Alfonso Reginelli, Giovanna Vacca, Sabrina Giovine, Andrea Izzo, Andrea Agostini, Maria Paola Belfiore, Michaela Cellina, Chiara Floridi, Alessandra Borgheresi, Pierpaolo Palumbo, Andrea Giovagnoni, Salvatore Cappabianca, Roberto Grassi
Perianal fistulas represent one of the most critical complications of Crohn's disease (CD). Management and treatment need a multidisciplinary approach with an accurate description of imaging findings. AIM: This study aspires to assess the significative role of Magnetic Resonance Imaging (MRI) in the study of perianal fistulas, secondary extensions, and abscess in patients with CD. Therefore it is essential to standardize an appropriate protocol of sequences that allow the correct evaluation of disease activity and complications...
July 13, 2020: Acta Bio-medica: Atenei Parmensis
Hayley Fowler, Rachael Clifford, Paul Sutton, Angus Watson, Nicola Fearnhead, Simon Bach, Brendan Moran, Azmina Rose, Richard Jackson, Dale Vimalachandran
INTRODUCTION: In patients with low rectal cancer, it is occasionally necessary to avoid a low colo-anal anastomosis due to patient frailty or poor function. In such situations there are two alternative approaches: Hartmann's procedure [HP] or intersphincteric APE [IAPE]. There are little data to guide surgeons as to which of these two procedures is the safest. The aim of this study was to determine the surgical complication rates associated with each procedure. METHODS: This was a multicentre, non-randomised prospective cohort study of patients undergoing either HP or IAPE...
September 16, 2020: Colorectal Disease
Hyung Ju Lee, Ji Young Woo, Jieun Byun
OBJECTIVE: Acute appendicitis is known for one of the most common cause of acute abdomen. However, it is still challenging to clearly distinguish complicated from uncomplicated appendicitis preoperatively. We investigated the association between right hydronephrosis and complicated appendicitis compared with other computed tomography (CT) findings of acute appendicitis. MATERIALS AND METHODS: 1275 patients who pathologically diagnosed with acute appendicitis were included...
August 29, 2020: European Journal of Radiology
Nawaf Abdulkareem Alomary, Majid Zaab Albeeshi, Rasha Eidah Al Thebaity, Zeyad Mohammed Yousef, Sami Abdelkereim El-Boghdadly
Aggressive angiomyxoma (AA) is an uncommon mesenchymal tumor that mainly affects the perineum and pelvis in females of reproductive age. AA is commonly misdiagnosed as a Bartholin's duct cyst, abscess or levator hernia. A 42-year-old female presented with a large, progressive and painless perineal swelling. She was initially diagnosed with an obturator hernia three times over the past 10 years and underwent multiple surgeries for recurrences. For this presentation, she underwent exploratory laparotomy. No hernia was identified...
September 2020: Journal of Surgical Case Reports
Maciej Borejsza-Wysocki, Adam Bobkiewicz, Tomasz Kościński, Tomasz Banasiewicz, Łukasz Krokowicz
Aim An ileal pouch anal anastomosis (IPAA) leak is one of the most severe complication after restorative proctocoletomy (RPC). We present a rare case of a successful management of IPAA leak after RPC without defunctionig stoma with the utility of endoscopic vacuum therapy. Methods A 57-year-old male with a ileal pouch anal anastomosis leak after RPC due to ulcerative colitis with presacral abscess was qualified for endoscopic vacuum therapy (EVT). The abscess of the left buttock was drained and secured with suction drain (redon drain)...
October 18, 2019: Polski Przeglad Chirurgiczny
L Ludovic, F Carmen, A Arnaud, M Benjamin
Abdominal pelvic radiation therapy can induce acute or chronic lesions in the small bowel wall, called radiation enteritis. Treatment of acute radiation enteritis is essentially symptomatic; symptoms regress when radiation is discontinued. Conversely, late toxicity can occur up to 30 years after discontinuation of radiation therapy, posing diagnostic problems. Approximately one out of five patients treated by radiation therapy will present clinical signs of radiation enteritis, including obstruction, malabsorption, malnutrition and/or other complications...
August 31, 2020: Journal of Visceral Surgery
Rachel M Lee, Adriana C Gamboa, Michael K Turgeon, Sanjana Prasad, Gifty Kwakye, Maryam Mohammed, Jennifer Holder-Murray, Sherif Abdel-Misih, Charles Kimbrough, Mosope Soda, Alexander T Hawkins, William C Chapman, Matthew Silviera, Shishir K Maithel, Glen Balch
BACKGROUND: Intraoperative pelvic drains are often placed during low anterior resection (LAR) to evacuate postoperative fluid collections and identify/control potential anastomotic leaks. Our aim was to assess the validity of this practice. METHODS: Patients from the US Rectal Cancer Consortium (2007-2017) who underwent curative-intent LAR for a primary rectal cancer were included. Patients were categorized as receiving a closed suction drain intraoperatively or not...
