scholarly journals Postoperative Lymphorrhagia- a Possible Complication Following Cephalic Duodenopancreatectomy

2019 ◽  
Vol 65 (3) ◽  
pp. 121-122
Author(s):  
Adrian Tudor ◽  
Marian Botoncea ◽  
Cedric Kwizera ◽  
Bianca Cornelia Tudor ◽  
Cosmin Nicolescu ◽  
...  
Keyword(s):  
Lymphatic Vessel ◽  
Discharge Rate ◽  
Treatment Options ◽  
Pancreatic Head ◽  
Patient Discharge ◽  
Electrolyte Solutions ◽  
Favorable Result ◽  
Parenteral Therapy ◽  
Venous Shunt ◽  
Pancreatic Head Tumor

AbstractSurgery associated with lymphadenectomy may sometimes result in a lymphorrhagia, which usually resolves spontaneously within a few days, sometimes becoming a refractory complication to the treatment. In the case of large flows, particular attention should be paid to hydro-electrolytic and protein losses. We present the case of a patient with persistent lymphorrhagia after a cephalic duodenopancreatectomy for a pancreatic head tumor. From the 5th postoperative day, the patient had a milky-like secretion on the subhepatic drainage tube. The discharge rate was variable, between 500 and 1500 ml per day, requiring parenteral administration of amino acids, plasma and electrolyte solutions. The postoperative progression was slowly favorable, with the patient discharge on the 25th day following surgery. There are several treatment options for a lymphorrhagia following an extended lymphadenectomy, from intensive parenteral therapy to peritoneal-venous shunt or ligation of the lymphatic vessel responsible for the production of lymphorrhagia. In this case the conservative treatment had a favorable result.

Pancreatic Head Tumor in an Infant With New-Onset Jaundice

2015 ◽  
Vol 60 (2) ◽  
pp. e14-e15
Author(s):  
Dyer Heintz ◽  
Steve Megison ◽  
Sandy Cope-Yokoyama ◽  
Aakash Goyal
Keyword(s):  
Pancreatic Head ◽  
Pancreatic Head Tumor ◽  
New Onset

PP20 UK Ambulance Service resuscitation management of pulseless electrical activity: a systematic review of text and opinion

2021 ◽  
Vol 38 (9) ◽  
pp. A9.2-A9
Author(s):  
Ali Coppola ◽  
Michael A Smyth ◽  
Sasha Johnston ◽  
Sarah Black ◽  
Ruth Endacott
Keyword(s):  
Electrical Activity ◽  
Early Identification ◽  
Discharge Rate ◽  
Treatment Options ◽  
Pulseless Electrical Activity ◽  
Ambulance Service ◽  
National Guidelines ◽  
Improve Patient Survival ◽  
The United Kingdom ◽  
Improve Patient

BackgroundIn the United Kingdom, out of hospital cardiac arrest patients with pulseless electrical activity (PEA) have a poor survival to discharge rate of 5.3%.1 PEA is managed according to national guidelines.2 These guidelines are imperfect due to limited research resulting in ambulance services locally amending guidelines to support resuscitation decisions.3 This review aimed to examine the local guidelines of UK ambulance services for the management of PEA.MethodsA three-step search strategy was applied from August 2020 to October 2020. 1) A search of UK ambulance service websites was conducted to identify published local guidelines. Where guidelines were not available a written request was made for the guideline, associated guideline or a narrative summary in the absence of a guideline. 2) Documents referenced within the local guidelines specific to pulseless electrical activity were identified and extracted as supporting literature. 3) Documents referenced in the supporting literature identified as having pulseless electrical activity in the title were extracted.ResultsTwenty-two documents of textual data met the inclusion criteria. Twenty-nine conclusions were extracted and analysed to generate ten categories, forming three synthesised themes relating to the variability in the clinical management of PEA between UK ambulance services, the early identification of reversible causes and appropriate treatment options to increase survivability and the consensus for further research.ConclusionComprehensive national guidelines are lacking due to limited research. The local clinical guidelines and practices of UK ambulance services which aim to address the gaps in research, introduce variability in the management of pulseless electrical activity. Early identification and treatment to reverse the cause of pulseless electrical activity was highlighted to improve patient survival, however, this was complex and challenging to achieve during pre-hospital resuscitation. There was a consensus in the paucity of evidence and the potential for future prognostic research to improve patient outcomes.

Preoperative endoscopic pancreatic stenting for prophylaxis of pancreatic duct disruption during extirpation of a pancreatic head tumor

2007 ◽  
Vol 194 (4) ◽  
pp. 553-555 ◽  
Author(s):  
Tatsuo Shimura ◽  
Taketoshi Suehiro ◽  
Hideki Suzuki ◽  
Yasushi Mochida ◽  
Koji Okada ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Pancreatic Head ◽  
Pancreatic Duct Disruption ◽  
Pancreatic Head Tumor ◽  
Duct Disruption

scholarly journals A Rare Case of Mixed Neuroendocrine Tumor and Adenocarcinoma of the Pancreas

