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emergency laparotomy

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https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#1
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29145901/-food-bolus-obstruction-of-the-oesophagus-or-ingestion-of-a-foreign-body-what-should-you-do
#2
P R Oosterwijk, M A C Meijssen
A food bolus obstruction of the oesophagus and foreign body ingestion are frequently encountered in common clinical practice. There is currently no guideline in the Netherlands for management of these problems. We present two cases to illustrate how these can be managed in line with European and American guidelines. The first patient was a 36-year-old female with total obstruction of the oesophagus by a food bolus. Biopsies taken following endoscopic removal showed eosinophilic infiltration of the mucosa and a subsequent diagnosis of eosinophilic oesophagitis...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29145325/perforated-appendicitis-after-colonoscopy-cause-or-coincidence-a-rare-case-report-and-literature-review
#3
Xiao-Cong Zhou, Chun-Wei Huang, Yan-Yan Dai, Zhi-Yang Huang, Zheng Lou
RATIONALE: Colonoscopy is a relatively safe and common procedure with low risks of complications, and acute appendicitis with perforation is an extremely rare complication of colonoscopy. The current study presents an unusual case of acute gangrenous appendicitis with perforation following a screening colonoscopy. PATIENT CONCERNS: A 73-year-old man presented to our emergency department with lower right abdominal pain 3 days after a routine screening colonoscopy...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145243/obstructive-internal-hernia-caused-by-mesodiverticular-bands-in-children-two-case-reports-and-a-review-of-the-literature
#4
Mirko Bertozzi, Berardino Melissa, Elisa Magrini, Giuseppe Di Cara, Susanna Esposito, Antonino Apignani
INTRODUCTION: The mesodiverticular band (MDB) is an embryologic remnant of the vitelline circulation, which carries the arterial supply to the Meckel diverticulum. In the event of an error of involution, a patent or nonpatent arterial band persists and extends from the mesentery to the apex of the antimesenteric diverticulum. This creates a snare-like opening through which bowel loops may herniate and become obstructed. This report describes 2 rare cases of small bowel occlusion owing to an internal hernia caused by a MDB...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29140948/hypertonic-saline-resuscitation-following-emergent-laparotomy-and-temporary-abdominal-closure
#5
Tyler J Loftus, Philip A Efron, Trina M Bala, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Our objective was to establish the safety of 3% hypertonic saline (HTS) resuscitation for trauma and acute care surgery patients undergoing emergent laparotomy and temporary abdominal closure (TAC) with the hypothesis that HTS administration would be associated with hyperosmolar hypercholoremic acidosis, lower resuscitation volumes, and higher fascial closure rates, without adversely affecting renal function. METHODS: We performed a retrospective cohort analysis of 189 trauma and acute care surgery patients who underwent emergent laparotomy and TAC, comparing patients with normal baseline renal function who received 3% HTS at 30 mL/h (n=36) to patients with standard resuscitation (n=153) by baseline characteristics, resuscitation parameters, and outcomes including primary fascial closure and KDIGO stages of acute kidney injury...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29134253/the-role-of-the-neutrophil-lymphocyte-ratio-nlr-and-the-crp-albumin-ratio-car-in-predicting-mortality-following-emergency-laparotomy-in-the-over-80-age-group
#6
G Simpson, R Saunders, J Wilson, C Magee
INTRODUCTION: Emergency laparotomy in the elderly is an increasingly common procedure which carries high morbidity and mortality. Risk prediction tools, although imperfect, can help guide management decisions. Novel markers of surgical outcomes may contribute to these scoring systems. The neutrophil:lymphocyte ratio (NLR) and CRP:albumin ratio (CAR) have been associated with outcomes in malignancy and sepsis. We assessed the use of ratio NLR and CAR as prognostic indicators in patients over the age of 80 undergoing emergency laparotomy...