August 31, 2020: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Abhinav Mohan, Jacob Rubin, Priyank Chauhan, Juan Lemos Ramirez, German Giese
 is a gram-positive bacillus in the female genital tract believed to be a commensal organism that inhibits the growth of more virulent pathogens.  Prevotella bivia  is a gram-negative bacillus species also typically commensal in the female genital tract. Lactobacillus as the primary causative agent in perinephric abscesses and bacteremia has been documented, albeit very uncommon and opportunistic.  Prevotella bivia  is not classically associated with perinephric abscesses but has been implicated in rare cases of pelvic inflammatory disease and tubo-ovarian abscesses...
March 3, 2020: Journal of Community Hospital Internal Medicine Perspectives
Andrea Lisotti, Anna Cominardi, Igor Bacchilega, Romano Linguerri, Pietro Fusaroli
Background and Aims: Pelvic fluid collections (PFCs) are frequent adverse events of abdominal surgery or inflammatory conditions. A percutaneous approach to deep PFCs could be challenging and result in a longer, painful recovery. The transvaginal approach has been considered easy but is limited by the difficulty of leaving a stent in place. The transrectal approach has been described, but issues related to fecal contamination were hypothesized. Data on EUS-guided transrectal drainage (EUS-TRD) with lumen-apposing metal stents (LAMSs) are few and suggest unsatisfactory outcomes...
August 2020: VideoGIE
Rui Du, Jiajie Zhou, Dongliang Li, Qi Zhang, Jiawen Liu, Changmin Ma, Liuhua Wang, Daorong Wang
Lateral lymph node dissection (LLND) is a challenging procedure due to its technical difficulty and higher incidence of surgical morbidity, thus the purpose of this study is to compare the postoperative morbidity and mortality between laparoscopic and conventional open LLND after mesorectal excision (ME) for advanced rectal cancer. A comprehensive search was conducted in August 2019 based on data from PubMed, Embase, Cochrane Library, CNKI and Wanfang Data to identify relevant studies, and studies comparing laparoscopic with conventional open LLND were included...
August 11, 2020: Asian Journal of Surgery
Franziska Siegenthaler, Elke Krause, Michael D Mueller
Management of Pelvic Inflammatory Disease Abstract. Pelvic inflammatory disease (PID) is a common medical problem, but the diagnosis of PID can be challenging because the clinical manifestations may mimic those of other pelvic and abdominal processes. As PID might cause late complications such as infertility or chronic pelvic pain, it is of prime importance that the diagnosis of PID is made promptly to assure the early onset of an adequate antibiotic therapy. Where uncomplicated PID usually has a favorable course, complicated forms with tubo-ovarian abscess generally require surgical exploration...
2020: Therapeutische Umschau. Revue Thérapeutique
Gaetano Luglio, Alfonso Amendola, Gianluca Pagano, Francesca Paola Tropeano, Chiara Errico, Enrica Esposito, Giuseppe Palomba, Paola Dinuzzi, Giuseppe De Simone, Giovanni Domenico De Palma
Introduction: We report the case of a successful management with combined aggressive surgery and negative pressure therapy, to treat a severely ill-septic patient, affected by multiple chronic enterocutaneous fistulas. Presentation of case: A 26-year-old female patient presented with multiple pelvic and intra-abdominal abscesses, enterocutaneous fistulas and central venous catheter-related bacteraemia in extremely poor general conditions.The patient underwent both an abdominal CT which showed multiple digestive loops stuck and apparently fistulised and an abdominal-pelvic MRI, confirming the CT findings, and demonstrating a third fistula involving the Pouch and responsible for a pelvic and retroperitoneal chronic abscess...
September 2020: Annals of Medicine and Surgery
Nima Ahmadi, Praveen Ravindran, Taejun Kim, Salah E Ayoubi, Christopher M Byrne, Christopher J Young
BACKGROUND: C-reactive protein (CRP) is a useful marker for monitoring response to treatment in sepsis. The aim of this study was to examine the use of CRP trajectory in predicting the need for intervention in conservatively managed patients with acute diverticulitis (AD). METHODS: A retrospective review of patients with AD who were managed conservatively was performed. They were divided into four groups based on CRP relative to the median at day 0 and 2: 'Low rise' (levels below median at day 0 and 2), 'High rise' (levels above median at day 0 and 2), 'Rapid rise' (levels below median at day 0 but above median at day 2) and 'Decline' (levels above median at day 0 but below median at day 2)...
