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Intra abdominal sepsis

Dong-Guang Niu, Qian Huang, Fan Yang, Wei-Liang Tian, Yun-Zhao Zhao
BACKGROUND: Coupled plasma filtration adsorption (CPFA) is an extracorporeal treatment based on plasma filtration associated with an adsorbent cartridge and hemofiltration. CPFA is able to remove inflammatory mediators and it has been used to treat severe sepsis and multiple organ dysfunction. Limited experience exists on the use of CPFA in treating intra-abdominal infection (IAI). METHODS: In this study, the efficacy of CPFA in treating patients with severe IAI and liver failure was evaluated in a retrospective analysis of 76 cases...
March 15, 2019: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Christopher Antônio Febres-Aldana, Amilcar Antonio Castellano-Sanchez, John Alexis
Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant disorder caused by mutations in the COL3A1 or COL1A1 genes. Its mortality is secondary to sudden and spontaneous rupture of arteries or hollow organs. The genotype influences the distribution of arterial pathology with aneurysms of intra-abdominal visceral arteries being relatively uncommon. We describe the case of a young man with probable VEDS who died of a spontaneous rupture and dissection of the cystic artery. The patient initially presented with abdominal pain due to an unrecognized spontaneous perforation of the small intestine complicated by sepsis...
January 2019: Autopsy & Case Reports
Pragnya Das, Santosh K Panda, Beamon Agarwal, Sumita Behera, Syed M Ali, Mark E Pulse, Joseph S Solomkin, Steven M Opal, Vineet Bhandari, Suchismita Acharya
In Gram-negative bacterial sepsis, production of excess pro-inflammatory cytokines results in hyperinflammation and tissue injury. Anti-inflammatory cytokines such as IL-10 inhibit inflammation and enhance tissue healing. Here, we report a novel approach to treat septicemia associated with intra-abdominal infection in a murine model by delicately balancing pro- and anti-inflammatory cytokines. A novel oligosaccharide compound AVR-25 selectively binds to the TLR4 protein (IC50  = 0.15 µM) in human peripheral blood monocytes and stimulates IL-10 production...
February 27, 2019: Scientific Reports
Hai-Feng Li, Guo-Qiang Hu, Wen-Wen Liu
OBJECTIVE: To observe the clinical therapeutic effect of acupuncture of Huatuo Jiaji (EX-B2) in the treatment of gastrointestinal dysfunction in sepsis patients, aiming at providing new clinical approach and evidence for improving septic gastrointestinal activity. METHODS: A total of 40 patients with septic gastrointestinal dysfunction who met our inclusive criteria were randomly divided into control group and treatment group ( n =20 cases in each). Patients in the control group received routine treatment of nasogastric mosapride citrate (5 mg/time, three times a day) and tifidobacterium triple viable capsules (420 mg, twice a day), intravenous infusion of omeprazole (40 mg, twice a day), rational dose of antibiotics, maintenance treatment of functions of the heart, lung, brain, kidney and other important organs and water electrolyte balance, as well as symptomatic treatment...
January 25, 2019: Zhen Ci Yan Jiu, Acupuncture Research
Chang Sik Yu, Sung Woo Jung, Jong Lyul Lee, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk Kyun Ynag, Byung Duk Ye, Sang Hyung Park, Minkyu Han, Jin Cheon Kim
Background: Many patients with Crohn's disease (CD) are treated with medications, including steroids, immunomodulators, and anti-tumor necrosis factor alpha (anti-TNF-α) agents, at the time of surgery. This study evaluated the effects of these medications on postoperative complications in CD patients. Methods: This retrospective study analyzed patients who underwent bowel resection for CD between January 2006 and December 2015. Postoperative complications were defined as a Clavien-Dindo classification of grade 2A or higher within the first 30 days after surgery...
February 8, 2019: Inflammatory Bowel Diseases
Mutua Irene, Mariga Denver, Marilyn Omondi, Kiptoon Dan
INTRODUCTION: Peptic ulcer perforation is a common surgical emergency that is a complication of 9% of patients with peptic ulcer disease (Kjetil et al., 2015 [1]). Despite advances in the management of peptic ulcer disease, the number of acute complications have remained constant. Intra-abdominal sepsis is defined as inflammation of the peritoneum caused by pathogenic micro-organisms and their products (Pavlidis, 2003). CASE PRESENTATION: We present a case report on intra-abdominal sepsis in a 20 yr old patient admitted in the intensive care unit at our institution following a perforated duodenal ulcer that was repaired by modified Graham patch method but leaked and he had multiple surgeries thereafter necessitating the open abdomen...
