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emergency laparotomy

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https://www.readbyqxmd.com/read/28321558/a-novel-scoring-system-for-diagnosing-acute-mesenteric-ischemia-in-the-emergency-ward
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28302240/a-rare-fetal-firearm-injury
#5
Imran Hashim, Nabila Talat
Firearm injury (FAI) in pregnant women is reported in the literature; however, no reference to date was found to address the neonatal abdominal surgery performed after maternal FAI. FAI during fetal life is extremely rare and very few cases have been reported. We present a report of a 37-week gestation newborn whose mother had an accidental FAI. The neonate was delivered by emergency caesarian section along with emergency laparotomy of the newborn. The baby presented at eight hours of life, who was managed surgically in emergency for multiple small and large bowel perforations and a piece of bullet was recovered from anterior part of thigh...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28302233/an-unusual-case-of-caecal-volvulus-due-to-appendicitis-successfully-managed-by-caecopexy
#6
Samiullah Bhatti, Mahmood Ayyaz Khan, Waris Farooka, Usman Ismat Butt, Usman Ali Rehman, Awais Amjad Malik
Caecal volvulus is a rare cause of intestinal obstruction. Caecal volvulus precipitated by acute appendicitis is even rarer. We report an unusual case of caecal volvulus with acute appendicitis as a cause. A 55-year female presented in surgical emergency with 3 days history of abdominal pain, distension and absolute constipation; and 2 days history of vomiting. Her past surgical history was significant for hysterectomy 5 years back. On examination, abdomen was distended and bowel sounds exaggerated. X-ray abdomen erect showed a single large air fluid level in the right hemiabdomen...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28301395/increased-anatomic-severity-in-appendicitis-is-associated-with-outcomes-in-a-south-african-population
#7
Matthew C Hernandez, Victor Y Kong, Johnathon M Aho, John L Bruce, Stephanie F Polites, Grant L Laing, Martin D Zielinski, Damian L Clarke
BACKGROUND: Severity of emergency general surgery diseases (EGS) has not been standardized until recently. The American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system for EGS diseases to facilitate communication and quality comparisons between providers and hospitals. Previous work has demonstrated validity of the system for appendicitis in the United States. In order to demonstrate generalizability, we aim to externally validate this grading system in South African patients with appendicitis...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28298776/a-comparative-study-for-post-operative-analgesia-in-the-emergency-laparotomies-thoracic-epidural-ropivacaine-with-nalbuphine-and-ropivacaine-with-butorphanol
#8
Saravana Babu, Bikram Kumar Gupta, Gyanendra Kumar Gautam
BACKGROUND: Adequate postoperative pain therapy for emergency abdominal surgeries is important far beyond the perioperative period because sensitization to painful stimuli can cause postoperative morbidity. A prospective, double-blind, randomized study was carried out to compare the quality of postoperative analgesia and side-effect profile between epidurally administered butorphanol and nalbuphine as an adjuvant to 0.2% ropivacaine. MATERIALS AND METHODS: A total of eighty patients, 43 men and 37 women between the age of 18 and 65 years of American Society of Anesthesiologists (ASA) Class I E and II E, who underwent intestinal perforation repair surgery were randomly allocated into two groups ropivacaine with butorphanol (RB) and ropivacaine with nalbuphine (RN), comprising of 40 patients each...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28292519/interventional-radiology-service-provision-and-practice-for-the-management-of-traumatic-splenic-injury-across-the-regional-trauma-networks-of-england
#9
Jane Hughes, Ashley Scrimshire, Laura Steinberg, Petros Yiannoullou, Katherine Newton, Claire Hall, Lyndsay Pearce, Andrew Macdonald
