Severe Vascular Complications Of Acute Pancreatitis

2015 ◽  
Vol 87 (10) ◽  
Author(s):  
Stanisław Głuszek ◽  
Łukasz Nawacki ◽  
Jarosław Matykiewicz ◽  
Marta Kot ◽  
Jakub Kuchinka
Keyword(s):  
Acute Pancreatitis ◽  
Interventional Radiology ◽  
Surgical Treatment ◽  
Mortality Rate ◽  
Conservative Treatment ◽  
Vascular Complications ◽  
Abdominal Ultrasound ◽  
Etiological Factor ◽  
Study Group ◽  
Endovascular Embolisation

AbstractAcute pancreatitis (AP) develops as a result of the imbalance of the mechanisms inhibiting the activity of enzymes in the pancreatic cells, which causes their autoactivation in the pancreas. The incidence of AP ranges from 10 up to 100 cases per 100,000 population per year in different parts of the world. The overall mortality rate for acute pancreatitis is 10-15%. The mortality rate in patients diagnosed with the severe form of acute pancreatitis is up to 30-40%.The study included 10 patients treated due to acute pancreatitis in two surgical departments run by one of the authors (S.G.) in the years 2004-2014, who developed a serious complication in the form of haemorrhage into the inflammatory tumour/pancreatic cyst or an adjacent organ. Haemorrhage was diagnosed based on the clinical picture, most often a sudden drop in blood pressure, peritonitis symptoms and imaging findings – abdominal ultrasound and abdominal computed tomography. Therapeutic methods included conservative treatment, endovascular embolisation and, in the absence of efficacy of the above mentioned methods, surgical treatment. Patients age and gender, the etiological factor, comorbidities, Atlanta Classification, treatment outcomes and mortality rate were assessed.Alcohol was the most common etiological factor in the investigated AP cases. The patients received conservative treatment, interventional radiology treatment (endovascular embolisation) or surgical treatment. In the study group, 6 patients required surgical treatment, 3 patients received invasive radiology treatment, and conservative treatment was used in one patient. The mortality rate in the study group was 30%.Haemorrhages into the inflammatory cisterns or adjacent organs (stomach, transverse colon mesentery) secondary to AP are the most severe complications, which are difficult to manage. The successful use of interventional radiology methods to inhibit and prevent the recurrence of bleeding in some of the patients is a significant milestone.

scholarly journals Tactics of treatment of complicated diverticulitis

2018 ◽  
Vol 22 (3) ◽  
pp. 518-521
Author(s):  
N. I. Tutchenko ◽  
I.V. Klusko ◽  
A.A. Evgrafov ◽  
E.A. Syrenko ◽  
D.Y. Zhytnik
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Conservative Treatment ◽  
Success Rate ◽  
Complicated Diverticulitis ◽  
Laparoscopic Lavage ◽  
Stoma Formation ◽  
Number Of Patients ◽  
High Level

The aim of our study — to evaluate the success rate of laparoscopic lavage in controlling sepsis in patients with Hinchey III diverticulitis. The result of treatment of 79 patients with complicated diverticulitis was analyzed. Among them, conservative treatment was performed out in 56 patients (71%), surgical treatment was performed in 23 patients (29%). Laparoscopic lavage was performed in 17 patients. The success rate after laparoscopic lavage was 70%. The mortality rate in this group was 4.3%. Laparotomy was performed in 6 patients (26.5%) followed by VAC-assisted laparostomy in 3 patients. The mortality rate in this group was 8.8%. Thus, laparoscopic lavage showed a high level of success in controlling sepsis in patients with diverticular peritonitis Hinchey III with a low mortality rate, repeated operations and stoma formation. We plan to conduct this study with the analysis of data from a larger number of patients to confirm the results obtained.

scholarly journals Acute Fulminant Pancreatitis: Debridement or Formal Resection of the Pancreas

HPB Surgery ◽  
1993 ◽  
Vol 6 (4) ◽  
pp. 255-262
Author(s):  
Heikki Kiviniemi ◽  
Jyrki MäKelä ◽  
Matti I. Kairaluoma
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Mortality Rate ◽  
Pancreatic Resection ◽  
Severe Disease ◽  
Mortality Rates ◽  
Central Hospital ◽  
Conservative Strategy ◽  
Resection Group ◽  
Resection Of The Pancreas

During the ten year period from 1980 to 1989, 51 patients were treated at Oulu University Central Hospital for fulminant acute pancreatitis. Five were in a moribund state on admission and died shortly afterwards, 6 were treated conservatively and survived, and 40 were operated on, 17 by primary pancreatic resection and 23 by debridement of the peripancreatic area. Mortality rates were 53 per cent for the resection group and for the debridement group 22 per cent.Reoperations were performed in 24 per cent of patients in the pancreatic resection group and in 60 per cent of those in the debridement group.The high mortality rate associated with primary pancreatic resection has caused us to adopt a more conservative strategy, and surgical treatment is directed towards later complications of this severe disease.

