Surgical disorders causing neonatal respiratory distress.
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Airway Obstruction↗
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Results for “Digestive System Fistula”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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[Palliative procedures in advanced stomach cancer].
Gastric carcinoma still occurs in the advanced form, despite easier availability of endoscopic examinations. Symptoms, location and the degree of progression of gastric carcinoma in 186 patients treated between 1980-1997 were presented in the paper. Curative partial gastrectomy was carried out in 69 patients. The palliative procedure of partial gastrectomy, gastroenterostomy shunt and trophic fistula was carried out 117 patients. Attention was paid to the most recent methods of treatment which, hopefully, improve the results of the treatment of advanced gastric carcinoma.
Adult↗
[Effect of various types of ration on the digestive processes of ewe lambs].
Two groups of lambs of the same age (from two weeks to one year), breed, and live weight were given various types of rations: I - a 'concentrate' group, fed concentrates, and II -a 'haylage' group, fed rations in which roughage prevailed. After the completion of one year of age duodenal anastomoses were effected in three animals of each group. Balance and physiologic experiments were carried out with the animals in each group, that were supplied with fistulae. In the first experiment each group was given a ration of the same structure as that given up to the age of one year. In the second experiment the rations of the two groups were exchanged. In the third experiment both groups obtained one and same ration of the optimal size and structure. It was found that the feeding of growing animals with a given type of ration led to the adaptation of the digestive system to such diet, with best utilization of the individual feedstuffs.
Adaptation, Physiological↗
[Clinical study of 102 cases of abdominal-anus resection with telescopic anastomosis of colon rectal mucosa for lower segment of rectal cancer].
OBJECTIVE: To investigate the reliability and feasibility of abdominal-anus resection with preservation of anal sphincter by telescopic anastomisis of colon rectal mucosa for middle-lower segment of rectal cancer. METHODS: A retrospective analysis was made for abdominal-anus resection with telescopic anastomosis of colon rectal mucosa in 102 cases of middle-lower segment of rectal cancer. RESULTS: No anastomotic fistula and anastomotic stenosis occurred in the 102 cases. The increased defecation was found during early stage of postoperation, about 6-12 times per day. But this was easily controlled by antidiarrheal drugs. Twelve to 18 weeks later, defecation returned to normal. Follow-up was performed in 91 patients, and the follow-up rate was 89.2%. Mean follow-up period was 4.7 years. Local recurrence rate of the carcinoma was 5.4% (5/91), and hepatic metastasis rate was 13.1% (12/91). Three-year survival rate of postoperation was 86.9% (60/80), and five-year survival rate was 70.7% (29/41). CONCLUSIONS: With telescopic anastomosis of colon rectal mucosa, colon stoma can be avoided, and anastomotic fistula can be prevented. The operation is safety and effective in preservation of anal sphincter for rectal cancer therapy.
Adult↗
Fecal control following pyloric valve transposition after abdominoperineal resection.
BACKGROUND: The objective of this study was to learn if a transposed pyloric valve could be mobilized to the perianal area following an abdominoperineal resection and function as a replacement for the excised anal sphincter. METHODS: The study was performed in a surgical research laboratory. Eleven cats were used in the study: 9 served as experimental animals and 2 were controls. The operation involved mobilization of the pyloric valve based on an intact omental pedicle; the proximal side of the pyloric valve was anastomosed to the divided end of the left colon and the distal end of the pyloric valve was sutured to the perianal area. RESULTS: The excellent healing of the pyloric valve in its ectopic position was confirmed anatomically and histologically following the sacrifice of the animals. The pyloric valve was effective in maintaining complete fecal control in 4 cats and almost complete fecal continence in 2 other cats. Three other cats developed fecal incontinence due to a perianal fistula, and 2 control cats had complete fecal incontinence. CONCLUSION: There appears to be no anatomical or technical reason why the pyloric valve cannot be applied in the human as a replacement for an excised anal sphincter.
