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Treating abdominal fistulas

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https://www.readbyqxmd.com/read/28058018/factors-associated-with-surgery-in-patients-with-intra-abdominal-fistulizing-crohn-s-disease
#1
Shaul Yaari, Ariel Benson, Eyal Aviran, Naama Lev Cohain, Ran Oren, Jacob Sosna, Eran Israeli
AIM: To characterize radiological and clinical factors associated with subsequent surgical intervention in Crohn's disease (CD) patients with intra-abdominal fistulae. METHODS: From a cohort of 1244 CD patients seen over an eight year period (2006 to 2014), 126 patients were identified as having intra-abdominal fistulae, and included in the study. Baseline patient information was collected from the medical records. Imaging studies were assessed for: anatomic type and number of fistulae; diameter of the inflammatory conglomerate; length of diseased bowel; presence of a stricture with pre-stenotic dilatation; presence of an abscess; lymphadenopathy; and the degree of bowel enhancement...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28043693/preoperative-biliary-stenting-versus-operation-first-in-jaundiced-patients-due-to-malignant-lesions-in-the-pancreatic-head-a-meta-analysis-of-current-literature
#2
REVIEW
Florian Scheufele, Stephan Schorn, Ihsan Ekin Demir, Mine Sargut, Elke Tieftrunk, Lenika Calavrezos, Carsten Jäger, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Obstructive jaundice is a common presenting symptom among patients with pancreatic cancer. While benefits of preoperative biliary drainage have been suggested by previous studies, recent evidence has shown no significant improvements of preoperative biliary drainage on the postoperative outcome but rather an increase of complications. There is no clear consensus on whether to treat malignant obstructive jaundice with preoperative biliary drainage prior to operative intervention or to proceed directly to resection...
December 30, 2016: Surgery
https://www.readbyqxmd.com/read/28034703/hybrid-treatment-expanding-the-armamentarium-for-infected-infrarenal-abdominal-aortic-and-iliac-aneurysms
#3
Kichang Han, Do Yun Lee, Man-Deuk Kim, Sak Lee, Jong Yun Won, Joon Ho Kwon, Donghoon Choi, Young-Guk Ko
PURPOSE: To investigate safety and efficacy of hybrid treatment for infected aortic and iliac aneurysms. MATERIALS AND METHODS: Between July 2007 and May 2011, hybrid treatment was performed in 6 male patients (mean age, 67.7 y; range, 57-76 y). Hybrid treatment consisted of extraanatomic bypass (EAB) and isolation of infected aneurysm with vascular plugs. Aneurysms were divided into primary and secondary infected aneurysms. Primary infected aneurysm refers to an aneurysm arising from bacterial infection of the native arterial wall; secondary infected aneurysm refers to infection involving an aneurysm that was previously treated with graft placement...
December 26, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28028982/secondary-aortoenteric-fistula-after-abdominal-aortic-graft-implementation-in-our-own-material
#4
Jan Gnus, Stanisław Ferenc, Magdalena Kościelna, Małgorzata Paprocka-Borowicz, Piotr Dawidczyk, Małgorzata Dziewiszek, Wojciech Witkiewicz
BACKGROUND: Secondary aortoenteric fistula is a rare but severe complication occurring after abdominal aortic graft implementation. OBJECTIVES: The aim of our study was to review the clinical presentation, diagnosis and postoperative course of patients with aortoenteric fistulas following vascular operations on the abdominal aorta in the years 2000-2014. MATERIAL AND METHODS: Among all the patients treated in our center, during a 10-year period, aortoenteric fistulas were observed in 24 cases...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28018510/spontaneous-evacuation-of-a-vascular-metallic-stent-through-a-graft-duodenal-fistula-with-concomitant-non-surgical-fistula-closure
#5
Shunya Shindo, Hidenori Inoue, Shinya Motohashi, Hirotomo Uchiyama, Junetsu Akasaka
We report a patient who developed ileus caused by vascular stent migration into the duodenum with periprosthetic retroperitoneal abscess. The patient previously underwent removal of an infected abdominal aortic aneurysm with concomitant axillobifemoral arterial reconstruction. An occlusion of the graft leg was treated by a unilateral aortoiliac bypass where endovascular surgery with a metallic stent was later needed. The abscess and ileus were vigorously drained. Following the spontaneous evacuation of the metallic stent via the digestive tract, the abscess was completely drained and fistula closure was achieved without surgical intervention...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28000196/-analysis-of-clinical-characteristics-of-perianal-crohn-s-disease-in-a-single-center
#6
Ping Zhu, Yugen Chen, Yunfei Gu, Hongjin Chen, Xiaohai An, Yingrui Cheng, Ying Gao, Bolin Yang
OBJECTIVE: To discuss the clinical features of perianal Crohn disease (PCD). METHODS: Clinical data of 52 PCD patients who were treated at the Department of Colorectal Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine from June 2011 to October 2014 were analyzed retrospectively. Montreal classification, clinical symptoms, the subtype of perianal lesions, history of perianal surgery and medical treatment, disease active indexes, serum inflammation markers and nutritional indexes were included...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27965903/atypical-aortoesophageal-fistula-with-atypical-and-delayed-presentation-and-negative-imaging-studies
