Laparoscopic‐assisted omental patch repair of colovaginal fistula – a video vignette

2020 ◽  
Vol 22 (9) ◽  
pp. 1202-1203
Author(s):  
M.‐F. Ho ◽  
D. C.‐K. Ng ◽  
J. F.‐Y. Lee ◽  
S. S.‐M. Ng
Keyword(s):  
Patch Repair ◽  
Omental Patch ◽  
Colovaginal Fistula ◽  
Laparoscopic Assisted ◽  
Video Vignette

A Case of Successful Endovascular Aortic Repair of Primary Aortoenteric Fistula Without Aortic Explantation

2022 ◽  
pp. 152660282110677
Author(s):  
Joshua Winston ◽  
Thomas Lovelock ◽  
Thomas Kelly ◽  
Thodur Vasudevan
Keyword(s):  
Endovascular Aortic Repair ◽  
Aortoenteric Fistula ◽  
Patch Repair ◽  
Oral Antibiotics ◽  
Omental Patch ◽  
Oral Fluconazole ◽  
Infrarenal Aortic Aneurysm ◽  
The Third ◽  
Aortic Repair ◽  
History Of

Purpose: The objective of this study is to report a case of a primary aortoenteric fistula successfully treated with endovascular repair without aortic explant. Case Report: A 48-year-old man presented with a 24-hour history of hematemesis and malena. A computed tomography (CT) abdomen and pelvis demonstrated a 6 cm infrarenal aortic aneurysm with periaortic stranding and contrast enhancement within the lumen of the third part of the duodenum. The patient underwent emergency Endovascular Aortic Repair (EVAR). The patient was discharged on day 8 of his admission on oral antibiotics. He returned 7 weeks postindex procedure and underwent a laparotomy with omental patch repair of the aortic defect. Intraoperative cultures grew candida albicans, and the patient was discharged on lifelong oral Fluconazole and Amoxycillin-Clavulanic Acid. At 18 months postoperatively, the patient was clinically stable with improved appearances on CT aortogram. Conclusion: We discuss the use of EVAR without aortic explant as a possible treatment option in the management of patient with primary aortoenteric fistulae. This may potentially avoid the significant morbidity and mortality associated with aortic explant in suitable candidates without perioperative signs of sepsis.

Routine versus selective upper gastrointestinal contrast series after omental patch repair for gastric or duodenal perforation

2017 ◽  
Vol 32 (1) ◽  
pp. 400-404 ◽  
Author(s):  
Stephenie Poris ◽  
Andrew Fontaine ◽  
Julie Glener ◽  
Stacey Kubovec ◽  
Paula Veldhuis ◽  
...  
Keyword(s):  
Patch Repair ◽  
Duodenal Perforation ◽  
Omental Patch ◽  
Upper Gastrointestinal

Routine laparoscopic single-stitch omental patch repair for perforated peptic ulcer: experience from 338 cases

2008 ◽  
Vol 23 (2) ◽  
pp. 457-458 ◽  
Author(s):  
D. C. T. Wong ◽  
W. T. Siu ◽  
S. K. H. Wong ◽  
Y. P. Tai ◽  
M. K. W. Li
Keyword(s):  
Peptic Ulcer ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Omental Patch

scholarly journals Rapunzel syndrome resulting in gastric perforation

2016 ◽  
Vol 98 (1) ◽  
pp. e6-e7 ◽  
Author(s):  
JS Parakh ◽  
A McAvoy ◽  
DJ Corless
Keyword(s):  
Gastric Perforation ◽  
Postoperative Recovery ◽  
Patch Repair ◽  
Free Fluid ◽  
Proximal Jejunum ◽  
Rapunzel Syndrome ◽  
Omental Patch ◽  
History Of ◽  
Entire Stomach

We report the case of an 18-year-old female patient with no past medical history who presented to the emergency department with acute abdominal pain and vomiting on the background of a long history of ingesting hair (trichophagia). Computed tomography revealed pneumoperitoneum and free fluid in keeping with visceral perforation. In addition, a large hair bolus was seen extending in contiguity from the stomach to the jejunum. A laparotomy was performed, revealing an anterior gastric perforation secondary to a 120cm long trichobezoar, which had formed a cast of the entire stomach, duodenum and proximal jejunum. The bezoar was removed and an omental patch repair to the anterior ulcer was performed. The patient made an excellent postoperative recovery and was discharged home with psychiatric follow-up review.

scholarly journals Duodenojejunostomy, an Old Technique but Novel Solution for Giant Duodenal Perforations - A Report of Four Cases and Review of Literature

2020 ◽  
pp. 1-5
Author(s):  
Jesse Hu Shulin ◽  
Daniel Tan Ee Lee ◽  
Jesse Hu Shulin ◽  
Lee Chin Li ◽  
Tiffany Rui Xuan Gan
Keyword(s):  
Elderly Patients ◽  
Current Literature ◽  
High Risk Patient ◽  
Surgical Techniques ◽  
Partial Gastrectomy ◽  
Advanced Age ◽  
Patch Repair ◽  
General Surgeon ◽  
Omental Patch ◽  
Operative Recovery

