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https://www.readbyqxmd.com/read/28728102/uterine-necrosis-following-a-combination-of-uterine-compression-sutures-and-vascular-ligation-during-a-postpartum-hemorrhage-a-case-report
#1
Saad Benkirane, Hanane Saadi, Badr Serji, Ahmed Mimouni
INTRODUCTION: The Postpartum bleeding is the first cause of maternal mortality in Morocco. It is an obstetrical emergency that requires a fast multimodal management including medical care, interventional procedure and in few cases a salvatory surgery. CLINICAL CASE: We report a rare case of uterine necrosis following postpartum hemorrhage, refractory to medical therapy, and which was controlled by a combination of uterine hemostatic techniques and vascular ligation three days after surgery, the patient developed a fever (39°C)...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28721190/a-case-of-fatal-internal-jugular-vein-perforation-during-nasogastric-tube-insertion
#2
Katherine A Smith, Jeffrey P Fleming, Robert D Bennett, Andrew A Taitano
Nasogastric tube (NGT) insertion is a routine procedure in the management of surgical patients. We report the second case of internal jugular vein perforation during NGT insertion. A 79-year-old man presented with diffuse abdominal pain secondary to a perforated viscus. Abdominal CT revealed pneumoperitoneum, necessitating emergent exploratory laparotomy. On post-operative Day 7, the patient developed mild abdominal distension and subjective nausea for which NGT placement was ordered for decompression. Tube placement was confirmed by insufflation of air without aspiration of gastric contents...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28720994/early-migration-of-bone-graft-causing-sigmoid-colon-perforation-after-trans-foraminal-lumbar-interbody-fusion
#3
Bhavuk Garg, Amit Singla, Sahil Batra, Senthil Kumar
BACKGROUND: Tran foraminal lumbar interbody fusion (TLIF) is a well accepted and standard technique of achieving spinal fusion using pedicle screws, cage and bone graft. We are presenting here a case of L4-L5 lumbar canal stenosis managed with TLIF that presented with sigmoid colon perforation due to bone graft migration 4 days after surgery. CASE REPORT: A 35 years old female underwent open TLIF (from right side) with decompression for L4-L5 lumbar canal stenosis...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720692/primary-greater-omental-gist-presenting-with-acute-intra-abdominal-haemorrhage
#4
Shariful Islam, Devin Hosein, Vinoo Bheem, Patrick Harnarayan
Primary omental gastrointestinal stromal tumours (GISTs) are classified as extra-GISTs with a reported incidence of <1% of all GISTs. There are only a few cases in the English literature reporting omental GIST with none reporting acute intra-abdominal haemorrhage as a presenting feature. We report a case of a 67-year-old man who presented with haemorrhage from a primary omental GIST requiring emergency laparotomy.
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28718887/operative-learning-curve-trajectory-in-a-cohort-of-surgical-trainees
#5
C Brown, T Abdelrahman, N Patel, C Thomas, M J Pollitt, W G Lewis
BACKGROUND: Certification of completion of training in general surgery in the UK requires demonstration of competence in index operations by means of three level 4 competence consultant-validated procedure-based assessments (PBAs). The aim of this study was to evaluate the trajectory of operative learning curves related to PBA performance levels for curriculum-defined indicative operations with respect to numbers performed and training time. METHODS: Logbook data from consecutive higher general surgical trainees were compared with PBA evaluations to determine the relationship between PBA performance level, operative experience, training time and indicative numbers...
July 18, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28712196/small-gut-volvulus-a-rare-twist-in-the-setting-of-an-even-rarer-entity-multiple-giant-jejuno-ileal-diverticula
#6
Ayesha Khan, Faheem Khan, Kashif Rafique, Sarwar Khan, Anam Majid, Khalid Khan, Asad Ullah
Small gut volvulus with multiple Jejuno-ileal diverticulosis is an unusual pathology of the small intestine with a scarce number of cases reported so far. It usually goes unnoticed because it is often asymptomatic but complications like diverticulitis, perforation, bleeding or intestinal obstruction can occur in 10-30% of the cases. Mechanical obstruction, if it occurs, can be caused by adhesions or stenosis due to diverticulitis, intussusception at the site of the diverticulum and volvulus of the segment containing the diverticula...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28706893/rectal-perforation-by-compressed-air
#7
Young Jin Park
As the use of compressed air in industrial work has increased, so has the risk of associated pneumatic injury from its improper use. However, damage of large intestine caused by compressed air is uncommon. Herein a case of pneumatic rupture of the rectum is described. The patient was admitted to the Emergency Room complaining of abdominal pain and distension. His colleague triggered a compressed air nozzle over his buttock. On arrival, vital signs were stable but physical examination revealed peritoneal irritation and marked distension of the abdomen...