#7
Seifeldin Hakim, Mihajlo Gjeorgjievski, Lohit Garg, Molly Orosey, Tusar Desai
A 59-year-old man with past medical history of thoracic aortic aneurysm treated with thoracic endovascular aortic repair presented with melena for 2 weeks. Initial EGD did not reveal the source of bleeding and showed normal esophagus; abdominal arteriogram did not reveal a fistulous communication and initial CTA showed normal position of the aortic graft stent without endoleak. The sixth EGD revealed a submucosal tumor-like projection in the upper esophagus and stigmata of recent bleeding. Another thoracic endovascular aortic repair with stent was placed over the old graft for presumed aortoesophageal fistula...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27882164/inflammatory-bowel-disease-in-chinese-children-a-retrospective-analysis-of-49-cases
#8
Ying Zhou, Ying Huang
To present study reports the clinical characteristics, diagnosis and management of pediatric patients with inflammatory bowel disease (IBD) in China. Clinical records of 49 pediatric patients with IBD at Fudan University Children's Hospital (Shanghai, China) between July 2001 and May 2012 were reviewed. Of 49 patients (30 males and 19 females), 8 patients had ulcerative colitis (UC) and 41 patients had Crohn's disease (CD). The mean age was 10.4 years in patients with UC and 10.1 years in patients with CD. The percentages of patients with UC with abdominal pain, diarrhea or rectal bleeding were 62...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27829600/two-cases-of-aortoenteric-fistula-with-gastrointestinal-bleeding
#9
Yuu Matsubara, Tomoyuki Ohta, Ryoji Tatsumi, Takuma Takasaka, Jun Sakamoto, Ryu Sato, Keisuke Kimura
Aortoenteric fistula (AEF) is a life-threatening condition that can present with gastrointestinal (GI) bleeding. AEFs have been classified into primary and secondary types. Primary AEF (PAEF) is a direct communication between the aorta and the GI tract. Secondary AEF (SAEF) is the result of a previous abdominal aortic aneurysm repair involving placement of a synthetic aortic graft. Diagnosis of AEF, especially PAEF, is difficult largely because AEF is so rarely encountered in practice. Computed tomography (CT) and endoscopic gastroduodenoscopy (EGD) are most frequently used to diagnose AEF, with abdominal contrast-enhanced CT being the preferred initial diagnostic test of choice...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27790873/preperitoneal-onlay-mesh-repair-for-ventral-abdominal-wall-and-incisional-hernia-a-novel-technique
#10
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/27783843/azathioprine-or-6-mercaptopurine-for-induction-of-remission-in-crohn-s-disease
#11
REVIEW
Nilesh Chande, Cassandra M Townsend, Claire E Parker, John K MacDonald
BACKGROUND: The results from controlled clinical trials investigating the efficacy of azathioprine and 6-mercaptopurine for the treatment of active Crohn's disease have been conflicting and controversial. An updated meta-analysis was performed to assess the effectiveness of these drugs for the induction of remission in active Crohn's disease. OBJECTIVES: The primary objective was to determine the efficacy and safety of azathioprine and 6-mercaptopurine for induction of remission in active Crohn's disease...
October 26, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27752163/-effect-of-gum-chewing-on-bowel-function-recovery-in-patients-after-radical-cystectomy-with-urinary-diversion
#12
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
#13
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/27733326/impact-of-centralization-of-pancreaticoduodenectomy-coupled-with-fast-track-recovery-protocol-a-comparative-study-from-india
#14
Omar J Shah, Sadaf A Bangri, Manmohan Singh, Reyaz A Lattoo, Mohammad Y Bhat, Feroze A Khan
BACKGROUND: Fast track strategy in the management of patients undergoing intra-abdominal surgery of various types has emerged as a landmark approach to reduce surgical stress and accelerate recovery. This study was to evaluate the effect of fast track strategy on patients subjected to pancreaticoduodenectomy (PD) from an individual unit during transit from low to a high volume center. METHODS: A total of 142 PD patients who had been subjected to fast track strategy between June 2008 and September 2012 were compared with 46 patients who had received conventional surgery between January 2006 and May 2008...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27606045/endoscopic-multiple-metal-stenting-for-the-treatment-of-enteral-leaks-near-the-biliary-orifice-a-novel-effective-rescue-procedure
#15
Massimiliano Mutignani, Lorenzo Dioscoridi, Stefanos Dokas, Paolo Aseni, Pietro Carnevali, Edoardo Forti, Raffaele Manta, Mariano Sica, Alberto Tringali, Francesco Pugliese
Between April 2013 and October 2015, 6 patients developed periampullary duodenal or jejunal/biliary leaks after major abdominal surgery. In all patients, percutaneous drainage of the collection or re-operation with primary surgical repair was attempted at first but failed. A fully covered enteral metal stent was placed in all patients to seal the leak. Subsequently, we cannulated the common bile duct and, in some cases, and the main pancreatic duct inserting hydrophilic guidewires through the stent after dilating the stent mesh with a dilatation balloon or breaking the meshes with Argon Plasma Beam...
