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Treating abdominal fistulas

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https://www.readbyqxmd.com/read/29182900/laparoscopic-sleeve-gastrectomy-for-morbid-obesity-role-of-intraluminal-and-intraperitoneal-postoperative-drainage
#1
G Currò, G Piscitelli, C Lazzara, I Komaei, A Fortugno, G Pinto, F Guccione, A Cogliandolo, A Dattola, S Latteri, G Navarra
BACKGROUND AND AIMS: Bleeding and staple line leak are the most common postoperative complications of LSG. To prevent and/or to promptly identify such complications, conventional peri-operative protocols imply post-operative gastric decompression (NGT) and staple line drain (IAD). Our aim was to evaluate the role of naso-gastric tube (NGT) and intra-abdominal drain (IAD) in preventing and/or facilitating identification and treatment of post-operative complications after sleeve gastrectomy...
July 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29181746/severe-dehiscence-of-gastrojejunal-anastomosis-after-gastric-bypass-its-cure-by-using-partially-covered-stent-and-avoiding-migration
#2
Helga C A W Alhinho, Flávio C Ferreira, Rodrigo C L Medeiros, Álvaro A B Ferraz, Josemberg M Campos
BACKGROUND: Gastric leak is a severe complication of gastric bypass that is associated with significant morbidity and mortality. Anastomosis dehiscence usually occurs at gastrojejunal anastomosis and can appear simultaneously with gastric leak, for which treatment can be a challenge. Fistula may have several clinical impacts, depending on patient-related factors, fistula characteristics, onset time, and therapy proposal. Abdominal toilet, drainage, gastrostomy, and revisional surgery constitute the traditional approaches to dehiscence and fistula closure, with variable results...
November 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29163954/successful-management-of-life-threatening-bleeding-of-intraductal-papillary-mucinous-neoplasms-in-the-pancreatic-head
#3
Hiroyuki Tokue, Hideo Morita, Azusa Tokue, Yoshito Tsushima
Complications associated with intraductal papillary mucinous neoplasms, such as acute pancreatitis, perforation, and fistula formation, have been documented. Intraductal papillary mucinous neoplasm with intratumoral hemorrhage is rare. To the best of our knowledge, there have been no previous reports of intraductal papillary mucinous neoplasm rupture and bleeding with intra-abdominal hemorrhage. A 74-year-old woman complained of acute upper right abdominal pain. She was under follow-up for an intraductal papillary mucinous neoplasm in the pancreatic head...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29162069/martius-flap-for-recurrent-perineal-and-rectovaginal-fistulae-in-a-patient-with-crohn-s-disease-endometriosis-and-a-mullerian-anomaly
#4
Gaetano Gallo, Alberto Realis Luc, Giuseppe Clerico, Mario Trompetto
BACKGROUND: Rectovaginal fistulas represent 5% of all anorectal fistulae and are a disastrous manifestation of Crohn's disease that negatively affects patients' social and sexual quality of life. Treatment remains challenging for colorectal surgeons, and the recurrence rate remains high despite the numerous available options. CASE PRESENTATION: We describe a 31-year-old female patient with a Crohn's disease-related recurrent perineo-vaginal and recto-vaginal fistulae and a concomitant mullerian anomaly...
November 21, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#5
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29116490/impact-of-sarcopenic-obesity-on-failure-to-rescue-from-major-complications-following-pancreaticoduodenectomy-for-cancer-results-from-a-multicenter-study
#6
Nicolò Pecorelli, Giovanni Capretti, Marta Sandini, Anna Damascelli, Giulia Cristel, Francesco De Cobelli, Luca Gianotti, Alessandro Zerbi, Marco Braga
BACKGROUND: Failure to rescue (FTR) is a quality-of-care indicator in pancreatic surgery, but may also identify patients who may not tolerate major postoperative complications despite being treated with best available care. Previous studies found that high visceral adipose tissue-to-skeletal muscle ratio is associated with poor outcomes following pancreaticoduodenectomy (PD). The aim of the study is to assess the impact of sarcopenic obesity on occurrence of FTR from major complications in cancer patients undergoing PD...