Background: Despite advances in the medical management of peptic ulcer disease, duodenal ulcer (DU) perforation remains a common surgical emergency. Most DU perforations are small and can be managed with omental patch repair. However, occasionally the surgeon may encounter a giant perforation not amenable to this. Giant DU perforations are defined as > 2cm. They are associated with high leak rates and mortality. Prognosis in elderly patients are particularly poor because of advanced age and comorbidities. Furthermore, there are no specific recommendations for their management despite a variety of repair techniques being described. Here, we aim to describe a novel technique used to treat such patients, especially those of advanced age, in our institution and to review the current literature. Case presentation: Four patients with giant DU perforation underwent emergency laparotomy and repair with our duodenojejunostomy technique at our hospital. Post-operatively, patients were monitored clinically and radiologically and discharged when well and tolerating diet. The mean age of the patients was 67 years with an equal gender distribution. The average Charlson Comorbidity Index (CCI) score was 3 (moderately severe). All presented with peritonitis and two had concomitant bleeding. There were two anterior and two posterior ulcers. One was a revision repair after a leak post laparoscopic omental patch repair for the initial perforation. In all cases, the duodenojejunostomy repair technique was used. Post-operative recovery was uneventful for all except one who developed pneumonia. In particular; there were no anastomotic leaks, intra-abdominal collections, gastric outlet obstructions or mortalities. Conclusion: Giant DU perforation remains a challenge to the general surgeon, particularly so in elderly patients with multiple comorbids. A review of the current literature suggests a myriad of surgical techniques but no perfect solution. Some suggested techniques include omental patch with pyloric exclusion, controlled tube duodenostomy, jejunal pedicled graft or serosal patch, gastric disconnection and partial gastrectomy. Here, we propose that isolated duodenojejunostomy can be a quick, safe and novel solution that ensures definitive repair of giant ulcer perforation in a single setting in the high-risk patient.

An individualized laparoscopic‐assisted approach in a patient with a sigmoid tumour and a giant incisional hernia – a video vignette

2019 ◽  
Vol 21 (8) ◽  
pp. 972-973
Author(s):  
C. Clancy ◽  
M. Flanagan ◽  
M. Bughio ◽  
M. G. O'Riordain
Keyword(s):  
Incisional Hernia ◽  
Laparoscopic Assisted ◽  
Video Vignette

Laparoscopic‐assisted resection of small bowel GISTs: A video vignette

2021 ◽  
Author(s):  
Jessica M Ryan ◽  
Rhodri Hill ◽  
Michael Flanagan ◽  
Peter McCullough ◽  
Fiachra Cooke ◽  
...  
Keyword(s):  
Small Bowel ◽  
Laparoscopic Assisted ◽  
Video Vignette

scholarly journals Strict Selection Criteria During Surgical Training Ensures Good Outcomes in Laparoscopic Omental Patch Repair (LOPR) for Perforated Peptic Ulcer (PPU)

2015 ◽  
Vol 100 (2) ◽  
pp. 370-375 ◽  
Author(s):  
Vishal G. Shelat ◽  
Saleem Ahmed ◽  
Clement L. K. Chia ◽  
Yee Lee Cheah
Keyword(s):  
Peptic Ulcer ◽  
Acute Care ◽  
Selection Criteria ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Perioperative Outcomes ◽  
Omental Patch ◽  
Severity Scores ◽  
Care Surgery ◽  
Strict Selection

Application of minimal access surgery in acute care surgery is limited due to various reasons. Laparoscopic omental patch repair (LOPR) for perforated peptic ulcer (PPU) surgery is safe and feasible but not widely implemented. We report our early experience of LOPR with emphasis on strict selection criteria. This is a descriptive study of all patients operated on for PPU at academic university-affiliated institutes from December 2010 to February 2012. All the patients who were operated on for LOPR were included as the study population and their records were studied. Perioperative outcomes, Boey score, Mannheim Peritonitis Index (MPI), and physiologic and operative severity scores for enumeration of mortality and morbidity (POSSUM) scores were calculated. All the data were tabulated in a Microsoft Excel spreadsheet and analyzed using Stata Version 8.x. (StataCorp, College Station, TX, USA). Fourteen patients had LOPR out of a total of 45 patients operated for the PPU. Mean age was 46 years (range 22−87 years). Twelve patients (86%) had a Boey score of 0 and all patients had MPI < 21 (mean MPI = 14). The predicted POSSUM morbidity and mortality were 36% and 7%, respectively. Mean ulcer size was 5 mm (range 2−10 mm), mean operating time was 100 minutes (range 70−123 minutes) and mean length of hospital stay was 4 days (range 3−6 days). There was no morbidity or mortality pertaining to LOPR. LOPR should be offered by acute care surgical teams when local expertise is available. This can optimize patient outcomes when strict selection criteria are applied.

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