Endoscopic negative pressure therapy as stand-alone treatment for perforated duodenal diverticulum: presentation of two cases

Abstract Background Endoscopic negative pressure therapy is a novel and successful treatment method for a variety of gastrointestinal leaks. This therapy mode has been frequently described for rectal and esophageal leakages. Duodenal diverticular perforations are rare but life-threatening events. The early diagnosis of duodenal diverticular perforation is often complicated by inconclusive symptoms. This is the first report about endoscopic negative pressure therapy in patients with perforated duodenal diverticula. Case presentation We present two cases of duodenal diverticula perforations treated with endoscopic negative pressure therapy as stand-alone treatment. Start of symptoms varied from one to three days before hospital admission. Early sectional imaging led to the diagnosis of duodenal diverticular perforation. Both patients were treated with endoluminal endoscopic negative pressure therapy with simultaneous feeding option. Three respective changes of the suction device were performed. Both patients were treated with antibiotics and antimycotics during their hospital stay and be discharged from hospital after 20 days. Conclusions This is the first description of successful stand-alone treatment by endoscopic negative pressure therapy in two patients with perforated duodenal diverticulum. We thus strongly recommend to attempt interventional therapy with endoluminal endoscopic negative pressure therapy in patients with duodenal diverticular perforations upfront to surgery.

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Endoscopic negative pressure therapy (ENPT) of a post-laryngectomy pharyngocutaneous fistula: first report of a new treatment method

HNO ◽

10.1007/s00106-019-0653-3 ◽

2019 ◽

Vol 67 (S2) ◽

pp. 77-79 ◽

Cited By ~ 1

Author(s):

J. Loeck ◽

H.-J. von Lücken ◽

W. Kehrl ◽

G. Loske

Keyword(s):

Negative Pressure ◽

Treatment Method ◽

Pharyngocutaneous Fistula ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

First Report ◽

New Treatment

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Massive Hematochezia from a Large Bleeding Duodenal Diverticulum

Case Reports in Gastrointestinal Medicine ◽

10.1155/2021/5585264 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

Marcus Juan Esteban ◽

Amit Sureen ◽

Daniel Herlihy ◽

Sherif Elhanafi ◽

Marc J. Zuckerman

Keyword(s):

Duodenal Diverticulum ◽

Common Finding ◽

Upper Endoscopy ◽

Gi Tract ◽

Case Presentation ◽

Epinephrine Injection ◽

Duodenal Diverticula ◽

Life Threatening ◽

Possible Cause ◽

Prompt Diagnosis

Background. Duodenal diverticula are a rare cause of gastrointestinal (GI) bleeding despite being a common finding in the GI tract. We present a case of a patient who had massive hematochezia due to a complex duodenal diverticulum. Case Presentation. A 74-year-old Hispanic female presented initially with generalized weakness. During admission, the patient had an episode of a large amount of hematochezia and had to be transferred to the intensive care unit (ICU). Upper endoscopy was done using a forward-viewing endoscope which revealed a bleeding complex duodenal diverticulum. Successful hemostasis was achieved through epinephrine injection followed by placement of hemostatic clips. Conclusion. Although rare, gastroenterologists need to be aware of duodenal diverticulum as a possible cause of gastrointestinal bleed. It could be life-threatening, and thus, prompt diagnosis and management is necessary.

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Using Negative Pressure Therapy Can Accelerate Wound Healing

Internal Medicine News ◽

10.1016/s1097-8690(05)71480-3 ◽

2005 ◽

Vol 38 (3) ◽

pp. 43

Author(s):

Kerri Wachter

Keyword(s):

Wound Healing ◽

Negative Pressure ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

Accelerate Wound Healing

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Negative pressure therapy – How many dressing changes are enough?

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0031-1297467 ◽

2012 ◽

Vol 60 (S 01) ◽

Author(s):

S Raab ◽

T Weimann ◽

W Sienel ◽

L Lampl ◽

M Beyer

Keyword(s):

Negative Pressure ◽

Negative Pressure Therapy ◽

Pressure Therapy

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Four Cases of Lower Extremity Ulcers Treated with Negative Pressure Therapy

Nishi Nihon Hifuka ◽

10.2336/nishinihonhifu.77.456 ◽

2015 ◽

Vol 77 (5) ◽

pp. 456-460

Author(s):

Maiko SAKAMOTO-TOYA ◽

Sho MIAKE ◽

Satoko SHIBATA-KIKUCHI ◽

Masutaka FURUE

Keyword(s):