July 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28706618/isolated-ileal-perforation-in-infancy-a-lethal-initial-presentation-of-hirschsprung-s-disease
#8
Fadi Iskandarani, Chawki Hammoud, Sarah Srour, Gloria Pelizzo, Ghassan Nakib, Valeria Calcaterra, Amir Khanafer
Arare case of ileal perforation, as a fatal initial presentation of total colonic aganglionosis (TCA) in infancy is reported. A 10-week-old boy, was brought to the emergency department with symptoms of complicated intestinal obstruction. He looked ill, was lethargic, markedly dehydrated and had a severely distended abdomen. An abdominal X-ray revealed multiple air fluid levels seen in a distended small intestine. During exploratory laparotomy the ileum was massively dilated with distal segment perforation. Ileal perforation repair was performed...
June 26, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28691348/rare-complication-of-fibroids-in-pregnancy-spontaneous-fibroid-rupture
#9
Alim Swarray-Deen, Shirley A Mensah-Brown, Jerry Coleman
Uterine fibroids in pregnancy present with numerous complications. However, spontaneous rupture is a rare and potentially life-threatening event. We report a case of a 43-year-old multiparous woman who presented with hypovolemic shock secondary to a ruptured uterine fibroid 2 days after a spontaneous vaginal delivery. Emergency laparotomy confirmed massive intra-abdominal hemorrhage from the ruptured capsule of a 10-cm subserosal fibroid. A myomectomy was performed. Her postoperative recovery period was uneventful...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28690909/congenital-infantile-fibrosarcoma-causing-intestinal-perforation-in-a-newborn
#10
Margarita Kaiser, Bernadette Liegl-Atzwanger, Eszter Nagy, Daniela Sperl, Georg Singer, Holger Till
Congenital infantile fibrosarcoma (CIF) is a rare malignant mesenchymal tumor and only 14 cases have been reported with gastrointestinal manifestation. We report about a female newborn delivered per emergency cesarean section at 34 weeks of gestation. Postnatally, she rapidly developed an acute abdomen and sonographic evidence of intestinal perforation requiring laparotomy on the first day of life. A perforated 2 × 3 cm sized spherical tumorous structure of the jejunum was identified. Due to unknown histopathology at this point and unclear resectional margins, she received a temporary ileostomy, which was closed two months later...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28689604/outcomes-of-hospitalized-patients-undergoing-emergency-general-surgery-remote-from-admission
#11
Catherine E Sharoky, Elizabeth A Bailey, Morgan M Sellers, Elinore J Kaufman, Andrew J Sinnamon, Christopher J Wirtalla, Daniel N Holena, Rachel R Kelz
BACKGROUND: Emergency general surgery during hospitalization has not been well characterized. We examined emergency operations remote from admission to identify predictors of postoperative 30-day mortality, postoperative duration of stay >30 days, and complications. METHODS: Patients >18 years in The American College of Surgeons National Surgical Quality Improvement Program (2011-2014) who had 1 of 7 emergency operations between hospital day 3-18 were included...
July 6, 2017: Surgery
https://www.readbyqxmd.com/read/28686924/emergency-splenectomy-for-trauma-in-the-setting-of-splenomegaly-axillary-lymphadenopathy-and-incidental-b-cell-chronic-lymphocytic-leukemia-a-case-report
#12
Rodolfo J Oviedo, Andrew A Glickman
INTRODUCTION: The spleen is the most commonly injured intra-abdominal solid organ following blunt trauma. B-cell chronic lymphocytic leukemia (CLL) is the most common leukocytic dyscrasia affecting adults in Western countries. Splenomegaly with axillary and retroperitoneal lymphadenopathy are common physical findings. This case investigates an emergency splenectomy in a community hospital involving a 45-year-old man with blunt abdominal trauma following an assault with incidental splenomegaly and axillary lymphadenopathy, with surgical pathology findings of B-cell CLL...
June 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28686923/rare-case-of-incarcerated-obturator-hernia-case-report-and-review-of-literature
#13
N C Sá, V C M Silva, P R L Carreiro, A S Matos Filho, I A Lombardi
INTRODUCTION: Obturator hernia is a rare condition accounting for less than 1% of all intra abdominal hernias. Clinical diagnosis is considered a challenge for most surgeons. It usually appears as an intestinal obstruction. Confirmation of diagnosis is carried out by means of imaging or during surgery. CASE REPORT: An 85-year-old female patient, with symptoms of intestinal obstruction of 24h duration was admitted to the emergency room of Unimed Hospital - Belo Horizonte...
