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emergency laparotomy

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https://www.readbyqxmd.com/read/28445796/decreasing-the-use-of-damage-control-laparotomy-in-trauma-a-quality-improvement-project
#1
John A Harvin, Lillian S Kao, Mike K Liang, Sasha D Adams, Michelle K McNutt, Joseph D Love, Laura J Moore, Charles E Wade, Bryan A Cotton, John B Holcomb
BACKGROUND: Our institution has published damage control laparotomy (DCL) rates of 30% and documented the substantial morbidity associated with the open abdomen. The purpose of this quality improvement (QI) project was to decrease the rate of DCL at a busy, Level 1 trauma center in the United States. STUDY DESIGN: A prospective cohort of all emergent trauma laparotomies from 11/2013-10/2015 (QI group) were followed. The QI intervention was multi-faceted and included audit and feedback for every DCL case...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28440847/diafragmabr%C3%A3-ck-ledde-till-kolonileus-med-sekund%C3%A3-r-mediastinal-%C3%A3-verskjutning-ovanligt-fall-visar-att-hiatusbr%C3%A3-ck-m%C3%A3-ste-tas-p%C3%A3-allvar
#2
Victor Mill, Claes Brodin
Large bowel obstruction with effects on the mediastinum We present a patient in which the colon and left kidney herniated through a left-sided diaphragmatic hernia. The cause of the hernia was unknown, although most likely it emanated from an earlier diaphragmatic rupture caused by trauma. Due to a diverticular stenosis of the sigmoid colon, the patient developed large bowel obstruction, causing displacement of mediastinal structures. Emergency laparotomy and anterolateral thoracotomy was performed.
April 19, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28434082/senior-general-surgery-residents-can-be-trained-to-perform-focused-assessment-with-sonography-for-trauma-patients-accurately
#3
Sheng-Der Hsu, Cheng-Jueng Chen, De-Chuan Chan, Jyh-Cherng Yu
PURPOSES: Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments...
April 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28433976/isolated-duodenal-rupture-primary-repair-without-diversion-is-it-safe-review-of-literature
#4
Muwaffaq Mezeil Telfah
Isolated duodenal rupture is a rare injury encountered among children following blunt abdominal trauma. Early diagnosis and treatment are essential to decrease the associated morbidity and mortality. The debate is about the optimum operative management. We report a 6-year-old child who presented with acute abdominal pain due to isolated duodenal injury following blunt abdominal trauma. Emergency laparotomy revealed duodenal rupture at the junction of the first and second part of duodenum and absence of any other visceral injuries...
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28431198/serum-amylase-and-lipase-and-urinary-trypsinogen-and-amylase-for-diagnosis-of-acute-pancreatitis
#5
REVIEW
Gianluca Rompianesi, Angus Hann, Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with acute abdominal pain differs if they have acute pancreatitis. It is important to know the diagnostic accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis, so that an informed decision can be made as to whether the person with abdominal pain has acute pancreatitis. There is currently no Cochrane review of the diagnostic test accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28413286/transversus-abdominis-plane-catheters-for-postoperative-pain-relief-in-pediatric-patients
#6
Sumitra G Bakshi, Jeson R Doctor, Bhakti D Trivedi, Sajid S Qureshi
Regional techniques provides excellent post operative pain relief in pediatric patients. Transversus abdominis plane (TAP) block is a newer regional technique available. Though there is emerging evidence proving the efficacy of TAP blocks, there is limited literature on use of TAP catheters in pediatric patients. TAP catheters were placed in two children following laparotomy with transverse incisions and in both epidural was avoided, with good post operative pain relief. Ultrasound guidance was used in one child, while in the other the catheter was placed under direct vision after dissection of the plane between transversus abdominis and internal oblique...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28399839/case-report-preoperatively-diagnosed-perforated-meckel-s-diverticulum-containing-gastric-and-pancreatic-type-mucosa
#7
Georges A Abizeid, Hager Aref
BACKGROUND: Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract, and it represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, its infrequent occurrence is mirrored by the paucity of large series of data on it in the literature. Hemorrhage, obstruction and inflammation are most common complications of Meckel's diverticulum. Perforation of Meckel's diverticulum is considered very rare. CASE PRESENTATION: We present the case of a 17-year -old male, who presented to the emergency department with 1-day history of lower abdominal pain...
April 11, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28389805/a-multicentric-prospective-study-evaluating-the-safety-and-efficacy-of-kii-%C3%A2-fios-%C3%A2-first-entry-trocar-in-laparoscopic-bariatric-surgery
#8
Marcelo Loureiro, Mohamad Ramadan, El Mehdi Skalli, Pierre Blanc, Jean Michel Fabre, David Nocca
INTRODUCTION: Laparoscopic surgery has evolved as an important field of surgery due to its clear benefits when compared to open laparotomy surgery. However, specific complications of laparoscopic surgery have been reported, of which the majority are complications associated with first entry to the abdominal cavity. The emergence of bariatric surgery, combined with the special considerations of the abdominal wall and cavity of obese patients, leads to seeking new modalities of access to the abdominal cavity in this specific population...
