Zhejiang Provincial People's Hospital(33 cases) and Frist Clinical Hospital of Jilin University(18 cases) between April and October 2016 were reviewed retrospectively. There were 31 male patients and 20 female patients. The mean age was(59±11)years...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28135678/curative-resection-for-locally-advanced-sigmoid-colon-cancer-using-neoadjuvant-chemotherapy-with-folfox-plus-panitumumab-a-case-report
#18
Kenji Tomizawa, Yuji Miura, Yudai Fukui, Yutaka Hanaoka, Shigeo Toda, Jin Moriyama, Naoko Inoshita, Yukinori Ozaki, Toshimi Takano, Shuichiro Matoba, Hiroya Kuroyanagi
INTRODUCTION: FOLFOX and panitumumab combined chemotherapy plays an important role for metastatic colorectal cancer. However the usefulness of this regimen for neoadjuvant therapy is unclear. CASE REPORT: A 67-year-old man with abdominal pain and pneumaturia was diagnosed with RAS wild-type sigmoid colon cancer with urinary bladder invasion and colovesical fistulas. Because the cancer was considered to be unresectable, a transverse-loop colostomy was performed. Colonoscopy and computed tomography revealed a marked reduction in the size of the primary tumor after six courses of FOLFOX4 (oxaliplatin, leucovorin, and 5-fluorouracil) plus panitumumab...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28112814/randomized-clinical-trial-of-duct-to-mucosa-pancreaticogastrostomy-versus-handsewn-closure-after-distal-pancreatectomy
#19
RANDOMIZED CONTROLLED TRIAL
K Uemura, S Satoi, F Motoi, M Kwon, M Unno, Y Murakami
BACKGROUND: Postoperative pancreatic fistula (POPF) remains a major cause of morbidity after distal pancreatectomy. The aim of this study was to investigate whether duct-to-mucosa pancreaticogastrostomy of the pancreatic stump decreased clinical POPF formation compared with handsewn closure after distal pancreatectomy. METHODS: This multicentre RCT was performed between April 2012 and June 2014. Patients undergoing distal pancreatectomy were assigned randomly to either duct-to-mucosa pancreaticogastrostomy or handsewn closure...
April 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28105625/-efficacy-of-over-the-scope-clip-for-gastrointestinal-fistula
#20
Gefei Wang, Zhiming Wang, Xiuwen Wu, Yanqing Diao, Yunzhao Zhao, Jianan Ren, Jieshou Li
OBJECTIVE: To explore the efficacy of over-the-scope clip (OTSC) in the treatment of gastrointestinal fistula. METHODS: Clinical data of 12 gastrointestinal fistula patients, including 3 internal fistula and 9 external fistula treated with OTSC in our institute from March 2015 to May 2016 were retrospectively analyzed. OTSC was performed when pus was drained thoroughly and intra-abdominal infection around gastrointestinal fistula was controlled, and each patient received one clip to close fistula...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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