Anal Canal↗
Pediatric foreign bodies and their management.
Ingestion of foreign bodies is a common pediatric problem, with more than 100,000 cases occurring each year. The vast majority of pediatric ingestions are accidental; increasing incidence of intentional ingestions starts in the adolescent age group. In the United States, the most common pediatric foreign bodies ingested are coins, followed by a variety of other objects, including toys, toy parts, sharp objects, batteries, bones, and food. In adolescents and adults, meat or food impactions are the most common accidental foreign body ingestion. Esophageal pathology underlies most cases of food impaction. Management of foreign body ingestions varies based on the object ingested, its location, and the patient's age and size. Esophageal foreign bodies as a group require early intervention because of their potential to cause respiratory symptoms and complications, esophageal erosions, or even an aortoesophageal fistula. Ingested batteries that lodge in the esophagus require urgent endoscopic removal even in the asymptomatic patient due to the high risk of complications. Sharp foreign bodies increase the foreign body complication rate from less than 1% to 15% to 35%, except for straight pins, which usually follow a relatively benign course unless multiple pins are ingested. Magnets are increasingly ingested, due to their ubiquitous nature and the perception that they do not pose a risk. Ingestion of multiple magnets creates a significant risk of obstruction, perforation, and fistula development. Methods to deal with foreign bodies include the suture technique, the double snare technique, and the combined forceps/snare technique for long, large, and sharp foreign bodies, along with newer equipment, such as retrieval nets and a variety of specialized forceps.
Child↗
Colonic triplication associated with anorectal malformation: case presentation of a rare embryological disorder.
Tubular colonic triplication is an extremely rare hindgut malformation, with only 2 reports in the literature to date. The present authors describe the new and unusual case of a boy born with an imperforate anus, rectovesical fistula, and 3 distinct left colons. The bladder was divided by an incomplete septum. Prenatal ultrasound suggested colonic duplication. Surgical management involved resection of the triplicated segment and posterosagittal anorectal pull through.
Adult↗
[Laparoscopic diagnosis and treatment of acute pancreatitis].
Laparoscopy and pancreatoscopy were performed in 2091 (62% of all hospitalized) patients with acute pancreatitis. High informative value of laparoscopy and pancreatoscopy in diagnosis of different morphologic forms of acute pancreatitis is demonstrated. Original fistula for pancreatoscopy was developed. It permits one to evaluate visually the dynamics of repair in the pancreas and surrounding tissues and to correct treatment policy.
Acute Disease↗
Organic hyperinsulinism and endoscopic surgery.
BACKGROUND: Experience with minimally invasive surgery for organic hyperinsulinism is limited. No criteria for patient selection with special regard to sporadic, hereditary, multiple and malignant tumors have been defined. METHODS: The estimated success rate of endoscopic surgery was retrospectively calculated by analysing 34 consecutive patients with organic hyperinsulinism operated on by open surgery. A literature search was undertaken to better define indications for endoscopic procedures. Differences in postoperative outcome (morbidity) between endoscopic and open procedures were analysed. RESULTS: Twenty-eight of 31 patients (90%) with solitary insulinomas and one of three patients with multiple insulinomas were correctly localized preoperatively. Twenty-six enucleations (76%) and eight distal resections (24%) including one endoscopic tail resection were performed. Theoretically only 14 out of 34 patients (41%) would have been suitable for endoscopic surgery (8 enucleations and 6 patients for distal resections which were enucleated using an open approach). Pancreatic fistulas were documented in three patients (9%). Reviewing 34 publications, 49 enucleations, 36 distal resections and 15 conversions to open surgery were performed, showing a higher proportion of distal resections in endoscopic surgery. The spleen was preserved in 88% of cases. Fourteen fistulas occurred after enucleations. CONCLUSIONS: Only solitary insulinomas localized in the pancreatic tail or superficially in the body or head may be candidates for endoscopic procedures. Patients with multiple insulinomas, MEN-1 syndrome or malignancy should undergo open surgery.