Lower Extremity ◽

Negative Pressure ◽

Negative Pressure Therapy ◽

Pressure Therapy

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NON-SURGICAL MANAGEMENT OF A SEVERE SCALP WOUND WITH COMBINATION TREATMENT INCLUDING NEGATIVE PRESSURE THERAPY AND SKIN CELL SPRAY

10.26226/morressier.578e3b52d462b80292382cef ◽

2016 ◽

Author(s):

Baljinder Sandhu

Keyword(s):

Surgical Management ◽

Combination Treatment ◽

Negative Pressure ◽

Negative Pressure Therapy ◽

Pressure Therapy ◽

Skin Cell ◽

Scalp Wound

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Negative Pressure Therapy in Wounds Surgical Treatment

Revista de Chimie ◽

10.37358/rc.17.11.5955 ◽

2017 ◽

Vol 68 (11) ◽

pp. 2687-2690 ◽

Cited By ~ 1

Author(s):

Bogdan Mihnea Ciuntu ◽

Stefan Octavian Georgescu ◽

Ciprian Cirdeiu ◽

Daniel Timofte ◽

Doina Azoicai ◽

...

Keyword(s):

Negative Pressure ◽

Healing Time ◽

Negative Pressure Therapy ◽

Simultaneous Application ◽

Average Hospital ◽

Pressure Therapy ◽

Days Of Therapy ◽

Functional Consequences ◽

Time Required ◽

A Prospective Study

The study aims to assess the significance of negative pressure therapy in the treatment of 1 January 2014 - 31 June 2017. The objectives intend to evaluate the healing time required after applying the method and the functional consequences for the patient. A prospective study was conducted on a sample of 31 patients with various tipe of wounds which were monitored their clinical course between September 2014 - February 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the wound, while complying with specified settings in accordance with patients� outcome. Healing was obtained in all cases, to an average hospital stay of 30 days and 12 days of therapy application.The negative result of microbial cultures was obtained after an average of 7.55 days by simultaneous application of negative pressure and antibiotic treatment according to the antibiogram. After basic treatment of the wound, auxiliary methods such as negative pressure contribute to the healing. Evolution was favorable with wound granulation in 95% cases, which allowed surgery under local anesthesia, and defect was covered with skin graft. VAC therapy falls into the last group of treatments by eliminating healing inhibitors. This regenerates the wound in a damp environment and essentially turns an open wound into a closed system.

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Negative Pressure Therapy in the Surgical Treatment of Diabetic Foot

Revista de Chimie ◽

10.37358/rc.17.7.5736 ◽

2017 ◽

Vol 68 (7) ◽

pp. 1648-1651

Author(s):

Bogdan Mihnea Ciuntu ◽

Ciprian Vasiluta ◽

Robert Negru ◽

Roxana Hultoana ◽

Roxana Ciuntu ◽

...

Keyword(s):

Abdominal Wall ◽

Negative Pressure ◽

Diabetic Foot ◽

Bacterial Load ◽

Abdominal Wall Defects ◽

Negative Pressure Therapy ◽

Simultaneous Application ◽

Average Hospital ◽

Pressure Therapy ◽

Days Of Therapy

The study aims to assess the significance of negative pressure therapy in the treatment of diabetic foot.The objectives intend to evaluate the healing time required after applying the method and the functional consequences for the patient. A prospective study was conducted on a sample of 37 patients with diabetic foot were monitored their clinical course between September 2014 - April 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the wound, while complying with specified settings (negative pressure, time of use of a kit) in accordance with patients� outcome.There were monitored changes in wound size (planimetric and volumetric measurement), their bacterial load and duration of treatment. Healing was obtained in all cases, to an average hospital stay of 27.3 days and 8 days of therapy application.The negative result of microbial cultures was obtained after an average of 6.45 days by simultaneous application of negative pressure and antibiotic treatment according to the antibiogram. Skin grafts were necessary to close the defect in 4 cases. After basic treatment of the wound, auxiliary methods such as negative pressure contribute to the healing.In patients with diabetic foot who were required surgical intervention, the use of negative pressure therapy yielded a significant benefit in the preservation of the affected limb, after minimal excision.The results we obtained throughout our experience recommend use of NPTW technique as indication for abdominal wall surgery in closing abdominal wall defects, compartment syndrome and surgical site infection after prosthetic mesh.

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