November 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29094033/inferior-mesenteric-arteriovenous-fistula
#7
Seunghun Lee, Jooweon Chung, Byungkwon Ahn, Seunghyun Lee, Sunguhn Baek
Arteriovenous fistula (AVF) involving the inferior mesenteric artery and vein is very rare with only 33 cases described in the literature and may be of congenital or acquired (iatrogenic or traumatic) or idiopathic etiology. The pathophysiology of AVF that acts as a left-to-right shunt has accounted for clinical signs and symptoms associated with ischemic colitis, portal hypertension, and heart failure. A low incidence and nonspecific clinical signs and symptoms such as abdominal pain, thrill and mass, lower and upper gastrointestinal bleeding make it difficult to establish a diagnosis of inferior mesenteric AVF...
October 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29061024/-comparison-of-laparoscopic-distal-pancreatectomy-and-open-distal-pancreatectomy-in-pancreatic-ductal-adenocarcinoma
#8
K Xu, J J Su, M Su, L Yan, J Feng, X L Xin, Y L Chen
Objective: To compare and evaluate the curative effect of laparoscopic distal pancreatectomy(LDP) and traditional open distal pancreatectomy(ODP) in pancreatic ductal adenocarcinoma. Methods: The clinical data of 15 patients treated by LDP and 87 contemporaneous cases treated by ODP from January 2010 to November 2015 was collected, and the curative effect and prognosis of these patients were retrospectively analyzed. Results: The operation time of LDP group was (286.5±48.1) min, significantly longer than that of OPD group(226...
October 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29054907/secondary-aortoduodenal-fistula-and-the-unrecognised-herald-bleed
#9
Francesc Simó Alari, Esther Molina González, Israel Gutierrez, Aïcha Ahamdanech-Idrissi
A 65-year-old man with history of aortobifemoral surgery 4 years ago was admitted to hospital after sudden abdominal pain. Initially misdiagnosed as renal colic, he was treated with analgesics, and while on observation he started with haematemesis, rapidly responding to volume infusion. Upper gastrointestinal endoscopy showed fresh blood in the stomach with no visible active bleeding. CT scan showed an important contrast extravasation from the aorta to the third duodenal portion, restarting haemodynamic instability and a cardiac arrest...
October 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29034307/uterine-clostridium-perfringens-infection-related-to-gynecologic-malignancy
#10
Kevin M Kremer, Megan E McDonald, Michael J Goodheart
Uterine gas gangrene caused by Clostridium perfringens is a serious, often life-threatening infection that is rarely encountered in the practice of gynecologic oncology. However, the hypoxic nature of gynecologic cancers due to necrosis and/or prior radiation therapy creates a microenvironment optimal for proliferation of anaerobic bacteria such as the Clostridium species. Early recognition and aggressive treatment with IV antibiotics and surgical debridement remain the cornerstones of management in order to decrease morbidity and mortality...
November 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/29033336/open-abdomen-therapy-with-vacuum-and-mesh-mediated-fascial-traction-after-aortic-repair-an-international-multicentre-study
#11
Stefan Acosta, Arne Seternes, Maarit Venermo, Leena Vikatmaa, Karl Sörelius, Anders Wanhainen, Mats Svensson, Khatereh Djavani, Martin Björck
OBJECTIVES: Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation. METHODS: This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015...