April 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28384964/post-extubation-bronchospasm-in-an-undiagnosed-case-of-ascariasis-anaesthetic-challenges
#9
Ravindra Gehlot, Shekhar Suman Saxena, Indira Kumari, Virendra Verma, Aditya Bidwaikar
One of the most prevalent parasitic infestation is ascariasis which poses a great challenge to both the person being infested with and the treating medical team. We present here a case of round worm (Ascaris lumbricoides) infestation. A 40-year-old male, weighing 60 kg, diagnosed as perforation peritonitis, was scheduled for emergency exploratory laparotomy. The round worm was crawling out from duodenal perforation vent during laparotomy confirming the infestation. Patient later developed bronchospasm in post-extubation period and was managed accordingly...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28372454/an-unusual-enterolith-ileus
#10
Ismael Mora-Guzmán, José Luis Muñoz de Nova, Ana Rodríguez Sánchez
The duodenum is an uncommon location of diverticula in the digestive tract, and they are often asymptomatic. Formation of an enterolith inside diverticula has been previously described, although it is a rare condition. In this context, intestinal obstruction due to distal migration of foreign bodies is extremely rare. We report a case of an 86-year-old woman with obstructive symptoms due to a jejunal foreign body that had migrated from a duodenal diverticulum. An emergency laparotomy was performed to extract a phytobezoar...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28363468/donor-mesenchymal-stem-cells-home-to-maternal-wounds-after-transamniotic-stem-cell-therapy-trascet-in-a-rodent-model
#11
Christopher D Graham, Hester F Shieh, Joseph A Brazzo, David Zurakowski, Dario O Fauza
PURPOSE: Transamniotic stem cell therapy (TRASCET) with amniotic fluid-derived MSCs (afMSCs) has emerged experimentally as a practical treatment strategy for congenital anomalies. In this study, we sought to determine whether afMSCs migrate to the mother following TRASCET. METHODS: Pregnant rat dams were divided into three groups. Two groups received volume-matched injections into all amniotic cavities of either a suspension of afMSCs labeled with a luciferase reporter gene or the luciferase protein alone...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28353606/prophylactic-vacuum-sealing-drainage-vsd-in-the-prevention-of-postoperative-surgical-site-infections-in-pediatric-patients-with-contaminated-laparotomy-incisions
#12
Bailin Chen, Fabao Hao, Yang Yang, Qingjuan Shang, Chunbao Guo
Surgical site infection (SSI) continues to be an issue in abdominal surgery, especially for contaminated (class III) and dirty-infected (class IV) wounds. Vacuum sealing drainage (VSD) was reported effective in the management of various types of wounds or skin grafts. Our goal was to investigate the efficacy of prophylactic VSD to better orient their medicosurgical care of high-risk incisions following laparotomy in a pediatric population.A total of 331 pediatric patients with contaminated (class III) and dirty-infected (class IV) wounds following emergency laparotomy were retrospectively reviewed between January 2005 and January 2013...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28350977/small-bowel-obstruction-caused-by-anisakis-and-meckel-s-diverticulum-a-rare-case
#13
G Carbotta, R Laforgia, Michele Milella, M G Sederino, M Minafra, F Fortarezza, D Piscitelli, N Palasciano
INTRODUCTION: Anisakiasis is a parasitic infection caused by the ingestion of raw fish contaminated by larval nematodes of Anisakis species. Intestinal or extraintestinal manifestations are rated to > 4% and >1% respectively. PRESENTATION OF CASE: A 61-year old patient was admitted to our General Surgical and Emergency Unit because of sudden abdominal pain, vomit and constipation. He had eaten raw fish 3 days before admission. Laboratory data showed high levels of WBC and PCR...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28348948/microscopic-polyangiitis-atypical-presentation-with-extensive-small-bowel-necrosis-diffuse-alveolar-hemorrhage-and-renal-failure
#14
Justin M Segraves, Vivek N Iyer
Microscopic polyangiitis is an uncommon systemic vasculitis of varying severity that is associated with myeloperoxidase (MPO) and perinuclear antineutrophil cytoplasmic (p-ANCA) antibodies. The most commonly affected organs are the lungs and kidneys. We report on a very unusual case of microscopic polyangiitis presenting with severe mesenteric ischemia in addition to diffuse alveolar hemorrhage and acute renal failure. The patient was initially diagnosed with acute pancreatitis at an outside facility given his severe abdominal pain and elevated pancreatic enzymes...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28348360/an-uncommon-case-of-lower-limb-deep-vein-thrombosis-with-multiple-etiological-causes
#15
Jing Miao, Geetha Naik, Sivakumar Muddana, Xiaohuan Li, Supriya Bhimasani, Ronald Alvin Mitchell, Dariush Alaie, Richard L Petrillo
BACKGROUND Deep vein thrombosis (DVT) is a type of venous thromboembolism with diverse clinical and environmental risk factors. Very few cases of DVT with multiple high risk factors have been reported. Here, we report an uncommon DVT case with multiple etiological causes, including appendicitis/appendectomy, morbid obesity, immobilization, positive phosphatidylserine IgG, and heterozygous factor V Leiden mutation. CASE REPORT A 43-year-old female was brought to the emergency room because of 2-week history of pain and swelling and ultrasound revealing evidence of DVT in the right leg...