2019: International Journal of Surgery Case Reports
Ahmad Alsaleh, Gianluca Pellino, Natasha Christodoulides, George Malietzis, Christos Kontovounisios
Anastomotic leak (AL) is a serious post-operative complication in colorectal surgery. It can lead to devastating morbidity and mortality. Clinicians usually depend on a combination of clinical, biochemical and radiological findings to diagnose this problem. In our article, we tried to look if electrolyte disturbances could be indicators for intra-abdominal sepsis due to AL. Systematic review of the literature identifies a potential correlation between electrolyte alterations and AL in digestive surgery. The following databases were searched: PubMed, EMBASE and MIDLINE...
February 8, 2019: Updates in Surgery
Pei Sze Carmen Tan, Arash Badiei, Deirdre B Fitzgerald, Yi Jin Kuok, Y C Gary Lee
Pleural infection as a complication of ascending urological infection is rare, and the mechanism often unclear. We report a complicated case of pleural infection and perinephric abscess in a patient who presented with a large right-sided pleural effusion. Pleural fluid culture yielded Morganella morganii , an unusual pathogen in pleuro-pulmonary infections. Her computed tomography (CT) scan of abdomen showed a right perinephric abscess which extended into the pleural cavity. Review of prior CT imaging suggested a pre-existing diaphragmatic defect, likely representing a congenital Bochdalek foramen, through which the infection ascended...
April 2019: Respirology Case Reports
Arwa Omar Takrouni, Mohammad Heitham Schammut, Mishal Al-Otaibi, Manal Al-Mulla, Antonio Privitera
Basidiobolomycosis is a rare fungal infection that may affect the gastrointestinal tract. It is caused by Basidiobolus ranarum and less than 80 cases have been reported in the literature. The incidence seems to be higher in the Middle East and in particular Saudi Arabia where most cases are diagnosed in the south-western region. An 18-year-old woman presented to the emergency department with an obstructing caecal mass initially suspected to be malignant. Surgical resection was complicated by bowel perforation, histology and cultures confirmed basidiobolomycosis infection...
January 29, 2019: BMJ Case Reports
Aziz Sener, Alper Sahbaz, Leyla Turker Sener, Merva Soluk Tekkesin, Bulent Kaya
OBJECTIVE: In this study, the effect of mesalazine was studied on TNF alpha IL-1 beta, IL-6, and C-reactive protein (CRP) levels and inflammatory changes in rat lungs with experimental peritonitis. METHODS: In total, 24 male Sprague-Dawley rats weighing 250-280 g were used in the study.The rats were divided into three groups based on no irrigation or irrigation with isotonic solution or mesalazine. Secondary peritonitis was generated by cecum penetrations. Group I, no irrigation was given after the development of peritonitis; Group II, irrigation was performed using isotonic solution 24 h after the development of peritonitis...
September 2018: Northern Clinics of Istanbul
A Hecker, M Reichert, C J Reuß, T Schmoch, J G Riedel, E Schneck, W Padberg, M A Weigand, M Hecker
PURPOSE: The abdomen is the second most common source of sepsis and is associated with unacceptably high morbidity and mortality. Recently, the essential definitions of sepsis and septic shock were updated (Third International Consensus Definitions for Sepsis and Septic Shock, Sepsis-3) and modified. The purpose of this review is to provide an overview of the changes introduced by Sepsis-3 and the current state of the art regarding the treatment of abdominal sepsis. RESULTS: While Sepsis-1/2 focused on detecting systemic inflammation as a response to infection, Sepsis-3 defines sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection...
January 26, 2019: Langenbeck's Archives of Surgery
Jonathan G Stine
No abstract text is available yet for this article.
January 2, 2019: Digestive Diseases and Sciences
Paul M Reynolds, Edward T Van Matre, Garth C Wright, R Brett McQueen, Ellen L Burnham, P Michael Ho, Marc Moss, R William Vandivier, Tyree H Kiser
BACKGROUND: Venous thromboembolism (VTE) occurs frequently in critically ill patients without heparin prophylaxis. Although heparin prevents VTE, VTEs occur frequently despite prophylaxis. Higher heparin dosage may be more effective for preventing VTE. METHODS: A retrospective study was conducted utilizing the Premier Incorporated Perspective Database to comparatively evaluate the effects of different heparin prophylaxis dosing strategies in the critically ill patient...
December 28, 2018: Pharmacotherapy
Adam C Fields, Pamela Lu, Deanna L Palenzuela, Ronald Bleday, Joel E Goldberg, Jennifer Irani, Jennifer S Davids, Nelya Melnitchouk
BACKGROUND: Appendectomy is the most commonly performed emergency operation in the United States, with approximately 370,000 patients undergoing the procedure every year. Although laparoscopic appendectomy is associated with decreased complications when compared with open appendectomy, the risk for infectious complications, including surgical site infection, intra-abdominal abscess, and sepsis, remains a significant source of postoperative morbidity and health care cost. The goal of this study is to determine whether the appendix retrieval technique during laparoscopic appendectomy affects risk of infectious complications...
