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[PMID]: 26188753
[Au] Autor:Vecchio R; Intagliata E; Marchese S; Battaglia S; Cacciola RR; Cacciola E
[Ti] Title:Surgical drain after open or laparoscopic splenectomy: is it needed or contraindicated?
[So] Source:G Chir;36(3):101-5, 2015 May-Jun.
[Is] ISSN:0391-9005
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The Authors report their experience with the routine use of surgical drainage in a large series of splenectomies. SUMMARY OF BACKGROUND DATA: Benefits and risks related to surgical drains have been always discussed, with some surgeons in favor of them and skeptic others considering not physiological their use. After splenectomy, their use is also largely debated, especially because of susceptibility of operated patients to infections. PATIENTS AND METHODS: Two thousand nine cases have been reviewed. Indications for splenectomy, performed either by open or laparoscopic approach, included idiopathic thrombocytopenic purpura in 137 patients (65,4%), splenic lymphoma in 36 (17,2%), hereditary spherocytosis in 15 (7,4%), ß-thalassemia in 8 (3,7%), other diseases in 13 (6,1%). RESULTS: "Active" or "passive" drains were placed in 80% and 20% of cases, respectively. Drains were removed 2-3 days after surgery in 90,2%, within 10 days in 4,3%, within 2 months in 0,4% of cases. In 2 cases a post-operative bleeding, detected through the drainage, required re-operation. One patient developed a subphrenic abscess, successfully treated by a percutaneous drainage. One case of pancreatic fistula was observed. CONCLUSIONS: In Authors' experience, the use of drains after splenectomy does not affect the risk of subsequent infectious complications, independently on the type of the drainage system used. Early removal of drains in this series might have played an important role in the very low incidence of abdominal infections reported. The use of surgical drains after splenectomy might play an important role to early detect post-operative bleeding, as it happened in 2 cases of this series.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Cu] Class update date: 150811
[Lr] Last revision date:150811
[Js] Journal subset:IM
[St] Status:In-Data-Review

  2 / 1195 MEDLINE  
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[PMID]: 26055585
[Au] Autor:Sasegbon A
[Ad] Address:Northampton General Hospital, Northampton, UK.
[Ti] Title:When is pneumonia not pneumonia?
[So] Source:BMJ Case Rep;2015, 2015.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:A 34-year-old man was admitted to hospital via the accident and emergency department with severe right-sided abdominal pain and raised inflammatory markers. His pain settled with analgaesia and he was discharged with a course of oral co-amoxiclav. He was readmitted to the hospital 7 days later reporting cough and shortness of breath. His chest X-ray showed a raised right hemi-diaphragm, presumed consolidation and a right-sided effusion. As a result, he was treated for pneumonia. Despite antibiotic therapy his C reactive protein remained elevated, prompting an attempt at ultrasound-guided drainage of his effusion. Finding only a small amount of fluid, a CT of the chest was performed, and this showed a subphrenic abscess and free air under the diaphragm. A CT of the abdomen was then carried out, showing a perforated appendix. An emergency laparotomy was performed, the patient's appendix was removed and the abscess drained.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Process

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[PMID]: 26182395
[Au] Autor:Hai S; Tanaka H; Takemura S; Sakabe K; Ichikawa T; Kubo S
[Ad] Address:Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan. shai1005@hyo-med.ac.jp....
[Ti] Title:Portal vein embolization for an intractable bile leakage after hepatectomy.
[So] Source:Clin J Gastroenterol;5(4):287-91, 2012 Aug.
[Is] ISSN:1865-7257
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:Bile leakages due to interruption of the intrahepatic bile duct after hepatectomy are often intractable. We herein report a case where portal vein embolization (PVE) decreased the bile production from the embolized part of the liver, which lead to healing of this type of bile leakage. A 77-year old man who had undergone an anterior segmentectomy of the liver for hepatocellular carcinoma 3 years prior was admitted to our hospital for an abscess in the right subphrenic space, and underwent percutaneous drainage. Fluoroscopy using a contrast medium from the drainage tube revealed that the root of the posterior branch of the bile duct was completely interrupted. The hilar side of the interrupted bile duct was closed, and all the bile from the posterior segment continued to be discharged at a rate of 100-150 ml/day for 2 months. The posterior branch of the portal vein was then embolized with fibrin glue by percutaneous transhepatic approach. After the PVE, the volume of discharge gradually decreased, and the drainage tube was removed 2 weeks after the PVE. Three months later, the patient was afebrile and doing well. PVE might be a useful method for treating interrupted type postoperative bile leakages.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Da] Date of entry for processing:150718
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1007/s12328-012-0319-0