October 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29029985/clinical-and-pathological-outcomes-after-irreversible-electroporation-of-the-pancreas-using-two-parallel-plate-electrodes-a-porcine-model
#12
Steffi J E Rombouts, Willemijn P M van Dijck, Maarten W Nijkamp, Tyche C Derksen, Lodewijk A A Brosens, Frederik J H Hoogwater, Maarten S van Leeuwen, Inne H M Borel Rinkes, Richard van Hillegersberg, Fred H Wittkampf, Izaak Q Molenaar
BACKGROUND: Irreversible electroporation (IRE) by inserting needles around the tumor as treatment for locally advanced pancreatic cancer entails several disadvantages, such as incomplete ablation due to field inhomogeneity, technical difficulties in needle placement and a risk of pancreatic fistula development. This experimental study evaluates outcomes of IRE using paddles in a porcine model. METHODS: Six healthy pigs underwent laparotomy and were treated with 2 separate ablations (in head and tail of the pancreas)...
October 10, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29021430/crizotinib-induced-rectal-perforation-with-abscess
#13
Asako Yanagisawa, Noriko Hayama, Hiroyuki Amano, Makoto Nakamura, Satoshi Hirano, Sukeyuki Nakamura, Hiroshi Tabeta
An 86-year-old Japanese man was diagnosed with stage IV lung adenocarcinoma. The patient was treated with crizotinib after EML4-ALK rearrangement was detected from his pleural effusion. He subsequently developed abdominal pain and rebound tenderness in the right lower abdomen. Contrast-enhanced abdominal CT showed a low-density area in the abdominal cavity. The size of the abscess was decreased by drainage and the administration of antibiotics. Fistulography revealed a fistula from the rectum to the abscess, and a diagnosis of lower intestinal tract perforation with abscess formation was made...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28967060/original-flow-chart-for-the-management-of-hydroureteronephrosis-caused-by-pessary-placement
#14
Matteo Balzarro, Emanuele Rubilotta, Antonio B Porcaro, Nicolò Trabacchin, Antonio D'Amico, Maria Angela Cerruto, Walter Artibani
INTRODUCTION: The use of a pessary to treat a pelvic organ prolapse (POP) is a valid non-invasive option. Severe complications are usually associated with neglected, oversized, or misplaced pessaries. Major complications include fistulas, bowel or bladder erosion, and hydroureteronephrosis (HUN). MATERIALS AND METHODS: We reviewed the literature and our experience in the management of HUN in the last decade, as a consequence of pessary placement. RESULTS: We used flow charts to take an accurate medical history of each patient...
October 25, 2017: Urologia
https://www.readbyqxmd.com/read/28939111/open-descending-thoracic-or-thoracoabdominal-aortic-approaches-for-complications-of-endovascular-aortic-procedures-19-year-experience
#15
Konstantinos Spiliotopoulos, Ourania Preventza, Susan Y Green, Matt D Price, Hiruni S Amarasekara, Brittany M Davis, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
OBJECTIVES: Endovascular aortic repair is increasingly being used to treat aneurysms, dissections, and traumatic injuries, despite its unknown long-term durability. We describe our 19-year experience with open descending thoracic and thoracoabdominal aortic repair after endovascular aortic repair. METHODS: Between 1996 and 2015, 67 patients were treated with open distal arch, descending thoracic, or thoracoabdominal aortic repair, or extra-anatomic bypass repair with aortic extirpation for complications after endovascular repair of the thoracic (n = 45, 67%) or abdominal (n = 22, 33%) aorta...
August 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28898386/pancreaticojejunostomy-versus-pancreaticogastrostomy-reconstruction-for-the-prevention-of-postoperative-pancreatic-fistula-following-pancreaticoduodenectomy
#16
REVIEW
Yao Cheng, Marta Briarava, Mingliang Lai, Xiaomei Wang, Bing Tu, Nansheng Cheng, Jianping Gong, Yuhong Yuan, Pierluigi Pilati, Simone Mocellin
BACKGROUND: Pancreatoduodenectomy is a surgical procedure used to treat diseases of the pancreatic head and, less often, the duodenum. The most common disease treated is cancer, but pancreatoduodenectomy is also used for people with traumatic lesions and chronic pancreatitis. Following pancreatoduodenectomy, the pancreatic stump must be connected with the small bowel where pancreatic juice can play its role in food digestion. Pancreatojejunostomy (PJ) and pancreatogastrostomy (PG) are surgical procedures commonly used to reconstruct the pancreatic stump after pancreatoduodenectomy...
