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https://www.readbyqxmd.com/read/29769190/pneumoperitoneum-in-a-neonate-weighing-less-than-500-g-what-do-we-really-know-about-it
#1
Audrienne Sammut, Miguel Soares Oliveira, Claire Jackson, Cristine Sortica da Costa
Pneumoperitoneum in preterm infants is a surgical emergency as it is usually indicative of intestinal perforation. Rare cases of idiopathic pneumoperitoneum have been described in the literature, the underlying causes and pathophysiology of which remain uncertain. We present a case of pneumoperitoneum in an extremely preterm infant with severe growth restriction. This occurred while she was receiving high frequency oscillatory ventilation. She had respiratory distress syndrome with pulmonary interstitial emphysema...
May 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29764844/second-look-laparostomy-for-perforated-gangrenous-gastric-volvulus-to-prevent-total-gastrectomy
#2
Paul K Okeny, Omar Abbassi, Ali Warsi
A 42-year-old Caucasian woman presented to the emergency department with severe upper abdominal pain and vomiting. Clinically, she was septic, and abdominal examination suggested peritonitis. Following immediate resuscitation, the patient was stabilised and underwent urgent contrast-enhanced CT of the abdomen and pelvis. This revealed a mesenteroaxial gastric volvulus with traction on the mesentery and a small volume of free fluid. She underwent laparotomy revealing gangrenous gastric fundus perforation complicated by persistent intraoperative hypotension...
May 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29764832/large-bowel-obstruction-in-a-27-year-old-woman-caused-by-a-sigmoid-faecal-bolus
#3
Radford Arran James Smith, Muhammad Abdalkoddus, Robert Bethune
A 27-year-old woman presented to the emergency department with a 24-hour history of severe left iliac fossa pain associated with vomiting. She reported a history of ovarian cysts and was provisionally diagnosed with a ruptured ovarian cyst and admitted under the obstetrics and gynaecology team for further investigation. 24 hours later, she became haemodynamically unstable with increasing abdominal distention and developed a metabolic acidosis. A CT scan revealed large bowel obstruction (LBO) secondary to a faecal bolus in the sigmoid colon with appearances suggestive of adult-onset Hirschsprung's disease...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29762333/hemodynamic-shock-caused-by-tension-pneumoperitoneum-in-a-5-year-old-girl
#4
Marie-Sophie Zentar, Laureline Berteloot, Naziha Khen Dunlop, Olivier Bustarret, Bénédicte Pigneur, Gérard Cheron, François Angoulvant
Tension pneumoperitoneum is a relatively rare occurrence in the pediatric population. However, tension pneumoperitoneum is associated with significant morbidity and mortality if it is not promptly diagnosed and treated. A 5-year-old girl was admitted to emergency department with abdominal pain. She was in shock, and the radiograph film of the abdomen revealed a voluminous tension pneumoperitoneum. Aggressive fluid challenges were performed in intensive care followed by urgent laparotomy. Primary abdominal compartment due to trapped gas caused a decreased venous return and visceral perfusion...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29761676/planned-re-laparotomy-in-a-non-trauma-setting-a-single-center-experience
#5
Yehuda Hershkovitz, Itamar Ashkenazi, Zahar Shapira, Oded Zmora, Igor Jeroukhimov
BACKGROUND: Damage control laparotomy (DCL) is the widely accepted procedure of choice in management of severely injured trauma patient. It has been implemented in non-trauma-related surgical pathology in the last decade. OBJECTIVES: To evaluate our experience with planned re-laparotomy (PRL) in non-trauma patients and compare it to other reports. METHODS: Charts of all patients admitted to Assaf Harofeh Medical Center who underwent PRL for non-trauma-related abdominal pathology during a 6 year period were reviewed...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29756107/analysis-of-89-patients-who-underwent-tube-thoracostomy-performed-by-general-surgeons
#6
Cihad Tatar, Ahmet Kocakuşak, Bahri Özer, Mehmet Celal Kızılkaya, Tamer Karşıdağ, Aziz Arı, Kenan Büyükaşık
Objective: Death due to thoracic trauma accounts for 20% of all trauma deaths. The aim of this study was to discuss the approach applied by general surgeons to thoracic trauma in our center. Material and Methods: A total of 89 patients (82 male, 7 female; mean age: 26.8 years; range: 7 to 77 years) with thoracic trauma who were admitted to the emergency department and underwent thoracostomy performed by general surgeons between January 2008 and December 2013 were retrospectively analyzed...
