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Treating abdominal fistulas

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https://www.readbyqxmd.com/read/28229301/safety-and-efficacy-of-postoperative-pharmacologic-thromboprophylaxis-with-enoxaparin-after-pancreatic-surgery
#1
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
#2
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
#3
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
#4
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
#5
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 (AVF) 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 femoro-popliteal bypass for peripheral arterial occlusive disease and elective surgical treatment for a non-ruptured infrarenal aortic aneurysm (Dacron tube graft)...
February 2, 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
#6
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
#7
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...
January 17, 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
#8
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...
January 23, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28105625/-efficacy-of-over-the-scope-clip-for-gastrointestinal-fistula
#9
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
https://www.readbyqxmd.com/read/28099974/temporary-vacuum-assisted-closure-of-the-open-abdomen-in-neonates
#10
Kengo Hattori, Alp Numanoglu, Sharon Cox
Introduction The need for open abdomen in the treatment of severely ill neonates will increase in time as more complex abdominal procedures are undertaken. However, the experience of temporary closure of an open abdomen using vacuum-assisted closure (VAC) system is still relatively limited in premature and term neonates. The aim of this study is to describe and review our experience in the use of temporary VAC of the open abdomen for neonates with varying pathological processes. Materials and Methods A retrospective folder review of all neonates treated with VAC for open abdomen over the study period of 2010 to 2014 at our institution was performed...
January 18, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28093615/the-open-abdomen-route-by-eurahs-introduction-of-the-data-set-and-initial-results-of-procedures-and-procedure-related-complications
#11
A Willms, F Muysoms, C Güsgen, R Schwab, J Lock, S Schaaf, C Germer, I Richardsen, U Dietz
INTRODUCTION: Open abdomen management has become a well-established strategy in the treatment of serious intra-abdominal pathologies. Key objectives are fistula prevention and high fascial closure rates. The current level of evidence on laparostoma is insufficient. This is due to the rareness of laparostomas, the heterogeneity of study cohorts, and broad diversity of techniques. Collecting data in a standardised, multicentre registry is necessary to draw up evidence-based guidelines. MATERIALS AND METHODS: In order to improve the level of evidence on laparostomy, CAMIN (surgical working group for military and emergency surgery) of DGAV (German Society for General and Visceral Surgery), initiated the implementation of a laparostomy registry...
January 16, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28058018/factors-associated-with-surgery-in-patients-with-intra-abdominal-fistulizing-crohn-s-disease
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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