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Abdominal fistula treatments

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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/29033757/gallstone-ileus-an-unlikely-cause-of-mechanical-small-bowel-obstruction
#2
Estela Abich, Daniel Glotzer, Edward Murphy
Gallstone ileus is a rare disease that accounts for 1-4% of intestinal obstructions. Almost exclusively a condition in the older female population, it is a difficult diagnosis to make. We report the case of gallstone ileus in a 94-year-old Caucasian female, who presented to the emergency department with acute-onset nausea, coffee-ground emesis, lack of bowel movement, and abdominal distension. On CT scan, the diagnosis of gallstone ileus was made by the presence of a cholecystoduodenal fistula, pneumobilia, and small bowel obstruction...
May 2017: Case Reports in Gastroenterology
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/29022054/diagnosis-and-management-of-365-ureteric-injuries-following-obstetric-and-gynecologic-surgery-in-resource-limited-settings
#4
Thomas J I P Raassen, Carrie J Ngongo, Marietta M Mahendeka
INTRODUCTION: Ureteric injuries are among the most serious complications of pelvic surgery. The incidence in low-resource settings is not well documented. METHODS: This retrospective review analyzes a cohort of 365 ureteric injuries with ureterovaginal fistulas in 353 women following obstetric and gynecologic operations in 11 countries in Africa and Asia, all low-resource settings. The patients with ureteric injury were stratified into three groups according to the initial surgery: (a) obstetric operations, (b) gynecologic operations, and (c) vesicovaginal fistula (VVF) repairs...
October 11, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/29021430/crizotinib-induced-rectal-perforation-with-abscess
#5
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/28963700/enterocutaneous-fistulas-a-primer-for-radiologists-with-emphasis-on-ct-and-mri
#6
REVIEW
Massimo Tonolini, Paolo Magistrelli
Enterocutaneous fistulas (ECFs) represent abnormal communications between the gastrointestinal tract and the skin. Nowadays, the majority (~80%) of ECFs develops secondary to abdominal surgeries; alternative, less common causes include chronic inflammatory bowel diseases (IBD) such as Crohn's disease, tumours, and radiation enteritis in descending order of frequency. These rare disorders require thorough patient assessment and multidisciplinary management to limit the associated morbidity and mortality. This pictorial review includes an overview of causes, clinical manifestations, complications and management of ECFs...
September 29, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28953204/does-pancreaticogastrostomy-decrease-the-occurrence-of-delayed-gastric-emptying-after-pancreatoduodenectomy
#7
Chloé Vandermeeren, Patrizia Loi, Jean Closset
OBJECTIVES: This study investigates the factors that could influence the development of delayed gastric emptying (DGE) after pancreatoduodenectomy (PD). Delayed gastric emptying is a common complication after PD. The postoperative course is affected by a lengthened hospital stay, a decrease of the patients' quality of life, and a delayed adjuvant treatment. METHODS: From January 2000 to December 2012, 257 patients underwent PD in the same center. Forty-six variables were retrospectively extracted from medical records...
August 4, 2017: Pancreas
https://www.readbyqxmd.com/read/28944942/paramedian-forehead-flap-for-repair-of-refractory-high-flow-anterior-skull-base-csf-leak
#8
Jeremy Ciporen, Brandon Lucke-Wold, Haley Gillham, David Cua, Jason Kim, Paul Akins
AIM: The paramedian forehead flap (PMFF) has been well described for nasal reconstruction. However, it has never been reported for use in the repair of high flow anterior skull base cerebral spinal fluid (CSF) leaks. MATERIAL AND METHODS: The patient is a 55 yo African American male cocaine abuser who initially presented with a high flow anterior skull base CSF leak, extensive pneumocephalus, and intra-cerebral and intra-ventricular abscesses with an oro-nasal-cerebral fistula...
July 11, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28923055/clinical-outcome-of-laparoscopic-complete-mesocolic-excision-in-the-treatment-of-right-colon-cancer
#9
Yong Wang, Chuan Zhang, Dongsheng Zhang, Zan Fu, Yueming Sun
BACKGROUND: This study aimed to investigate the clinical outcome of complete mesocolic excision (CME) with a caudal-to-cranial medial approach in the treatment of right colon cancer. METHODS: The clinical data of 172 patients who underwent laparoscopic CME for right colon cancer and were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2010 to April 2015 were retrospectively analyzed. The 3-year disease-free survival (DFS) and overall survival (OS) in relation to gender, age, history of abdominal surgery, tumor size, complications, and tumor-node-metastasis (TNM) classification were analyzed using the Kaplan-Meier survival curves...
September 18, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28913134/management-of-vesicovaginal-fistulas-after-gynecologic-surgery
#10
Burak Tatar, Taylan Oksay, Fatma Selcen Cebe, Sedat Soyupek, Evrim Erdemoğlu
OBJECTIVE: In developed nations, surgery, especially gynecologic procedures, is the major cause of vesicovaginal fistulas (VVFs). We retrospectively evaluated our treatment modalities for VVF repair caused by a gynecologic surgery, and discussed the reasons of selecting certain surgical techniques and their outcomes. MATERIALS AND METHODS: We compared the surgical procedure preferences of surgeons and their results with patient and surgeon characteristics for the management of VVFs after an inciting gynecologic surgery in Süleyman Demirel University Hospital, Isparta over a 10-year period...