2018: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29756105/non-operative-management-of-abdominal-gunshot-injuries-is-it-safe-in-all-cases
#7
Nidal İflazoğlu, Orhan Üreyen, Osman Zekai Öner, Ulvi Mehmet Meral, Murat Yülüklü
Objective: In line with advances in diagnostic methods and expectation of a decrease in the number of negative laparotomies, selective non-operative management of abdominal gunshot wounds has been increasingly used over the last three decades. We aim to detect the possibility of treatment without surgery and present our experience in selected cases referred from Syria to a hospital at the Turkish-Syrian border. Material and Methods: Between February 2012 and June 2014, patients admitted with abdominal gunshot wounds were analyzed...
2018: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29751813/ruptured-caesarean-scar-ectopic-pregnancy-a-diagnostic-dilemma-in-a-resource-limited-setting
#8
Atem Bethel Ajong, Bruno Kenfack, Valirie Ndip Agbor, Philip Nana Njotang
BACKGROUND: Caesarean scar pregnancy (CSP) remains a very rare form of ectopic pregnancy associated with serious life threatening obstetric complications and even death in case of late diagnosis and treatment. CASE PRESENTATION: We report a case of a ruptured caesarean scar pregnancy in a 29 year-old gravida 5, para 3 with a past obstetric history of two consecutive caesarean sections done 9 and 5 years ago respectively. The patient presented with intermittent lower abdominal pains on a 20 weeks gestation associated with mild epigastralgia and 2 previous episodes of mild pervaginal bleeding (2 and 1 months ago respectively before consultation) managed with injectable progesterone...
May 11, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29751790/obliterative-cholangiopathy-in-acquired-cystic-biliary-atresia-type-iii-after-cyst-perforation-a-case-report
#9
Tsugumichi Koshinaga, Kensuke Ohashi, Kakou Ono, Hide Kaneda, Takeshi Furuya
BACKGROUND: In biliary atresia, the disease process of obliterative cholangiopathy may begin in the perinatal period; however, no chronological evidence exists on how the cholangiopathy progresses to biliary obliteration. This is the first acquired case with the final diagnosis of type III cystic biliary atresia with an extrahepatic biliary cyst which showed the progression of obliterative cholangiopathy in chronological order after birth. CASE PRESENTATION: An 81-day-old girl presented with acute abdominal distress due to bilious peritonitis caused by biliary cyst perforation, for which she underwent emergency biliary drainage...
May 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29748057/massive-bleeding-from-inferior-mesenteric-vein-with-hypovolemic-shock-a-rare-complication-of-acute-pancreatitis
#10
Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Woon Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho
BACKGROUND: Acute pancreatitis may cause massive intra-abdominal bleeding as vascular complications caused by the erosion of a major pancreatic or peripancreatic vessel. In terms of treatment, the differentiation between arterial bleeding and venous bleeding using abdominal computed tomography (CT) angiography is important. In addition, hypovolemic shock caused by bleeding from the inferior mesenteric vein (IMV) in acute pancreatitis has not been reported. CASE REPORT: A 58-year-old man presented to our emergency department with complaints of abdominal pain of 10 hours' duration...