scholarly journals To the question of the treatment of pancreatic necrosis

2021 ◽  
Author(s):  
S.Y.k. Hasanova
Keyword(s):  
Stem Cells ◽  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Mortality Rate ◽  
Pancreatic Necrosis ◽  
Infected Pancreatic Necrosis ◽  
Results Of Treatment ◽  
Blood Stem Cells

The results of surgical treatment of pancreatic necrosis using stem cells, the structure of mortality and complications for the period 2013-2019 were analyzed. It has been shown that the use of cordon blood stem cells after laparotomy in the treatment of pancreatic necrosis can reduce the mortality rate associated with complications of infected pancreatic necrosis and improve the overall results of treatment of acute pancreatitis.

Chemical Ablation in Adenoid Surgery

2018 ◽  
Vol 69 (10) ◽  
pp. 2722-2724
Author(s):  
Teodora Ioana Ghindea ◽  
Alexandru Dumitras Meius ◽  
Dragos Cristian Stefanescu ◽  
Catalina Pietrosanu ◽  
Irina Ionita ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Chronic Inflammation ◽  
Lymphatic Tissue ◽  
Tissue Mass ◽  
Surgical Method ◽  
Endoscopic Control ◽  
Chemical Ablation ◽  
Pharyngeal Tonsil

The pharyngeal tonsil is a lymphatic tissue mass located in the roof of the nasopharynx. The function of the pharyngeal tonsil is to prevent infections with the help of antibodies. Chronic inflammation and allergies lead to hyperplasia of the adenoids that is found almost exclusively in children. The treatment of choice is surgical treatment; conservative treatment is only indicated preoperatively or if surgery is contraindicated. In this paper, we will present a new surgical method for adenoidectomy performed trans-orally with coblation, under endoscopic control.

scholarly journals Efficacy and safety of condylectomy with minimally invasive surgery in the treatment of interdigital corns of the lesser toes compared to conservative treatment

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Luis M. Marti-Martinez ◽  
Rubén Lorca-Gutierrez ◽  
Salvador Pedro Sánchez-Pérez ◽  
Jonatan Garcia-Campos ◽  
Nadia Fernández Ehrling ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Minimally Invasive ◽  
Functional Status ◽  
Invasive Surgery ◽  
Joint Stiffness ◽  
Efficacy And Safety ◽  
Clinical And Functional Status

Abstract Background Minimally invasive surgery (MIS) procedures cause less trauma to the patient and might improve recovery. This study aimed to determine the efficacy and safety of condylectomy with MIS to treat interdigital corns of the lesser toes. Methods This prospective cohort study was conducted in seven podiatry centers. Patients with interdigital corns of the lesser toes, progressing for more than a year, with one or more recurrences in the last year following conservative treatments were eligible. The recruited patients were classified according to their treatment: conservative or surgical (condylectomy with MIS) and were compared. Patient satisfaction, pain, the clinical and functional status of the foot and the appearance of sequelae were assessed at 3 and 6 months after treatment. Results At 6 months, patients in the surgical treatment group showed no pain on pressure, which significantly differed from the conservative treatment group (p <  0.001). They also improved clinical and functional status of the foot, reaching values comparable to those of the standard population. No paresthesia, joint stiffness or instability, toe malalignment, or corn transfer to a contiguous site resulted from the surgical treatment. Conclusions Condylectomy with MIS is effective and safe to treat interdigital corns of the lesser toes.

scholarly journals Early Surgery Does Not Improve Outcomes for Patients with Periprosthetic Femoral Fractures—Results from the Registry for Geriatric Trauma of the German Trauma Society

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 517
Author(s):  
Christopher Bliemel ◽  
Katherine Rascher ◽  
Tom Knauf ◽  
Juliana Hack ◽  
Daphne Eschbach ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Femoral Fractures ◽  
Geriatric Trauma ◽  
Outcome Parameters ◽  
Periprosthetic Femoral Fractures ◽  
Trauma Society ◽  
Eq5d Index ◽  
Early Surgical Treatment

