scholarly journals Treating of duodenal perforation following endoscopic retrograde transpapillary manipulations

2019 ◽  
Vol 10 (1) ◽  
pp. 42-48
Author(s):  
Vyacheslav I. Korobka ◽  
Sergey V. Tolstopyatov ◽  
Alexander M. Shapovalov ◽  
Roman V. Korobka
Keyword(s):  
Surgical Management ◽  
Surgical Complications ◽  
Abdominal Cavity ◽  
Septic Complication ◽  
Duodenal Perforation ◽  
Primary Reconstruction ◽  
Two Stage ◽  
Endoscopic Retrograde ◽  
Primary Surgery

Objective: valuation of diff erent duodenal perforation surgical management following endoscopic retrograde transpapillary manipulations. Materials and methods: thirty-one patients with duodenal perforation following transpapillary manipulations (17 own observations, 14 — admission from other hospitals). Th e 14 (45.2 %) cases had a diagnosis less than 24 hours, 17 (54.8 %) — more than 24 hours aft er injury. Twenty patients had the primary reconstruction of duodenum with various drainage options of zone of injury. Sixteen patients had a two-stage surgery procedure: 5 cases aft er of primary reconstruction of duodenum and 11 — like a primary surgery (more than a day aft er injury). Results: aft er primary of duodenum reconstruction 11 patients (55.0 %) had no complications, 5 (25.0 %) — were re-operated, 4 (20.0 %) — were died. Aft er two-stage surgery procedure 9 patients (56.3 %) had no complications, fi ve (31.2 %) had surgical complications, 2 (12.5 %) were died. Conclusion: the primary of duodenum reconstruction can be performing, when the duodenal perforation there is less than a day. When there is a clinic of septic complication of retroperitoneum and abdominal cavity, two-stage surgery procedure is justifi ed.

scholarly journals Surgical Treatment for Septic Complications in Patients with Duodenal Perforation Following Endoscopic Retrograde Transpapillary Interventions

2019 ◽  
Vol 14 (2) ◽  
pp. 13-20
Author(s):  
V. L. Korobka ◽  
S. V. Tolstopyatov ◽  
A. M. Shapovalov
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Abdominal Sepsis ◽  
Original Method ◽  
Duodenal Perforation ◽  
Symptomatic Therapy ◽  
Primary Reconstruction ◽  
Two Stage ◽  
Septic Complications ◽  
Primary Surgery

Background The most severe clinical cases following transpapillary endoscopic interventions are duodenal perforation with damage to the common bile duct and pancreatic duct, entrance into the abdominal cavity and retroperitoneum the aggressive contents of intestine and the infections. They usually lead to higher mortality. Aim Evaluation of the optimal management for duodenal perforation in patients who have undergone transpapillary endoscopic interventions. Material and Methods A retrospective analysis of surgical treatment in thirty-two patients with duodenal perforation after transpapillary endoscopic interventions from the year 2007 to 2018 in one center was carried out. Nineteen cases (59.4%) were diagnosed less than 24 hours, 13 (40.6%) – more than 24 hours after injury. Twenty patients had the primary reconstruction of duodenum with various drainage options of injury area. In 19 cases there were a two-stage surgical procedure according the original method: 12 had a primary surgery, 7 were reoperated. Results After primary reconstruction of duodenum 11 patients (55.0%) had complications, seven (63.6%) – were re-operated, in four we have applied efferent treatments and symptomatic therapy. Three patients (15.8%) died. After two-stage surgery procedure 7 patients (36.8%) had surgical complications, five (26.3%) – were re-operated. Three patients (15.8%) – were died. Conclusion Primary duodenum reconstruction can be performed if the injury occurred less than 24 hours before surgery. Two-staged surgery is justified in cases with purulent inflammation in abdominum and reproperitoneal cavity because procedure allows reducing mortality from abdominal sepsis

scholarly journals Surgical Management of Duodenal Perforation Post Endoscopic Retrograde Cholangiopancreatography Series of Cases

2021 ◽  
Vol 233 (5) ◽  
pp. e67
Author(s):  
Mauricio Pedraza Ciro ◽  
Luis F. Cabrera Vargas ◽  
David Acevedo ◽  
Laura Cabrera ◽  
Marcia Santafe Guerrero ◽  
...  
Keyword(s):  
Surgical Management ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Duodenal Perforation ◽  
Endoscopic Retrograde

scholarly journals ERCP-Related Duodenal Perforation Presenting as Pneumoscrotum

2018 ◽  
Vol 12 (1) ◽  
pp. 1-6
Author(s):  
Mohammad Saud Khan ◽  
Faisal Jamal ◽  
Zubair Khan ◽  
Abhinav Tiwari ◽  
Hermann Simo ◽  
...  
Keyword(s):  
Supportive Care ◽  
Male Patient ◽  
Subcutaneous Emphysema ◽  
Duodenal Perforation ◽  
Close Monitoring ◽  
Air Leak ◽  
Endoscopic Retrograde ◽  
Scrotal Pain ◽  
Life Threatening ◽  
Life Threatening Complication

Duodenal perforation is a rare but life-threatening complication of endoscopic retrograde cholangiopancreatography (ERCP). Duodenal perforation can cause air leak into the extraperitoneal space. In rare instances, the air in the extraperitoneal space could dissect along the fascial planes of the abdomen to reach scrotum, leading to pneumoscrotum. We present the case of a 35-year-old male patient who developed scrotal pain and swelling following ERCP. He was found to have extensive pneumoscrotum, pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema. The patient was diagnosed with retroperitoneal duodenal perforation. He was managed conservatively with close monitoring and supportive care.