May 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29743472/a-case-of-perforated-jejunal-diverticulum-an-unexpected-cause-of-pneumoperitoneum-in-a-patient-presenting-with-an-acute-abdomen
#11
Bruno Augusto Alves Martins, Rosana Rodrigues Galletti, Júlio Marinho Dos Santos Neto, Caroline Neiva Mendes
BACKGROUND Jejunal diverticulosis is a rare clinical condition, and the majority of patients are asymptomatic. However, some patients can develop serious complications, including perforation. We report the case of a 74-year-old female patient with a perforated jejunal diverticulum who presented with an 'acute abdomen' and with pneumoperitoneum on X-ray radiography. CASE REPORT A 74-year-old female patient presented to the emergency department with a 24-hour history of acute onset of diffuse abdominal pain associated with nausea and vomiting...
May 10, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29737923/post-anaesthetic-care-of-emergency-laparotomy-patient-for-the-optimization-of-surgical-outcome
#12
Claire-Collins Obi
This is a case study of a 45 year old male patient who underwent an emergency laparotomy procedure. Perioperative risks and associated postoperative outcomes could occur from the complex interaction between the patient's physical health status, the actual surgery performed, anaesthetic procedure and intra/postoperative events. The patient experienced renal compromise and physiological impairment during surgery. This article discusses his assessment and management as well as the various factors which have an impact upon his physiology...
January 1, 2018: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29735871/ruptured-ectopic-in-heterotopic-pregnancy-management-and-spontaneous-vertex-delivery-of-a-live-baby-at-term
#13
R C Onoh, B N Ejikeme, A B Onwe, O U Asiegbu
Spontaneous heterotopic pregnancy is an uncommon clinical condition in which there is a simultaneous development of intrauterine and extrauterine pregnancies. It is a life-threatening emergency when the ectopic ruptures. We present Mrs. EC, a 27-year-old G1 P0 + 0 with a family history of multiple gestations who had a heterotopic pregnancy at a gestational age of 7 weeks. She presented with features of threatened miscarriage at early pregnancy with an ultrasound confirmation of intrauterine pregnancy. The diagnosis of ruptured ectopic pregnancy coexisting with intrauterine gestation was made with ultrasound findings as well as clinical features necessitating emergency exploratory laparotomy...
May 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29727349/the-feasibility-of-laparoscopic-surgery-in-gynecologic-oncology-for-obese-and-morbidly-obese-patients
#14
Jessie Peng, Sarah Sinasac, Katherine J Pulman, Liying Zhang, Joan Murphy, Tomer Feigenberg
BACKGROUND: Surgical interventions are the mainstay of treatment for many gynecological cancers. Although minimally invasive surgery offers many potential advantages, performing laparoscopic pelvic surgery in obese patients remains challenging. To overcome this, many centers have shifted their practice to robotic surgery; however, the high costs associated with robotic surgery are concerning and limit its use. OBJECTIVE: This study aimed to examine the feasibility of performing laparoscopic gynecologic oncology procedures in obese and morbidly obese patients...
April 30, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29725977/gastrosplenic-fistula-with-gastrointestinal-bleeding-a-rare-and-potentially-fatal-complication-after-sleeve-gastrectomy
#15
Laura Montana, Laurent Genser, Alexandre Cortes, Eric Poupardin, Christophe Barrat, Sergio Carandina
BACKGROUND: Although the surgical technique is safe and standardized, laparoscopic sleeve gastrectomy (LSG) is associated with serious and potentially life-threatening complications, such as gastric leak and bleeding. METHODS: In this retrospective study, three French university hospitals reviewed their experience with LSG. Between September 2014 and May 2016, three cases of gastrosplenic fistula complicated by massive upper gastrointestinal hemorrhage (UGIH) were recorded...
May 3, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29719839/a-randomized-controlled-trial-on-intra-abdominal-irrigation-during-emergency-trauma-laparotomy-time-for-yet-another-paradigm-shift
#16
Hassan Mashbari, Mohannad Hemdi, Kevin L Chow, James C Doherty, Gary J Merlotti, Steven L Salzman, Eduardo Smith Singares
Objective: To determine the optimal volume of abdominal irrigation that will prevent surgical site infections (both deep and superficial), eviscerations and fistula formations; and improve 30-day mortality in trauma patients. Methods: We conducted a three-arm parallel clinical superiority randomized controlled trial comparing different volumes of effluent (5, 10 and 20 liters) used in trauma patients (both blunt and penetrating) age 14 and above undergoing an emergency laparotomy between April 2002 and July 2004 in a busy urban Level 1 trauma center...
