Emergency colorectal resections in Asian octogenarians: Factors impacting surgical outcome
Conclusions The mortality and morbidity of emergency colorectal resections among Asian octogenarians are high and can be predicted by
their ASA status.
Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00595-008-3925-1Authors
Quor Meng Leong, Tan Tock Seng Hospital Department of General Surgery 11 Jalan Tan Tock Seng Singapore 308433 SingaporeMyint Oo Aung, Tan Tock Seng Hospital Department of General Surgery 11 Jalan Tan Tock Seng Singapore 308433 SingaporeChoon Kiat Ho, Tan Tock Seng Hospital Department of General Surgery 11 Jalan Tan Tock Seng Singapore 308433 SingaporeRichard Sim, Tan Tock Seng Hospital Department of General Surgery 11 Jalan Tan Tock Seng Singapore 308433 Singapore
Journal Surgery TodayOnline ISSN 1436-2813Print ISSN 0941-129......
POSTED 06/29/2009 at 08:55 AM --
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Chicken-bone perforation of a sigmoid colon diverticulum into the right groin and subsequent phlegmonous inflammation of the abdominal wall.
We report an 82-year-old woman with perforation of a sigmoid diverticulum into the right groin with subsequent phlegmonous inflammation of the abdominal wall. A Hartmann's procedure with necrectomy of the abdominal wall was performed. Histopathologic examination revealed an ingested chicken bone perforating the diverticulum. When diverticulitis or diverticular abscess is suspected in an elderly patient, foreign body impaction or perforation should be considered as a possible cause.
PMID: 19412753 [PubMed - indexed for MEDLINE] (Source: Wiener Klinische Wochenschrift)...
POSTED 06/27/2009 at 01:20 PM --
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Accuracy of multidetector computed tomography in differentiating primary epiploic appendagitis from left acute colonic diverticulitis associated with secondary epiploic appendagitis
The objectives of this study are to evaluate the prevalence of left acute colonic diverticulitis (LACD) associated with secondary
epiploic appendagitis (SEA) detected by computed tomography (CT); to describe CT features that distinguish LACD associated
with SEA from primary epiploic appendagitis (PEA); and to assess the accuracy of CT in diagnosing LACD associated with SEA
versus PEA. Institutional review board approval was obtained. We retrospectively identified 46 consecutive patients with LACD
between July 2004 and July 2005 and 26 patients with PEA between 2000 and 2005 investigated using multidetector CT. Two radiologists
blinded to the final diagnosis reviewed the CT images for findings of LACD-associated SEA or PEA. Each reader classified each
CT scan into one of four categori......
POSTED 06/11/2009 at 09:05 AM --
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Current Recommendations on Diagnosis and Management of Right-Sided Diverticulitis
We present the case of a 52-year-old female with recurrent symptomatic ascending colon diverticulitis who ultimately underwent elective laparoscopic right hemicolectomy. The following is a case report and literature review pertaining to right colonic diverticular disease. (Source: Gastroenterology Research and Practice)...
POSTED 06/09/2009 at 12:24 PM --
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[Breast Cancer] Feasibility Trial of Partial Breast Irradiation With Concurrent Dose-Dense Doxorubicin and Cyclophosphamide in Early-Stage Breast Cancer
Conclusion
PBI with concurrent ddAC is feasible, and local/systemic toxicity is acceptable. Larger studies are warranted to assess long-term locoregional control and late toxicities. (Source: Journal of Clinical Oncology)...
POSTED 06/07/2009 at 11:00 PM --
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Reversal of Hartmann’s procedure following acute diverticulitis: is timing everything?
Conclusions Reversal of Hartmann’s procedure can be offered to appropriately selected patients though with a significant (25%) morbidity
rate. The identification of potential modifiable factors such as current smoking, prolonged time to reversal and low preoperative
albumin may allow optimisation of such patients preoperatively.
Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-009-0747-6Authors
Fergal J. Fleming, Our Lady of Lourdes Hospital Surgical Professorial Unit, Department of Surgery Drogheda Co Louth IrelandPeter Gillen, Our Lady of Lourdes Hospital Surgical Professorial Unit, Department of Surgery Drogheda Co Louth Ireland
Journal International Journal of Colorectal DiseaseOnline ISSN 1432-1262Print ISSN 0179-1958 (Source: Inte......
