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[PMID]: 29382008 [Au] Autor: Ruan XJ; Ye BL; Zheng ZH; Zhou HH; Zheng XF; Zhou ZX [Ad] Endereço: Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, China. [Ti] Título: Laparoscopic surgery assisted by colonoscopy for a submucosal cecal fecalith presenting as acute appendicitis: A case report. [So] Source: Medicine (Baltimore);96(47):e8872, 2017 Nov. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: A cecal submucosal fecalith is extremely rare and is likely to be misdiagnosed as appendicitis with an incarcerated fecalith. PATIENT CONCERNS: This review presents the case of a female patient complaining of recurrent abdominal pain in the right lower quadrant, similar to the clinical symptoms of appendicitis. Physical examination revealed an abdominal tenderness in the right lower quadrant without rebound tenderness or muscular tension. An ultrasound examination found a mass located in the right lower abdomen. Computed tomography showed a high-density shadow in the cecal cavity. DIAGNOSES: A fecalith was detected in the submucosal cecal wall. The postoperative pathologic examination showed that the fecalith was located in the submucosa. INTERVENTIONS: A partial cecal excision was performed under laparoscopic surgery assisted by colonoscopy. OUTCOMES: The patient was discharged 1 week after surgery without postoperative complications. LESSONS: Fecaliths should be considered in the differential diagnosis of submucosal occupying lesions of the cecum. [Mh] Termos MeSH primário: Apendicite/diagnóstico Doenças do Ceco/cirurgia Colonoscopia/métodos Impacção Fecal/cirurgia Laparoscopia/métodos [Mh] Termos MeSH secundário: Idoso Diagnóstico Diferencial Erros de Diagnóstico Feminino Seres Humanos Mucosa Intestinal/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180209 [Lr] Data última revisão: 180209 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008872

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[PMID]: 29307523 [Au] Autor: Wu GJ; Lin YW; Chuang CY; Tsai HC; Chen RM [Ad] Endereço: Department of Anesthesiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. [Ti] Título: Liver nitrosation and inflammation in septic rats were suppressed by propofol via downregulating TLR4/NF-κB-mediated iNOS and IL-6 gene expressions. [So] Source: Life Sci;195:25-32, 2018 Feb 15. [Is] ISSN: 1879-0631 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: AIMS: Propofol can be applied as an anesthetic or sedative agent for septic patients. Our previous studies showed that propofol ameliorated inflammation- and nitrosative stress-induced cellular insults. This study further evaluated effects of propofol on cecal ligation and puncture (CLP)-induced septic insults to rats and its possible mechanisms. MAIN METHODS: Wistar rats were administered with CLP and effects of propofol on CLP-induced liver dysfunction and rat death were evaluated. Levels of hepatic or systemic nitrogen oxides (NOx) and interleukin (IL)-6 were quantified. Sequentially, inducible nitric oxide synthase (iNOS) and IL-6 gene expressions, toll-like receptor 4 (TLR4) protein levels, and nuclear factor (NF)-κB translocation were determined. KEY FINDINGS: Subjecting rats to CLP led to body weight loss, liver weight gain, and death. Administration of propofol lessened CLP-induced augmentations of serum and hepatic nitrosative stress and IL-6 levels. Additionally, propofol suppressed CLP-induced enhancements in levels of hepatic iNOS protein. Furthermore, the CLP-induced iNOS and IL-6 mRNA expressions in the liver were inhibited following propofol administration. Sequentially, subjecting rats to CLP enhanced hepatic TLR4 protein levels and NF-κB translocation to nuclei, but propofol inhibited these augmentations. SIGNIFICANCE: Consequently, exposure to propofol protected against CLP-induced liver dysfunction and increased the survival rates of the animals. This study shows that propofol can protect rats against septic insults through suppression of systemic and hepatic nitrosative and inflammatory stress due to inhibition of TLR4/NF-κB-mediated iNOS