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[PMID]: 25912332
[Au] Autor:Franke M; Chang DH
[Ti] Title:Eine seltene Komplikation: Die akute ischämische Magennekrose im Rahmen einer nicht-okklusiven mesenterialen Ischämie (NOMI). [A rare complication: acute ischemic stomach necrosis in non-occlusive mesenteric ischemia].
[So] Source:Rofo;36(2):127-9, 2015 May.
[Is] ISSN:1438-9010
[Cp] Country of publication:Germany
[La] Language:ger
[Mh] MeSH terms primary: Extravasation of Diagnostic and Therapeutic Materials/radiography
Gastric Fistula/radiography
Ischemia/radiography
Mesenteric Ischemia/complications
Mesenteric Ischemia/radiography
Stomach Rupture/radiography
Stomach/blood supply
Stomach/pathology
Tomography, X-Ray Computed
[Mh] MeSH terms secundary: Acute Disease
Fatal Outcome
Female
Humans
Intestines/pathology
Liver/injuries
Middle Aged
Myocardial Infarction/complications
Myocardial Infarction/therapy
Necrosis
Postoperative Complications/radiography
Rupture, Spontaneous
Shock, Hemorrhagic/complications
Shock, Hemorrhagic/therapy
Splenectomy
Splenic Rupture/complications
Splenic Rupture/therapy
Subphrenic Abscess/radiography
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[Da] Date of entry for processing:150428
[St] Status:MEDLINE
[do] DOI:10.1055/s-0034-1384900

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[PMID]: 24871376
[Au] Autor:Georgiou GK; Gizas I; Papadopoulos C; Goussia AC; Michos G; Stefos T; Glantzounis GK
[Ad] Address:1 Department of Surgery, University Hospital of Ioannina , Ioannina, Greece .
[Ti] Title:Subphrenic abscess after appendiceal rupture in full-term pregnancy.
[So] Source:Surg Infect (Larchmt);16(2):204-5, 2015 Apr.
[Is] ISSN:1557-8674
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1504
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1089/sur.2013.234

  6 / 1195 MEDLINE  
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[PMID]: 24287016
[Au] Autor:Godinho AR; Tomé E; Vaz A; Gomes A; Vaz P
[Ad] Address:Serviço de Cardiologia, Hospital de São João, Porto, Portugal. Electronic address: rita_biscaia_godinho@hotmail.com....
[Ti] Title:Endocardite por Gemella: uma entidade agressiva. [Gemella endocarditis: an aggressive entity].
[So] Source:Rev Port Cardiol;32(12):1027-30, 2013 Dec.
[Is] ISSN:2174-2030
[Cp] Country of publication:Portugal
[La] Language:por
[Ab] Abstract:The authors present a rare case of subacute endocarditis caused by Gemella morbillorum. A 72-year-old man, with a history of hypertension, aortic valve disease and upper and lower endoscopy six months previously, was admitted due to fever and abdominal pain. He also complained of long-standing dyspnea on exertion and petechiae on his lower limbs. Imaging scans showed a consolidation in the lower left lung field, a splenic infarct and a left subphrenic abscess. Transthoracic echocardiogram findings were highly suggestive of endocarditis affecting three valves, with destruction of the mitral valve anterior leaflet. G. morbillorum was identified in three blood cultures and was considered the etiologic pathogen. Due to the patient's worsening condition, he underwent cardiac surgery, aiming to control the infection and to resolve the associated mechanical complications. This case highlights the need for a complete and thorough history to arrive at likely diagnostic hypotheses that, together with complementary exams, will lead to correct diagnosis and the prompt institution of appropriate therapy.
[Mh] MeSH terms primary: Gemella
Gram-Positive Bacterial Infections
[Mh] MeSH terms secundary: Aged
Endocarditis, Bacterial/diagnosis
Endocarditis, Bacterial/therapy
Gram-Positive Bacterial Infections/diagnosis
Gram-Positive Bacterial Infections/therapy
Humans
Male
[Pt] Publication type:CASE REPORTS; ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1504
[Js] Journal subset:IM
[Da] Date of entry for processing:131216
[St] Status:MEDLINE

  7 / 1195 MEDLINE  
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[PMID]: 25385432
[Au] Autor:Jun CH; Yoon JH; Wi JW; Park SY; Lee WS; Jung SI; Park CH; Joo YE; Kim HS; Choi SK; Rew JS
[Ad] Address:Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
[Ti] Title:Risk factors and clinical outcomes for spontaneous rupture of pyogenic liver abscess.
[So] Source:J Dig Dis;16(1):31-6, 2015 Jan.
[Is] ISSN:1751-2980
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To evaluate the risk factors and clinical outcomes in patients with spontaneous rupture of pyogenic liver abscess (PLA). METHODS: A total of 602 patients diagnosed with PLA between January 2004 and July 2013 were retrospectively analyzed. Among them, 23 patients experienced a spontaneous rupture of liver abscess (SRLA). RESULTS: The prevalence of SRLA was 3.8%. Using multivariate analysis, liver cirrhosis (OR 4.651, P = 0.009), gas-forming abscesses (OR 3.649, P = 0.026), abscess ≥6 cm in diameter (OR 10.989, P = 0.002) and other septic metastases (OR 1.710, P = 0.047) were risk factors for SRLA. Regarding the site of rupture, 20 (87.0%) patients had a localized rupture, specifically, subphrenic abscess in 3 (13.0%), peri-hepatic abscess in 10 (43.5%), localized peritoneal abscess in 3 (13.0%) and empyema in 4 (17.5%); and the other 3 (13%) had peritonitis. Ruptures resulting in peritonitis require urgent surgery, whereas localized ruptures were managed with surgical or percutaneous drainage in addition to appropriate antibiotics. The in-hospital mortality rate of SRLA was 4.3%. CONCLUSION: Patients with cirrhosis, having abscess ≥6 cm in diameter, gas-forming abscesses and other septic metastases in those with PLA should be monitored closely and may need early intervention for SRLA.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1501
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1111/1751-2980.12209