March 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28331644/term-abdominal-pregnancy-revealed-by-amnioperitoneum-in-rural-area
#16
Henri Donald Mutarambirwa, Bruno Kenfack, Jovanny Tsuala Fouogue
Abdominal pregnancy (AP) accounts for 1% of ectopic implantations. In sub-Saharan Africa, the high prevalence of sexually transmitted infections explains the increasing frequency of this pathology. In Cameroon it rose from 1/10000 deliveries (1995) to 3.3/10000 (2015). Authors herein report a case of a viable abdominal pregnancy discovered at term during emergency laparotomy for suspected uterine rupture. The 24-year-old G2P0 patient was HIV-positive, under antiretrovirals, though AP exceptionally occurs in HIV patients...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28321558/a-novel-scoring-system-for-diagnosing-acute-mesenteric-ischemia-in-the-emergency-ward
#17
Zhen Wang, Jun-Qiang Chen, Jin-Lu Liu, Lei Tian
BACKGROUND: Early diagnosis of acute mesenteric ischemia (AMI) based on clinical judgment has been proved to be too difficult. Therefore, it is important for identifying clinical parameters that can differentiate AMI from other acute abdomen upon presentation. METHODS: We analyzed a database of 106 consecutive patients admitted to the emergency ward for suspected AMI in whom diagnosis of AMI was confirmed by laparotomy, CT angiography or mesenteric angiography. The patients' demographics, previous history, clinical signs, results of laboratory investigations and ultrasonography were collected...
March 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28315818/sclerosing-encapsulated-peritonitis-a-devastating-and-infrequent-disease-complicating-kidney-transplantation-case-report-and-literature-review
#18
Liliana Caicedo, Alejandro Delgado, Luis A Caicedo, Juan Carlos Bravo, Laura S Thomas, Martin Rengifo, Jorge I Villegas, Oscar Serrano, Gabriel J Echeverri
INTRODUCTION: Sclerosing Encapsulating Peritonitis (SEP) is a rare condition with an incidence of up to 3% and a mortality of up to 51% among peritoneal dialysis (PD) patients (Brown et al., Korte et al. and Kawanishi et al.). In the last ten years, the incidence of SEP in kidney transplant recipients has increased (Nakamoto, de Sousa et al. and Korte et al.). PRESENTATION OF CASE: A 31-year old male with a 15 years history of PD and later kidney retransplantation was admitted to the emergency service after experiencing several weeks of diffuse abdominal pain which had escalated to include vomiting and diarrhea during the 24h previous to admission...
March 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28306583/successful-resuscitation-following-massive-obstetric-hemorrhage-in-a-patient-of-the-jehovah-s-witness-faith-a-case-report
#19
Richard M Hubbard, Jonathan H Waters, Mark H Yazer
Hemorrhage is a leading cause of maternal morbidity and mortality worldwide. It is especially difficult to treat in patients of the Jehovah's Witness faith because they refuse certain blood products. This case report describes the resuscitation of a parturient Jehovah's Witness whose postcesarean delivery course was complicated by massive hemorrhage from unrecognized arterial bleeding in the intensive care unit with significant hemodynamic instability that necessitated an emergency bedside laparotomy. Her hemoglobin nadir was 1...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28303069/ileo-ileal-knot-a-rare-case-of-acute-strangulated-intestinal-obstruction
#20
Kohei Taniguchi, Ryo Iida, Tomohiko Watanabe, Masahiko Nitta, Masao Tomioka, Kazuhisa Uchiyama, Akira Takasu
Strangulated intestinal obstruction is one of the most common types of acute abdomen and requires urgent surgical treatment. Herein, we report a very rare case of strangulated intestinal obstruction caused by an ileo-ileal knot. An 80-year-old woman was admitted to our hospital with suspicion of strangulation ileus and underwent emergency laparotomy after investigation by exploratory single-port laparoscopy. During surgery, a small bowel gangrene caused by an ileo-ileal knot was found. The gangrenous segment was resected, and primary anastomosis was performed...
February 2017: Nagoya Journal of Medical Science
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