and IL-6 mRNA and protein expressions. [Mh] Termos MeSH primário: Hepatite/tratamento farmacológico Hipnóticos e Sedativos/uso terapêutico Interleucina-6/biossíntese Fígado/metabolismo Fígado/patologia NF-kappa B/efeitos dos fármacos Óxido Nítrico Sintase Tipo II/biossíntese Nitrosação/efeitos dos fármacos Propofol/uso terapêutico Sepse/tratamento farmacológico Receptor 4 Toll-Like/efeitos dos fármacos [Mh] Termos MeSH secundário: Actinas/metabolismo Animais Doenças do Ceco/metabolismo Doenças do Ceco/patologia Regulação para Baixo Regulação da Expressão Gênica/efeitos dos fármacos Hepatite/metabolismo Hepatite/patologia Interleucina-6/genética Masculino Óxido Nítrico Sintase Tipo II/genética Ratos Ratos Wistar Sepse/metabolismo Sepse/patologia Translocação Genética/efeitos dos fármacos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Actins); 0 (Hypnotics and Sedatives); 0 (Interleukin-6); 0 (NF-kappa B); 0 (Tlr4 protein, rat); 0 (Toll-Like Receptor 4); EC 1.14.13.39 (Nitric Oxide Synthase Type II); EC 1.14.13.39 (Nos2 protein, rat); YI7VU623SF (Propofol) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180208 [Lr] Data última revisão: 180208 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180109 [St] Status: MEDLINE

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[PMID]: 28777650 [Au] Autor: Dane B; Hindman N; Johnson E; Rosenkrantz AB [Ad] Endereço: 1 Department of Radiology, NYU Langone Medical Center, 660 First Ave, 3rd Fl, New York, NY 10016. [Ti] Título: Utility of CT Findings in the Diagnosis of Cecal Volvulus. [So] Source: AJR Am J Roentgenol;209(4):762-766, 2017 Oct. [Is] ISSN: 1546-3141 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: The objective of our study was to assess the utility of CT features in the diagnosis of cecal volvulus. MATERIALS AND METHODS: Forty-three patients undergoing CT for cecal volvulus and with surgical or clinical follow-up were included. Two radiologists (11 years and 1 year of experience) evaluated CT examinations for the following: whirl sign, abnormal cecal position, "bird beak" sign, severe cecal distention, mesenteric engorgement, a newly described "central appendix" sign (defined as abnormal appendix position near midline), and overall impression for cecal volvulus. Univariable and multivariable assessments were performed. Patients with CT examinations in which the appendix was not visible were excluded from calculations involving the central appendix sign. RESULTS: Fifty-one percent (n = 22) of patients had cecal volvulus. All CT findings were significantly more common in patients with cecal volvulus (p < 0.01) other than mesenteric engorgement for reader 1 (p = 0.332). Readers 1 and 2 identified the central appendix sign in 92.9% and 92.3% of patients with volvulus versus in 37.5 and 31.1% of patients without volvulus. The whirl sign exhibited a sensitivity for cecal volvulus of 90.9% for reader 1 and 95.5% for reader 2, and a specificity of 61.9% for both readers. Abnormal cecal position exhibited a sensitivity of 90.0% for reader 1 and 100.0% for reader 2 and a specificity of 66.7% and 38.1%. The bird beak sign exhibited a sensitivity of 86.4% for reader 1 and 100.0% for reader 2 and a specificity of 85.7% and 71.4%. Severe cecal distention exhibited a sensitivity of 100.0% for both readers and a specificity of 81.0% and 61.9%. Mesenteric engorgement exhibited a sensitivity of 40.9% for reader 1 and 100.0% for reader 2 and a specificity of 76.2% and 71.4%. The central appendix sign exhibited a sensitivity of 92.9% for reader 1 and 92.3% for reader 2 and a specificity of 62.5% and 68.8%. Overall impression exhibited a sensitivity of 100.0% for both readers and a specificity of 76.2% and 57.1%. At multivariable analysis, the AUC for cecal volvulus ranged from 0.787 to 0.931, and the whirl sign was an independent predictor of volvulus for both readers (p ≤ 0.014); the central appendix sign was also an independent predictor in patients with a visualized appendix for reader 2 (p ≤ 0.001). CONCLUSION: CT exhibited high diagnostic performance and very high sensitivity for cecal volvulus. The whirl sign was a significant independent predictor of volvulus for both readers. [Mh] Termos MeSH primário: Doenças do Ceco/diagnóstico por imagem Volvo Intestinal/diagnóstico por imagem Tomografia Computadorizada por Raios X [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Feminino Seres Humanos Masculino Meia-Idade Estudos Retrospectivos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171006 [Lr] Data última revisão: 171006 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170805 [St] Status: MEDLINE [do] DOI: 10.2214/AJR.16.17715