August 4, 2020: ANZ Journal of Surgery
Sakurako Mukai, Shunsuke Shinmei, Masayuki Muto, Tomoya Hatayama, Hiroyuki Shikuma, Shunsuke Miyamoto, Shinsuke Fujii, Kousuke Sadahide, Yohei Sekino, Keisuke Hieda, Shogo Inoue, Tetsutaro Hayashi, Jun Teishima, Akio Matsubara
Introduction: Refractory fistulas of the bladder are not rare, but they can rarely be closed naturally. Bladder fistulas can be treated in various ways. We report the case of an old woman who had a refractory fistula of the bladder that was able to be repaired with transurethral cystoscopic injection of N -butyl-2-cyanoacrylate. Case presentation: For decades after being treated for cervical cancer in 1970s, the woman frequently suffered from fevers. A computed tomography scan showed pelvic abscess at the left side of her bladder, and cystography showed urine leakage at the wall...
January 2020: IJU case reports
Jocelyn Compton, John Yanik, Nathan Hendrickson, Naina Bagrodia, Peter Nau, Andrew J Pugley
Background: Disconnection of the tubing between the port and LAGB is a well-known complication in general surgery and accounts for up to 17% of LAGB complications. Typically, when this complication occurs patients present with abdominal or pelvic complaints. A complication of spinal infection due to trans-foraminal migration has not been previously reported. The aim of this study is to highlight an unusual infection of the thoracolumbar spine due to laparoscopic adjustable gastric band (LAGB) intragastric erosion, and migration into the lumbar spine causing epidural abscesses, discitis, and osteomyelitis...
2020: Iowa Orthopaedic Journal
Laurie Bezjian Wallace, Patrick Wallace, Joel Herness
We report a case of acute urinary retention in an adolescent female secondary to hematocolpos. A 13-year-old female presented to the emergency department with acute urinary retention and suprapubic abdominal pain for 24 hours. She denied menstruation or sexual history. Bedside bladder ultrasound scan revealed 1.2 L of retained urine and a Foley catheter was placed. A formal renal ultrasound detected a debris-filled structure in the abdomino-pelvic cavity. Follow-up computed tomography of the abdomen and pelvis revealed an 8...
July 30, 2020: Military Medicine
Fady Michael Fahmy Ibrahim, Abd El-Rady Mahmoud Abd El-Rady
Iliopsoas abscess refers to collection of fluid in iliopsoas muscle compartment. It is well-known condition in medical history as a complication of tuberculous spine infection. Most of the cases now are due to pyogenic infection. Patient usually presents late due to delayed diagnosis. We aim to present a less invasive technique for surgical drainage of iliopsoas abscess. PATIENTS AND METHODS: It is a prospective study done between 2015 and 2018. The study included 28 patients with confirmed diagnosis of iliopsoas abscess...
July 26, 2020: International Orthopaedics
Anastasia Barnes, Avneet Kaur, Michael Augenbraun
Actinomyces is a rare cause of prostatic abscess. Most reported cases of abdominal and pelvic actinomycosis are a consequence of invasive procedures or abdominal infections. In this report, we present a previously healthy 53-year-old man with inguinal pain, fever and dysuria who was found to have a prostate abscess, secondary to Actinomyces turicensis and Peptostreptococcus, which was removed via transurethral resection of the prostate. This case was complicated by Peptostreptococcus bacteremia and a facial abscess...
June 17, 2020: Curēus
Pierre Lecoanet, Guillaume Pascal, Abderrahmane Khaddad, Nicolas Hubert, Jean-Louis Lemelle, Nicolas Berte, Grégoire Capon
PURPOSE: To assess the outcomes of continent urinary diversion according to the Mitrofanoff principle by robot-assisted laparoscopic surgery in terms of continence, catheterization and repeat surgery. METHODS: All adult patients who underwent procedures for continent urinary diversion via a robot-assisted laparoscopic route between October 2014 and November 2018 were enrolled retrospectively. Abdominal continence and clean intermittent catheterization ability were noted, as well as patient characteristics, details of the technique, intra- and perioperative parameters, and complications...
July 20, 2020: World Journal of Urology
Yiyu Yin, Zhenfang Qin, Xiaobing Xu, Peng Lu, Xu Liu, Huaxin Zou, Junhua Cao
The purpose of this study was to investigate and analyze the difficulties and influencing factors in the laparoscopic surgery for appendiceal abscess in children. 46 patients with appendiceal abscess receiving laparoscopic surgery (laparoscopic surgery group) in Xuzhou Children's Hospital from January 2012 to March 2017 were retrospectively analyzed. The surgery was performed using the 3-hole method, the 30° lens was placed in umbilical region, and the left lower abdomen and superior pubis were the operating holes...
July 20, 2020: Minerva Pediatrica
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