December 24, 2018: Surgery
Xuzhao Li, Xiaoyong Wu, Bin Bai, Deliang Yu, Pengfei Yu, Qingchuan Zhao
Gastrointestinal fistula patients may suffer from complicated intra-abdominal infection and sepsis with improper treatment, which is characterized by high mortality ranging from 20% to 60%, as well as high medical costs. Gastrointestinal fistula patients with complicated intra-abdominal infections are not often diagnosed early, and proper treatment remains an unsolved problem. Therefore it is a great challenge for surgeons to repair broken intestines under complicated intra-abdominal infection conditions and to repair ruptured intestines under conditions of severe abdominal adhesions and swelling of the intestinal wall and mesentery...
December 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
James Jen Yao Chong, Francesca Kum, Marios Hadjipavlou, Wasim Mahmalji, Jemma Hale, Andrew Dickinson, Jonathan Glass
Objectives To present our experience of the Detour extra-anatomic stent (EAS) (Porges-Coloplast, Denmark) to bypass ureteric obstruction. Use of the EAS is indicated in patients with complex ureteric strictures or malignant disease, where long-term nephrostomy drainage is undesirable. Methods Between December 2001 and October 2017, 20 Detour EAS were implanted into 13 patients. The primary indication was ureteric obstruction or injury secondary to metastatic malignancy, or from treatment for malignancy. Five patients required bilateral EAS, with two patients having bilateral EAS following initial unilateral insertion...
December 26, 2018: Journal of Endourology
Mircea Gabriel Mureșan, Ioan Alexandru Balmoș, Iudita Badea, Ario Santini
Despite the significant development and advancement in antibiotic therapy, life-threatening complication of infective diseases cause hundreds of thousands of deaths world. This paper updates some of the issues regarding the etiology and treatment of abdominal sepsis and summaries the latest guidelines as recommended by the Intra-abdominal Infection (IAI) Consensus (2017). Prognostic scores are currently used to assess the course of peritonitis. Irrespective of the initial cause, there are several measures universally accepted as contributing to an improved survival rate, with the early recognition of IAI being the critical matter in this respect...
October 2018: The journal of critical care medicine
Danilo Coco, Silvana Leanza
Laparostomy is defined as a surgical technique in which the peritoneal cavity is opened and left open, called "open abdomen" (OA). An open abdomen presents numerous challenges for the clinician. Specific pathologies like severe intraabdominal sepsis, trauma requiring damage control, abdominal compartment syndrome, staged abdominal repair and other complex abdominal pathologies can be managed with laparostomy. Laparostomy allows abdominal re-exploration, clearing and control of abdominal fluid of the fascia, avoiding intra-abdominal hypertension (IAH), abdominal wall closure...
September 2018: Mædica
Paula Ferrada, Luke Wolfe, Juan Duchesne, Gustavo P Fraga, Elizabeth Benjamin, Augustin Alvarez, Andre Campbell, Christopher Wybourn, Alberto Garcia, Carlos Morales, Julieta Correa, Bruno M Pereira, Marcelo Ribeiro, Martha Quiodettis, Gregory Peck, Juan C Salamea, Victor F Kruger, Rao R Ivatury, Thomas Scalea
INTRODUCTION: The operative management of duodenal trauma remains controversial. Our hypothesis is that a simplified operative approach could lead to better outcomes. METHODS: We conducted an international multicenter study, involving 13 centers. We performed a retrospective review from January 2007 to December of 2016. Data on demographics, mechanism of trauma, blood loss, operative time, and associated injured organs were collected. Outcomes included postoperative intra-abdominal sepsis, leak, need for unplanned surgery, length of stay, renal failure, and mortality...
March 2019: Journal of Trauma and Acute Care Surgery
Hassan Zafar, Milton H Saier
The communities of beneficial bacteria that live in our intestines, the gut microbiome, are important for the development and function of the immune system. Bacteroides species make up a significant fraction of the human gut microbiome, and can be probiotic and pathogenic, depending upon various genetic and environmental factors. These can cause disease conditions such as intra-abdominal sepsis, appendicitis, bacteremia, endocarditis, pericarditis, skin infections, brain abscesses and meningitis. In this study, we identify the transport systems and predict their substrates within seven Bacteroides species, all shown to be probiotic; however, four of them (B...
2018: PloS One
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