INTRODUCTION: The management of blunt splenic injuries (BSI) has evolved toward strategies that avoid splenectomy. There is growing adoption of interventional radiology (IR) techniques in non-operative management of BSI, with evidence suggesting a corresponding reduction in emergency laparotomy requirements and increased splenic preservation rates. Currently there are no UK national guidelines for the management of blunt splenic injury. This may lead to variations in management, despite the reorganisation of trauma services in England in 2012...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28286841/diagnostic-accuracy-of-abdominal-wall-ultrasonography-and-local-wound-exploration-in-predicting-the-need-for-laparotomy-following-stab-wound
#10
Ali Vafaei, Kamran Heidari, Afshin Saboorizadeh, Amin Shams Akhtari
INTRODUCTION: Screening of patients with anterior abdominal penetrating trauma in need for laparotomy is an important issue in management of these cases. This study aimed to compare the accuracy of abdominal wall ultrasonography (AWU) and local wound exploration (LWE) in this regard. METHODS: This diagnostic accuracy study was conducted on ≥ 18 year-old patients presenting to emergency department with anterior abdominal stab wound and stable hemodynamics, to compare the characteristics of AWU and LWE in screening of patients in need of laparotomy...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285209/acute-large-bowel-pseudo-obstruction-due-to-atrophic-visceral-myopathy-a-case-report
#11
Sean M Wrenn, Charles S Parsons, Michelle Yang, Ajai K Malhotra
PURPOSE: Atrophic visceral myopathy is a pathological diagnosis characterized by atrophy of the smooth muscle layers of the viscera with intact ganglia. Rarely, it can present acutely as an intestinal pseudo-obstruction. We describe a rare case report and explore how this diagnosis can be distinguished from other forms of intestinal obstruction. CASE DESCRIPTION: A 60-year-old male with a past medical history of hypothyroidism presented to the emergency department with a two-day history of worsening abdominal distention and pain associated with nausea and vomiting...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28282008/long-term-surgical-outcome-of-trocar-site-hernia-repair
#12
Yoon-Hye Kwon, Eun Kyung Choe, Seung-Bum Ryoo, Jeong-Ki Kim, Kyu Joo Park
Port site hernias are emerging as a problematic complication of laparoscopic surgery. The aim of this study was to elucidate the characteristics of port site hernias and determine the long-term outcomes based on the interval between primary surgery and hernia occurrence. Twenty-four patients were surgically treated for trocar site hernia between 1997 and 2013. The patients were grouped into early-onset group (EOG; less than one month) and late-onset group (LOG; more than one month) based on the interval between laparoscopic surgery and hernia onset...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28281433/a-randomised-trial-comparing-laparoscopy-with-laparotomy-in-the-management-of-women-with-ruptured-ectopic-pregnancy
#13
L Snyman, T Makulana, J D Makin
BACKGROUND: Ruptured ectopic pregnancy (REP) is a common gynaecological emergency in resource-poor settings, where laparotomy is the standard treatment despite laparoscopic surgery being regarded as the optimal treatment. There is a lack of prospective randomised data comparing laparoscopic surgery with laparotomy in the surgical management of women with REP. OBJECTIVE: To compare operative laparoscopy with laparotomy in women with REP. METHODS: This was a randomised parallel study...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28278710/surgical-treatment-of-acute-abdominal-complications-in-hematology-patients-outcomes-and-prognostic-factors
#14
Djamel Mokart, Marion Penalver, Laurent Chow-Chine, Jacques Ewald, Antoine Sannini, Jean Paul Brun, Magali Bisbal, Bernard Lelong, Jean Robert Delpero, Marion Faucher, Olivier Turrini
The decision to operate on hematology patients with abdominal emergencies can be difficult, as neutropenia and thrombocytopenia are common and the usual causes of abdominal pain are broad. We conducted a retrospective observational study including all hematology patients undergoing emergency abdominal surgery between January 1998 and January 2013. Of the fifty-eight consecutive patients included in the study, nineteen (33%) underwent an operation during the neutropenia period. In the multivariate analysis, a laparotomy after 2002 was protective (HR: 0...