  8 / 1195 MEDLINE  
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[PMID]: 25685508
[Au] Autor:Okasha H; Mahmoud M
[Ad] Address:Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt.
[Ti] Title:Treatment for resistant subphrenic abscess by combined intracavitary doxycycline and cyanoacrylate injection.
[So] Source:J Adv Res;5(3):409-11, 2014 May.
[Is] ISSN:2090-1232
[Cp] Country of publication:Egypt
[La] Language:eng
[Ab] Abstract:We report the case of a male patient with resistant subphrenic abscess complicating radiofrequency ablation (RFA) of two left lobe hepatocellular carcinoma (HCCs). The causative organism was multidrug resistant Escherichia coli. Percutaneous pigtail drainage together with IV antibiotics failed to resolve the abscess which persisted for 4 months. Intracavitary doxycycline injection causes moderate reduction in the volume of the drained fluid. This was followed by percutaneous cyanoacrylate injection inside the abscess cavity and the fistulous tract which causes complete resolution of the abscess.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1502
[Cu] Class update date: 150226
[Lr] Last revision date:150226
[Da] Date of entry for processing:150216
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.jare.2013.08.001

  9 / 1195 MEDLINE  
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[PMID]: 24886112
[Au] Autor:Salústio R; Nabais C; Paredes B; Sousa FV; Porto E; Fradique C
[Ti] Title:Association of intestinal malrotation and Bochdalek hernia in an adult: a case report.
[So] Source:BMC Res Notes;7:296, 2014.
[Is] ISSN:1756-0500
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Late presentations of congenital diaphragmatic hernia are rare and differ from the classic neonatal presentation. The association with other congenital malformations in children, mainly intestinal malrotation, is well documented. The diagnosis of this association in adults is very rare, and depends on a high degree of suspicion. CASE PRESENTATION: We report a case of a 50-year-old female Caucasian patient with a previous history of intestinal malrotation diagnosed in adolescence and treated conservatively. She was referred to the hospital with signs and symptoms of intestinal obstruction. The patient undertook computed tomography that confirmed small bowel obstruction with no obvious cause, and a right subphrenic abscess with right empyema was also present. An exploratory laparotomy was performed that revealed an intestinal malrotation associated with a right gangrenous and perforated Bochdalek hernia. Resection of the affected small bowel, closure of the Bochdalek foramen and the Ladd procedure were carried out. CONCLUSION: This case shows a rare association of two rare conditions in adults, and highlights the challenge in reaching the diagnosis and management options.
[Mh] MeSH terms primary: Hernias, Diaphragmatic, Congenital/complications
Intestinal Volvulus/complications
[Mh] MeSH terms secundary: Adult
Female
Hernias, Diaphragmatic, Congenital/radiography
Hernias, Diaphragmatic, Congenital/surgery
Humans
Intestinal Obstruction/complications
Intestinal Obstruction/radiography
Intestinal Obstruction/surgery
Intestinal Volvulus/radiography
Intestinal Volvulus/surgery
Tomography, X-Ray Computed
Young Adult
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140604
[St] Status:MEDLINE
[do] DOI:10.1186/1756-0500-7-296

  10 / 1195 MEDLINE  
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[PMID]: 23364107
[Au] Autor:Hensey N; Ahmed S; Minchin J; Athavale N; Abdelhafiz A
[Ad] Address:Rotherham General Hospital, UK. nikkihensey@doctors.org.uk
[Ti] Title:Intra-abdominal abscess in older patients: two atypical presentations to the Acute Medical Unit.
[So] Source:Acute Med;11(4):226-30, 2012.
[Is] ISSN:1747-4892
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:An abscess is a localised collection of necrotic tissue, white cells and bacteria, collectively forming pus. Intra-abdominal abscesses can occur viscerally (e.g. hepatic abscess), retroperitoneally (e.g. psoas abscess) or intraperitoneally (e.g. subphrenic abscess).(1, 2) Clinical presentation is variable and largely depends on the site of abscess. Fever and abdominal pain are the classic symptoms although in older people presentation can be non-specific. Prompt diagnosis and early intervention are vital for good outcomes.(3) We present two cases of older women whose presentation with atypical symptoms resulted in a delay in diagnosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1301
[Js] Journal subset:IM
[St] Status:In-Data-Review


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