April 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29713028/post-operative-morbidity-and-mortality-of-a-cohort-of-steroid-refractory-acute-severe-ulcerative-colitis-nationwide-multicenter-study-of-the-geteccu-eneida-registry
#17
I Ordás, E Domènech, M Mañosa, V García-Sánchez, E Iglesias-Flores, F Rodríguez-Moranta, L Márquez, O Merino, F Fernández-Bañares, F Gomollón, M Vera, A Gutiérrez, J LLaó, J P Gisbert, M Aguas, L Arias, I Rodríguez-Lago, C Muñoz, N Alcaide, X Calvet, C Rodríguez, M A Montoro, S García, M L De Castro, M Piqueras, L Pareja, J Ribes, J Panés, M Esteve
BACKGROUND: Despite the increased use of rescue medical therapies for steroid refractory acute severe ulcerative colitis, mortality related to this entity still remains high. We aimed to assess the mortality and morbidity related to colectomy and their predictive factors in steroid refractory acute severe ulcerative colitis, and to evaluate the changes in mortality rates, complications, indications of colectomy, and the use of rescue therapy over time. METHODS: We performed a multicenter observational study of patients with steroid refractory acute severe ulcerative colitis requiring colectomy, admitted to 23 Spanish hospitals included in the ENEIDA registry (GETECCU) from 1989 to 2014...
May 1, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29707608/intestinal-perforation-after-surgical-treatment-for-incisional-hernia-iatrogenic-or-idiopathic
#18
V Amorosi, B Longo, M Sorotos, G Firmani, F D'Angelo, F Santanelli di Pompeo
Intestinal perforation (IP) is a life-threatening gastroenterological condition requiring urgent surgical care, which may present itself as an uncommon complication following incisional hernia repair surgery, most often because of iatrogenic traumatism occurring during the procedure. However, we report a case where a spontaneous onset can be hypothesised. A 60-years-old patient underwent repair of an abdominal laparocele, through rectus abdominis muscle plasty, 5 years after development of an incisional hernia due to exploratory laparotomy for the treatment of acute appendicitis...
2018: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/29701416/co-existence-of-abdominal-aortic-aneurysm-with-urologic-neoplasm-which-should-be-treated-first-in-the-endovascular-era
#19
José Oliveiar-Pinto, Nilo Mosquera, José Vidoedo, Sérgio Moreira-Sampaio, José Teixeira
INTRODUCTION: Prevalence of Abdominal Aortic Aneurysm (AAA) with concomitant malignancy rounds 3-13%. Considering only urological neoplasms the prevalence is around 3.6%. Survival at 5 years of bladder carcinoma without extravesical invasion (stage II) rounds 63%. Endovascular Aneurysm Repair (EVAR), due to its minimally invasive profile, is an option for treatment of AAA prior to urological surgery as it does not require laparotomy not conditioning the delay of oncologic surgery. METHODS: Male, 62 years old...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696573/reshape-intragastric-balloon-complicated-by-gastric-perforation-and-peritonitis
#20
Aleksandr Kalabin, Vishnu R Mani, Anant Dinesh, Paritosh Suman, Leaque Ahmed
BACKGROUND: Obesity is a growing global epidemic with tremendous financial burden and health care costs worldwide. Restrictive surgery has emerged as the definitive treatment option to combat morbid obesity and its associated comorbidities. The advent of endoscopy has new grounds in obesity with the introduction of inflatable balloon placed in the stomach that decreases satiety by volume restriction. MATERIALS AND METHODS: We report a first case of gastric perforation with peritonitis after ReShape intragastric balloon placement that needed emergent surgical intervention...
April 26, 2018: Obesity Surgery
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