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[PMID]: 28755505 [Au] Autor: Moulder JK; Siedhoff MT; Melvin KL; Jarvis EG; Hobbs KA; Garrett J [Ad] Endereço: Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA. [Ti] Título: Risk of appendiceal endometriosis among women with deep-infiltrating endometriosis. [So] Source: Int J Gynaecol Obstet;139(2):149-154, 2017 Nov. [Is] ISSN: 1879-3479 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To determine whether deep-infiltrating endometriosis (DE) carries an increased risk of appendiceal endometriosis (AppE) as compared with superficial endometriosis or no endometriosis. METHODS: In a retrospective study, data were obtained by chart review of an internal database for women who underwent coincidental appendectomy during benign gynecologic surgery between July 2009 and February 2014 at a tertiary referral center in the USA. Univariate, bivariate, and regression analyses were performed. The primary exposure was surgically documented endometriosis (DE, superficial, or no endometriosis). The primary outcome was AppE. RESULTS: Endometriosis was diagnosed for 151 (38.2%) of 395 women; 82 (54.3%) had DE. The prevalence of AppE was 13.2% (52/395) overall; 8 (11.6%) of 69 women with superficial endometriosis and 32 (39.0%) of 82 with DE were affected. Frequency of AppE was increased among women with DE, abnormal appendix appearance, and surgical indication (all P<0.001). Women with DE had a 5.9-fold (95% confidence interval [CI] 2.9-11.9) higher risk of AppE compared with women without endometriosis, controlling for appendiceal appearance and surgical indication, and a 2.7-fold (95% CI 1.2-6.2) higher risk of AppE compared with those with superficial endometriosis. CONCLUSION: Women with DE have increased risk of AppE. Coincidental appendectomy should form part of complete endometriosis excision for these patients. [Mh] Termos MeSH primário: Apêndice Doenças do Ceco/epidemiologia Endometriose/epidemiologia [Mh] Termos MeSH secundário: Adulto Apendicectomia Doenças do Ceco/patologia Doenças do Ceco/cirurgia Bases de Dados Factuais Endometriose/patologia Endometriose/cirurgia Feminino Seres Humanos North Carolina/epidemiologia Prevalência Encaminhamento e Consulta Estudos Retrospectivos Fatores de Risco Índice de Gravidade de Doença [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171030 [Lr] Data última revisão: 171030 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170730 [St] Status: MEDLINE [do] DOI: 10.1002/ijgo.12286

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[PMID]: 28114867 [Au] Autor: Adaska JM; Moeller RB; Blanchard PC; Aly SS [Ad] Endereço: California Animal Health and Food Safety Laboratory System (Adaska, Moeller, Blanchard), School of Veterinary Medicine, University of California, Davis, CA. [Ti] Título: Cecal infarction in neonatal calves. [So] Source: J Vet Diagn Invest;29(2):242-244, 2017 Mar. [Is] ISSN: 1943-4936 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Cecal infarction is an uncommon lesion in calves that results in localized peritonitis and, on occasion, perforation with secondary diffuse peritonitis and death. This lesion in calves has not been described previously. We reviewed the postmortem cases of cecal infarction in dairy calves ≤30 d of age that had been submitted over the course of 5 y to the Tulare branch of the California Animal Health and Food Safety Laboratory System. The area of cecal infarction and the associated lesion margins were examined histologically. Ischemic necrosis of the mucosal side of the cecal wall