August 10, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27602129/peritoneal-bladder-fistula-following-radiotherapy-for-cervical-cancer-a-case-report
#16
Fan Shi, Tao Wang, Jiquan Wang, Beina Hui, Yanlan Chai, Juan Wang, Zi Liu
The occurrence of a peritoneal bladder fistula as a result of radiation cystitis following radiotherapy for cervical cancer is extremely rare and, to the best of our knowledge, has not been reported previously. The present study reports the case of a 50-year-old woman who was diagnosed with cervical cancer 20 years previously and was treated with radiotherapy. The patient was diagnosed with radiation cystitis 10 years ago, which was treated with Chinese medicine, and began experiencing sudden abdominal pain and bowel difficulties following urination 3 years ago...
September 2016: Oncology Letters
https://www.readbyqxmd.com/read/27601035/abdominal-wall-integrity-after-open-abdomen-long-term-results-of-vacuum-assisted-wound-closure-and-mesh-mediated-fascial-traction-vawcm
#17
A Willms, S Schaaf, R Schwab, I Richardsen, D Bieler, B Wagner, C Güsgen
PURPOSE: The open abdomen has become a standard technique in the management of critically ill patients undergoing surgery for severe intra-abdominal conditions. Negative pressure and mesh-mediated fascial traction are commonly used and achieve low fistula rates and high fascial closure rates. In this study, long-term results of a standardised treatment approach are presented. METHODS: Fifty-five patients who underwent OA management for different indications at our institution from 2006 to 2013 were enrolled...
September 6, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27592735/recent-results-of-in-situ-abdominal-aortic-reconstruction-with-cryopreserved-arterial-allograft
#18
S-H Heo, Y-W Kim, S-Y Woo, Y-J Park, D-K Kim, D-R Chung
OBJECTIVE: To evaluate treatment outcomes of in situ abdominal aortic reconstruction with cryopreserved arterial allograft (CAA) for patients with abdominal aortic infection. MATERIALS AND METHODS: A retrospective review of prospectively collected data was conducted of patients who underwent in situ aortic reconstruction using CAA for primary, secondary, or prosthetic infection of the abdominal aorta between May 2006 and July 2015, at a single institution. Clinical presentation, indications for treatment, procedural details, early post-operative mortality and morbidity, late death, and graft related complications during the follow up period were investigated...
September 1, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27586124/point-by-point-parent-artery-sinus-obliteration-using-detachable-pushable-0-035-inch-coils
#19
Susumu Yamaguchi, Nobutaka Horie, Kentaro Hayashi, Shuji Fukuda, Yoichi Morofuji, Takeshi Hiu, Tsuyoshi Izumo, Minoru Morikawa, Takayuki Matsuo
BACKGROUND: Parent artery occlusion for intractable aneurysms or sinus packing for dural arteriovenous fistulas (DAVFs) is sometimes difficult and requires many expensive coils to accomplish complete occlusion. To help solve these problems, we reviewed our experience using 0.035-inch coil (0.035 coil; Boston Scientific, San Leandro, CA, USA), which has been used in cardiovascular and abdominal lesions. METHODS: These 0.035 coils were preferably used in addition to the detachable and fibered coils for patients with intractable aneurysms, traumatic vessel blowout, and DAVF...
November 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27582884/closure-of-gastrointestinal-defects-with-ovesco-clip-long-term-results-and-clinical-implications
#20
Gianfranco Donatelli, Fabrizio Cereatti, Parag Dhumane, Bertrand Marie Vergeau, Thierry Tuszynski, Christian Marie, Jean-Loup Dumont, Bruno Meduri
BACKGROUND: The Over-The-Scope Clip (OTSC®, Ovesco Endoscopy GmbH, Tübingen, Germany) is an innovative clipping device that provides a strong tissue grasp and compression without provoking ischemia or laceration. In this retrospective study we evaluated immediate and long-term success rates of OTSC deployment in various pathologies of the gastrointestinal (GI) tract. METHODS: A total of 45 patients (35 female, 10 male) with an average age of 56 years old (range, 24-90 years) were treated with an OTSC for GI defects resulting from a diagnostic or interventional endoscopic procedure (acute setting group) or for fistula following abdominal surgery (chronic setting group)...
September 2016: Therapeutic Advances in Gastroenterology
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