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emergency laparotomy

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https://www.readbyqxmd.com/read/29348992/hernioscopy-in-incarcerated-inguinal-hernia-spontaneously-reduced-after-general-anesthesia-induction
#1
Irwin C White-Gittens, Aleksandr Kalabin, Vishnu R Mani, Anant Dinesh, Raja Sabbagh
Hernioscopy is essentially hernia sac laparoscopy. Hernia repair has evolved over the years with better outcomes; however, strangulated inguinal hernias are acute surgical emergencies which require emergent operative intervention. During anesthesia induction and/or after incision, hernia self-reduction is possible, with or without compromised bowel, back into the abdominal cavity. It is pivotal to examine the bowel to decide on further operative course. A simple alternative to unnecessary laparotomy or standard laparoscopy is hernioscopy, which is quite uncommon...
November 15, 2017: Curēus
https://www.readbyqxmd.com/read/29342420/-use-of-bronchial-blocker-in-emergent-thoracotomy-in-presence-of-upper-airway-hemorrhage-and-cervical-spine-fracture-a-difficult-decision
#2
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29335010/acute-intestinal-obstruction-due-to-extrinsic-compression-by-previa-myoma-and-ectopic-pregnancy-a-case-report
#3
Harissou Adamou, Ibrahim Amadou Magagi, Souleymane Oumarou Garba, Oumarou Habou
BACKGROUND: Acute intestinal obstruction during pregnancy is a rare digestive surgical emergency with significant maternal and fetal mortality. Diagnosis is difficult, often delaying the management. Here, we report an exceptional association of mechanical acute intestinal obstruction due to compression by previa uterine leiomyoma, and a ruptured ectopic pregnancy. CASE PRESENTATION: This is the case report of a 43-year-old primiparous black woman from a rural area, who was admitted to the surgical emergency department for acute intestinal obstruction...
January 16, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29325783/validation-of-the-aast-egs-acute-cholecystitis-grade-and-comparison-with-the-tokyo-guidelines
#4
Matthew Hernandez, Brittany Murphy, Johnathan M Aho, Nadeem N Haddad, Humza Saleem, Muhammad Zeb, David S Morris, Donald H Jenkins, Martin Zielinski
BACKGROUND: Acute cholecystitis presents with heterogeneous severity. The Tokyo Guidelines 2013 is a validated method to assess cholecystitis severity, but the variables are multifactorial. The American Association for the Surgery of Trauma (AAST) developed an anatomically based severity grading system for surgical diseases, including cholecystitis. Because the Tokyo Guidelines represent the gold standard to estimate acute cholecystitis severity, we wished to validate the AAST emergency general surgery scoring system and compare the performance of both systems for several patient outcomes...
January 8, 2018: Surgery
https://www.readbyqxmd.com/read/29322212/meta-analysis-on-materials-and-techniques-for-laparotomy-closure-the-match-review
#5
REVIEW
N A Henriksen, E B Deerenberg, L Venclauskas, R H Fortelny, M Miserez, F E Muysoms
BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate closure materials and suture techniques for emergency and elective laparotomies. The primary outcome was incisional hernia after 12 months, and the secondary outcomes were burst abdomen and surgical site infection. METHODS: A systematic literature search was conducted until September 2017. The quality of the RCTs was evaluated by at least 3 assessors using critical appraisal checklists...
January 10, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29316583/-foreign-body-ingestion-a-rare-cause-of-abdominal-pain
#6
Philipp Kasper, Fabian Kütting, Hans Anton Schlößer, Stefan Paul Mönig, Tobias Goeser, Natalie Jaspers
HISTORY AND FINDINGS UPON ADMISSION:  A 50-year-old man presented at the emergency unit with abdominal pain in the right lower quadrant and dysuria. He described an increase in pain during micturition. EXAMINATIONS:  After multiple examinations (CT-scan, MR-scan, ileocolonoscopy) were performed to no avail, a toothpick was detected in the terminal ileum during an ultrasound scan of the small intestine. Prompted elevation of intra-abdominal pressure led to migration of the radiolucent sharp foreign body into the wall of the urinary bladder, inducing pain...
January 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29310972/porto-mesenteric-venous-thrombosis-after-laparoscopic-sleeve-gastrectomy-a-case-report-and-systematic-review-of-the-104-cases
#7
Kerem Karaman, Mehmet Aziret, Ali Bal, Volkan Öter, Metin Ercan, Erdal Birol Bostancı
INTRODUCTION: Porto-mesenteric venous thrombosis (PMVT) is a rare but fatal complication after bariatric surgery. However, an increasing number of PMVT complications have been observed in the last years after laparoscopic sleeve gastrectomy (LSG) operations. CASE REPORT: A 35-year-old male was admitted to the emergency clinic in a septic status with a sudden once of abdominal pain and vomiting. The patient underwent laparoscopic sleeve gastrectomy (LSG) 15 days ago...