with various degrees of neutrophilic inflammation of subjacent tissues was found consistently, and thrombosis and vascular occlusion within the areas of necrosis and inflammation was found in 21 of 34 cases. Cecal infarction cases were then compared to controls using a retrospective matched case-control study design. Cases ( n = 34) and controls ( n = 86) were compared with respect to bacteremia (as defined by pure culture of a single bacterial agent from lung and/or liver), species of bacteria isolated, and for the presence of K99 Escherichia coli (calves ≤5 d), attaching and effacing E. coli, Cryptosporidium (calves ≥5 d of age), Salmonella isolation from the intestine, rotavirus, Bovine coronavirus, and Bovine viral diarrhea virus. In addition, the presence of rumenitis or abomasitis, and omphalitis were compared between cases and controls. There were no significant differences in ruminal, abomasal, or umbilical cord tissue inflammation, or pathogen test-positive status between cases and controls. [Mh] Termos MeSH primário: Doenças dos Bovinos/epidemiologia Doenças do Ceco/veterinária Infecções por Escherichia coli/veterinária [Mh] Termos MeSH secundário: Animais Animais Recém-Nascidos California/epidemiologia Estudos de Casos e Controles Bovinos Doenças dos Bovinos/microbiologia Doenças dos Bovinos/patologia Doenças do Ceco/epidemiologia Ceco/irrigação sanguínea Coronavirus Bovino/isolamento & purificação Cryptosporidium/isolamento & purificação Indústria de Laticínios Escherichia coli/isolamento & purificação Infecções por Escherichia coli/epidemiologia Fezes/microbiologia Feminino Infarto/epidemiologia Infarto/veterinária Estudos Retrospectivos Rotavirus/isolamento & purificação Salmonella/isolamento & purificação [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170622 [Lr] Data última revisão: 170622 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170125 [St] Status: MEDLINE [do] DOI: 10.1177/1040638716688046

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[PMID]: 27958285 [Au] Autor: Fumery M; Seksik P; Auzolle C; Munoz-Bongrand N; Gornet JM; Boschetti G; Cotte E; Buisson A; Dubois A; Pariente B; Zerbib P; Chafai N; Stefanescu C; Panis Y; Marteau P; Pautrat K; Sabbagh C; Filippi J; Chevrier M; Houze P; Jouven X; Treton X; Allez M; REMIND study group investigators [Ad] Endereço: Department of Gastroenterology, Amiens University Hospital, University Picardie Jules Verne, Amiens, France. [Ti] Título: Postoperative Complications after Ileocecal Resection in Crohn's Disease: A Prospective Study From the REMIND Group. [So] Source: Am J Gastroenterol;112(2):337-345, 2017 Feb. [Is] ISSN: 1572-0241 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVES: We sought to determine the frequency of and risk factors for early (30-day) postoperative complications after ileocecal resection in a well-characterized, prospective cohort of Crohn's disease patients. METHODS: The REMIND group performed a nationwide study in 9 French university medical centers. Clinical-, biological-, surgical-, and treatment-related data on the 3 months before surgery were collected prospectively. Patients operated on between 1 September 2010 and 30 August 2014 were included. RESULTS: A total of 209 patients were included. The indication for ileocecal resection was stricturing disease in 109 (52%) cases, penetrating complications in 88 (42%), and medication-refractory inflammatory disease in 12 (6%). A two-stage procedure was performed in 33 (16%) patients. There were no postoperative deaths. Forty-three (21%) patients (23% of the patients with a one-stage procedure vs. 9% of those with a two-stage procedure, P=0.28) experienced a total of 54 early postoperative complications after a median time interval of 5 days (interquartile range, 4-12): intra-abdominal septic complications (n=38), extra-intestinal infections (n=10), and hemorrhage (n=6). Eighteen complications (33%) were severe (Dindo-Clavien III-IV). Reoperation was necessary in 14 (7%) patients, and secondary stomy was performed in 8 (4.5%). In a multivariate analysis, corticosteroid treatment in the 4 weeks before