Background and Objectives: Appropriate timing of surgery for periprosthetic femoral fractures (PFFs) in geriatric patients remains unclear. Data from a large international geriatric trauma register were analyzed to examine the outcome of patients with PFF with respect to the timing of surgical stabilization. Materials and Methods: The Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie (DGU)) (ATR-DGU) was analyzed. Patients treated surgically for PFF were included in this analysis. As outcome parameters, in-house mortality rate and mortality at the 120-day follow-up as well as mobility, the EQ5D index score and reoperation rate were analyzed in relation to early (<48 h) or delayed (≥48 h) surgical stabilization. Results: A total of 1178 datasets met the inclusion criteria; 665 fractures were treated with osteosynthesis (56.4%), and 513 fractures were treated by implant change (43.5%). In contrast to the osteosynthesis group, the group with implant changes underwent delayed surgical treatment more often. Multivariate logistic regression analysis of mortality rate (p = 0.310), walking ability (p = 0.239) and EQ5D index after seven days (p = 0.812) revealed no significant differences between early (<48 h) and delayed (≥48 h) surgical stabilization. These items remained insignificant at the follow-up as well. However, the odds of requiring a reoperation within 120 days were significantly higher for delayed surgical treatment (OR: 1.86; p = 0.003). Conclusions: Early surgical treatment did not lead to decreased mortality rates in the acute phase or in the midterm. Except for the rate of reoperation, all other outcome parameters remained unaffected. Nevertheless, for most patients, early surgical treatment should be the goal, so as to achieve early mobilization and avoid secondary nonsurgical complications. If early stabilization is not possible, it can be assumed that orthogeriatric co-management will help protect these patients from further harm.

scholarly journals Effect of childhood overweight on distal metaphyseal radius fractures treated by closed reduction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu Liu ◽  
Chunjie Liu ◽  
Dongmei Guo ◽  
Ning Wang ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Closed Reduction ◽  
Pediatric Population ◽  
Normal Weight ◽  
Medical Community ◽  
Overweight Children ◽  
Radius Fractures

Abstract Background The medical community has recognized overweight as an epidemic negatively affecting a large proportion of the pediatric population, but few studies have been performed to investigate the relationship between overweight and failure of conservative treatment for distal radius fractures (DRFs). This study was performed to investigate the effect of overweight on the outcome of conservative treatment for DRFs in children. Methods We performed a retrospective study of children with closed displaced distal metaphyseal radius fractures in our hospital from January 2015 to May 2020. Closed reduction was initially performed; if closed reduction failed, surgical treatment was performed. Patients were followed up regularly after treatment, and redisplacement was diagnosed on the basis of imaging findings. Potential risk factors for redisplacement were collected and analyzed. Results In total, 142 children were included in this study. The final reduction procedure failed in 21 patients, all of whom finally underwent surgical treatment. The incidences of failed final reduction and fair reduction were significantly higher in the overweight/obesity group than in the normal-weight group (P = 0.046 and P = 0.041, respectively). During follow-up, 32 (26.4%) patients developed redisplacement after closed reduction and cast immobilization. The three risk factors associated with the incidence of redisplacement were overweight/obesity [odds ratio (OR), 2.149; 95% confidence interval (CI), 1.320–3.498], an associated ulnar fracture (OR, 2.127; 95% CI, 1.169–3.870), and a three-point index of ≥ 0.40 (OR, 3.272; 95% CI, 1.975–5.421). Conclusions Overweight increases the risk of reduction failure and decreases the reduction effect. Overweight children were two times more likely to develop redisplacement than normal-weight children in the present study. Thus, overweight children may benefit from stricter clinical follow-up and perhaps a lower threshold for surgical intervention.

scholarly journals Ultrasonographic Monitoring in 38 Dogs with Clinically Suspected Acute Pancreatitis

2020 ◽  
Vol 7 (4) ◽  
pp. 180
Author(s):  
Federico Puccini Leoni ◽  
Tina Pelligra ◽  
Simonetta Citi ◽  
Veronica Marchetti ◽  
Eleonora Gori ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Clinical Examination ◽  
Pancreatic Lipase ◽  
Abdominal Ultrasound ◽  
Diagnostic Evaluation ◽  
Ultrasonographic Diagnosis ◽  
Study Population

Abdominal ultrasound examinations (AUEs) are commonly used in the diagnostic evaluation of canine acute pancreatitis (AP). The purpose of this retrospective study was to evaluate and monitor the ultrasonographic changes observed in dogs with clinically suspected AP on consecutive AUEs. The study population was constituted by 38 client-owned dogs hospitalized for no less than 48 h from January 2016 to December 2019. Dogs included in this study were suspected of AP based on the clinical examination and abnormal rapid specific canine pancreatic lipase test performed at admission. Dogs were submitted to two AUEs, the first on the first day of hospitalization, and the second between 40–52 h after the first one. Twelve dogs had both AUEs suggestive of AP. Fourteen dogs received an ultrasonographic diagnosis of AP exclusively on the second AUE. Twelve dogs remained negative on both the first and the second AUE. In 26 out of 38 patients the second AUE was suggestive of AP. If a patient is suspected of AP, it is advisable to carry out ultrasonographic monitoring at least within the first 52 h after admission, since ultrasonographic signs of AP may only become observable later after hospitalization.

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