Endoscopy, Digestive System↗
Zero mortality after 152 consecutive pancreaticoduodenectomies with pancreaticogastrostomy.
BACKGROUND: Since 1968, there have been three published reports in the United States literature of 41, 118, and 145 consecutive patients undergoing pancreaticoduodenectomy without mortality. In all of these series, the pancreatic remnant was anastomosed to the jejunum. STUDY DESIGN: This study was designed to review 152 consecutive patients who underwent pancreaticoduodenectomy in whom the pancreatic remnant was anastomosed to the stomach (pancreaticogastrostomy). RESULTS: A total of 152 patients underwent pancreaticoduodenectomy with pancreaticogastrostomy between July 1992 and May 2002. There were 85 men and 67 women with a mean age of 65.7 years (range 31 to 90 years). Of the patients, 87 were less than 69 years of age and 65 were more than 69 years. A total of 114 patients had a malignant neoplasm and the remaining 38 had either cystic neoplasms or benign disease. When the two groups were compared, the patients who were more than 69 years of age had a significantly high incidence of hypertension, previous cancer, atrial fibrillation, and coronary artery disease. In addition, patients more than 69 years of age had a significantly high incidence of jaundice and placement of preoperative stents. Patients more than 69 years of age had significantly less operative time but there was no between-group difference in estimated blood loss, transfusion, number of units transfused, and postoperative length of stay. There was no postoperative mortality [corrected] in this series. Pancreatic leak and fistulae were the most common complications, followed by intraabdominal abscess, wound infection, and delayed gastric emptying. CONCLUSIONS: In this study, 152 consecutive patients underwent pancreaticoduodenectomy with pancreaticogastrostomy without postoperative mortality. Morbidity was mostly because of pancreatic leaks and fistulae, which were successfully treated nonoperatively. With proper selection, careful preoperative preparation, and proper intraoperative conduct of operation, the Whipple procedure can be performed without postoperative mortality.
Adenocarcinoma↗
Computed tomography vs barium studies in the acutely symptomatic patient with Crohn disease.
Gastrointestinal contrast studies and CT performed on 43 patients with known Crohn disease with acute symptoms were retrospectively reviewed to assess the ability of each study to define the location and extent of disease. In 39 of 43 (91%) patients the contrast studies and CT agreed on the location of active disease. However, in 15 of 43 (35%) patients, contrast studies demonstrated additional areas of mucosal disease remote from the major area of activity that were not suggested by CT. In addition to demonstrating more extensive mucosal disease, contrast studies proved superior in demonstrating enteroenteric fistulae, sinus tracts, strictures, postsurgical anatomy, and relation of recurrence to anastomosis. Computed tomography proved superior in demonstrating mesenteric inflammation, abscesses, enterovesical and enterocutaneous fistulae, fistula to iliopsoas muscle and to sacrum. We conclude that in the patient with suspected abscess, enterovesical or enterocutaneous fistula, CT is the study of choice. In other clinical circumstances both CT and contrast studies should be performed since they are complementary.
Acute Disease↗
[Elimination of residual cavities in multiple echinococcosis of liver].
The results of operative treatment of 65 patients with multiple echinococcosis of the liver are analysed. For the purpose of treatment of the cyst's residual cavity in 19 cases the authors used furacillin solution warmed up to 70 degrees C. As a result of the study it was established, that at a distance of 2 cm around the fibrous capsule rather high temperature is mounted, which is fatal for oncosphera. This method advantageously differs from others (4% formalin solution, iodine tincture). In 29 cases the residual cavity was treated with 4% formalin solution, in 11 cases 4% formalin solution was combined with iodine tincture, in the rest 6 cases--4% formalin solution was used and 1% chlorhexidinum solution followed by 70% alcohol. For elimination of residual cavities, which appeared after echinococcectomy, combinations of various methods were used, among which the proposed by the authors method of "hood", which is formed from the omentum with vascular pedicle. Complications (purulent fistulas formation) occurred in 5 patients. The authors come to a conclusion that for elimination of residual cavities after echinococcectomy in multiple echinococcosis of the liver the combination of various methods is obligatory.