surgery was significantly associated with an elevated postoperative complication rate (odds ratio (95% confidence interval)=2.69 (1.15-6.29); P=0.022). Neither preoperative exposure to anti-tumor necrosis factor (TNF) agents (n=93, 44%) nor trough serum anti-TNF levels were significant risk factors for postoperative complications. CONCLUSIONS: In this large, nationwide, prospective cohort, postoperative complications were observed after 21% of the ileocecal resections. Corticosteroid treatment in the 4 weeks before surgery was significantly associated with an elevated postoperative complication rate. In contrast, preoperative anti-TNF therapy (regardless of the serum level or the time interval between last administration and surgery) was not associated with an elevated risk of postoperative complications. [Mh] Termos MeSH primário: Ceco/cirurgia Doença de Crohn/cirurgia Procedimentos Cirúrgicos do Sistema Digestório Íleo/cirurgia Complicações Pós-Operatórias/epidemiologia Sepse/epidemiologia [Mh] Termos MeSH secundário: Adolescente Corticosteroides/uso terapêutico Adulto Idoso Doenças do Ceco/etiologia Doenças do Ceco/cirurgia Estudos de Coortes Constrição Patológica/etiologia Constrição Patológica/cirurgia Doença de Crohn/complicações Doença de Crohn/tratamento farmacológico Feminino França/epidemiologia Seres Humanos Doenças do Íleo/etiologia Doenças do Íleo/cirurgia Ileostomia Imunossupressores/uso terapêutico Perfuração Intestinal/etiologia Perfuração Intestinal/cirurgia Masculino Meia-Idade Análise Multivariada Razão de Chances Hemorragia Pós-Operatória/epidemiologia Estudos Prospectivos Reoperação Fatores de Risco Fator de Necrose Tumoral alfa/antagonistas & inibidores Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Adrenal Cortex Hormones); 0 (Immunosuppressive Agents); 0 (Tumor Necrosis Factor-alpha) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170620 [Lr] Data última revisão: 170620 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161214 [St] Status: MEDLINE [do] DOI: 10.1038/ajg.2016.541

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[PMID]: 27913997 [Au] Autor: Chey WY; Chang V; Hoellrich CM; Lee KY; Lubkin M; Corcoran D; Chang TM; Chey WD [Ad] Endereço: Rochester Institute for Digestive Diseases and Sciences, Rochester, NY, USA. cheywilliamy@gmail.com. [Ti] Título: Mega-Cecum: An Unrecognized Cause of Symptoms in Some Female Patients with Uro-Gynecological Symptoms and Severe Slow Transit Constipation. [So] Source: Dig Dis Sci;62(1):217-223, 2017 Jan. [Is] ISSN: 1573-2568 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: A subset of female patients with severe constipation report overlapping uro-gynecological symptoms which have been attributed to visceral hypersensitivity. AIMS: To study colon morphology and motor function in female patients with medically refractory chronic constipation with or without uro-gynecological symptoms and to assess clinical outcomes following laparoscopic ileo-proctostomy. METHODS: Colon anatomy and cecal emptying time were assessed with plain films and fluoroscopy following a standardized test meal mixed with barium. Transit time was determined with radiopaque markers. IBS-QOL and urinary incontinence questionnaires were employed to assess post-colectomy clinical response. RESULTS: In 21 consecutive patients, mean colon transit time (h) was 211.1 ± 11.3, which was significantly greater than 58.9 ± 5.1 of 10 normal subjects (P < 0.001). Mega-cecum was found in 15 (Group 1) with mean cecal volume of 587 ± 27.9 cm , significantly greater (P < 0.001) than 169.5 ± 10.4 cm of six without mega-cecum (Group 2). Mean cecal empting time (days) of barium-mixed feces in Group 1, 4.0 ± 0.6 was significantly greater than 1.33 ± 0.21 in Group 2 (P < 0.001). Eighteen patients (Groups 1 and 2) who had laparoscopic ileo-proctostomy experienced significantly improved quality of life (P < 0.001). In particular, Group 1 patients benefited significantly from improved uro-gynecological symptoms. CONCLUSIONS: Hitherto an unrecognized mega-cecum with markedly impaired emptying function was found in patients with