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Treating abdominal fistulas

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https://www.readbyqxmd.com/read/29034307/uterine-clostridium-perfringens-infection-related-to-gynecologic-malignancy
#1
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
#2
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
#3
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
#4
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
#5
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...
September 9, 2017: Urologia
https://www.readbyqxmd.com/read/28939111/open-descending-thoracic-or-thoracoabdominal-aortic-approaches-for-complications-of-endovascular-aortic-procedures-19-year-experience
#6
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
#7
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
#8
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...
September 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28890059/covered-stent-grafts-for-acquired-arterial-venous-fistulas-a-case-series
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28826728/cryopreserved-arterial-allografts-for-in-situ-reconstruction-of-abdominal-aortic-native-or-secondary-graft-infection
#12
Sabrina Ben Ahmed, Adrien Louvancourt, Guillaume Daniel, Pierre Combe, Ambroise Duprey, Jean-Noël Albertini, Jean-Pierre Favre, Eugenio Rosset
OBJECTIVE: The objective of this study was to evaluate the early and long-term outcome of cryopreserved arterial allografts (CAAs) used for in situ reconstruction of abdominal aortic native or secondary graft infection and to identify predictors of mortality. METHODS: We retrospectively included 71 patients (mean age, 65.2 years [range, 41-84 years]; men, 91.5%) treated for abdominal aortic native or secondary graft infection (65 prosthetic graft infections; 16 of them had secondary aortoenteric fistula, 2 venous graft infections, and 4 mycotic aneurysms) by in situ reconstruction with CAA in the university hospitals of Clermont-Ferrand and Saint-Etienne from 2000 to 2016...
August 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28797991/an-unusual-case-of-proctosigmoiditis-secondary-to-arteriovenous-fistulization
#13
Veljko Strjina, Scott R Kelley
Refractory chronic colitis presents a medical and surgical challenge, and underlying etiologies are diverse with potential for misclassification as inflammatory bowel disease. We present an unusual case of chronic proctosigmoiditis with rare vascular etiology. A 48-year-old Caucasian male presented with severe diarrhea, weight loss, and abdominal pain. Computed tomography (CT) suggested proctosigmoiditis. Colonoscopy and biopsy findings were non-specific but were suggestive of ischemic etiology and venous congestion...
August 9, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28780610/pancreatic-leaks-and-fistulae-an-endoscopy-oriented-classification
#14
REVIEW
Massimiliano Mutignani, Stefanos Dokas, Alberto Tringali, Edoardo Forti, Francesco Pugliese, Marcello Cintolo, Raffaele Manta, Lorenzo Dioscoridi
BACKGROUND: Pancreatic leaks occur as a complication of upper gastrointestinal surgery, acute pancreatitis, or abdominal trauma. Pancreatic fistulas and leaks are primarily managed conservatively. Overall, conservative measures are successful in more than half of cases. Whenever conservative treatment is not efficient, surgery is usually considered the treatment of choice. Nowadays however, endoscopic treatment is being increasingly considered and employed in many cases, as a surgery sparing intervention...
October 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28762169/successful-surgical-treatment-of-intractable-chylous-ascites-using-the-lymphatic-cable-flap-a-retrospective-review-study
#15
Shih-Heng Chen, Li-Fan Yeh, Pedro Ciudad, Hung-Chi Chen
OBJECTIVE: For evaluation of a novel surgical procedure for the treatment of chylous ascites. Chylous ascites is a debilitating condition associated with high morbidity and mortality rates. At least one-third of patients are refractory to medical therapy and may warrant further treatment. Traditional methods involving ligation of lymphatic fistulas or small bowel resection do not address the basic pathophysiologic mechanism of the underlying obstruction, and identification of chyloperitoneal fistulas may be challenging...
July 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28740836/mycotic-aneurysm-with-aortoduodenal-fistula
#16
REVIEW
Bruno Kusznir Vitturi, Amanda Frias, Raphael Sementilli, Marcelo de Castro Jorge Racy, Roberto Augusto Caffaro, Geanete Pozzan
Firstly described in the 19th century by Sir William Osler, the mycotic aneurysm (MA) is a rare entity characterized by an abnormal arterial dilation, which is potentially fatal, and is associated with the infection of the vascular wall. Elderly patients are mostly involved, especially when risk factors like chronic diseases, immunosuppression, neoplasia, and arterial manipulation are associated. The authors report the case of a young male patient diagnosed with an aortic aneurysm of infectious origin in the presence of repeated negative blood cultures...
April 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28710233/venobiliary-fistula-with-haemobilia-a-rare-complication-of-percutaneous-liver-biopsy
#17
Rotimi Ayoola, Parth Jamindar, Renee Williams
We describe a case of a 36-year-old man with a history of chronic hepatitis C who presented with abdominal pain 3 days after undergoing a percutaneous ultrasound-guided liver biopsy. Initial investigations revealed a venobiliary fistula with haemobilia and obstructive jaundice with direct bilirubin peaking at 9.2 mg/dL. He underwent an endoscopic retrograde cholangiopancreatography with sphincterotomy and stent placement, bilirubin decreased to 3.7 mg/dL, and the patient was discharged. The patient returned with recurrent abdominal pain and upper gastrointestinal bleeding with haemoglobin of 8...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28687504/infected-abdominal-aortic-aneurysms-treated-with-extra-anatomic-prosthesis-bypass-in-the-retroperitoneum
#18
You-Fei Qi, Zhan-Xiang Xiao, Chang Shu, Jie Yue, Sa-Hua Liu, Hao Chen, Zhao-Fan Zeng, Wen-Bo Zhang
BACKGROUND: Infected abdominal aortic aneurysms (iAAAs) are rare but life-threatening diseases. The purpose of the present study was to report our experience of extra-anatomic prosthesis bypass in the retroperitoneum as a treatment for iAAAs. METHODS: Data of 8 consecutive patients diagnosed with iAAAs and treated by an extra-anatomic prosthesis bypass in the retroperitoneum were retrospectively collected. Operative details were as follows: one side of the retroperitoneal space was selected to build a track, and a bifurcated expanded polytetrafluoroethylene prosthesis was placed through the track...
July 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#19
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...
September 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28603565/current-concepts-congenital-scoliosis
#20
Agnivesh Tikoo, Manish K Kothari, Kunal Shah, Abhay Nene
BACKGROUND: Congenital scoliosis is one of the 'difficult to treat' scenarios which a spine surgeon has to face. Multiple factors including the age of child at presentation, no definite pattern of deformity and associated anomalies hinder the execution of the ideal treatment plan. All patients of congenital scoliosis need to be investigated in detail. X rays and MRI of spine is usually ordered first. Screening investigations to rule out VACTERL (Visceral, Anorectal, Cardiac, Tracheo-esophageal fistula, Renal and Lung) abnormalities are required...
2017: Open Orthopaedics Journal
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