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https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#1
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28604511/incidence-and-risk-factors-for-perianal-disease-in-pediatric-crohn-s-disease-patients-followed-in-cedata-gpge-registry
#2
Annecarin Brückner, Katharina J Werkstetter, Jan de Laffolie, Claudia Wendt, Christine Prell, Tanja Weidenhausen, Klaus P Zimmer, Sibylle Koletzko
BACKGROUND AND AIMS: Perianal disease (PD) with fistula and/or abscess formation is a severe complication in Crohn's disease (CD). We examined prevalence, incidence and risk factors for PD development in a pediatric CD cohort. METHODS: CD patients from the prospective, multi-center registry for inflammatory bowel disease from Germany and Austria (CEDATA-GPGE) were included if diagnosed ≤18 years of age, registered within three months after diagnosis, and having at least two follow-up visits within the first year of registration...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28604510/safety-and-efficacy-of-the-push-endoscopic-technique-in-the-management-of-esophageal-food-bolus-impactions-in-children
#3
Jamal Kriem, Riad Rahhal
OBJECTIVES: Adult-based guidelines support the use of the pull (extraction) endoscopic technique in managing esophageal food bolus impactions (FBIs) but allow the consideration of the push (advancement) technique with caution based on available published literature. The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines mention the use of gentle endoscopic pushing for disimpaction but elaborate that this technique has not been studied in children...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28598298/efficacy-of-exclusive-enteral-nutrition-in-complicated-crohn-s-disease
#4
Qingfan Yang, Xiang Gao, Huiping Chen, Miao Li, Xiaojian Wu, Min Zhi, Ping Lan, Pinjin Hu
AIM: To investigate the efficacy of exclusive enteral nutrition (EEN) in induction of remission in adult active Crohn's disease (CD) complicated with intestinal fistula/abdominal abscess or inflammatory intestinal stricture. METHOD: Patients diagnosed with active CD with complications were recruited between July 2013 and July 2015. Patients were offered EEN for 12 weeks. Patients with abscess received antibiotic treatment with or without percutaneous drainage. Clinical variables were recorded (ClinicalTrials...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597827/inflammatory-bowel-disease-in-childhood-and-adolescence
#5
Jan Däbritz, Patrick Gerner, Axel Enninger, Martin Claßen, Michael Radke
BACKGROUND: The incidence of inflammatory bowel disease (IBD) in childhood and adolescence is 5-11 cases per 100 000 persons per year, corresponding to a new diagnosis of IBD in 800-1470 patients in Germany each year. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, including guidelines from Germany and abroad. RESULTS: Children and adolescents with IBD often have extensive involvement and an aggressive course of disease...
May 12, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28575884/predictors-of-clinical-outcomes-in-hemodialysis-patients-a-multicenter-observational-study
#6
Tayebeh Soleymanian, Hossein Niyazi, Shaghayegh Noorbakhsh Jafari Dehkordi, Shokoufeh Savaj, Hassan Argani, Iraj Najafi
INTRODUCTION: Cardiovascular and noncardiovascular mortality and morbidity rates of hemodialysis patients are high despite improvement in dialysis delivery. MATERIALS AND METHODS: Hemodialysis patients (n = 532) from 9 hemodialysis facilities were enrolled in this cohort study in September 2012. Causes of death, hospitalization, and hemodialysis exit were recorded during a 28-month follow-up period. A Cox proportional hazard model was used to predict death adjusting for case-mix variables, nutrition variables, bone mineral variables, Kt/V, vascular access, and Charlson comorbidities index...
May 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28540837/enterovesical-fistula-after-enteric-conversion-of-a-bladder-drained-pancreatic-allograft-a-case-report
#7
Clifford Akateh, Amer Rajab, Mitchell Henry, Ashraf El-Hinnawi
Since the inception of pancreas transplant as a treatment for type 1 diabetes mellitus, there has been considerable debate about the best way to manage exocrine secretions and monitor patients for graft rejection. For patients who undergo bladder exocrine drainage of a pancreatic allograft, a bladder-to-enteric drainage conversion can serve as a rescue procedure in case of anastomotic leaks or other complications. However, this procedure is associated with its own complications, including a rarely described enterovesical fistula...
