- Covered perforation of Meckel's diverticulum ulcer to transverse colon: highlighting the urgent intervention and the avoidance of a dramatic evolution (case report and literature review). [Journal Article]
- FMFolia Med Cracov 2018; 58(3):83-87
- Meckel's diverticulum represents a remnant of the proximal end of the omphalomesenteric duct, which constitutes a connection between the middle intestine and the vitelline vesicle. It is the most com...
Meckel's diverticulum represents a remnant of the proximal end of the omphalomesenteric duct, which constitutes a connection between the middle intestine and the vitelline vesicle. It is the most common congenital anomaly of the gastrointestinal tract and is found in approximately 0.3-2% of the general population. Complications such as hemorrhage, bowel obstruction, inflammation, perforation, intussusception, volvulus and malignant transformation develop in only 4-4.8% of all patients, with most cases presenting in childhood, while relative risk decreases during life. The aim of the present study is to present our experience in managing a 15-year old male patient with Meckel's diverticulum covered perforation. It was a case of disguised perforation of the Meckel's diverticulum, with development of adhesions to the anterior surface of the right third of the transverse colon, which was successfully treated on the basis of emergency. Diagnosis was made intraoperatively and was documented by histological examination of the excised diverticulum.
- Platelet transfusion practices in immune thrombocytopenia related hospitalizations. [Journal Article]
- TTransfusion 2018 Dec 05
- CONCLUSIONS: Platelets are administered to a small fraction of the hospitalized ITP patients. In a majority of these cases however, platelet usage does not appear to be concordant with the current guidelines or associated with improvement in clinical outcomes.
- A case of duodenal hemorrhage due to arteriovenous malformation around a serous cystic neoplasm. [Journal Article]
- SCSurg Case Rep 2018 Dec 05; 4(1):140
- CONCLUSIONS: There have been no reports of duodenal hemorrhage due to acquired pancreatic AVM around pancreatic tumor, including SCN. We successfully treated a case of duodenal hemorrhage due to pancreatic AVM around SCN by pancreatoduodenectomy.
- Endoscopy Is Relatively Safe in Patients with Acute Ischemic Stroke and Gastrointestinal Hemorrhage. [Journal Article]
- DDDig Dis Sci 2018 Dec 05
- CONCLUSIONS: Gastrointestinal endoscopy can be safely performed in a substantial number of patients with AIS and GIH.
- [Imaging characteristics of gastrointestinal neoplastic acute abdomen]. [Journal Article]
- ZWZhonghua Wei Chang Wai Ke Za Zhi 2018 Nov 25; 21(11):1223-1229
- Both malignant tumors derived from gastrointestinal tract and metastasis from peritoneal spread, hematogenous dissemination and lymph node can lead to acute abdomen. Such acute abdomen patients have ...
Both malignant tumors derived from gastrointestinal tract and metastasis from peritoneal spread, hematogenous dissemination and lymph node can lead to acute abdomen. Such acute abdomen patients have poor prognosis, high mortality, and complex clinical manifestations. It is difficult to make a correct diagnosis in clinical practice. Recent studies show that gastrointestinal tumors are associated with clinical emergency. Malignant gastrointestinal tumors mostly result in obstruction, so upper gastrointestinal contrast for gastric cancer and post-enhanced CT for colon cancer are recommended; gastrointestinal stromal tumors usually cause bleeding, so computed tomography angiography (CTA) is the first choice for examination; primary gastrointestinal lymphoma tends to cause perforation and usually occurs in small intestine, so CT is the first examination for patients with ischemic acute abdomen, and post-enhanced CT is essential to exclude small intestine carcinoid because of its rising incidence in recent years. The possibility of gastrointestinal metastasis should be kept in mind for patients with cancer presenting acute abdomen. This article focuses on the imaging features of common gastrointestinal tumors and their acute obstruction, perforation, and hemorrhage, and aims to improve the understanding of such symptoms in clinical practice so that correct diagnosis and treatment can be made in time.
- [Role of oncologic radiotherapy in multidisciplinary team treatment of malignant acute abdomen]. [Journal Article]
- ZWZhonghua Wei Chang Wai Ke Za Zhi 2018 Nov 25; 21(11):1212-1217
- Malignant acute abdomen is a emergency with abrupt onset, rapid progress and often a complex etiology, presenting difficulties for treatment and high mortality. Therefore, multidisciplinary team (MDT...
