scholarly journals Left lower limb fasciitis due to sigmoid colonic perforated diverticulitis: a rare case of colocutaneous fistula

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Alice Rubartelli ◽  
Lorenzo Cocchi ◽  
Nicola Solari ◽  
Ferdinando Cafiero ◽  
Michele Minuto ◽  
...  
Keyword(s):  
Lower Limb ◽  
Primary Anastomosis ◽  
Acute Diverticulitis ◽  
Rare Event ◽  
Sigmoid Resection ◽  
Sigmoid Diverticulitis ◽  
Perforated Diverticulitis ◽  
Ileal Loop ◽  
Colocutaneous Fistula ◽  
Left Lower Limb

Abstract Up to 25% of patients with acute diverticulitis develop complicated disease. Colocutaneous fistula with lower limb fasciitis secondary to complicated diverticulitis is a rare event. A 71-year-old woman with Class 3 obesity and Type 2 diabetes was admitted to the hospital because of left lower limb fasciitis associated with acute sigmoid diverticulitis complicated by covered perforation. The fasciitis was treated with multiple fasciotomies, antibiotics and hyperbaric oxygen therapy. The patient was readmitted 25 days after discharge because of the formation of a left leg colocutaneous fistula associated with an enterocolic fistula. Patient underwent sigmoid resection with primary anastomosis and ileal loop repair. Three-month follow-up showed fistula healing and absence of symptoms. Fasciitis secondary to acute diverticulitis is a rare clinical scenario. Although our therapeutic strategy was successful, the optimal treatment timing and surgical technique for fasciotomy and colon resection remain to be assessed.

scholarly journals Diverticulitis

2008 ◽  
Vol 55 (3) ◽  
pp. 97-102 ◽  
Author(s):  
J. Pfeifer
Keyword(s):  
Diverticular Disease ◽  
Primary Anastomosis ◽  
Acute Diverticulitis ◽  
Treatment Modalities ◽  
Perforated Diverticulitis ◽  
Western World ◽  
Common Disease ◽  
Concomitant Treatment ◽  
Wide Range ◽  
Life Threatening

Diverticular disease produces a wide range of clinical presentations varying from minimal clinical discomfort to life-threatening complications. Often there is a considerable discrepancy between clinical, radiologic, endoscopic and pathologic findings. Diverticulosis is a quite common disease affecting about 2/3 of people in the Western world over the age 80. The exact incidence of acute diverticulitis is unclear. We distinguish between uncomplicated and complicated diverticular disease forms. The latter includes abscess formation, stricture, obstruction, and free perforation causing life-threatening peritonitis. Several classifications for perforated diverticulitis have been proposed. From the practical point of view the Hansen-Stock classification seems to be the most appropriate one as it includes all forms of diverticular disease; it can also be used preoperatively. Prophylactic resection to avoid complications is not justified in minimally symptomatic individuals. Timing of the operation depends on the clinical course and the grade of peritonitis and on concomitant treatment modalities. Emergency operations should be avoided if possible, to reduce morbidity and mortality. Elective operations should be performed best 6-8 weeks after a second diverticulitis attack. Resection plus primary anastomosis is preferred to a Hartmann?s procedure, if possible. Elective surgery should be done laparoscopically. In acute diverticulitis the goal is to treat uncomplicated forms conservatively, while complicated forms should undergo elective, laparoscopic colon resection.

Surgical Treatment of Diverticulitis

2019 ◽  
Author(s):  
Tiffany K Weidner ◽  
John T Kidwell ◽  
David A Etzioni
Keyword(s):  
Surgical Treatment ◽  
Diverticular Disease ◽  
Primary Anastomosis ◽  
Acute Diverticulitis ◽  
Sigmoid Resection ◽  
Hartmann Procedure ◽  
Laparoscopic Lavage ◽  
Uncomplicated Diverticulitis ◽  
Recurrent Diverticulitis ◽  
Purulent Peritonitis