January 5, 2018: Obesity Research & Clinical Practice
https://www.readbyqxmd.com/read/29305372/uterocutaneous-fistula-following-b-lynch-suture-for-primary-postpartum-haemorrhage
#8
Monika Thakur, Sandeep S Rathore, Aditi Jindal, Kunal Mahajan
A 30-year-old woman, who had undergone emergency lower segment caesarean section (LSCS) for failed induction 2 months back, presented with a fistulous opening along with discharge from her previous incision scar. She had developed a massive primary postpartum haemorrhage at the time of LSCS 2 months back, which was managed with B-Lynch suture and vessel ligation. Fistulogram revealed a connection between the uterus and the skin. The diagnosis was confirmed by a contrast-enhanced CT scan. Patient was subjected to laparotomy...
January 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29288070/neonatal-erythropoietin-mitigates-impaired-gait-social-interaction-and-diffusion-tensor-imaging-abnormalities-in-a-rat-model-of-prenatal-brain-injury
#9
Shenandoah Robinson, Christopher J Corbett, Jesse L Winer, Lindsay A S Chan, Jessie R Maxwell, Christopher V Anstine, Tracylyn R Yellowhair, Nicholas A Andrews, Yirong Yang, Laurel O Sillerud, Lauren L Jantzie
Children who are born preterm are at risk for encephalopathy of prematurity, a leading cause of cerebral palsy, cognitive delay and behavioral disorders. Current interventions are limited and none have been shown to reverse cognitive and behavioral impairments, a primary determinant of poor quality of life for these children. Moreover, the mechanisms of perinatal brain injury that result in functional deficits and imaging abnormalities in the mature brain are poorly defined, limiting the potential to target interventions to those who may benefit most...
December 26, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/29288067/nationwide-trends-in-the-utilization-of-and-payments-for-hysterectomy-in-the-united-states-among-commercially-insured-women
#10
Daniel M Morgan, Neil S Kamdar, Carolyn W Swenson, Emily K Kobernik, Anne G Sammarco, Brahmajee Nallamothu
BACKGROUND: Laparotomy followed by inpatient hospitalization has traditionally been the most common surgical care for hysterectomy. The financial implications of the increased use of laparoscopy and outpatient hysterectomy are unknown. OBJECTIVES: To quantify the increasing use of laparoscopy and outpatient hysterectomy and to describe the financial implications among women with commercially based insurance in the United States. STUDY DESIGN: Hysterectomies between 2010 and 2013 were identified in the Health Care Cost Institute, a national dataset with inpatient and outpatient private insurance claims for more than 25 million women...
December 26, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29282514/measuring-outcomes-of-clinical-care-victorian-emergency-laparotomy-audit-using-quality-investigator
#11
Claire L Stevens, Christopher Brown, David A K Watters
BACKGROUND: The Australian and New Zealand Audit of Surgical Mortality (ANZASM) National Report 2015 found that within the cohort of audited deaths, 85% were emergencies with acute life-threatening conditions, and by far, the most common procedures were laparotomy and colorectal procedures. Emergency laparotomy outcomes have shown improvement through audit and reporting in the UK. The purpose of this study was to determine the outcome of emergency laparotomy in the state of Victoria, Australia...
December 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29282383/intussusception-due-to-an-inverted-meckel-s-diverticulum-diagnosed-by-double-balloon-enteroscopy
#12
Yuki Kawasaki, Satoshi Shinozaki, Tomonori Yano, Kenichi Oshiro, Mitsuaki Morimoto, Alan Kawarai Lefor, Hironori Yamamoto
An 18-year-old man presented after undergoing multiple investigations for abdominal pain. Retrograde double-balloon enteroscopy showed a protruding red lesion in the ileum with small ulcers, approximately 75 cm proximal to the ileocecal valve, resulting in an intussusception. An inverted Meckel's diverticulum was strongly suspected. Pressure was applied to the protruding lesion using contrast medium injection after wedging the lumen with a balloon. The intussusception partially reduced, avoiding the need for emergent surgery...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29273999/distal-duodenogastrostomy-or-proximal-jejunogastrostomy-in-the-management-of-ultra-short-bowel
#13
Tjipke Olivier Hofker, Mirjam Anna Kaijser, Vincent B Nieuwenhuijs, Johan Frederick Michel Lange, Hendrik Sijbrand Hofker
Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records...
