PubMed Health⌕ Search

Biomedical subjects

John L Petrini

Publications and source records attributed to John L Petrini.

15 recordsLinked to original sources

Fools rush in ...

Explore the source record for details and available documents.

Cholangiopancreatography, Endoscopic Retrograde↗

Risk assessment and management for endoscopists in an ambulatory surgery center.

The practice of medicine places the practitioner at risk for accusations of malpractice. The exposure can be greater for gastroenterologists who work in a n ambulatory surgery center. Endoscopists are liable for cognitive misadventures and the risks of injury inherent in endoscopic practice. Working within a private surgery center compounds potential areas for liability. This article provides a brief overview of malpractice law and explores current data on malpractice suits against gastroenterologists. It also looks at areas that may be of potential concern to endoscopists working in ambulatory surgery centers.

Endoscopy, Gastrointestinal↗

Anisakiasis of the colon presenting as bowel obstruction.

Anisakiasis is a disease caused by human infection by the Anisakis larvae, a marine nematode found in raw or undercooked fish. With the increased popularity of eating sushi and raw fish (sashimi) in the United States infection with anisakis is expected to rise. We present the first reported case in the United States of intestinal anisakiasis presenting as a bowel obstruction. A 25-year-old healthy woman with no prior history of surgery presented to the emergency room with bowel obstruction by history and CT. CT also showed a mass in the right lower quadrant. She had eaten seviche, a raw fish appetizer, 2 days earlier and sashimi 3 weeks before admission. She was taken to the operating room for an exploratory laparotomy and was found to have an obstruction, the 2-cm mass in the mesentery, and diffuse mesenteric adenopathy. She had an ileocolectomy. Pathology showed a degenerating fish worm, anisakiasis. She also had a serologic test for immunoglobulin E specific to anisakiasis and it was highly positive. Human infections, as mentioned before, are principally the result of ingestion of the Anisakis larvae. These larvae are usually found in herring, mackerel, salmon, cod, halibut, rockfish, sardine, and squid. Most human infections have been reported from Japan and The Netherlands and involve the stomach. Invasion of the gastric or intestinal wall one to 5 days after eating raw fish may be characterized by the abrupt onset of abdominal pain, nausea and/or vomiting, diarrhea, or an ileus. For transient anisakiasis, supportive measures and reassurance are all that is needed. If the larvae have invaded the intestine or the stomach wall diagnosis and cure occur with endoscopic or surgical removal if evidence of obstruction or perforation is found. The incidence of anisakiasis in the United States is unknown but will likely continue to increase with the popularity of eating sashimi. This case is meant to demonstrate another possible cause for bowel obstruction in the patient who has just eaten raw or undercooked fish.

Adult↗