Surgical evaluation and treatment is commonly required for the treatment of diverticulitis in both the acute and elective situations. This chapter discusses the surgical treatment of the clinically important manifestations of diverticular disease. Different options for surgical treatment are described for patients in both the urgent and elective settings, including technical aspects of these options. Current controversies are reviewed, including resection versus laparoscopic lavage for the treatment of purulent peritonitis, the use of gastrointestinal diversion in the surgical treatment of acute diverticulitis, and timing of operation for recurrent diverticulitis.  This review contains 8 figures, 4 tables, and 67 references. Key Words: acute diverticulitis, complicated diverticulitis, diverticular disease, diverticulitis, diverticulosis, Hartmann procedure, laparoscopic lavage, sigmoid resection with primary anastomosis, uncomplicated diverticulitis

Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽  
2020 ◽  
pp. 1-6 ◽  
Author(s):  
Marina Di Pilla ◽  
Stefano Barco ◽  
Clara Sacco ◽  
Giovanni Barosi ◽  
Corrado Lodigiani
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Review Of The Literature ◽  
Heparin Induced Thrombocytopenia ◽  
Lower Limb Ischemia ◽  
Vein Thrombosis ◽  
Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

Effect of Punarnavadi Mandoor and Shiva Gutika in Acute Deep Vein Thrombosis - A Case Report

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Wasedar Vishwanath S. ◽  
Pusuluri YVSM Krishna ◽  
Dani Harshikha
Keyword(s):  
Lower Limb ◽  
Blood Clot ◽  
Acute Case ◽  
Vein Thrombosis ◽  
Oral Medications ◽  
Doppler Study ◽  
Brown Discoloration ◽  
Left Lower Limb ◽  
Life Threatening ◽  
Deep Vein

Objectives: To minimise the dose of Anti-platelet drugs and to treat the acute case of DVT through Ayurvedic oral medications. Methods: The present diagnosed case of DVT approached to OPD of KLE BMK Ayurveda Hospital with a complaints of swelling and pain in the calf muscle of the left lower limb associated with reddish brown discoloration in the foot and occasionally nasal and gum bleeding was treated consequently for 5 months with Punarnavadi Mandoor and Shiva Gutika orally. Results: There is significant decrease in the symptoms of DVT and also major changes seen in Venous Colour Doppler study of the left lower limb. Conclusion: Acute DVT is caused by a blood clot in a deep vein and can be life threatening as it may leads to serious complication like pulmonary embolism which can be cured through Ayurvedic oral medications.

scholarly journals Segmental Neurofibromatosis

2021 ◽  
Author(s):  
Dimble Raju ◽  
Nabanita Ghosh ◽  
Sayan Das ◽  
Prasad Krishnan
Keyword(s):  
Lower Limb ◽  
Posterior Aspect ◽  
Left Lower Limb

Abstract Segmental neurofibromas are the rarest variant of neurofibromatosis. We describe one such case in a 34-year-old man with multiple subcutaneous swellings in the posterior aspect of the left lower limb.

Internal valvuloplasty combined with sleeve wrapping in the treatment of severe deep venous incompetence: A case report

Vascular ◽  
2021 ◽  
pp. 170853812199012
Author(s):  
Yingfeng Wu ◽  
Libing Wei ◽  
Xixiang Gao ◽  
Yixia Qi ◽  
Zhu Tong ◽  
...  
Keyword(s):  
Lower Limb ◽  
Venous Insufficiency ◽  
Femoral Vein ◽  
Duplex Ultrasound ◽  
Vein Wall ◽  
Polyester Urethane ◽  
Left Lower Limb ◽  
Deep Vein ◽  
Color Duplex Ultrasound

Background The main cause of severe chronic venous insufficiency is deep venous incompetence. Deep venous reconstructive surgeries are reserved for cases that do not show a good response to conservative therapies. Method We present the case of a 68-year-old man presenting with swelling, pain, and pigmentation in his left lower limb for 14 years and ulcers for 10 years. Descending venography identified a Kistner’s grade IV reflux in the deep vein of the left lower limb. Internal valvuloplasty was performed following Kistner’s method. Meanwhile, external wrapping with a 1-cm-wide polyester-urethane vascular patch was performed to strengthen the vein wall in the venospasm condition. Results Symptoms were immediately relieved postoperatively. Refractory ulcers healed five months after the procedure. At the six-month follow-up, color duplex ultrasound of the deep vein of the left lower limb showed no reflux in the proximal segment of the femoral vein. Conclusion Internal valvuloplasty combined with sleeve wrapping is feasible in the treatment of severe deep venous incompetence with good short-term results.

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