November 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29130015/jejunal-diverticular-perforation-causing-small-bowel-obstruction-in-a-type-4-hiatal-hernia-a-rare-case-report-of-a-nonagenarian-patient-and-review-of-relevant-literature
#7
Saptarshi Biswas, Shekhar Gogna, Prem Patel
Type IV paraesophageal hernia (PEH) is very rare and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a case of a 90-year-old male patient who presented at our emergency department complaining of epigastric pain that he had experienced over the past few hours and getting progressively worse. On the day after admission, his pain became severe. Chest radiography revealed an intrathoracic intestinal gas bubble; emergency exploratory laparotomy identified a type IV PEH with herniation of only the jejunum with perforated diverticula on mesenteric side through a hiatal defect into mediastinum...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29123864/right-sided-bochdalek-hernia-in-an-elderly-patient-a-case-review-of-adult-bochdalek-hernias-from-1982-to-2015-in-japan
#8
Yasuhiro Ohtsuka, Tiberiu H Suzuki
Case: An 89-year-old woman was admitted to our hospital because of dyspnea following abdominal pain and vomiting. According to chest computed tomography findings, a diagnosis of acute respiratory failure due to right-sided Bochdalek hernia was made. Outcome: Emergency laparotomy revealed that a bowel loop from the terminal ileum to the transverse colon had herniated into the right thoracic cavity through the foramen of Bochdalek. The herniated organs were reduced to the abdominal cavity and the foramen was repaired by direct suturing...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123859/non-traumatic-bladder-rupture-showing-less-than-10-hounsfield-units-of-ascites
#9
Naoto Mizumura, Satoshi Okumura, Sho Toyoda, Atsuo Imagawa, Masao Ogawa, Masayasu Kawasaki
Aim: Bladder ruptures are commonly misdiagnosed as gastrointestinal perforations or intestinal ischemia. If a diagnosis is made preoperatively, conservative treatment is a safe and effective option. We evaluated the validity of using the attenuation value of ascites, measured by non-contrast computed tomography (CT), to identify patients with bladder ruptures. Methods: A retrospective search of our hospital database identified 7 patients with confirmed bladder ruptures between 2007 and 2013...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29119221/preparing-japanese-surgeons-for-potential-mass-casualty-situations-will-require-innovative-and-systematic-programs
#10
H Uchino, V Y Kong, J L Bruce, G V Oosthuizen, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The ongoing state of global geo-political instability means that it is prudent to prepare civilian surgeons to manage major military-type trauma. Japan has enjoyed a prolonged period of peace and consequently it is unlikely that surgeons will have been exposed to a sufficient volume of cases. This study reviews the state of trauma training and preparedness in Japan and reviews the trauma workload of a major Japanese emergency medical center and compared with a major South African trauma center with the intention of quantifying and comparing the time needed to gain adequate exposure to major trauma at the two centers...
November 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29112788/non-strangulating-intestinal-infarctions-associated-with-strongylus-vulgaris-clinical-presentation-and-treatment-outcomes-of-30-horses-2008-2016
#11
T H Pihl, M K Nielsen, S N Olsen, P S Leifsson, S Jacobsen
BACKGROUND: Strongylus vulgaris is re-emerging in horses kept under surveillance-based parasite control regimens. Information on non-strangulating intestinal infarction associated with S. vulgaris is needed in order to improve recognition of the condition. OBJECTIVE: To describe the typical clinical presentation, laboratory findings, gross pathology, treatment and outcome of horses with non-strangulating intestinal infarction. STUDY DESIGN: Retrospective case-series...
November 7, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29107715/differed-surgery-in-patient-with-colorectal-endometriosis-and-pregnancy-intention-is-it-reasonable
#12
S Touleimat, E Huet, S Sanguin, H Roman
The management of patients presenting deep infiltrating endometriosis involving the rectum (DIER) and pregnancy intention is controversial. Assisted Reproduction Techniques (ART) are often proposed first, but this may lead to complications and further difficulties managing DIER. A 29-years-old woman was diagnosed with pre-occlusive DIER. However, she was offered in vitro fertilization (IVF) and underwent six unsuccessful cycles with serious complications: an ectopic pregnancy and a hemoperitoneum following arterial injury during oocyte retrieval, requiring two laparotomies in emergency...
October 28, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/29100217/nontraumatic-emergency-laparotomy-surgical-principles-similar-to-trauma-need-to-be-adopted
#13
Deepak Singh-Ranger, Edmund Leung, Mei-Ling Lau-Robinson, Sean Ramcharan, James Francombe
OBJECTIVES: In 2011, the Royal College of Surgeons published Emergency Surgery: Standards for Unscheduled Care in response to variable clinical outcomes for emergency surgery. The purpose of this study was to examine whether different treatment modalities would alter survival. METHODS: All patients who underwent emergency laparotomy between April 2011 and December 2012 at Warwick Hospital (Warwick, UK) were included retrospectively. Information relating to their demographics; preoperative score; primary pathology; timing of surgery; intraoperative details; and postoperative outcome, including 30-day mortality, were collated for statistical analysis...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29099696/treatment-of-duodenal-injuries-and-complications-after-surgery-case-reports
#14
Z Beriashvili, M Gurgenidze
A 28-year-old male patient came to Surgical Department 15.07.2003 after a gunshot wound. An emergency operation was performed. Among the other damages of different part of intestinum damage of the anterior wall of the second anatomical part of the duodenum was diagnosed intraoperatively. The size of the damaged area was 3×1 sm. The doudenal wound was sutured with two layers after updating the edges. On the fifth postoperative day the wound leakage was detected. Later the giant sizes of duodenal fistula was formed...