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sofia Xenaki ◽  
Konstantinos Lasithiotakis ◽  
Alexandros Andreou ◽  
Sofia Aggelaki ◽  
Maria Tzardi ◽  
...  
Keyword(s):  
Adjuvant Treatment ◽  
Pancreatic Head ◽  
Neoplastic Disease ◽  
Low Grade ◽  
Distant Relapse ◽  
Well Differentiated ◽  
Hepatic Lesions ◽  
Adenocarcinoma Of The Pancreas ◽  
Pancreatic Head Tumor ◽  
Clinical Problems

Introduction.Neuroendocrine carcinoma (NEC) of pancreas is a rare tumor with aggressive progression and poor prognosis. Its coexistence with adenocarcinoma poses significant clinical problems and has not been addressed in the literature.Methods.We describe a case of a 51-year-old male who underwent pancreatoduodenectomy due to pancreatic head tumor1.5×1×1.4 cm. Histological examination of the specimen revealed a mixed neoplasm: (1) a well differentiated adenocarcinoma, neoplastic blasts of which are extended focally to the submucosa without invading the muscular layer, and (2) a low differentiated NEC consisting of solid clusters and pagetoid formations. All 18 lymph nodes of the specimen were free of neoplastic disease and the surgical margins of the specimen were tumor-free. No adjuvant treatment was administered and two months after the operation the patient developed liver metastasis. FNA cytology of the hepatic lesions revealed low grade carcinoma with neuroendocrine characteristics. Five lines of chemotherapy were administered: VP + CDDP, paclitaxel + ifosfamide + Mesna + CDDP, Folfox + Avastin, Folfiri + Avastin, and CAV. During his treatment he revealed PD and succumbed to his disease 13 months after the operation.Conclusion.Coexistence of NEC with adenocarcinoma of the pancreas is a very rare entity presenting significant challenges regarding its adjuvant treatment and the treatment of distant relapse.

A duodenal stromal tumor mimicking a pancreatic head tumor: one case report and literature review

2013 ◽  
Vol 45 (1) ◽  
pp. 40-43
Author(s):  
O. Mouaqit ◽  
R. Ktaibi ◽  
A. Ktaibi ◽  
M. Mounim ◽  
El H. O. El malki ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Pancreatic Head ◽  
Stromal Tumor ◽  
Pancreatic Head Tumor

Surgical ICU Underutilization Does not Significantly Discourage Discharge

1996 ◽  
Vol 9 (4) ◽  
pp. 238-242 ◽  
Author(s):  
F. Dexter ◽  
K. Pearson ◽  
D. L. Griffiths ◽  
P. Jebson
Keyword(s):  
Discharge Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Patient Discharge ◽  
Poor Quality ◽  
Excess Capacity ◽  
Admission Rates ◽  
Discharge Rates ◽  
Number Of Patients

An SICU must have sufficient capacity to handle peak weekly demand to prevent re-admission and/or poor quality of care. Excess capacity may, however, encourage unnecessary SICU utilization. The goal of this study was to assess the influence of availability of SICU beds on patient discharge and re-admission rates. The case series included 1,492 days, 36,816 patient days, 8,821 discharges, and 186 re-admissions within 3 days from a 24-bed multidisciplinary SICU at a tertiary care center. Census was defined to equal the total number of patients in the SICU each day. We found low census levels were not associated with significantly lower discharge rates. Decreasing the census from 19–24 to 13–18 patients per day decreased discharge rates from 31% to 30%. Odds ratio that a decrease in census by five from 24 decreased discharge rate equaled 1.01 (95% confidence interval 0.96 to 1.06). We conclude that when hospital managers choose an appropriate SICU capacity they need not be concerned that intermittent excess capacity will prompt physicians to significantly decrease their discharge rates.

scholarly journals A Case of Solid Pseudopapillary Neoplasm Spontaneously Ruptured Into the Duodenum: Case Report

2019 ◽  
Vol 103 (9-10) ◽  
pp. 461-467
Author(s):  
Seiji Natsume ◽  
Yoshiki Senda ◽  
Tsuyoshi Sano ◽  
Seiji Ito ◽  
Koji Komori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Portal Vein ◽  
Rare Case ◽  
Pancreatic Head ◽  
Resected Specimen ◽  
Solid Pseudopapillary Neoplasm ◽  
Contrast Radiography ◽  
Pancreatic Head Tumor

There have been no reports of ruptured solid pseudopapillary neoplasm (SPN) into adjacent organs. A 22-year-old female was referred to our hospital for treatment of a pancreatic head tumor. Computed tomography (CT) examination at our hospital showed a 5-cm tumor containing air, although CT at a previous hospital revealed an 8-cm tumor without air. Thus, a spontaneous rupture of the tumor into the duodenum was suspected. Subtotal stomach preserving pancreaticoduodenectomy with combined resection of the portal vein was performed. Contrast radiography of resected specimen showed the medium injected into the tumor leaking out from the 2nd portion of the duodenum. Histologically, the patient was diagnosed as SPN. Microscopic invasion to the portal vein and duodenum were also confirmed. She did not experience any postoperative complications and has remained well without any signs of recurrence during 2 years of follow-up. Although there have been 14 studies reporting ruptured SPN, this is the first report of SPN that spontaneously ruptured into the duodenum. An extremely rare case of SPN of the pancreatic head that spontaneously ruptured into the duodenum was reported.

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