POSTED 06/05/2009 at 04:47 AM --
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How important is it to investigate the whole of the colon after initial assessment at a rapid access colorectal clinic?
Conclusions A rapid access colorectal clinic using flexible sigmoidoscopy as the initial diagnostic test was safe and effective in investigating
distal colonic pathologies. However, over two thirds of patients proceeded to imaging of the remaining colon, and most of
them were found to have only benign pathologies. The cost effectiveness and acceptability of this were unclear.
Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-009-0741-zAuthors
Chung Sim Lim, Forth Valley NHS Department of General Surgery, Stirling Royal Infirmary Livilands Stirling FK8 2AU UKLinnet McGeever, Forth Valley NHS Department of General Surgery, Stirling Royal Infirmary Livilands Stirling FK8 2AU UKJudith Helen Grey, Forth Valley NHS Department of General Surgery, Stirli......
POSTED 06/05/2009 at 04:47 AM --
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Arterial Chemoembolization/Embolization and Early Complications after Hepatocellular Carcinoma Treatment: A Safe Standardized Protocol in Selected Patients with Child Class A and B Cirrhosis
Conclusions: Transarterial treatments can be considered safe in patients with Child class A and B cirrhosis when an adjusted dose of epirubicin is used according to body surface, severity of liver disease, and white blood cell count. Accurate patient selection and procedure-related factors may reduce the frequency of complications and help preserve liver function. (Source: Journal of Vascular and Interventional Radiology : JVIR)...
POSTED 06/03/2009 at 06:00 PM --
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Diverticulitis
— Comprehensive overview covers symptoms, treatment, causes of this common colon disease.
Sponsored by:Chemotherapy.com - http://www.chemotherapy.com (Source: MayoClinic.com Full Feed)...
POSTED 05/21/2009 at 12:00 AM --
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Nonsteroidal Anti-Inflammatory Drugs and Lower Gastrointestinal Complications
Nonsteroidal anti-inflammatory drug (NSAID)-associated intestinal damage to the small and/or large bowel is frequent and may be present in up to 60% to 70% of patients taking these drugs long term. Intestinal damage is subclinical in most cases (eg, increased mucosal permeability, inflammation, erosions, ulceration), but more serious clinical outcomes, such as anemia and overall bleeding, perforation, obstruction, diverticulitis, and deaths, have also been described. Recent data suggest that serious lower gastrointestinal (GI) clinical events linked to NSAID use may be as frequent and severe as upper GI complications. Treatment and prevention strategies of NSAID-induced damage to the lower GI tract have not been defined so far. Misoprostol, antibiotics, and sulphasalazine have been proven ......
POSTED 05/19/2009 at 12:29 PM --
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Post inflammatory damage to the enteric nervous system in diverticular disease and its relationship to symptoms
Abstract: Some patients with colonic diverticula suffer recurrent abdominal pain and exhibit visceral hypersensitivity, though the mechanism is unclear. Prior diverticulitis increases the risk of being symptomatic while experimental colitis in animals increases expression of neuropeptides within the enteric nervous system (ENS) which may mediate visceral hypersensitivity. Our aim was to determine the expression of neuropeptides within the ENS in diverticulitis (study 1) and in patients with symptomatic disease (study 2). Study 1 [ndash] Nerves in colonic resection specimens with either acute diverticulitis (AD, n = 16) or chronic diverticulitis (CD, n = 16) were assessed for neuropeptide expression recording % area staining with protein gene product (PGP9.5), substance P (SP), neuropeptide......
POSTED 05/14/2009 at 11:00 PM --
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Diverticular disease
Contributed by Dr Samuel Adegbola, surgical trainee Eastern Deanery, and Mr Joe Dawson, specialist registrar North East Thames rotation, Basildon and Thurrock University Hospitals NHS Foundation Trust. (Source: HealthcareRepublic Clinical Articles)...