Malignant acute abdomen is a emergency with abrupt onset, rapid progress and often a complex etiology, presenting difficulties for treatment and high mortality. Therefore, multidisciplinary team (MDT) treatment modality is required. Compared with single-discipline diagnosis and treatment modality, diagnosis made from MDT discussion is more accurate, where specialists can improve efficiency and quality of the treatment through better communication. A good MDT can cover all stages from the diagnosis to the assessment and treatment of the disease, and combine them into a more coherent process. This article discusses the development of radiotherapy-related malignant acute abdomen and the role of radiotherapy in the treatment of malignant acute abdomen from the perspective of oncologic radiotherapy. Common causes of radiotherapy-related acute abdomen from gastric cancer include gastric hemorrhage, upper gastrointestinal obstruction and gastric perforation, while those of radiotherapy-related acute abdomen from colorectal cancer include lower gastrointestinal hemorrhage, intestinal obstruction, intestinal perforation and intestinal fistula. For patients with acute bleeding from gastric cancer that can not be treated by surgery, endoscopic hemostasis or embolization, palliative radiotherapy should be considered. Palliative hypofractionated radiotherapy has the advantage of reducing tumor burden in addition to relieving symptoms of gastric cancer. In patients with acute lower gastrointestinal hemorrhage, as relatively few studies have been established, short course of hypofractionated radiotherapy can be selectively applied. For patients with obstruction, palliative radiotherapy may be considered when surgical assessment is not feasible or tolerable. As malignant acute abdomen has rapid onset and progress, complex etiology and high rate of comorbidity MDT should be fully carried out. For patients with mild symptoms and slow development, radiotherapy can be applied with caution. Emergency treatment such as surgery and intervention should be given when necessary. Passive observation can result in missing the treatment opportunity and should be avoided.
- External validation of a clinical prediction rule for very low risk pediatric blunt abdominal trauma. [Journal Article]
- AJAm J Emerg Med 2018 Nov 23
- CONCLUSIONS: One out of 133 patients with CIIAI met very low risk criteria based on the PECARN prediction rule. This study supports the PECARN clinical prediction rule in decreasing CT use in pediatric patients at very low risk for CIIAI.
- Severe iron-deficiency anemia as initial manifestation of pulmonary hemosiderosis in a child. [Case Reports]
- EEinstein (Sao Paulo) 2018 Nov 29; 16(4):eRC4505
- Idiopathic pulmonary hemosiderosis is a potentially fatal disease that results from episodes of alveolar hemorrhage of unknown origin. The clinical spectrum is varied, and anemia may constitute the o...
Idiopathic pulmonary hemosiderosis is a potentially fatal disease that results from episodes of alveolar hemorrhage of unknown origin. The clinical spectrum is varied, and anemia may constitute the only manifestation of illness, preceding other signs and symptoms by several months. We present the case of a 4 year-old child presenting with fever, vomiting and prostration, associated with pallor. He had microcytic and hypochromic anemia refractory to iron therapy. Gastrointestinal bleeding was ruled out after negative extensive etiological investigation. Subsequently, pulmonary infiltrates suggestive of alveolar hemorrhage were observed in the chest radiography. The cytological exam of the bronchoalveolar lavage showed hemosiderin-laden macrophages. After the etiological study, the diagnosis of idiopathic pulmonary hemosiderosis was made by exclusion. He was initiated on corticosteroid therapy, later associated to an immunosuppressive agent, with subsequent correction of anemia and of the radiological pattern. The patient is currently asymptomatic.
- Thrombosis in the portal venous system caused by hypereosinophilic syndrome: A case report. [Journal Article]
- MMedicine (Baltimore) 2018; 97(48):e13425
- CONCLUSIONS: The clinical manifestations of HES are complex and varied, and this condition can cause severe and extensive arteriovenous thrombosis. Anticoagulation therapy and thrombolysis are necessary interventions, and appear to be safe and effective.
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- Hemosuccus pancreaticus and hematochezia - An unusual presentation of a rare disease. [Journal Article]
- DLDig Liver Dis 2018 Nov 08