May 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28537654/effect-of-ecological-immune-enhanced-enteral-nutrition-on-patients-with-gastrointestinal-fistulas
#8
Q-H Wang
OBJECTIVE: The aim of this study was to determine the effects of early ecological immune-enhanced enteral nutrition on the nutritional status, immune function and intestinal mucosal barrier in patients with gastrointestinal fistulas. PATIENTS AND METHODS: 54 patients with gastrointestinal fistulas were randomized to either the ecological immune-enhanced enteral nutrition group (EIEN group, 28) or the parenteral nutrition group (PN group, 26). The changes in the immunity, nutrition index and intestinal mucosal barrier indexes before the ecological immune-enhanced enteral nutrition support and at 7 days and 14 days after the ecological immune-enhanced enteral nutrition support were determined...
May 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28534335/-consistency-analysis-between-preoperative-ct-enterography-and-intraoperative-findings-in-patients-undergoing-surgery-for-crohn-s-disease
#9
Jianbo Yang, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the diagnostic value of preoperative CT enterography (CTE) on obstruction, fistula and abscess formation compared to intraoperative findings in patients undergoing surgery for Crohn's disease(CD), aiming to provide reference to clinical practice. METHODS: Preoperative CTE data of 176 CD patients confirmed by clinic, endoscopy, imaging, operation and pathology at the Department of General Surgery in Nanjing Jinling Hospital from January 2013 to December 2015 were enrolled in retrospective cohort study...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28502887/open-surgical-treatment-of-secondary-aorto-esophageal-and-aortobronchial-fistula-after-thoracic-endovascular-aortic-repair-and-esophagocoloplasty-in-a-second-procedure
#10
Milos Sladojevic, Milos Bjelovic, Nikola Ilic, Perica Mutavdzic, Igor Koncar, Marko Dragas, Lazar Davidovic
INTRODUCTION: Aorto-esophageal (AEF) and aortobronchial fistula (ABF) after TEVAR are rare complications with catastrophic consequences without treatment. In this case report we presented a patient with AEF and ABF after TEVAR successfully treated with endograft explantation and replaced by Dacron graft followed by esophagectomy and left principal bronchus repairing. CASE REPORT: We report a patient with AEF and ABF after TEVAR who was evaluated due to dysphagia and chest pain followed by hematemesis and hemoptysis...
May 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28460565/early-simultaneous-esophagopleural-and-bronchopleural-fistula-after-right-pneumonectomy
#11
Marek Szkorupa, Josef Chudacek, Olga Klementová, Cestmir Neoral, Martin Stasek
BACKGROUND: Esophagopleural and bronchopleural fistulas represent a rare, but life-threatening complication after lung resections, most often after a right pneumonectomy. CASE STUDY: A 64 years old woman was indicated for right pulmectomy for local recurrence of initially stage IIB lung cancer treated by lower lobectomy. On the postoperative day 34, an esophagopleurobronchial fistula occurred. Further course required thoracostomy with closure of the bronchial stump and vacuum-assisted closure therapy and two-phase esophagectomy with 6 weeks interval to the esophageal reconstruction...
May 2, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28384642/incidence-of-and-risk-factors-and-reinterventions-for-post-pancreatoduodenectomy-hemorrhage-retrospective-analysis
#12
Wei-Guo Wang, Lan Fu, Shah Ram Babu, Li Wang, Cui-Ping Liang, Bo-Le Tian
AIMS: To analyze the incidence of and risk factors for post-pancreatoduodenectomy (PD) hemorrhage (PPH) and to evaluate the outcomes of reinterventions for PPH. METHODS: All PDs between January 2009 and December 2014 were retrospectively evaluated. PPH was evaluated according to the criteria of the International Study Group of Pancreatic Surgery. Both univariate and multivariate analyses of risk factors for PPH and mortality were performed. Reinterventions were also evaluated...
April 7, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28358595/treatment-of-enterocutaneous-fistulas-then-and-now
#13
Luis Alfonso Ortiz, Bin Zhang, Maureen Walsh McCarthy, Haytham M A Kaafarani, Peter Fagenholz, David R King, Marc De Moya, George Velmahos, Daniel Dante Yeh
BACKGROUND: An enterocutaneous fistula (ECF) is an aberrant connection between the gastrointestinal tract and the skin or atmosphere (enteroatmospheric fistula [EAF]). Multimodal treatment includes surgical procedures, nutrition support, and wound care. We evaluated our practice and compared our outcomes with previous results published from our institution. MATERIALS AND METHODS: We performed a retrospective analysis of hospitalized ECF/EAF patients admitted between January 2011 and November 2015...