Anti-Infective Agents, Local↗
Pathological classification and diagnosis of intestinal duplication.
OBJECTIVE: To determine the pathological classification and the clinical characteristics of intestinal duplication. METHODS: Eighty-four pediatric patients with intestinal duplication were proved on operation in the last 20 years in the Second Hospital of Harbin Medical University and Harbin Children's Hospital. The pathological classifications were as follows: enteral septum type (2), parietal cyst type (9), parenteral canal type (31), parenteral cyst type (35), and solitary type (1). The clinical presentations and complications included: abdominal mass (24), illius (41), hemorrhage of digestive tract (15) and intestinal perforation with peritonitis (3). Two asymptomatic cases were discovered incidentally. RESULTS: Among the 84 patients, 82 healed, 1 newborn complicated by intestinal fistula died of septicemia, and the other one died of toxic shock. CONCLUSIONS: Recognizing the pathological types, common presentations and complications, and applying the corresponding examination methods timely, doctors may improve the diagnostic accuracy.
Adolescent↗
A 94-mm human fetus with the VACTERL association of anomalies.
A spontaneously aborted human male fetus of 94 mm crown-rump length had multiple malformations including atresia of the esophagus with tracheoesophageal fistula, anorectal agenesis, anomalies of the heart and great vessels, kidneys, bladder, and left testis, and a single umbilical artery. This association of defects has not previously been described in a fetus at this immature stage of development.
Abnormalities, Multiple↗
Anorectal malformation with tubular hindgut duplication.
The association of hindgut duplication and anorectal malformation is rare. Published classifications of this association are confusing in respect of terminology. We report a case of blind-ending, Y-shaped tubular duplication of the distal hindgut, associated with an anorectal malformation (rectourethral fistula) affecting the colon proper. Surgical options at time of presentation and of reconstructive surgery are discussed. A review and suggested modification of the classifications is presented.
Abnormalities, Multiple↗
[Heterotopic segmental autotransplantation of the pancreas with digestive system anastomosis in the dog].
Segmental autotransplantation of pancreas in the heterotopic position, with digestive anastomosis protected by an epiploplasty was performed in a series of 22 dogs. Twenty dogs survived the operation and nine were followed up for 4 weeks: the histologic and morphologic qualities of the graft were very favorable from both endocrine and exocrine points of view. This morphohistologic quality can be related to the digestive anastomosis performed, which failed to provoke any specific complications to a large extent. This study should be completed by improvement in the vascularization of the graft by a splenic arteriovenous fistula and a concomitant study of the endocrine function of the transplanted pancreas in dogs with experimentally-induced diabetes.
Animals↗
[Inferior mesenteric arteriovenous fistula of congenital origin. A report on one case and review of the published literature (author's transl)].
A fourth case of inferior mesenteric arteriovenous fistula of congenital origin is described by the authors, who also review the general characteristics of mesenteric (or portal) arteriovenous fistulae. Early clinical signs are hemorrhage from the digestive tract and chronic anemia. Endoscopy and barium X-rays are normal, and angiography is the only means of diagnosis. Surgical treatment is essential because of the risk of hemorrhages and portal hypertension.
Adult↗
[Digestive associated malformations in esophageal atresia. A study of 125 patients (author's transl)].
The incidence of digestive malformations associated to esophageal atresia and tracheoesophageal fistula is reviewed in a series of 125 surgically treated patients during the last five years' period. A correlation is drawn with other associated malformations. Its influence upon the mortality rate is stressed.
Abnormalities, Multiple↗