scholarly journals Endoscopic Management of Drain Inclusion in the Gastric Pouch after Gastrojejunal Leakage after Laparoscopic Roux-en-Y Gastric Bypass for the Treatment of Morbid Obesity (LRYGBP)

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Ramon Vilallonga ◽  
José Manuel Fort ◽  
Oscar Gonzalez ◽  
Juan Antonio Baena ◽  
Albert Lecube ◽  
...  

Background. Drain inclusion inside the gastric pouch is rare and can represent an important source of morbidity and mortality associated with laparocopic Roux-en-Y gastric bypass (LRYGBP). These leaks can become chronic and challenging. Surgical options are often unsuccessful. We present the endoscopic management of four patients with drain inclusion. Patients. All four obese morbidly patients underwent LRYGBP and presented a gastro-jejunal fistula after acute anastomotic leakage. During follow-up endoscopy the drain was found inside the gastric pouch. It was moved into the abdominal cavity. Fistula debit reduced significantly and closed. Results. Gastric leak closure in less than 24 hours was achieved in all, with complete resolution of symptoms. These patients benefited exclusively from endoscopic treatment. Conclusions. Endoscopy is useful and technically feasible in chronic fistulas. This procedure is a less invasive alternative to traditional surgical revision. Other therapeutic strategies can be used such as clips and fibrin glue. Drains should not be placed in contact with the anastomosis or stapled lines. Drain inclusion must be suspected when fistula debit suddenly arises. If so, endoscopy is indicated for diagnostic accuracy. Under endoscopy vision, the drain is gently removed from the gastric reservoir leading to sudden and complete resolution of the fistula.

Author(s):  
Sanjeev Mohanty ◽  
Manu Vergis ◽  
Devipriya V. ◽  
Haripriya G. ◽  
Lakshmi Shree Nallapaneni ◽  
...  

<p>This 32-year-old male patient presented with complaints of restricted mouth opening and gross facial asymmetry owing to the massive jaw swelling on the right side. After a thorough examination, a diagnosis of unicystic ameloblastoma of maxilla. Although, the standard of care surgical approach was through Weber-Fergusson incision, a concerted attempt to excise the tumour with the minimally invasive endoscopic route was made successfully. The patient was symptom free now with complete resolution of swelling on a regular follow up post operatively. This case report highlighted the modern day protocol of organ preservation concepts in surgical management of a rare tumour in otolaryngology practice</p>


2019 ◽  
Vol 30 (3) ◽  
pp. 875-881 ◽  
Author(s):  
Tuure Saarinen ◽  
Kirsi H. Pietiläinen ◽  
Antti Loimaala ◽  
Toni Ihalainen ◽  
Henna Sammalkorpi ◽  
...  

Abstract Introduction Data on postoperative bile reflux after one anastomosis gastric bypass (OAGB) is lacking. Bile reflux scintigraphy (BRS) has been shown to be a reliable non-invasive tool to assess bile reflux after OAGB. We set out to study bile reflux after OAGB with BRS and endoscopy in a prospective series (RYSA Trial). Methods Forty patients (29 women) underwent OAGB between November 2016 and December 2018. Symptoms were reported and upper gastrointestinal endoscopy (UGE) was done preoperatively. Six months after OAGB, bile reflux was assessed in UGE findings and as tracer activity found in gastric tube and esophagus in BRS (follow-up rate 95%). Results Twenty-six patients (68.4%) had no bile reflux in BRS. Twelve patients (31.6%) had bile reflux in the gastric pouch in BRS and one of them (2.6%) had bile reflux also in the esophagus 6 months postoperatively. Mean bile reflux activity in the gastric pouch was 5.2% (1–21%) of total activity. De novo findings suggestive of bile reflux (esophagitis, stomal ulcer, foveolar inflammation of gastric pouch) were found for 15 patients (39.5%) in postoperative UGE. BRS and UGE findings were significantly associated (P = 0.022). Eight patients experienced de novo reflux symptoms at 6 months, that were significantly associated with BRS and de novo UGE findings postoperatively (P = 0.033 and 0.0005, respectively). Conclusion Postoperative bile reflux in the gastric pouch after OAGB is a common finding in scintigraphy and endoscopy. The long-term effects of bile exposure will be analyzed in future reports after a longer follow-up. Trial registration Clinical Trials Identifier NCT02882685


2018 ◽  
Vol 53 (8) ◽  
pp. 917-922 ◽  
Author(s):  
K. V. Engebretsen ◽  
I. K. Blom-Høgestøl ◽  
S. Hewitt ◽  
H. Risstad ◽  
B. Moum ◽  
...  

2020 ◽  
Vol 74 ◽  
pp. 5-10
Author(s):  
Cristobalina Rodríguez- Álvarez ◽  
Alfonso Orelve Acosta-Torrecilla ◽  
Enrique González- Dávila ◽  
Ángeles Arias

Author(s):  
Luigi Angrisani ◽  
Luca Ferraro ◽  
Antonella Santonicola ◽  
Rossella Palma ◽  
Giampaolo Formisano ◽  
...  

2021 ◽  
Vol 42 (4) ◽  
pp. 248-253
Author(s):  
Soo Bo Shim ◽  
Hyun Kyung Sung ◽  
Hye Lim Lee

Objectives: Plantar wart is a common viral skin disease caused by human papillomavirus infection and poses a therapeutic challenge in the paediatric patient population. Acupuncture and moxibustion are effective treatments for a wide range of skin conditions.Case report: This study presents the case of a 9-year-old girl for whom complete resolution of recalcitrant warts was achieved with acupuncture and moxibustion treatment.Results: After 20-week treatment, the wart lesions and pain were completely resolved. At the 6-month follow-up, the lesions remained fully resolved.Conclusion: This result suggests that acupuncture and moxibustion could be effective therapeutic strategies for plantar warts.


2008 ◽  
Vol 95 (11) ◽  
pp. 1375-1379 ◽  
Author(s):  
M. K. Müller ◽  
S. Räder ◽  
S. Wildi ◽  
R. Hauser ◽  
P.-A. Clavien ◽  
...  

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