September 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28895037/management-of-acute-sleeve-gastrectomy-leaks-by-conversion-to-roux-en-y-gastric-bypass-a-small-case-series
#17
Kutay Saglam, Aydin Aktas, Ersin Gundogan, Ismail Ertugrul, Ali Tardu, Servet Karagul, Serdar Kirmizi, Fatih Sumer, Veysel Ersan, Cuneyt Kayaalp
Management of early sleeve gastrectomy leak remains challenging. The recommended approach is endoscopic stenting and abdominal drainage. Conversion to a Roux-en-Y gastric bypass (RYGB) is a common procedure used for late fistulas with distal obstruction. Here, we have presented three cases of early staple line leaks treated by conversion to RYGB. These patients had uncontrolled abdominal infections despite intensive medical treatments, and surgery was elected for abdominal drainage as well as to control the source of sepsis...
November 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28890059/covered-stent-grafts-for-acquired-arterial-venous-fistulas-a-case-series
#18
Timur P Sarac, Lina Vargas, Vikram Kashyap, Jonathan Cardella, Cassius Ochoa Chaar
INTRODUCTION: Stent grafts have become the preferred method for treating abdominal aortic aneurysms (AAAs), but also have utility in treating other vasculopathies. In 2005, peripheral stent grafts were approved for treating superficial femoral artery (SFA) occlusive disease. This report describes our experience using covered stent grafts to treat acquired arterial venous fistulae (aAVF). METHODS: We reviewed the records of patients treated for aAVF with covered stent grafts...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28868312/a-case-of-primary-aortoduodenal-fistula-and-abdominal-aortic-aneurysm-in-a-patient-with-chronic-q-fever
#19
Arne de Niet, Ignace F J Tielliu, Paul M van Schaik, Jan J A M van den Dungen, Clark J Zeebregts
A 70-year-old man was successfully treated for an aortoduodenal fistula originating from a Q fever-related abdominal aortic aneurysm. He had no known history of contact with cattle or sheep. Although the combination of abdominal aortic aneurysm and aortoduodenal fistula is rare, one should be suspicious of Q fever infection as the causative agent, and additional medical treatment should be initiated.
February 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28838644/laparoscopic-ileocaecal-resection-versus-infliximab-for-terminal-ileitis-in-crohn-s-disease-a-randomised-controlled-open-label-multicentre-trial
#20
Cyriel Y Ponsioen, E Joline de Groof, Emma J Eshuis, Tjibbe J Gardenbroek, Patrick M M Bossuyt, Ailsa Hart, Janindra Warusavitarne, Christianne J Buskens, Ad A van Bodegraven, Menno A Brink, Esther C J Consten, Bart A van Wagensveld, Marno C M Rijk, Rogier M P H Crolla, Casper G Noomen, Alexander P J Houdijk, Rosalie C Mallant, Maarten Boom, Willem A Marsman, Hein B Stockmann, Bregje Mol, A Jeroen de Groof, Pieter C Stokkers, Geert R D'Haens, Willem A Bemelman
BACKGROUND: Treatment of patients with ileocaecal Crohn's disease who have not responded to conventional therapy is commonly scaled up to biological agents, but surgery can also offer excellent short-term and long-term results. We compared laparoscopic ileocaecal resection with infliximab to assess how they affect health-related quality of life. METHODS: In this randomised controlled, open-label trial, in 29 teaching hospitals and tertiary care centres in the Netherlands and the UK, adults with non-stricturing, ileocaecal Crohn's disease, in whom conventional therapy has failed were randomly allocated (1:1) by an internet randomisation module with biased-coin minimisation for participating centres and perianal fistula to receive laparoscopic ileocaecal resection or infliximab...
November 2017: Lancet. Gastroenterology & Hepatology
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