March 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28338158/-diagnosis-and-treatment-of-duodenal-injury-and-fistula
#14
Kunmei Gong, Shikui Guo, Kunhua Wang
Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28338154/-experience-of-the-three-stage-strategy-for-intestinal-fistula-complicated-with-complex-abdominal-infection
#15
Qingchuan Zhao, Xuzhao Li, Xiaohua Li, Juan Wang
Intestinal fistula, as a serious complication after abdominal surgery, not only leads to a series of pathophysiological changes such as fluid loss, malnutrition and organ dysfunction, but also causes the severe abdominal infection, which often threatens the life of patients. How to make the diagnosis and give the treatment of intestinal fistula is the key to save the lives of high-risk patients. In our hospital, during the past course of diagnosis and treatment for intestinal fistula complicated with severe abdominal infection, based on the combination of literatures at home and abroad with our clinical experiences for many years, an effective three-stage prevention and treatment strategy was formed gradually, which included early diagnosis, effective treatment of infection source, open drainage of abdominal infection and early enteral nutrition support...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28275475/surgery-and-perioperative-management-for-post-intubation-tracheoesophageal-fistula-case-series-analysis
#16
Francesco Puma, Jacopo Vannucci, Stefano Santoprete, Moira Urbani, Lucio Cagini, Marco Andolfi, Rossella Potenza, Niccolò Daddi
BACKGROUND: Post-intubation tracheoesophageal fistula (PITEF) is an often mistreated, severe condition. This case series reviewed for both the choice and timing of surgical technique and outcome PITEF patients. METHODS: This case series reviewed ten consecutive patients who had undergone esophageal defect repair and airway resection/reconstruction between 2000 and 2014. All cases were examined for patients: general condition, medical history, preparation to surgery, diagnostic work-up, timing of surgery and procedure, fistula size and site, ventilation type, nutrition, post-operative course and complications...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28237561/evolution-of-endoscopic-treatment-of-sleeve-gastrectomy-leaks-from-partially-covered-to-long-fully-covered-stents
#17
Fabio Garofalo, Maxime Noreau-Nguyen, Ronald Denis, Henri Atlas, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) has become a widely accepted option in the treatment of morbid obesity. Gastric leaks after SG occur in .9%-2.2% of the patients, mostly at the gastroesophageal junction. The current treatment algorithm includes drainage, antibiotics, nutritional support, and endoluminal control. OBJECTIVES: Our hypothesis is that long, fully covered stents represent a safe, effective solution for SG leaks. SETTING: University hospital...
December 26, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28230654/surgical-endoscopy-versus-endoscopic-surgery-for-obesity
#18
Bogdan Silviu Ungureanu, Ştefan Pătraşcu, Valeriu Şurlin, Adrian Săftoiu
BACKGROUND: Obesity treatment options are of great interest worldwide with major developments in the past 20 years. From general surgery to natural orifice transluminal endoscopic surgery intervention nowadays, obesity surgical therapies have surely developed and are now offering a variety of possibilities. AREAS OF UNCERTAINTY: Although surgery is the only proven approach for weight loss, a joint decision between the physician and patient is required before proceeding to such a procedure...
February 3, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28226350/-value-of-endoscopy-application-in-the-management-of-complications-after-radical-gastrectomy-for-gastric-cancer
#19
Yiqun Zhang, Pinghong Zhou
Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28225051/low-muscle-mass-at-initiation-of-anti-tnf-therapy-for-inflammatory-bowel-disease-is-associated-with-early-treatment-failure-a-retrospective-analysis
#20
D Q Holt, P Varma, B J G Strauss, A S Rajadurai, G T Moore
BACKGROUND/OBJECTIVES: Delayed treatment failure occurs in a significant proportion of inflammatory bowel disease (IBD) patients treated with tumor necrosis factor-alpha (TNF) antagonists. Identification of predictors of loss of response (LOR) may help to optimize therapy. We sought to determine whether body composition parameters at the commencement of anti-TNF therapy were associated with earlier treatment failure. SUBJECTS/METHODS: A retrospective cohort study was performed on 68 patients who had undergone cross-sectional abdominal imaging coincident with the commencement of anti-TNF drugs...
June 2017: European Journal of Clinical Nutrition
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