June 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28685016/incarcerated-congenital-transmesenteric-hernia-in-an-adult-a-case-report
#14
Sam Alhayo, Preet Gosal, Anthony Shakeshaft
Transmesenteric hernia is a rare cause of bowel obstruction and strangulation. It can be due to iatrogenic injury, trauma, inflammatory and less likely congenital. We present a case of true congenital transmesenteric hernia in a 26-year-old male with no previous surgical history or trauma. The patient presented acutely with no prior symptoms. Investigations provided limited information towards the diagnosis of the hernia, but suggestive of mid-gut volvulus. Emergency laparotomy was performed to find >75% of small bowel herniating through a proximal jejunal mesenteric defect leading to incarceration and early strangulation...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28683785/mesenteric-cysts-and-mesenteric-venous-thrombosis-leading-to-intestinal-necrosis-in-pregnancy-managed-with-laparotomy-a-case-report-and-review-of-the-literature
#15
Aris Giannos, Sofoklis Stavrou, Nikolaos Goumalatsos, George Fragkoulidis, Eleni Chra, Dimitrios Argiropoulos, Dimitrios Loutradis, Peter Drakakis
BACKGROUND: Mesenteric cyst is a rare clinical entity especially in pregnancy; therefore, few cases have been reported in the literature. The standard method of their treatment is surgical excision either with laparotomy or laparoscopy. In addition, mesenteric vein thrombosis is a rare and life-threatening condition in pregnancy and needs immediate treatment because it can lead to intestinal necrotic ischemia. This is the first report of the coexistence of mesenteric cysts and mesenteric vein thrombosis during gestation...
July 7, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28682130/the-front-line-general-surgery-consultant-as-a-new-model-of-emergency-care
#16
A P Navarro, Ejo Hardy, B Oakley, E Mohamed, N T Welch, S L Parsons
INTRODUCTION Emergency general surgery services in England are undergoing rapid structural change with the aim of improving care. In our centre, the key issues identified were high numbers of admissions, inappropriate referrals, prolonged waiting times, delayed senior input and poor patient satisfaction. A new model was launched in January 2015 to address these issues: the surgical triage unit (STU). This study assesses the success of the new service. METHODS All emergency general surgical admissions during a five-month period before introduction of the STU were compared with those of a comparable five-month period after its introduction...
July 6, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28679320/a-rare-case-of-non-traumatic-acute-intraabdominal-hemorrhage-ruptured-superior-mesenteric-artery-aneurysm
#17
Ersin Borazan, Latif Yılmaz, Alper Aytekin, Gökhan Gökaslan, Selim Kervancıoğlu
INTRODUCTION: Rupture of superior mesenteric artery aneurysm (SMAA) is a very rare and life-threatening condition, presenting with acute intraabdominal hemorrhage. CASE: The patient was hospitalized upon complaint of nonspecific severe abdominal pain. Diagnosis of SMAA was established by abdominal Doppler ultrasound that showed a pseudo-aneurysmal lesion with size of 76 × 47 mm at the superior mesenteric main branch. Endovascular stenting was not performed because of the wide neck in the segment of the jejunal branches from SMA and the risk of branch loss during treatment...
July 6, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28677408/delayed-sigmoid-ischemic-rupture-following-open-repair-abdominal-aortic-aneurysm
#18
Thomas Kotsis, Panagitsa Christoforou, Nikolaos Asaloumidis, Ioannis Papaconstantinou
Colon ischemia following aortic reconstruction is a severe complication with an incidence of 1% to 2% of the operated patients; this infrequent complication will be lethal for nearly half of these patients. Commonly, colon ischemia may be an intraoperative observation or an early postoperative finding. However, in the case presented here, sigmoid rupture and small and large intestine communication was revealed 3 months following repair of the abdominal aorta. A 71-year-old man, following open repair of an abdominal aortic aneurysm, went home on the fifth postoperative day...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28673376/adaptive-process-triage-system-cannot-identify-patients-with-gastrointestinal-perforation
#19
Aske Mathias Bohm, Mai-Britt Tolstrup, Ismail Gögenur
INTRODUCTION: Adaptive process triage (ADAPT) is a triage tool developed to assess the severity and address the priority of emergency patients. In 2009-2011, ADAPT was the most frequently used triage system in Denmark. Until now, no Danish triage system has been evaluated based on a selective group of patients in need of acute abdominal surgery. Gastrointestinal perforation (GIP) is acknowledged as one of the surgical conditions with the highest mortality rates. The aim of this study was to evaluate whether ADAPT can identify patients with GIP...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28671499/focal-intramural-pericardial-effusion-and-cardiac-tamponade-associated-with-necrotic-adipose-tissue-in-a-dog
#20
Terence A Krentz, Robert J Schutrumpf, Julie C Zitz
CASE DESCRIPTION A 1-year-old castrated male German Shepherd Dog was examined because of an acute onset of lethargy, tachypnea, and inappetence. CLINICAL FINDINGS On initial physical examination, the dog was tachypneic with muffled heart sounds on thoracic auscultation and a palpable abdominal fluid wave. Transthoracic echocardiography revealed focal intramural pericardial effusion and cardiac tamponade. TREATMENT AND OUTCOME The patient underwent emergency therapeutic pericardiocentesis, followed by right lateral intercostal thoracotomy and subtotal pericardiectomy...
July 15, 2017: Journal of the American Veterinary Medical Association
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