Two-stage resection of the large intestine with deep peritoneal stitching

1927 ◽  
Vol 23 (2) ◽  
pp. 246-246
Author(s):  
I. Tsimkhes
Keyword(s):  
Colorectal Cancer ◽  
Large Intestine ◽  
Abdominal Cavity ◽  
Parietal Peritoneum ◽  
Abdominal Wound ◽  
Two Stage ◽  
Wound Area

For almost 20 years, in colorectal cancer, where the affected loop and adjacent healthy sections of the large intestine cannot be sufficiently mobilized, even after separation and ligation of the mesentery, the author has been cutting off the parietal peritoneum with fascia of the abdominal wound area and plunging them as deeply into the abdominal cavity as possible.

scholarly journals Perforated Peptic Ulcer Combined with Posttraumatic Diaphragmatic Hernia in Third Gestation Trimester: a Clinical Case

2021 ◽  
Vol 11 (3) ◽  
pp. 251-255
Author(s):  
V. S. Panteleev ◽  
I. B. Fatkullina ◽  
A. Kh. Mustafin ◽  
R. S. Khalitova ◽  
A. S. Petrov
Keyword(s):  
Peptic Ulcer ◽  
Pregnant Women ◽  
Diaphragmatic Hernia ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Perforated Peptic Ulcer ◽  
Favourable Outcome ◽  
Duodenal Perforation ◽  
Duodenal Ulcers ◽  
In Pregnancy

Background. Gastric and duodenal ulcers are extremely rare in pregnancy, according to published literature. Peptic ulcer is found in 1 per 4,000 pregnant women, a figure probably underestimated due to its hampered diagnosis in pregnancy. Pregnancy peptic ulcer is considered less expected. Perforated gastric and duodenal ulcers comprise about 1.5 % of total acute abdominal diseases, and the perforation rate in ulcer patients ranges within 5–15 %. This complication afflicts the ages of 20–40 years in men much more frequently than in women. Three perforation types occur: free into abdominal cavity (87 %), contained (9 %), into lesser omentum and retroperitoneal tissue (4 %).Materials and methods. The clinical case describes surgical management of posttraumatic diaphragmatic hernia-comorbid perforated gastric ulcer in a pregnant woman in third trimester. Surgery with postoperative patient management enabled for a favourable outcome.Results and discussion. Perforation-entailing gastric and duodenal ulcers in pregnant women have received negligible attention due to rarity in clinical practice. Paul et al. described 14 cases of duodenal perforation in pregnancy, all fatal.Conclusion. Early diagnosis of surgical pathology during gestation is still difficult contributing to the development of severe complications associated with high mortality. The patient’s admission to a level III interspecialty hospital was key to enable a timely consilium-driven decision of caesarean intervention for saving the child, diagnosing intraoperatively life-threatening complicated surgical diseases and opting for radical surgery that ended in a favourable outcome.

Proposal for the management of myopic traction maculopathy based on the new MTM staging system

2020 ◽  
pp. 112067212098094
Author(s):  
Barbara Parolini ◽  
Michele Palmieri ◽  
Alessandro Finzi ◽  
Rino Frisina
Keyword(s):  
Retrospective Review ◽  
Surgical Complications ◽  
Pars Plana Vitrectomy ◽  
Staging System ◽  
Combined Surgery ◽  
Primary Surgery ◽  
Myopic Traction Maculopathy ◽  
Pars Plana ◽  
Phakic Eyes

Purpose: To propose the Myopic Traction Maculopathy (MTM) management Table, based on the MTM Staging System (MSS). Methods: A retrospective review of 157 eyes affected by MTM, operated with pars plana vitrectomy (PPV), or macular buckle (MB) or combined surgery (MB + PPV). Each case was classified according to the MSS. Anatomical results were evaluated with OCT at an intermediate follow-up (3–6 months) and at a final follow-up (2–8 years), considering changes both in the foveal and in the retinal pattern. The number and type of operations needed were noted. The surgical complications were reported. Results: Primary surgery was MB for 83 eyes (52%), PPV for 36 (23%) and MB + PPV for 38 (24%). At intermediate follow-up, the retinal pattern was restored in 55.41% and foveal in 42.68%. Further surgery was indicated as PPV in 25.48%, MB in 14.65%. At the final follow-up, the retinal pattern was restored in 96.16% and the foveal pattern in 87.90%. BCVA improved at the final follow-up ( p < 0.05). The complications of MB were not sight-threatening. The complications of PPV were FTMH in 67% cases in stages 2, 3, and 4. Cataract developed in 60% of phakic eyes. The complications of combined MB+PPV were cataract (56%) and PVR (5%). Conclusions: Both PPV and MB may be used to treat MTM. PPV addresses the changes in the foveal pattern while MB addresses the changes in the retinal pattern. The MTM management table offers a proposal for the choice of type and timing of treatment customized per each stage of MTM.

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