October 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29099149/closure-methods-for-laparotomy-incisions-for-preventing-incisional-hernias-and-other-wound-complications
#15
REVIEW
Sunil V Patel, David D Paskar, Richard L Nelson, Satyanarayana S Vedula, Scott R Steele
BACKGROUND: Surgeons who perform laparotomy have a number of decisions to make regarding abdominal closure. Material and size of potential suture types varies widely. In addition, surgeons can choose to close the incision in anatomic layers or mass ('en masse'), as well as using either a continuous or interrupted suturing technique, of which there are different styles of each. There is ongoing debate as to which suturing techniques and suture materials are best for achieving definitive wound closure while minimising the risk of short- and long-term complications...
November 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29096353/malignant-lymphoma-incidentally-diagnosed-due-to-the-perforation-of-the-small-intestine-caused-by-a-fish-bone-a-case-report
#16
Masatsugu Hiraki, Atsushi Miyoshi, Go Anegawa, Hiroshi Kubo, Osamu Ikeda, Keiichi Ohira, Shinya Azama, Shinichi Kido, Daisuke Mori, Hitoshi Aibe, Toshiya Tanaka, Kenji Kitahara, Seiji Sato
INTRODUCTION: The ingestion of a foreign body is relatively common. However, it rarely results in the perforation of gastrointestinal tract. We herein report an unusual case of malignant lymphoma incidentally diagnosed after the perforation of the small intestine by a fish bone. PRESENTATION OF CASE: A 90-year-old woman was admitted to our hospital because of abdominal pain and vomiting. Abdominal computed tomography demonstrated free air and ascites in the abdominal cavity...
October 26, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29095150/spleen-preserving-distal-pancreatectomy-in-isolated-pancreatic-trauma
#17
Bora Barut, Felat Ciftci, Cuneyt Kayaalp
INTRODUCTION: Isolated pancreatic trauma is a rare condition and commonly come up in children or young adults.The poor initial symptoms lead to delay diagnosis and treatment. The treatment of isolated distal pancreatic trauma including the Wirsung's duct is generally distal pancreatectomy. In an emergency setting, splenectomy is a common additional organ resection requirement with the distal pancreatectomy. However, in circumstances, spleen preserving distal pancreatectomy can provide advantages in these age groups even in emergency conditions...
September 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29093588/-complicated-jejunoileal-diverticular-disease-a-12-cases-serie-and-literature-review
#18
Aylhin Joana López Marcano, José Manuel Ramia, Roberto De la Plaza Llamas, Soledad Alonso, Johnny David Gonzales Aguilar, Andree Wolfgang Kühnhardt Barrantes
OBJECTIVE: To perform a retrospective analysis of a series of complicated JID (jejunoileal diverticulitis) cases surgically treated in our service during the period from 2002 to 2015. MATERIALS AND METHODS: We treated 12 cases of jejunoileal complicated diverticulosis. 7 women and 5 men. The mean age was 76 years. The clinical presentation in all cases was acute abdominal pain, one with gastrointestinal bleeding. All cases had leukocytosis, neutrophilia and increased acute phase reactants...
July 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29089697/selective-non-operative-management-of-patients-with-abdominal-trauma-is-cect-scan-mandatory
#19
Sunil Kumar, Puneet Prakash, Mohit Kumar Joshi, Vinita Rathi
CECT scan is considered essential for selective non-operative management (SNOM) of patients with abdominal trauma. However, CECT has its own hazards and limitations. We evaluated the safety and efficacy of selective non-operative management of patients with abdominal trauma without the mandatory use of CECT scan in a prospective study. Patients with peritonitis and ongoing intra-abdominal bleed were excluded. Consenting FAST positive, hemodynamically stable patients with blunt and penetrating abdominal trauma between 18 and 60 years of age were included and admitted for SNOM and detailed ultrasonography of the abdomen (in all) with or without CECT abdomen (selectively)...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29076695/broad-ligament-haematoma-following-normal-vaginal-delivery
#20
Faiza Ibrar, Azra Saeed Awan, Touseef Fatima, Hina Tabassum
A 37-year-old, patient presented in emergency with history of normal vaginal delivery followed by development of abdominal distention, vomiting, constipation for last 3 days. She was para 4 and had normal vaginal delivery by traditional birth attendant at peripheral hospital 3 days back. Imaging study revealed a heterogeneous complex mass, ascites, pleural effusion, air fluid levels with dilatation gut loops. Based upon pelvic examination by senior gynaecologist in combination with ultrasound; a clinical diagnosis of broad ligament haematoma was made...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
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