severe slow transit constipation and uro-gynecological symptoms. Subtotal colectomy relieved constipation and improved significantly uro-gynecological symptoms, suggesting strongly that mega-cecum is causally related to these symptoms. [Mh] Termos MeSH primário: Doenças do Ceco/fisiopatologia Ceco/fisiopatologia Constipação Intestinal/fisiopatologia Trânsito Gastrointestinal [Mh] Termos MeSH secundário: Adulto Idoso Anastomose Cirúrgica Compostos de Bário Doenças do Ceco/complicações Doenças do Ceco/diagnóstico por imagem Doenças do Ceco/cirurgia Ceco/diagnóstico por imagem Colectomia Constipação Intestinal/diagnóstico por imagem Constipação Intestinal/etiologia Constipação Intestinal/cirurgia Dispareunia/etiologia Feminino Fluoroscopia Seres Humanos Laparoscopia Meia-Idade Tamanho do Órgão Qualidade de Vida Radiografia Incontinência Urinária/etiologia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Barium Compounds) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 171019 [Lr] Data última revisão: 171019 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 161204 [St] Status: MEDLINE [do] DOI: 10.1007/s10620-016-4392-y

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[PMID]: 27913053 [Au] Autor: Vyas M; Wong S; Zhang X [Ad] Endereço: Department of Pathology, Yale University School of Medicine, New Haven, CT USA. [Ti] Título: Intestinal metaplasia of appendiceal endometriosis is not uncommon and may mimic appendiceal mucinous neoplasm. [So] Source: Pathol Res Pract;213(1):39-44, 2017 Jan. [Is] ISSN: 1618-0631 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Endometriosis of the appendix can be an incidental finding or a cause of appendicitis, intussusception, perforation or retention mucocele. Intestinal metaplasia of appendiceal endometriosis may occur, which can lead to a misdiagnosis of low-grade appendiceal mucinous neoplasm. On a retrospective search of the pathology database from 2001 to 2015, we identified 78 appendiceal endometriosis cases and intestinal metaplasia was present in 10/78 (13%) cases. In most of the cases (90%), the foci of intestinal metaplasia were mainly localized close to the mucosa. Intestinal and endometrial hybrid glands were present in 9/10 (90%) cases. These cases were often associated with marked appendiceal distortion, luminal obliteration and mass formation, causing concern for a mucinous neoplasm clinically and pathologically. Our findings indicate that intestinal metaplasia in appendiceal endometriosis is not an uncommon phenomenon, which can be mistaken for a mucinous neoplasm. Endometriosis should be kept in mind when a diagnosis of appendiceal mucinous neoplasm is made, especially in a young woman with a clinical history of endometriosis. [Mh] Termos MeSH primário: Adenocarcinoma Mucinoso/patologia Neoplasias do Apêndice/patologia Doenças do Ceco/patologia Endometriose/patologia Intestinos/patologia [Mh] Termos MeSH secundário: Adulto Bases de Dados Factuais Diagnóstico Diferencial Feminino Seres Humanos Metaplasia/patologia Meia-Idade Estudos Retrospectivos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170406 [Lr] Data última revisão: 170406 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161204 [St] Status: MEDLINE

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[PMID]: 27769665 [Au] Autor: Kiliç MÖ; Güldogan CE; Balamir I; Tez M [Ad] Endereço: Department of General Surgery, Numune Training and Research Hospital, Ankara, Turkey. Electronic address: murat05ozgur@hotmail.com. [Ti] Título: Ischemia-modified albumin as a predictor of the severity of acute appendicitis. [So] Source: Am J Emerg Med;35(1):92-95, 2017 Jan. [Is] ISSN: 1532-8171 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The early prediction of gangrenous/perforated appendicitis is of great importance for the surgical planning, further treatments, and predicting the course of disease. Ischemia-modified albumin (IMA) was previously reported as a biomarker of various ischemia-based diseases. Our aim is to determine the predictive value of serum IMA in the severity of acute appendicitis. METHODS: Sixty-two patients who