POSTED 05/14/2009 at 07:00 PM --
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Emergency Laparoscopic-Assisted Versus Open Right Hemicolectomy for Complicated Cecal Diverticulitis: A Comparative Study
Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)...
POSTED 05/11/2009 at 10:40 AM --
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[Original articles] An incidental enterocolic lymphocytic phlebitis pattern is seen commonly in the rectal stump of patients with diversion colitis superimposed on inflammatory bowel disease
Conclusion:
ELP occurs most frequently in cases that have been diverted for inflammatory bowel disease. Fewer cases of ELP were noted in cases of inflammatory bowel disease in the absence of diversion colitis. It is postulated that altered bowel flora and immune dysregulation may be pivotal in the causation of this association. (Source: Journal of Clinical Pathology)...
POSTED 04/26/2009 at 11:00 PM --
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Bt05modern management of colonic diverticulitis in the obese
Colonic diverticulitis is a dietary disorder of the ageing Western population associated with a low intake of oral fibre. Symptoms develop in only 10% of patients and overall only 1% of patients experience a complication. CT scan is the investigation of choice, although CT fails to predict clinical outcomes in many cases. Uncomplicated diverticulitis is reliably managed by antibiotics in the great majority of cases. So much so that enthusiasm for elective surgical resection after two documented attacks is waning, particularly in the high risk patient i.e. obese. Complicated diverticulitis (abscess, peritonitis, fistulae, stricture or bleeding) that fails conservative management is traditionally treated by open Hartmann's rectosigmoidectomy. Alternatives to laparoscopy are particularly help......
POSTED 04/26/2009 at 11:00 PM --
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Gs12hartmann's vs. stent and washout, a review of 112 cases
Conclusion: Patient selection, technical expertise and long learning curve were all aspects that influenced the early results of stenting and washout. Hartmann's is no longer the preferred treatment option for left sided colonic emergencies. (Source: ANZ Journal of Surgery)...
POSTED 04/26/2009 at 11:00 PM --
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Cr09*laparoscopic washout for diverticulitis
Conclusions: Laparoscopic washout is superior in cases of perforated Diverticulitis with purulent peritonitis(Hinchey III). It is recommended in Hinchey I and II cases, when percutaneous drainage is unhelpful. Hartmann's colonic resection should be reserved for genuine cases of faecal peritonitis (Hinchey IV). (Source: ANZ Journal of Surgery)...
POSTED 04/26/2009 at 11:00 PM --
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Cr32ppredictors of day stay after colonic surgery in a structured multi-modal care program
Conclusion: Choice of incision and Cr-POSSUM score are independent predictors of day stay in the ERAS setting. (Source: ANZ Journal of Surgery)...
POSTED 04/26/2009 at 11:00 PM --
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Gs01hernia repair: are we there yet?
Herniae have been documented since ancient times, but the era of modern hernia treatment is accepted as starting with the surgery of Bassini. Suture repairs of various types then dominated the treatment of hernia until the era of mesh repair championed by Stoppa and Lichtenstein. Surgeons feel that mesh repairs have revolutionized hernia surgery. Have the mesh repairs really made such a difference? There is evidence that all is not as it seems! Published recurrence figures don't seem to withstand close scrutiny. One of the trendy terms in herniology is the "myo-pectineal orifice", while many hernia specialists pay lip service to this concept, very few available hernia operations address this problem. The latest area of interest in the world of hernia surgery is the area of post-hernia groi......
POSTED 04/26/2009 at 11:00 PM --
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Image Guided Treatment Helping Women With Tubo Ovarian Abscesses Avoid Unnecessary Surgery
Image guided drainage of tubo ovarian abscesses help women avoid surgery, according to a study performed at Massachusetts General Hospital in Boston, MA. Tubo ovarian abscesses (TOAs) are an infected collection of pus, involving a patient's fallopian tube(s) or ovaries. They can occur in patients with complicated cases of pelvic inflammatory disease, appendicitis or diverticulitis. The study included 54 TOAs in 46 patients. (Source: MRI / PET / Ultrasound News From Medical News Today)...
POSTED 04/24/2009 at 08:00 AM --
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