March 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28911880/pelvic-exenteration-for-gynecologic-malignancies-postoperative-complications-and-oncologic-outcomes
#11
A Romeo, M I Gonzalez, J Jaunarena, M E Zubieta, G Favre, J C Tejerizo
INTRODUCTION AND OBJECTIVE: To evaluate complications, morbidity and oncologic outcomes of pelvic exenteration as treatment for gynecologic malignancies. MATERIALS AND METHODS: Between 2008 and 2015, a total of 35 patients underwent pelvic exenteration, due to recurrence of gynecological cancer. Surgical outcomes, early and late postoperative complications, and recurrence/survival outcomes were assessed. RESULTS: Mean patient age was 53.8 years...
September 11, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28903762/mesh-penetrating-the-cecum-and-bladder-following-inguinal-hernia-surgery-a-case-report
#12
Hiroshi Asano, Saori Yajima, Yoshie Hosoi, Makoto Takagi, Hiroyuki Fukano, Yasuhiro Ohara, Nozomi Shinozuka, Takaya Ichimura
BACKGROUND: Tension-free repair using mesh is a common inguinal hernia surgical procedure. However, various complications such as mesh-related infection and recurrence may develop as a result. Moreover, although rare, there are also reports of intestinal obstruction caused by adhesion of the mesh to the intestinal wall and cases of mesh migration into various organs. Here, we report our experience with a patient in whom mesh extraction was performed due to migration of mesh into the intestinal tract following inguinal hernia surgery and formation of a fistula with the bladder...
September 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28902649/percutaneous-treatment-of-a-superior-mesenteric-artery-pseudoaneurysm-and-arteriovenous-fistula-with-coil-embolization-a-case-report
#13
Alparslan Kılıç, Mikail Yarlıoğlueş, Elif Ergün, Yılmaz Ünal, Sani Namık Murat
Visceral artery pseudoaneurysm and arteriovenous fistula following penetrating abdominal injuries is a rarely observed complication. Presently described is the case of a 44-year-old male admitted to the hospital after having previously experienced penetrating abdominal trauma. The patient had developed a pseudoaneurysm in the superior mesenteric artery and an arteriovenous fistula between the superior mesenteric artery and vein following surgery. The patient underwent successful coil embolization procedure and he was discharged 1 day after intervention...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28895037/management-of-acute-sleeve-gastrectomy-leaks-by-conversion-to-roux-en-y-gastric-bypass-a-small-case-series
#14
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
#15
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/28876594/salmonella-typhimurium-infected-abdominal-aortic-aneurysm-endovascular-repair-with-secondary-aortoenteric-fistula-formation
#16
M Dickfos, K Garnham, J Jenkins
Endovascular aneurysm repair (EVAR) is a widely accepted and used technique for the treatment of abdominal aortic aneurysms (AAA). However, it comes with a unique set of complications, two of the rarer being infection and aorto-enteric fistula formation. Due to the infrequency of the situation, there are currently no guidelines for their management. A 75-year-old male presented with vague abdominal pain and fevers. He was diagnosed with an infected abdominal aortic EVAR stent graft on computer tomography imaging...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28868312/a-case-of-primary-aortoduodenal-fistula-and-abdominal-aortic-aneurysm-in-a-patient-with-chronic-q-fever
#17
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/28866827/fistula-following-laparoscopic-sleeve-gastrectomy-a-proposed-classification-and-algorithm-for-optimal-management
#18
G Al Hajj, R Chemaly
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is an accepted restrictive procedure with a hormonal component. There is no definitive course of treatment for post-LSG fistula; it remains a feared complication. We aimed to classify post-LSG fistulas and propose an algorithm to optimize their treatment. METHODS: Following primary and revisional LSG in obese patients, a retrospective observational study of fistulas was undertaken. Radiological studies were performed to identify anatomically distinct types of fistulas...
September 2, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28852462/non-curative-surgery-for-aortoenteric-fistula
#19
Bent Are Hansen, Svein Amundsen, Håkon Reikvam, Øystein Wendelbo, Gustav Pedersen
Graft infection with secondary aortic fistula is a rare complication following implantation of aortic prostheses, frequently occurring after emergency procedures and reoperations. The condition is associated with considerable morbidity and mortality. Curative treatment consists of explantation of the infected graft followed by fistula revision and implantation of a new graft in combination with antimicrobial therapy. Non-curative treatment with aortic stentgraft and long-term substitution treatment with antibiotics may be an option in cases where graft explantation is deemed too risky...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28841540/laparoscopically-assisted-treatment-of-entero-atmospheric-fistula-following-abdominal-wall-repair-of-complex-incisional-hernia-case-report
#20
Francesca Ceci, Linda D'Amore, Maria Romana Grimaldi, Elena Annesi, Domenico Tuscano, Francesco Gossetti, Paolo Negro
INTRODUCTION: Entero-atmospheric fistula (EAF) is an uncommon complication. Its timing and surgical management could be extremely challenging because extensive adhesions may heavily affect the approach to the abdominal cavity. PRESENTATION OF CASE: We hereby report a case of EAF in a 70 year-old man. In order to control the fistula output and the surrounding tissue damage from enteric content, the patient was managed conservatively using different technical solutions...
August 8, 2017: International Journal of Surgery Case Reports
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