December 22, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29273354/a-comparison-of-alcohol-positive-and-alcohol-negative-trauma-patients-requiring-an-emergency-laparotomy
#14
Cedric Benson, Janice Weinberg, Chaitan K Narsule, Tejal S Brahmbhatt
BACKGROUND: The effect of alcohol exposure on patients undergoing a laparotomy for trauma is unknown. The purpose of this study was to compare outcomes of morbidity and mortality between alcohol positive and alcohol negative trauma patients who required emergent laparotomies using the National Trauma Data Bank (NTDB). METHODS: A retrospective database analysis was performed using 28,354 NTDB incident trauma cases, from 2007 through 2012, who had been tested for alcohol and who required abdominal operations (using ICD-9-CM procedure codes) within 24h of presentation...
November 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29251701/lower-emergency-general-surgery-egs-mortality-among-hospitals-with-higher-quality-trauma-care
#15
John W Scott, Thomas C Tsai, Pooja U Neiman, Gregory J Jurkovich, Garth H Utter, Adil H Haider, Ali Salim, Joaquim M Havens
BACKGROUND: Patients undergoing emergency general surgery (EGS) procedures are up to eight times more likely to die than patients undergoing the same procedures electively. This excess mortality is often attributed to non-modifiable patient factors including comorbidities and physiologic derangements at presentation, leaving few targets for quality improvement. Though the hospital-level traits that contribute to EGS outcomes are not well understood, we hypothesized that facilities with lower trauma mortality would have lower EGS mortality...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29250478/an-unusual-complication-of-congenital-diaphragmatic-hernia
#16
E Tian Tan, Keren Sloan, Kokila Lakhoo
A term newborn was referred to our unit with a postnatal diagnosis of a right-sided congenital diaphragmatic hernia (CDH). She was managed with high-frequency oscillatory ventilation, inotropic support, and nitric oxide, with planned surgical repair when she was medically optimized. On day 6 of life, there was an acute deterioration causing difficulty maintaining adequate ventilation and the infant requiring increasing analgesia and paralysis, especially during abdominal examination. A repeat X-ray showed distended bowel loops in the right hemithorax when compared with previous films raising suspicion of bowel obstruction...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/29245362/characteristics-of-computed-tomography-in-hemodynamically-unstable-blunt-trauma-patients-experience-at-a-tertiary-care-center
#17
Youn-Jung Kim, June-Sung Kim, Soo-Han Cho, Jun-Il Bae, Chang Hwan Sohn, Yoon-Seon Lee, Jae-Ho Lee, Kyoung-Soo Lim, Won Young Kim
Emergent exploratory laparotomy is recommended for hemodynamically unstable blunt trauma patients suspected of having hemoperitoneum. However, given the unreliability of ultrasonography and rapid scan speed of computed tomography (CT), CT might help clinicians provide accurate information even in hemodynamically unstable trauma patients. This observational study aimed to describe the bleeding site and hospital course of severe blunt trauma patients with hemoperitoneum diagnosed by CT scan.We enrolled all consecutive adult blunt trauma patients (≥18 years old) who underwent whole-body CT before operation between February 2012 and October 2016...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#18
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29239841/totally-intra-corporeal-pringle-maneuver-during-laparoscopic-liver-resection
#19
Andrea Laurenzi, Daniel Cherqui, Rodrigo Figueroa, René Adam, Eric Vibert, Antonio Sa Cunha
INTRODUCTION: Laparoscopic resection has gained a significant place in liver surgery. As in open liver resection, bleeding control during hepatic transection remains a major issue and it represents the main reason for conversion to laparotomy. Pringle maneuver (PM) remains the standard inflow occlusion technique and a specific step-by-step description of totally intracorporeal laparoscopic PM is described. METHODS: The technique includes placement of a tape around the hepatoduodenal which is then passed through a plastic drain...
November 24, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29232630/opioid-drugs-and-stercoral-perforation-of-the-colon-case-report-and-review-of-literature
#20
Renée Poitras, Daun'Lee Warren, Sylvanus Oyogoa
INTRODUCTION: Stercoral perforation of the colon is a rare pathology, which is believed to be caused by an increased intraluminal pressure created by a fecaloma. Opioid induced constipation is a rare and often unsuspected cause of colonic perforation. PRESENTATION OF CASE: We report the case of a 58-year-old woman, who presented to the emergency department (ED) with severe hypotension, abdominal pain and gastrointestinal bleeding. She was found to have a diffusely tender and distended abdomen...
December 7, 2017: International Journal of Surgery Case Reports
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