February 28, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28275833/survey-of-emergency-and-essential-surgical-obstetric-and-anaesthetic-services-available-in-bangladeshi-government-health-facilities
#15
Jonathan Loveday, Sonal P Sachdev, Meena N Cherian, Francisco Katayama, A K M Akhtaruzzaman, Joe Thomas, N Huda, E Brian Faragher, Walter D Johnson
OBJECTIVE: Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services. METHODS: Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies...
March 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28273609/a-rare-case-of-a-strangulated-littre-s-hernia-with-meckel-s-diverticulum-duplication-case-report-and-literature-review
#16
C R López-Lizárraga, M P Sánchez-Muñoz, G E Juárez-López, L Pelayo-Orozco, L F De la Cerda-Trujillo, C F Ploneda-Valencia
INTRODUCTION: The Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract present in approximately 1-4% of the population; the MD duplication is exceedingly rare with only a few reports of it. Here we present the firs case of a strangulated Littre's hernia with MD duplication. PRESENTATION OF CASE: A 30-year-old male presented to the emergency room with clinical signs of small bowel obstruction, at physical examination, a right incarcerated inguinal hernia with erythema was found...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28272851/the-effect-of-emergency-medical-services-response-on-outcome-of-trauma-laparotomy-at-a-level-1-trauma-centre-in-south-africa
#17
S Chowdhury, P H Navsaria, S Edu, A J Nicol
BACKGROUND: Due to resource constrained pre-hospital emergency medical services (EMSs) there is a significant delay in injured patients arriving at Groote Schuur Hospital Trauma Centre (GSHTC). The aim of the study was to examine the effectiveness of EMSs in transferring trauma patients to GSHTC. The effect of any delay to laparotomy from injury was noted. METHOD: A prospective audit of patients presented directly from the scene to GSHTC following abdominal trauma over a four-month period was performed...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28272849/enhanced-recovery-after-surgery-eras-in-penetrating-abdominal-trauma-a-prospective-single-center-pilot-study
#18
M R Moydien, R Oodit, S Chowdhury, S Edu, A J Nicol, P H Navsaria
BACKGROUND: Enhanced recovery after surgery (ERAS) programmes employed in elective surgery have provided strong evidence for decreased lengths of hospital stay without increase in postoperative complications. The aim of this study was to explore the role and benefits of ERAS implemented in patients undergoing emergency laparotomy for penetrating abdominal trauma. METHOD: Institutional University of Cape Town Human Research Ethics Committee (UCT-HREC) approved study...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28267697/reduced-rate-of-dehiscence-after-implementation-of-a-standardized-fascial-closure-technique-in-patients-undergoing-emergency-laparotomy
#19
Mai-Britt Tolstrup, Sara Kehlet Watt, Ismail Gögenur
OBJECTIVE: In elective surgery, it is well documented that a midline laparotomy should be closed with a slowly absorbable monofilament suture material in a continuous technique, in a ratio of at least 4 : 1. The evidence concerning the suture material or suturing technique in the emergency setting is lacking. We aimed to investigate whether this technique would reduce the rate of dehiscence. METHODS: A standardized procedure of closing the midline laparotomy by using a "small steps" technique of continuous suturing with a slowly absorbable (polydioxanone) suture material in a wound-suture ratio of minimum 1 : 4 was introduced in June 2014...
April 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28264595/uterine-rupture-after-previous-low-segment-transverse-cesarean-is-rarely-catastrophic
#20
Sofia Soltsman, Yuri Perlitz, Moshe Ben Ami, Izhar Ben Shlomo
OBJECTIVE: The cornerstone of concerns over trial of labor after cesarean (TOLAC) is the risk of uterine rupture. The purpose of this study was to document the rate of uterine rupture during TOLAC and to delineate its severity and consequences. MATERIALS AND METHODS: We retrospectively collected the data on vaginal and cesarean deliveries after a previous cesarean section with specific emphasis on uterine rupture and dehiscence in our center from 2006 through 2013...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
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