underwent urgent appendectomy were included in the study. Plasma level of IMA was measured after diagnosis and before treatment. All patients were classified as noncomplicated (acute) appendicitis and complicated (gangrenous/perforated) appendicitis according to histopathological findings, and comparisons were made between the groups. RESULTS: The data of 62 patients with a mean age of 30.1 years were statistically evaluated. The pathological diagnoses were acute appendicitis in 33 (53.2%), and gangrenous/perforated appendicitis in 29 (46.8%) patients. There were significant differences in computed tomography (CT) findings (P = .031) and IMA (P = .012) levels between the groups. A strong positive correlation between IMA levels and CT findings was also found (Spearman ρ = +0.688, P = .003). CONCLUSIONS: The IMA can be considered as a novel and useful marker to distinguish gangrenous/perforated appendicitis from noncomplicated appendicitis. The correlation of IMA with CT findings also enhances the predictive value of IMA. [Mh] Termos MeSH primário: Apendicite/sangue Apêndice/patologia Perfuração Intestinal/sangue [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Apendicectomia Apendicite/diagnóstico por imagem Apendicite/patologia Apendicite/cirurgia Biomarcadores/sangue Doenças do Ceco/sangue Doenças do Ceco/diagnóstico por imagem Doenças do Ceco/patologia Doenças do Ceco/cirurgia Feminino Gangrena Seres Humanos Perfuração Intestinal/diagnóstico por imagem Perfuração Intestinal/patologia Perfuração Intestinal/cirurgia Laparoscopia Masculino Meia-Idade Albumina Sérica Albumina Sérica Humana Índice de Gravidade de Doença Tomografia Computadorizada por Raios X Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Biomarkers); 0 (Serum Albumin); 0 (ischemia-modified albumin); ZIF514RVZR (Serum Albumin, Human) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 171116 [Lr] Data última revisão: 171116 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161023 [St] Status: MEDLINE

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[PMID]: 27766543 [Au] Autor: Tsukui H; Koinuma K; Morimoto M; Horie H; Lefor AK; Kagaya Y; Takahashi H; Yano T; Matsubara D; Yamamoto H; Sata N [Ad] Endereço: Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. yesterdayoncemore0228@gmail.com. [Ti] Título: Crohn's disease presenting as a ceco-urachal fistula. [So] Source: Clin J Gastroenterol;10(1):32-36, 2017 Feb. [Is] ISSN: 1865-7265 [Cp] País de publicação: Japan [La] Idioma: eng [Ab] Resumo: We report the case of a patient with Crohn's disease who initially presented with a ceco-urachal fistula. The patient was a 31-year-old female who underwent an appendectomy 6 years before presenting to our institution. She had a one-year history of diarrhea, and had recently developed polyuria and a sensation of residual urine. She was admitted with fever and lower abdominal pain. Endoscopy and computed tomography revealed a ceco-urachal fistula, which was consistent with Crohn's disease. An urachal resection was performed, which included partial cystectomy and ileocecal resection. A ceco-urachal fistula is a rare initial symptom of Crohn's disease. During the surgical management of such cases, it is necessary to resect the urachus, the affected portion of the bladder, the fistula, and the affected part of the digestive tract in order to avoid recurrence. [Mh] Termos MeSH primário: Doenças do Ceco/etiologia Doença de Crohn/complicações Fístula Intestinal/etiologia Úraco [Mh] Termos MeSH secundário: Adulto Doenças do Ceco/diagnóstico Doenças do Ceco/cirurgia Colonoscopia Enteroscopia de Duplo Balão Feminino Seres Humanos Doenças do Íleo/diagnóstico Doenças do Íleo/etiologia Doenças do Íleo/cirurgia Fístula Intestinal/diagnóstico Fístula Intestinal/cirurgia Tomografia Computadorizada por Raios X Úraco/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1702 [Cu] Atualização por classe: 171110 [Lr] Data última revisão: 171110 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161022 [St] Status: MEDLINE [do] DOI: 10.1007/s12328-016-0691-2

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