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Korean Journal of Radiology Jan 2022Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause... (Review)
Review
Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause various GI emergencies in neonates and infants. Given the overlapping or nonspecific clinical findings of many different neonatal and infantile GI emergencies and the unique characteristics of this age group, appropriate imaging is key to accurate and timely diagnosis while avoiding unnecessary radiation hazard and medical costs. In this paper, we discuss the radiological findings of essential neonatal and infantile GI emergencies, including esophageal atresia and tracheoesophageal fistula, hypertrophic pyloric stenosis, duodenal atresia, malrotation, midgut volvulus for upper GI emergencies, and jejunoileal atresia, meconium ileus, meconium plug syndrome, meconium peritonitis, Hirschsprung disease, anorectal malformation, necrotizing enterocolitis, and intussusception for lower GI emergencies.
Topics: Diagnostic Imaging; Duodenal Obstruction; Humans; Infant; Infant, Newborn; Intestinal Atresia; Intussusception
PubMed: 34983099
DOI: 10.3348/kjr.2021.0111 -
BMJ Open Gastroenterology 2019Gallstone ileus is an important complication of cholecystolithiasis. In general, surgery is the treatment of choice for such cases, but clinicians face difficulty in... (Review)
Review
Gallstone ileus is an important complication of cholecystolithiasis. In general, surgery is the treatment of choice for such cases, but clinicians face difficulty in the selection of an appropriate approach. Closure of a cholecystoenteric fistula can be achieved through one-stage or two-stage operation. Two-stage operation has a lower mortality rate than a one-stage procedure, but persistence of the cholecystoenteric fistula is associated with the risk of carcinogenesis and recurrence of gallstone ileus. This study reviews the different surgical approaches according to the impaction site of the gallstone, using data of previous studies by our group and clinical reports in the literature. First, for cases involving impaction at the duodenum, the cholecystoenteric fistula can be repaired in the same surgical field, and one-stage operation obtains favourable outcome; hence, one-stage operation is considered as treatment of choice. Second, for cases involving impaction at the small intestine, natural closure of the cholecystoenteric fistula or low mortality is expected; hence, two-stage operation may be performed, possibly using minimally invasive laparoscopy. Third, for cases involving impaction at the colon, natural closure of the cholecystocolonic fistula is unlikely, and patients have a high risk of reflux cholangitis due to faecal fluid; hence, one-stage operation is considered as treatment of choice.
PubMed: 31875141
DOI: 10.1136/bmjgast-2019-000344 -
JPMA. the Journal of the Pakistan... Jul 2023Duodenal ulcer perforation, a frequent surgical emergency, needs simple closure with indirect Graham's Omentopexy which is effective with excellent results in majority...
Duodenal ulcer perforation, a frequent surgical emergency, needs simple closure with indirect Graham's Omentopexy which is effective with excellent results in majority of cases despite patients' late presentation. The objective of the study was to determine the frequency of postoperative complications of perforated duodenal ulcer, conducted in the Surgery Department, Jinnah Postgraduate Medical Centre, Karachi, from March 20, 2018 to September 20, 2018. The study was a descriptive case series of 108 patients of both genders with perforated duodenal ulcer > 1 week old with ASA score I & II. Patients with trauma and comorbidities were excluded. The patients underwent laparotomy and peritoneal toilet, and after noting the site of perforation indirect Graham's Omentopexy was performed. Complications like duodenal fistula, peritonitis, and paralytic ileus, and patient's death within 10 days of surgery were noted. Age ranged from 18 to 50 years with mean age of 35.027±5.13 years, mean weight 71.120±12.77 kg, mean height 1.541 ±0.09 metres, mean BMI 29.975±4.99 kg/m2, and the mean duration of complaint was 4.194±1.30 weeks. Male predominance in 75 (69.4%) patients. Duodenal fistula was seen in 10 (9.3%) patients, peritonitis 12 (11.1%), paralytic ileus 14 (13%) and mortality was in 11 (10.2%) patients.
Topics: Humans; Male; Female; Adult; Infant; Duodenal Ulcer; Risk Factors; Peptic Ulcer Perforation; Peritonitis; Fistula
PubMed: 37469068
DOI: 10.47391/JPMA.4768 -
Arquivos Brasileiros de Cirurgia... 2021
Topics: Duodenal Diseases; Humans; Intestinal Fistula; Tuberculosis
PubMed: 34008711
DOI: 10.1590/0102-672020190004e1570 -
VideoGIE : An Official Video Journal of... Jan 2022There is growing interest in closure of larger mucosal defects, given the increasing use of endoscopic resection for early GI neoplasia and the advent of submucosal...
BACKGROUND AND AIMS
There is growing interest in closure of larger mucosal defects, given the increasing use of endoscopic resection for early GI neoplasia and the advent of submucosal endoscopy, including peroral endoscopic myotomy. Existing closure methods include through-the-scope clips, over-the-scope clips, and over-the-scope suturing. Although over-the-scope clips and over-the-scope suturing allow closure of large defects, both require endoscope removal for device application and may have difficulty in treating lesions in the proximal colon or the small intestine. Hence, a significant gap exists for a through-the-scope device capable of closing larger defects. The novel X-Tack system (Apollo Endosurgery, Austin, Tex, USA) offers through-the-scope suturing (TTSS), which eliminates the need to withdraw the endoscope from the patient before applying therapy.
METHODS
We demonstrate the possible indications for endoscopic mucosal adhesion with TTSS through a video case series. We present 5 cases to illustrate the use of TTSS in the closure of a duodenal EMR defect, a cecal EMR defect, mucostomy after esophageal and gastric peroral endoscopic myotomy, and, finally, for primary closure of a gastrogastric fistula.
RESULTS
All defects were successfully closed with 1 to 2 TTSS systems. There were no postprocedure adverse events, including bleeding or perforation, at a median of 30 (range 14-30) days of follow-up.
CONCLUSIONS
TTSS is a valuable addition to mucosal closure devices, which allows closure through a gastroscope or a colonoscope, without requiring endoscope removal for device application. Likely applications include larger or more distant defects and those located within tight spaces. Pending further clinical evaluation, important areas for research include assessment of the learning curve, comparative trials with other closure devices, and cost-effectiveness analysis.
PubMed: 35059543
DOI: 10.1016/j.vgie.2021.08.006 -
Revista Espanola de Enfermedades... Dec 2021We present the case of a 72-year-old male with upper gastrointestinal bleeding. He had been discharged from hospital two weeks before after severe COVID-19 infection,...
We present the case of a 72-year-old male with upper gastrointestinal bleeding. He had been discharged from hospital two weeks before after severe COVID-19 infection, treated with lopinavir-ritonavir (L-R), hydroxychloroquine, tocilizumab, and methylprednisolone. On presentation, he was in hypovolemic shock. Esophagogastroduodenoscopy showed an ulcer in the third duodenal portion, which was sclerosed and hemodynamic stability was recovered. A scan was performed as it was in an atypical location for ulcers, showing an aortic aneurysm in close relationship to the duodenum, suggesting a primary aortoenteric fistula (PAEF).
Topics: Aged; Aortic Diseases; COVID-19; Duodenal Diseases; Gastrointestinal Hemorrhage; Humans; Intestinal Fistula; Male; SARS-CoV-2; Vascular Fistula
PubMed: 34488422
DOI: 10.17235/reed.2021.8272/2021